Monica Galipienso-Eri, Marta Baraldés-Canals, Andrés Aliaga-Martínez, Alejandro Hernández
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The Usefulness of the Alpha-Defensin Lateral Flow Test in the Diagnosis of Prosthetic Infection: A Retrospective Cohort Study.
Background/purpose: Periprosthetic joint infection (PJI) accounts for up to 25% of failed total knee arthroplasties and 15% of the hips. The ICM18 established the criteria for the diagnosis, and the alpha-defensin lateral flow test (ADLT) was included within minors. This study aims to analyze the behavior of the ADLT, assessing its PPV and NPV for the diagnosis of PJI at two surgical times.
Methods: One hundred fifty procedures were selected and grouped according to the first (1stS) or the second stage (2ndS) of replacement. The joint fluid was divided into 1 mL for cell count, 3 mL for microbiological culture analysis, and 0.5 mL for Synovasure® Test.
Results: The prevalence was 52.9% for 1stS and 7.1% for 2ndS. The negative predictive value (NPV) was 59.3% for the 1stS group and 96.3% for the 2ndS.
Conclusion: Our results confirm that a negative result during the 1stS is less reliable than a negative result during the 2ndS. ADLT is a rapid test with a high capacity to confirm infection, but a low ability to rule it out. Thus, it is useful for a second stage of septic replacement to avoid the placement of a new implant when there is infection persistence.
期刊介绍：
IJO welcomes articles that contribute to Orthopaedic knowledge from India and overseas. We publish articles dealing with clinical orthopaedics and basic research in orthopaedic surgery. Articles are accepted only for exclusive publication in the Indian Journal of Orthopaedics. Previously published articles, articles which are in peer-reviewed electronic publications in other journals, are not accepted by the Journal. Published articles and illustrations become the property of the Journal. The copyright remains with the journal. Studies must be carried out in accordance with World Medical Association Declaration of Helsinki.
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