Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois 60612, USA.
J Arthroplasty. 2012 Sep;27(8 Suppl):8-11. doi: 10.1016/j.arth.2012.03.037. Epub 2012 May 17.
A total of 223 consecutive total hip or total knee arthroplasties were evaluated for periprosthetic joint infection (PJI) using leukocyte esterase reagent (LER) strips. Fifty-two LER strips were read as positive (23.3%), 106 were read as negative (47.5%), and 65 strips (29.2%) were unable to be read secondary to debris or blood in the aspiration. Using a synovial fluid white blood cell count of greater than 3000 white blood cell per microliter as an indicator of PJI, the sensitivity and specificity were 92.9% and 88.8%, respectively. When using positive cultures for diagnosis of PJI, sensitivity and specificity were 93.3% and 77.0% and 100% and 86.8% for the cases where a reoperation was performed and a combination of factors were used to define PJI. Leukocyte esterase reagent strips represent a rapid, inexpensive, and sensitive tool for the diagnosis of PJI. Their utility is limited, however, by blood or debris in the synovial fluid rendering them unreadable in one-third of cases.
共评估了 223 例连续的全髋关节或全膝关节置换术的假体周围关节感染（PJI），使用白细胞酯酶试剂（LER）条。52 条 LER 条被读为阳性（23.3%），106 条被读为阴性（47.5%），65 条条（29.2%）由于抽吸物中的碎屑或血液而无法读取。使用滑膜白细胞计数大于 3000 个白细胞/微升作为 PJI 的指标，敏感性和特异性分别为 92.9%和 88.8%。当使用阳性培养物诊断 PJI 时，在进行翻修手术的情况下，敏感性和特异性分别为 93.3%和 77.0%，而在使用综合因素定义 PJI 的情况下，敏感性和特异性分别为 100%和 86.8%。白细胞酯酶试剂条是一种快速、廉价、敏感的 PJI 诊断工具。然而，由于滑膜中的血液或碎屑使三分之一的病例无法读取，因此其应用受到限制。
