Laboratory diagnosis of periprosthetic joint infection after total joint arthroplasty

doi:10.3969/j.issn.1673-8640.2020.01.016

Abstract

Abstract:

Periprosthetic joint infection（PJI） is a serious complication in total joint arthroplasty patients,which leads to severe consequences if unresolved timely. Because of the low sensitivity and specificity of the conventional diagnostic tools,the diagnosis of PJI is still a challenge in modern medicine. In the recent years,some new diagnostic techniques,with high sensitivity and specificity,such as biomarker determination and the culture of pathogenic bacteria,have been developed. This review is to provide a comprehensive and up-to-date review on the diagnostic strategies for PJI.

Key words: Periprosthetic joint infection, Laboratory diagnosis, Biomarker, Microbiological technique

CLC Number:

R446.1

PAN Yunqi, TANG Jin, WANG Jianqiang, LI Yungai. Laboratory diagnosis of periprosthetic joint infection after total joint arthroplasty[J]. Laboratory Medicine, 2020, 35(1): 75-78.

References 33

[1]	BEDAIR H,TING N,JACOVIDES C,et al.The mark coventry award:diagnosis of early postoperative TKA infection using synovial fluid analysis[J]. Clin Orthop Relat Res,2011,469(1):34-40.
[2]	XU C,GUO H,QU P,et al.Preoperatively elevated serum inflammatory markers increase the risk of periprosthetic joint infection following total knee arthroplasty in patients with osteoarthritis[J]. Ther Clin Risk Manag,2018,14:1719-1724.
[3]	ENAYATOLLAHI M A,PARVIZI J.Diagnosis of infected total hip arthroplasty[J]. HIP Int,2015,25(4):294-300.
[4]	LEE Y S,KOO K H,KIM H J,et al.Synovial fluid biomarkers for the diagnosis of periprosthetic joint infection:a systematic review and meta-analysis[J]. J Bone Joint Surg Am,2017,99(24):2077-2084.
[5]	QU X,ZHAI Z,LIU X,et al.Evaluation of white cell count and differential in synovial fluid for diagnosing infections after total hip or knee arthroplasty[J]. PLoS One,2014,9(1):e84751.
[6]	DWYER M K,DAMSGAARD C,WADIBIA J,et al.Laboratory tests for diagnosis of chronic periprosthetic joint infection can help predict outcomes of two-stage exchange[J]. J Bone Joint Surg Am,2018,100(12):1009-1015.
[7]	BUTTARO M A,MARTORELL G,QUINTEROS M,et al.Intraoperative synovial C-reactive protein is as useful as frozen section to detect periprosthetic hip infection[J]. Clin Orthop Relat Res,2015,473(12):3876-3881.
[8]	TETREAULT M W,WETTERS N G,MORIC M,et al.Is synovial C-reactive protein a useful marker for periprosthetic joint infection?[J]. Clin Orthop Relat Res,2014,472(12):3997-4003.
[9]	PARVIZI J,JACOVIDES C,ANTOCI V,et al.Diagnosis of periprosthetic joint infection:the utility of a simple yet unappreciated enzyme[J]. J Bone Joint Surg Am,2011,93(24):2242-2248.
[10]	WETTERS N G,BEREND K R,LOMBARDI A V,et al.Leukocyte esterase reagent strips for the rapid diagnosis of periprosthetic joint infection[J]. J Arthroplasty,2012,27(8 Suppl):8-11.
[11]	TISCHLER E H,CAVANAUGH P K,PARVIZI J.Leukocyte esterase strip test:matched for musculoskeletal infection society criteria[J]. J Bone Joint Surg Am,2014,96(22):1917-1920.
[12]	BONANZINGA T,ZAHAR A,DÜTSCH M,et al. How reliable is the alpha-defensin immunoassay test for diagnosing periprosthetic joint infection? A prospective study[J]. Clin Orthop Relat Res,2017,475(2):408-415.
[13]	WYATT M C,BESWICK A D,KUNUTSOR S K,et al.The alpha-defensin immunoassay and leukocyte esterase colorimetric strip test for the diagnosis of periprosthetic infection:a systematic review and meta-analysis[J]. J Bone Joint Surg Am,2016,98(12):992-1000.
