Can implant factors (i.e., type of bearing) influence the thresholds for serum and synovial markers in acute and chronic periprosthetic joint infections (PJIs)?

Authors: Kevin Perry, AliSina Shahi

RECOMMENDATION: Yes. Different bearing surfaces such as metal-on-metal (MoM), metal-on-polyethylene and dual taper modular stems in the setting of taper corrosion can influence the serum and synovial markers. Metal debris may interfere with automated cell counts. Manual cell
counts are preferred when evaluating patients for PJIs who have elevated synovial fluid metal levels. Optimal thresholds for serum and synovial markers for diagnosing PJIs in these settings still need to be established.

LEVEL OF EVIDENCE: Moderate

DELEGATE VOTE: Agree: 97%, Disagree: 1%, Abstain: 2% (Unanimous, Strongest Consensus)

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