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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2019, Number 2

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Acta Ortop Mex 2019; 33 (2)

What’s new for the diagnosis of periprosthetic infections after the Philadelphia consensus?

Gómez-García F, Espinoza-Mendoza RL

Language: Spanish
References: 58
Page: 127-135
PDF size: 194.78 Kb.


ABSTRACT

We now have a great variety of laboratory diagnostic tools, for the detection of PJI, some of them widely used and others under study. After the Philadelphia Consensus, they have emerged some new biomarkers. Because of that, we consider useful to review which new biomarkers we have for the diagnosis of PJI after the Consensus and which of them could be more useful in daily clinic work. Material and methods: We searched for articles published from 2013 to 2017 in 5 high impact journals. The analized variables were: biomarker type, cutoff value, sensitivity, specificity, positive predictive value, negative predictive value, area under the curve, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio. We value their evidence level. Results: Results were grouped in tables. They were found 54 articles, 31 of them didn’t meet the inclusion criteria so they were excluded; 23 studies were included in the revision. We found a total of 19 biomarkers studies, 5 of them weren’t reported before 2013: Sinovial α defensin 1, human β defensin-3, sinovial lactate and Toll-like receptors 1 and 6. Conclusion: Of all the markers reviewed for the diagnosis of PJI, C reactive protein, esterase test strip, interleukin-6, interleukin-1 β, α defensin and interleukin-17 show the highest diagnostic utility. We found 5 new markers. The articles studies show high heterogeneity in their reported sensitivity, specificity and cutoff values. In most of them were not used advanced statistical tools which could make them more reliable.


REFERENCES

  1. Peersman G, Laskin R, Davis J, Peterson M. Infection in total knee replacement: a retrospective review of 6489 total knee replacements. Clin Orthop Relat Res. 2001; 392: 15-23.

  2. Phillips JE, Crane TP, Noy M, Elliott TS, Grimer RJ. The incidence of deep prosthetic infections in a specialist orthopedic hospital: a 15-year prospective survey. J Bone Joint Surg Br. 2006; 88(7): 943-8.

  3. Parvizi J, Ghanem E, Azzam K, Davis E, Jaberi F, Hozack W. Periprosthetic infection: are current treatment strategies adequate? Acta Orthop Belg. 2008; 74(6): 793-800.

  4. Sculco TP. The economic impact of infected total joint arthroplasty. Instr Course Lect. 1993; 42: 349-51.

  5. Alegre-Rico F, Cervantes OI. Infección en la artroplastía total de cadera primaria. Acta Ortop Mex. 2004; 18(6): 235-9.

  6. Parvizi J, Gehrke T; International Consensus Group on Periprosthetic Joint Infection. Definition of periprosthetic joint infection. J Arthroplasty. 2014; 29(7): 1331.

  7. Reunión de Consenso Internacional sobre Infecciones Articulares Periprotésicas. Acta Ortop Mex. 2013; 27(S1).

  8. Shah RP, Plummer DR, Moric M, Sporer SM, Levine BR, Della Valle CJ. Diagnosing infection in the setting of periprosthetic fractures. J Arthroplasty. 2016; 31(9 Suppl): 140-3.

  9. Chevillotte CJ, Ali MH, Trousdale RT, Larson DR, Gullerud RE, Berry DJ. Inflammatory laboratory markers in periprosthetic hip fractures. J Artrhoplasty. 2009; 24(5): 722-27.

  10. Muñoz-Mahamud E, Bori G, García S, Ramírez J, Riba J, Soriano A. Usefulness of histology for predicting infection at the time of the hip revision for the treatment of Vancouver B2 periprosthetic fractures. J Arthoplasty. 2013; 28(8): 1247-50.

  11. Tischler EH, Plummer DR, Chen AF, Della Valle CJ, Parvizi J. Leukocyte esterase: metal-on-metal failure and periprosthetic joint infection. J Arthroplasty. 2016; 31(10): 2260-3.

  12. Alijanipour P, Adeli B, Hansen EN, Chen AF, Parvizi J. Intraoperative purulence is not reliable for diagnosing periprosthetic joint infection. J Arthoplasty. 2015; 30(8): 1403-6.

  13. Nelson GN, Paxton ES, Narzikul A, Williams G, Lazarus MD, Abboud JA. Leukocyte esterase in the diagnosis of shoulder periprosthetic joint infection. J Shoulder Elbow Sur. 2015; 24(9): 1421-6.

  14. Villacis D, Merriman JA, Yalamanchili R, Omid R, Itamura J, Rick H, et al. Serum interleukin-6 as a marker of periprosthetic shoulder infection. J Bone Joint Surg Am. 2014; 96(1): 41-5.

  15. Frangiamore SJ, Saleh A, Kovac MF, Grosso MJ, Zhang X, Bauer TW, et al. Synovial fluid interleukin-6 as a predictor of periprosthetic shoulder infection. J Bone Joint Surg Am. 2015; 97(1): 63-70.