[14]	FRANGIAMORE S J,GAJEWSKI N D,SALEH A,et al.Alpha-defensin accuracy to diagnose periprosthetic joint infection-best available test?[J]. J Arthroplasty,2016,31(2):456-460.
[15]	KASPAREK M F,KASPAREK M,BOETTNER F,et al.Intraoperative diagnosis of periprosthetic joint infection using a novel alpha-defensin lateral flow assay[J]. J Arthroplasty,2016,31(12):2871-2874.
[16]	SIGMUND I K,HOLINKA J,GAMPER J,et al. Qualitative α-defensin test(Synovasure) for the diagnosis of periprosthetic infection in revision total joint arthroplasty[J]. Bone Joint J,2017,99-B(1):66-72.
[17]	RENZ N,YERMAK K,PERKA C,et al.Alpha defensin lateral flow test for diagnosis of periprosthetic joint infection:not a screening but a confirmatory test[J]. J Bone Joint Surg Am,2018,100(9):742-750.
[18]	SIMS N A,WALSH N C.GP130 cytokines and bone remodelling in health and disease[J]. BMB reports,2010,43(8):513-523.
[19]	DEIRMENGIAN C,HALLAB N,TARABISHY A,et al.Synovial fluid biomarkers for periprosthetic infection[J]. Clin Orthop Relat Res,2010,468(8):2017-2023.
[20]	FRANGIAMORE S J,SIQUEIRA M B,SALEH A,et al.Synovial cytokines and the MSIS criteria are not useful for determining infection resolution after periprosthetic joint infection explantation[J]. Clin Orthop Relat Res,2016,474(7):1630-1639.
[21]	DEIRMENGIAN C,KARDOS K,KILMARTIN P,et al.Diagnosing periprosthetic joint infection:has the era of the biomarker arrived?[J]. Clin Orthop Relat Res,2014,472(11):3254-3262.
[22]	PATEL R,ALIJANIPOUR P,PARVIZI J.Advancements in diagnosing periprosthetic joint infections after total hip and knee arthroplasty[J]. Open Orthop J,2016,10:654-661.
[23]	KONIGSBERG B S,HARTMAN C W,HEWLETT A L,et al.Current and future trends in the diagnosis of periprosthetic hip infection[J]. Orthop Clin North Am,2014,45(3):287-293.
[24]	QU X,ZHAI Z,WU C,et al.Preoperative aspiration culture for preoperative diagnosis of infection in total hip or knee arthroplasty[J]. J Clin Microbiol,2013,51(11):3830-3834.
[25]	LARSEN L H,LANGE J,XU Y,et al.Optimizing culture methods for diagnosis of prosthetic joint infections:a summary of modifications and improvements reported since 1995[J]. J Med Microbiol,2012,61(Pt 3):309-316.
[26]	TRAMPUZ A,PIPER K E,JACOBSON M J,et al.Sonication of removed hip and knee prostheses for diagnosis of infection[J]. N Engl J Med,2007,357(7):654-663.
[27]	ZHAI Z,LI H,QIN A,et al.Meta-analysis of sonication fluid samples from prosthetic components for diagnosis of infection after total joint arthroplasty[J]. J Clin Microbiol,2014,52(5):1730-1736.
[28]	SHEN H,TANG J,WANG Q,et al.Sonication of explanted prosthesis combined with incubation in BD bactec bottles for pathogen-based diagnosis of prosthetic joint infection[J]. J Clin Microbiol,2015,53(3):777-781.
[29]	CAZANAVE C,GREENWOOD-QUAINTANCE K E,HANSSEN A D,et al. Rapid molecular microbiologic diagnosis of prosthetic joint infection[J]. J Clin Microbiol,2013,51(7):2280-2287.
[30]	GHEBREMEDHIN B,LAYER F,KÖNIG W,et al. Genetic classification and distinguishing of Staphylococcus species based on different partial gap,16S rRNA,hsp60,rpoB,sodA,and tuf gene sequences[J]. J Clin Microbiol,2008,46(3):1019-1025.
[31]	TARABICHI M,SHOHAT N,GOSWAMI K,et al.Diagnosis of periprosthetic joint infection:the potential of next-generation sequencing[J]. J Bone Joint Surg Am,2018,100(2):147-154.
[32]	TARABICHI M,SHOHAT N,GOSWAMI K,et al. Can next generation sequencing play a role in detecting pathogens in synovial fluid?[J]. Bone Joint J,2018,100-B(2):127-133.
[33]	PÉREZ-PRIETO D,PORTILLO M E,PUIG-VERDIÉ L,et al. C-reactive protein may misdiagnose prosthetic joint infections,particularly chronic and low-grade infections[J]. Int Orthop,2017,41(7):1315-1319.