Özet:

The context of a constant increase of the number of primary and revision total joint arthroplasty performed each year is associated with the increased risk of complication that is expected (both prosthetic joint infection and aseptic loosening). Having in mind this fact, the Academic Emergency Hospital Sibiu, Romania adopted and implemented, with the beginning of September 2016, a new strategy for the diagnosis of prosthetic joint infections, strategy that uses sonication fluid cultures and different synovial fluid biomarkers. The aim of this study was to evaluate the role of cellular count of the synovial fluid, leucocyte esterase, and C-reactive protein in synovial. The sensitivity and the specificity of the synovial fluid leukocyte count, % of neutrophils in the synovial fluid, synovial leucocyte esterase and synovial C-reactive protein were 73.33%/100%, 80%/85.71%, 80%/93.33%, 100%/86.66% respectively. In conclusion, bacteria culture of SF remains the gold standard (with a sensitivity and a specificity of 100%). Leucocyte esterase, synovial fluid leukocyte count, the % of neutrophils in the synovial fluid, and the synovial C-reactive protein represent a useful tool for rapid diagnosis of prosthetic joint infections. A diagnosis that remains a difficult one.

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