ArticleArchives of orthopaedic and trauma surgery2024
Assessing the reliability of automated cell count analysis of synovial fluid in the setting of revision total knee arthroplasty.
Article in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- Presence of Metallosis Can Interfere With Culture Positivity in Prosthetic Joint Infection of the Hip.Arthroplasty today · 2025Article
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeThe diagnostic challenges of periprosthetic joint infection (PJI) for orthopedic surgeons are significant. Prior research has indicated that patients with adverse reactions, dislocations, and aseptic loosening exhibit a heightened count of white blood cells (WBC) in their synovial fluid, along with an increased polymorphonuclear cell percentage (PMN%). The prevalence of false-positive results raises concerns about the reliability of these tools in distinguishing aseptic failure from PJI.
methodsWe have performed a retrospective inquiry of the medical records of all patients who have undergone aseptic revision total knee arthroplasty (TKA) at our tertiary referral arthroplasty center. We conducted an assessment on 552 knees by applying the guidelines set forth by the 2018 International Consensus Meeting. Recorded preoperative parameters: aspiration results (WBC, PMN%, and AD immunoassay), preoperative and intraoperative diagnoses, microbiologic and histopathologic findings from periprosthetic tissue samples, and prosthetic details.
resultsAmong the causes of aseptic revision investigated, patients with polyethylene wear exhibited the highest median WBC count (median 1091 cells/µL, range 83.5-1715.5 cells/µL; p = 0.010). Concerning periprosthetic conditions, patients with wear-induced synovitis exhibited a significantly higher synovial fluid WBC count (median 1093 cells/µL, range 587-1683 cells/µL; p < 0.001). Among all the reasons for failure, periprosthetic fractures had the greatest percentage of WBC counts surpassing 3000 cells/µL (18.1% [2 of 11]; p = 0.006).
conclusionOur study has uncovered significant variations in WBC count during aseptic revision TKA when utilizing automated cell counting. Therefore, to optimize diagnostic accuracy in synovial aspiration during aseptic revision TKA, it is advisable to employ a combination of WBC count and PMN%, along with manual counting techniques or AD, depending on the specific clinical scenario. LEVEL OF EVIDENCE: III.
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