Related Experiment Video
Updated: Jun 29, 2025
Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
Advancing the Diagnosis of Periprosthetic Joint Infections: Integrated Microfluidic Platform for
Rishabh Gandotra1, Hung-Bin Wu2, Feng-Chih Kuo3
1Institute of NanoEngineering and Microsystems, National Tsing Hua University, Hsinchu 30013, Taiwan.
Abstract:
Periprosthetic joint infections (PJIs) pose a significant challenge in orthopedic surgery, particularly total joint arthroplasty (TJA), due to the potential for implant failure and increased patient morbidity. Early and accurate detection of PJIs is crucial for timely intervention and better patient prognosis. Herein, we successfully screened a high-affinity aptamer targeting alpha-defensin complex human neutrophil protein 1-3 (HNP 1-3; potential PJI biomarkers in synovial fluid [SF]) for the first time using systematic evolution of ligands by exponential enrichment (SELEX) on an integrated microfluidic platform. The compact microfluidic device enabled efficient screening, with each round completed within <2 h, comprising five rounds of positive selection, two rounds of negative selection, and one round of competitive selection. A novel one-aptamer-one-antibody assay was further developed from the optimal aptamer screened, and it could accurately quantify HNP 1-3 in SF within 3 h with only ∼50 μL of SF. The assay demonstrated strong binding affinity and specificity for the target protein in SF. Thirteen PJI SF samples were accurately diagnosed and the assay was accurate over a wide dynamic range (0.32-100 mg/L). This study has showcased a rapid and accurate diagnostic tool for PJI detection, which should see widespread use in the clinic, holding promise for potential analytical applications in orthopedic surgery and improving patient care.
Insights
This study developed a rapid aptamer-based assay for detecting alpha-defensin complex human neutrophil protein 1-3 (HNP 1-3), a key biomarker for periprosthetic joint infections (PJIs). The novel diagnostic tool offers accurate PJI detection using minimal synovial fluid in just 3 hours.
Area of Science:
- Biotechnology
- Medical Diagnostics
- Orthopedic Surgery
Background:
- Periprosthetic joint infections (PJIs) are a major complication of total joint arthroplasty (TJA), leading to implant failure and increased patient morbidity.
- Early and accurate PJI diagnosis is critical for effective treatment and improved patient outcomes.
Purpose of the Study:
- To develop a rapid and accurate diagnostic method for PJI detection.
- To screen a high-affinity aptamer targeting human neutrophil protein 1-3 (HNP 1-3), a potential PJI biomarker.
Main Methods:
- Systematic evolution of ligands by exponential enrichment (SELEX) was performed on an integrated microfluidic platform to screen aptamers against HNP 1-3.
- A novel one-aptamer-one-antibody assay was developed using the screened aptamer.
- The assay was validated using synovial fluid (SF) samples from PJI patients.
Main Results:
- A high-affinity aptamer targeting HNP 1-3 was successfully screened using a microfluidic SELEX approach.
- The developed aptamer-antibody assay accurately quantified HNP 1-3 in SF within 3 hours using approximately 50 μL of sample.
- The assay demonstrated strong binding affinity, specificity, and accuracy across a wide dynamic range (0.32-100 mg/L), correctly diagnosing 13 PJI SF samples.
Conclusions:
- A rapid, sensitive, and specific diagnostic tool for PJI detection has been developed.
- This aptamer-based assay shows significant promise for clinical application in orthopedic surgery, potentially improving patient care.
- The microfluidic platform facilitated efficient aptamer screening, paving the way for novel diagnostic applications.
