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A Modern Approach to Biofilm-Related Orthopaedic Implant Infections pp 69–79Cite as

The Role of Biomarkers for the Diagnosis of Implant-Related Infections in Orthopaedics and Trauma

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Part of the book series: Advances in Experimental Medicine and Biology ((AMIDPH,volume 971))

Abstract

Diagnosis of implant-related (periprosthetic joint) infections poses a major challenge to infection disease physicians and orthopaedic surgeons. Conventional diagnostic tests continue to suffer from issues of accuracy and feasibility. Biomarkers are used throughout medicine for diagnostic and prognostic purposes, as they are able to objectively determine the presence of a disease or a biological state. There is increasing evidence to support the measurement of specific biomarkers in serum and/or synovial fluid of patients with suspected periprosthetic joint infections. Promising serum biomarkers include interleukin (IL)-4, IL-6, tumour necrosis factor (TNF)-α, procalcitonin, soluble intercellular adhesion molecule 1 (sICAM-1), and D-dimer. In addition to c-reactive protein and leucocyte esterase, promising biomarkers that can be measured in synovial fluid include antimicrobial proteins such as human β-defensin (HBD)-2 and human β-defensin (HBD)-3, and cathelicidin LL-37, as well as several interleukins such as IL-1β, IL-6, IL-8, IL-17, TNF- α, interferon-δ, and vascular endothelial growth factor.

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References

  • Aalto K, Osterman K, Peltola H, Rasanen J (1984) Changes in erythrocyte sedimentation rate and C-reactive protein after total hip arthroplasty. Clin Orthop Relat Res 184:118–120

    Google Scholar 

  • Aggarwal VK, Tischler E, Ghanem E, Parvizi J (2013) Leukocyte esterase from synovial fluid aspirate: a technical note. J Arthroplast 28(1):193–195. doi:10.1016/j.arth.2012.06.023

    Article  Google Scholar 

  • Ali S, Christie A, Chapel A (2009) The pattern of procalcitonin in primary total hip and knee arthroplasty and its implication in periprosthetic infection. J Clin Med Res 1(2):90–94. doi:10.4021/jocmr2009.04.1236

    CAS  PubMed  PubMed Central  Google Scholar 

  • Alijanipour P, Bakhshi H, Parvizi J (2013) Diagnosis of periprosthetic joint infection: the threshold for serological markers. Clin Orthop Relat Res 471(10):3186–3195. doi:10.1007/s11999-013-3070-z

    Article  PubMed  PubMed Central  Google Scholar 

  • Arkader R, Troster EJ, Lopes MR, Junior RR, Carcillo JA, Leone C, Okay TS (2006) Procalcitonin does discriminate between sepsis and systemic inflammatory response syndrome. Arch Dis Child 91(2):117–120. doi:10.1136/adc.2005.077446

    Article  CAS  PubMed  Google Scholar 

  • Atkins BL, Athanasou N, Deeks JJ, Crook DW, Simpson H, Peto TE, McLardy-Smith P, Berendt AR (1998) Prospective evaluation of criteria for microbiological diagnosis of prosthetic-joint infection at revision arthroplasty. The OSIRIS Collaborative Study Group. J Clin Microbiol 36(10):2932–2939

    CAS  PubMed  PubMed Central  Google Scholar 

  • Bedair H, Ting N, Jacovides C, Saxena A, Moric M, Parvizi J, Della Valle CJ (2011) The Mark Coventry Award: diagnosis of early postoperative TKA infection using synovial fluid analysis. Clin Orthop Relat Res 469(1):34–40. doi:10.1007/s11999-010-1433-2

    Article  PubMed  Google Scholar 

  • Bejon P, Byren I, Atkins BL, Scarborough M, Woodhouse A, McLardy-Smith P, Gundle R, Berendt AR (2011) Serial measurement of the C-reactive protein is a poor predictor of treatment outcome in prosthetic joint infection. J Antimicrob Chemother 66(7):1590–1593. doi:10.1093/jac/dkr182

