Evidence map›Paper›PMID 34939833›Full record

ArticleAnnals of the Royal College of Surgeons of England2022

The combined measurement of synovial markers in the diagnosis of periprosthetic joint infection.

A Felstead, P Kundasamy, G Penfold, K Whiting, J Buck, S Sturridge, M Meda

Open access · greenAbstract read
In one paragraph

Article in Annals of the Royal College of Surgeons of England, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 29% 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

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
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.

A FelsteadFrimley Health NHS Foundation Trust, UK.
P KundasamyFrimley Health NHS Foundation Trust, UK.
G PenfoldFrimley Health NHS Foundation Trust, UK.
K WhitingFrimley Health NHS Foundation Trust, UK.
J BuckFrimley Health NHS Foundation Trust, UK.
S SturridgeFrimley Health NHS Foundation Trust, UK.
M MedaFrimley Health NHS Foundation Trust, UK.
Frimley Health NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionCurrently there is no single test for periprosthetic joint infection (PJI) that demonstrates an acceptable level of sensitivity. The aim of this pilot study was to identify a combination of biomarkers that could exclude periprosthetic infection prior to revision surgery in hip and knee arthroplasty. This would help in equivocal cases of PJI, such as those with low-virulence organisms, chronic low-grade infection or 'aseptic' loosening. Current research has focused on measuring the levels of biomarkers in the patient's synovial fluid, and these can be combined to improve accuracy.

methodsWe selected synovial white cell count (SF-WCC) and C-reactive protein (SF-CRP), as they demonstrated an acceptable level of sensitivity and specificity which could be measured using existing equipment. One hundred and sixty-one synovial fluid samples from 134 patients were collected and analysed prospectively using calculated cut-off values of 10mg/l for SF-CRP and 3,000×10

resultsThe combined test demonstrated a sensitivity greater than 98.5% and specificity above 80% in all samples analysed or looked at separately for total hip replacement and total knee replacement infections. All ten aspirates taken from chronically infected joints tested positive.

conclusionsThe combination of SF-CRP and SF-WCC measurement has been shown to have high sensitivity of over 99% in detecting both acute and chronic PJI in both hip and knee arthroplasty. This ability of the test to exclude infection with a high degree of certainty will help in preoperative planning of PJIs.

Indexed as

Arthritis, InfectiousArthroplasty, Replacement, HipArthroplasty, Replacement, KneeProsthesis-Related InfectionsBiomarkersC-Reactive ProteinHumansPilot ProjectsSensitivity and SpecificityBiomarkersC-Reactive ProteinCRPInfectionJointPeriprostheticSynovial

Identifiers

PMID34939833
PMCPMC10335238
OpenAlexW4200207785

What OpenQuestion holds

Textmetadata
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.