  16. Gollwitzer H, Dombrowski Y, Prodinger PM, Peric M, Summer B, Hapfelmeier A, et al. Antimicrobial peptides and proinflammatory cytokines in periprosthetic joint infection. J Bone Joint Surg Am. 2013; 95(7): 644-51.

  17. Bingham J, Clarke H, Spangehl M, Schwartz A, Beauchamp C, Goldberg B. The alpha defensin-1 biomarker assay can be used to evaluate the potentially infected total joint arthroplasty. Clin Orthop Relat Res. 2014; 472(12): 4006-9.

  18. Frangiamore SJ, Gajewski ND, Salet A, Farias-Koyac M, Barsoum WK, Higera CA. α-defensin accuracy to diagnose periprosthetic joint infection-best available test? J Arthroplasty. 2016; 31(2): 456-60.

  19. Deirmengian C, Kardos K, Kilmartin P, Cameron A, Schiller K, Parvizi J. Combined measurement of synovial fluid α-defensin and c-reactive protein levels: highly accurate for diagnosing periprosthetic joint infection. J Bone Joint Surg Am. 2014; 96(17): 1439-45.

  20. Centre for Evidence-Based. University of Oxford. http//www.cebm.net.

  21. Lenski M, Scherer MA. Synovial IL-6 AS inflammatory marker in periprosthetic joint infections. J Arthroplasty. 2014; 29(6): 1105-9.

  22. Cipriano C, Maiti A, Hale G, Jiranek W. The host response: toll-like receptor expression in periprosthetic tissues as a biomarker for deep joint infection. J Bone Joint Surg Am. 2014; 96(20): 1692-8.

  23. Australian Orthopaedic Association National Joint Replacement Registry. Annual Report. Adelaide: AOA; 2013.

  24. American Joint Replacement Registry 2016 Annual Report.

  25. Lachiewicz PF, Rogers GD, Thomason HC. Aspiration of the hip joint before revision total hip arthroplasty: clinical and laboratory factors influencing attainment of a positive culture. J Bone Joint Surg Am. 1996; 78(5): 749-54.

  26. Mirra JM, Marder RA, Amstutz HC. The pathology of failed total joint arthroplasty. Clin Orthop Relat Res. 1982; 170: 175-83.

  27. Padgett DE, Silverman A, Sachjowicz F, Simpson RB, Rosenberg AG, Galante JO. Efficacy of intraoperative cultures obtained during revision total hip arthroplasty. J Arthroplasty. 1995; 10(4): 420-6.

  28. Tunney MM, Patrick S, Gorman SP, Nixon JR, Anderson N, Davis RI, et al. Improved detection of infection in hip replacements: a currently underestimated problem. J Bone Joint Surg Br. 1998; 80(4): 568-72.

  29. Parvizi J, Jacovides CH, Zmistowski B, Jung KA. Definition of periprosthetic joint infection is there a consensus? Clin Orthop Relat Res. 2011; 469(11): 3022-30.

  30. Maragakis LL, Perl TM. Acinetobacter baumannii: epidemiology, antimicrobial resistance, and treatment options. Clin Infect Dis. 2008; 46(8): 1254-63.

  31. Pendleton JN, Gorman SP, Gilmore BF. Clinical Relevance of the ESKAPE Pathogens. Expert Rev Anti Infect Ther. 2013; 11(3): 297-308.

  32. Wetters NG, Berend KR, Lombardi AV, Morris MJ, Tucker TL, et al. Leukocyte esterase reagent strips for the rapid diagnosis of periprosthetic joint infection. J Arthroplasty. 2012; 27(8 Suppl): 8-11.

  33. Jacobides CL, Kreft R, Adeli B, Hozack B, Ehrlich, Parvizi J. Successful identification of pathogens by polymerase chain reaction (PCR)-based electron spray ionization time-of-flight mass spectrometry (ESI-TOF-MS) in culture-negative periprosthetic joint infection. J Bone Joint Surg Am. 2012; 94(24): 2247-54.

  34. Achermann Y, Vogt M, Leunig M, Wüst J, Trampuz A. Improved diagnosis of periprosthetic joint infection by multiplex PCR of sonication fluid from removed implants. J Clin Microbiol. 2010; 48(4): 1208-14.

  35. Esteban J, Alonso-Rodriguez N, del-Prado G, Ortiz-Pérez A, Molina-Manso D, Cordero-Ampuero J, et al. PCR-hybridization after sonication improves diagnosis of implant-related infection. Acta Orthop. 2012; 83(3): 299-304.

  36. Rak M, Barlič-Maganja D, Kavčič M, Trebše R, Cör A. Comparison of molecular and culture method in diagnosis of prosthetic joint infection. FEMS Microbiol Lett. 2013; 343(1): 42-8.

  37. Portillo ME, Salvadó M, Sorli L, Alier A, Martínez S, Trampuz A, et al. Multiplex PCR of sonication fluid accurately differentiates between prosthetic joint infection and aseptic failure. J Infect. 2012; 65(6): 541-8.

