ArticleBMC musculoskeletal disorders2020
Neutrophil to lymphocyte ratio as a predictor for diagnosis of early Periprosthetic joint infection.
Article in BMC musculoskeletal disorders, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07718386 (The Diagnosis Dilemma), which is not on this map. Cited by 33 papers, 2 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.
The Diagnosis Dilemma: Efficacy of Serum ESR, CRP, Synovial Leucocyte Esterase Dipstick Test in the Diagnosis of Chronic Infection in Total Joint Arthroplasty.
Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- Serum versus synovial fluid interleukin-6 for periprosthetic joint infection diagnosis: a systematic review and meta-analysis of 30 diagnostic test accuracy studies.Journal of orthopaedic surgery and research · 2022Pooled it
- Neutrophil to Lymphocyte Ratio and Spontaneous Bacterial Peritonitis among Cirrhotic Patients: A Systematic Review and Meta-analysis.Canadian journal of gastroenterology & hepatology · 2022Pooled it
- Additional Erythrocyte Field Is Helpful for Graphic Type Differentiation of Cell Count Determination Between Acute Periprosthetic Joint Infection and Hematoma.Antibiotics (Basel, Switzerland) · 2026Article
- Diagnostic Performance of Serum Neutrophil-Lymphocyte and Serum Monocyte-Lymphocyte Ratios in Periprosthetic Joint Infection: A Comparative Meta-Analytic Review of 29 Studies.Journal of clinical medicine · 2025Review
- Natural course of postoperative C-reactive protein and erythrocyte sedimentation rate in unilateral and simultaneous bilateral total knee arthroplasty.BMC musculoskeletal disorders · 2025Article
- Blood Cell Ratio Combinations for Diagnosing Periprosthetic Joint Infections: A Preliminary Study.Infection and drug resistance · 2025Article
- Serum inflammatory markers for the screening and diagnosis of periprosthetic joint infection: a systematic review and meta-analysis.Journal of bone and joint infection · 2025Review
- What is the diagnostic accuracy of neutrophil to lymphocyte ratio and monocyte to lymphocyte ratio in detecting acute periprosthetic joint infections? A gender-specific analysis.Archives of orthopaedic and trauma surgery · 2024Article
- Analysis of Serum and Synovial Inflammatory Markers in Periprosthetic Joint Infections: A Narrative Review.Cureus · 2024Review
- Assessing the predictive value of pre- and post-operative inflammatory markers in patients undergoing total knee arthroplasty.Journal of orthopaedic surgery and research · 2024Article
- Role of Serum Biomarkers in Differentiating Periprosthetic Joint Infections from Aseptic Failures after Total Hip Arthroplasties.Journal of clinical medicine · 2024Article
- Different biomarker ratios in peripheral blood have limited value in diagnosing periprosthetic joint infection after total joint arthroplasty: a single-center, retrospective study.BMC musculoskeletal disorders · 2024Article
- Graphic type differentiation of cell count data for diagnosis of early and late periprosthetic joint infection: A new method.Technology and health care : official journal of the European Society for Engineering and Medicine · 2024Article
- Neutrophil-Lymphocyte Ratio and Lymphocyte-Monocyte Ratio correlate with Chronic Prosthetic Joint Infection but are not useful markers for diagnosis.Archives of orthopaedic and trauma surgery · 2024Article
- Can C-Reactive Protein-Lymphocyte Ratio Be Used as a Screening Tool to Confirm the Diagnosis of Periprosthetic Joint Infection?Clinics in orthopedic surgery · 2023Article
- Utility of Blood Cell Ratio Combinations for Diagnosis of Periprosthetic Joint Infection.Arthroplasty today · 2023Article
- Article
- Diagnosis of Periprosthetic Joint Infection: The Utility of Biomarkers in 2023.Antibiotics (Basel, Switzerland) · 2023Review
- The Role of Combined Inflammatory Biomarkers in the Diagnosis of High- and Low-Virulence FRI Among High-Risk Lower Extremity Fractures.International journal of general medicine · 2023Article
- C-Reactive Protein-to-Albumin Ratio (CAR) and C-Reactive Protein-to-Lymphocyte Ratio (CLR) are Valuable Inflammatory Biomarker Combination for the Accurate Prediction of Periprosthetic Joint Infection.Infection and drug resistance · 2023Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPeriprosthetic joint infection (PJI) is a catastrophic complication after total knee or hip arthroplasty. The diagnosis of PJI is very difficult, especially in the early postoperative period. The value of the neutrophil to lymphocyte ratio (NLR) is useful for diagnosing infectious diseases. The objective of this study was to investigate the accuracy of the NLR for the diagnosis of early PJI after total knee or hip arthroplasty.
methodsWe retrospectively evaluated consecutive primary total knee or hip arthroplasty and identified the patients who readmitted within the first 90 days postoperatively between January 2011 and October 2018.There were 20 cases diagnosed early PJI and 101 uninfected cases on the basis of the modified Musculoskeletal Infection Society (MSIS) criteria. The serum parameters including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood-cell (WBC) count, NLR and interleukin-6 (IL-6) were compared between the two groups. Receiver operating characteristic curves were generated to estimate the optimal cutoff values for each parameter. The sensitivity, specificity, positive predictive value and negative predictive value for each parameter were calculated.
resultsThe CRP, ESR, WBC, NLR and IL-6 values were all significally higher in the infected group than the uninfected group. The median of CRP was 66.6 mg/l in the infected group and 8.6 mg/l in the uninfected group (p < 0.001). The median of ESR was 34.8 mm/hr. in the infected group and 17.4 mm/hr. in the uninfected group (p < 0.001). In the infected group and uninfected group, the median of WBC was 8.2X10
conclusionsThis study is the first to show that NLR values are more accurate than CRP and may be considered as useful parameters for the diagnosis of early PJI because it is a cheap and convenient parameter to be calculated in daily practice without extra costs.
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Registered trials
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.