Evidence map›Paper›PMID 34056503›Full record

ArticleJB & JS open access

Novel Biomarkers for Diagnosing Periprosthetic Joint Infection from Synovial Fluid and Serum.

Hannes Keemu, Felix Vaura, Anu Maksimow, Mikael Maksimow, Aleksi Jokela, Maija Hollmén, Keijo Mäkelä

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JB & JS open access. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
3.6field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Hannes KeemuDepartments of Orthopaedics and Traumatology (H.K., A.J., and K.M.) and Perioperative Services, Intensive Care, and Pain Medicine (A.M.), Turku University Hospital and the University of Turku, Turku, Finland.
Felix VauraMediCity Research Laboratory, University of Turku, Turku, Finland.
Anu MaksimowDepartments of Orthopaedics and Traumatology (H.K., A.J., and K.M.) and Perioperative Services, Intensive Care, and Pain Medicine (A.M.), Turku University Hospital and the University of Turku, Turku, Finland.
Mikael MaksimowMediCity Research Laboratory, University of Turku, Turku, Finland.
Aleksi JokelaDepartments of Orthopaedics and Traumatology (H.K., A.J., and K.M.) and Perioperative Services, Intensive Care, and Pain Medicine (A.M.), Turku University Hospital and the University of Turku, Turku, Finland.
Maija HollménMediCity Research Laboratory, University of Turku, Turku, Finland.
Keijo MäkeläDepartments of Orthopaedics and Traumatology (H.K., A.J., and K.M.) and Perioperative Services, Intensive Care, and Pain Medicine (A.M.), Turku University Hospital and the University of Turku, Turku, Finland.
University of Turku · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSynovial fluid bacterial culture is the cornerstone of confirmation or exclusion of periprosthetic joint infection (PJI). The aim of this study was to assess synovial fluid and serum biomarker patterns of patients with total joint arthroplasty (TJA), and the association of these patterns with PJI.

methodsSynovial fluid and serum samples were collected from 35 patients who were admitted to the Arthroplasty Unit of the Department of Orthopaedics and Traumatology at Turku University Hospital. Of the 25 patients who were included in the study, 10 healthy patients with an elective TJA for osteoarthritis served as the control group, and 15 patients who were admitted due to clinical suspicion of PJI with local redness, swelling, wound drainage, pain, and/or fever and who had a positive synovial fluid bacterial culture served as the study group. Logistic regression was used to assess the ability of 37 biomarkers (including cytokines, chemokines, and growth factors) with commercially available tests to detect PJIs.

resultsIn synovial fluid, the concentrations of sTNF-R1 and sTNF-R2 (soluble tumor necrosis factor receptors 1 and 2) and BAFF (B-cell activating factor, also known as TNFSF13B) were significantly higher in the PJI group (p < 0.002). In serum, the sTNF-R1 concentration was significantly higher in the PJI group, whereas the TWEAK (tumor necrosis factor-like weak inducer of apoptosis) and osteocalcin concentrations were significantly lower (p < 0.002). The sensitivity for detecting PJI using synovial fluid was 1.00 for sTNF-R2, 0.93 for sTNF-R1, and 0.87 for BAFF/TNFSF13B. The specificity of all 3 synovial markers was 1.00. The sensitivity using serum was 0.80 for TWEAK, 0.73 for sTNF-R1, and 0.80 for osteocalcin. The specificity of all 3 serum markers was 1.00.

conclusionsSynovial sTNF-R2 is a promising new biomarker for detecting PJI. We are not aware of any previous reports of the use of sTNF-R2 in PJI diagnosis. More research is needed to assess the clinical importance of our findings. LEVEL OF EVIDENCE: Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Identifiers

PMID34056503
PMCPMC8154383
OpenAlexW3155071895

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.