Determining "True" leukocytosis in bloody joint aspiration


Ghanem E., Houssock C., Pulido L., Han S., Jaberi F. M., Parvizi J.

JOURNAL OF ARTHROPLASTY, cilt.23, sa.2, ss.182-187, 2008 (SCI-Expanded) identifier identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 23 Sayı: 2
  • Basım Tarihi: 2008
  • Doi Numarası: 10.1016/j.arth.2007.08.016
  • Dergi Adı: JOURNAL OF ARTHROPLASTY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.182-187
  • Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Hayır

Özet

This study intends to determine the diagnostic value of implementing a corrective formula that can adjust for serum leukocytes in bloody joint fluid. Our cohort included 91 infected and 37 aseptic total knee arthroplasties. Joint fluid leukocyte count (>1760/mu L) and neutrophil percentage (>73%) were the cutoff values for deep infection. The adjusted fluid leukocyte counts were calculated using the following simple formula: WBCadjusted = WBCobserved - [(WBCblood x RBCfluid/RBCblood)](predicted). Adjusted fluid cell counts of only 5 infected patients dropped below the cutoff value, whereas the remaining 86 maintained a high cell count. Ten noninfected patients had false-positive cell counts, 6 of which were successfully corrected to levels below the designated thresholds. The aspirates that were corrected had a greater number of introduced white blood cells. This study suggests that our corrective formula can detect false-positive joint aspirations without jeopardizing the diagnosis of periprosthetic infection.