Elevated plasma D‐dimer concentration has higher efficacy for the diagnosis of periprosthetic joint infection of the knee than of the hip—A single‐center, retrospective study

Abstract Background Polymicrobial periprosthetic joint infection is a subset of periprosthetic joint infection and indicates disastrous outcomes. However, the incidence of polymicrobial PJI can be underestimated so we perform a single-center retrospective study with an intention to predict the incidence of polymicrobial PJI based on culture results. Materials and methods Medical records about 153 patients with PJI between 2017/1/1 and 2018/12/31 in a joint center were selected retrospectively. Multivariable analysis was utilized to evaluate the association between various pathogens and polymicrobial PJI. Result Staphylococcus aureus (OR:3.83, 95%CI(1.30,11.27), p-value = 0.015 ), coagulase negative staphylococci (OR: 2.68 ,95%CI: (1.10, 6.25), p-value = 0.028), Enterococcus spp (OR:6.46;95%CI(1.35,30.87),P-value = 0.020)andStreptococcusspp(OR:19.38, 95%CI:(3.57,105.21), p-value = 0.001) indicate higher risk of polymicrobial pathogens compared with other pathogens Conclusion Streptococcus spp and Enterococcus spp are associated with higher risk of polymicrobial PJI and more pathogens are like to be found in additional culture when these pathogens are detected by a single culture.

Download Full-text

Plasma Fibrinogen Exhibits Better Performance Than Plasma D-Dimer in the Diagnosis of Periprosthetic Joint Infection

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.18.00624 ◽

2019 ◽

Vol 101 (7) ◽

pp. 613-619 ◽

Cited By ~ 35

Author(s):

Rui Li ◽

Hong-Yi Shao ◽

Li-Bo Hao ◽

Bao-Zhan Yu ◽

Peng-Fei Qu ◽

...

Keyword(s):

Periprosthetic Joint Infection ◽

Joint Infection ◽

Plasma Fibrinogen ◽

D Dimer

Download Full-text

The diagnostic effect of α-defensin, D-dimer, and IL-6 in periprosthetic joint infection: A systematic review and diagnostic meta-analysis

Journal of Orthopaedic Surgery ◽

10.1177/2309499020971861 ◽

2020 ◽

Vol 28 (3) ◽

pp. 230949902097186

Author(s):

Baozhong Tian ◽

Liwen Cui ◽

Weihai Jiang

Keyword(s):

Systematic Review ◽

Sensitivity And Specificity ◽

Periprosthetic Joint Infection ◽

Meta Analysis ◽

Joint Infection ◽

Common Complication ◽

Online Databases ◽

Artificial Joint Replacement ◽

Sensitivity Specificity ◽

D Dimer

Background: Periprosthetic joint infection (PJI) is the most common complication after artificial joint replacement as previously reported. However, the main problem at present is its difficulty in diagnosis. This systematic review and meta-analysis aimed to compare the diagnostic accuracy of α-defensin, D-dimer, and interleukin-6 (IL-6) in clinical practice. Method: Online databases were systematically searched until June 18th, 2020 with keywords and medical sub-headings terms. Studies mentioned the sensitivity and specificity of biological markers in detecting PJI were included in our study. The sensitivity, specificity, and diagnostic odds ratios (DORs) were obtained after integration. Results: A total of 34 studies with 1036 patients diagnosing as PJI were included for comparing α-defensin, D-dimer, and IL-6. The sensitivity and specificity of α-defensin for PJI were 0.88 and 0.96, and the DOR was 189 (95% CI 72–496), respectively. The sensitivity and specificity of D-dimer (0.82 and 0.72) and IL-6 (0.80 and 0.89) were lower than α-defensin. Conclusion: The detection of α-defensin is a promising biomarker for diagnosing PJI. The optional cut-off needs to be curtained when using other biomarkers.

Download Full-text

Plasma Fibrin Degradation Product and D-Dimer Are of Limited Value for Diagnosing Periprosthetic Joint Infection

The Journal of Arthroplasty ◽

10.1016/j.arth.2019.05.009 ◽

2019 ◽

Vol 34 (10) ◽

pp. 2454-2460 ◽

Cited By ~ 26

Author(s):

Hong Xu ◽

Jinwei Xie ◽

Qiang Huang ◽

Yiting Lei ◽

Shaoyun Zhang ◽

...

