Icmd meeting1/14/2024 Further validation studies considering the acknowledged limitations are recommended. The cutoff level seems to be different between the hip and knee. The modified scoring system proposed by the 2018 International Consensus Meeting in diagnosing PJI showed high sensitivity and a good performance, especially as rule-out diagnostic criteria. Diagnostic performance was better for the hip (AUC = 0.92 ACC = 0.90 sensitivity = 0.96 specificity = 0.86 PPV = 0.81 NPV = 0.98) than the knee (AUC = 0.89 ACC = 0.85 sensitivity = 0.95 specificity = 0.83 PPV = 0.59 NPV = 0.98). A cutoff score of ≥6 points had the following diagnostic performance: area under the curve (AUC) = 0.90 ACC = 0.88 sensitivity = 0.96 specificity = 0.84 PPV = 0.70 NPV = 0.98. Sensitivity, specificity, mean accuracy (ACC), positive predictive value (PPV), and negative predictive value (NPV) were analyzed.Ī total of 345 cases were included. Using the new minor criteria, a score of ≥6 reflects PJI, while a score <3 can be considered as noninfected. Cases with at least 1 major criterion were considered as infected. Serum C-reactive protein, synovial white blood cell count and polymorphonuclear percentage, leukocyte esterase test, alpha-defensin, microbiological and histologic results, and documented existence of sinus tract and intraoperative purulence were available for all patients. We retrospectively reviewed patients who underwent a revision total hip or knee arthroplasty at our institution from May 2015 to August 2018. We aimed to validate the modified scoring system at a high-volume center. The new system combines preoperative and intraoperative findings, reportedly achieving high sensitivity and specificity. Recently, a revised definition of the minor criteria scoring system for diagnosing periprosthetic joint infection (PJI) was developed by the second International Consensus Meeting on musculoskeletal infection.
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