Table 2.

Performance characteristics of intraoperative Gram Stains for the detection of periprosthetic infection as reported in the literature

Author	Year	Reference method	Specimen*	Gram stain		Culture		Number of patients	Number of infections	Infected arthroplasties
				Sensitivity (%)	Specificity (%)	Sensitivity (%)	Specificity (%)			Hips	Knees
Chimento et al. [6]	1996	Culture and/or histopathology	Tissue	0	0	NG†	NG†	169	32	11	21
Barrack et al. [3]	1997	Culture and/or histopathology	Preoperative synovial fluid	10	100	55	96	67	20	–	20
Atkins et al. [1]	1998	Histopathology	Tissue	12	98	65	99.6	297	41	NG†	NG†
Kraemer et al. [14]	1998	Culture	Tissue	23	100	N/A	N/A	55	3	3	–
Della Valle et al. [7]	1999	Composite findings	Tissue	14.7	98.8	NG†	NG†	413	68	260	153
Spangehl et al. [19]	1999	Composite findings	Tissue	19	98	96	97	178	35	35	–
Banit et al. [2]	2002	Culture	Tissue	43	100	N/A	N/A	121	21‡	11	9
Ko et al. [12]	2005	Culture	Tissue	0	0	N/A	N/A	40	9	8	1
Parvizi et al. [17]	2006	Composite findings	Synovial fluid Tissue	35	97	90	97	70	39	–	39
				22	100	86	100
Morgan et al. [15]	2009	Composite findings	Synovial fluid and tissue	27	99.9	NG†	NG†	921§	247	–	247
Ghanem et al. [9]	2009	Composite findings	Tissue	31	100	92.8	NG†	1004	321	150	171
Oethinger et al. [current study]	2010	Culture	Synovial fluid and tissue
Before intervention				23	92	N/A	N/A	269||	NG	NG†	NG†
After intervention				9	99	N/A	N/A	390||		NG†	NG†

* All specimens were obtained intraoperatively unless noted otherwise; ^†not given; ^‡one case was a shoulder hemiarthroplasty; ^§number of arthroplasties, not patients; ^||number of specimens, not patients; N/A = not applicable.