Abstract：
BACKGROUND:Synovial fluid biomarkers have demonstrated diagnostic accuracy surpassing the currently used diagnostic tests for periprosthetic joint infection (PJI). QUESTIONS/PURPOSES:The purpose of this study is to directly compare the sensitivity and specificity of the synovial fluid α-defensin immunoassay to the leukocyte esterase (LE) colorimetric test strip. METHODS:Synovial fluid was collected from 46 patients meeting the inclusion criteria of this prospective diagnostic study. Synovial fluid samples were tested with both a novel synovial-fluid-optimized immunoassay for α-defensin and the LE colorimetric test strip. The Musculoskeletal Infection Society (MSIS) definition was used to classify 23 periprosthetic infections and 23 aseptic failures; this classification was used as the standard against which the two diagnostic tests were compared. RESULTS:The synovial fluid α-defensin immunoassay correctly predicted the MSIS classification of all patients in the study, demonstrating a sensitivity and specificity of 100% for the diagnosis of PJI. The α-defensin assay could be read for all samples, including those with blood in the synovial fluid. The leukocyte esterase test strip could not be interpreted in eight of 46 samples (17%) as a result of blood interference. Analysis of the LE strips that could be interpreted yielded a sensitivity of 69% and a specificity of 100%. CONCLUSIONS:The synovial fluid α-defensin immunoassay outperformed the LE colorimetric test strip in this study and provided reliable results even when the LE test strip failed as a result of blood interference. The simple analytic results provided by the α-defensin immunoassay, compared with the more complex and interpretive nature of both the MSIS criteria and LE colorimetric test strip, make it a highly attractive diagnostic tool. LEVEL OF EVIDENCE:Level II, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Deirmengian C,Kardos K,Kilmartin P,Cameron A,Schiller K,Booth RE Jr,Parvizi Jdoi
10.1007/s11999-014-3722-7subject
Has Abstractpub_date
2015-01-01 00:00:00pages
198-203issue
1eissn
0009-921Xissn
1528-1132journal_volume
473pub_type
杂志文章abstract：UNLABELLED:We sought to determine whether open reduction and internal fixation in combination with free vascularized bone grafting and elbow contracture release is an effective treatment for patients with recalcitrant distal humeral nonunions with segmental bone loss. In addition, we wondered whether this treatment str...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：2005-06-01 00:00:00
abstract：UNLABELLED:Acetabular retroversion (AR) alters load distribution across the hip and is more prevalent in pathologic conditions involving the hip. We hypothesized the abnormal orientation and mechanical changes may predispose certain individuals to stress injuries of the femoral neck. We retrospectively reviewed the ant...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-009-0969-5
更新日期：2010-03-01 00:00:00
abstract：:The extraosseous blood supply to the femoral head was studied by microdissection of latex-injected vessels in 19 neonatal hips. The fetuses were of black African descent. Although the general pattern was similar to that described by previous investigators, in seven of the specimens the largest contribution to the bloo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-04-01 00:00:00
abstract：:Sixty-six cases of noninfected nonunions (27 femoral and 39 tibial) were treated with an interlocking nail. In these cases, 92.6% of the femurs and 94.8% of the tibias healed after the first operation in a mean time of 15.4 and 13.0 weeks, respectively. Deep infection complicated five nailings (7.5%, two femur and thr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-11-01 00:00:00
abstract：:Eight patients with osteochondritis dissecans of the talus were reviewed. The average followup was 17.6 months (range, 8-26 months). The mean age of the patients was 31.8 years (range, 22-42 years). All patients had a preoperative examination, magnetic resonance imaging, and radiologic classification of the lesion thr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200202000-00021
更新日期：2002-02-01 00:00:00
abstract：:Infected arthroplasties reportedly have a lower eradication rate when caused by highly resistant and/or polymicrobial isolates and in these patients most authors recommend intravenous antibiotics. We asked whether two-stage revision with interim oral antibiotics could eradicate these infections. We prospectively follo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-009-0808-8
更新日期：2009-09-01 00:00:00
abstract：:Joint damage occurs when structures protecting the joint fail. Because osteoarthritis consists of end-stage joint damage, I propose that risk factors for disease can be best understood as either impairments of joint protectors, increasing joint vulnerability, or as factors that excessively load the joint, leading to i...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000144971.12731.a2
