Prospective cohort study (n=149) evaluating whether synovial fluid α-defensin and CRP, measured by ELISA, can accurately diagnose periprosthetic joint infection using the MSIS definition as the reference standard — including in patients with inflammatory conditions or concurrent antibiotic treatment.
When you aspirate a painful arthroplasty — especially in a patient already on antibiotics or with rheumatoid arthritis where leukocyte counts and serum markers are unreliable.
Synovial fluid α-defensin (with reflex synovial CRP if positive) provides near-perfect diagnostic accuracy; a negative α-defensin effectively rules out PJI, and the combined algorithm eliminates false positives from metallosis and inflammatory arthritis.
Prospective cohort study (n=149) evaluating whether synovial fluid α-defensin and CRP, measured by ELISA, can accurately diagnose periprosthetic joint infection using the MSIS definition as the reference standard — including in patients with inflammatory conditions or concurrent antibiotic treatment.
When you aspirate a painful arthroplasty — especially in a patient already on antibiotics or with rheumatoid arthritis where leukocyte counts and serum markers are unreliable.
Synovial fluid α-defensin (with reflex synovial CRP if positive) provides near-perfect diagnostic accuracy; a negative α-defensin effectively rules out PJI, and the combined algorithm eliminates false positives from metallosis and inflammatory arthritis.