Journal of Bone and Joint Infection
Journal of Bone and Joint Infection
JBJI
Articles | Volume 8, issue 2
Articles | Volume 8, issue 2
https://doi.org/10.5194/jbji-8-109-2023
© Author(s) 2023. This work is distributed under
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-8-109-2023
© Author(s) 2023. This work is distributed under
the Creative Commons Attribution 4.0 License.
Articles | Volume 8, issue 2
Original full-length article
 | 
29 Mar 2023
Original full-length article |  | 29 Mar 2023

Simple and inexpensive synovial fluid biomarkers for the diagnosis of prosthetic joint infection according to the new EBJIS definition

Sara Elisa Diniz, Ana Ribau, André Vinha, José Carlos Oliveira, Miguel Araújo Abreu, and Ricardo Sousa

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Cited articles

Amanatullah, D. F., Cheng, R. Z., Huddleston Iii, J. I., Maloney, W. J., Finlay, A. K., Kappagoda, S., Suh, G. A., and Goodman, S. B.: The routine use of synovial alpha-defensin is not necessary, Bone Joint J., 102-B, 593–599, https://doi.org/10.1302/0301-620X.102B5.BJJ-2019-0473.R3, 2020. 
Chen, Y., Kang, X., Tao, J., Zhang, Y., Ying, C., and Lin, W.: Reliability of synovial fluid alpha-defensin and leukocyte esterase in diagnosing periprosthetic joint infection (PJI): a systematic review and meta-analysis, J. Orthop. Surg. Res., 14, 453, https://doi.org/10.1186/s13018-019-1395-3, 2019. 
Deirmengian, C., Kardos, K., Kilmartin, P., Cameron, A., Schiller, K., and Parvizi, J.: Combined measurement of synovial fluid alpha-Defensin and C-reactive protein levels: highly accurate for diagnosing periprosthetic joint infection, J. Bone Joint Surg. Am., 96, 1439–1445, https://doi.org/10.2106/JBJS.M.01316, 2014. 
De Vecchi, E., Romano, C.L., De Grandi, R., Cappelletti, L., Villa, F., and Drago, L.: Alpha defensin, leukocyte esterase, C-reactive protein, and leukocyte count in synovial fluid for pre-operative diagnosis of periprosthetic infection, Int. J. Immunopath. Ph., 32, 2058738418806072, https://doi.org/10.1177/2058738418806072, 2018. 
Dinneen, A., Guyot, A., Clements, J., and Bradley, N.: Synovial fluid white cell and differential count in the diagnosis or exclusion of prosthetic joint infection, Bone Joint J., 95-B, 554–557, https://doi.org/10.1302/0301-620X.95B4.30388, 2013. 
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While there is no gold standard test to diagnose periprosthetic joint infection (PJI), we believe synovial fluid analysis, especially preoperatively, is a critical step in differentiating between infection and aseptic failure. Adding simple and inexpensive biomarkers such as synovial C-reactive protein (CRP) or adenosine deaminase (ADA) and combined interpretation can be helpful in the context of inconclusive results.
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