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dc.contributor.authorThanat Kanthawangen_US
dc.contributor.authorJannis Boddenen_US
dc.contributor.authorGabby B. Josephen_US
dc.contributor.authorThomas Vailen_US
dc.contributor.authorDerek Warden_US
dc.contributor.authorRina Patelen_US
dc.contributor.authorThomas M. Linken_US
dc.description.abstractPurpose: To assess the value of preoperative joint aspiration in detecting periprosthetic joint infection (PJI) in patients undergoing revision hip arthroplasty and to compare these with the clinical findings, serum markers, and intraoperative findings. Materials and methods: Fluoroscopically guided hip aspirations in patients with pain after hip arthroplasty were retrospectively reviewed from January 2014 to December 2018. All hips underwent subsequent revision hip arthroplasty. Antibiotics were discontinued at least 2 weeks before the aspiration. The 2018 Musculoskeletal Infection Society (MSIS) criteria served as a standard of reference for PJI. Clinical, serum, synovial, and intraoperative parameters were recorded in all patients. Correlations between all parameters with PJI diagnosis were analyzed using linear and logistic regression models with ROC analysis. Results: In 202 hips that included 91 septic hips, hip aspiration (AUC = 0.78) and intraoperative (0.80) parameters performed better than serum-based tests (0.64) and clinical parameters (0.68) in detecting PJI. Using MSIS criteria as a standard of reference, hip aspiration had a sensitivity of 64.0% and an accuracy of 78.5% for cultures and a sensitivity of 74.2% and an accuracy of 82.1% for synovial polymorphonuclear neutrophils% (PMN%). Results substantially improved sensitivity after excluding patients that were treated with antibiotics, particularly culture results. Conclusions: Preoperative hip aspiration showed good diagnostic performance in diagnosing PJI compared with MSIS criteria as a standard of reference. But a negative result from aspirate could not rule out PJI. Based on our findings, hip aspiration is an essential test for treatment planning in patients with pain after hip arthroplasty.en_US
dc.titleDiagnostic value of fluoroscopy-guided hip aspiration for periprosthetic joint infectionen_US
article.title.sourcetitleSkeletal Radiologyen_US
article.volume50en_US rechts der Isar der Technischen Universität Münchenen_US of Medicine, Chiang Mai Universityen_US of California, San Franciscoen_US
Appears in Collections:CMUL: Journal Articles

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