Articles | Volume 4, issue 4
https://doi.org/10.7150/jbji.34854
© Author(s) 2019. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
https://doi.org/10.7150/jbji.34854
© Author(s) 2019. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
Factors to Consider When Assessing the Diagnostic Accuracy of Synovial Leukocyte Count in Periprosthetic Joint Infection
Karsten D Ottink
Department of Orthopaedics, University of Groningen, University Medical Centre Groningen, the Netherlands
Carol Strahm
Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, Switzerland
Anneke Muller-Kobold
Department of Laboratory Medicine, University of Groningen, University Medical Centre Groningen, The Netherlands
Parham Sendi
Department of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University Basel, Basel, Switzerland
Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland.
Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
Marjan Wouthuyzen-Bakker
Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Centre Groningen, The Netherlands
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Cited
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- Synovial Fluid Leukocyte Count and Differential Are Poor Standalone Rule-in Tests for Periprosthetic Joint Infection: Results of a Methodological Audit and Reanalysis of the 2025 Meta-analysis Underpinning the Unified Periprosthetic Joint Infection Criteria A. Parthasarathi et al. https://doi.org/10.1097/CORR.0000000000004002
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- The potential utility of synovial C-reactive protein, interleukin-6, and presepsin in diagnostics of periprosthetic joint infection L. Lyubimova et al. https://doi.org/10.17816/2311-2905-17578
- Dynamics of Synovial Fluid Markers Following Single-Stage Exchange and Debridement, Antibiotics, and Implant Retention Procedure With Topical Antibiotic Infusion in Treating Periprosthetic Joint Infection W. Mu et al. https://doi.org/10.1016/j.arth.2024.11.045
- Multiplex cytokine analysis for the identification of novel potential synovial fluid biomarkers for periprosthetic joint infections C. Argyrou et al. https://doi.org/10.1016/j.injury.2024.111659
- The optimal diagnostic cut-off of WBC and PMN counts for joint aspiration in periprosthetic joint infection is 2479/µL and 67%, respectively: ICM criteria thresholds are too high Y. Gramlich et al. https://doi.org/10.1007/s00402-023-04822-0
- A Highly Efficacious Electrical Biofilm Treatment System for Combating Chronic Wound Bacterial Infections F. Zhao et al. https://doi.org/10.1002/adma.202208069
- Image-guided synovial biopsy with a focus on infection R. Macnair et al. https://doi.org/10.1007/s00256-022-04245-9
- D-lactate is a promising biomarker for the diagnosis of periprosthetic joint infection M. Fuchs et al. https://doi.org/10.3389/fsurg.2022.1082591
- Assessing the diagnostic accuracy of synovial fluid send-out laboratory panels for suspected knee periprosthetic joint infection R. Palmer et al. https://doi.org/10.1302/0301-620X.108B4.BJJ-2024-1345.R2
- Application of leukocyte esterase strip test in the screening of periprosthetic joint infections and prospects of high-precision strips Q. Zheng & G. Zhang https://doi.org/10.1186/s42836-020-00053-5
- Elevated ESR and CRP Prior to Second-Stage Reimplantation Knee Revision Surgery for Periprosthetic Joint Infection Are Associated with Increased Reinfection Rates C. Klemt et al. https://doi.org/10.1055/s-0041-1733902
- Diagnosis of orthopaedic-implant-associated infections caused by slow-growing Gram-positive anaerobic bacteria – a clinical perspective D. Ponraj et al. https://doi.org/10.5194/jbji-6-367-2021
- Simple and inexpensive synovial fluid biomarkers for the diagnosis of prosthetic joint infection according to the new EBJIS definition S. Diniz et al. https://doi.org/10.5194/jbji-8-109-2023
- Periprosthetic joint infections in a city hospital in Türkiye: A cross-sectional study B. Kaya et al. https://doi.org/10.1097/MD.0000000000045783
- Clinical Benefit of Using Differential Cutoff Values of Synovial C-Reactive Protein in Acute and Chronic Infected as Well as Aseptic Hip and Knee Revision Arthroplasties S. Sebastian et al. https://doi.org/10.1016/j.arth.2025.04.011
- Are Synovial Inflammatory Markers Increased in Patients Who Have Aseptic Total Hip Arthroplasty Dislocation Indicated for Revision? J. Hubert et al. https://doi.org/10.1016/j.arth.2023.08.054
- Diagnosis of Periprosthetic Joint Infection: The Utility of Biomarkers in 2023 M. Yilmaz et al. https://doi.org/10.3390/antibiotics12061054
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- The significance of synovial biopsy in the diagnostic workup of the low-grade periprosthetic joint infection of shoulder arthroplasty M. Mederake et al. https://doi.org/10.1007/s00402-021-03932-x
- How Reliable Is the Absolute Synovial Polymorphonuclear Neutrophil Cell Count in Diagnosing Periprosthetic Joint Infection? T. Karlidag et al. https://doi.org/10.1016/j.arth.2023.10.038
- Mycobacterium flavescens Infection - An Unusual Case of Prosthetic Joint Infection P. Holleb et al. https://doi.org/10.2174/0118715265274138231229070757
- Introducing image-guided synovial aspiration and biopsy in assessing peri-prosthetic joint infection: an early single-centre experience R. Rajakulasingam et al. https://doi.org/10.1007/s00256-021-03774-z
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- Periprosthetic Joint Infections A. Hewlett et al. https://doi.org/10.1016/j.idc.2025.02.010
- Serum calprotectin: a potential biomarker to diagnose chronic prosthetic joint infection after total hip or knee arthroplasty T. Ackmann et al. https://doi.org/10.1038/s41598-022-09724-6
- Value of “true” leukocytosis formula in determining total knee arthroplasty prosthetic joint infection in the community hospital setting B. Sweeney et al. https://doi.org/10.5312/wjo.v17.i2.113667
- Current Concepts in Shoulder Periprosthetic Joint Infections—Are Shoulders the Same as Hips and Knees? F. Frank et al. https://doi.org/10.3390/jcm14082578
- Analytical and clinical considerations of synovial fluid calprotectin in diagnosing periprosthetic joint infections M. Alkadhem et al. https://doi.org/10.1080/10408363.2025.2463634
- Unsuspected Positive Cultures in Planned Aseptic Revision Knee or Hip Arthroplasty—Risk Factors and Impact on Survivorship J. Schwarze et al. https://doi.org/10.1016/j.arth.2022.02.054
- Synovial fluid viscosity with synovial fluid cell count, valuable diagnostic marker of prosthetic joint infections S. Roškar et al. https://doi.org/10.1038/s41598-025-00760-6
- What is the best cutoff point of leukocyte esterase for diagnosis of periprosthetic joint infections? a systematic review and meta-analysis M. Poursalehian et al. https://doi.org/10.1186/s42836-025-00325-y
- Septic arthritis and prosthetic joint infections: microbial spectrum and evolving resistance patterns M. Gürler et al. https://doi.org/10.5194/jbji-11-123-2026
- Diagnostic accuracy of neutrophil counts in histopathological tissue analysis in periprosthetic joint infection using the ICM, IDSA, and EBJIS criteria I. Sigmund et al. https://doi.org/10.1302/2046-3758.108.BJR-2021-0058.R1
- Leukocyte Esterase Strip Quantitative Detection Based on RGB Photometry is a Probable Method to Diagnose Periprosthetic Joint Infection: An Exploratory Study Q. Zheng et al. https://doi.org/10.1111/os.13667
Latest update: 11 Jun 2026