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Diagnosing a periprosthetic shoulder infection: A systematic review.
Journal Title
Journal of orthopaedics
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Publication Date
2021-07-13
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26
Publication Issue
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58
Publication End
66
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Abstract
Introduction: The aim of this study was to systematically review the literature regarding accurate shoulder prosthetic joint infection (PJI) diagnosis.
Methods: Using PRISMA guidelines, we analyzed 25 studies reporting on 5535 patients and 646 infections.
Results: Cutibacterium acnes (C. acnes) cultures were positive in 60% of patients. Serum markers WBC, CRP, ESR, and IL-6 appear to lack diagnostic reliability. Synovial IL-6 and alpha-defensin may be more accurate in detecting infections.
Conclusion: Synovial IL-6 and alpha-defensin appear to have greater utility than serum markers. These may be incorporated into new criteria to accurately diagnose shoulder PJI.
Level of evidence: IV.
Keywords: C. acnes; Cutibacterium acnes; Diagnosis; Infection; Periprosthetic infection; Shoulder arthroplasty.
Citation
Jauregui JJ, Tran A, Kaveeshwar S, Nadarajah V, Chaudhri MW, Henn RF 3rd, Gilotra MN, Hasan SA. Diagnosing a periprosthetic shoulder infection: A systematic review. J Orthop. 2021 Jul 13;26:58-66. doi: 10.1016/j.jor.2021.07.012. PMID: 34305349; PMCID: PMC8283270.