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10 October 2023: Lab/In Vitro Research

Diagnostic Value of Synovial Fluid Biomarkers for Periprosthetic Joint Infection: A Prospective, Double-blind Trial

Ying Xu 123BCDE , Xueting Ma 4BCD , Haoran Guo 135CF , Hairong Tang 1BF , Jiayu Liu 1CD , Chengbin Wang 123AG* , Chi Wang 13ADF*

DOI: 10.12659/MSM.940842

Med Sci Monit 2023; 29:e940842

Table 5 Diagnostic efficiency of common infection biomarkers for periprosthetic joint infection.

VariableAUC valueCut-off valueSensitivitySpecificityPPVNPV
SF-WBC0.923 (95% CI: 0.884–0.982)2.36082.1%92.9%91.4%84.8%
SF-PMN0.931 (95% CI: 0.870–0.992)0.69583.8%97.0%96.9%84.6%
ESR0.856 (95% CI: 0.767–0.945)27.5081.1%81.4%78.9%83.3%
WBC0.703 (95% CI: 0.590–0.817)6.12576.3%60.5%63.0%74.3%
CRP0.855 (95% CI: 0.771–0.940)0.66576.3%83.7%80.6%80.0%
IL-60.823 (95% CI: 0.731–0.915)5.16092.1%65.1%70.0%90.3%
D-D0.587 (95% CI: 0.447–0.726)1.44074.3%45.2%65.0%65.4%
Fib0.896 (95% CI: 0.828–0.964)4.4378.4%87.2%85.3%81.0%
S100A8+SF-WBC+SF-PMN0.975 (95% CI: 0.943–1.000)94.6%93.9%94.6%93.9%
S100A9+SF-WBC+SF-PMN0.953 (95% CI: 0.898–1.000)89.2%97.0%97.1%88.9%
HNP1-3+SF-WBC+SF-PMN0.973 (95% CI: 0.938–1.000)89.2%100.0%100.0%89.2%
AUC – area under the ROC curve; 95% CI – 95% confidence interval; PPV – positive predictive value; NPV – negative predictive value; SF-WBC – synovial fluid white blood cell count; SF-PMN – percentage of polymorphonuclear neutrophil in the synovial fluid; ESR – erythrocyte sedimentation rate; WBC – whole blood white blood cell count; CRP – whole blood C-reactive protein; IL-6 – plasma interleukin-6; D-D – plasma D-dimer; Fib – plasma fibrinogen.

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750