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Does inflammatory joint diseases affect the accuracy of infection biomarkers in patients with periprosthetic joint

Mesut Tahta1, Mehmet Emin Simsek2, Cetin Isik3

  • 1Katip Celebi University, Ataturk Training and Research Hospital, Department of Orthopaedics and Traumatology, Izmir, Turkey.

Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association
|October 1, 2018
PubMed
Abstract

Insights

Diagnosing periprosthetic joint infection (PJI) in inflammatory joint disease (IJD) patients is challenging. Biomarkers like Alpha defensin, Lactoferrin, and synovial CRP accurately detect PJI in IJD patients.

Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Biomarker Research

Background:

  • Diagnosing periprosthetic joint infections (PJI) in patients with inflammatory joint diseases (IJD) presents diagnostic challenges.
  • Baseline inflammatory characteristics of IJD can affect the accuracy of standard PJI diagnostic tests.
  • This study evaluates specific infection biomarkers in a challenging subgroup of patients with both PJI and IJD.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of various infection biomarkers in patients with periprosthetic joint infections (PJI) and inflammatory joint diseases (IJD).
  • To determine if inflammatory joint diseases impact the reliability of infection biomarkers for PJI diagnosis.

Main Methods:

  • Prospective evaluation of 38 patients undergoing revision arthroplasty for suspected PJI between January 2014 and August 2017.
  • Patients were classified into PJI (n=17) and non-PJI (n=21) groups based on MSIS criteria.
  • Assessed biomarkers included serum ESR, CRP, Procalcitonin, synovial fluid analysis (cell count, neutrophils), synovial CRP, Lactoferrin, ELA-2, Thiol-Disulphide, BPI, and Alpha defensin.

Main Results:

  • Significant differences (p<0.001) were observed across all evaluated biomarkers between PJI and non-PJI groups.
  • Alpha defensin, Lactoferrin, ELA-2, BPI, Procalcitonin, and synovial CRP demonstrated high diagnostic accuracy (area under the curve >0.90).

Conclusions:

  • Inflammatory joint diseases do not appear to compromise the accuracy of infection biomarkers in diagnosing PJI.
  • Alpha defensin, Lactoferrin, ELA-2, BPI, Procalcitonin, and synovial CRP are reliable diagnostic tools for PJI in patients with IJD.

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