Value of “true” leukocytosis formula in determining total knee arthroplasty prosthetic joint infection in the community hospital setting

Table 1 Preoperative international consensus meeting criteria scoring system

	Cut off	Score1
Serum CRP	> 1 mg/dL	2
Serum D-dimer	> 860 ng/mL	2
Serum ESR	> 30 mm/hour	1
WBC (synovial)	> 3000 cells/μL	3
Alpha-defensin (synovial)	Qualitative	3
Leukocyte esterase (synovial)	Qualitative	3
Neutrophil (synovial, %)	> 80%	2
CRP (synovial)	> 6.9 mg/L	1

¹Adapted from Parvizi et al[11].

CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate; WBC: White blood cell.

Table 2 Patient demographics (n = 81), n (%)

Characteristic	Value
Age (mean ± SD, range)	68.3 ± 9.1, 52-88
Gender
Male	46 (56.79)
Female	35 (43.21)
BMI (mean ± SD, range)	35.3 ± 8.5, 19.2-61.9
10-year survival (mean ± SD, range, %)	65.4 ± 17.0, 0-95.9
Comorbid conditions
DM	21 (25.93)
HLD	34 (41.98)
HTN	64 (79.01)
Obesity (BMI > 35)	38 (46.91)
AFIB	9 (11.11)
CKD	12 (14.81)
Smoking	3 (3.70)
Anxiety/depression	40 (49.38)
Sleep apnea	25 (30.86)

BMI: Body mass index; DM: Diabetes mellitus; HLD: Hyperlipidemia; HTN: Hypertension; AFIB: Atrial fibrillation; CKD: Chronic kidney disease.

Table 3 Average results from fluid analysis

	Average	Range
RBC serum cells (× 106)	4.02	2.1-5.1
RBC synovial	183761	4843-4063600
WBC serum cells (× 103)	10.9	6.3-31.7
TNC synovial	66076.5	117-494920
Polymorphonuclear cells (%)	87.37407407	74-100
C-reactive protein serum	16	0.6-33.9
Erythrocyte sedimentation rate (mm/hour)	60.5	6.8-140

RBC: Red blood cell; WBC: White blood cell; TNC: Total nucleated cell.

Table 4 Species of bacteria isolated on intra-operative cultures

Bacterium isolated	Number of patients	Percent of patients
MRSA	14	17.3
Methicillin sensitive staphylococcus aureus	21	25.9
Coagulase negative Staphylococcu spp.	7	8.6
Enterobacter spp.	4	4.9
Pseudomonas spp.	3	3.7
Proteus spp.	1	1.2
Corynebacterium spp.	3	3.7
Enterococcus Faecelis	8	9.9
Bacteroides spp.	1	1.2
Group A streptococcus spp.	5	6.2
Peptostreptococcus spp.	1	1.2
Group B hemolytic streptocossu	5	6.2
Escherichia coli	2	2.5
Mycobacterium spp.	1	1.2
Propionibacterium acnes	1	1.2
Serratia spp.	1	1.2
Bacillus spp.	3	3.7

MRSA: Methicillin-resistant staphylococcus aureus.