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Researchers correlate aspiration results with periprosthetic sepsis in revision THA

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Researchers in this retrospective review found a white blood cell count of 745 was the most accurate diagnostic threshold for infection and the most accurate segmented cell count was 73.5% after revision total hip arthroplasty.

“Our data confirm the current [American Academy of Orthopaedic Surgeons Clinical Practice Guidelines white blood cell] and segmented cell thresholds,” Peter N. Chalmers, MD, and colleagues from Rush University Medical Center, stated in a press release. “Dividing [erythrocyte sedimentation rate] ESR and [C-reactive protein] CRP elevations into grades may be more useful than division into normal and abnormal while still allowing comparison between studies and laboratories.”

Chalmers and colleagues identified 52 hips with periprosthetic sepsis. They noted that apart from the 745 white blood cell and 73.5% segmented cell count, there was 98% sensitivity and 37% specificity, according to the abstract.

The accuracy of the tests was 50%, the researchers noted. These results were similar to the American Academy of Orthopaedic Surgeons Clinical Practice Guidelines, which when applied had an accuracy of 49%, according to the abstract.

Disclosure: One of the authors (Sporer) receives royalties from and is a paid consultant for Zimmer and Smith & Nephew. One of the authors (Levine) is a paid consultant for Zimmer, Conmed, Janssen Pharmaceuticals, and Ethicon and receives research support from Zimmer and Biomet.