The analysis of synovial fluid has proved to be of crucial importance in the diagnostic process of prosthetic joint infections (PJI), suggesting the presence of an infection before the microbiological culture results. In this context, several studies illustrated the efficacy of synovial calprotectin in supporting the diagnosis of PJI [1, 2]. However, several testing methods have been explored to detect synovial calprotectin levels, emphasizing the need to use a standardized, rapid and rapid test. In this study, synovial calprotectin was analyzed by means of a commercial stool test [3] to explore whether the detected levels might predict PJIs and, therefore, being a promising tool for the fast and reliable diagnosis of this complication. The synovial fluid of 55 patients underwent to revision of the prosthetic implant were analyzed. The measurement of calprotectin was carried out by of commercial stool test, following the protocol for liquid samples. Calprotectin levels were then compared to other synovial biomarkers of PJI such as leucocyte esterase and count and percentage of polymorphonuclear cells. Data analysis were performed using R software v4.1.1 (R Core Team) and package “pROC” [4]. Receiver operator characteristics curves were designed using culture test as gold standard to evaluate the area under curve (AUC) of each method (with DeLong method for confidence-interval calculation). Thresholds were calculated to maximize Youden's index; sensitivity and specificity were reported. One-to-one Pearson's correlations coefficient were calculated for each pair of methods. P value <0.05 were considered statistically significant.Aim
Method
Total shoulder replacement is a successful treatment for gleno-humeral osteoarthritis. However, components loosening and painful prostheses, related to components wrong positioning, are still a problem for those patients who underwent this kind of surgery. CT-based intraoperative navigation system is a suitable option to improve accuracy and precision of the implants as previously described in literature for others district. Eleven reverse shoulder prostheses were performed at Modena Polyclinic from October 2018 to April 2019 using GPS CT-based intraoperative navigation system (Exactech, Gainsville, Florida). In the preoperative planning, Walch classification was used to assess glenoid type. The choice of inclination of the glenoid component, the screw length, as well as the inclination of the reamer was study and recorded using specific software using the CT scan of shoulder of each patient (Fig.1, Fig.2). Intraoperative and perioperative complications were recorded. Three patients were male, eight were female. Mean age was 72 years old (range 58=84). Three glenoid were type B2, six cases were B1, two case were type C1.Introduction
Method