ArticleJournal of clinical medicine2024
Acidity Is an Excellent Marker of Infection in Hip and Knee Arthroplasty.
Article in Journal of clinical medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 13 citations in OpenAlex.
- [Computer-assisted sensing in periprosthetic joint infection : Current evidence and future perspectives for wearables].Orthopadie (Heidelberg, Germany) · 2026Review
- Coordinated control of miniature magnetic pumps for liquid sampling and delivery in a knee implant.Device · 2026Article
- Spatiotemporal immunomodulation with programmable biomaterials to promote musculoskeletal tissue regeneration.Bioactive materials · 2026Review
- Functional-responsive hydrogel microspheres based on microenvironment sensing promote the sequential repair of infected bone defects by regulating ROS balance.Journal of nanobiotechnology · 2026Article
- Exploring immobilization strategies of antimicrobial peptides onto MAO-treated titanium to fight MRSA colonization and preserve osteogenic activity.Materials today. Bio · 2026Article
- Blood gas analyzers enable reliable measurement of synovial pH, lactate, and glucose in native and periprosthetic joint infection: an analytical agreement study.Journal of bone and joint infection · 2026Article
- The Molecular Mechanisms Underlying Dercum's Disease: Exploring the Intersection of Obesity, Pain, and Inflammation.International journal of molecular sciences · 2025Review
- Biosensor-Integrated Tibial Components in Total Knee Arthroplasty: A Narrative Review of Innovations, Challenges, and Translational Frontiers.Bioengineering (Basel, Switzerland) · 2025Review
- Synovial pH, lactate, and glucose as adjunct biomarkers to exclude periprosthetic joint infection in hip and knee arthroplasty: a prospective study.Journal of bone and joint infection · 2025Article
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThe diagnosis of joint replacement infection is a difficult clinical challenge that often occurs when the implant cannot be salvaged. We hypothesize that the pH value of synovial fluid could be an important indicator of the inflammatory status of the joint. However, in the literature, there is a lack of data on the pH changes in hip and knee joint replacements and their relation to infection and implant failure. In this study, we aimed to measure the pH levels of synovial fluid in patients with hip and knee joint replacements. We also investigated the potential of pH measurement as a diagnostic tool for joint replacement infection. In this study, we recorded the pH values to be 7.55 and 7.46 in patients where MATERIALS AND
methodsIn our cohort of 155 patients with implanted hip (THA; n = 85) or knee (TKA; n = 70) joint replacements, we conducted a prospective study with a pH measurement. Out of the whole cohort, 44 patients had confirmed joint replacement infection (28.4%) (44/155). In 111 patients, infection was ruled out (71.6%) (111/155). Joint replacement infection was classified according to the criteria of the Musculoskeletal Infection Society (MSIS) from 2018. Based on the measured values, we determined the cut-off level for the probability of ongoing inflammation. We also determined the sensitivity and specificity of the measurement.
resultsThe group of patients with infection (n = 44) had a significantly lower synovial fluid pH (pH = 6.98 ± 0.48) than the group of patients with no infection (n = 111, pH = 7.82 ± 0.29,
conclusionsOur results confirm that it is appropriate to include a pH measurement in the diagnostic spectrum of hip and knee replacements. This diagnostic approach has the potential to provide continuous in vivo feedback, facilitated by specialized biosensors. The advantage of this method is the future incorporation of a pH-detecting sensor into intelligent knee and hip replacements that will assess pH levels over time. By integrating these biosensors into intelligent implants, the early detection of joint replacement infections could be achieved, enhancing proactive intervention strategies.
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