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Published on: December 3, 2017
Meta-analysis of synovial fluid polymerase chain reaction for diagnosing periprosthetic hip and knee infection
Cheng Li1,2, Hao Li3, Xue Yang3
1Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Beijing, China. cheng.li@charite.de.
Background And Objective:
The purpose of this study was to estimate the diagnostic performance of synovial fluid polymerase chain reaction (PCR) in periprosthetic hip and knee infection, and whether synovial fluid PCR has greater diagnostic significance than conventional methods.
Methods:
The literature databases PubMed, Scopus, and the Web of Science were searched for English articles describing periprosthetic joint infection (PJI) diagnosis by synovial fluid PCR. Articles were limited to the period between January 1990 and December 2019. Subsequently, conventional methods that were used on at least two occasions were included for further analysis. Data analysis was performed using the Meta-DiSc and Stata software.
Results:
Eleven studies with 1360 cases were included in the meta-analysis. The pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of synovial fluid PCR were 0.70 (95% CI 0.66-0.74), 0.92 (95% CI 0.90-0.93), and 37.4 (95% CI 17.77-78.74), respectively.
Conclusions:
Synovial fluid PCR provides an effective tool for rapid diagnosis of PJI, and also in the early stages of culture-negative bacterial infections.
Insights
Synovial fluid polymerase chain reaction (PCR) effectively diagnoses periprosthetic joint infections (PJI), offering rapid results and aiding in early detection of culture-negative cases.
Area of Science:
- Orthopedic surgery
- Infectious disease diagnostics
- Molecular biology
Background:
- Periprosthetic joint infection (PJI) is a serious complication following hip and knee replacement.
- Accurate and timely diagnosis of PJI is crucial for effective treatment and patient outcomes.
- Conventional diagnostic methods for PJI can be time-consuming and may have limitations, especially in culture-negative scenarios.
Purpose of the Study:
- To evaluate the diagnostic performance of synovial fluid polymerase chain reaction (PCR) for periprosthetic hip and knee infections.
- To compare the diagnostic significance of synovial fluid PCR against conventional diagnostic methods.
Main Methods:
- A systematic literature search was conducted in PubMed, Scopus, and Web of Science for studies published between January 1990 and December 2019.
- Meta-analysis was performed on 11 studies including 1360 cases of PJI.
- Conventional methods used in at least two instances were included for comparative analysis.
Main Results:
- The meta-analysis revealed a pooled sensitivity of 0.70 (95% CI 0.66-0.74) and specificity of 0.92 (95% CI 0.90-0.93) for synovial fluid PCR in PJI diagnosis.
- The diagnostic odds ratio (DOR) for synovial fluid PCR was calculated as 37.4 (95% CI 17.77-78.74).
Conclusions:
- Synovial fluid PCR is an effective tool for the rapid diagnosis of periprosthetic joint infections.
- This molecular diagnostic method is particularly valuable for identifying early-stage, culture-negative bacterial infections.
