Current Recommendations for the Diagnosis of Acute and Chronic PJI for Hip and Knee—Cell Counts, Alpha-Defensin, Leukocyte Esterase, Next-generation Sequencing

被引：144

作者：

Goswami K. ^{[1
]}

Parvizi J. ^{[1
]}

Maxwell Courtney P. ^{[1
]}

机构：

[1] The Rothman Institute at Thomas Jefferson University, 125 S 9th St. Ste 1000, Philadelphia, 19107, PA

来源：

Current Reviews in Musculoskeletal Medicine | 2018年 / 11卷 / 3期

关键词：

Alpha-defensin; Diagnosis; IL-6; Leucocyte esterase; Next-generation sequencing; Periprosthetic joint infection;

D O I：

10.1007/s12178-018-9513-0

中图分类号：

学科分类号：

摘要：

Purpose of Review: Despite significant progress in recent years, the diagnosis of periprosthetic joint infection (PJI) remains a challenge and no gold standard test exists. A combination of serological, synovial, microbiological, histological, and radiological investigations is performed that are expensive, often invasive, and imperfect. Novel biomarkers and molecular methods have shown promise in recent years. The purpose of this review is to provide an update about the diagnostic recommendations for PJI and cover a selection of emerging diagnostic tools. Recent Findings: Recent literature highlights a new evidence-based definition for diagnosing hip and knee PJI that shows excellent performance on formal external multi-institutional validation. There is also increasing evidence to support the measurement of selected biomarkers in serum and synovial fluid, such as alpha-defensin, D-dimer, and interleukin-6. Finally, the emerging utility of next-generation sequencing for pathogen identification is discussed. Summary: In summary, we describe current recommendations and emerging tests for the diagnosis of PJI. Residual limitations and directions for future research are also discussed. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.

引用

页码：428 / 438

页数：10

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