    Article  CAS  PubMed  Google Scholar 

  • Berbari EF, Marculescu C, Sia I, Lahr BD, Hanssen AD, Steckelberg JM, Gullerud R, Osmon DR (2007) Culture-negative prosthetic joint infection. Clin Infect Dis 45(9):1113–1119. doi:10.1086/522184

    Article  PubMed  Google Scholar 

  • Berbari E, Mabry T, Tsaras G, Spangehl M, Erwin PJ, Murad MH, Steckelberg J, Osmon D (2010) Inflammatory blood laboratory levels as markers of prosthetic joint infection: a systematic review and meta-analysis. J Bone Joint Surg Am 92(11):2102–2109. doi:10.2106/JBJS.I.01199

    Article  PubMed  Google Scholar 

  • Biomarkers Definitions Working G (2001) Biomarkers and surrogate endpoints: preferred definitions and conceptual framework. Clin Pharmacol Ther 69(3):89–95. doi:10.1067/mcp.2001.113989

    Article  Google Scholar 

  • Bottner F, Wegner A, Winkelmann W, Becker K, Erren M, Gotze C (2007) Interleukin-6, procalcitonin and TNF-alpha: markers of peri-prosthetic infection following total joint replacement. J Bone Joint Surg (Br) 89(1):94–99. doi:10.1302/0301-620X.89B1.17485

    Article  CAS  Google Scholar 

  • Choe H, Deirmengian CA, Hickok NJ, Morrison TN, Tuan RS (2015) Molecular diagnostics. J Am Acad Orthop Surg 23(Suppl):S26–S31. doi:10.5435/JAAOS-D-14-00409

    Article  PubMed  PubMed Central  Google Scholar 

  • Ciriello V, Gudipati S, Stavrou PZ, Kanakaris NK, Bellamy MC, Giannoudis PV (2013) Biomarkers predicting sepsis in polytrauma patients: current evidence. Injury 44(12):1680–1692. doi:10.1016/j.injury.2013.09.024

    Article  PubMed  Google Scholar 

  • De Vecchi E, Villa F, Bortolin M, Toscano M, Tacchini L, Romano CL, Drago L (2016) Leucocyte esterase, glucose and C-reactive protein in the diagnosis of prosthetic joint infections: a prospective study. Clin Microbiol Infect 22(6):555–560. doi:10.1016/j.cmi.2016.03.020

    Article  CAS  PubMed  Google Scholar 

  • Deirmengian C, Lonner JH, Booth RE Jr (2005) The Mark Coventry Award: white blood cell gene expression: a new approach toward the study and diagnosis of infection. Clin Orthop Relat Res 440:38–44

    Article  PubMed  Google Scholar 

  • Deirmengian C, Hallab N, Tarabishy A, Della Valle C, Jacobs JJ, Lonner J, Booth RE Jr (2010) Synovial fluid biomarkers for periprosthetic infection. Clin Orthop Relat Res 468(8):2017–2023. doi:10.1007/s11999-010-1298-4

    Article  PubMed  PubMed Central  Google Scholar 

  • Deirmengian C, Kardos K, Kilmartin P, Cameron A, Schiller K, Parvizi J (2014a) Combined measurement of synovial fluid alpha-Defensin and C-reactive protein levels: highly accurate for diagnosing periprosthetic joint infection. J Bone Joint Surg Am 96(17):1439–1445. doi:10.2106/JBJS.M.01316

    Article  PubMed  Google Scholar 

  • Deirmengian C, Kardos K, Kilmartin P, Cameron A, Schiller K, Parvizi J (2014b) Diagnosing periprosthetic joint infection: has the era of the biomarker arrived? Clin Orthop Relat Res 472(11):3254–3262. doi:10.1007/s11999-014-3543-8

