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The purpose of this study is to determine whether an undirected synovial biopsy technique has the same accuracy in detecting periprosthetic joint infection in the knee as an arthroscopic assisted directed synovial biopsy technique.
Successful treatment of an infected joint arthroplasty depends on correctly identifying the responsible pathogens. The value of a preoperative biopsy remains controversial. We compared the sensitivity and specificity of two techniques of synovial biopsy of knee joint arthroplasties suspicious for infection and asked whether the results correlate with intraoperative findings at revision.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| undirected and directed biopsy | Experimental | Via an antero-lateral incision of the knee samples are taken without visual control; Afterwards an arthroscope is inserted and samples are taken from 5 defined regions of the knee (suprapatellar pouch, medial and lateral gutter, notch, Hoffa's fat pad) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| synovial biopsy of total knee arthroplasty | Procedure | synovial biopsies are taken via two different techniques in the same patient to allow direct comparison of results |
|
| Measure | Description | Time Frame |
|---|---|---|
| Correlation of microbiological and histological results of undirected and directed synovial biopsies | 5 microbiological samples and 1 histological sample are taken form the knee undirected via an antero-lateral approach. Afterwards the same sample numbers are taken under arthroscopic view. Correlation of results between those two methods are investigated. If infection is detected two-stage exchange of prosthesis is performed. At this surgery samples from synovia and the implant-bone interface are again taken and again investigated for correlation. | within the first 14 days after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Correlation of microbiological results from synovial biopsy with intraoperative findings at revision | within the first 14 days after surgery |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Norbert Harrasser, Dr. | Contact | 00498941405229 | norbert.harrasser@gmx.net | |
| Ingo Banke, Dr. | Contact | 00408941405284 | ingo@banke.eu |
| Name | Affiliation | Role |
|---|---|---|
| Ruediger Eisenhart-Rothe, Prof. | Klinikum rechts der Isar, TU Munich | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Klinikum rechts der Isar | Recruiting | Munich | Bavaria | 81675 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31658475 | Derived | Scheele C, Krauel I, Pohlig F, Muehlhofer H, Gerdesmeyer L, Lasic I, Prodinger PM, Banke I, von Eisenhart-Rothe R, Harrasser N. Guided and Unguided Biopsy in the Diagnostic of Periprosthetic Infections of the Knee - Evaluation of an Evidence-based Algorithm. Z Orthop Unfall. 2019 Dec;157(6):684-694. doi: 10.1055/a-1034-0923. Epub 2019 Oct 28. English, German. |
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| ID | Term |
|---|---|
| D007239 | Infections |
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