Diagnostic Accuracy and Cost-effectiveness Analysis of Serum and Synovial Fluid Markers for the Diagnosis of Periprosthetic Hip and Knee Joint Infections

What this Trial Is About

Researchers are investigating diagnostic methods for periprosthetic joint infection (PJI), a serious complication following total joint replacement (TJR) surgeries, especially in hip and knee joints. The study aims to evaluate the accuracy and cost-effectiveness of combining different serum and synovial fluid markers to improve the diagnosis of PJI, helping to guide the choice of surgical and antimicrobial treatments. This observational study focuses on patients hospitalized for revision surgery due to suspected PJI or other causes around the replaced joint. The study involves analyzing various blood and synovial fluid markers such as white blood cell count, C-reactive protein, alpha-defensin, and others, measured within a week or two months depending on the marker. It compares combinations of these markers to identify those with the highest diagnostic accuracy and cost-effectiveness, based on established criteria by the Musculoskeletal Infection Society. This includes both preoperative and intraoperative assessments, aiming to accelerate diagnosis and optimize surgical strategies. Participants will undergo evaluations including blood tests, synovial fluid analysis, clinical and radiological examinations, and laboratory assessments of microbial resistance and biofilm formation. The primary outcomes are multiple inflammatory and infection markers measured within seven days or two months. The study monitors diagnostic effectiveness and microbial characteristics to improve PJI management. Participants are involved during their hospitalization for revision surgery, with no additional treatment interventions outside standard care. The study is expected to continue until March 2026.

Periprosthetic Joint Infections: Diagnostic Accuracy and Cost-effectiveness Analysis of Serum and Synovial Markers