Synoviale Biomarker für die Differenzialdiagnostik der schmerzhaften Endoprothese

I J Banke; N Stade; P M Prodinger; H M Mühlhofer; P Thomas; B Thomas; B Summer; M van Griensven; R von Eisenhart-Rothe; H Gollwitzer

doi:10.1007/s00132-015-3188-7

Synoviale Biomarker für die Differenzialdiagnostik der schmerzhaften Endoprothese

Translated title of the contribution: Synovial biomarkers for differential diagnosis of painful arthroplasty

I J Banke^*, N Stade, P M Prodinger, H M Mühlhofer, P Thomas, B Thomas, B Summer, M van Griensven, R von Eisenhart-Rothe, H Gollwitzer

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: The diagnosis and treatment of periprosthetic joint infection (PJI) remain true clinical challenges. PJI diminishes therapeutic success, causes dissatisfaction for the patient and medical staff, and often requires extensive surgical revision(s). At the present time, an extensive multimodal algorithmic approach is used to avoid time- and cost-consuming diagnostic aberrations. However, especially in the case of the frequent and clinically most relevant "low-grade" PJI, the current diagnostic "gold standard" has reached its limits.

EVALUATION: Synovial biomarkers are thought to close this diagnostic gap, hopefully enabling the safe differentiation among aseptic, (chronic) septic, implant allergy-related and the arthrofibrotic genesis of symptomatic arthroplasty. Therefore, joint aspiration for obtaining synovial fluid is preferred over surgical synovial tissue biopsy because of the faster results, greater practicability, greater patient safety, and lower costs. In addition to the parameters synovial IL-6, CRP, and leukocyte esterase, novel biomarkers such as antimicrobial peptides and other proinflammatory cytokines are currently highlighted because of their very high to excellent diagnostic accuracy.

CONCLUSION: Independent multicenter validation studies are required to show whether a set of different innovative synovial fluid biomarkers rather than a few single parameters is favorable for a safe "one-stop shop" differential diagnosis of PJI.

Translated title of the contribution	Synovial biomarkers for differential diagnosis of painful arthroplasty
Original language	German
Pages (from-to)	93, 936-8, 940-1
Journal	Orthopade
Volume	44
Issue number	12
DOIs	https://doi.org/10.1007/s00132-015-3188-7
Publication status	Published - Dec 2015
Externally published	Yes

Keywords

Arthralgia/diagnosis
Biomarkers/blood
Cytokines/metabolism
Diagnosis, Differential
Evidence-Based Medicine
Humans
Prosthesis-Related Infections/diagnosis
Synovial Fluid/metabolism

Access to Document

10.1007/s00132-015-3188-7

Cite this

@article{c03b718b35334c5f85f4f5649dec42a6,

title = "Synoviale Biomarker f{\"u}r die Differenzialdiagnostik der schmerzhaften Endoprothese",

abstract = "BACKGROUND: The diagnosis and treatment of periprosthetic joint infection (PJI) remain true clinical challenges. PJI diminishes therapeutic success, causes dissatisfaction for the patient and medical staff, and often requires extensive surgical revision(s). At the present time, an extensive multimodal algorithmic approach is used to avoid time- and cost-consuming diagnostic aberrations. However, especially in the case of the frequent and clinically most relevant {"}low-grade{"} PJI, the current diagnostic {"}gold standard{"} has reached its limits.EVALUATION: Synovial biomarkers are thought to close this diagnostic gap, hopefully enabling the safe differentiation among aseptic, (chronic) septic, implant allergy-related and the arthrofibrotic genesis of symptomatic arthroplasty. Therefore, joint aspiration for obtaining synovial fluid is preferred over surgical synovial tissue biopsy because of the faster results, greater practicability, greater patient safety, and lower costs. In addition to the parameters synovial IL-6, CRP, and leukocyte esterase, novel biomarkers such as antimicrobial peptides and other proinflammatory cytokines are currently highlighted because of their very high to excellent diagnostic accuracy.CONCLUSION: Independent multicenter validation studies are required to show whether a set of different innovative synovial fluid biomarkers rather than a few single parameters is favorable for a safe {"}one-stop shop{"} differential diagnosis of PJI.",

