Articles | Volume 10, issue 2
https://doi.org/10.5194/jbji-10-41-2025
© Author(s) 2025. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-10-41-2025
© Author(s) 2025. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
Synovial glucose and serum-to-synovial-glucose ratio perform better than other biomarkers for the diagnosis of acute postoperative prosthetic knee infection
Orthopedic and Traumatology Department, Clínic Barcelona, Carrer Villarroel 170, 08036 Barcelona, Spain
Oscar Garcia
Orthopedic and Traumatology Department, Clínic Barcelona, Carrer Villarroel 170, 08036 Barcelona, Spain
Laia Boadas
Orthopedic and Traumatology Department, Clínic Barcelona, Carrer Villarroel 170, 08036 Barcelona, Spain
Laura Morata
Department of Infectious Diseases, Clínic Barcelona, Carrer Villarroel 170, 08036 Barcelona, Spain
IDIBAPS (Institut d'Investigacions Biomèdiques Agustí-Pi Sunyer, University of Barcelona, Barcelona, Spain
Alex Soriano
Department of Infectious Diseases, Clínic Barcelona, Carrer Villarroel 170, 08036 Barcelona, Spain
IDIBAPS (Institut d'Investigacions Biomèdiques Agustí-Pi Sunyer, University of Barcelona, Barcelona, Spain
CIBERINF (CIBER for infectious diseases), Barcelona, Spain
Juan Carlos Martínez-Pastor
Orthopedic and Traumatology Department, Clínic Barcelona, Carrer Villarroel 170, 08036 Barcelona, Spain
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J. Bone Joint Infect., 10, 237–241, https://doi.org/10.5194/jbji-10-237-2025, https://doi.org/10.5194/jbji-10-237-2025, 2025
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This study's aim was to analyse the healing and failure rates of one-stage knee replacement in patients with positive and negative preoperative cultures and sinus presence. We concluded that culture-negative infections or the presence of a sinus tract showed similar results compared to patients that had undergone the same procedure with positive cultures or spared soft tissue.
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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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.
Laia Boadas-Gironès, Marta Sabater-Martos, Marc Ferrer-Banus, Àlex Soriano-Viladomiu, and Juan Carlos Martínez-Pastor
J. Bone Joint Infect., 9, 241–248, https://doi.org/10.5194/jbji-9-241-2024, https://doi.org/10.5194/jbji-9-241-2024, 2024
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When acute soft tissue defects are present after knee arthroplasty, the infection risk is high. A gastrocnemius flap is used for anterior defects, and it is not usually combined with debridement surgery unless infection is clear. We examined the benefit of combining coverage treatment with debridement surgery, DAIR, comparing the isolated traditional coverage treatment. The results suggested a higher healing rate in the combined treatment, so we recommended it.
Marta Sabater-Martos, Marc Ferrer, Laura Morata, Alex Soriano, and Juan Carlos Martínez-Pastor
J. Bone Joint Infect., 9, 17–26, https://doi.org/10.5194/jbji-9-17-2024, https://doi.org/10.5194/jbji-9-17-2024, 2024
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This is a meta-analysis of six studies describing the cutoff values of white blood cell count and polymorphonuclear percentage in synovial fluid for the diagnosis of acute postoperative peri-prosthetic joint infection (PJI).
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We found that both the WBC count and PMN percentage are good markers for diagnosis of acute postoperative PJI. However, the synovial WBC count is more powerful in diagnosing acute postoperative PJI.
Christen Ravn, Jeroen Neyt, Natividad Benito, Miguel Araújo Abreu, Yvonne Achermann, Svetlana Bozhkova, Liselotte Coorevits, Matteo Carlo Ferrari, Karianne Wiger Gammelsrud, Ulf-Joachim Gerlach, Efthymia Giannitsioti, Martin Gottliebsen, Nis Pedersen Jørgensen, Tomislav Madjarevic, Leonard Marais, Aditya Menon, Dirk Jan Moojen, Markus Pääkkönen, Marko Pokorn, Daniel Pérez-Prieto, Nora Renz, Jesús Saavedra-Lozano, Marta Sabater-Martos, Parham Sendi, Staffan Tevell, Charles Vogely, Alex Soriano, and the SANJO guideline group
J. Bone Joint Infect., 8, 29–37, https://doi.org/10.5194/jbji-8-29-2023, https://doi.org/10.5194/jbji-8-29-2023, 2023
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Management of septic arthritis in native joints (SANJO) is often conducted by clinicians of different specialties, experience levels, and at all hours of the day. The SANJO guideline group makes evidence-based recommendations for diagnosis, microbiological investigation, initial surgery, empirical antibiotic treatment, early mobilization, evaluation of outcomes, and treatment failure. Special considerations were made for children, tuberculosis, and SANJO after cruciate ligament reconstruction.
