Barker Connor J, Marriot Alan, Khan Munir, Oswald Tamsin, Tingle Samuel J, Partington Paul F, Carluke Ian, Reed Mike R
South Tees NHS Foundation Trust, Middlesbrough, TS4 3BW, UK.
Northumbria Healthcare NHS Foundation Trust, Cramlington, NE23 6NZ, UK.
J Bone Jt Infect. 2021 May 10;6(6):165-170. doi: 10.5194/jbji-6-165-2021. eCollection 2021.
: We undertook this study to know the sensitivity, specificity and post-test probabilities of hip aspiration when diagnosing periprosthetic hip infections. We also examined "dry tap" (injection with saline and aspiration) results and aspiration volumes. : This is a retrospective cohort study of patients aspirated for suspected periprosthetic joint infection between July 2012 and October 2016. All aspirations were carried out by one trained surgical care practitioner (SCP). All aspirations followed an aseptic technique and fluoroscopic guidance. Aspiration was compared to tissue biopsy taken at revision. Aspiration volumes were analysed for comparison. : Between January 2012 and September 2016, 461 hip aspirations were performed by our SCP. Of these 125 progressed to revision. We calculated sensitivity 59 % (confidence interval (CI) 35 %-82 %) and specificity 94 % (CI 89 %-98 %). Pre-test probability for our cohort was 0.14. Positive post-test probability was 0.59 and negative post-test probability 0.06. Aspiration volume for infected ( ) and non-infected ( ) joints was compared and showed no significant difference. Dry taps were experienced five times; in each instance the dry tap agreed with the biopsy result. : Our data show that hip aspiration culture is a highly specific investigation for diagnosing infection but that it is not sensitive. Aspiration volume showed no significant difference between infected and non-infected groups. Each time a joint was infiltrated with saline to achieve a result, the result matched tissue sampling.
我们开展这项研究，旨在了解髋关节穿刺术在诊断人工髋关节周围感染时的敏感性、特异性和检验后概率。我们还检查了“干抽”（注入生理盐水后抽吸）结果及抽吸量。
这是一项回顾性队列研究，研究对象为2012年7月至2016年10月间因疑似人工关节周围感染而接受穿刺的患者。所有穿刺均由一名经过培训的外科护理人员（SCP）进行。所有穿刺均遵循无菌技术并在荧光透视引导下进行。将穿刺结果与翻修时获取的组织活检结果进行比较。对抽吸量进行分析以作比较。
2012年1月至2016年9月期间，我们的SCP共进行了461次髋关节穿刺。其中125例进展为翻修手术。我们计算出敏感性为59%（置信区间[CI] 35% - 82%），特异性为94%（CI 89% - 98%）。我们队列的检验前概率为0.14。检验后阳性概率为0.59，检验后阴性概率为0.06。对感染（ ）和未感染（ ）关节的抽吸量进行比较，结果显示无显著差异。出现了5次干抽情况；每次干抽结果均与活检结果一致。
我们的数据表明，髋关节穿刺培养对于诊断感染具有高度特异性，但敏感性欠佳。感染组和未感染组之间的抽吸量无显著差异。每次通过向关节内注入生理盐水以获取结果时，结果均与组织采样相符。
