ArticleEFORT open reviews2019
The role of alpha defensin in prosthetic joint infection (PJI) diagnosis: a literature review.
Article in EFORT open reviews, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04858217 (Diagnostic Accuracy and Cost-effectiveness Analysis of Serum and Synovial Fluid Markers for the Diagnosis of Periprosthetic Hip and Knee Joint Infections), which is not on this map. Cited by 28 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Diagnostic Accuracy and Cost-effectiveness Analysis of Serum and Synovial Fluid Markers for the Diagnosis of Periprosthetic Hip and Knee Joint Infections
Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- Reliable Diagnostic Tests and Thresholds for Preoperative Diagnosis of Non-Inflammatory Arthritis Periprosthetic Joint Infection: A Meta-analysis and Systematic Review.Orthopaedic surgery · 2022Pooled it
- Laboratory testing of extravascular body fluids: National recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine. Part II - Synovial fluid.Biochemia medica · 2020Guideline
- Alpha-Defensin versus Leukocyte Esterase in Periprosthetic Joint Infection: An Updated Meta-Analysis.BioMed research international · 2020Pooled it
- Diagnostic Value of Synovial Fluid Biomarkers for Periprosthetic Joint Infection: A Prospective, Double-blind Trial.Medical science monitor : international medical journal of experimental and clinical research · 2023Trial
- Synovial fluid proteomic biomarkers in periprosthetic joint infection: A systematic review with gene ontology and protein network analyses.Journal of experimental orthopaedics · 2026Review
- A novel host-based strategy for detecting low-grade prosthetic joint infection using immune cell pattern in synovial fluid.Molecular medicine (Cambridge, Mass.) · 2026Article
- Article
- The Application of artificial intelligence in periprosthetic joint infection.Journal of advanced research · 2026Review
- Beyond Cultures: The Evolving Role of Molecular Diagnostics, Synovial Biomarkers and Artificial Intelligence in the Diagnosis of Prosthetic Joint Infections.Journal of clinical medicine · 2025Review
- 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
- The Usefulness of the Alpha-Defensin Lateral Flow Test in the Diagnosis of Prosthetic Infection: A Retrospective Cohort Study.Indian journal of orthopaedics · 2025Article
- Timepoint of aspiration can impact diagnostic of PJI - synovial fluid analyses exhibit a high intraindividual variation in periprosthetic joint infections of the knee.Archives of orthopaedic and trauma surgery · 2025Article
- Article
- Performance of α-Defensins in Diagnosing Nosocomial Ventriculitis.Open forum infectious diseases · 2025Article
- Imaging approach to prosthetic joint infection.Skeletal radiology · 2024Review
- Future directions for early detection of fracture related infections.Journal of orthopaedics · 2024Article
- Article
- Diagnosis of Periprosthetic Joint Infection: The Utility of Biomarkers in 2023.Antibiotics (Basel, Switzerland) · 2023Review
- Use of α-Defensins to Help Diagnose Nosocomial Ventriculitis.Neurocritical care · 2023Article
- Diagnostic Performance of Neutrophil to Lymphocyte Ratio, Monocyte to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, and Platelet to Mean Platelet Volume Ratio in Periprosthetic Hip and Knee Infections: A Systematic Review and Meta-Analysis.Diagnostics (Basel, Switzerland) · 2022Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Prosthetic joint infection (PJI) management is not standardized worldwide and the outcome is frequently unsatisfactory.More and more arthroplasties are now being performed. An increasing number of highly virulent and antibiotic-resistant bacteria and an ageing population of patients presenting with many comorbidities make it necessary to focus on this important topic.Diagnosis of PJI remains challenging because the clinical signs and symptoms and elevation of systemic biomarkers (C-reactive protein, erythrocyte sedimentation rate) may be unclear.In the last few years, the clinical research has focused on synovial fluid biomarkers as a possible breakthrough in the complex scenario of PJI diagnosis.Synovial biomarkers have shown encouraging results and they should be used as diagnostic adjuncts to synovial white cell count and culture bacteriology. Synovial leukocyte esterase (LE) and synovial C-reactive protein (CRP) have been evaluated as good screening measures; however, the most promising synovial fluid biomarker in terms of sensitivity and specificity for PJI seems to be alpha defensin (AD).The laboratory-based alpha defensin enzyme-linked immunosorbent assay (ELISA) test demonstrated the highest ever reported accuracy for PJI diagnosis. However, an alpha defensin lateral flow test could have its place in ruling in a suspected PJI intraoperatively because of its high specificity and rapid results. Cite this article:
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