Arthroscopic tissue culture for the evaluation of periprosthetic shoulder infection

Matthew Dilisio, Lindsay R. Miller, Jon J P Warner, Laurence D. Higgins

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Background: Periprosthetic shoulder infections can be difficult to diagnose. The purpose of this study was to investigate the utility of arthroscopic tissue culture for the diagnosis of infection following shoulder arthroplasty. Our hypothesis was that culture of arthroscopic biopsy tissue is a more reliable method than fluoroscopically guided shoulder aspiration for diagnosing such infection. Methods: A retrospective review identified patients who had undergone culture of arthroscopic biopsy tissue during the evaluation of a possible chronic periprosthetic shoulder infection. The culture results of the arthroscopic biopsies were compared with those of fluoroscopically guided glenohumeral aspiration and open tissue biopsy samples obtained at the time of revision surgery. Results: Nineteen patients had undergone arthroscopic biopsy to evaluate a painful shoulder arthroplasty for infection. All subsequently underwent revision surgery, and 41% of those with culture results at that time had a positive result, which included Propionibacterium acnes in each case. All arthroscopic biopsy culture results were consistent with the culture results obtained during the revision surgery, yielding 100% sensitivity, specificity, positive predictive value, and negative predictive value. In contrast, fluoroscopically guided glenohumeral aspiration yielded a sensitivity of 16.7%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 58.3%. Conclusions: Arthroscopic tissue biopsy is a reliable method for diagnosing periprosthetic shoulder infection and identifying the causative organism.

Original languageEnglish
Pages (from-to)1952-1958
Number of pages7
JournalJournal of Bone and Joint Surgery - Series A
Volume96
Issue number23
DOIs
StatePublished - Dec 3 2014
Externally publishedYes

Fingerprint

Biopsy
Infection
Reoperation
Arthroplasty
Sensitivity and Specificity
Propionibacterium acnes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine
  • Medicine(all)

Cite this

Arthroscopic tissue culture for the evaluation of periprosthetic shoulder infection. / Dilisio, Matthew; Miller, Lindsay R.; Warner, Jon J P; Higgins, Laurence D.

In: Journal of Bone and Joint Surgery - Series A, Vol. 96, No. 23, 03.12.2014, p. 1952-1958.

Research output: Contribution to journalArticle

Dilisio, Matthew ; Miller, Lindsay R. ; Warner, Jon J P ; Higgins, Laurence D. / Arthroscopic tissue culture for the evaluation of periprosthetic shoulder infection. In: Journal of Bone and Joint Surgery - Series A. 2014 ; Vol. 96, No. 23. pp. 1952-1958.
@article{224d79f1992647b691483243df9d004a,
title = "Arthroscopic tissue culture for the evaluation of periprosthetic shoulder infection",
abstract = "Background: Periprosthetic shoulder infections can be difficult to diagnose. The purpose of this study was to investigate the utility of arthroscopic tissue culture for the diagnosis of infection following shoulder arthroplasty. Our hypothesis was that culture of arthroscopic biopsy tissue is a more reliable method than fluoroscopically guided shoulder aspiration for diagnosing such infection. Methods: A retrospective review identified patients who had undergone culture of arthroscopic biopsy tissue during the evaluation of a possible chronic periprosthetic shoulder infection. The culture results of the arthroscopic biopsies were compared with those of fluoroscopically guided glenohumeral aspiration and open tissue biopsy samples obtained at the time of revision surgery. Results: Nineteen patients had undergone arthroscopic biopsy to evaluate a painful shoulder arthroplasty for infection. All subsequently underwent revision surgery, and 41{\%} of those with culture results at that time had a positive result, which included Propionibacterium acnes in each case. All arthroscopic biopsy culture results were consistent with the culture results obtained during the revision surgery, yielding 100{\%} sensitivity, specificity, positive predictive value, and negative predictive value. In contrast, fluoroscopically guided glenohumeral aspiration yielded a sensitivity of 16.7{\%}, specificity of 100{\%}, positive predictive value of 100{\%}, and negative predictive value of 58.3{\%}. Conclusions: Arthroscopic tissue biopsy is a reliable method for diagnosing periprosthetic shoulder infection and identifying the causative organism.",
author = "Matthew Dilisio and Miller, {Lindsay R.} and Warner, {Jon J P} and Higgins, {Laurence D.}",
year = "2014",
month = "12",
day = "3",
doi = "10.2106/JBJS.M.01512",
language = "English",
volume = "96",
pages = "1952--1958",
journal = "Journal of Bone and Joint Surgery - Series A",
issn = "0021-9355",
publisher = "Journal of Bone and Joint Surgery Inc.",
number = "23",

