Rothman Institute of Orthopedics at Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
J Arthroplasty. 2013 Jan;28(1):193-5. doi: 10.1016/j.arth.2012.06.023. Epub 2012 Aug 3.
Accurate and efficient diagnosis of periprosthetic joint infection remains one of the most challenging tasks for orthopedic surgeons. Currently, no widely used diagnostic test allows for quick and efficient performance, low cost, and high sensitivity and specificity. Aspiration of synovial fluid from a patient's joint can be done in the clinic both quickly and easily; oftentimes, the aspirate obtained is bloody, thus rendering the use of colorimetric strip testing impractical. We describe a simple, inexpensive, and effective protocol using centrifugation to allow for leukocyte esterase (LE) testing after bloody joint aspirations. In all cases, both septic and aseptic, there was a 100% concordance in LE enzyme test results. Although further validation may be necessary, these initial results demonstrate that accuracy of LE testing is not affected by centrifugation.
准确且高效地诊断人工关节周围感染仍然是骨科医生面临的最具挑战性的任务之一。目前，没有广泛使用的诊断测试能够实现快速、高效、低成本以及高灵敏度和特异性。从患者关节抽吸滑液既快速又简单；通常情况下，获得的抽吸物是血性的，因此使得比色条测试的应用不切实际。我们描述了一种简单、廉价且有效的方法，即使用离心来允许在血性关节抽吸后进行白细胞酯酶（LE）检测。在所有情况下，包括感染性和非感染性，LE 酶检测结果均完全一致。尽管可能需要进一步验证，但这些初步结果表明，离心不会影响 LE 检测的准确性。
