ArticleInternational orthopaedics2014
Excluding infections in arthroplasty using leucocyte esterase test.
Article in International orthopaedics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 4 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 4 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Diagnostic accuracy of the leukocyte esterase test for native joint septic arthritis and prosthetic joint infections: a systematic review and meta-analysis.Advances in rheumatology (London, England) · 2026Pooled it
- Alpha-Defensin versus Leukocyte Esterase in Periprosthetic Joint Infection: An Updated Meta-Analysis.BioMed research international · 2020Pooled it
- Reliability of synovial fluid alpha-defensin and leukocyte esterase in diagnosing periprosthetic joint infection (PJI): a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2019Pooled it
- A meta-analysis of synovial biomarkers in periprosthetic joint infection: Synovasure™ is less effective than the ELISA-based alpha-defensin test.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2018Pooled it
- What is the best cutoff point of leukocyte esterase for diagnosis of periprosthetic joint infections? a systematic review and meta-analysis.Arthroplasty (London, England) · 2025Review
- Current relevance of biomarkers in diagnosis of periprosthetic joint infection: an update.Arthroplasty (London, England) · 2023Review
- Diagnostic Accuracy for Periprosthetic Joint Infection Does Not Improve by a Combined Use of Glucose and Leukocyte Esterase Strip Reading as Diagnostic Parameters.Journal of clinical medicine · 2022Article
- The management of infected shoulder arthroplasty by two-stage revision.Shoulder & elbow · 2020Article
- Improved diagnostic accuracy with the classification tree method for diagnosing low-grade periprosthetic joint infections by quantitative measurement of synovial fluid alpha-defensin and C-reactive protein.International orthopaedics · 2020Article
- What Is the Diagnostic Accuracy of Alpha-Defensin and Leukocyte Esterase Test in Periprosthetic Shoulder Infection?Clinical orthopaedics and related research · 2019Article
- Comparison of Leukocyte Esterase Testing of Synovial Fluid with Synovial Histology for the Diagnosis of Periprosthetic Joint Infection.Medical science monitor : international medical journal of experimental and clinical research · 2017Article
- [Tibial pilon fractures : Advoidance and therapy of complications].Der Unfallchirurg · 2017Review
- Are There Benefits In Early Diagnosis Of Prosthetic Joint Infection With Multiplex Polymerase Chain Reaction?Journal of bone and joint infection · 2017Article
- Investigation of neutrophilic peptides in periprosthetic tissue by matrix-assisted laser desorption ionisation time-of-flight imaging mass spectrometry.International orthopaedics · 2015Article
- Synovial Alpha-defensin at Reimplantation in Two-stage Revision Arthroplasty to Rule Out Persistent Infection.In vivo (Athens, Greece)Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePeriprosthetic joint infections remain a major challenge for the surgeon in modern arthroplasty. The decision on how to handle a case is often difficult due to the variety of clinical presentations. The aim of this study was to establish the leucocyte esterase test as an intra-operative rapid diagnostic tool in an unclear infected or aseptic situation.
methodsIn the setting of 364 endoprosthetic joint procedures on knee, hip and shoulder, we aspirated synovial fluid before performing capsulotomy. We performed a leucocyte esterase test. The results were correlated with the pre-operative synovial fluid aspirations, the laboratory blood sample parameters (C-reactive protein, white blood cells) and the intra-operative histopathological and microbiological findings.
resultsThe leucocyte esterase test has a sensitivity of 100% and a specificity of 96.5%. The positive predictive value was 82% and the negative predictive value was 100%. Correlation with conventional methods such as serum C-reactive protein and serum white blood cells is given. The histopathological evaluation confirmed the microbiological results in all but three cases.
conclusionsBased on our results and the current literature, we recommend the leucocyte esterase test as a useful tool in the diagnosis of periprosthetic joint infection.
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