The search for a single standard reference test for determining periprosthetic joint infection (PJI) through analysis of synovial fluid has yielded numerous biomarkers as potential candidates. The purpose of the present systematic review and meta-analysis was to evaluate the diagnostic accuracy of synovial fluid biomarkers and to determine which test has the highest diagnostic odds ratio (DOR) for the diagnosis of PJI.
Synovial fluid leukocyte count, PMN%, CRP, a-defensin, LE, IL-6, and IL-8 all demonstrated high sensitivity for diagnosing PJI, with a-defensin being the best synovial marker based on the highest log DOR. However, other synovial fluid tests that demonstrate good diagnostic performance can also be used in combination for the diagnosis of PJI.
Level of evidence: Diagnostic Level IV. Copyright remains with the authors and publisher.
The search for a single standard reference test for determining periprosthetic joint infection (PJI) through analysis of synovial fluid has yielded numerous biomarkers as potential candidates. The purpose of the present systematic review and meta-analysis was to evaluate the diagnostic accuracy of synovial fluid biomarkers and to determine which test has the highest diagnostic odds ratio (DOR) for the diagnosis of PJI.
Synovial fluid leukocyte count, PMN%, CRP, a-defensin, LE, IL-6, and IL-8 all demonstrated high sensitivity for diagnosing PJI, with a-defensin being the best synovial marker based on the highest log DOR. However, other synovial fluid tests that demonstrate good diagnostic performance can also be used in combination for the diagnosis of PJI.
Level of evidence: Diagnostic Level IV. Copyright remains with the authors and publisher.