周围假肢肩关节整形感染的诊断性关节镜检查:一个系统的审查和元分析
Amin Karimi1,2, Pooyan Jalalpour2, Rajiv P Reddy1
1Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, Pittsburgh, PA, USA.
JSES international
|September 18, 2023
概括
诊断肩围假肢关节感染 (PJI) 是一个挑战. 关节镜活检显示出良好的诊断准确性,具有高灵敏度和特异性,为检测肩膀PJI提供了可靠的工具.
科学领域:
- 整形外科手术 整形外科手术
- 传染性疾病 传染性疾病
- 诊断的准确性 诊断的准确性
背景情况:
- 肩膀周围假肢关节感染 (PJI) 是一种严重的并发症,影响1%-15.4%的患者.
- 目前用于肩部PJI的诊断方法,包括血清学测试和关节切口,通常在准确性方面存在局限性.
- 本综述重点是评估关节镜活检作为肩膀PJI的诊断工具.
研究的目的:
- 系统地审查和评估关节镜活检用于诊断肩膀PJI的可靠性和有效性.
- 在现有文献中评估关节镜活检的诊断准确性.
主要方法:
- 通过使用来自MEDLINE,Scopus,Web of Sciences,Google Scholar和Cochrane数据库的数据进行了系统审查和元分析.
- 从创立到2022年6月发表的研究报告了PJI的肩膀关节镜活检的诊断准确性.
- 该审查遵循了系统审查和元分析 (PRISMA) 的首选报告项目指南.
主要成果:
- 分析包括了7项研究,涉及112名患者.
- 关节镜活检的聚合灵敏度为0.87 (95% CI:0.73-0.95) 和聚合特异性为0.79 (95% CI:0.67-0.88).
- 阳性和阴性概率比分别为4.15和0.17,整体诊断几率比为19.92.
结论:
- 关节镜活检对肩膀PJI具有很好的诊断准确性,其特点是高灵敏度和特异性.
- 需要进一步的前性研究来规范活检协议,并确定其在肩膀PJI诊断和管理中的最终作用.
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