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Role of frozen section histology in diagnosis of infection during revision arthroplasty

¹ Foothills Hospital, Calgary, Alberta, Canada
² Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, UK

Correspondence to:
Correspondence to:
Dr A D Musso
411-1450 Chestnut St, Vancouver, BC V6J 3k3 Canada; damimusso{at}hotmail.com

The accurate diagnosis of deep infection in total joint arthroplasty is difficult. No single test on its own is entirely reliable. Frozen section histology has been used for the last two decades as an adjunct to diagnose infection with variable results. In this retrospective analysis, experience of the use of frozen section histology as a diagnostic tool in 45 cases of suspected infected total joint arthroplasty is reported.

Taking intraoperative cultures as the "gold standard", the results showed 50% sensitivity, 95% specificity, positive predictive value of 60%, negative predictive value of 92%, and an accuracy of 89%, which is similar to other existing reports in the literature. Based on these findings, the use of frozen section histology in diagnostic work-up of all suspected cases of total joint infection is recommended.

Keywords: arthroplasty; infection; frozen section histology

Abbreviations: ESR, erythrocyte sedimentation rate; PML, polymorphonuclear leucocytes

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