Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Beijing, China.
Center for Musculoskeletal Surgery (CMSC), Charité-Universitätsmedizin Berlin, Berlin, Germany.
J Orthop Surg Res. 2022 Jan 4;17(1):3. doi: 10.1186/s13018-021-02813-8.
The purpose of this study was to estimate the diagnostic performance of synovial fluid polymerase chain reaction (PCR) in periprosthetic hip and knee infection, and whether synovial fluid PCR has greater diagnostic significance than conventional methods.
The literature databases PubMed, Scopus, and the Web of Science were searched for English articles describing periprosthetic joint infection (PJI) diagnosis by synovial fluid PCR. Articles were limited to the period between January 1990 and December 2019. Subsequently, conventional methods that were used on at least two occasions were included for further analysis. Data analysis was performed using the Meta-DiSc and Stata software.
Eleven studies with 1360 cases were included in the meta-analysis. The pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of synovial fluid PCR were 0.70 (95% CI 0.66-0.74), 0.92 (95% CI 0.90-0.93), and 37.4 (95% CI 17.77-78.74), respectively.
Synovial fluid PCR provides an effective tool for rapid diagnosis of PJI, and also in the early stages of culture-negative bacterial infections.
本研究旨在评估关节滑液聚合酶链反应（PCR）在人工关节周围感染中的诊断性能，以及关节滑液 PCR 是否比传统方法具有更大的诊断意义。
检索 PubMed、Scopus 和 Web of Science 三个英文文献数据库，查找描述关节滑液 PCR 诊断人工关节感染（PJI）的文章。文献纳入时间限定为 1990 年 1 月至 2019 年 12 月。随后，纳入至少两次使用的传统方法进行进一步分析。数据分析使用 Meta-DiSc 和 Stata 软件进行。
共有 11 项研究，共 1360 例患者纳入荟萃分析。关节滑液 PCR 的汇总敏感度、特异度和诊断比值比（DOR）分别为 0.70（95%CI 0.66-0.74）、0.92（95%CI 0.90-0.93）和 37.4（95%CI 17.77-78.74）。
关节滑液 PCR 为 PJI 的快速诊断提供了有效工具，也可用于培养阴性的细菌性感染的早期诊断。