Marta Sabater-Martos, Laura Morata, Josep Maria Segur, Alex Soriano, and Juan Carlos Martínez-Pastor
J. Bone Joint Infect., 10, 237–241, https://doi.org/10.5194/jbji-10-237-2025, https://doi.org/10.5194/jbji-10-237-2025, 2025
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This study's aim was to analyse the healing and failure rates of one-stage knee replacement in patients with positive and negative preoperative cultures and sinus presence. We concluded that culture-negative infections or the presence of a sinus tract showed similar results compared to patients that had undergone the same procedure with positive cultures or spared soft tissue.
Hendrika M. Schenk, Marine Sebillotte, Jose Lomas, Adrian Taylor, Eva Benavent, Oscar Murillo, Marta Fernandez-Sampedro, Kaisa Huotari, Craig Aboltins, Rihard Trebse, Alex Soriano, Marjan Wouthuyzen-Bakker, and on behalf of the ESCMID Study Group on Implant Associated Infections (ESGIAI)
J. Bone Joint Infect., 10, 217–224, https://doi.org/10.5194/jbji-10-217-2025, https://doi.org/10.5194/jbji-10-217-2025, 2025
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Patients with rheumatoid arthritis have a high treatment failure rate when faced with a late acute periprosthetic joint infection. Because of the rarity of the condition, we performed a multicenter case-control study. We identified predictors of treatment failure to ultimately improve the treatment outcome. Exchange of modular components seems important in this patient group, likely due to a higher rate of positive blood cultures compared to control patients.
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
J. Bone Joint Infect., 10, 165–184, https://doi.org/10.5194/jbji-10-165-2025, https://doi.org/10.5194/jbji-10-165-2025, 2025
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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.
Irene K. Sigmund, Marjan Wouthuyzen-Bakker, Tristan Ferry, Willem-Jan Metsemakers, Martin Clauss, Alex Soriano, Rihard Trebse, and Ricardo Sousa
J. Bone Joint Infect., 10, 139–142, https://doi.org/10.5194/jbji-10-139-2025, https://doi.org/10.5194/jbji-10-139-2025, 2025
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This is a summary of our position paper on debridement, antimicrobial therapy, and implant retention (DAIR) procedures as a curative treatment strategy for acute periprosthetic hip and knee infections. It includes the defined indications as well as the contraindications of DAIR procedures when eradication/cure is intended, based on the currently available literature.
Irene K. Sigmund, Tristan Ferry, Ricardo Sousa, Alex Soriano, Willem-Jan Metsemakers, Martin Clauss, Rihard Trebse, and Marjan Wouthuyzen-Bakker
J. Bone Joint Infect., 10, 101–138, https://doi.org/10.5194/jbji-10-101-2025, https://doi.org/10.5194/jbji-10-101-2025, 2025
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In this paper, we discuss the most relevant factors influencing the outcome and define indications, contraindications, and risk factors of a DAIR procedure based on the currently available literature. Furthermore, we discuss the surgical technique in combination with systemic antimicrobial therapy in patients undergoing a DAIR procedure.
Laia Boadas-Gironès, Marta Sabater-Martos, Marc Ferrer-Banus, Àlex Soriano-Viladomiu, and Juan Carlos Martínez-Pastor
J. Bone Joint Infect., 9, 241–248, https://doi.org/10.5194/jbji-9-241-2024, https://doi.org/10.5194/jbji-9-241-2024, 2024
Short summary
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When acute soft tissue defects are present after knee arthroplasty, the infection risk is high. A gastrocnemius flap is used for anterior defects, and it is not usually combined with debridement surgery unless infection is clear. We examined the benefit of combining coverage treatment with debridement surgery, DAIR, comparing the isolated traditional coverage treatment. The results suggested a higher healing rate in the combined treatment, so we recommended it.
