ArticleJournal of clinical orthopaedics and trauma2020
Loosening of total knee arthroplasty - always aseptic?
Article in Journal of clinical orthopaedics and trauma, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Prevalence, interpretation, and management of unexpected positive cultures in revision TKA: a systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Pooled it
- Reliability of circulating fibrinogen in the diagnosis of prosthesis-related infections: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2021Pooled it
- Multiscale Hybrid Surface Topographies Orchestrate Immune Regulation, Antibacterial Defense, and Tissue Regeneration.Advanced healthcare materials · 2026Article
- Thermal Effects of Burr and Saw Cutting Tools in Total Knee Arthroplasty.Advances in orthopedics · 2026Article
- Differential synovial fluid white blood cell count for the diagnosis of chronic peri-prosthetic joint infection - a systematic review and meta-analysis.Journal of bone and joint infection · 2025Article
- Diagnosis of periprosthetic loosening of total hip and knee arthroplasty usingArchives of orthopaedic and trauma surgery · 2024Article
- Does Robotic Assistance Help with Bone Preservation in Total Knee Replacement?Indian journal of orthopaedics · 2024Article
- Passive Biotelemetric Detection of Tibial Debonding in Wireless Battery-Free Smart Knee Implants.Sensors (Basel, Switzerland) · 2024Article
- Survivability of Titanium Implant Materials: In Vitro Simulated Inflammatory and Infectious Environment.Annals of biomedical engineering · 2023Article
- Highly cross-linked polyethylene versus conventional polyethylene in primary total knee arthroplasty: comparable clinical and radiological results at a 10-year follow-up.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Applications of artificial intelligence in orthopaedic surgery.Frontiers in medical technology · 2022Review
- The Antibacterial Activity Comparison between Novel Carbon-Based Nanofilm Coated Titanium Alloy and Co-Cr-Mo Alloy.Evidence-based complementary and alternative medicine : eCAM · 2022Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWhen revision surgery is needed in total knee arthroplasty (TKA) the most frequent reasons are aseptic loosening (AL) and periprosthetic joint infection (PJI). However preoperative distinction between AL and PJI remains challenging. Aim of this study is to determine the incidence of PJI in patients with suspected AL after TKA and to evaluate a diagnostic algorithm for reliable differential diagnosis.
methodsIn this study a total of 149 symptomatic patients with radiographic signs of prosthetic loosening and suspected AL were included. Preoperatively all patients underwent a standardized diagnostic algorithm. For each patient demographics, as well as the results of laboratory and microbiological testing were collected from the medical records.
resultsOf the included patients 117 (78.5%) were diagnosed with AL and 32 (21.5%) with PJI. The latency period from primary arthroplasty to the presentation with symptomatic implant loosening was significantly shorter for PJI compared to AL (p < 0.05). The initial CRP values were significantly higher in patients with PJI compared to patients with AL (p < 0.05). Elevated count of white blood cells or percentage of neutrophils within the synovial fluid support the diagnosis of PJI. The sensitivity of synovial cell count (CC) count for PJI in patients with radiographic signs of loosening was 0.84 (CI 0.81-0.87) with a specificity of 0.96 (CI 0.92-0.98). The single best measure for the diagnosis of PJI was synovial fluid cultures with a specificity of 1, however this measure provides poor sensitivity.
conclusionPatients with radiographic signs of loosening in TKA need thorough diagnostics. Information about primary TKA, serological testing, and results of joint aspiration can rule out a PJI in most cases.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.