    Article  PubMed  PubMed Central  Google Scholar 

  • Deirmengian C, Kardos K, Kilmartin P, Cameron A, Schiller K, Booth RE Jr, Parvizi J (2015a) The alpha-defensin test for periprosthetic joint infection outperforms the leukocyte esterase test strip. Clin Orthop Relat Res 473(1):198–203. doi:10.1007/s11999-014-3722-7

    Article  PubMed  Google Scholar 

  • Deirmengian C, Kardos K, Kilmartin P, Gulati S, Citrano P, Booth RE Jr (2015b) The alpha-defensin test for periprosthetic joint infection responds to a wide spectrum of organisms. Clin Orthop Relat Res 473(7):2229–2235. doi:10.1007/s11999-015-4152-x

    Article  PubMed  PubMed Central  Google Scholar 

  • Deirmengian CA, Citrano PA, Gulati S, Kazarian ER, Stave JW, Kardos KW (2016) The C-reactive protein may not detect infections caused by less-virulent organisms. J Arthroplast. doi:10.1016/j.arth.2016.01.060

    Google Scholar 

  • Di Cesare PE, Chang E, Preston CF, Liu CJ (2005) Serum interleukin-6 as a marker of periprosthetic infection following total hip and knee arthroplasty. J Bone Joint Surg Am 87(9):1921–1927. doi:10.2106/JBJS.D.01803

    PubMed  Google Scholar 

  • Dinneen A, Guyot A, Clements J, Bradley N (2013) Synovial fluid white cell and differential count in the diagnosis or exclusion of prosthetic joint infection. Bone Joint J 95-B(4):554–557. doi:10.1302/0301-620X.95B4.30388

    Article  CAS  PubMed  Google Scholar 

  • Dos Anjos PB, da Luz FA, de Faria PR, Oliveira AP, de Araujo RA, Silva MJ (2014) Far beyond the usual biomarkers in breast cancer: a review. J Cancer 5(7):559–571. doi:10.7150/jca.8925

    Article  Google Scholar 

  • Drago L, Vassena C, Dozio E, Corsi MM, De Vecchi E, Mattina R, Romano C (2011) Procalcitonin, C-reactive protein, interleukin-6, and soluble intercellular adhesion molecule-1 as markers of postoperative orthopaedic joint prosthesis infections. Int J Immunopathol Pharmacol 24(2):433–440

    Article  CAS  PubMed  Google Scholar 

  • Ghanem E, Antoci V Jr, Pulido L, Joshi A, Hozack W, Parvizi J (2009a) The use of receiver operating characteristics analysis in determining erythrocyte sedimentation rate and C-reactive protein levels in diagnosing periprosthetic infection prior to revision total hip arthroplasty. Int J Infect Dis 13(6):e444–e449. doi:10.1016/j.ijid.2009.02.017

    Article  CAS  PubMed  Google Scholar 

  • Ghanem E, Azzam K, Seeley M, Joshi A, Parvizi J (2009b) Staged revision for knee arthroplasty infection: what is the role of serologic tests before reimplantation? Clin Orthop Relat Res 467(7):1699–1705. doi:10.1007/s11999-009-0742-9

    Article  PubMed  PubMed Central  Google Scholar 

  • Glehr M, Friesenbichler J, Hofmann G, Bernhardt GA, Zacherl M, Avian A, Windhager R, Leithner A (2013) Novel biomarkers to detect infection in revision hip and knee arthroplasties. Clin Orthop Relat Res 471(8):2621–2628. doi:10.1007/s11999-013-2998-3

    Article  PubMed  PubMed Central  Google Scholar 

  • Goldberg B, Sichtig H, Geyer C, Ledeboer N, Weinstock GM (2015) Making the leap from research laboratory to clinic: challenges and opportunities for next-generation sequencing in infectious disease diagnostics. MBio 6(6):e01888–e01815. doi:10.1128/mBio.01888-15

