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Alpha-defensin lateral flow test yielded excellent sensitivity, specificity for PJI
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NEW YORK — The alpha-defensin lateral flow test yielded excellent sensitivity and specificity for periprosthetic joint infection and had a similar diagnostic performance to the laboratory-based test for alpha defensin, according to results presented at the Musculoskeletal Infection Society Annual Open Scientific Meeting.
In a prospective, multicenter adjudicator-blinded study, Carl A. Deirmengian, MD, and colleagues included a prospective cohort of patients prior to anticipated revision hip or knee arthroplasty (n=305) and a laboratory-derived fresh synovial fluid sample cohort of patients who met Musculoskeletal Infection Society criteria for periprosthetic joint infection (PJI; n=65).
“We used the 2013 [Musculoskeletal Infection Society] MSIS criteria, and the judges who were surgeons used that criteria to diagnose each patient,” Deirmengian said in his presentation, which received the Jon T. Mader Award for the best clinical paper. “At the end of this, adjudication yielded 122 PJI patients and 248 that were considered not to have PJI.”
When looking at the prospective patient cohort, Deirmengian noted the alpha-defensin lateral flow test had a sensitivity of 89.5 and a specificity of 94.8.
“If you got rid of the bloody samples — these are not just blood contamination, these look like blood — the sensitivity goes up to 94.3,” Deirmengian said.
Among the synovial fluid samples, the lateral flow alpha-defensin test had a sensitivity and specificity of about 95, according to Deirmengian. He added the lateral flow alpha-defensin test missed one sample out of 65 in the retrospective cohort of positive controls.
“The sensitivity and specificity were not statistically significantly different between the lab test and the lateral flow test,” Deirmengian said. “When you look at all of the tests in this study and rank them just by accuracy, both alpha defensin tests came out on top.” – by Casey Tingle
Reference:
Deirmengian CA, et al. Prospective, multicenter, adjudicator-blinded clinical trial of the alpha-defensin (AD) lateral flow test for periprosthetic infection (PJI). Presented at: Musculoskeletal Infection Society Annual Open Scientific Meeting; Aug 2-3, 2019; New York.
Disclosure: Deirmengian reports he is a paid consultant for Biomet, Biostar Venture and Zimmer; has stock or stock options with Biostar Ventures and Trice; and is a paid presenter or speaker for and receives research support from Zimmer.