Diagnosis of prosthetic joint infection with alpha-defensin using a lateral flow device
| Autor: | M. Van Cauter, J. Neyt, Johan Bellemans, Olivier Cornu, Ronald Driesen, P. Berger |
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| Přispěvatelé: | UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male alpha-Defensins Prosthetic joint infection medicine.medical_specialty Prosthesis-Related Infections Arthroplasty Replacement Hip medicine.medical_treatment Sensitivity and Specificity Prosthesis Alpha defensin 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests medicine Humans Synovial fluid Orthopedics and Sports Medicine Prospective Studies 030212 general & internal medicine Arthroplasty Replacement Knee Aged Aged 80 and over 030222 orthopedics Alpha-defensin Receiver operating characteristic business.industry Area under the curve Middle Aged Confidence interval Surgery Cohort Female business Biomarkers |
| Zdroj: | The Bone & Joint Journal, Vol. 99-B, no. 9, p. 1176-1182 (2017) |
| ISSN: | 2049-4408 2049-4394 |
| Popis: | Aims The purpose of this current multicentre study is to analyse the presence of alpha-defensin proteins in synovial fluid using the Synovasure lateral flow device and to determine its diagnostic reliability and accuracy compared with the prosthetic joint infection (PJI) criteria produced by the Musculoskeletal Infection Society (MSIS). Patients and Methods A cohort of 121 patients comprising 85 total knee arthroplasties and 36 total hip arthroplasties was prospectively evaluated between May 2015 and June 2016 in three different orthopaedic centres. The tests were performed on patients with a chronically painful prosthesis undergoing a joint aspiration in a diagnostic pathway or during revision surgery. Results Based on the MSIS criteria, 34 patients (28%) would have had a PJI, and 87 patients had no PJI. Testing with the lateral flow device had a sensitivity of 97.1% (95% confidence intervals (CI) 84.5 to 99.9) and a specificity of 96.6% (95% CI 90.3 to 99.2). The positive predictive value was 91.7% (95% CI 77.7% to 98.3), and the negative predictive value was 98.8% (95% CI 93.6 to 99.9). Receiver operator characteristics analysis demonstrated an area under the curve for the Synovasure test of 0.97 (95% CI 0.93 to 1.00). Conclusion Our findings suggest that the Synovasure test has an excellent diagnostic performance to confirm or reject the diagnosis of a PJI. The results are promising for the care of the painful or problematic knee and hip joint arthroplasty and the test should be considered as part of the diagnostic toolbox for PJIs. Cite this article: Bone Joint J 2017;99-B:1176–82 |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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