The role of biopsy in diagnosing infection after hip and knee arthroplasty: a meta-analysis.
Arch Orthop Trauma Surg
; 143(4): 1779-1792, 2023 Apr.
Article
en En
| MEDLINE
| ID: mdl-35061082
ABSTRACT
INTRODUCTION:
Early diagnosis of periprosthetic hip and knee infection still represents a major challenge, as no single test can achieve ideal results. Currently, multiple preoperative indicators were performed to diagnose periprosthetic joint infection (PJI) to confirm or exclude infection in the early stage. However, the diagnostic value of biopsy-related tests in diagnosing periprosthetic hip and knee infection remains unclear. MATERIALS ANDMETHODS:
Publications in PubMed, Embase, and the Web of Science databases were searched systematically until October 2020. Inclusion and exclusion criteria were used for screening biopsy-related studies of the diagnosis of periprosthetic hip and knee infection.RESULTS:
Three biopsy-related tests were identified in 14 articles and further analyzed in the present meta-analysis. The combined method had the highest value for the area under the curve (0.9805), followed by histology (0.9425) and microbiological tests (0.9292). In the subgroup, statistical differences were identified in sensitivity and specificity for PJI diagnosis between the synovial fluid culture and biopsy culture group, as well as in the biopsy-related combined method and serum C-reactive protein.CONCLUSIONS:
Biopsy culture does not appear to be advantageous compared to synovial fluid culture in the preoperative diagnosis of periprosthetic hip and knee infection. In contrast, combined biopsy microbial culture with histology analysis shows great potential in improving the preoperative diagnosis of PJI. The standard procedure of biopsy needs to be further explored. Further research is required to verify our results.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Artritis Infecciosa
/
Infecciones Relacionadas con Prótesis
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Artroplastia de Reemplazo de Cadera
/
Artroplastia de Reemplazo de Rodilla
Tipo de estudio:
Diagnostic_studies
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Prognostic_studies
/
Screening_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Año:
2023
Tipo del documento:
Article