Rothman at Jefferson research suggests abandon convention in diagnosing periprosthetic joint infection

February 8, 2012, Thomas Jefferson University

In their search for new, better ways to diagnose periprosthetic joint infection, Rothman Institute at Jefferson researchers have discovered that measurement of C-reactive protein in the synovial fluid is extremely accurate, while measuring a patients' serum white blood cell count (WBC) and the percentage of neutrophils (PMN%), the conventional method for diagnosis, has a minimal role in the determination of PJI.

The synovial fluid is the that lubricates the joints and feeds the cartilage.

"This research indicates that we may need to reexamine how we diagnose PJI," said Javad Parvizi, MD, director of Research at the Rothman Institute and Professor of Orthopedics at Jefferson Medical College.

The study retrospectively examined 2,067 cases of revision hip or between 2004 and 2010. Of these, 961 cases had a diagnosis of PJI based on institutional criteria. Preoperative WBC counts and PMN numbers were examined at and found to be only 58.8 percent sensitive for infection and 62.2 percent specific for WBC; and 57 percent sensitive and 71 percent specific at the determined threshold of 7,650 cells/ml.

The results will be shared at the American Academy of Orthopedic Surgeons (AAOS) annual meeting on Wednesday, February 8th at 11:24 am Pacific Time.

"Our study confirms the long held belief that serum white and differential has minimal role in routine work-up of patients with suspected PJI," said Parvizi, an author on this influential study.

Explore further: Research suggests use of LE strips to diagnose PJI

Related Stories

Research suggests use of LE strips to diagnose PJI

February 7, 2012
Rothman Institute at Jefferson joint researchers continue to seek better ways to diagnose and subsequently treat periprosthetic joint infection (PJI) in patients following total joint arthroplasty. Their latest research shows ...

A new definition for periprosthetic joint infection

November 4, 2011
A rise in periprosthetic joint infection (PJI) rates has the orthopedic community moving to develop it's first-ever agreed upon definition and diagnostic criteria to help better treat patients.

Recommended for you

Don't hold your nose and close your mouth when you sneeze, doctors warn

January 15, 2018
Pinching your nose while clamping your mouth shut to contain a forceful sneeze isn't a good idea, warn doctors in the journal BMJ Case Reports.

New antifungal provides hope in fight against superbugs

January 12, 2018
Microscopic yeast have been wreaking havoc in hospitals around the world—creeping into catheters, ventilator tubes, and IV lines—and causing deadly invasive infection. One culprit species, Candida auris, is resistant ...

Dengue takes low and slow approach to replication

January 11, 2018
A new study reveals how dengue virus manages to reproduce itself in an infected person without triggering the body's normal defenses. Duke researchers report that dengue pulls off this hoax by co-opting a specialized structure ...

Different strains of same bacteria trigger widely varying immune responses

January 11, 2018
Genetic differences between different strains of the same pathogenic bacterial species appear to result in widely varying immune system responses, according to new research published in PLOS Pathogens.

Human protein may aid neuron invasion by virus that causes hand, foot, and mouth disease

January 11, 2018
A human protein known as prohibitin may play a significant role in infection of the nervous system by EV71, one of several viruses that can cause hand, foot, and mouth disease. Issac Too of the National University of Singapore ...

Untangling how Epstein-Barr virus infects cells

January 11, 2018
A team led by scientists at Northwestern Medicine has discovered a new epithelial receptor for Epstein-Barr virus, according to a study published recently in Nature Microbiology.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.