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Background/Purpose <p>Periprosthetic joint infection (PJI) accounts for up to 25% of failed total knee arthroplasties and 15% of the hips. The ICM18 established the criteria for the diagnosis, and the alpha-defensin lateral flow test (ADLT) was included within minors. This study aims to analyze the behavior of the ADLT, assessing its PPV and NPV for the diagnosis of PJI at two surgical times.</p> Methods <p>One hundred fifty procedures were selected and grouped according to the first (1stS) or the second stage (2ndS) of replacement. The joint fluid was divided into 1&#xa0;mL for cell count, 3&#xa0;mL for microbiological culture analysis, and 0.5&#xa0;mL for <i>Synovasure</i>® Test.</p> Results <p>The prevalence was 52.9% for 1stS and 7.1% for 2ndS. The negative predictive value (NPV) was 59.3% for the 1stS group and 96.3% for the 2ndS.</p> Conclusion <p>Our results confirm that a negative result during the 1stS is less reliable than a negative result during the 2ndS. ADLT is a rapid test with a high capacity to confirm infection, but a low ability to rule it out. Thus, it is useful for a second stage of septic replacement to avoid the placement of a new implant when there is infection persistence.</p>

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The Usefulness of the Alpha-Defensin Lateral Flow Test in the Diagnosis of Prosthetic Infection: A Retrospective Cohort Study

  • 期刊论文

  • 发表日期：

    2025年5月24日

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  • Monica Galipienso-Eri,
  • Marta Baraldés-Canals,
  • Andrés Aliaga-Martínez,
  • Alejandro Hernández

摘要

Background/Purpose

Periprosthetic joint infection (PJI) accounts for up to 25% of failed total knee arthroplasties and 15% of the hips. The ICM18 established the criteria for the diagnosis, and the alpha-defensin lateral flow test (ADLT) was included within minors. This study aims to analyze the behavior of the ADLT, assessing its PPV and NPV for the diagnosis of PJI at two surgical times.

Methods

One hundred fifty procedures were selected and grouped according to the first (1stS) or the second stage (2ndS) of replacement. The joint fluid was divided into 1 mL for cell count, 3 mL for microbiological culture analysis, and 0.5 mL for Synovasure® Test.

Results

The prevalence was 52.9% for 1stS and 7.1% for 2ndS. The negative predictive value (NPV) was 59.3% for the 1stS group and 96.3% for the 2ndS.

Conclusion

Our results confirm that a negative result during the 1stS is less reliable than a negative result during the 2ndS. ADLT is a rapid test with a high capacity to confirm infection, but a low ability to rule it out. Thus, it is useful for a second stage of septic replacement to avoid the placement of a new implant when there is infection persistence.