Interface membrane is the best sample for histological study to diagnose prosthetic joint infection
Interface membrane is the best sample for histological study to diagnose prosthetic joint infection
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DOI：
10.1038/modpathol.2010.219
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发表时间：
2011-04-01
期刊：
影响因子：
7.5
通讯作者：
Soriano, Alex
中科院分区：
文献类型：
--
作者：
Bori, Guillem;Munoz-Mahamud, Ernesto;Soriano, Alex
本研究的目的是研究假关节感染的组织学诊断（假关节囊或关节界面膜）中哪个是最准确的标本。这是一项前瞻性研究，包括2007年1月至2009年6月进行的髋关节翻修置换手术。每位患者均获得假包膜和界面膜标本。当发现>= 5中性粒细胞/高倍视场（x40）时，认为组织学为感染阳性。当>= 2培养物对同一种微生物呈阳性时，即考虑感染的明确诊断。根据感染的定义，将患者分为两组：(A)手术中无菌性松动培养阴性患者和(B)假体关节感染患者。该研究共进行了69次修订；A组57例，B组12例。B组界面膜组织学阳性百分率显著高于假包膜组织学阳性百分率（83% vs 42%, P = 0.04， Fisher精确检验）。结果表明，假体周围界面膜是诊断假体关节感染的最佳组织学标本。现代病理学（2011）24,579-584；doi: 10.1038 / modpathol.2010.219;2010年12月3日在线发布
The objective of our study was to study which is the most accurate specimen for histological diagnosis of prosthetic joint infections (pseudocapsule or interface membrane). This is a prospective study including hip revision arthroplasties performed from January 2007 to June 2009. Specimens from pseudocapsule and from interface membrane were obtained from each patient. The histology was considered positive for infection when >= 5 neutrophils per high-power field (x 40) were found. Definitive diagnosis of infection was considered when >= 2 cultures were positive for the same microorganism. According to the definition of infection, patients were classified in two groups: (A) patients with aseptic loosening in whom cultures obtained during surgery were negative and (B) patients with prosthetic joint infection. A total of 69 revisions were included in the study; 57 were classified in group A and 12 in group B. In group B, the percentage of positive interface membrane histology was significantly higher than the percentage of positive pseudocapsule histology (83 vs 42%, P = 0.04, Fisher's exact test). The results suggest that periprosthetic interface membrane is the best specimen for the histological diagnosis of prosthetic joint infection. Modern Pathology (2011) 24, 579-584; doi: 10.1038/modpathol.2010.219; published online 3 December 2010