Total joint replacement (TJR) is an increasing effective procedure in orthopedics. However, TJR failure due to aseptic or septic loosening remains an important problem, often due to predisposing factors of the patient, which determine the need to perform a revision surgery. In light of the recent conclusions emerged on the still open problems concerning the diagnostic accuracy of serum and synovial fluid markers in the diagnosis of peri-prosthetic joint infection (PJI), the project aims at evaluating the diagnostic accuracy and cost-effectiveness of the combination of serum and/or synovial markers in the diagnosis of PJI. Through a diagnostic clinical study on patients hospitalized for revision surgery the project would provide evidences on the potentiality of the combination of some markers in accelerating the PJI diagnosis for the best selection of surgical strategy, choosing the suitable cutoff thresholds to mitigate the effect of some factors on markers' discriminatory capability.
Age range
18 Years
Sex
ALL
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White blood cell count (WBC, cells/μL)
Timeframe: 7 days
Erythrocyte sedimentation rate (ESR, mm/hour)
Timeframe: 7 days
C-reactive Protein (CRP, mg/L)
Timeframe: 7 days
D-dimer (ng/ml)
Timeframe: 7 days
IL-6 (pg/ml)
Timeframe: 7 days
Procalcitonin (ng/ml)
Timeframe: 2 months
Soluble Intercellular Adhesion Molecule-1 (sICAM-1, ng/L)
Timeframe: 7 days
Synovial WBC (sWBC, cells/μL)
Timeframe: 7 days
Percentage of polymorphonucleates (%PMM, %) in synovial fluid
Timeframe: 7 days
Synovial C-reactive Protein (sCRP, mg/L)
Timeframe: 7 days
Synovial alpha-defensin (positive or negative)
Timeframe: 7 days
Synovial leukocyte esterase (positive or negative)
Timeframe: 7 days
Synovial IL-6 (pg/ml)
Timeframe: 7 days
Synovial cathelicidin LL-37 (μg/ml)
Timeframe: 7 days
Synovial calprotectin (ng/ml)
Timeframe: 7 days