TY - JOUR
T1 - Comparative analysis of 23 synovial fluid biomarkers for hip and knee periprosthetic joint infection detection
AU - Sharma, Katyayini
AU - Ivy, Morgan
AU - Block, Darci R.
AU - Abdel, Matthew P.
AU - Hanssen, Arlen D.
AU - Beauchamp, Christopher
AU - Perry, Kevin I.
AU - Rosemark, Christopher L.
AU - Greenwood-Quaintance, Kerryl E.
AU - Mandrekar, Jay
AU - Patel, Robin
N1 - Funding Information:
We acknowledge CD Diagnostics for kindly providing α-defensin reagents.
Funding Information:
Dr. Patel is supported in part by R01 AR056647 from the National Institutes of Health. Dr. Patel reports grants from CD Diagnostics, Merck, Hutchison Biofilm Medical Solutions, Accelerate Diagnostics, ContraFect, TenNor Therapeutics Limited and Shionogi. Dr. Patel is a consultant to Curetis, Specific Technologies, Next Gen Diagnostics, PathoQuest, and Qvella; monies are paid to Mayo Clinic. In addition, Dr. Patel has a patent on PCR issued, a patent on a device/method for sonication with royalties paid by Samsung to Mayo Clinic, and a patent on an anti‐biofilm substance issued. Dr. Patel receives travel reimbursement from ASM and IDSA, an editor's stipend from ASM and IDSA, and honoraria from the NBME, Up‐to‐Date, and the Infectious Diseases Board Review Course. Bordetella pertussis/parapertussis
Publisher Copyright:
© 2020 Orthopaedic Research Society. Published by Wiley Periodicals LLC
PY - 2020/12
Y1 - 2020/12
N2 - There is interest in novel synovial fluid biomarkers for the detection of periprosthetic joint infection (PJI). Here, we assessed the diagnostic accuracy of 23 simple or sophisticated synovial fluid biomarkers for periprosthetic hip or knee infection detection. One hundred seven subjects were studied, 57 of whom had aseptic failure (AF) and 50 PJI. The following synovial fluid biomarkers were tested using spectrophotometric assays, immunoassays, lateral flow tests, or test strips: leukocyte count, monocyte percentage, lymphocyte percentage, neutrophil percentage, C-reactive protein (CRP), glucose, lactate, granulocyte-macrophage colony-stimulating factor, interferon-γ, interleukin-1β (IL-1β), IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, IL-17A, IL-23, tumor necrosis factor-α, α-defensin, and leukocyte esterase. The best-performing synovial fluid biomarkers to differentiate PJI from AF—that is, those with highest area under the curve compared to all other biomarkers—were leukocyte count, percent neutrophils and percent monocytes, CRP, and α-defensin (P <.0001).
AB - There is interest in novel synovial fluid biomarkers for the detection of periprosthetic joint infection (PJI). Here, we assessed the diagnostic accuracy of 23 simple or sophisticated synovial fluid biomarkers for periprosthetic hip or knee infection detection. One hundred seven subjects were studied, 57 of whom had aseptic failure (AF) and 50 PJI. The following synovial fluid biomarkers were tested using spectrophotometric assays, immunoassays, lateral flow tests, or test strips: leukocyte count, monocyte percentage, lymphocyte percentage, neutrophil percentage, C-reactive protein (CRP), glucose, lactate, granulocyte-macrophage colony-stimulating factor, interferon-γ, interleukin-1β (IL-1β), IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, IL-17A, IL-23, tumor necrosis factor-α, α-defensin, and leukocyte esterase. The best-performing synovial fluid biomarkers to differentiate PJI from AF—that is, those with highest area under the curve compared to all other biomarkers—were leukocyte count, percent neutrophils and percent monocytes, CRP, and α-defensin (P <.0001).
KW - arthroplasty
KW - biomarkers
KW - infection
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U2 - 10.1002/jor.24766
DO - 10.1002/jor.24766
M3 - Article
C2 - 32485031
AN - SCOPUS:85087120374
SN - 0736-0266
VL - 38
SP - 2664
EP - 2674
JO - Journal of Orthopaedic Research
JF - Journal of Orthopaedic Research
IS - 12
ER -