Seung-Jae Yoon, Paul C. Jutte, Alex Soriano, Ricardo Sousa, Wierd P. Zijlstra, and Marjan Wouthuyzen-Bakker
J. Bone Joint Infect., 9, 231–239, https://doi.org/10.5194/jbji-9-231-2024, https://doi.org/10.5194/jbji-9-231-2024, 2024
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This study validated three models for predicting infection after hip and knee replacement surgery. By analyzing data from 2684 patients in the Netherlands, Portugal, and Spain, we found that the models developed by Tan, Del Toro, and Bülow effectively identified high-risk patients. These models can be used to enhance preoperative counseling and to tailor infection prevention measures individually, potentially improving outcomes and reducing healthcare costs.
Marta Sabater-Martos, Marc Ferrer, Laura Morata, Alex Soriano, and Juan Carlos Martínez-Pastor
J. Bone Joint Infect., 9, 17–26, https://doi.org/10.5194/jbji-9-17-2024, https://doi.org/10.5194/jbji-9-17-2024, 2024
Short summary
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This is a meta-analysis of six studies describing the cutoff values of white blood cell count and polymorphonuclear percentage in synovial fluid for the diagnosis of acute postoperative peri-prosthetic joint infection (PJI).
We found that both the WBC count and PMN percentage are good markers for diagnosis of acute postoperative PJI. However, the synovial WBC count is more powerful in diagnosing acute postoperative PJI.
We found that both the WBC count and PMN percentage are good markers for diagnosis of acute postoperative PJI. However, the synovial WBC count is more powerful in diagnosing acute postoperative PJI.
Christen Ravn, Jeroen Neyt, Natividad Benito, Miguel Araújo Abreu, Yvonne Achermann, Svetlana Bozhkova, Liselotte Coorevits, Matteo Carlo Ferrari, Karianne Wiger Gammelsrud, Ulf-Joachim Gerlach, Efthymia Giannitsioti, Martin Gottliebsen, Nis Pedersen Jørgensen, Tomislav Madjarevic, Leonard Marais, Aditya Menon, Dirk Jan Moojen, Markus Pääkkönen, Marko Pokorn, Daniel Pérez-Prieto, Nora Renz, Jesús Saavedra-Lozano, Marta Sabater-Martos, Parham Sendi, Staffan Tevell, Charles Vogely, Alex Soriano, and the SANJO guideline group
J. Bone Joint Infect., 8, 29–37, https://doi.org/10.5194/jbji-8-29-2023, https://doi.org/10.5194/jbji-8-29-2023, 2023
Short summary
Short summary
Management of septic arthritis in native joints (SANJO) is often conducted by clinicians of different specialties, experience levels, and at all hours of the day. The SANJO guideline group makes evidence-based recommendations for diagnosis, microbiological investigation, initial surgery, empirical antibiotic treatment, early mobilization, evaluation of outcomes, and treatment failure. Special considerations were made for children, tuberculosis, and SANJO after cruciate ligament reconstruction.
Efthymia Giannitsioti, Mauro José Salles, Andreas Mavrogenis, Dolors Rodriguez-Pardo, Ibai Los-Arcos, Alba Ribera, Javier Ariza, María Dolores del Toro, Sophie Nguyen, Eric Senneville, Eric Bonnet, Monica Chan, Maria Bruna Pasticci, Sabine Petersdorf, Natividad Benito, Nuala O' Connell, Antonio Blanco García, Gábor Skaliczki, Pierre Tattevin, Zeliha Kocak Tufan, Nikolaos Pantazis, Panayiotis D. Megaloikonomos, Panayiotis Papagelopoulos, Alejandro Soriano, Antonios Papadopoulos, and the ESGIAI collaborators study group
J. Bone Joint Infect., 7, 279–288, https://doi.org/10.5194/jbji-7-279-2022, https://doi.org/10.5194/jbji-7-279-2022, 2022
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Our multicentre study on a lower-limb osteosynthesis-associated infection (OAI) cohort by multidrug (MDR) and extensively drug (XDR) resistant Gram-negative bacteria found the following: implant retention with debridement was mostly performed in early OAI; 50.9 % of patients achieved remission of infection; remission reached 50 % (MDR) vs. 25 % (XDR) in early OAI and 60 % (MDR) vs. 44.4 % (XDR) in late OAI; age (> 60) and multiple surgeries were independent factors influencing lack of remission.
