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Good accuracy of the alpha-defensin lateral flow test for hip periprosthetic joint infection: A pilot study in a retrospective cohort of 52 patients

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World Journal of Orthopedics 2020年第1期11卷 36-46页

作者： Jesse WP Kuiper pieter pander Stan J Vos Department of Orthopedic Surgery Noordwest ZiekenhuisgroepAlkmaar 1815 JDNetherlands Centre for Orthopedic Research Alkmaar Noordwest ZiekenhuisgroepAlkmaar 1815 JDNetherlands

BACKGROUND The alpha-defensin lateral flow(ADLF)test is a new diagnostic tool for periprosthetic joint infection(PJI).Test accuracy for combined cohorts of hip and knee PJI has been reported to be *** To assess the accuracy of the ADLF test for hip PJI,and to compare three different diagnostic criteria for *** A cohort of 52 patients was identified,with a painful or poor-functioning total hip-or hemi-arthroplasty,that underwent aspiration and a subsequent ADLF *** was diagnosed with Musculoskeletal Infection Society(MSIS)criteria,and sensitivity,specificity,overall accuracy,positive predictive value and negative predictive value were ***,test specifics were compared with the European Bone and Joint Infection Society(EBJIS)and 2018 International Consensus Meeting(ICM)criteria for *** Using MSIS criteria,sensitivity was 100%(CI:54%-100%)and specificity was 89%(CI:76%-96%).Six true positives and 5 false positives were found,including one case of *** EBJIS criteria,more PJIs were found(11 vs 6),sensitivity was lower(71%,CI:42%-92%)and specificity was higher(97%,CI:86%-100%),with 4 false negatives and one false positive *** 2018 ICM criteria,sensitivity was 91%(62%-100%)and specificity 100%(91%-100%).The results in this cohort are comparable to previous *** Overall test accuracy of the ADLF test was good in this cohort,with a sensitivity of 100%and specificity of 89%.Using different PJI definition criteria,sensitivity and specificity changed slightly but overall accuracy remained around 90%.Using the ADLF test in metallosis cases can result in false positive results and should be performed with caution.

关键词： Periprosthetic Arthroplasty Replacement Hip Infection Periprosthetic joint infection Alpha-defensin Synovasure

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