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Table 3 Diagnostic Accuracy for Grouped Parameters in 498 Patients with Aseptic Loosening and Prosthetic Joint Infection (18 early, 35 delayed and 77 late)

From: Accuracy of different diagnostic tests for early, delayed and late prosthetic joint infection

 

AL

PJI

Specificity (%)

Sensitivity (%)

PPV (%)

NPV (%)

ROC area

P-value*

TN/total

TP/total

(95% CI)

(95% CI)

(95% CI)

(95% CI)

(95% CI)

CRP + Synovial fluid culture

 All patients

261/309

91/114

84.5 (79.9–88.3)

79.8 (71.3–86.8)

65.5 (56.9–73.3)

91.9 (88.1–94.8)

0.822 (0.779–0.863)

0.073

 Early

10/13

12/14

76.9 (46.2–95.0)

85.7 (57.2–98.2)

80.0 (51.9–95.7)

83.3 (51.6–97.9)

0.813 (0.660–0.966)

 Delayed

14/17

30/33

82.4 (56.6–96.2)

90.9 (75.7–98.1)

90.9 (75.7–98.1)

82.4 (56.6–96.2)

0.866 (0.760–0.972)

 Late

237/279

49/67

84.9 (80.2–88.9)

73.1 (60.9–83.2)

53.8 (43.1–64.4)

92.9 (89.1–95.8)

0.790 (0.733–0.848)

CRP + Peri-implant tissue culture

 All patients

310/367

110/128

84.5 (80.4–88.0)

85.9 (78.7–91.4)

65.9 (58.1–73.0)

94.5 (91.5–96.7)

0.852 (0.817–0.888)

0.331

 Early

10/13

16/16

76.9 (46.2–95.0)

100 (79.4–100)

84.2 (60.4–96.6)

100 (69.2–100)

0.885 (0.765–1.000)

 Delayed

20/23

32/35

87.0 (66.4–97.2)

91.4 (76.9–98.2)

91.4 (76.9–98.2)

87.0 (66.4–97.2)

0.892 (0.807–0.977)

 Late

280/331

62/77

84.6 (80.2–88.3)

80.5 (69.9–88.7)

54.9 (45.2–64.2)

94.9 (91.8–97.1)

0.826 (0.777–0.874)

CRP + Sonicate fluid culture

 All patients

309/367

119/128

84.2 (80.1–87.8)

93.0 (87.1–96.7)

67.2 (59.8–74.1)

97.2 (94.7–98.7)

0.886 (0.857–0.915)

0.532

 Early

10/13

15/16

76.9 (46.2–95.0)

93.8 (69.8–99.8)

83.3 (58.6–96.4)

90.9 (58.7–99.8)

0.853 (0.719–0.987)

 Delayed

20/23

34/35

87.0 (66.4–97.2)

97.1 (85.1–99.9)

91.9 (78.1–98.3)

95.2 (76.2–99.9)

0.921 (0.845–0.996)

 Late

279/331

70/77

84.3 (79.9–88.0)

90.9 (82.2–96.3)

57.4 (48.1–66.3)

97.6 (95.0–99.0)

0.876 (0.838–0.914)

Histology + Peri-implant tissue culture

 All patients

367/368

123/128

99.7 (98.5–100)

96.1 (91.1–98.7)

99.2 (95.6–100)

98.7 (96.9–99.6)

0.979 (0.962–0.996)

0.061

 Early

13/13

18/18

100 (75.3–100)

100 (81.5–100)

100 (81.5–100)

100 (75.3–100)

1.000 (1.000–1.000)

 Delayed

24/24

32/33

100 (85.8–100)

97.0 (84.2–99.9)

100 (89.1–100)

96.0 (79.6–99.9)

0.985 (0.955–1.000)

 Late

330/331

73/77

99.7 (98.3–100)

94.8 (87.2–98.6)

98.6 (92.7–100)

98.8 (97.0–99.7)

0.973 (0.947–0.998)

Histology + Sonicate fluid culture

 All patients

366/368

128/128

99.5 (98.1–99.9)

100 (97.2–100)

98.5 (94.3–99.8)

100 (99.0–100)

0.997 (0.993–1.000)

0.37

 Early

13/13

18/18

100 (75.3–100)

100 (81.5–100)

100 (81.5–100)

100 (75.3–100)

1.000 (1.000–1.000)

 Delayed

23/24

33/34

95.8 (78.9–99.9)

100 (89.4–100)

97.1 (84.7–99.9)

100 (85.2–100)

0.978 (0.938–1.000)

 Late

330/331

77/77

99.7 (98.3–100)

100 (95.3–100)

98.7 (93.1–100)

100 (98.9–100)

0.999 (0.996–1.000)

Peri-implant tissue culture + Sonicate fluid culture

 All patients

365/368

111/130

99.2 (97.6–99.8)

85.4 (78.1–91.0)

97.4 (92.5–99.5)

95.1 (92.4–97.0)

0.923 (0.892–0.954)

0.32

 Early

13/13

16/18

100 (75.3–100)

88.9 (65.3–98.6)

100 (79.4–100)

86.7 (59.5–98.4)

0.945 (0.870–1.000)

 Delayed

23/24

33/34

95.8 (78.9–99.9)

94.3 (80.8–99.3)

97.1 (84.7–99.9)

92.0 (74.0–99.0)

0.951 (0.894–1.000)

 Late

329/331

62/77

99.4 (97.8–99.9)

80.5 (69.9–88.7)

96.9 (96.2–99.6)

95.6 (92.9–97.5)

0.900 (0.855–0.944)

  1. AL aseptic loosening, PJI prosthetic joint infection, TN true negative, TP true positive, CI confidence interval, PPV positive predictive value, NPV negative predictive value, CRP C-reactive protein
  2. *Two sided P-value Test of equality of independent ROC areas in the three groups of patients with PJI: early, delayed and late