Kai Xie1, Xinhua Qu1, Mengning Yan1. 1. Shanghai Key Laboratory of Orthopaedic Implant, Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
Abstract
BACKGROUND: Current methods to diagnose periprosthetic joint infection (PJI) before revision surgery have limited diagnostic accuracy. This meta-analysis was performed to estimate the accuracy of procalcitonin (PCT) and α-defensin for the diagnosis of PJI. METHODS: Articles on the diagnostic value of PCT or α-defensin for PJI diagnosis were searched in the PubMed database. Sensitivity, specificity, diagnostic odds ratio, the area under the curve of summary receiver operating characteristic curves (AUC), the positive likelihood ratio, and the negative likelihood ratio were calculated to evaluate the diagnostic ability of PCT and the α-defensin test for the diagnosis of PJI. RESULTS: The pooled sensitivities for detecting PJI using PCT and α-defensin were 0.53 (95% confidence interval [CI], 0.24-0.80) and 0.96 (95% CI, 0.85-0.99), respectively. The pooled specificities for detecting PJI using PCT and α-defensin were 0.92 (95% CI, 0.45-0.99) and 0.95 (95% CI, 0.89-0.98), respectively. The pooled diagnostic odds ratios for detecting PJI using PCT and α-defensin were 13 (95% CI, 3-70) and 496 (95% CI, 71-3456), respectively. The pooled AUCs for PCT and α-defensin were 0.76 (95% CI, 0.72-0.80) and 0.99 (95% CI, 0.97-0.99), respectively. The positive likelihood ratio and the negative likelihood ratio of PCT were 6.8 (95% CI, 1.0-48.1) and 0.51 (95% CI, 0.31-0.84), respectively, whereas those of α-defensin were 19.6 (95% CI, 8.2-46.8) and 0.04 (95% CI, 0.01-0.17), respectively. CONCLUSION: Synovial fluid α-defensin has a great potential to diagnose PJI.
BACKGROUND: Current methods to diagnose periprosthetic joint infection (PJI) before revision surgery have limited diagnostic accuracy. This meta-analysis was performed to estimate the accuracy of procalcitonin (PCT) and α-defensin for the diagnosis of PJI. METHODS: Articles on the diagnostic value of PCT or α-defensin for PJI diagnosis were searched in the PubMed database. Sensitivity, specificity, diagnostic odds ratio, the area under the curve of summary receiver operating characteristic curves (AUC), the positive likelihood ratio, and the negative likelihood ratio were calculated to evaluate the diagnostic ability of PCT and the α-defensin test for the diagnosis of PJI. RESULTS: The pooled sensitivities for detecting PJI using PCT and α-defensin were 0.53 (95% confidence interval [CI], 0.24-0.80) and 0.96 (95% CI, 0.85-0.99), respectively. The pooled specificities for detecting PJI using PCT and α-defensin were 0.92 (95% CI, 0.45-0.99) and 0.95 (95% CI, 0.89-0.98), respectively. The pooled diagnostic odds ratios for detecting PJI using PCT and α-defensin were 13 (95% CI, 3-70) and 496 (95% CI, 71-3456), respectively. The pooled AUCs for PCT and α-defensin were 0.76 (95% CI, 0.72-0.80) and 0.99 (95% CI, 0.97-0.99), respectively. The positive likelihood ratio and the negative likelihood ratio of PCT were 6.8 (95% CI, 1.0-48.1) and 0.51 (95% CI, 0.31-0.84), respectively, whereas those of α-defensin were 19.6 (95% CI, 8.2-46.8) and 0.04 (95% CI, 0.01-0.17), respectively. CONCLUSION: Synovial fluid α-defensin has a great potential to diagnose PJI.
Authors: Thao L Masters; Aditya V Bhagwate; Mrunal K Dehankar; Kerryl E Greenwood-Quaintance; Matthew P Abdel; Jay N Mandrekar; Robin Patel Journal: Gene Date: 2022-03-17 Impact factor: 3.688
Authors: Benjamin F Ricciardi; Gowrishankar Muthukrishnan; Elysia A Masters; Nathan Kaplan; John L Daiss; Edward M Schwarz Journal: J Orthop Res Date: 2020-01-31 Impact factor: 3.494