Leukocyte Esterase: Metal-on-Metal Failure and Periprosthetic Joint Infection

November 4, 2016 at 8:01 am

Journal of Arthroplasty October 2016 V.31 N.10 P.2260–2263

Eric H. Tischler, Darren R. Plummer, Antonia F. Chen, Craig J. Della Valle, Javad Parvizi

Background

Adverse local tissue reactions (ALTRs) and periprosthetic joint infection can occur after metal-on-metal total hip arthroplasty (THA), both potentially generating purulent synovial fluid (SF) and elevated white cell count. This makes it difficult to distinguish between diagnoses; therefore, we evaluated leukocyte esterase (LE) strip test’s reliability in ruling out periprosthetic joint infection in ALTR revision THA.

Methods

Sixty-one patients with ALTRs and an LE strip test were evaluated, excluding 15 cases with SF metallic debris. LE strip tests were classified −/trace, + (mildly positive), and ++ (strongly positive).

Results

LE strip tests were ++, +, −/trace in 8 patients (13.1%), 14 (23.0%), and 39 (63.9%), respectively. Means and ranges of SF white cell count and polymorphonuclear percentage were 1291.4 (0-10,886 cells/μL), and 46.1% (0%-94%), respectively.

Conclusion

++ LE strip test, in conjunction with preoperative work-ups, reliably rules out infection in 92.9% of patients undergoing THA revision secondary to ALTR.

PDF

http://www.arthroplastyjournal.org/article/S0883-5403(16)00248-5/pdf

 

2016-10 PJI – Leukocyte Esterase  Metal-on-Metal Failure and Periprosthetic Joint Infection J Parvizi

Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Biología Molecular, Epidemiología, FIEBRE en el POSTOPERATORIO, Health Care-Associated Infections, Infecciones nosocomiales, Infecciones osteo-articulares-musculares, Infecciones relacionadas a prótesis, Metodos diagnosticos, Resistencia bacteriana, Sepsis, Update. Tags: .

Wound Hygiene Practices After Total Knee Arthroplasty: Does It Matter? 2016-11 WHO – GLOBAL GUIDELINES FOR THE PREVENTION OF SURGICAL SITE INFECTION 186 pags.


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