Abstract
Amaç: Bu çalışmanın amacı enfekte total kalça ve diz artroplastisi hastalarında pozitif ve negatif mikrobiyolojik kültür sonuçları ile mukayeseli olarak ESH ve CRP değerlerinin tanı koymadaki duyarlılık ve özgüllüğünü değerlendirmektir.Gereç ve Yöntem: Bu çalışmada enfekte total kalça veya total diz artroplastisi tanısı ile tedavi edilmiş toplam 80 hastanın klinik verileri retrospektif olarak değerlendirildi.Serum ESH ve CRP değerleri ile birlikte cerrahi olarak elde edilmiş mikrobiyolojik kültür sonuçları kaydedildi. 30 mm/saat üzerindeki ESH ve 10 mg/L üzerindeki CRP değerleri pozitif test olarak tanımlandı. Kültür sonuçları da pozitif ve negatif steril olarak sınıflandı.Bulgular: Çalışmada elde edilen verilere göre periprostetik enfeksiyon tanısında CRP’nin duyarlılığı %98 %88 - %99 aralığında ve özgüllüğü %0 %0 - %15 aralığında ; ESH’nin ise duyarlılığı %98 %88 - %99 aralığında ve özgüllüğü %7 %1 - %15 aralığında tespit edilmiştir.Sonuç: ESH ve CRPperiprostetik enfeksiyon tanısında yüksek duyarlılığa sahip değerli serolojik belirteçlerdir. Ortopedik cerrahlar yalancı pozitif sonuçlar olabileceğini göz önünde bulundurmalı ve gerekli görüldüğünde kesin tanı için ek yöntemler kullanılmalıdır
References
- Bozic KJ, Kurtz SM, Lau EL, et al. The epidemiology of re- vision total knee arthroplasty in the United States.Clin Ort- hop Relat Res 2010;468:45-51.
- Muñoz-Mahamud E, Gallart X, Soriano A. One-stage revi- sion arthroplasty for infected hip replacements. Open Ort- hop J 2013;7:184-9.
- Winkler H, Stoiber A, Kaudela K et al. One stage uncemen- ted revision of infected total hip replacement using cancel- lous allograft bone impregnated with antibiotics. J Bone Joint Surg Br 2008; 90:1580-4.
- Del Pozo JL, Patel R. Infection associated with prosthetic joints. N Engl J Med 2009; 361:787–94.
- Parvizi J, Erkocak OF, Della Valle C. Culture-negative pe- riprostetik joint infection. J Bone Joint Surg Am 2014; 96:430-6.
- Greidanus NV, Masri BA, Garbuz DS, et al. Use of ery- throcyte sedimentation rate and C-reactive protein level to diagnose infection before revision total knee arth- roplasty: a prospective evaluation. J Bone Joint Surg Am 2007;89:1409–16.
- Austin MS, Ghanem E, Joshi A, Lindsay A, Parvizi J. A simple, cost-effective screening protocol to rule out pe- riprosthetic infection. J Arthroplasty 2008;23:65-8.
- Parvizi J, Zmistowski B, Berbari EF, Bauer TW, Springer BD, Della Valle CJ, Zalavras, CG. New definition for pe- riprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society. Clin Orthop Relat Res 2011; 469:2992-4.
- Vinay K Aggarwal, Mohammad R Rasouli, and Javad Par- vizi Periprosthetic joint infection: Current Concept Indian J Orthop 2013; 47: 10-17.
- Della Valle C, Parvizi J, Bauer TW, Dicesare PE, Evans RP, Segreti J, et al. American Academy of Orthopaedic Surge- ons.Diagnosis of periprosthetic joint infections of the hip and knee. J Am Acad Orthop Surg 2010; 18:760–70.
- Yi PH, Cross MB, Moric M, Levine BR, Sporer SM, Papros- ky WG, Jacobs JJ, Della Valle CJ. Do serologic and synovial tests help diagnose infection in revision hip arthroplasty with metal-on-metal bearings or corrosion? Clin Orthop Relat Res 2015;473:498-505.
