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The role of biopsy in diagnosing infection after hip and knee arthroplasty: a meta-analysis
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 e...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10030426/ https://www.ncbi.nlm.nih.gov/pubmed/35061082 http://dx.doi.org/10.1007/s00402-021-04323-y |
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author | Li, Cheng Margaryan, Donara Perka, Carsten Trampuz, Andrej |
author_facet | Li, Cheng Margaryan, Donara Perka, Carsten Trampuz, Andrej |
author_sort | Li, Cheng |
collection | PubMed |
description | 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 AND METHODS: 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. |
format | Online Article Text |
id | pubmed-10030426 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-100304262023-03-23 The role of biopsy in diagnosing infection after hip and knee arthroplasty: a meta-analysis Li, Cheng Margaryan, Donara Perka, Carsten Trampuz, Andrej Arch Orthop Trauma Surg Orthopaedic Surgery 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 AND METHODS: 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. Springer Berlin Heidelberg 2022-01-21 2023 /pmc/articles/PMC10030426/ /pubmed/35061082 http://dx.doi.org/10.1007/s00402-021-04323-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Orthopaedic Surgery Li, Cheng Margaryan, Donara Perka, Carsten Trampuz, Andrej The role of biopsy in diagnosing infection after hip and knee arthroplasty: a meta-analysis |
title | The role of biopsy in diagnosing infection after hip and knee arthroplasty: a meta-analysis |
title_full | The role of biopsy in diagnosing infection after hip and knee arthroplasty: a meta-analysis |
title_fullStr | The role of biopsy in diagnosing infection after hip and knee arthroplasty: a meta-analysis |
title_full_unstemmed | The role of biopsy in diagnosing infection after hip and knee arthroplasty: a meta-analysis |
title_short | The role of biopsy in diagnosing infection after hip and knee arthroplasty: a meta-analysis |
title_sort | role of biopsy in diagnosing infection after hip and knee arthroplasty: a meta-analysis |
topic | Orthopaedic Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10030426/ https://www.ncbi.nlm.nih.gov/pubmed/35061082 http://dx.doi.org/10.1007/s00402-021-04323-y |
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