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Κυριακή 28 Φεβρουαρίου 2021

Synovial Alpha-defensin at Reimplantation in Two-stage Revision Arthroplasty to Rule Out Persistent Infection

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In Vivo. 2021 Mar-Apr;35(2):1073-1081. doi: 10.21873/invivo.12352.

ABSTRACT

BACKGROUND/AIM: 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: 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: A 15% of our patients met the Del phi Criteria within 1 year. None of the markers investigated were significantly different in patients with and without reinfection.

CONCLUSION: Further research is necessary to identify biomarkers more suitable for indicating persistent infection before reimplantation.

PMID:33622904 | DOI:10.21873/invivo.12352

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