ArticleInternational orthopaedics2020
Improved pre-operative diagnostic accuracy for low-grade prosthetic joint infections using second-generation multiplex Polymerase chain reaction on joint fluid aspirate.
Article in International orthopaedics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Periprosthetic joint infection and heterotopic ossification after total hip arthroplasty: systematic review and meta-analysis.BMC musculoskeletal disorders · 2025Pooled it
- Molecular Tools for Guiding Therapy in Patients With Staphylococcal Bone and Joint Infections: A Diagnostic Test Accuracy Meta-analysis.Frontiers in endocrinology · 2022Pooled it
- Diagnostic and therapeutic strategies in combating implanted medical device-associated bacterial biofilm infections.Folia microbiologica · 2025Review
- Molecular diagnostics for perioperative microbial identification in periprosthetic joint infection: A scoping review and proposal of a diagnostic flow chart.Journal of experimental orthopaedics · 2025Review
- Diagnostic Accuracy of Rotational Thromboelastometry for Low-Virulence Periprosthetic Joint Infections: A Pilot Study.Microorganisms · 2024Article
- Diagnostics in Late Periprosthetic Infections-Challenges and Solutions.Antibiotics (Basel, Switzerland) · 2024Review
- Multiplex PCR test as an intra-operative diagnostic tool for periprosthetic joint infection in presumed aseptic revision hip and knee arthroplasty: a 1-year follow-up study of 200 cases.Journal of bone and joint infection · 2024Article
- Joint aspiration for diagnosis of chronic periprosthetic joint infection: when, how, and what tests?Arthroplasty (London, England) · 2023Review
- Real-Life Experience and Diagnostic Utility of the BioFire Joint Infection PCR Panel in Bone and Joint Infections: Analysis of a Prospective Validation Study.Infectious diseases and therapy · 2023Article
- Orthopaedic Implant-Associated Staphylococcal Infections: A Critical Reappraisal of Unmet Clinical Needs Associated with the Implementation of the Best Antibiotic Choice.Antibiotics (Basel, Switzerland) · 2022Article
- Diagnostic accuracy of multiplex polymerase chain reaction on tissue biopsies in periprosthetic joint infections.Scientific reports · 2021Article
- Evaluation and interpretation of prosthetic joint infection diagnostic investigations.International orthopaedics · 2021Review
- Invited reply to the letter to the editor by McNally et al., 2021.BMC musculoskeletal disorders · 2021Article
- An update about molecular biology techniques to detect orthopaedic implant-related infections.EFORT open reviews · 2021Review
- [Fracture-related infections in traumatology : Current standards and new developments in diagnostics and treatment].Der Orthopade · 2020Review
- Diagnostic algorithm in septic total knee arthroplasty failure - What is evidence-based?Journal of orthopaedicsArticle
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA major obstacle for the treatment of prosthetic joint infection (PJI) is the identification of the underlying causative organism. While the diagnostic criteria ruling PJI in or out have become ever more accurate, the detection of the causative pathogen(s) still relies mostly on conventional and time-consuming microbial culture. The aim of this study was to evaluate the diagnostic potential of a second-generation multiplex PCR assay (Unyvero ITI G2, Curetis AG, Holzgerlingen, Germany) used on synovial fluid specimens. Our hypothesis was that the method would yield a higher diagnostic accuracy in the pre-operative workup than synovial fluid culture. Thus, a more precise classification of septic and aseptic prosthesis failure could be achieved before revision surgery.
methodsProspectively collected frozen joint fluid specimens from 26 patients undergoing arthroplasty revision surgery of the hip or knee were tested as per the manufacturer's protocol. Sensitivities, specificities, positive and negative predictive values as well as positive and negative likelihood ratios with corresponding confidence intervals were estimated using the statistical software R. A combination of the serum C-reactive protein (CRP) level, leukocyte count, erythrocyte sedimentation rate, joint fluid culture, tissue biopsy culture, and tissue biopsy histology served as the gold standard.
resultsOf the 26 patients included in the study, 15 were infected and 11 were aseptic. Conventional joint fluid culture showed a sensitivity of 0.67 and a specificity of 0.91. Joint fluid multiplex PCR yielded a sensitivity of 0.8 and a specificity of 1.0.
conclusionsUsing the second-generation Unyvero ITI cartridge on joint fluid aspirate for the detection of prosthetic joint infection, we were able to achieve a higher diagnostic accuracy than with conventional culture. We conclude that to improve pathogen detection before revision surgery, this method represents a valuable and practicable tool.
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