Evidence map›Paper›PMID 33306153›Full record

ArticleZeitschrift fur Rheumatologie2022

Diagnostic value of the CD 15 focus score in two-stage revision arthroplasty of periprosthetic joint infections : High specificity in diagnosing infect eradication.

C Liewen, V T Krenn, R Dieckmann, L Bause, M Liebisch, A Niemeier, A Trampuz, V Krenn

Erratum issuedAbstract read
PubMed Publisher
In one paragraph

Article in Zeitschrift fur Rheumatologie, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. [Particle disease and its effects on periarticular tissue].Orthopadie (Heidelberg, Germany) · 2023
    Review
  4. [Histopathological diagnostics of arthrofibrosis].Unfallchirurgie (Heidelberg, Germany) · 2022
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

C LiewenMVZ-Zentrum für Histologie, Zytologie und Molekulare Diagnostik Trier GmbH, Max-Planck-Straße 5, 54296, Trier, Germany.
V T KrennFakultät für Medizin, Sigmund Freud PrivatUniversität Wien, Vienna, Austria.
R DieckmannKrankenhaus der Barmherzigen Brüder Trier, Trier, Germany.
L BauseSt. Josef-Stift Sendenhorst, Sendenhorst, Germany.
M LiebischFakultät für Medizin, Sigmund Freud PrivatUniversität Wien, Vienna, Austria.
A NiemeierDepartment of Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
A TrampuzCenter for Musculoskeletal Surgery (CMSC), Charité-Universitätsmedizin Berlin, Berlin, Germany.
V KrennMVZ-Zentrum für Histologie, Zytologie und Molekulare Diagnostik Trier GmbH, Max-Planck-Straße 5, 54296, Trier, Germany. Krenn@patho-trier.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe purpose of this study is to use the CD15 focus score (FS) to determine the sensitivity and specificity of bacterial infection persistence in spacer-based two-stage revision arthroplasty.

methodsThe analysis comprises 112 cases that were subjected to revision due to the presence of infection upon replacement of a joint endoprosthesis. The histopathological data were collected in accordance with the synovial-like interface membrane (SLIM) classification and the CD15-FS and correlated with the microbiological data (MD). The quantifying evaluation of the CD15-FS was performed without knowledge regarding the microbiological data (MD). Correlation with the MD was performed after a 14-day cultivation period.

resultsWith a single evaluation (1 focus, field area: 1.2 mm2) with a score value of 42, the CD15-FS showed a sensitivity for the eradication of infections of 0.64 and a specificity of 0.79 (PPV = 0.5; NPV = 0.87). With tenfold evaluation (10 foci, field area: 12 mm2) with a score value of 220, the sensitivity for the eradication was 0.68, the specificity 0.91 (PPV = 0.7; NPV = 0.89). No statistically significant correlation between the score values and the different infectious species could be detected. Based on the MD in 112 cases the rate of infection eradication was 75%. Polymethylmethacrylate-particles (PMMA) were detected in the perispacertissue in 64 cases (58%). No significant correlation could be established between microbiological pathogen detection and the presence of PMMA.

conclusionIn all cases (n = 112), periimplant synovial tissue (SLIM) with variable fibroblastic cellularity, capillary proliferation, leukocytic infiltration, fibrin deposition, new formation of woven bone and detection of PMMA particles was observed. These cases were classified as type IX perispacer synovialis/SLIM: type IX‑A with histopathological infection eradication and type IX‑B with histopathological infection persistence.

Indexed as

Arthritis, InfectiousArthroplasty, Replacement, HipArthroplasty, Replacement, KneeProsthesis-Related InfectionsHumansPolymethyl MethacrylateReoperationRetrospective StudiesSensitivity and SpecificityPolymethyl MethacrylateCD15 focus scoreEradication of infectionPeriprosthetic joint infectionSLIM-ClassificationTwo-stage revision arthroplasty

Identifiers

PMID33306153

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.