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Gollwitzer H, Dombrowski Y, Prodinger PM, Peric M, Summer B, Hapfelmeier A, Saldamli B, Pankow F, von Eisenhart-Rothe R, Imhoff AB, Schauber J, Thomas P, Burgkart R, Banke IJ (2013) Antimicrobial peptides and proinflammatory cytokines in periprosthetic joint infection. J Bone Joint Surg Am 95(7):644–651. doi:10.2106/JBJS.L.00205

    Article  PubMed  Google Scholar 

  • Heinrich PC, Castell JV, Andus T (1990) Interleukin-6 and the acute phase response. Biochem J 265(3):621–636

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Henry NL, Hayes DF (2012) Cancer biomarkers. Mol Oncol 6(2):140–146. doi:10.1016/j.molonc.2012.01.010

    Article  CAS  PubMed  Google Scholar 

  • Hugle T, Schuetz P, Mueller B, Laifer G, Tyndall A, Regenass S, Daikeler T (2008) Serum procalcitonin for discrimination between septic and non-septic arthritis. Clin Exp Rheumatol 26(3):453–456

    CAS  PubMed  Google Scholar 

  • Jacovides CL, Parvizi J, Adeli B, Jung KA (2011) Molecular markers for diagnosis of periprosthetic joint infection. J Arthroplast 26(6 Suppl):99–103 . doi:10.1016/j.arth.2011.03.025e101

    Article  Google Scholar 

  • Krenn V, Morawietz L, Perino G, Kienapfel H, Ascherl R, Hassenpflug GJ, Thomsen M, Thomas P, Huber M, Kendoff D, Baumhoer D, Krukemeyer MG, Natu S, Boettner F, Zustin J, Kolbel B, Ruther W, Kretzer JP, Tiemann A, Trampuz A, Frommelt L, Tichilow R, Soder S, Muller S, Parvizi J, Illgner U, Gehrke T (2014) Revised histopathological consensus classification of joint implant related pathology. Pathol Res Pract 210(12):779–786. doi:10.1016/j.prp.2014.09.017

    Article  CAS  PubMed  Google Scholar 

  • Lee YH, Pratley RE (2005) The evolving role of inflammation in obesity and the metabolic syndrome. Curr Diab Rep 5(1):70–75

    Article  CAS  PubMed  Google Scholar 

  • Lehrer RI, Ganz T (1992) Defensins: endogenous antibiotic peptides from human leukocytes. CIBA Found Symp 171:276–290. ; discussion 290–273

    CAS  PubMed  Google Scholar 

  • Liu JZ, Saleh A, Klika AK, Barsoum WK, Higuera CA (2014) Serum inflammatory markers for periprosthetic knee infection in obese versus non-obese patients. J Arthroplast 29(10):1880–1883. doi:10.1016/j.arth.2014.07.005

    Article  Google Scholar 

  • Malekzadeh D, Osmon DR, Lahr BD, Hanssen AD, Berbari EF (2010) Prior use of antimicrobial therapy is a risk factor for culture-negative prosthetic joint infection. Clin Orthop Relat Res 468(8):2039–2045. doi:10.1007/s11999-010-1338-0

    Article  PubMed  PubMed Central  Google Scholar 

  • Mason JB, Fehring TK, Odum SM, Griffin WL, Nussman DS (2003) The value of white blood cell counts before revision total knee arthroplasty. J Arthroplast 18(8):1038–1043

    Article  Google Scholar 

  • Mayeux R (2004) Biomarkers: potential uses and limitations. NeuroRx 1(2):182–188. doi:10.1602/neurorx.1.2.182

    Article  PubMed  PubMed Central  Google Scholar 

  • McArthur BA, Abdel MP, Taunton MJ, Osmon DR, Hanssen AD (2015) Seronegative infections in hip and knee arthroplasty: periprosthetic infections with normal erythrocyte sedimentation rate and C-reactive protein level. Bone Joint J 97-B(7):939–944. doi:10.1302/0301-620X.97B7.35500

