TY - JOUR
T1 - Periprosthetic Joint Infection Diagnosis. A Complete Understanding of White Blood Cell Count and Differential
AU - Zmistowski, Benjamin
AU - Restrepo, Camilo
AU - Huang, Ronald
AU - Hozack, William J.
AU - Parvizi, Javad
PY - 2012/10
Y1 - 2012/10
N2 - Recent research has raised doubts regarding the utility of serum white blood cell count (WBC) for diagnosis of periprosthetic joint infection (PJI). As synovial WBC and neutrophil (PMN) percentage have been adopted as accurate markers of PJI, this study investigated the correlation of WBC in serum versus joint fluid and diagnostic value of all WBC levels for failed arthroplasty patients. 153 patients (73 PJI) undergoing revision knee arthroplasty were identified. Weak correlations between joint fluid and serum for WBC (R = 0.19), PMN count (R = 0.31), and lymphocyte count (R = -0.22) were observed. Diagnostic accuracy of PMN (93%) and WBC (93%) synovial count relative to serum was similar to synovial WBC (93%) and PMN% (95%) alone. Serum WBC analysis does little to improve the accurate diagnosis of PJI.
AB - Recent research has raised doubts regarding the utility of serum white blood cell count (WBC) for diagnosis of periprosthetic joint infection (PJI). As synovial WBC and neutrophil (PMN) percentage have been adopted as accurate markers of PJI, this study investigated the correlation of WBC in serum versus joint fluid and diagnostic value of all WBC levels for failed arthroplasty patients. 153 patients (73 PJI) undergoing revision knee arthroplasty were identified. Weak correlations between joint fluid and serum for WBC (R = 0.19), PMN count (R = 0.31), and lymphocyte count (R = -0.22) were observed. Diagnostic accuracy of PMN (93%) and WBC (93%) synovial count relative to serum was similar to synovial WBC (93%) and PMN% (95%) alone. Serum WBC analysis does little to improve the accurate diagnosis of PJI.
KW - Knee arthroplasty
KW - Knee revision
KW - Periprosthetic joint infection
KW - Synovial and serum white blood cell count
UR - http://www.scopus.com/inward/record.url?scp=84866347219&partnerID=8YFLogxK
U2 - 10.1016/j.arth.2012.03.059
DO - 10.1016/j.arth.2012.03.059
M3 - Article
C2 - 22543180
AN - SCOPUS:84866347219
SN - 0883-5403
VL - 27
SP - 1589
EP - 1593
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
IS - 9
ER -