Utility of Intraoperative Frozen Section Histopathology in the Diagnosis of Periprosthetic Joint Infection

by Geoffrey Tsaras, Awele Maduka-Ezeh, Carrie Y. Inwards, Tad Mabry, Patricia J. Erwin, M. Hassan Murad, Victor M. Montori, Colin P. West, Douglas R. Osmon, and

Elie F. Berbari

J Bone Joint Surg AmVolume 94(18):1700-1711

September 19, 2012

©2012 by The Journal of Bone and Joint Surgery, Inc.

Flow chart illustrating study selection.

Geoffrey Tsaras et al. J Bone Joint Surg Am 2012;94:1700-1711

©2012 by The Journal of Bone and Joint Surgery, Inc.

Forest plot of the diagnostic odds ratio (OR) of frozen section histopathology for the diagnosis of periprosthetic joint infection.

Geoffrey Tsaras et al. J Bone Joint Surg Am 2012;94:1700-1711

©2012 by The Journal of Bone and Joint Surgery, Inc.

Forest plot of the likelihood ratio (LR) of a positive frozen section result for the diagnosis of periprosthetic joint infection.

Geoffrey Tsaras et al. J Bone Joint Surg Am 2012;94:1700-1711

©2012 by The Journal of Bone and Joint Surgery, Inc.

Forest plot of the likelihood ratio (LR) of a negative frozen section result for the exclusion of periprosthetic joint infection.

Geoffrey Tsaras et al. J Bone Joint Surg Am 2012;94:1700-1711

©2012 by The Journal of Bone and Joint Surgery, Inc.

Forest plot of the likelihood ratio (LR) of a positive frozen section result using a threshold of 5 polymorphonuclear leukocytes per high-power field for the diagnosis of periprosthetic joint

infection.

Geoffrey Tsaras et al. J Bone Joint Surg Am 2012;94:1700-1711

©2012 by The Journal of Bone and Joint Surgery, Inc.

Forest plot of the likelihood ratio (LR) of a negative frozen section result using a threshold of 5 polymorphonuclear leukocytes per high-power field for the exclusion of periprosthetic joint

infection.

Geoffrey Tsaras et al. J Bone Joint Surg Am 2012;94:1700-1711

©2012 by The Journal of Bone and Joint Surgery, Inc.

Fagan nomogram for calculating the post-test probability of periprosthetic joint infection.

Geoffrey Tsaras et al. J Bone Joint Surg Am 2012;94:1700-1711

©2012 by The Journal of Bone and Joint Surgery, Inc.