Publication details
Diagnostika periprotetického infektu
| Title in English | THE DIAGNOSTICS OF PERIPROSTHETIC INFECTION |
|---|---|
| Authors | |
| Year of publication | 2010 |
| Type | Article in Periodical |
| Magazine / Source | Ortopedie |
| MU Faculty or unit | |
| Citation | |
| Field | Traumatology and orthopaedic surgery |
| Keywords | infection of endoprosthesis; laboratory tests; imaging methods; microbiological methods; nonculture methods; subjective evaluation |
| Description | Infection is the most serious complication of endoprosthetics. Rapid and exact diagnostics is the fundamental presumption for successful infection therapy. Difficulties could occur especially in case of mitigated infections where bacteria survive in biofilm formation with a minimal response of the host organism. Authors provide a survey of diagnostic methods used in endoprosthetic infections. Patient’s history and physical examination is the basis for endoprosthetic infection diagnostics. Laboratory techniques are used as a standard method in endoprosthetic infection diagnostics. Their sensitivity is good but specificity is insufficient. Imaging methods show considerable inaccuracy in differential diagnostics of septic and aseptic loosening of endoprosthesis; scintigraphy with labeled leukocytes, antibodies or their combinations is an exception but those methods are laborious and rather expensive. Microbiological methods are also used in diagnostics of endoprosthetic infection. Their accuracy increases with the use of sonication and extensive biomaterial cultivation. Nonculture methods have been developed in last decades. High sensitivity and velocity is their significant advantage. High costs and a possibility of false positive results is a disadvantage of this method. Imunofluorescence microscopy with a minimal risk of false positive result is relatively easy and promising method. The authors also mention the subjective opinion of the surgeon which is indispensable. At the conclusion the authors underline that a simple, fast and accurate diagnostic method leading to exact evaluation of endoprosthetic infection does not exist, complex assessment is always necessary. |