Are Frozen Sections and MSIS Criteria Reliable at the Time of Reimplantation of Two-stage Revision Arthroplasty?

• DOI: 10.1007/s11999-015-4673-3
• Publication Date: 2015-12-21T15:44:54Z
• Authors: Jaiben George; Grzegorz Kwiecien; Alison K. Klika; Deepak Ramanathan; Thomas W. Bauer; Wael K. Barsoum; Carlos A. Higuera
• Keywords: Gold standard (test)

Frozen section histology is widely used to aid in the diagnosis of periprosthetic joint infection at second stage revision arthroplasty, although there are limited data regarding its utility. Moreover, no definitive method assess control time reimplantation. Because failure a two-stage can have serious consequences, it important identify cases that might fail and defer reimplantation if necessary. Thus, reliable test providing information about risk subsequent necessary.(1) At second-stage surgery, what diagnostic accuracy frozen sections as compared with Musculoskeletal Infection Society (MSIS) gold standard? (2) What parameters for MSIS criteria predicting reimplantation? (3) Do positive or increase failure?A total 97 patients undergoing hip arthroplasty knee 2013 (PJI) were considered eligible study. Of these, 11 had incomplete seven lacked 1-year followup, leaving 79 (38 knees 41 hips) available analysis. reimplantation, results modified standard detecting infection. Subsequently, success was defined by (1) infection, characterized healed wound without fistula, drainage, pain; surgical intervention after surgery; occurrence PJI-related mortality; treatment calculated both sections.At useful ruling where specificity 94% (95% confidence interval [CI], 89%-99%); however, less utility out because sensitivity only 50% (CI, 13%-88%). Both high (MSIS specificity: 96% [CI, 91%-100%]; section: 95% 88%-100%]), but screening capabilities sensitivity: 26% 9%-44%]; 22% 9%-29%]). Positive factor (hazard ratio [HR], 5.22 [1.64-16.62], p = 0.005), whereas not (HR, 1.16 [0.15-8.86], 0.883).On basis our results, recommended arthroplasty. failure, demonstrated specificity. should be evaluated performing significantly increases failure.Level III,