Ernesto Muñoz-Mahamud, Eduard Tornero, José A. Estrada, Jenaro A. Fernández-Valencia, Juan C. Martínez-Pastor, and Álex Soriano
J. Bone Joint Infect., 7, 109–115, https://doi.org/10.5194/jbji-7-109-2022, https://doi.org/10.5194/jbji-7-109-2022, 2022
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A patient with normal D-dimer value has a low risk of prosthetic joint infection, so serum D-dimer assessment should always be considered as a useful test to rule out chronic prosthetic joint infection (especially in those cases caused by low-virulence microorganisms in which conventional tests may lead to misdiagnosis). Conversely, the platelet count to mean platelet volume ratio may be of limited value for accurately diagnosing prosthetic joint infection.
Karel-Jan Dag François Lensen, Rosa Escudero-Sanchez, Javier Cobo, Rihard Trebše, Camelia Gubavu, Sara Tedeschi, Jose M. Lomas, Cedric Arvieux, Dolors Rodriguez-Pardo, Massimo Fantoni, Maria Jose Garcia Pais, Francisco Jover, Mauro José Costa Salles, Ignacio Sancho, Marta Fernandez Sampedro, Alex Soriano, Marjan Wouthuyzen-Bakker, and ESCMID Study Group of Implant Associated Infections (ESGIAI)
J. Bone Joint Infect., 6, 313–319, https://doi.org/10.5194/jbji-6-313-2021, https://doi.org/10.5194/jbji-6-313-2021, 2021
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Our data suggest that, in periprosthetic joint infection (PJI) patients with a draining sinus, suppressive antibiotic treatment (SAT) can be considered on an individual basis. SAT may reduce pain and favour the closure of the sinus tract in certain individuals, but the prescription of SAT does not appear to have any influence on the prevention of prosthetic loosening and other infectious complications.
Ernesto Muñoz-Mahamud, Jenaro Ángel Fernández-Valencia, Andreu Combalia, Laura Morata, and Álex Soriano
J. Bone Joint Infect., 6, 85–90, https://doi.org/10.5194/jbji-6-85-2021, https://doi.org/10.5194/jbji-6-85-2021, 2021
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A plausible cause of persistent infection after septic hip revision may be the presence of nonviable osteomyelitic bone. We present our initial experience in hip revision for chronic infection in which fluorescent tetracycline bone labeling was used as an additional aid to provide a visual index of surgical bone debridement. In the present series, the use of this technique successfully aided the surgeon to detect the presence of nonviable bone.
Karel-Jan Lensen, Rosa Escudero-Sanchez, Javier Cobo, Alex Soriano, and Marjan Wouthuyzen-Bakker
J. Bone Joint Infect., 6, 43–45, https://doi.org/10.5194/jbji-6-43-2020, https://doi.org/10.5194/jbji-6-43-2020, 2020
Cited articles
Akobeng, A. K. and Akobeng, A. K.: Understanding diagnostic tests 3: receiver operating characteristic curves, Acta Paediatr., 96, 644–647, https://doi.org/10.1111/J.1651-2227.2006.00178.X, 2007.
Bauer, T. W., Parvizi, J., Kobayashi, N., and Krebs, V.: Diagnosis of Periprosthetic Infection, J. Bone Joint Surg. Am., 88, 869–882, 2006.
Bedair, H., Ting, N., Jacovides, C., Saxena, A., Moric, M., Parvizi, J., and Della Valle, C. J.: The mark coventry award: Diagnosis of early postoperative TKA infection using synovial fluid analysis, in: Clinical Orthopaedics and Related Research, 34–40, https://doi.org/10.1007/s11999-010-1433-2, 2011.
Benito, N., Mur, I., Ribera, A., Soriano, A., Rodríguez-Pardo, D., Sorlí, L., Cobo, J., Fernández-Sampedro, M., del Toro, M., Guío, L., Praena, J., Bahamonde, A., Riera, M., Esteban, J., Baraia-Etxaburu, J., Martínez-Alvarez, J., Jover-Sáenz, A., Dueñas, C., Ramos, A., Sobrino, B., Euba, G., Morata, L., Pigrau, C., Horcajada, J., Coll, P., Crusi, X., and Ariza, J.: The Different Microbial Etiology of Prosthetic Joint Infections according to Route of Acquisition and Time after Prosthesis Implantation, Including the Role of Multidrug-Resistant Organisms, J. Clin. Med., 8, 673, https://doi.org/10.3390/jcm8050673, 2019.
