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Research Article
Shuqiang Chen
The First Afilliated Hospital of Fujian Medical University
Corresponding Author
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Objective: To explore the diagnostic efficiency of ultrasound for the identification of periprosthetic joint infection (PJI) and aspetic loosening.
Methods: 50 patients with joint pain after total hip arthroplasty, who were all clinically diagnosed as aseptic prosthesis loosening or PJI, were examined by ultrasonography combined with C-reactive protein, erythrocyte sedimentation rate, bacterial culture and pathology.
Results: Thirty-eight of the 50 cases were PJI (group A) , and twelve cases were aseptic loosening (group B) . Fourteen patients with extra-capsular effusion were diagnosed as PJI, while none appeared extra-capsular effusion effusion in group B. 34 cases PJI obtained joint fluid, which was more than group B (7/11) (P < 0.05). The average depth of joint effusion of group B (19.83 ± 8.9mm), was significantly less than group A (25.97±15.25mm) (P < 0.05). In group A , 21 cases (55.26%) had grade 2-3 synovial blood flow signal,which was higher than group B (8.3%) (P < 0.05). Under the circumstance that PJI was diagnosed: (1) There was a sinus tract or extra-capsular effusion; or (2) Joint fluid depth was ≥ 17.0 mm; or (3) Grade 2-3 synovial blood flow signal was detected,the positive predictive value of ultrasound diagnosis of PJI was 92.1% (35/38)，and the accuracy of aseptic loosening was 83.3% (10/12) (P < 0.05).
Conclusions: Ultrasound has significant value in the differential diagnosis of PJI and aspetic loosening.
Keywords
Infection, Aseptic loosening, Ultrasound, Hip arthroplasty
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No competing interests reported.
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research Article
Shuqiang Chen
The First Afilliated Hospital of Fujian Medical University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 22 Feb, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objective: To explore the diagnostic efficiency of ultrasound for the identification of periprosthetic joint infection (PJI) and aspetic loosening.
Methods: 50 patients with joint pain after total hip arthroplasty, who were all clinically diagnosed as aseptic prosthesis loosening or PJI, were examined by ultrasonography combined with C-reactive protein, erythrocyte sedimentation rate, bacterial culture and pathology.
Results: Thirty-eight of the 50 cases were PJI (group A) , and twelve cases were aseptic loosening (group B) . Fourteen patients with extra-capsular effusion were diagnosed as PJI, while none appeared extra-capsular effusion effusion in group B. 34 cases PJI obtained joint fluid, which was more than group B (7/11) (P < 0.05). The average depth of joint effusion of group B (19.83 ± 8.9mm), was significantly less than group A (25.97±15.25mm) (P < 0.05). In group A , 21 cases (55.26%) had grade 2-3 synovial blood flow signal,which was higher than group B (8.3%) (P < 0.05). Under the circumstance that PJI was diagnosed: (1) There was a sinus tract or extra-capsular effusion; or (2) Joint fluid depth was ≥ 17.0 mm; or (3) Grade 2-3 synovial blood flow signal was detected,the positive predictive value of ultrasound diagnosis of PJI was 92.1% (35/38)，and the accuracy of aseptic loosening was 83.3% (10/12) (P < 0.05).
Conclusions: Ultrasound has significant value in the differential diagnosis of PJI and aspetic loosening.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
No competing interests reported.
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