- Johnson AJ, Zywiel MG, Stroh A, Marker DR, Mont MA. Serological markers can lead to false negative diagnoses of periprosthetic infections following total knee arthroplasty. Int Orthop 2011;35:1621-16.
Abstract
Objective: The purpose of this study was to define the ‘sensitivity’ and ‘specifity’ of ESR and CRP values for the diagnosis of periprosthetic joint infection by comparing them with positive and negative microbiological cultures. Materials and Methods: We retrospectively analysed the data of 80 patients with the diagnosis of infected primary hip or knee arthroplasty, and noted ESR and CRP levelsas well as intraoperative microbiological culture results. ESR rates over 30 mm/h and CRP rates over 10 mg/dl were defined as positive test, and rates under these values defined as negative test. Culture results were also divided as negative sterile and positive.Results: According to our results, CRP had 98% sensitivity ranges, 88% to 99 % and 0 % specificity ranges, 0 % to 15% for the diagnosis periprosthetic infection; ESR had 98% sensitivity ranges, 88% to 99 % and 7 % specificity ranges, 1% to 25 % for the diagnosis periprosthetic infection. Conclusion: CRP and ESR tests are valuable and sensitive tests for the diagnosis of periprosthetic infection. On the other hand, orthopedic surgeons must be aware of false positive results of these tests and further investigation should be added for the definite diagnosis if needed
References
- Bozic KJ, Kurtz SM, Lau EL, et al. The epidemiology of re- vision total knee arthroplasty in the United States.Clin Ort- hop Relat Res 2010;468:45-51.
- Muñoz-Mahamud E, Gallart X, Soriano A. One-stage revi- sion arthroplasty for infected hip replacements. Open Ort- hop J 2013;7:184-9.
- Winkler H, Stoiber A, Kaudela K et al. One stage uncemen- ted revision of infected total hip replacement using cancel- lous allograft bone impregnated with antibiotics. J Bone Joint Surg Br 2008; 90:1580-4.
- Del Pozo JL, Patel R. Infection associated with prosthetic joints. N Engl J Med 2009; 361:787–94.
- Parvizi J, Erkocak OF, Della Valle C. Culture-negative pe- riprostetik joint infection. J Bone Joint Surg Am 2014; 96:430-6.
- Greidanus NV, Masri BA, Garbuz DS, et al. Use of ery- throcyte sedimentation rate and C-reactive protein level to diagnose infection before revision total knee arth- roplasty: a prospective evaluation. J Bone Joint Surg Am 2007;89:1409–16.
- Austin MS, Ghanem E, Joshi A, Lindsay A, Parvizi J. A simple, cost-effective screening protocol to rule out pe- riprosthetic infection. J Arthroplasty 2008;23:65-8.
- Parvizi J, Zmistowski B, Berbari EF, Bauer TW, Springer BD, Della Valle CJ, Zalavras, CG. New definition for pe- riprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society. Clin Orthop Relat Res 2011; 469:2992-4.
- Vinay K Aggarwal, Mohammad R Rasouli, and Javad Par- vizi Periprosthetic joint infection: Current Concept Indian J Orthop 2013; 47: 10-17.
- Della Valle C, Parvizi J, Bauer TW, Dicesare PE, Evans RP, Segreti J, et al. American Academy of Orthopaedic Surge- ons.Diagnosis of periprosthetic joint infections of the hip and knee. J Am Acad Orthop Surg 2010; 18:760–70.
- Yi PH, Cross MB, Moric M, Levine BR, Sporer SM, Papros- ky WG, Jacobs JJ, Della Valle CJ. Do serologic and synovial tests help diagnose infection in revision hip arthroplasty with metal-on-metal bearings or corrosion? Clin Orthop Relat Res 2015;473:498-505.
- Johnson AJ, Zywiel MG, Stroh A, Marker DR, Mont MA. Serological markers can lead to false negative diagnoses of periprosthetic infections following total knee arthroplasty. Int Orthop 2011;35:1621-16.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Original Article |
| Authors | |
| Publication Date | March 1, 2017 |
| Published in Issue | Year 2017 Volume: 27 Issue: 1 |
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