ArticleInternational orthopaedics2023
The synovial fluid calprotectin lateral flow test for the diagnosis of chronic prosthetic joint infection in failed primary and revision total hip and knee arthroplasty.
Article in International orthopaedics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.
- Is synovial calprotectin lateral flow test a reliable intraoperative biomarker for periprosthetic joint infection? A systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2026Pooled it
- Synovial calprotectin in prosthetic joint infection. A systematic review and meta-analysis of the literature.Archives of orthopaedic and trauma surgery · 2024Pooled it
- 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
- Diagnostic accuracy of serum and synovial biomarker thresholds for diagnosing periprosthetic joint infection: a QUADAS-C-guided systematic review and meta-analysis.Arthroplasty (London, England) · 2026Review
- INFECTION PROFILE IN HIP ARTHROPLASTY AT A REFERRAL HOSPITAL.Acta ortopedica brasileira · 2026Article
- Calprotectin as a Biomarker for Infectious Diseases: A Comparative Review with Conventional Inflammatory Markers.International journal of molecular sciences · 2025Review
- Diagnostic Challenges and Risk Stratification of Periprosthetic Joint Infection in Patients with Inflammatory Arthritis.Journal of clinical medicine · 2025Review
- Joint aspiration for diagnosis of chronic periprosthetic joint infection: when, how, and what tests?Arthroplasty (London, England) · 2023Review
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6 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeThe diagnostic criteria of prosthetic joint infection (PJI) recommended by the most commonly used diagnostic algorithms can be obscured or distorted by other inflammatory processes or aseptic pathology. Furthermore, the most reliable diagnostic criteria are garnered during revision surgery. A robust, reliable addition to the preoperative diagnostic cascade is warranted. Calprotectin has been shown to be an excellent diagnostic marker for PJI. In this study, we aimed to evaluate a lateral flow test (LFT) in the challenging patient cohort of a national referral centre for revision arthroplasty.
methodsBeginning in March 2019, we prospectively included patients scheduled for arthroplasty exchange of a total hip (THA) or knee arthroplasty (TKA). Synovial fluid samples were collected intra-operatively. We used the International Consensus Meeting of 2018 (ICM) score as the gold standard. We then compared the pre-operative ICM score with the LFT result to calculate its diagnostic accuracy as a standalone pre-operative marker and in combination with the ICM score as part of an expanded diagnostic workup.
resultsA total of 137 patients with a mean age of 67 (± 13) years with 53 THA and 84 TKA were included. Ninety-nine patients (72.8%) were not infected, 34 (25.0) were infected, and four (2.9%) had an inconclusive final score and could not be classified after surgery. The calprotectin LFT had a sensitivity (95% confidence interval) of 0.94 (0.80-0.99) and a specificity of 0.87 (0.79-0.93). The area under the receiver operating characteristic curve (AUC) for the calprotectin LFT was 0.94 (0.89-0.99). In nine cases with an inconclusive pre-operative ICM score, the calprotectin LFT would have led to the correct diagnosis of PJI.
conclusionsThe synovial fluid calprotectin LFT shows excellent diagnostic metrics both as a rule-in and a rule-out test, even in a challenging patient cohort with cases of severe osteolysis, wear disease, numerous preceding surgeries, and poor soft tissue conditions, which can impair the common diagnostic criteria. As it is available pre-operatively, this test might prove to be a very useful addition to the diagnostic algorithm.
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