J Korean Orthop Assoc.  2001 Oct;36(5):437-442.

Analysis of Preoperative and Intraoperative Investigations for the Diagnosis of Active Infection in the Hip

Affiliations
  • 1Department of Orthopaedic Surgery, College of Medicine, Pusan National University, Pusan, Korea.

Abstract

PURPOSE
To evaluate the usefulness of preoperative, intraoperative studies and combination for the diagnosis of active infection in the hip.
MATERIALS AND METHODS
We analyzed results of the preoperative and intraoperative investigations in 58 patients with a total of 69 hip surgeries. White blood cell, differential counts, erythrocyte sedimentation rate, and C-reactive protein were determined preoperatively. Frozen sections and culture were analyzed intraoperatively, and the sensitivity, specificity, positive and negative predictive values of each investigation were calculated and analyzed to determine if any combination of studies could be used to diagnosis hip infection.
RESULTS
When both the erythrocyte sedimentation rate and the level of C-reactive protein show negative findings, the probability of hip infection is 0%, and when both tests are positive, the probability of infection is 67%. Moreover, when intraoperative frozen section of tissue, erythrocyte sedimentation rate, and C-reactive protein are all positive, the probability of infection is 100%.
CONCLUSION
The combination of a normal erythrocyte sedimentation rate and normal C-reactive protein is a reliable predictor of the absence of infection. Intraoperative frozen sections are useful in an equivocal situation, but the intraoperative culture proved to be an unreliable predictor of infection.

Keyword

Hip; Active infection; Preoperative and intraoperative investigations
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