Analysis of Preoperative and Intraoperative Investigations for the Diagnosis of Active Infection in the Hip.
- Author:
Kuen Tak SUH
1
;
Ju Young JUNG
;
Sang Dai BAIK
Author Information
1. Department of Orthopaedic Surgery, College of Medicine, Pusan National University, Pusan, Korea.
- Publication Type:Original Article
- Keywords:
Hip;
Active infection;
Preoperative and intraoperative investigations
- MeSH:
Blood Sedimentation;
C-Reactive Protein;
Diagnosis*;
Erythrocyte Count;
Frozen Sections;
Hip*;
Humans;
Leukocytes;
Sensitivity and Specificity
- From:The Journal of the Korean Orthopaedic Association
2001;36(5):437-442
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To evaluate the usefulness of preoperative, intraoperative studies and combination for the diagnosis of active infection in the hip. MATERIALS AND METHODS: We analyzed results of the preoperative and intraoperative investigations in 58 patients with a total of 69 hip surgeries. White blood cell, differential counts, erythrocyte sedimentation rate, and C-reactive protein were determined preoperatively. Frozen sections and culture were analyzed intraoperatively, and the sensitivity, specificity, positive and negative predictive values of each investigation were calculated and analyzed to determine if any combination of studies could be used to diagnosis hip infection. RESULTS: When both the erythrocyte sedimentation rate and the level of C-reactive protein show negative findings, the probability of hip infection is 0%, and when both tests are positive, the probability of infection is 67%. Moreover, when intraoperative frozen section of tissue, erythrocyte sedimentation rate, and C-reactive protein are all positive, the probability of infection is 100%. CONCLUSION: The combination of a normal erythrocyte sedimentation rate and normal C-reactive protein is a reliable predictor of the absence of infection. Intraoperative frozen sections are useful in an equivocal situation, but the intraoperative culture proved to be an unreliable predictor of infection.
