{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T18:15:37Z","timestamp":1783016137900,"version":"3.54.6"},"reference-count":41,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82001458"],"award-info":[{"award-number":["82001458"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Periprosthetic joint infection (PJI) remains a devastating complication of joint arthroplasty. Although intraoperative frozen section histology (&gt;\u20095 neutrophils\/HPF) is incorporated into the 2018 MSIS diagnostic criteria, its prognostic value for predicting postoperative PJI remains controversial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Primary or revision THA\/TKA procedures in our hospital between January 1, 2015 and December 31, 2021 with intraoperative frozen section histologic results were eligible for inclusion. Association between intraoperative frozen section histology and postoperative PJI was investigated based on the medical records, and a similar analysis of C\u2010reactive protein (CRP) and erythrocyte sedimentation rate (ESR) was also performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 14,969 knee\/hip procedures were identified. After case selection, 797 cases comprising 529 (66.4%) primary and 268 (33.6%) revision were included. According to our data, frozen section positivity showed no PJI association, both in primary (OR, 1.206 [95% CI, 0.133\u201310.914],\n                      <jats:italic>P<\/jats:italic>\n                      &gt;\u20090.999) and revision procedures (OR, 1.287 [95% CI, 0.331\u20135.007],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.717). Conversely, elevated CRP (OR, 15.196 [95% CI, 1.916\u2013120.523],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) and ESR (OR, 5.794 [95% CI, 1.4979\u201322.4129],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008) predicted PJI exclusively in revisions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Therefore, isolated positive frozen section results should not be the sole basis for surgical strategy. Elevated\n                      <jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>\n                      \/\n                      <jats:styled-content style=\"fixed-case\">ESR<\/jats:styled-content>\n                      levels during revision surgery warrant heightened vigilance and consideration of extended anti\u2010infective treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70346","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T06:24:53Z","timestamp":1779171893000},"page":"1342-1349","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Is It Safe to Implant Prosthesis When Frozen Section Reports Positive During Joint Arthroplasty? A Retrospective Cohort Study"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1605-8093","authenticated-orcid":false,"given":"Chiyuan","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Orthopedics Surgery The Second Affiliated Hospital, Zhejiang University School of Medicine  Zhejiang Province Hangzhou China"},{"name":"Orthopedics Research Institute of Zhejiang University  Zhejiang Province Hangzhou China"},{"name":"Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province  Zhejiang Province Hangzhou China"},{"name":"State Key Laboratory of Transvascular Implantation Devices  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pingan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Surgery The Second Affiliated Hospital, Zhejiang University School of Medicine  Zhejiang Province Hangzhou China"},{"name":"Orthopedics Research Institute of Zhejiang University  Zhejiang Province Hangzhou China"},{"name":"Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province  Zhejiang Province Hangzhou China"},{"name":"State Key Laboratory of Transvascular Implantation Devices  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingyun","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology The 1st Affiliated Hospital, Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jieli","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Surgery The Second Affiliated Hospital, Zhejiang University School of Medicine  Zhejiang Province Hangzhou China"},{"name":"Orthopedics Research Institute of Zhejiang University  Zhejiang Province Hangzhou China"},{"name":"Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province  Zhejiang Province Hangzhou China"},{"name":"State Key Laboratory of Transvascular Implantation Devices  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxuan","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Surgery The Second Affiliated Hospital, Zhejiang University School of Medicine  Zhejiang Province Hangzhou China"},{"name":"Orthopedics Research Institute of Zhejiang University  Zhejiang Province Hangzhou China"},{"name":"Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province  Zhejiang Province Hangzhou China"},{"name":"State Key Laboratory of Transvascular Implantation Devices  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengfei","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Surgery The Second Affiliated Hospital, Zhejiang University School of Medicine  Zhejiang Province Hangzhou China"},{"name":"Orthopedics Research Institute of Zhejiang University  Zhejiang Province Hangzhou China"},{"name":"Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province  Zhejiang Province Hangzhou China"},{"name":"State Key Laboratory of Transvascular Implantation Devices  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2561-6069","authenticated-orcid":false,"given":"Lidong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Surgery The Second Affiliated Hospital, Zhejiang University School of Medicine  Zhejiang Province Hangzhou China"},{"name":"Orthopedics Research Institute of Zhejiang University  Zhejiang Province Hangzhou China"},{"name":"Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province  Zhejiang Province Hangzhou China"},{"name":"State Key Laboratory of Transvascular Implantation Devices  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haobo","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Surgery The Second Affiliated Hospital, Zhejiang University School of Medicine  Zhejiang Province Hangzhou China"},{"name":"Orthopedics Research Institute of Zhejiang University  Zhejiang Province Hangzhou China"},{"name":"Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province  Zhejiang Province Hangzhou China"},{"name":"State Key Laboratory of Transvascular Implantation Devices  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30345-1"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2007.10.017"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2020.05.031"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199610000-00017"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-009495"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2024.07.034"},{"issue":"8","key":"e_1_2_11_8_1","first-page":"1076","article-title":"The Epidemiology of Revision Total Knee and Hip Arthroplasty in England and Wales: A Comparative Analysis With Projections for the United States. A Study Using the National Joint Registry Dataset","volume":"97","author":"Patel A.","year":"2015","journal-title":"Bone & Joint Journal"},{"issue":"3","key":"e_1_2_11_9_1","first-page":"20","article-title":"Comparison of the Norwegian Knee Arthroplasty Register and a United States Arthroplasty Registry","volume":"93","author":"Paxton E. W.","year":"2011","journal-title":"Journal of Bone and Joint Surgery. American Volume"},{"issue":"8","key":"e_1_2_11_10_1","first-page":"802","article-title":"Periprosthetic Joint Infection of the Hip","volume":"106","author":"Kennedy J. W.","year":"2024","journal-title":"Bone & Joint Journal"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0150866"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.2147\/TCRM.S175854"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.31729\/jnma.231"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2007.05176.x"},{"issue":"6","key":"e_1_2_11_15_1","first-page":"1232","article-title":"Usefulness of Histological Analysis for Predicting the Presence of Microorganisms at the Time of Reimplantation After Hip Resection Arthroplasty for the Treatment of Infection","volume":"89","author":"Bori G.","year":"2007","journal-title":"Journal of Bone and Joint Surgery. American Volume"},{"issue":"5","key":"e_1_2_11_16_1","first-page":"684","article-title":"Analysis of Frozen Sections of Intraoperative Specimens Obtained at the Time of Reoperation After Hip or Knee Resection Arthroplasty for the Treatment of Infection","volume":"81","author":"Della Valle C. J.","year":"1999","journal-title":"Journal of Bone and Joint Surgery. 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