Analysis of tissue biopsy and joint aspiration in the diagnosis of periprosthetic hip infections: cross-sectional study

Abstract

Objective: To evaluate sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of preoperative joint aspiration (PJA) and periarticular tissue percutaneous biopsy (PTPB), as well as their combination, in the diagnosis of infection after total hip arthroplasty.

Methods: This cross-sectional study (Level of Evidence II) was conducted with prospective data on 29 patients submitted to PJA with PTPB at the National Institute of Orthopedics and Traumatology from September 2015 to January 2016. Specimens obtained during the procedures underwent microbiological analyses, and the results were compared with those obtained in subsequent revision arthroplasty surgeries.

Results: PJA, PTPB, and their combination reached values of 78%, 73%, 89% for sensitivity, respectively; 72%, 90%, 94% for specificity; and 76%, 80%, 90% for accuracy.

Conclusions: PJA combined with PTPB was sensitive, specific, and effective in diagnosing periprosthetic hip infection. Level of Evidence II, Prospective Cross-Sectional Study

Objetivo: Avaliar a sensibilidade, especificidade, acurácia, valor preditivo positivo e valor preditivo negativo dos métodos diagnósticos aspirado articular pré-operatório (AAPO), biópsia percutânea de tecidos periarticulares (BPTP) e ambos associados na infecção pós-artroplastia total de quadril (IPATQ).

Método: Trata-se de um estudo transversal (Nível de Evidência II) com coleta prospectiva de dados obtidos de 29 pacientes submetidos a AAPO com BPTP no Instituto Nacional de Ortopedia e Traumatologia durante o período de setembro de 2015 à janeiro de 2016. Foram comparados os resultados das análises microbiológicas dos espécimes obtidos por meio da BPTP e do AAPO com os obtidos intraoperatoriamente nas cirurgias subsequentes de revisão das artroplastias.

Resultado: Encontramos uma sensibilidade da AAPO, BPTP e ambos, respectivamente de 78%, 73%, 89%, uma especificidade de 72%, 90%, 94% e uma acurácia de 76%, 80%, 90%.

Conclusão: O procedimento de AAPO com BPTP para diagnóstico de infecção periprotética de quadril é sensível, específico e eficaz. Nível de Evidência II, Estudo Transversal Prospectivo.