}

TY - JOUR

T1 - Arthroscopic tissue culture for the evaluation of periprosthetic shoulder infection

AU - Dilisio, Matthew

AU - Miller, Lindsay R.

AU - Warner, Jon J P

AU - Higgins, Laurence D.

PY - 2014/12/3

Y1 - 2014/12/3

N2 - Background: Periprosthetic shoulder infections can be difficult to diagnose. The purpose of this study was to investigate the utility of arthroscopic tissue culture for the diagnosis of infection following shoulder arthroplasty. Our hypothesis was that culture of arthroscopic biopsy tissue is a more reliable method than fluoroscopically guided shoulder aspiration for diagnosing such infection. Methods: A retrospective review identified patients who had undergone culture of arthroscopic biopsy tissue during the evaluation of a possible chronic periprosthetic shoulder infection. The culture results of the arthroscopic biopsies were compared with those of fluoroscopically guided glenohumeral aspiration and open tissue biopsy samples obtained at the time of revision surgery. Results: Nineteen patients had undergone arthroscopic biopsy to evaluate a painful shoulder arthroplasty for infection. All subsequently underwent revision surgery, and 41% of those with culture results at that time had a positive result, which included Propionibacterium acnes in each case. All arthroscopic biopsy culture results were consistent with the culture results obtained during the revision surgery, yielding 100% sensitivity, specificity, positive predictive value, and negative predictive value. In contrast, fluoroscopically guided glenohumeral aspiration yielded a sensitivity of 16.7%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 58.3%. Conclusions: Arthroscopic tissue biopsy is a reliable method for diagnosing periprosthetic shoulder infection and identifying the causative organism.

AB - Background: Periprosthetic shoulder infections can be difficult to diagnose. The purpose of this study was to investigate the utility of arthroscopic tissue culture for the diagnosis of infection following shoulder arthroplasty. Our hypothesis was that culture of arthroscopic biopsy tissue is a more reliable method than fluoroscopically guided shoulder aspiration for diagnosing such infection. Methods: A retrospective review identified patients who had undergone culture of arthroscopic biopsy tissue during the evaluation of a possible chronic periprosthetic shoulder infection. The culture results of the arthroscopic biopsies were compared with those of fluoroscopically guided glenohumeral aspiration and open tissue biopsy samples obtained at the time of revision surgery. Results: Nineteen patients had undergone arthroscopic biopsy to evaluate a painful shoulder arthroplasty for infection. All subsequently underwent revision surgery, and 41% of those with culture results at that time had a positive result, which included Propionibacterium acnes in each case. All arthroscopic biopsy culture results were consistent with the culture results obtained during the revision surgery, yielding 100% sensitivity, specificity, positive predictive value, and negative predictive value. In contrast, fluoroscopically guided glenohumeral aspiration yielded a sensitivity of 16.7%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 58.3%. Conclusions: Arthroscopic tissue biopsy is a reliable method for diagnosing periprosthetic shoulder infection and identifying the causative organism.

UR - http://www.scopus.com/inward/record.url?scp=84916878391&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84916878391&partnerID=8YFLogxK

U2 - 10.2106/JBJS.M.01512

DO - 10.2106/JBJS.M.01512

M3 - Article

C2 - 25471909

AN - SCOPUS:84916878391

VL - 96

SP - 1952

EP - 1958

JO - Journal of Bone and Joint Surgery - Series A

JF - Journal of Bone and Joint Surgery - Series A

SN - 0021-9355

IS - 23

ER -