Keyword(s):

Periprosthetic Joint Infection ◽

Degradation Product ◽

Joint Infection ◽

Fibrin Degradation Product ◽

D Dimer

Download Full-text

The 2018 International Consensus Meeting Minor Criteria for Chronic Hip and Knee Periprosthetic Joint Infection: Validation From a Single Center

The Journal of Arthroplasty ◽

10.1016/j.arth.2020.03.014 ◽

2020 ◽

Vol 35 (8) ◽

pp. 2200-2203 ◽

Cited By ~ 1

Author(s):

Hussein Abdelaziz ◽

Kristof Rademacher ◽

Eduardo M. Suero ◽

Thorsten Gehrke ◽

Christian Lausmann ◽

...

Keyword(s):

Periprosthetic Joint Infection ◽

Joint Infection ◽

Consensus Meeting ◽

Single Center ◽

International Consensus ◽

Minor Criteria

Download Full-text

Meta-analysis of serum and/or plasma D-dimer in the diagnosis of periprosthetic joint infection

10.21203/rs.2.21286/v1 ◽

2020 ◽

Author(s):

Cheng Li ◽

Donara Margaryan ◽

Cristina Ojeda-Thies ◽

Carsten Perka ◽

Andrej Trampuz

Keyword(s):

Likelihood Ratio ◽

Periprosthetic Joint Infection ◽

Degradation Products ◽

Meta Analysis ◽

Joint Infection ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Diagnostic Value ◽

Medical Subject Headings ◽

D Dimer

Abstract Background The purpose of this meta-analysis was to evaluate the diagnostic value of D-dimer in detecting periprosthetic joint infection (PJI). Methods A systematic search and screen of relevant studies was performed in the PubMed, Web of Science and Embase databases using the following medical subject headings (MeSH) or keywords: “arthroplasty or joint prosthesis or joint replacement or periprosthetic joint or prosthetic joint”, “infection or infectious or infected”, and “D-dimer or serum D-dimer or plasma D-dimer or fibrin degradation products”. Then, the data were analysed and processed by Meta-Disc software. Results A total of 7 studies with 1285 patients were included in this meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR) were 0.75 (95% confidence interval [CI]: 0.70 to 0.79), 0.69 (95% CI: 0.66 to 0.72), 3.01 (95% CI: 1.84 to 4.93), 0.32 (95% CI: 0.19 to 0.53) and 10.20 (95% CI: 3.63 to 28.64), respectively. Subgroup analyses showed that use of serum D-dimer had better sensitivity and specificity than plasma D-dimer for the diagnosis of PJI (0.86, 0.84 vs. 0.67, 0.60, respectively). Conclusion Serum D-dimer had a better diagnostic value than plasma D-dimer for the diagnosis of PJI.

Download Full-text

Meta-analysis of serum and/or plasma D-dimer in the diagnosis of periprosthetic joint infection

10.21203/rs.2.21286/v2 ◽

2020 ◽

Author(s):

Cheng Li ◽

Donara Margaryan ◽

Cristina Ojeda-Thies ◽

Carsten Perka ◽

Andrej Trampuz

Keyword(s):

Likelihood Ratio ◽

Periprosthetic Joint Infection ◽

Degradation Products ◽

Meta Analysis ◽

Joint Infection ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Diagnostic Value ◽

Medical Subject Headings ◽

D Dimer

Abstract Background The purpose of this meta-analysis was to evaluate the diagnostic value of D-dimer in detecting periprosthetic joint infection (PJI). Methods A systematic search and screening of relevant studies was performed in the databases PubMed, Web of Science, and Embase using the following medical subject headings (MeSH) or keywords: “arthroplasty or joint prosthesis or joint replacement or periprosthetic joint or prosthetic joint”, “infection or infectious or infected”, and “D-dimer or serum D-dimer or plasma D-dimer or fibrin degradation products”. Data were subsequently analysed and processed using Meta-Disc. Results Seven studies with 1285 patients were included in this meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 0.75 (95% confidence interval [CI]: 0.70–0.79), 0.69 (95% CI: 0.66–0.72), 3.01 (95% CI: 1.84–4.93), 0.32 (95% CI: 0.19–0.53), and 10.20 (95% CI: 3.63–28.64), respectively. Subgroup analyses showed that the use of serum D-dimer had better sensitivity and specificity than plasma D-dimer for the diagnosis of PJI . Conclusion Serum D-dimer was shown to have a better diagnostic value than plasma D-dimer for the diagnosis of PJI. Further research is required for clarification.

Download Full-text