    Article  CAS  PubMed  Google Scholar 

  • Meermans G, Haddad FS (2010) Is there a role for tissue biopsy in the diagnosis of periprosthetic infection? Clin Orthop Relat Res 468(5):1410–1417. doi:10.1007/s11999-010-1245-4

    Article  PubMed  PubMed Central  Google Scholar 

  • Mikkelsen DB, Pedersen C, Hojbjerg T, Schonheyder HC (2006) Culture of multiple peroperative biopsies and diagnosis of infected knee arthroplasties. APMIS 114(6):449–452. doi:10.1111/j.1600-0463.2006.apm_428.x

    Article  PubMed  Google Scholar 

  • Miller VM, Redfield MM, McConnell JP (2007) Use of BNP and CRP as biomarkers in assessing cardiovascular disease: diagnosis versus risk. Curr Vasc Pharmacol 5(1):15–25

    Article  CAS  PubMed  Google Scholar 

  • Nanda N, Juthani-Mehta M (2009) Novel biomarkers for the diagnosis of urinary tract infection-a systematic review. Biomark Insights 4:111–121

    CAS  PubMed  PubMed Central  Google Scholar 

  • Nijnik A, Hancock RE (2009) The roles of cathelicidin LL-37 in immune defences and novel clinical applications. Curr Opin Hematol 16(1):41–47

    Article  CAS  PubMed  Google Scholar 

  • Niskanen RO, Korkala O, Pammo H (1996) Serum C-reactive protein levels after total hip and knee arthroplasty. J Bone Joint Surg (Br) 78(3):431–433

    Article  CAS  Google Scholar 

  • Overhage J, Campisano A, Bains M, Torfs EC, Rehm BH, Hancock RE (2008) Human host defense peptide LL-37 prevents bacterial biofilm formation. Infect Immun 76(9):4176–4182. doi:10.1128/IAI.00318-08

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Pandey R, Berendt AR, Athanasou NA (2000) Histological and microbiological findings in non-infected and infected revision arthroplasty tissues. The OSIRIS Collaborative Study Group. Oxford Skeletal Infection Research and Intervention Service. Arch Orthop Trauma Surg 120(10):570–574

    Article  CAS  PubMed  Google Scholar 

  • Parvizi J, Jacovides C, Antoci V, Ghanem E (2011a) Diagnosis of periprosthetic joint infection: the utility of a simple yet unappreciated enzyme. J Bone Joint Surg Am 93(24):2242–2248. doi:10.2106/JBJS.J.01413

    Article  PubMed  Google Scholar 

  • Parvizi J, Zmistowski B, Berbari EF, Bauer TW, Springer BD, Della Valle CJ, Garvin KL, Mont MA, Wongworawat MD, Zalavras CG (2011b) New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society. Clin Orthop Relat Res 469(11):2992–2994. doi:10.1007/s11999-011-2102-9

    Article  PubMed  PubMed Central  Google Scholar 

  • Parvizi J, Jacovides C, Adeli B, Jung KA, Hozack WJ, Mark B (2012a) Coventry Award: synovial C-reactive protein: a prospective evaluation of a molecular marker for periprosthetic knee joint infection. Clin Orthop Relat Res 470(1):54–60. doi:10.1007/s11999-011-1991-y

    Article  PubMed  Google Scholar 

  • Parvizi J, McKenzie JC, Cashman JP (2012b) Diagnosis of periprosthetic joint infection using synovial C-reactive protein. J Arthroplast 27(8 Suppl):12–16. doi:10.1016/j.arth.2012.03.018

    Article  Google Scholar 

  • Parvizi J, Erkocak OF, Della Valle CJ (2014) Culture-negative periprosthetic joint infection. J Bone Joint Surg Am 96(5):430–436. doi:10.2106/JBJS.L.01793

    Article  PubMed  Google Scholar 

  • Pierrakos C, Vincent JL (2010) Sepsis biomarkers: a review. Crit Care 14(1):R15. doi:10.1186/cc8872

