The role of biomarkers in the diagnosis of periprosthetic joint infection

Abstract

The role of serum erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) as the first line for evaluating a patient with periprosthetic joint infection (PJI) has been debunked.We are living in the era of biomarkers for the diagnosis of PJI, and to that effect, several biomarkers have been introduced such as synovial fluid alpha defensin and leukocyte esterase.The synovial fluid leukocyte esterase test has a low cost, is accessible, and has provided promising results for diagnosing PJI.There is an urgent need for an accurate and reliable serum biomarker for diagnosing patients with PJI.Cite this article: Shahi A, Parvizi J. The role of biomarkers in the diagnosis of periprosthetic joint infection. EFORT Open Rev 2016;1:275-278. DOI: 10.1302/2058-5241.1.160019.

Curcumin nanoparticles are a promising anti-bacterial and anti-inflammatory agent for treating periprosthetic joint infections

“…49 Moreover, IL-6, TNF-α, and MCP-1 are involved in inflammation and are sensitive markers for PJIs or deep implants. 43,44 S. aureus biofilm infection induced the upregulation of TNF-α, IL-6, and MCP-1, which were reduced by CURN treatment in this study. This suppression agrees with the results of previous studies on inflammation 29 and indicates that CURN reduced MDSC expansion by downregulating the expression of inflammatory cytokines.…”

“…Several inflammatory factors, such as IL-6, TNF-α, and monocyte chemoattractant protein-1 (MCP-1), are highly associated with PJIs. 43,44 Thus, the levels of these proteins were evaluated after CURN treatment. (39.2% at 25 µM), MCP-1 (38.7% at 25 µM), and TNF-α (18% at 25 µM), while no significant effects were observed in the biofilm-negative groups ( Figure 3A-C).…”

Is Procalcitonin (PCT) a reliable biomarker for preoperative diagnosing of low grade periprosthetic joint infection? A prospective study

“…Alpha-Defensins are microbicidal peptides that are active against many Gram-negative and Gram-positive bacteria, fungi, and enveloped viruses [37]. Bingham et al (2014) concluded that the sensitivity and specificity of the synovial fluid α-defensin assay is superior to other currently available clinical tests [38,39]. However, there are also reports about low sensitivity values (64%) of synovial alpha-1-defensin [20].…”

Primer total diz artroplastisi sonucu oluşan derin enfeksiyonun oluş nedenleri ile güncel tanı ve tedavi yaklaşımları

“…[86][87][88] Teknesyum-99 izotop kullanımında hat boyuncu tutulumun olmaması enfeksiyonu dışlama açısından kullanılabilmekte, ancak Indium-111 molekülü Teknesyum-99 molekülüne göre daha doğru tanı kullanılan bu belirteçlerden, ESR %91'lik bir duyarlılık, %72'lik bir özgünlük ve CRP %94'lük bir duyarlılık ile %74'lük bir özgünlük oranına sahiptir. [75] Ameliyat sonrası erken dönemde meydana gelebilecek enfeksiyonlara karşı dikkatli olunmalıdır. CRP ve sedimentasyon hızı haricinde prokalsitonin kullanılan diğer bir ölçüt olup daha özgündür, fakat implantla ilişkili enfeksiyonu belirlemede çok yeterli değildir.…”