Articles | Volume 11, issue 1
https://doi.org/10.5194/jbji-11-1-2026
https://doi.org/10.5194/jbji-11-1-2026
Case report
 | 
07 Jan 2026
Case report |  | 07 Jan 2026

Synovial fluid α-defensin might be false positive in early stages after major total arthroplasty revision surgery

Sankalp Mrutyunjaya, Wade A. Banta, Joseph R. B. Espiritu, and Derek F. Amanatullah

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Cited articles

Bingham, J., Clarke, H., Spangehl, M., Schwartz, A., Beauchamp, C., and Goldberg, B.: The Alpha Defensin-1 Biomarker Assay can be Used to Evaluate the Potentially Infected Total Joint Arthroplasty, Clinical Orthopaedics and Related Research®, 472, 4006–4009, https://doi.org/10.1007/s11999-014-3900-7, 2014. 
Cooper, K. B., Siegel, E. R., Stambough, J. B., Bumpass, D. B., and Mears, S. C.: The Alpha-Defensin Prosthetic Joint Infection Test Has Poor Validity for Native Knee Joint Infection, J. Arthroplasty, 36, 2957–2961, https://doi.org/10.1016/j.arth.2021.03.020, 2021. 
Davis, C.: Generalizing from clinical trials, Controlled Clinical Trials 15, 11–14, https://doi.org/10.1016/0197-2456(94)90023-x, 1994. 
Heckmann, N. D., Wang, J. C., Liu, K. C., Won, P., Chung, B. C., Mayer, L. W., Longjohn, D. B., Oakes, D. A., Christ, A. B., and Lieberman, J. R.: Refining the Role of Routine Synovial Alpha-Defensin in Periprosthetic Joint Infection Following Total Knee Arthroplasty: An Analysis of Limitations, Journal of Arthroplasty, 38, 2691–2697, https://doi.org/10.1016/j.arth.2023.05.095, 2023. 
Kim, S.-J. and Cho, Y. J.: Current Guideline for Diagnosis of Periprosthetic Joint Infection: A Review Article, Hip and Pelvis, 33, 11–17, https://doi.org/10.5371/hp.2021.33.1.11, 2021. 
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Short summary
This is a case report which follows a patient who received multiple false positive synovial alpha-defensin test results following a revision for total knee arthroplasty. The report looks at the importance of generalizability in diagnostic testing and how a lack thereof can extend the cost and duration of care.
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