PERİPROSTETİK EKLEM ENFEKSİYONUNDA TANIYA YARDIMCI İNTRAOPERATİF TESTLER

Emin Süha Dedeoğulları1
Güngör Alibakan2

1Esenyurt Necmi Kadıoğlu Devlet Hastanesi, Ortopedi ve Travmatoloji Kliniği, İstanbul, Türkiye
2Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, İstanbul, Türkiye

Dedeoğulları ES, Alibakan G. Periprostetik Eklem Enfeksiyonunda Tanıya Yardımcı İntraoperatif Testler. Karaaslan F. editör. Periprostetik Eklem Enfeksiyonunda Tanı ve Tedavi. 1. Baskı. Ankara: Türkiye Klinikleri; 2024. p.55-63.

ÖZET

Periprostetik eklem enfeksiyonunda (PEE) tanı koymak ve etken patojeni belirlemek, tedavi başarısında kritik rol oynar. Her zaman pre-operatif olarak kesin tanı koymak mümkün olmadığından, intraoperatif testler önem kazanmaktadır. Bu yazıda, PEE tanısında kullanılabilecek intraoperatif testler gözden geçirilmiştir. Frozen ince- leme tanıyı doğrulamada faydalı olabilir. Lökosit esteraz testi, sinoviyal sıvıda lökosit yoğunluğunu ölçerek en- feksiyonu tespit etmede yüksek özgüllüğe sahiptir. Alfa-defensin testi, sinoviyal sıvıda bakteriyel enfeksiyonlara özgü bir belirteç olup, son yıllarda giderek popülarite kazanmıştır. Intraoperatif kültürler, enfeksiyonun kesin ta- nısı için önemlidir ve sonikasyon yöntemi kültür verimliliğini artırabilir. Moleküler yöntemler, özellikle PCR ve yeni nesil dizileme, enfeksiyöz ajanların tespitinde yüksek doğruluk sağlar ancak yüksek maliyet ve aşırı duyar- lılık gibi sınırlamaları bulunmaktadır. Her yöntemin avantajları ve sınırlamaları göz önünde bulundurulmalıdır.

Anahtar Kelimeler: Periprostetik eklem enfeksiyonu; Tanı; Intraoperatif test; Artroplasti; Kültür

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