    Article  PubMed  PubMed Central  Google Scholar 

  • Qureshi A, Gurbuz Y, Niazi JH (2012) Biosensors for cardiac biomarkers detection: a review. Sensors Actuators B Chem 171:62–76

    Article  Google Scholar 

  • Sanzen L, Sundberg M (1997) Periprosthetic low-grade hip infections. Erythrocyte sedimentation rate and C-reactive protein in 23 cases. Acta Orthop Scand 68(5):461–465

    Article  CAS  PubMed  Google Scholar 

  • Schinsky MF, Della Valle CJ, Sporer SM, Paprosky WG (2008) Perioperative testing for joint infection in patients undergoing revision total hip arthroplasty. J Bone Joint Surg Am 90(9):1869–1875. doi:10.2106/JBJS.G.01255

    Article  PubMed  Google Scholar 

  • Schuetz P, Albrich W, Mueller B (2011) Procalcitonin for diagnosis of infection and guide to antibiotic decisions: past, present and future. BMC Med 9:107. doi:10.1186/1741-7015-9-107

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Selberg O, Hecker H, Martin M, Klos A, Bautsch W, Kohl J (2000) Discrimination of sepsis and systemic inflammatory response syndrome by determination of circulating plasma concentrations of procalcitonin, protein complement 3a, and interleukin-6. Crit Care Med 28(8):2793–2798

    Article  CAS  PubMed  Google Scholar 

  • Shahi A, Parvizi J (2016) Serum D-dimer levels may be a reliable test for diagnosis of periprosthetic joint infection. Orthopaedics Today

    Google Scholar 

  • Shahi A, Deirmengian C, Higuera C, Chen A, Restrepo C, Zmistowski B, Parvizi J (2015) Premature therapeutic antimicrobial treatments can compromise the diagnosis of late periprosthetic joint infection. Clin Orthop Relat Res 473(7):2244–2249. doi:10.1007/s11999-015-4142-z

    Article  PubMed  PubMed Central  Google Scholar 

  • Shahi A, Parvizi J, Kazarian GS, Higuera C, Frangiamore S, Bingham J, Beauchamp C, Valle CD, Deirmengian C (2016) The alpha-defensin test for periprosthetic joint infections is not affected by prior antibiotic administration. Clin Orthop Relat Res 474(7):1610–1615. doi:10.1007/s11999-016-4726-2

    Article  PubMed  PubMed Central  Google Scholar 

  • Simon L, Gauvin F, Amre DK, Saint-Louis P, Lacroix J (2004) Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis. Clin Infect Dis 39(2):206–217. doi:10.1086/421997

    Article  CAS  PubMed  Google Scholar 

  • Talebi-Taher M, Shirani F, Nikanjam N, Shekarabi M (2013) Septic versus inflammatory arthritis: discriminating the ability of serum inflammatory markers. Rheumatol Int 33(2):319–324. doi:10.1007/s00296-012-2363-y

    Article  CAS  PubMed  Google Scholar 

  • Toossi N, Adeli B, Rasouli MR, Huang R, Parvizi J (2012) Serum white blood cell count and differential do not have a role in the diagnosis of periprosthetic joint infection. J Arthroplast 27(8 Suppl):51–54 . doi:10.1016/j.arth.2012.03.021e51

    Article  Google Scholar 

  • Trampuz A, Hanssen AD, Osmon DR, Mandrekar J, Steckelberg JM, Patel R (2004) Synovial fluid leukocyte count and differential for the diagnosis of prosthetic knee infection. Am J Med 117(8):556–562. doi:10.1016/j.amjmed.2004.06.022

    Article  PubMed  Google Scholar 

  • Tsaras G, Maduka-Ezeh A, Inwards CY, Mabry T, Erwin PJ, Murad MH, Montori VM, West CP, Osmon DR, Berbari EF (2012) Utility of intraoperative frozen section histopathology in the diagnosis of periprosthetic joint infection: a systematic review and meta-analysis. J Bone Joint Surg Am 94(18):1700–1711. doi:10.2106/JBJS.J.00756

