Evidence map›Paper›PMID 35199219›Full record

SynthesisInternational orthopaedics2022

Is sonication superior to dithiothreitol in diagnosis of periprosthetic joint infections? A meta-analysis.

Konstantinos Tsikopoulos, Savas Ilias Christofilos, Dimitrios Kitridis, Konstantinos Sidiropoulos, Panagiotis N Stoikos, Christoforos Gravalidis, Panagiotis Givissis, Paraskevi Papaioannidou

Erratum issuedAbstract readMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in International orthopaedics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 10% 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

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

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

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Konstantinos Tsikopoulos1st Department of Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece. ktsikopo@auth.gr.ORCID http://orcid.org/0000-0001-5923-4782
Savas Ilias ChristofilosDepartment of Genetics, Evolution and Environment, University College London, London, UK.
Dimitrios Kitridis1st Orthopaedic Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Konstantinos SidiropoulosSchool of Medicine, University of Patras, Patras, Greece.
Panagiotis N StoikosSchool of Medicine, Faculty of Health Sciences, University of Thessaly, Volos, Greece.
Christoforos GravalidisSolid State Physics Sector, Physics Department, Faculty of Exact Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Panagiotis Givissis1st Orthopaedic Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Paraskevi Papaioannidou1st Department of Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Aristotle University of Thessaloniki · GRUniversity College London · GBUniversity of Patras · GRUniversity of Thessaly · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeEven though effective techniques in diagnosis of periprosthetic joint infections (PJIs) have been developed, the optimal modality has yet to be determined. The present meta-analysis aimed to compare the diagnostic accuracy of dithiothreitol (DTT) and sonication against the Musculoskeletal Infection Society criteria in patients undergoing revision joint surgery.

methodsWe searched the PubMed, Scopus, and Central Cochrane register of controlled trials as well as gray literature until the 9th of November, 2021. We included articles considering the comparative diagnostic accuracy of sonication and DTT in adult patients having revision hip and knee arthroplasty for septic or aseptic reasons. We calculated pooled sensitivity, specificity, and diagnostic accuracy of the above diagnostic techniques against the Musculoskeletal Infection Society (MSIS) criteria and created receiver operating characteristics (ROC) curves to enable comparisons between each other. The quality of included papers was evaluated utilizing QUADAS-2 and QUADAS-C tools.

resultsData from five comparative studies totaling 726 implants were pooled together. The diagnostic accuracy of DTT and sonication were 86.7% (95% CI 82.7 to 90.1) and 83.9% (95% CI 79.7 to 87.5), respectively. Pooled sensitivity and specificity showed no statistically significant differences between DTT and sonication (0.7 [95% CI 0.62 to 0.77] vs 0.72 [95% CI 0.65 to 0.78], p = 0.14; and 0.99 [95% CI 0.97 to 1] vs 0.97 [95% CI 0.93 to 0.99], p = 5.5, respectively).

conclusionsThis meta-analysis did not identify any clinically meaningful difference between the diagnostic potential of sonication and the chemical-based biofilm dislodgment methods. This finding remained robust after adjusting for the administration of antibiotics prophylaxis, implementation of the polymerase chain reaction of sonicated fluid, and study quality.

Indexed as

Arthritis, InfectiousDithiothreitolProsthesis-Related InfectionsSonicationAdultArthroplasty, Replacement, HipArthroplasty, Replacement, KneeHip ProsthesisHumansKnee ProsthesisSensitivity and SpecificityDithiothreitolDiagnostic accuracyDithiothreitolDTTMeta-analysisSensitivitySonicationSpecificity

Identifiers

PMID35199219
OpenAlexW4220691961

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.