{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T19:19:16Z","timestamp":1788808756500,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to determine diagnostic thresholds for synovial fluid leucocyte count and polymorphonuclear (PMN) percentage to identify the diagnosis periprosthetic joint infection (PJI) in patients with failed unicompartmental knee arthroplasties (UKAs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicentre retrospective cohort study included 239 patients who underwent revision of an UKA for either septic or aseptic indications at five university\u2010affiliated medical centres. Among these, 30 patients (13%) underwent revision for PJI and 209 (87%) for noninfectious causes. PJI was diagnosed according to the European Bone and Joint Infection Society (EBJIS) criteria. Preoperative synovial fluid leucocyte count, synovial PMN percentage, serum C\u2010reactive protein (CRP) and white blood cell (WBC) count were evaluated. Diagnostic performance and optimal thresholds for each parameter were assessed using receiver operating characteristic curves and Youden's index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The PJI group demonstrated significantly higher median synovial leucocyte counts (11,399\/\u03bcL vs. 429\/\u03bcL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and significantly higher synovial PMN percentage (82% vs. 28%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared to the non\u2010PJI group. The optimal diagnostic cut\u2010off for synovial fluid leucocyte count was 2318\/\u03bcL (area under curve [AUC] 0.93; sensitivity 83%, specificity 95%) and for PMN percentage, 64% (AUC 0.90; sensitivity 76%, specificity 95%). Serum CRP (cut\u2010off 9\u2009mg\/L; AUC 0.85) and WBC count (cut\u2010off 8\u2009G\/L; AUC 0.71), showed lower diagnostic accuracy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study establishes UKA\u2010specific diagnostic thresholds for PJI, which are consistent with the EBJIS PJI criteria established for TKA. Synovial biomarkers, particularly synovial fluid leucocyte count and PMN percentage, demonstrated superior diagnostic performance compared to serum CRP and WBC count. These findings underscore the need for tailored diagnostic criteria to improve the accuracy of PJI diagnosis and guide clinical decision\u2010making in UKA revision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70036","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T09:48:42Z","timestamp":1756979322000},"page":"1310-1317","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Lower synovial leucocyte count and polymorphonuclear percentage reliably differentiate periprosthetic joint infection after unicompartmental knee arthroplasty"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8270-0462","authenticated-orcid":false,"given":"Stefanie","family":"Donner","sequence":"first","affiliation":[{"name":"Center for Musculoskeletal Surgery Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5105-5875","authenticated-orcid":false,"given":"Georg","family":"Matziolis","sequence":"additional","affiliation":[{"name":"Orthopedic Department Waldkliniken Eisenberg University Hospital Jena, FSU Jena, Campus Eisenberg Eisenberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5594-308X","authenticated-orcid":false,"given":"Yves","family":"Gramlich","sequence":"additional","affiliation":[{"name":"Agaplesion Markus Krankenhaus Frankfurt Germany"},{"name":"BG Unfallklinik Frankfurt Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7403-5535","authenticated-orcid":false,"given":"Igor","family":"Lazic","sequence":"additional","affiliation":[{"name":"Clinic of Orthopedics and Sports Orthopedics Klinikum Rechts der Isar Technische Universit\u00e4t M\u00fcnchen M\u00fcnchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2696-1769","authenticated-orcid":false,"given":"Daniel","family":"Schrednitzki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery Sana Hospital Lichtenberg Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6104-622X","authenticated-orcid":false,"given":"Anne","family":"Pohrt","sequence":"additional","affiliation":[{"name":"Insitute of Biometry and Clinical Epidemiology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8011-6684","authenticated-orcid":false,"given":"Nora","family":"Renz","sequence":"additional","affiliation":[{"name":"Center for Musculoskeletal Surgery Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Berlin Germany"},{"name":"Department of Infectious Diseases, Inselspital Bern, Bern University Hospital University of Bern  Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7321-219X","authenticated-orcid":false,"given":"Nils","family":"Mei\u00dfner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Sana Hospital Sommerfeld Kremmen 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