更新日期：2004-10-01 00:00:00
abstract：:To update the status of chymopapain in the treatment of herniated intervertebral discs, a review of the current literature and data from an unpublished Texas study are presented. Studies in animals and humans have consistently demonstrated that chymopapain can dissolve the nucleus pulposus. Twenty-eight uncontrolled a...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,评审
doi：
更新日期：1984-03-01 00:00:00
abstract：BACKGROUND:Coronal malalignment occurs frequently in TKA and may affect implant durability and knee function. Designed to improve alignment accuracy and precision, the patient-specific positioning guide is predicated on restoration of the overall mechanical axis and is a multifaceted new tool in achieving traditional g...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-1996-6
更新日期：2012-01-01 00:00:00
abstract：:A 14-year-old girl with painful scoliosis was found to have an osteoid osteoma involving the body of the left seventh rib. Excision of the tumor was facilitated by intraoperative bone scanning that precisely located its position. Following surgery, preoperative pain was completely relieved and the spinal curvature had...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-05-01 00:00:00
abstract：:In 20 dogs olecranon osteotomies fixed with tension band wires were studied histologically to reveal the pattern of healing. Different degrees of stability existed in different areas of the osteotomy. Under stable conditions cancellous bone healed by direct formation of woven bone. Instability resulted in an internal ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-08-01 00:00:00
abstract：:Insertion of distal interlocking screws in femoral nails can be technically demanding and may entail substantial exposure. A method of insertion of femoral interlocking screws that uses a laser guiding system in addition to the standard image intensifier was used in an attempt to improve the accuracy of distal screw p...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-08-01 00:00:00
abstract：BACKGROUND:Although some clinical reports suggest patient-specific instrumentation in TKA may improve alignment, reduce surgical time, and lower hospital costs, it is unknown whether it improves pain- and function-related outcomes and gait. QUESTIONS/PURPOSES:We hypothesized that TKA performed with patient-specific in...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11999-014-3544-7
更新日期：2014-08-01 00:00:00
abstract：:A retrospective review of 262 consecutive cervical spine fractures revealed that 41 (16%) were odontoid fractures. Twenty patients were younger than 40 years of age (19 fractures were the result of a motor vehicle accident), whereas 19 fractures occurred in subjects older than 60 (13 were the result of a fall). Fractu...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-03-01 00:00:00
abstract：:Twelve cases of supracondylar fracture of the femur in rheumatoid arthritis patients with previously implanted resurfacing or MacIntosh arthroplasty of the knee had long standing severe polyarticular rheumatoid arthritis (duration, ten to 41 years; mean 24.8 years). The fractures occurred following a long interval aft...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-04-01 00:00:00
abstract：:This article presents a prospective clinical and radiologic review of 55 total hip replacements in 50 patients in which the cementless Harris-Galante porous-coated acetabular component was used. All patients were 50 years of age or younger. The cups were inserted by 15 different surgeons. The minimum followup was 5 ye...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200007000-00021
更新日期：2000-07-01 00:00:00
abstract：:Plate fixation of metacarpal and phalangeal fractures is designed to provide rigid internal fixation in order to facilitate early motion and thereby minimize joint and tendon complications. In a series of plate fixations, 16 of 38 (42%) of proximal phalangeal and metacarpal shaft fractures developed complications of s...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-01-01 00:00:00
abstract：:Rupture of the peroneus longus tendon with an associated fracture of the os peroneum is an uncommon injury, which may present as chronic lateral ankle instability. There have been only seven cases documented in the literature since 1966. A case of chronic peroneus longus tendon rupture with os peroneum fracture is pre...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-199908000-00021
更新日期：1999-08-01 00:00:00
