Journal of Bone and Joint Infection
Journal of Bone and Joint Infection
JBJI
Articles | Volume 10, issue 3
Articles | Volume 10, issue 3
https://doi.org/10.5194/jbji-10-165-2025
© Author(s) 2025. This work is distributed under
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-10-165-2025
© Author(s) 2025. This work is distributed under
the Creative Commons Attribution 4.0 License.
Articles | Volume 10, issue 3
Original full-length article
 | 
14 May 2025
Original full-length article |  | 14 May 2025

Differential synovial fluid white blood cell count for the diagnosis of chronic peri-prosthetic joint infection – a systematic review and meta-analysis

Marta Sabater-Martos, Martin Clauss, Ana Ribau, Ricardo Sousa, and on behalf of the Leukocyte Count Synovial Fluid working group for the Unified PJI definition task force

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Latest update: 29 Oct 2025
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Short summary
This meta-analysis evaluates synovial fluid white blood cell count and polymorphonuclear neutrophil proportion in order to diagnose chronic peri-prosthetic joint infection. Based on 74 studies, it identifies optimal thresholds, with rule-in and rule-out thresholds enhancing diagnostic precision. Confounding factors such as fractures and inflammatory arthritis are addressed. The findings support standardized diagnostic frameworks in improving accuracy and clinical consistency.
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