Defining a synovial fluid white blood cell count threshold to predict periprosthetic infection after shoulder arthroplasty

Please always quote using this URN: urn:nbn:de:bvb:20-opus-252275
  • Background: 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. Methods: Retrospective study of preoperative and intraoperative fluid aspiration of 31 patients who underwent a revision of a shoulderBackground: 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. Methods: 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. Results: WBC was significantly higher in patients with PSI than in other patients. A threshold of 2800 leucocytes/mm\(^3\) 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%. Conclusions: A threshold of 2800 leucocytes/mm\(^3\) 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.show moreshow less

Download full text files

Export metadata

Additional Services

Share in Twitter Search Google Scholar Statistics
Metadaten
Author: Laura Elisa Streck, Chiara Gaal, Johannes Forster, Christian Konrads, Sebastian Philipp von Hertzberg-Boelch, Kilian Rueckl
URN:urn:nbn:de:bvb:20-opus-252275
Document Type:Journal article
Faculties:Medizinische Fakultät / Institut für Hygiene und Mikrobiologie
Medizinische Fakultät / Lehrstuhl für Orthopädie
Language:English
Parent Title (English):Journal of Clinical Medicine
ISSN:2077-0383
Year of Completion:2021
Volume:11
Issue:1
Article Number:50
Source:Journal of Clinical Medicine (2022) 11:1, 50. https://doi.org/10.3390/jcm11010050
DOI:https://doi.org/10.3390/jcm11010050
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:ICM; IDSA; MSIS; WBC; cutibacteria; joint aspiration; joint infection; leucocyte count; upper extremity
Release Date:2022/09/12
Date of first Publication:2021/12/23
Licence (German):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International