Synovial Alpha-defensin at Reimplantation in Two-stage Revision Arthroplasty to Rule Out Persistent Infection.
Arthroplasty, Replacement, Hip
/ adverse effects
Arthroplasty, Replacement, Knee
/ adverse effects
Biomarkers
Humans
Predictive Value of Tests
Prospective Studies
Prosthesis-Related Infections
/ diagnosis
Reoperation
Replantation
Retrospective Studies
Sensitivity and Specificity
Synovial Fluid
alpha-Defensins
Alpha-defensin
arthroplasty
persistent PJI
reimplantation
spacer
synovial fluid
Journal
In vivo (Athens, Greece)
ISSN: 1791-7549
Titre abrégé: In Vivo
Pays: Greece
ID NLM: 8806809
Informations de publication
Date de publication:
Historique:
received:
23
11
2020
revised:
06
12
2020
accepted:
07
12
2020
entrez:
24
2
2021
pubmed:
25
2
2021
medline:
22
6
2021
Statut:
ppublish
Résumé
Owing to the lack of a diagnostic gold standard, ruling out persistent periprosthetic joint infection (PJI) before second-stage surgery in the setting of two-stage revision arthroplasty constitutes a major challenge. We evaluated if the alpha-defensin-1 (AD-1) test could predict successful infection eradication before reimplantation of a new prosthesis. Our prospective study included 20 patients who underwent two-stage revision arthroplasty for treatment of PJI. A standard quantitative enzyme AD-1 immunoassay of synovial fluid, the synovial leukocyte esterase test and routine laboratory blood testing were performed prior to explantation and reimplantation. Treatment failure was defined according to the Delphi-based consensus criteria after a minimum follow-up of 1 year. A 15% of our patients met the Delphi Criteria within 1 year. None of the markers investigated were significantly different in patients with and without reinfection. Further research is necessary to identify biomarkers more suitable for indicating persistent infection before reimplantation.
Sections du résumé
BACKGROUND/AIM
OBJECTIVE
Owing to the lack of a diagnostic gold standard, ruling out persistent periprosthetic joint infection (PJI) before second-stage surgery in the setting of two-stage revision arthroplasty constitutes a major challenge. We evaluated if the alpha-defensin-1 (AD-1) test could predict successful infection eradication before reimplantation of a new prosthesis.
PATIENTS AND METHODS
METHODS
Our prospective study included 20 patients who underwent two-stage revision arthroplasty for treatment of PJI. A standard quantitative enzyme AD-1 immunoassay of synovial fluid, the synovial leukocyte esterase test and routine laboratory blood testing were performed prior to explantation and reimplantation. Treatment failure was defined according to the Delphi-based consensus criteria after a minimum follow-up of 1 year.
RESULTS
RESULTS
A 15% of our patients met the Delphi Criteria within 1 year. None of the markers investigated were significantly different in patients with and without reinfection.
CONCLUSION
CONCLUSIONS
Further research is necessary to identify biomarkers more suitable for indicating persistent infection before reimplantation.
Identifiants
pubmed: 33622904
pii: 35/2/1073
doi: 10.21873/invivo.12352
pmc: PMC8045128
doi:
Substances chimiques
Biomarkers
0
alpha-Defensins
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1073-1081Informations de copyright
Copyright© 2021, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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