Results of the intraoperative alpha defensin lateral flow test in the second stage of revision hip arthroplasty
Background Alpha defensin lateral flow (ADLF) test is a current accurate tool for detecting/excluding periprosthetic joint infection (PJI); however, its usage in patients with a hip joint spacer has not yet been fully studied. The purpose of the study was to determine the diagnostic parameters (a...
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Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
2024-12-01
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| Series: | Гений oртопедии |
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| author | Valery Yu. Murylev Javad Parvizi Alexander I. Rudnev Grigory A. Kukovenko Pavel M. Elizarov Aleksey V. Muzychenkov Semen S. Alekseev Dmitriy O. Golubkin Konstantin G. Yakovlev Anastasia O. Ugolnikova |
| author_facet | Valery Yu. Murylev Javad Parvizi Alexander I. Rudnev Grigory A. Kukovenko Pavel M. Elizarov Aleksey V. Muzychenkov Semen S. Alekseev Dmitriy O. Golubkin Konstantin G. Yakovlev Anastasia O. Ugolnikova |
| author_sort | Valery Yu. Murylev |
| collection | DOAJ |
| description | Background Alpha defensin lateral flow (ADLF) test is a current accurate tool for detecting/excluding
periprosthetic joint infection (PJI); however, its usage in patients with a hip joint spacer has not yet been fully
studied.
The purpose of the study was to determine the diagnostic parameters (accuracy, specificity, sensitivity, AUC)
of the alpha-defensin lateral flow test as part of the reinfection verification in patients with a hip joint spacer
in the second stage of revision hip arthroplasty (RHA).
Material and methods In a prospective study the effectiveness of the intraoperative use of ADLF test was
evaluated in 105 patients with hip joint spacers during the 2nd stage of revision hip arthroplasty (RHA).
The standard microbiological examination of intraoperative samples of tissues and synovial fluid was accepted
as the gold standard for re-infection diagnosis.
Results The growth of microflora according to the results of intraoperative microbiological examination was
detected in 24 (23 %) cases. The discrepancy in the results of intraoperative microbiological examination
and the results of the ADLF test was found in 10 (11 %) cases. False positive and false negative cases were
identified. ADLF test demonstrated 96.39 % specificity, 89.52 % accuracy and 63.64 % sensitivity. The AUC
index was 0.8.
Discussion ADLF test has good diagnostic indicators for the verification of PJI in patients after hip replacement.
The use of ADLF test in patients with a hip joint spacer who continue antibacterial therapy allows the test
to be performed in the 2nd stage of RHA. However, the results of ADLF test in patients during the 2nd stage
of RHA show that additional studies are required.
Conclusion The ADLF test, despite the divergent data from scientific publications, demonstrates high
diagnostic value for intraoperative verification of reinfection in patients with a hip joint spacer, allowing timely
correction of treatment tactics. "Dry tap", bloody synovial fluid, as well as weakly virulent coagulase‑negative
microflora, including in microbial associations, are limitations of the ADLF test application. |
| format | Article |
| id | doaj-art-a404106fac6a44e0b01d5511aa011914 |
| institution | Kabale University |
| issn | 1028-4427 2542-131X |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics |
| record_format | Article |
| series | Гений oртопедии |
| spelling | doaj-art-a404106fac6a44e0b01d5511aa0119142024-12-23T03:50:26ZengRussian Ilizarov Scientific Center for Restorative Traumatology and OrthopaedicsГений oртопедии1028-44272542-131X2024-12-0130681182110.18019/1028-4427-2024-30-6-811-821Results of the intraoperative alpha defensin lateral flow test in the second stage of revision hip arthroplastyValery Yu. Murylev0https://orcid.org/0000-0001-5753-8926Javad Parvizi1https://orcid.org/0000-0002-6985-5870Alexander I. Rudnev2https://orcid.org/0000-0003-4490-2922Grigory A. Kukovenko3https://orcid.org/0000-0001-6700-0222Pavel M. Elizarov4https://orcid.org/0000-0002-0217-2434Aleksey V. Muzychenkov5https://orcid.org/0000-0002-3933-672XSemen S. Alekseev6https://orcid.org/0000-0001-7599-7472Dmitriy O. Golubkin7https://orcid.org/0000-0003-3293-0918Konstantin G. Yakovlev8https://orcid.org/0009-0008-8558-7643Anastasia O. Ugolnikova9https://orcid.org/0000-0002-0456-9435Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation; Botkin City Clinical Hospital, Moscow, Russian FederationAcibadem University, Istanbul, TurkeySechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation; Botkin