High performance of α-defensin lateral flow assay (Synovasure) in the diagnosis of chronic knee prosthetic infections

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2018-06, Vol.26 (6), p.1717-1722
• Main Authors: Balato, Giovanni, Franceschini, Vincenzo, Ascione, Tiziana, Lamberti, Alfredo, D’Amato, Michele, Ensini, Andrea, Baldini, Andrea
• Format: Article
• Language: English
• Subjects: Arthroplasty (knee); Biomedical materials; C-reactive protein; Diagnostic systems; Erythrocyte sedimentation rate; Erythrocytes; Infections; Joint diseases; Joint surgery; Knee; Leukocytes; Mathematical analysis; Medical diagnosis; Medicine; Medicine & Public Health; Orthopedics; Patients; Prostheses; Proteins; Sensitivity; Sensitivity analysis; Surgical implants; Synovial fluid
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-017-4745-x

Purpose This prospective study was undertaken to evaluate the diagnostic accuracy of the Synovasure™ α-defensin lateral flow assay to detect or exclude infection and to compare it to the sensitivity and specificity of other diagnostic criteria according to the International Consensus Group on Periprosthetic Joint Infection (PJI). Methods All patients who have undergone revision total knee arthroplasty (TKA) from September 2015 to July 2016 were included: 16 chronic (more than 3 months after performing arthroplasty) infections and 35 aseptic joints were identified. The diagnostic performance of single test was assessed by receiver operating characteristic (ROC) curve analyses. The sensitivity and specificity were calculated for each of the cut-off values and the area under the curve (AUC) was also calculated. Results The median synovial fluid (SF) leukocyte count, as well as the neutrophil percentage, was significantly higher in patients with PJI than in those with aseptic failure ( p