Utility of synovial fluid aspirations in failed metal-on-metal total hip arthroplasty

Cody C. Wyles, Dirk R. Larson, Matthew T. Houdek, Rafael J. Sierra, Robert T. Trousdale

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

White blood cell (WBC) count and neutrophil percentage from preoperative synovial fluid aspirations are used to help determine the presence or absence of periprosthetic joint infection (PJI) in failed total hip arthroplasty (THA). The clinical levels indicative of infection have not been delineated in metal-on-metal (MoM) bearings. We identified 39 patients who received a preoperative synovial fluid aspiration prior to MoM revision. Thirty-five of 39 cases were culture negative and 4 of 39 were culture positive. WBC count > 3000 cells/μL was 100% sensitive and 57.1% specific. Neutrophil percentage > 80% was 100% sensitive and 97.1% specific. Both CRP and ESR > 8.0. mg/L and > 22 mm/h, respectively were 75.0% sensitive and 67.6% specific. Our data suggest that synovial WBC count and serum ESR and CRP have poor predictive value in diagnosing PJI for failed MoM THA, whereas synovial neutrophil percentage is a highly accurate marker for diagnosing infection in this patient population.

Original languageEnglish (US)
Pages (from-to)818-823
Number of pages6
JournalJournal of Arthroplasty
Volume28
Issue number5
DOIs
StatePublished - May 2013

Fingerprint

Synovial Fluid
Arthroplasty
Hip
Metals
Leukocyte Count
Neutrophils
Infection
Joints
Serum
Population

Keywords

  • Aspiration
  • Total hip arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Wyles, C. C., Larson, D. R., Houdek, M. T., Sierra, R. J., & Trousdale, R. T. (2013). Utility of synovial fluid aspirations in failed metal-on-metal total hip arthroplasty. Journal of Arthroplasty, 28(5), 818-823. https://doi.org/10.1016/j.arth.2012.11.006

Utility of synovial fluid aspirations in failed metal-on-metal total hip arthroplasty. / Wyles, Cody C.; Larson, Dirk R.; Houdek, Matthew T.; Sierra, Rafael J.; Trousdale, Robert T.

In: Journal of Arthroplasty, Vol. 28, No. 5, 05.2013, p. 818-823.

Research output: Contribution to journalArticle

Wyles, CC, Larson, DR, Houdek, MT, Sierra, RJ & Trousdale, RT 2013, 'Utility of synovial fluid aspirations in failed metal-on-metal total hip arthroplasty', Journal of Arthroplasty, vol. 28, no. 5, pp. 818-823. https://doi.org/10.1016/j.arth.2012.11.006
Wyles, Cody C. ; Larson, Dirk R. ; Houdek, Matthew T. ; Sierra, Rafael J. ; Trousdale, Robert T. / Utility of synovial fluid aspirations in failed metal-on-metal total hip arthroplasty. In: Journal of Arthroplasty. 2013 ; Vol. 28, No. 5. pp. 818-823.
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