Table 3.
Comparison of the literature regarding serum white blood cell count (WBC), percentage of neutrophils (%N), neutrophils to lymphocytes ratio (NLR), and platelet count to mean platelet volume ratio (PC/mPV) in the diagnosis of periprosthetic joint infection.
| Infection Definition | Cut-Off (×109 Cells/L) | Sensitivity | Specificity | |
|---|---|---|---|---|
| Nilsdotter-Augustinsson et al. ActaOrtho 2007 [10] | Positive cultures together with the clinical evaluations by orthopedic surgeons | 10 | 92% | 60% |
| Bottner et al., JBJS Br, 2007 [11] | Based on findings of intraoperative culture and histology | 6.2 | 70% | 60% |
| Toossi et al., JoA, 2012 [35] | ≥1 of the following criteria: (1) positive culture, (2) Intraoperative purulence, (3) draining sinus tract. Or3 of the following 4: (a) ESR ≥ 30 mm/h, (b) CRP ≥ 10 mg/L, (c) Synovial WCC ≥ 1760 cells/µL (chronic) or ≥10,700 cells/µL, (d) percentage of neutrophils ≥ 73% (chronic) or 89% (acute). | 7.8 | 55% | 66% |
| Glehr et al., CORR, 2013 [13] | MSIS 2011 | 5.48 | 91% | 34% |
| Elgeidi et al., Int Orthop, 2014 [15] | ≥1 of the following criteria: (1) visible pus surrounding prosthesis, (2) sinus tract communicating to implant, (3) growth of bacteria on culture (≥2 intraoperative cultures or growth of a virulent organism in a single specimen) | 9.2 | 91% | 76% |
| Randau et al., Plos One, 2014 [16] | ≥1 of the following criteria: (1) purulent synovial fluid or ≥1700 leukocytes/µL or ≥65% neutrophils in the joint aspirate (TKA) (≥3600 leukocytes/µL or ≥80% neutrophils (THA)), (2) histological confirmation of PJI, (3) pathogen detection in sterile joint aspiration or in at least two intraoperative tissue specimen, or (4) definitive signs of PJI clinically or intraoperatively (e.g., sinus tract) | 10.3 | 21% | 94% |
| Yuan et al., Surgical Infection, 2015 [17] | ≥1 of the following criteria: (1) ≥1 positive tissue culture, (2) pus surrounding the prosthesis, or (3) positive histopathology | 10.5 | 64% | 54% |
| Klim et al., Sci Rep, 2018 [20] | MSIS 2011 | 5.68 | 90% | 39% |
| Yu et al., BMC Musculoskeletal Disorders, 2020 [23] | MSIS 2011 | 8.91 | 35% | 94% |
| Klim et al., Int Orthop, 2020 [25] | MSIS 2011 | 8.17 | 42% | 92% |
| Yang et al., Sci Rep, 2021 [29] | ICM 2018 | 7.4 | 79% | 49% |
| Sigmund et al., Int Orthop, 2021 [2] | EBJIS | 10 | 36% | 89% |
| %N | Cut-Off | |||
| Toossi et al., JoA, 2012 [35] | ≥1 of the following criteria: (1) positive culture, (2) Intraoperative purulence, (3) draining sinus tract. Or3 of the following 4: (a) ESR ≥ 30 mm/h, (b) CRP ≥ 10 mg/L, (c) Synovial WCC ≥ 1760 cells/µL (chronic) or ≥10,700 cells/µL, (d) percentage of neutrophils ≥ 73% (chronic) or 89% (acute). | 68% | 52% | 75% |
| Sigmund et al., Int Orthop, 2021 [2] | EBJIS | 69% | 66% | 67% |
| NLR | Cut-Off | |||
| Yu et al., BMC Musculoskeletal Disorders, 2020 [23] | MSIS 2011 | 2.13 | 85% | 68% |
| Sigmund et al., Int Orthop, 2021 [2] | EBJIS | 3.82 | 63% | 73% |
| PC/mPV | Cut-Off | |||
| Paziuk et al., JoA, 2020 [42] | MSIS (year not mentioned) | 31.7 | 48% | 81% |
| Huang et al., Orthopaedic Surgery, 2021 [28] | MSIS 2014 | 31.7 | 55% | 81% |
| Sigmund et al., Int Orthop, 2021 [2] | EBJIS | 29.4 | 43% | 81% |