ArticleJournal of orthopaedic surgery and research2021
The relationship of C-reactive protein/interleukin-6 concentrations between serum and synovial fluid in the diagnosis of periprosthetic joint infection.
Article in Journal of orthopaedic surgery and research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 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
- Reliable Diagnostic Tests and Thresholds for Preoperative Diagnosis of Non-Inflammatory Arthritis Periprosthetic Joint Infection: A Meta-analysis and Systematic Review.Orthopaedic surgery · 2022Pooled it
- Synovial interleukin-6 point-of-care testing, alone and combined with D-dimer, supports rapid diagnosis of periprosthetic joint infection.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Key Inflammatory Pathways, Biomarkers, and Targeted Management Strategies in Primary Total Joint Arthroplasty: A Narrative Review.Medicina (Kaunas, Lithuania) · 2026Review
- Identification of miRNA Biomarkers Associated With Staphylococcal Musculoskeletal Infections.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2025Article
- Beyond Cultures: The Evolving Role of Molecular Diagnostics, Synovial Biomarkers and Artificial Intelligence in the Diagnosis of Prosthetic Joint Infections.Journal of clinical medicine · 2025Review
- Periprosthetic joint infection after arthroplasty: advances and future prospects.Journal of orthopaedic surgery and research · 2025Review
- 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
- Analysis of Serum and Synovial Inflammatory Markers in Periprosthetic Joint Infections: A Narrative Review.Cureus · 2024Review
- Diagnostics in Late Periprosthetic Infections-Challenges and Solutions.Antibiotics (Basel, Switzerland) · 2024Review
- Surgical Management of Periprosthetic Joint Infections in Hip and Knee Megaprostheses.Medicina (Kaunas, Lithuania) · 2024Review
- Synovial Fluid C-reactive Protein Clinical Decision Limit and Diagnostic Accuracy for Periprosthetic Joint Infection.Cureus · 2024Article
- Diagnosis of Periprosthetic Joint Infection: The Utility of Biomarkers in 2023.Antibiotics (Basel, Switzerland) · 2023Review
- What's New in the Diagnosis of Periprosthetic Joint Infections: Focus on Synovial Fluid Biomarkers.Tropical medicine and infectious disease · 2022Review
- The Usefulness of Synovial Fluid Proteome Analysis in Orthopaedics: Focus on Osteoarthritis and Periprosthetic Joint Infections.Journal of functional morphology and kinesiology · 2022Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe relationship of C-reactive protein (CRP)/interleukin-6 (IL-6) concentrations between serum and synovial fluid and whether synovial CRP/IL-6 testing in addition to serum CRP/IL-6 testing would result in a benefit in the diagnosis of periprosthetic joint infection (PJI) deserves to be investigated.
methodsFrom June 2016 to July 2019, 139 patients were included in the study. Synovial CRP and IL-6 were tested by ELISA. The serum CRP and IL-6 were obtained from medical records. The definition of PJI was based on the modified Musculoskeletal Infection Society (MSIS) criteria. The relationship of serum and synovial CRP and IL-6 and the value of each index in the diagnosis of PJI were evaluated.
resultsThe receiver operating characteristic (ROC) curves showed that synovial IL-6 had the highest area under the curve (AUC) at 0.935, which was followed by synovial CRP, serum IL-6 and serum CRP 0.861, 0.847 and 0.821, respectively. When combining serum CRP and synovial CRP to diagnose PJI, the AUC was 0.849, which was slightly higher than the result obtained when using serum CRP alone. In contrast, when combining serum IL-6 and synovial IL-6 to diagnose PJI, the AUC increased to 0.940, which was significantly higher than that obtained using serum IL-6 alone.
conclusionThe synovial IL-6 has the highest diagnostic accuracy for PJI. However, inferring the level of CRP/IL-6 in the synovial fluid from the serum level of CRP/IL-6 was not feasible. Synovial CRP testing did not offer an advantage when combined with an existing serum CRP result to diagnose PJI, while additional synovial IL-6 was worthy of testing even if there was an existing serum IL-6 result.
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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.