Streck Laura Elisa, Gaal Chiara, Forster Johannes, Konrads Christian, von Hertzberg-Boelch Sebastian Philipp, Rueckl Kilian
Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, 97070 Wuerzburg, Germany.
Institute for Hygiene and Microbiology, University of Wuerzburg, 97070 Wuerzburg, Germany.
J Clin Med. 2021 Dec 23;11(1):50. doi: 10.3390/jcm11010050.
The diagnosis of periprosthetic shoulder infection (PSI) requires a thorough diagnostic workup. Synovial fluid aspiration has been proven to be a reliable tool in the diagnosis of joint infections of the lower extremity, but shoulder specific data is limited. This study defines a threshold for synovial fluid white blood cell count (WBC) and assesses the reliability of microbiological cultures.
Retrospective study of preoperative and intraoperative fluid aspiration of 31 patients who underwent a revision of a shoulder arthroplasty (15 with PSI defined by IDSA criteria, 16 without infection). The threshold for WBC was calculated by ROC/AUC analysis.
WBC was significantly higher in patients with PSI than in other patients. A threshold of 2800 leucocytes/mm showed a sensitivity of 87% and a specificity of 88% (AUROC 0.92). Microbiological cultures showed a sensitivity of 76% and a specificity of 100%.
A threshold of 2800 leucocytes/mm in synovial fluid can be recommended to predict PSI. Microbiological culture has an excellent specificity and allows for targeted antibiotic therapy. Joint aspiration presents an important pillar to diagnose PSI.
人工关节周围肩部感染（PSI）的诊断需要全面的诊断检查。滑膜液抽吸已被证明是诊断下肢关节感染的可靠工具，但肩部的相关具体数据有限。本研究确定了滑膜液白细胞计数（WBC）的阈值，并评估了微生物培养的可靠性。
对31例行肩关节置换翻修术患者的术前和术中液体抽吸进行回顾性研究（15例符合IDSA标准的PSI患者，16例无感染患者）。通过ROC/AUC分析计算WBC的阈值。
PSI患者的WBC显著高于其他患者。白细胞计数2800/mm的阈值显示敏感性为87%，特异性为88%（AUROC 0.92）。微生物培养显示敏感性为76%，特异性为100%。
滑膜液白细胞计数2800/mm的阈值可用于预测PSI。微生物培养具有出色的特异性，可实现针对性抗生素治疗。关节穿刺是诊断PSI的重要手段。
