Author/Editor		Terčič, Dunja; Trebše, Rihard
Title		Analiza periprotetičnega punktata v diagnostiki okužbe umetnih sklepov
Translated title		Analysis of periprosthetic aspirate in the diagnosis of prosthetic joint infection
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 78, št. Suppl 2
Publication year		2009
Volume		str. II-85-93
Language		slo
Abstract		Background: Complications during the life span of an artifi cial implant in prosthesis joint implant surgery (arthroplasty) are aspetic biomechanical loosening (ABL) and prosthesis joint infection (PJI). Aseptic loosening is the most common cause of prosthetic joint failure, followed by infection. It is important to diff erentiate between these two entities because their management differs. Combination of pre- and peri-operative diagnostic methods is usefull. It is ideal to diagnose or exclude PJI preoperatively to facilitate an appropriate surgical management and initial choice of systemic antimicrobial agents. At this point preoperative examination of a joint aspirate for cell count and differential as well as for microbiological culture is helpfull for diff erentiating a septic from an aseptic process. The cut-off values for leukocyte count and diff erential for diagnosing PJI are established and diff er from those applied for native joints. leukocyte count and diff erential with PMN % (polimorphonuclear leucocyte). Aftter synovial aspiration the sample is drawn into a lavander blood test tube containing K2EDTA solid anticoagulant. The examination in the medical laboratory is completed in 1-2 hours. The gross appearance and a microscopic examination of the sample under 400 x magnifi cation is sought to assess the cells present in the sample. All samples for the cytological examination are first treated with hyaluronidase solution. The leukocytes are counted in the Neubauer's counting chamber using a leukocyte counting solution (2-3% aq.sol gentiana violet in acetic acid). The result is expressed in SI units (in 109/L). The differential count is made from a stained smear according to Pappenheim and minimum 200 cells are diff erentiated. The result is exspressed as a percentage of PMN and other types of white blood cells. Conclusion: Pre- and peri-operative joint aspira Methods: (Abstract truncated at 2000 characters)
Descriptors		JOINT PROSTHESIS PROSTHESIS-RELATED INFECTIONS PUNCTURES SYNOVIAL FLUID LEUKOCYTE COUNT