SynthesisOrthopaedic surgery2022
Reliable Diagnostic Tests and Thresholds for Preoperative Diagnosis of Non-Inflammatory Arthritis Periprosthetic Joint Infection: A Meta-analysis and Systematic Review.
Synthesis in Orthopaedic surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 23 citations in OpenAlex.
- Synovial Calprotectin in Suspected Periprosthetic Joint Infection After Total Knee Arthroplasty: Diagnostic Accuracy and Exploratory Adjunctive Value to Preoperative ICM Classification.Antibiotics (Basel, Switzerland) · 2026Article
- Article
- Review
- Revisiting diagnostics: erythrocyte sedimentation rate and C-reactive protein: it is time to stop the zombie tests.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2025Article
- Diagnostic value of neutrophil-to-lymphocyte ratio and albumin-to-globulin ratio for periprosthetic joint infections: a systematic review and meta-analysis.EFORT open reviews · 2024Review
- 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
- The Cytological Energy Detection of Purulent Inflammation in Synovial Fluid Is Not All Black and White.Biomedicines · 2024Article
- An overview of the current diagnostic approach to Periprosthetic Joint Infections.Orthopedic reviews · 2024Article
- Accuracy of Albumin, Globulin, and Albumin-Globulin Ratio for Diagnosing Periprosthetic Joint Infection: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2023Review
- Leukocyte esterase and alpha-defensin in periprosthetic joint infection: predictive quality and correlation in a prospective study.International orthopaedics · 2023Article
- Periprosthetic Joint Infection: Current Clinical Challenges.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Periprosthetic Joint Infection Diagnosis: A Narrative Review.Antibiotics (Basel, Switzerland) · 2023Review
- Diagnosis of Periprosthetic Joint Infection: The Utility of Biomarkers in 2023.Antibiotics (Basel, Switzerland) · 2023Review
- Role of Biomarkers in Periprosthetic Joint Infections.Diagnostics (Basel, Switzerland) · 2022Review
- Comparative Diagnostic Value of Serological and Synovial Tests for Periprosthetic Joint Infections: A Comprehensive Analysis.JB & JS open accessArticle
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
objectiveThe current diagnostic criteria for periprosthetic joint infection (PJI) are diverse and controversial, leading to delayed diagnosis. This study aimed to evaluate and unify their diagnostic accuracy and the threshold selection of serum and synovial routine tests for PJI at an early stage.
methodsWe searched the MEDLINE and Embase databases for retrospective or prospective studies which reported preoperative-available assays (serum, synovial, or culture tests) for the diagnosis of chronic PJI among inflammatory arthritis (IA) or non-IA populations from January 1, 2000 to June 30, 2022. Threshold effective analysis was performed on synovial polymorphonuclear neutrophils (PMN%), synovial white blood cell (WBC), serum C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) to find the relevant cut-offs.
resultsTwo hundred and sixteen studies and information from 45,316 individuals were included in the final analysis. Synovial laboratory-based α-defensin and calprotectin had the best comprehensive sensitivity (0.91 [0.86-0.94], 0.95 [0.88-0.98]) and specificity (0.96 [0.94-0.97], 0.95 [0.89-0.98]) values. According to the threshold effect analysis, the recommended cut-offs are 70% (sensitivity 0.89 [0.85-0.92], specificity 0.90 [0.87-0.93]), 4100/μL (sensitivity 0.90 [0.87-0.93], specificity 0.97 [0.93-0.98]), 13.5 mg/L (sensitivity 0.84 [0.78-0.89], specificity 0.83 [0.73-0.89]), and 30 mm/h (sensitivity 0.79 [0.74-0.83], specificity 0.78 [0.72-0.83]) for synovial PMN%, synovial WBC, serum CRP, and ESR, respectively, and tests seem to be more reliable among non-IA patients.
conclusionsThe laboratory-based synovial α-defensin and synovial calprotectin are the two best independent preoperative diagnostic tests for PJI. A cut off of 70% for synovial PMN% and tighter cut-offs for synovial WBC and serum CRP could have a better diagnostic accuracy for non-IA patients with chronic PJI.
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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.