City Clinical Hospital, Moscow, Russian FederationSechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation; Botkin City Clinical Hospital, Moscow, Russian FederationSechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation; Botkin City Clinical Hospital, Moscow, Russian FederationSechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation; Botkin City Clinical Hospital, Moscow, Russian FederationBotkin City Clinical Hospital, Moscow, Russian FederationSechenov First Moscow State Medical University (Sechenov University), Moscow, Russian FederationBotkin City Clinical Hospital, Moscow, Russian FederationBotkin City Clinical Hospital, Moscow, Russian FederationBackground Alpha defensin lateral flow (ADLF) test is a current accurate tool for detecting/excluding periprosthetic joint infection (PJI); however, its usage in patients with a hip joint spacer has not yet been fully studied. The purpose of the study was to determine the diagnostic parameters (accuracy, specificity, sensitivity, AUC) of the alpha-defensin lateral flow test as part of the reinfection verification in patients with a hip joint spacer in the second stage of revision hip arthroplasty (RHA). Material and methods In a prospective study the effectiveness of the intraoperative use of ADLF test was evaluated in 105 patients with hip joint spacers during the 2nd stage of revision hip arthroplasty (RHA). The standard microbiological examination of intraoperative samples of tissues and synovial fluid was accepted as the gold standard for re-infection diagnosis. Results The growth of microflora according to the results of intraoperative microbiological examination was detected in 24 (23 %) cases. The discrepancy in the results of intraoperative microbiological examination and the results of the ADLF test was found in 10 (11 %) cases. False positive and false negative cases were identified. ADLF test demonstrated 96.39 % specificity, 89.52 % accuracy and 63.64 % sensitivity. The AUC index was 0.8. Discussion ADLF test has good diagnostic indicators for the verification of PJI in patients after hip replacement. The use of ADLF test in patients with a hip joint spacer who continue antibacterial therapy allows the test to be performed in the 2nd stage of RHA. However, the results of ADLF test in patients during the 2nd stage of RHA show that additional studies are required. Conclusion The ADLF test, despite the divergent data from scientific publications, demonstrates high diagnostic value for intraoperative verification of reinfection in patients with a hip joint spacer, allowing timely correction of treatment tactics. "Dry tap", bloody synovial fluid, as well as weakly virulent coagulase‑negative microflora, including in microbial associations, are limitations of the ADLF test application.periprosthetic joint infection (pji)diagnosis of hip joint reinfectionintraoperative aspiration of synovial fluid of the hip jointhip joint spacerrevision hip arthroplastyalpha defensin lateral flow test (adlf) |
| spellingShingle | Valery Yu. Murylev Javad Parvizi Alexander I. Rudnev Grigory A. Kukovenko Pavel M. Elizarov Aleksey V. Muzychenkov Semen S. Alekseev Dmitriy O. Golubkin Konstantin G. Yakovlev Anastasia O. Ugolnikova Results of the intraoperative alpha defensin lateral flow test in the second stage of revision hip arthroplasty Гений oртопедии periprosthetic joint infection (pji) diagnosis of hip joint reinfection intraoperative aspiration of synovial fluid of the hip joint hip joint spacer revision hip arthroplasty alpha defensin lateral flow test (adlf) |
| title | Results of the intraoperative alpha defensin lateral flow test in the second stage of revision hip arthroplasty |
| title_full | Results of the intraoperative alpha defensin lateral flow test in the second stage of revision hip arthroplasty |
| title_fullStr | Results of the intraoperative alpha defensin lateral flow test in the second stage of revision hip arthroplasty |
| title_full_unstemmed | Results of the intraoperative alpha defensin lateral flow test in the second stage of revision hip arthroplasty |
| title_short | Results of the intraoperative alpha defensin lateral flow test in the second stage of revision hip arthroplasty |
| title_sort | results of the intraoperative alpha defensin lateral flow test in the second stage of revision hip arthroplasty |
| topic | periprosthetic joint infection (pji) diagnosis of hip joint reinfection intraoperative aspiration of synovial fluid of the hip joint hip joint spacer revision hip arthroplasty alpha defensin lateral flow test (adlf) |
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