Brennan, M. B. and Hsu, J. L.: Septic arthritis in the native joint, Curr. Infect. Dis. Rep., 14, 558–565, https://doi.org/10.1007/s11908-012-0285-1, 2012.
Carpenter, C. R., Schuur, J. D., Everett, W. W., and Pines, J. M.: Evidence-based Diagnostics: Adult Septic Arthritis, Acad. Emerg. Med., 18, 781–796, https://doi.org/10.1111/j.1553-2712.2011.01121.x, 2011.
Christensen, C. P., Bedair, H., Valle, C. J. D., Parvizi, J., Schurko, B., and Jacobs, C. A.: The natural progression of synovial fluidwhite blood-cell counts and the percentage of polymorphonuclear cells after primary total knee arthroplasty a multicenter study, J. Bone Joint Surg., 95, 2081–2087, https://doi.org/10.2106/JBJS.L.01646, 2013.
Davis, L. E.: Acute Bacterial Meningitis, Continuum (Minneap Minn), 24, 1264–1283, https://doi.org/10.1212/CON.0000000000000660, 2018.
Elsissy, J. G., Liu, J. N., Wilton, P. J., Nwachuku, I., Gowd, A. K., and Amin, N. H.: Bacterial Septic Arthritis of the Adult Native Knee Joint: A Review, JBJS Rev., 8, e0059, https://doi.org/10.2106/JBJS.RVW.19.00059, 2020.
Fernández-Sampedro, M., Fariñas-Alvarez, C., Garces-Zarzalejo, C., Alonso-Aguirre, M. A., Salas-Venero, C., Martínez-Martínez, L., and Fariñas, M. C.: Accuracy of different diagnostic tests for early, delayed and late prosthetic joint infection, BMC Infect. Dis., 17, 592, https://doi.org/10.1186/s12879-017-2693-1, 2017.
Goswami, K., Parvizi, J., and Maxwell Courtney, P.: Current Recommendations for the Diagnosis of Acute and Chronic PJI for Hip and Knee – Cell Counts, Alpha-Defensin, Leukocyte Esterase, Next-generation Sequencing, Curr. Rev. Musculoskelet Med., 11, 428–438, https://doi.org/10.1007/s12178-018-9513-0, 2018.
Kim, S. G., Kim, J. G., Jang, K. M., Han, S. B., Lim, H. C., and Bae, J. H.: Diagnostic Value of Synovial White Blood Cell Count and Serum C-Reactive Protein for Acute Periprosthetic Joint Infection After Knee Arthroplasty, J. Arthroplasty, 32, 3724–3728, https://doi.org/10.1016/j.arth.2017.07.013, 2017a.
Kim, S. G., Kim, J. G., Jang, K. M., Han, S. B., Lim, H. C., and Bae, J. H.: Diagnostic Value of Synovial White Blood Cell Count and Serum C-Reactive Protein for Acute Periprosthetic Joint Infection After Knee Arthroplasty, J. Arthroplasty, 32, 3724–3728, https://doi.org/10.1016/j.arth.2017.07.013, 2017b.
Kinugasa, M., Kobayashi, D., Satsuma, S., Sakata, R., Shinada, Y., and Kuroda, R.: The predictive value of synovial glucose level in septic arthritis, J. Pediatr. Orthop. B, 29, 292–296, https://doi.org/10.1097/BPB.0000000000000628, 2020.
Krastev, N., Djurkov, V., Murdjeva, M., Akrabova, P., Karparova, T., Penkov, V., Kiprin, G., Asenov, K., Krastev, N., Djurkov, V., Murdjeva, M., Akrabova, P., Karparova, T., Penkov, V., Kiprin, G., and Asenov, K.: Diagnosis of spontaneous and secondary bacterial peritonitis in patients with hepatic cirrhosis and ascites, Khirurgiia (Sofiia), 2013, 254–266, 2013.
