Role of histological evaluation of periprosthetic tissue in diagnosis of periprosthetic joint infection
10.3760/cma.j.issn.0529-5807.2019.12.005
- VernacularTitle: 病理组织学评估在诊断人工关节置换术后假体周围关节感染中的价值
- Author:
Lihua GONG
1
;
Xi CHEN
2
;
Rongfang DONG
1
;
Hongyi SHAO
2
;
Tao BIAN
2
;
Yixin ZHOU
2
;
Yi DING
1
Author Information
1. Department of Pathology, Beijing Jishuitan Hospital, Fourth Medical College of Peking University, Beijing 100035, China
2. Department of Joint Surgery, Beijing Jishuitan Hospital, Fourth Medical College of Peking University, Beijing 100035, China
- Publication Type:Journal Article
- Keywords:
Arthroplasty, replacement;
Infection;
Pathology, surgical;
Sensitivity and specificity
- From:
Chinese Journal of Pathology
2019;48(12):940-944
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the role of histologicalpathology in the diagnosis of periprosthetic joint infection.
Methods:A total of 145 cases of joint arthroplasty during October 2017 and October 2018 from Beijing Jishuitan Hospital were collected. There were 23 cases of infection, including knee joint arthroplasty (12 cases) and hip arthroplasty (11 cases). There were 17 females and 6 males. Patients′ age ranged from 39 to 76 years (mean 63 years). The infection was diagnosed if there were >5 neutrophils per high power field in at least 5 high power field. The permanent sections were examined twice separately by two pathologists, and the interval time of histologic examination was at least two weeks. Sensitivity (SE), specificity (SP), positive predictivevalue (PPV), and negative predictive value (NPV) were calculated. The consistency evaluation of histologic examination of two pathologists was calculated by Kappa analysis.
Results:The neutrophil cells could locate scattered or focally in the synovium tissue of periprosthetic joint infection. Somewhere, the infiltration of vessel and the perivascular distribution could also exist. Opportunity coincidence rate between two pathologists was 91.3% (Kappa=0.817). The results showed that SE was 60.9%, SP was 100.0%, NPV was 93.1%, PPV was 100.0%.
Conclusions:The presence of polymorphonuclear cells in histologic examination is correlated with infection. There was high consistency between histologic examination and clinical diagnosis of joint arthroplasty.