ArticleBone & joint open2020
Synovial fluid interleukin-6 is not superior to cell count and differential in the detection of periprosthetic joint infection.
Article in Bone & joint open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 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
- Diagnostic accuracy of serum and synovial biomarker thresholds for diagnosing periprosthetic joint infection: a QUADAS-C-guided systematic review and meta-analysis.Arthroplasty (London, England) · 2026Review
- Synovial fluid viscosity with synovial fluid cell count, valuable diagnostic marker of prosthetic joint infections.Scientific reports · 2025Article
- Synovial fluid fibrin degradation product can be used as a new auxiliary marker for periprosthetic joint infection diagnosis.Frontiers in cellular and infection microbiology · 2025Article
- Periprosthetic joint infections: state-of-the-art.Archives of orthopaedic and trauma surgery · 2024Review
- Diagnostic accuracy of interleukin-6 in multiple diseases: An umbrella review of meta-analyses.Heliyon · 2024Review
- Diagnosis of Periprosthetic Joint Infection: The Utility of Biomarkers in 2023.Antibiotics (Basel, Switzerland) · 2023Review
- Profiling the Immune Response to Periprosthetic Joint Infection and Non-Infectious Arthroplasty Failure.Antibiotics (Basel, Switzerland) · 2023Review
- Synovial fluid neutrophil extracellular traps could improve the diagnosis of periprosthetic joint infection.Bone & joint research · 2023Article
- Role of Biomarkers in Periprosthetic Joint Infections.Diagnostics (Basel, Switzerland) · 2022Review
- Synovial fluid pH is as specific as synovial leukocyte count but less sensitive for the diagnosis of chronic prosthetic joint infection.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2022Article
- D-lactate is a promising biomarker for the diagnosis of periprosthetic joint infection.Frontiers in surgery · 2022Article
- Variation of synovial fluid leucocyte cell count and polymorphonuclear percentage in patients with aseptic revision total knee arthroplasty.Bone & joint open · 2021Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsSynovial fluid white blood cell (WBC) count and percentage of polymorphonuclear cells (%PMN) are elevated at periprosthetic joint infection (PJI). Leucocytes produce different interleukins (IL), including IL-6, so we hypothesized that synovial fluid IL-6 could be a more accurate predictor of PJI than synovial fluid WBC count and %PMN. The main aim of our study was to compare the predictive performance of all three diagnostic tests in the detection of PJI.
methodsPatients undergoing total hip or knee revision surgery were included. In the perioperative assessment phase, synovial fluid WBC count, %PMN, and IL-6 concentration were measured. Patients were labeled as positive or negative according to the predefined cut-off values for IL-6 and WBC count with %PMN. Intraoperative samples for microbiological and histopathological analysis were obtained. PJI was defined as the presence of sinus tract, inflammation in histopathological samples, and growth of the same microorganism in a minimum of two or more samples out of at least four taken.
resultsIn total, 49 joints in 48 patients (mean age 68 years (SD 10; 26 females (54%), 25 knees (51%)) were included. Of these 11 joints (22%) were infected. The synovial fluid WBC count and %PMN predicted PJI with sensitivity, specificity, accuracy, PPV, and NPV of 82%, 97%, 94%, 90%, and 95%, respectively. Synovial fluid IL-6 predicted PJI with sensitivity, specificity, accuracy, PPV, and NPV of 73%, 95%, 90%, 80%, and 92%, respectively. A comparison of predictive performance indicated a strong agreement between tests.
conclusionsSynovial fluid IL-6 is not superior to synovial fluid WBC count and %PMN in detecting PJI.Level of Evidence: Therapeutic Level IICite this article:
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