  38. Kobayashi N, Inaba Y, Choe H, Aoki C, Ike H, Ishida T, et al. Simultaneous intraoperative detection of methicillin-resistant Staphylococcus and pan-bacterial infection during revision surgery: use of simple DNA release by ultrasonication and real-time polymerase chain reaction. J Bone Joint Surg Am. 2009; 91(12): 2896-902.

  39. Glehr M, Friesenbicher J, Hofmann J, Bernhardt M, Avian A, Windhager R, et al. Novel biomarkers to detect infection in revision hip and knee arthroplasties. Clin Orthop Relat Res. 2013; 471(8): 2621-8.

  40. Rivas-Santiago B, Sada E, Hernández-Pando R, Tsutsumi V. Péptidos antimicrobianos en la inmunidad innata de enfermedades infecciosas. Salud Pública Méx. 2006; 48(1): 62-71.

  41. Kaplan SS, Heine RP, Simmons RL. Defensins impair phagocytic killing by neutrophils in biomaterial-related infection. Infect Immun. 1999; 67(4): 1640-45.

  42. Ecker DJ, Sampath R, Massire C, Blyn LB, Hall TA, Eshoo MW, Hofstadler SA. Ibis T5000: a universal biosensor approach for microbiology. Nat Rev Microbiol. 2008; 6(7): 553-58.

  43. Konigsberg BS, Hartman CW, Hewlett AL, Garvin KL. Current and future trends in the diagnosis of periprosthetic hip infection. Orthop Clin North Am. 2014; 45(3): 287-93.

  44. Chen A, Fei J, Deirmegian C. Diagnosis of periprosthetic infection: novel developments. J Knee Surg. 2014; 27(4): 259-65.

  45. Yuan K, Chen HL, Cui ZM. Diagnostic accuracy of C-reactive protein for periprosthetic joint infection: a meta-analysis. Surg Infect (Larchmt). 2014; 15(5): 548-59.

  46. Saleh A, Ramanathan D, Siqueira MB, Klika AK, Barsoum WK, Rueda CA. The diagnostic utility of synovial fluid markers in periprosthetic joint infection: a systematic review and meta-analysis. J Am Acad Orthop Surg. 2017; 25(11): 763-72.

  47. Deirmengian C, Kardos K, Kilmartin P, Cameron A, Schiller K, Parvizi J. Diagnosing periprosthetic joint infection: Has the era of the biomarker arrived? Clin Orthop Relat Res. 2014; 472(11): 3254-62.

  48. Deirmengian C, Hallab N, Tarabishy A, Della VC, Jacobs JJ, Lonner J, et al. Synovial fluid biomarkers for periprosthetic infection. Clin Orthop Relat Res. 2010; 468(8): 2017-23.

  49. Shahi A, Kheir MM, Tarabichi M, Hosseinzadeh HR, Tasn LT, Parvizi J. Serium D-dimer test in promising for the diagnosis of periprosthetic joint infection and timing of reimplantation. J Bone Joint Surg Am. 2017; 99(17): 1419-27.

  50. Xie K, Qu X, Yan M. Procalcitonin and α-defensin for diagnosis of periprosthetic joint infections. J Arthroplasty. 2017; 32(4): 1387-94.

  51. Kwon YM, Antoci V Jr, Leone WA, Tsai TY, Dimitriou D, Liow MH. Utility of serum inflammatory and synovial fluid counts in the diagnosis of infection in taper corrosion of dual taper modular stems. J Arthroplasty. 2016; 31(9): 1997-2003.

  52. Gehrke T, Alijanipour P, Parvizi J. The management of an infected total knee arthroplasty. Bone Joint J. 2015; 97-B(10 Supple A): 20-9.

  53. Omar M, Ettinger M, Reichling M, Petri M, Guenther D, Gehrke T, et al. Synovial C-reactive protein as a marker for chronic periprosthetic infection in total hip arthroplasty. Bone Joint J. 2015; 97-B(2): 173-6.

  54. Hoell S, Borgers L, Gosheger G, Dieckmann R, Schulz D, Gerss J, et al. Interleukin-6 in two-stage revision arthroplasty. Bone Joint J. 2015; 97-B(1): 71-5.

  55. Tischler EH, Cavanaugh PK, Parvizi J. Leukocyte esterase strip test: matched for musculoskeletal infection society criteria. J Bone Joint Surg Am. 2014; 96(22): 1917-20.

  56. Shafafy R, McClatchie W, Chettiar K, Gill K, Hargrove R, Sturridge S, et al. Use of leucocyte esterase reagent strips in the diagnosis or exclusion of prosthetic joint infection. Bone Joint J. 2015; 97-B(9): 1232-36.

  57. Zhao X, Guo C, Zhao GS, Lin T, Shi ZL, Yan SG. Ten versus five polymorphonuclear leukocytes as threshold in frozen section tests for periprosthetic infection: a meta-analysis. J Arthroplasty. 2013; 28(6): 913-7.

  58. Ahmadi S, Lawrence TM, Morrey BF, Sanchez-Sotelo J. The value of intraoperative histology in predicting infection in patients undergoing revision elbow arthroplasty. J Bone Joint Surg Am. 2013; 95(21): 1976-9.




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