abstract：:Managing tumors of the proximal fibula may require en bloc resection of the fibular head with the attachment site for the lateral collateral ligament. These resections of the proximal fibula cause unavoidable knee instability. We describe a reconstructive technique intended to minimize that instability. We retrospecti...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000238781.19692.16
更新日期：2007-01-01 00:00:00
abstract：:The effects of postoperative epidural infusions using local anesthetic and narcotic were assessed in reference to lower extremity blood flow. Nineteen patients who underwent unilateral total hip arthroplasty were randomly assigned to receive a postoperative epidural infusion of either 5 microg/ml fentanyl or 5 microg/...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1997-01-01 00:00:00
abstract：BACKGROUND:Chronic exertional compartment syndrome is diagnosed based on symptoms and elevated intramuscular pressure and often is treated with fasciotomy. However, what contributes to the increased intramuscular pressure remains unknown. QUESTIONS/PURPOSES:We investigated whether the stiffness or thickness of the mus...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2073-x
更新日期：2011-12-01 00:00:00
abstract：:Recombinant human bone morphogenetic protein-2 is an osteoinductive protein that plays a pivotal role in bone growth and regeneration. Several hundred studies were conducted in the past 7 years in numerous animal models to establish unequivocally the efficacy, safety, mechanism of action, pharmacokinetics, and surgica...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200202000-00011
更新日期：2002-02-01 00:00:00
abstract：BACKGROUND:Reverse shoulder arthroplasty has been proven to improve function in shoulders with cuff-tear arthropathy, but existing studies are primarily single-center studies with a small number of patients, which limits their ability to identify patients who have an increased risk of revision or a worse functional out...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/CORR.0000000000001114
更新日期：2020-05-01 00:00:00
abstract：:Plaster casts, custom-fabricated fracture braces, and prefabricated fracture braces were compared in the laboratory for the stability they provided to closed, experimental, diaphyseal fractures of the tibia and fibula on anatomic specimens. The stability was comparable for each type of device tested for the loading co...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-06-01 00:00:00
abstract：BACKGROUND:Metastatic bone disease is a substantial burden to patients and the healthcare system as a whole. Metastatic disease can be painful, is associated with decreased survival, and is emotionally traumatic to patients when they discover their disease has progressed. In the United States, more than 250,000 patient...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-016-4739-x
更新日期：2016-07-01 00:00:00
abstract：:Eleven intraoperative femur fractures occurred during 605 total hip replacements at Rancho Los Amigos Hospital, an incidence of 1.8%. Fractures occur more often in women, are usually located in the proximal femur, and mostly occur during femoral reaming. The main predisposing factors were osteoporosis and previous hip...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-11-01 00:00:00
abstract：:Aneurysmal bone cysts are benign active or aggressive bone tumors that commonly arise in the long bones, especially the femur, tibia, and humerus and the posterior elements of the spine. Aneurysmal bone cysts affect all age groups but are more common before skeletal maturity (first two decades of life). They usually i...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-010-1228-5
更新日期：2010-04-01 00:00:00
abstract：:Several extracellular matrices are formed by healing fractures, and the collagens within these matrices have been identified in rabbit and rat fracture models. Type III collagen is the major collagen of the fibrous matrix that forms along the periosteal surface. Type I collagen is secreted in large amounts as trabecul...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1990-06-01 00:00:00
abstract：UNLABELLED:Acetabular component orientation during total hip arthroplasty affects dislocation, range of motion, polyethylene wear, pelvic osteolysis, and component migration. New total hip arthroplasty navigation systems have been introduced to avoid the errors reported after acetabular component orientation using a ma...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000201165.82690.f8
更新日期：2006-04-01 00:00:00
abstract：:Mineral-matrix interactions regulate the process of hydroxyapatite formation in bones and teeth. In mineralizing tissues, many anionic macromolecules bind to mineral. By means of this binding, such molecules are able to regulate the size and shape of the mineral crystals, determine the site of initial crystal depositi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1992-08-01 00:00:00