    Article  PubMed  Google Scholar 

  • Wetters NG, Berend KR, Lombardi AV, Morris MJ, Tucker TL, Della Valle CJ (2012) Leukocyte esterase reagent strips for the rapid diagnosis of periprosthetic joint infection. J Arthroplast 27(8 Suppl):8–11. doi:10.1016/j.arth.2012.03.037

    Article  Google Scholar 

  • Whicher J, Bienvenu J, Monneret G (2001) Procalcitonin as an acute phase marker. Ann Clin Biochem 38(Pt 5):483–493

    Article  CAS  PubMed  Google Scholar 

  • Wirtz DC, Heller KD, Miltner O, Zilkens KW, Wolff JM (2000) Interleukin-6: a potential inflammatory marker after total joint replacement. Int Orthop 24(4):194–196

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Worthington T, Dunlop D, Casey A, Lambert R, Luscombe J, Elliott T (2010) Serum procalcitonin, interleukin-6, soluble intercellular adhesin molecule-1 and IgG to short-chain exocellular lipoteichoic acid as predictors of infection in total joint prosthesis revision. Br J Biomed Sci 67(2):71–76

    Article  CAS  PubMed  Google Scholar 

  • Wyatt MC, Beswick AD, Kunutsor SK, Wilson MJ, Whitehouse MR, Blom AW (2016) The alpha-defensin immunoassay and leukocyte esterase colorimetric strip test for the diagnosis of periprosthetic infection: a systematic review and meta-analysis. J Bone Joint Surg Am 98(12):992–1000. doi:10.2106/JBJS.15.01142

    Article  CAS  PubMed  Google Scholar 

  • Zeller V, Ghorbani A, Strady C, Leonard P, Mamoudy P, Desplaces N (2007) Propionibacterium acnes: an agent of prosthetic joint infection and colonization. J Infect 55(2):119–124. doi:10.1016/j.jinf.2007.02.006

    Article  PubMed  Google Scholar 

  • Zlonis M (1993) The mystique of the erythrocyte sedimentation rate. A reappraisal of one of the oldest laboratory tests still in use. Clin Lab Med 13(4):787–800

    CAS  PubMed  Google Scholar 

  • Zmistowski B, Restrepo C, Huang R, Hozack WJ, Parvizi J (2012) Periprosthetic joint infection diagnosis: a complete understanding of white blood cell count and differential. J Arthroplast 27(9):1589–1593. doi:10.1016/j.arth.2012.03.059

    Article  Google Scholar 

  • Zmistowski B, Della Valle C, Bauer TW, Malizos KN, Alavi A, Bedair H, Booth RE, Choong P, Deirmengian C, Ehrlich GD, Gambir A, Huang R, Kissin Y, Kobayashi H, Kobayashi N, Krenn V, Drago L, Marston SB, Meermans G, Perez J, Ploegmakers JJ, Rosenberg A, Simpendorfer C, Thomas P, Tohtz S, Villafuerte JA, Wahl P, Wagenaar FC, Witzo E (2014) Diagnosis of periprosthetic joint infection. J Arthroplast 29(2 Suppl):77–83. doi:10.1016/j.arth.2013.09.040

    Article  Google Scholar 

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  1. The Rothman Institute, 925 Chestnut Street, Philadelphia, PA, 19107, USA

    Abtin Alvand, Maryam Rezapoor & Javad Parvizi

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  1. Abtin Alvand
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  1. Department of Biomedical Sciences Health, University of Milan, Milan, Italy

    Lorenzo Drago

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Alvand, A., Rezapoor, M., Parvizi, J. (2017). The Role of Biomarkers for the Diagnosis of Implant-Related Infections in Orthopaedics and Trauma. In: Drago, L. (eds) A Modern Approach to Biofilm-Related Orthopaedic Implant Infections. Advances in Experimental Medicine and Biology(), vol 971. Springer, Cham. https://doi.org/10.1007/5584_2017_11

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