CORR Insights®: The Alpha-defensin Test for Periprosthetic Joint Infection is Not Affected by Prior Antibiotic Administration

Spangehl, Mark J.

doi:10.1007/s11999-016-4771-x

Cited by 2 publications

(1 citation statement)

References 8 publications

(10 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our data is consistent with this evidence and demonstrated that Synovasure™ is a reliable test even in presence of blood contamination of SF samples. The relatively high percentage (13.4%) of patients under antibiotic therapy started before referral to a specialized hospital, highlight the need of educational improvement of primary care providers who deal with patients with painful joint arthroplasty 34 .…”

Section: Discussionmentioning

confidence: 99%

Qualitative Alpha-defensin Versus The Main Available Tests For The Diagnosis Of Periprosthetic Joint Infection: Best Predictor Test?

Riccio

Cavagnaro

Akkouche

et al. 2018

J. Bone Joint Infect.

View full text Add to dashboard Cite

Introduction: Biomarkers such as α-defensin demonstrated to be a potentially useful option in periprosthetic joint infection (PJI) diagnosis. Recently, a new point-of-care test for α-defensin level detection in synovial fluid has been commercialized in Europe. The aim of this study is to compare the α-defensin test (SynovasureTM) diagnostic ability with the main available clinical tests for periprosthetic joint infection diagnosis in a practical clinical setting of a Bone Infection Unit.Methods: Between 2015 and 2017, 146 patients with suspected chronic PJI were screened with SynovasureTM. Seventy-three of these met the Musculoskeletal Infection Society (MSIS) criteria and were included in the analysis. According to MSIS criteria, 40 patients (54.7%) were classified as infected and 33 (45.3%) as not infected. The results obtained with SynovasureTM were recorded and compared with standard diagnostic methods for PJI diagnosis.Results: SynovasureTM showed a sensitivity of 85.0 % (95% CI 70.2 to 94.3) and a specificity of 96.9 % (95% CI 83.8 to 99.9) for PJI detection. The positive likelihood ratio of SynovasureTM was 27.2 (95% CI 3.9 to 188.1) and the negative likelihood ratio was 0.2 (95% CI 0.1 to 0.3). The diagnostic odds ratio was 181.3 (95% CI 20.7 to 1590.4). SynovasureTM demonstrated a statistical significant difference when compared to Erythrocyte Sedimentation Rate (ESR) and C-reactive Protein (CRP) specificity (at least one positive test) and preoperative culture sensitivity (1 positive culture).Conclusion: Our findings show that SynovasureTM sensitivity is lower than quantitative α-D test, but when compared to the main available tests shows a good specificity and the highest DOR. On the SF it is the easier test to do, due to the fact that it needs a minimal amount of SF and it is not limited by blood contamination or antibiotic use. Whereas there is no single standalone test, SynovasureTM should be considered a reliable additional test for periprosthetic joint infection diagnosis in everyday clinical practice.

show abstract

Section: Discussionmentioning

confidence: 99%

Qualitative Alpha-defensin Versus The Main Available Tests For The Diagnosis Of Periprosthetic Joint Infection: Best Predictor Test?

Riccio

Cavagnaro

Akkouche

et al. 2018

J. Bone Joint Infect.

View full text Add to dashboard Cite

show abstract

Definition of periprosthetic joint infection of the hip and new tools for diagnosis

Shirley

Romero

Estrera³

2017

Current Orthopaedic Practice

View full text Add to dashboard Cite

A diagnosis of periprosthetic joint infection after total hip arthroplasty remains a challenge without a simple solution. It can be difficult to distinguish from aseptic failure of a total hip but is a significantly worse complication. Recent research has gone into attempting to find a cost-effective laboratory test or imaging modality that can assist in definitive diagnosis of periprosthetic joint infection, but there is no single most effective test as of yet. There are several promising possibilities arising from a variety of serum and synovial laboratory values, including alpha-defensin and leukocyte esterase tests. This review provides information on the most recent advances in the literature with regards to diagnosis of periprosthetic joint infection after total hip arthroplasty.

show abstract

CORR Insights®: The Alpha-defensin Test for Periprosthetic Joint Infection is Not Affected by Prior Antibiotic Administration

Cited by 2 publications

References 8 publications

Qualitative Alpha-defensin Versus The Main Available Tests For The Diagnosis Of Periprosthetic Joint Infection: Best Predictor Test?

Qualitative Alpha-defensin Versus The Main Available Tests For The Diagnosis Of Periprosthetic Joint Infection: Best Predictor Test?

Definition of periprosthetic joint infection of the hip and new tools for diagnosis

Contact Info

Product

Resources

About