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Serum and Synovial Biomarkers for Distinguishing Between Chronic Periprosthetic Joint Infections and Rheumatoid Arthritis: A Prospective Cohort Study.
Qin, Leilei; Wang, Hai; Zhao, Chen; Chen, Cheng; Chen, Hong; Li, Xinyu; Wang, Jiawei; Hu, Ning; Huang, Wei.
Afiliação
  • Qin L; Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
  • Wang H; Department of Orthopaedics, Fuling Central Hospital of Chongqing City, Chongqing, China.
  • Zhao C; Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
  • Chen C; Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
  • Chen H; Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
  • Li X; Department of pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
  • Wang J; Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
  • Hu N; Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
  • Huang W; Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
J Arthroplasty ; 37(2): 342-346, 2022 02.
Article em En | MEDLINE | ID: mdl-34555458
ABSTRACT

BACKGROUND:

Inflammatory responses in patients with active rheumatoid arthritis (RA) may lead to the current serum and synovial fluid biomarkers that misidentify chronic periprosthetic joint infection (PJI). We sought to investigate the expression of serum and synovial biomarkers in patients with active RA and to calculate thresholds for valuable biomarkers that distinguish between chronic PJI and active RA.

METHODS:

This prospective study was initiated to enroll 70 patients undergoing revision arthroplasty from January 2019 to January 2021, and 30 patients with active RA cumulative knee from August 2020 to March 2021. The Musculoskeletal Infection Society definition of PJI was utilized for the classification of cases as aseptic or infected. Serum d-dimer, erythrocyte sedimentation rate, C-reactive protein, and interleukin-6 (IL-6), as well as synovial IL-6, percentage of polymorphonuclear neutrophils, and CD64 index level were measured preoperatively.

RESULTS:

An increase in biomarker concentrations were observed in group C (active RA). Synovial fluid CD64 index exhibited good discriminatory power between group B (chronic PJI) and group C with an area under curve of 0.930. For the diagnosis of chronic PJI in the presence of active RA, the optimal threshold value of synovial CD64 index was 0.87, with a sensitivity of 82.86% and a specificity of 93.33%.

CONCLUSION:

Current serum biomarkers (erythrocyte sedimentation rate, C-reactive protein, IL-6, and d-dimer) did not apply to the diagnosis of suspected PJI with active RA. Fortunately, satisfactory results can be achieved by adjusting the threshold of synovial fluid biomarkers.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artrite Reumatoide / Infecções Relacionadas à Prótese / Artroplastia de Quadril / Artroplastia do Joelho Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies Limite: Humans Idioma: En Revista: J Arthroplasty Assunto da revista: ORTOPEDIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: China

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artrite Reumatoide / Infecções Relacionadas à Prótese / Artroplastia de Quadril / Artroplastia do Joelho Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies Limite: Humans Idioma: En Revista: J Arthroplasty Assunto da revista: ORTOPEDIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: China