In patients with suspicion but no clear evidence of periprosthetic shoulder infection, published results showed diagnostic arthroscopy may be a useful diagnostic tool, offering high sensitivity and specificity.
Researchers routinely collected three tissue samples from synovia and the bone-prosthesis interface with signs of synovitis or abnormal appearance among patients who underwent diagnostic arthroscopy for painful shoulder arthroplasty. Researchers compared arthroscopic tissue culture results with culture results of intraoperative tissue samples obtained at the time of open revision surgery. Patients were considered to have a true presence of infection if two or more positive cultures for the same microorganism were obtained at open revision surgery.
Of the 23 cases in 22 patients included in the study, researchers classified five cases as true infection and diagnostic arthroscopy identified positive cultures in 16 cases. Results showed each case had Cutibacterium acnes isolated. Researchers found a sensitivity and negative predictive value of 100%, a specificity of 39% and a positive predictive value of 31.3% when classifying any microbiologic growth in the arthroscopic biopsies as positive for the detection of a periprosthetic shoulder infection. Although sensitivity and negative predictive value dropped to 80% and 94.4%, respectively, if at least two samples with the same microbiologic growth in the arthroscopic biopsies were considered positive, researchers noted specificity and positive predictive value increased to 94.4% and 80%, respectively. – by Casey Tingle
Disclosures: Akgun reports no relevant financial disclosures. Please see the study for a list of all other authors’ relevant financial disclosures.