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Study: synovial fluid alpha-defensin effectively predicts positive cultures in shoulder PJI
Compared with current diagnostic testing, synovial fluid alpha-defensin was more effective in predicting positive cultures in shoulder periprosthetic joint infection, according to researchers’ findings.
The researchers performed revision surgery among 30 patients evaluated for painful shoulder arthroplasty. Based on preoperative and intraoperative findings, patients were categorized into infection and no-infection groups. The researchers obtained synovial fluid from preoperative aspirations or intraoperative aspiration before arthrotomy and also obtained synovial fluid intraoperatively from a control group undergoing arthroscopic rotator cuff repair for baseline data on normal alpha-defensin levels in the shoulder.
Eric Ricchetti
Results showed an area under the curve of 0.78, sensitivity of 63%, specificity of 95%, positive likelihood ratio of 12.1 and a negative likelihood ratio of 0.38 for synovial alpha-defensin. A significant difference was observed between the infection and no-infection groups in alpha-defensin levels, according to the researchers.
The researchers also found elevated levels of synovial alpha-defensin in the presence of a culture positive for Propionibacterium acnes, as well as a moderate correlation with the number of positive cultures. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.