Diagnosis of Periprosthetic Joint Infection and the Common Pathogens, Durg-resistance in Periprosthetic Joint Infection

Study Overview
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Brief Summary
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This retrospective study aims to improve the diagnosis of PJI as well as to identify microorganisms causing periprosthetic joint infection (PJI) and the drug-resistant spectrum

Detailed Description
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160 patients who underwent revision or re-revision total hip or knee arthroplasty for different reasons in our institution were recruited from August 2013 to August 2016. 80 patients meet the criteria of PJI from the muscle and skeletal muscle Association (MSIS) are divided to the infection group, another 80 patients are divided into the non-infection group. Medical and demographic data were recorded. Collected lab examinations included blood routine test, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), synovial leukocyte counts, Receiver Operating Characteristic Curve-Area Under Curve (ROC-AUC) analysis will be used to evaluate the specific and sensitivity of diagnosis index. Moreover,microorganisms isolated from periprosthetic tissues and articular fluid. Postoperatively, the prosthesis was sent for ultrasound sonication. The sonicate extraction, implant surrounding tissue and synovium were sent for microbiologic culture, and the implant-surrounding-tissue were also sent for pathological examination. The isolated strains and drug-resistance rate for each bacterium for different antibiotics were presented.

Official Title
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Diagnosis of Periprosthetic Joint Infection and the Common Pathogens, Durg-resistance in Periprosthetic Joint Infection

Conditions
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Arthropathy of Hip, Arthropathy of Knee

Intervention / Treatment
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* Other: Periprosthetic Joint Infection
* Other: Non-Periprosthetic Joint Infection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patient who underwent revision or re-revision total hip or knee arthroplasty for different reasons in our institution Exclusion Criteria: Patients who refused to join the trial group; Revision total hip/knee replacement for periprosthetic fracture; patients who missed some of important examination; Revision total hip/knee replacement for metal sensitivity; Revision total hip/knee replacement for the last period of second-stage revision; Patient who underwent revision with RA or other inflammatory disease.

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| infectious group<br>Patients who met the criteria according of Periprosthetic Joint Infection were identified as the infectious group. | Other: Periprosthetic Joint Infection<br>* Periprosthetic Joint Infection is diagnosed according to the diagnosing criteria from the Workgroup of the Musculoskeletal Infection Society.<br>|
| non-infectious group<br>Patients who didn't meet the criteria according of Periprosthetic Joint Infection were identified as the non-periprosthetic joint infection group. | Other: Non-Periprosthetic Joint Infection<br>* PJI can not be diagnosed for the lack of clinical evidence according to the diagnosing criteria from the Workgroup of the Musculoskeletal Infection Society.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evaluation the specific and sensitivity of CRP | To test the specifity and sensitivity of CRP | within 4 weeks before the operation | 
| Evaluation the specific and sensitivity of ESR | To test the specifity and sensitivity of ESR | within 4 weeks before the operation | 
| Evaluation the specific and sensitivity of synovial leukocyte counts | To test the specifity and sensitivity of synovial leukocyte counts | within 4 weeks before the operation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Microorganisms identification and the | Identify microorganisms causing periprosthetic joint infection (PJI) as well as the drug-resistant spectrum. | within 4 weeks before the operation | 
| Drug-resistant spectrum. | Identify the drug-resistant spectrum of the microorganisms. | within 4 weeks before the operation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Periprosthetic Joint Infection