keywords = "Arthralgia/diagnosis, Biomarkers/blood, Cytokines/metabolism, Diagnosis, Differential, Evidence-Based Medicine, Humans, Prosthesis-Related Infections/diagnosis, Synovial Fluid/metabolism",

author = "Banke, {I J} and N Stade and Prodinger, {P M} and M{\"u}hlhofer, {H M} and P Thomas and B Thomas and B Summer and {van Griensven}, M and {von Eisenhart-Rothe}, R and H Gollwitzer",

year = "2015",

month = dec,

doi = "10.1007/s00132-015-3188-7",

language = "German",

volume = "44",

pages = "93, 936--8, 940--1",

journal = "Orthopade",

issn = "0085-4530",

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TY - JOUR

T1 - Synoviale Biomarker für die Differenzialdiagnostik der schmerzhaften Endoprothese

AU - Banke, I J

AU - Stade, N

AU - Prodinger, P M

AU - Mühlhofer, H M

AU - Thomas, P

AU - Thomas, B

AU - Summer, B

AU - van Griensven, M

AU - von Eisenhart-Rothe, R

AU - Gollwitzer, H

PY - 2015/12

Y1 - 2015/12

N2 - BACKGROUND: The diagnosis and treatment of periprosthetic joint infection (PJI) remain true clinical challenges. PJI diminishes therapeutic success, causes dissatisfaction for the patient and medical staff, and often requires extensive surgical revision(s). At the present time, an extensive multimodal algorithmic approach is used to avoid time- and cost-consuming diagnostic aberrations. However, especially in the case of the frequent and clinically most relevant "low-grade" PJI, the current diagnostic "gold standard" has reached its limits.EVALUATION: Synovial biomarkers are thought to close this diagnostic gap, hopefully enabling the safe differentiation among aseptic, (chronic) septic, implant allergy-related and the arthrofibrotic genesis of symptomatic arthroplasty. Therefore, joint aspiration for obtaining synovial fluid is preferred over surgical synovial tissue biopsy because of the faster results, greater practicability, greater patient safety, and lower costs. In addition to the parameters synovial IL-6, CRP, and leukocyte esterase, novel biomarkers such as antimicrobial peptides and other proinflammatory cytokines are currently highlighted because of their very high to excellent diagnostic accuracy.CONCLUSION: Independent multicenter validation studies are required to show whether a set of different innovative synovial fluid biomarkers rather than a few single parameters is favorable for a safe "one-stop shop" differential diagnosis of PJI.

AB - BACKGROUND: The diagnosis and treatment of periprosthetic joint infection (PJI) remain true clinical challenges. PJI diminishes therapeutic success, causes dissatisfaction for the patient and medical staff, and often requires extensive surgical revision(s). At the present time, an extensive multimodal algorithmic approach is used to avoid time- and cost-consuming diagnostic aberrations. However, especially in the case of the frequent and clinically most relevant "low-grade" PJI, the current diagnostic "gold standard" has reached its limits.EVALUATION: Synovial biomarkers are thought to close this diagnostic gap, hopefully enabling the safe differentiation among aseptic, (chronic) septic, implant allergy-related and the arthrofibrotic genesis of symptomatic arthroplasty. Therefore, joint aspiration for obtaining synovial fluid is preferred over surgical synovial tissue biopsy because of the faster results, greater practicability, greater patient safety, and lower costs. In addition to the parameters synovial IL-6, CRP, and leukocyte esterase, novel biomarkers such as antimicrobial peptides and other proinflammatory cytokines are currently highlighted because of their very high to excellent diagnostic accuracy.CONCLUSION: Independent multicenter validation studies are required to show whether a set of different innovative synovial fluid biomarkers rather than a few single parameters is favorable for a safe "one-stop shop" differential diagnosis of PJI.

KW - Arthralgia/diagnosis

KW - Biomarkers/blood

KW - Cytokines/metabolism

KW - Diagnosis, Differential

KW - Evidence-Based Medicine

KW - Humans

KW - Prosthesis-Related Infections/diagnosis

KW - Synovial Fluid/metabolism

U2 - 10.1007/s00132-015-3188-7

DO - 10.1007/s00132-015-3188-7

M3 - Article

C2 - 26542406

SN - 0085-4530

VL - 44

SP - 93, 936-8, 940-1

JO - Orthopade

JF - Orthopade

IS - 12

ER -