@article {BIELEFELD1073, author = {CHARLOTTE BIELEFELD and HARALD ENGLER and MARCUS J{\"A}GER and ALEXANDER WEGNER and DENNIS WASSENAAR and ANDRE BUSCH}, title = {Synovial Alpha-defensin at Reimplantation in Two-stage Revision Arthroplasty to Rule Out Persistent Infection}, volume = {35}, number = {2}, pages = {1073--1081}, year = {2021}, doi = {10.21873/invivo.12352}, publisher = {International Institute of Anticancer Research}, abstract = {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.}, issn = {0258-851X}, URL = {https://iv.iiarjournals.org/content/35/2/1073}, eprint = {https://iv.iiarjournals.org/content/35/2/1073.full.pdf}, journal = {In Vivo} }