Kurtz, S. M., Ong, K. L., Lau, E., Bozic, K. J., Berry, D., and Parvizi, J.: Prosthetic joint infection risk after TKA in the medicare population, Clin. Orthop. Relat. R., 468, 52–56, https://doi.org/10.1007/s11999-009-1013-5, 2010.
Mcnally, M., Sousa, R., Wouthuyzen-Bakker, M., Chen, A. F., Soriano, A., Vogely, H. C., Clauss, M., Higuera, C. A., and Trebše, R.: The EBJIS definition of periprosthetic joint infection, Bone Joint J., 103, 18–25, https://doi.org/10.1302/0301-620X.103B1.BJJ-2020-1381.R1, 2021.
Parvizi, J. and Gehrke, T.: Definition of Periprosthetic Joint Infection, J. Arthroplasty, 29, 1331, https://doi.org/10.1016/J.ARTH.2014.03.009, 2014.
Parvizi, J., Gehrke, T., and Chen, A. F.: Proceedings of the International Consensus on Periprosthetic Joint Infection, Bone Joint J., 95-B, 1450–1452, https://doi.org/10.1302/0301-620X.95B11.33135, 2013.
Parvizi, J., Tan, T. L., Goswami, K., Higuera, C., Della Valle, C., Chen, A. F., and Shohat, N.: The 2018 Definition of Periprosthetic Hip and Knee Infection: An Evidence-Based and Validated Criteria, J. Arthroplasty, 33, 1309–1314, https://doi.org/10.1016/j.arth.2018.02.078, 2018.
Signore, A., Sconfienza, L. M., Borens, O., Glaudemans, A. W. J. M., Cassar-Pullicino, V., Trampuz, A., Winkler, H., Gheysens, O., Vanhoenacker, F. M. H. M., Petrosillo, N., and Jutte, P. C.: Consensus document for the diagnosis of prosthetic joint infections: a joint paper by the EANM, EBJIS, and ESR (with ESCMID endorsement), Eur. J. Nucl. Med. Mol. I., 46, 971–988, https://doi.org/10.1007/s00259-019-4263-9, 2019.
Söderquist, B., Jones, I., Fredlund, H., and Vikerfors, T.: Bacterial or crystal-associated arthritis? Discriminating ability of serum inflammatory markers, Scand. J. Infect. Dis., 30, 591–596, https://doi.org/10.1080/00365549850161151, 1998.
Sukhonthamarn, K., Tan, T. L., Xu, C., Kuo, F. C., Lee, M. S., Citak, M., Gehrke, T., Goswami, K., and Parvizi, J.: Determining Diagnostic Thresholds for Acute Postoperative Periprosthetic Joint Infection, J. Bone Joint Surg., 102, 2043–2048, https://doi.org/10.2106/JBJS.20.00257, 2020.
Tande, A. J. and Patel, R.: Prosthetic joint infection, Clin. Microbiol. Rev., 27, 302–345, https://doi.org/10.1128/CMR.00111-13, 2014.
The Jamovi project: jamovi (Version 2.5), jamovi [code], https://www.jamovi.org (last access: 24 October 2024), 2024.
Workgroup, T. and Society, I.: New Definition for Periprosthetic Joint Infection, J. Arthroplasty, 26, 1136–1138, https://doi.org/10.1016/j.arth.2011.09.026, 2011.
Yi, P. H., Cross, M. B., Moric, M., Sporer, S. M., Berger, R. A., and Della Valle, C. J.: The 2013 frank stinchfield award: Diagnosis of infection in the early postoperative period after total hip arthroplasty, in: Clinical Orthopaedics and Related Research, 424–429, https://doi.org/10.1007/s11999-013-3089-1, 2014.
Zimmerli, W., Trampuz, A., and Ochsner, P. E.: Prosthetic-Joint Infections, New Engl. J. Med., 351, 1645–1654, https://doi.org/10.1056/NEJMra040181, 2004.
Short summary
This is a retrospective diagnostic study in acute postoperative prosthetic joint infection in total knee arthroplasty that wants to determine diagnostic accuracy of synovial glucose and serum-to-synovial glucose ratio in acute postoperative infection. Both tests demonstrated good diagnostic potential. Notably, these biomarkers exhibited superior accuracy compared to the combination of C-reactive protein, synovial white blood cell count and polymorphonuclear percentage.
This is a retrospective diagnostic study in acute postoperative prosthetic joint infection in...