滑膜α-防御素在二期翻修关节置换术中再植入以排除持续性感染。
Synovial Alpha-defensin at Reimplantation in Two-stage Revision Arthroplasty to Rule Out Persistent Infection.
机构信息
Department of Orthopaedics, Trauma and Reconstructive Surgery, St. Marien Hospital, Mülheim an der Ruhr, Germany.
Department of Orthopaedics and Trauma Surgery, University of Duisburg-Essen, Mülheim an der Ruhr, Germany.
出版信息
In Vivo. 2021 Mar-Apr;35(2):1073-1081. doi: 10.21873/invivo.12352.
BACKGROUND/AIM: Owing to the lack of a diagnostic gold standard, ruling out persistent periprosthetic joint infection (PJI) before second-stage surgery in the setting of two-stage revision arthroplasty constitutes a major challenge. We evaluated if the alpha-defensin-1 (AD-1) test could predict successful infection eradication before reimplantation of a new prosthesis.
PATIENTS AND METHODS
Our prospective study included 20 patients who underwent two-stage revision arthroplasty for treatment of PJI. A standard quantitative enzyme AD-1 immunoassay of synovial fluid, the synovial leukocyte esterase test and routine laboratory blood testing were performed prior to explantation and reimplantation. Treatment failure was defined according to the Delphi-based consensus criteria after a minimum follow-up of 1 year.
RESULTS
A 15% of our patients met the Delphi Criteria within 1 year. None of the markers investigated were significantly different in patients with and without reinfection.
CONCLUSION
Further research is necessary to identify biomarkers more suitable for indicating persistent infection before reimplantation.
背景/目的：由于缺乏诊断的金标准，在二期翻修关节置换术中，排除持续性假体周围关节感染（PJI）是一个主要的挑战。我们评估了α-防御素-1（AD-1）检测在重新植入新假体前是否可以预测成功清除感染。
患者和方法
我们的前瞻性研究包括 20 名因 PJI 而行二期翻修关节置换术的患者。在取出和重新植入前，对关节液进行了标准的定量酶 AD-1 免疫分析、关节白细胞酯酶试验和常规实验室血液检查。根据最低 1 年的随访后的 Delphi 共识标准，将治疗失败定义为符合标准。
结果
我们的患者中有 15%在 1 年内符合 Delphi 标准。在有和没有再感染的患者中，所研究的标志物均无显著差异。
结论
需要进一步研究以确定更适合在重新植入前指示持续性感染的生物标志物。
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