Orthopaedic Department, Center for Musculoskeletal Surgery, Charité - Universitätsmedizin, Charitéplatz 1, 10117, Berlin, Germany.
Int Orthop. 2013 May;37(5):931-6. doi: 10.1007/s00264-013-1853-1. Epub 2013 Mar 24.
The aim of this prospective study was to evaluate the diagnostic efficacy of sonicate fluid cultures (SFC) and the histological analysis of the periprosthetic membrane (PM) for the detection of periprosthetic joint infection (PJI).
The histological samples were evaluated according to the consensus classification of PM as defined by Morawietz and Krenn. All explanted endoprosthesis were subject to sonication. Additionally, a synovial aspiration and microbiological culture of tissue samples were performed for each patient. Twenty three of the 59 patients had an established PJI.
Sonication achieved the highest sensitivity out of all diagnostic methods with 91 % and a specificity of 81 %. The PM achieved a sensitivity of 87 % and a specificity of 100 %. In three cases of PJI a pathogen was isolated solely by sonication while all other microbiological methods were negative. In seven cases there was a positive bacterial culture through sonication with negative histology.
Our results show a high correlation between the microbiological and histological results. In our patient group sonication achieved the highest sensitivity out of all diagnostic methods and was more sensitive than conventional microbiological methods.
本前瞻性研究旨在评估超声液培养（SFC）和假体周围膜（PM）组织学分析在检测假体周围关节感染（PJI）中的诊断效能。
根据 Morawietz 和 Krenn 定义的 PM 共识分类对组织学样本进行评估。对所有取出的假体进行超声处理。此外，对每位患者的关节滑液抽吸和组织样本的微生物培养进行了分析。59 名患者中有 23 名被确诊为 PJI。
与所有其他诊断方法相比，超声检测的灵敏度最高，为 91%，特异性为 81%。PM 的灵敏度为 87%，特异性为 100%。在 3 例 PJI 中，仅通过超声分离出病原体，而其他所有微生物方法均为阴性。在 7 例中，超声培养阳性，组织学阴性。
我们的结果表明微生物学和组织学结果之间具有高度相关性。在我们的患者群体中，超声检测在所有诊断方法中的灵敏度最高，且比传统的微生物学方法更敏感。
