Evaluation of Synovial Calprotectin by Using a Lateral Flow Test for the Diagnosis of Prosthetic Joint Infections

Bottagisio, Marta; Viganò, Marco; Pellegrini, Antonio; Logoluso, Nicola; Zagra, Luigi; Prina, Andrea; Girolamo, Laura de; Vecchi, Elena De

doi:10.3390/diagnostics13040741

Cited by 2 publications

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“…We determine the diagnosis according to intraoperative pathologic examination with the lack of typical symptoms. It is difficult to accurately diagnose PJI before surgery, and it is a research hotspot to find specific serum markers such as interleukin-6, procalcitonin (PCT), and α-defensin ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of procalcitonin in patients with periprosthetic joint infection: a diagnostic meta-analysis

Sun,

Li,

et al. 2024

Front. Surg.

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BackgroundThe success rate of periprosthetic joint infection (PJI) treatment is still low. Early diagnosis is the key to successful treatment. Therefore, it is necessary to find a biomarker with high sensitivity and specificity. The diagnostic value of serum procalcitonin (PCT) for PJI was systematically evaluated to provide the theoretical basis for clinical diagnosis and treatment in this study.MethodsWe searched the Web of Science, Embase, Cochrane Library, and PubMed for studies that evaluated the diagnostic value of serum PCT for PJI (from the inception of each database until September 2020). Two authors independently screened the literature according to the inclusion and exclusion criteria. The quality of each selected literature was evaluated by using the Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2) tool. RevMan 5.3 software was used for the quality evaluation. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were merged by using Meta-DiSc 1.4 software. The area under the curve (AUC) and Q index were calculated after the summary receiver operating characteristic (SROC) was generated. We also performed subgroup analysis.ResultsA total of 621 patients were enrolled in the nine studies. The pooled sensitivity of serum PCT for PJI diagnosis was 0.441 [95% confidence interval (CI), 0.384–0.500], the pooled specificity was 0.852 (95% CI, 0.811–0.888), the pooled PLR was 2.271 (95% CI, 1.808–2.853), the pooled NLR was 0.713 (95% CI, 0.646–0.786), and the pooled DOR was 5.756 (95% CI, 3.673–9.026). The area under SROC (the pooled AUC) was 0.76 (0.72–0.79). Q index was 0.6948.ConclusionThis study showed that PCT detection of PJI had poor diagnostic accuracy. Hence, the serum PCT is not suitable as a serum marker for PJI diagnosis.

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Section: Introductionmentioning

confidence: 99%

Diagnostic value of procalcitonin in patients with periprosthetic joint infection: a diagnostic meta-analysis

Sun,

Li,

et al. 2024

Front. Surg.

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Synovial calprotectin in prosthetic joint infection. A systematic review and meta-analysis of the literature

Festa,

Ascione,

Di Gennaro

et al. 2024

Arch Orthop Trauma Surg

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Introduction Calprotectin is a protein endowed with antimicrobial properties, rendering it a distinctive marker for infection. Two methods are currently available for the assay of calprotectin: the enzyme-linked immunosorbent assay (ELISA) and the lateral flow test (LFT). We aimed to assess the diagnostic accuracy of synovial fluid calprotectin and to compare the accuracy of the laboratory-based test and the qualitative assessment for the diagnosis of hip and knee prosthetic infection. Materials and methods We searched (from inception to November 2023) MEDLINE, Scopus, EMBASE, Web of Science, and Cochrane for studies on calprotectin in the diagnosis of periprosthetic joint infection (PJI). Sensitivity, specificity, positive and negative likelihood ratio (LR), and diagnostic odds ratio were analyzed. The receiver-operating curve for each method was calculated. Results We included 14 articles in our meta-analysis, including 902 patients who underwent total hip and knee arthroplasties revision; 331 (37%) had a joint infection according to MSIS, MSIS-modified criteria, ICM 2018 and EBJIS 2021. Considering the false-positive result rate of 6% and false-negative result rate of 7%, pooled sensitivity and specificity were 0.92 (95% CI 0.89–0.94) and 0.93 (0.91–0.95), respectively. The area under the curve (AUC) was 0.93 (95% CI 0.91–0.94). No statistical differences in terms of sensitivity and specificity were found between ELISA and LFT. The pooled sensitivity and specificity of the two calprotectin assessment methods were: LFT 0.90 (95% CI 0.869–0.935) and 0.92 (95% CI 0.894–0.941), respectively; ELISA 0.96 (95% CI 0.914–0.986) and 0.97 (95% CI 0.934–0.988), respectively. The diagnostic odds ratio of the ELISA was superior to that of the LFT (906.6667, 95% CI 271.2686–3030.3712 versus 113.8886, 95% CI 70.4001-184.2414; p < 0.001). The AUC for ELISA and LFT was 0.968 (95% CI 0.944–0.984) and 0.915 (95% CI 0.895–0.933), respectively. Conclusions Detection of synovial calprotectin is an accurate test for diagnosis of hip and knee prosthetic infections. The diagnostic accuracy of the two calprotectin assessment methods is almost comparable. The LFT is a valid, rapid, and more available diagnostic tool, particularly to rule out PJI.

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Evaluation of Synovial Calprotectin by Using a Lateral Flow Test for the Diagnosis of Prosthetic Joint Infections

Cited by 2 publications

References 30 publications

Diagnostic value of procalcitonin in patients with periprosthetic joint infection: a diagnostic meta-analysis

Diagnostic value of procalcitonin in patients with periprosthetic joint infection: a diagnostic meta-analysis

Synovial calprotectin in prosthetic joint infection. A systematic review and meta-analysis of the literature

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