Author/Authors :
Ahmadi, Shahryar The Department of Orthopedic Surgery, Rochester, USA , Lawrence, Thomas M. The Department of Orthopedic Surgery, Rochester, USA , Sahota, Shawn The Department of Orthopedic Surgery, Rochester, USA , Schleck, Cathy D. The Department of Orthopedic Surgery, Rochester, USA , Harmsen, William S. The Department of Orthopedic Surgery, Rochester, USA , Cofield, Robert H. The Department of Orthopedic Surgery, Rochester, USA , Sperling, John W. The Department of Orthopedic Surgery, Rochester, USA
Abstract :
Background: The purpose of this study was to evaluate the value of perioperative tests for the diagnosis of infection in revision shoulder arthroplasty. Methods: A retrospective analysis was performed on 537 shoulder arthroplasties (429 patients) that underwent revision shoulder arthroplasty at our institution. Periprosthetic tissue cultures were positive in 169/537 surgeries. Results: White-blood cell count (WBC) was elevated in 3.8% revision arthroplasties. Erythrocyte sedimentation rate (ESR) was elevated in 23.1% revision arthroplasties. The C-reactive protein (CRP) was elevated in 20.8% revision arthroplasties. Bone scans (technetium, indium) were performed on 9.9% patients and it was positive for osteomyelitis in just one revision arthroplasty. Intra-operative pathology was read as consistent with acute inflammation in 11.9% revision arthroplasties. The positive and negative predictive values for intra-operative pathology were 56.7% and 71.6% respectively. Conclusion: All of the perioperative tests had a high specificity and negative predictive value, but low sensitivity and positive predictive value. Level of evidence: III
Keywords :
Infection in Revisions Shoulder Arthroplasty , Perioperative Tests , Shoulder , Shoulder Arthroplasty
