白细胞显像是否推荐用于膝关节假体周围感染的诊断？92例全膝关节置换术的回顾性研究

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2025-03-05 DOI:10.1016/j.knee.2025.02.005

Maria Pia Neri , Mirco Lo Presti , Davide Pellicanò , Marco Minerba , Monica Cosentino , Cosimo Vasco , Ludovica Solito , Gabrio Goracci , Stefano Zaffagnini

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引用次数: 0

摘要

目的评价体外标记白细胞闪烁成像（LS）在膝关节假体周围感染诊断中的准确性。方法回顾性研究纳入2011年1月至2023年3月我科所有全膝关节置换术（TKA）患者，这些患者在接受假体脓毒性或无菌性松动翻修手术前行LS。采用2018年国际共识会议（ICM）和2021年欧洲骨关节感染学会（EBJS）假体周围关节感染（PJI）定义来定义感染和未感染的患者。结果共纳入92例tka。这是根据2018年ICM PJI定义的LS诊断表现：敏感性89%，特异性80%，阳性预测值（PPV） 80%，阴性预测值（NPV） 89%，阳性似然比（LR +） 4.46，阴性似然比（LR-） 0.14。根据2021 EBJS PJI定义：灵敏度91%，特异性80%，PPV 76%, NPV 92%, LR + 4.43, LR- 0.12。结论先前发表的关于LS诊断性能的研究报告的结果差异很大，可能是由于每篇文章采用的PJI诊断标准不同且主观。这是首次采用最新PJI定义的研究之一，并证明LS可能具有比先前估计的更高的特异性和PPV。因此，它是一种有效的PJI诊断工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Is leukocyte scintigraphy recommended in periprosthetic knee infection diagnosis? A retrospective study of 92 total knee arthroplasties

Purpose

The aim of this study was to assess in vitro labelled leukocyte scintigraphy (LS) diagnostic accuracy in periprosthetic knee infection diagnosis.

Methods

This is a retrospective study that includes all patients with total knee arthroplasty (TKA) who performed LS before undergoing revision surgery for septic or aseptic loosening of the implant in our department from January of 2011 to March of 2023.

The 2018 International Consensus Meeting (ICM) and 2021 European Bone and Joint Infection Society (EBJS) periprosthetic joint infection (PJI) definitions were employed to define infected and not infected patients.

Results

92 TKAs were included in this study. This was the LS diagnostic performance according to the 2018 ICM PJI definition: sensitivity 89%, specificity 80%, positive predictive value (PPV) 80%, negative predictive value (NPV) 89%, positive likelihood ratio (LR + ) 4.46, negative likelihood ratio (LR-) 0.14. According to 2021 EBJS PJI definition: sensitivity 91%, specificity 80%, PPV 76%, NPV 92%, LR + 4.43, LR- 0.12.

Conclusion

Previously published studies on LS diagnostic performance report very variable results, probably due to the different and subjective PJI diagnostic criteria employed by each article. This is one of the first studies to employ the most recent PJI definitions and to demonstrate that LS may have a higher specificity and PPV than previously estimated. Therefore it represents a valid instrument in PJI diagnosis.

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.