Low sensitivity of a-defensin (Synovasure) test for intraoperative exclusion of prosthetic joint infection
DOI:
https://doi.org/10.1080/17453674.2018.1444301Abstract
Background and purpose — The Synovasure lateral flow test was developed as a rapid test for the detection or exclusion of periprosthetic joint infection (PJI). 3 studies have reported promising results on its diagnostic value in total joint revision surgery. We aimed to assess the sensitivity and specificity of the Synovasure test to exclude infection in patients undergoing revision surgery for suspected early aseptic loosening of a total hip or knee arthroplasty. Patients and methods — In a prospective study design, 37 patients who underwent revision surgery for suspected early aseptic loosening (< 3 years after primary arthroplasty) were included. The Synovasure test was used intraoperatively to confirm the aseptic nature of the loosening and 6 tissue cultures were obtained in all cases. Exclusion criteria were patients with a preoperatively confirmed PJI, acute revisions (< 90 days after primary arthroplasty) and cases with malpositioning, wear, or instability of the prosthesis. Results — 5 of the 37 patients were diagnosed with a PJI based on the intraoperative tissue cultures. In only 1 out of these 5 cases this was confirmed by the intraoperative Synovasure test. No tests were falsely positive. Interpretation — In this case series the Synovasure lateral flow test had a low sensitivity to exclude PJI in patients with suspected aseptic loosening. The role of the Synovasure lateral flow test in the intraoperative exclusion of PJI during revision surgery for suspected early aseptic loosening appears to be more limited than previously indicated.Downloads
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Published
2018-05-04
How to Cite
Scholten, R., Visser, J., Van Susante, J. L. C., & Van Loon, C. J. M. (2018). Low sensitivity of a-defensin (Synovasure) test for intraoperative exclusion of prosthetic joint infection. Acta Orthopaedica, 89(3), 357–359. https://doi.org/10.1080/17453674.2018.1444301
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Copyright (c) 2018 Ruben Scholten, Jetze Visser, Job L C Van Susante, Corné J M Van Loon
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Acta Orthopaedica (Scandinavica) content is available freely online as from volume 1, 1930. The journal owner owns the copyright for all material published until volume 80, 2009. As of June 2009, the journal has however been published fully Open Access, meaning the authors retain copyright to their work. As of June 2009, articles have been published under CC-BY-NC or CC-BY licenses, unless otherwise specified.