{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T05:46:57Z","timestamp":1772516817725,"version":"3.50.1"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2016,10,7]],"date-time":"2016-10-07T00:00:00Z","timestamp":1475798400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["International Orthopaedics (SICOT)"],"published-print":{"date-parts":[[2016,12]]},"DOI":"10.1007\/s00264-016-3306-0","type":"journal-article","created":{"date-parts":[[2016,10,6]],"date-time":"2016-10-06T18:36:58Z","timestamp":1475779018000},"page":"2447-2452","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Alpha-defensin\u2014novel synovial fluid biomarker for the diagnosis of periprosthetic joint infection"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0067-2416","authenticated-orcid":false,"given":"Jakrapun","family":"Pupaibool","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric J.","family":"Fulnecky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Robert L.","family":"Swords","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William W.","family":"Sistrunk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alastair D.","family":"Haddow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2016,10,7]]},"reference":[{"key":"3306_CR1","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1016\/j.jse.2010.02.009","volume":"19","author":"JS Day","year":"2010","unstructured":"Day JS, Lau E, Ong KL, Williams GR, Ramsey ML, Kurtz SM (2010) Prevalence and projections of total shoulder and elbow arthroplasty in the United States to 2015. J Shoulder Elb Surg \/ Am Shoulder Elb Surg 19:1115\u20131120. doi:\n                    10.1016\/j.jse.2010.02.009","journal-title":"J Shoulder Elb Surg \/ Am Shoulder Elb Surg"},{"key":"3306_CR2","doi-asserted-by":"publisher","first-page":"780","DOI":"10.2106\/jbjs.f.00222","volume":"89","author":"S Kurtz","year":"2007","unstructured":"Kurtz S, Ong K, Lau E, Mowat F, Halpern M (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 89:780\u2013785. doi:\n                    10.2106\/jbjs.f.00222","journal-title":"J Bone Joint Surg Am"},{"key":"3306_CR3","doi-asserted-by":"crossref","unstructured":"NIH (1995) NIH consensus conference: total hip replacement. NIH consensus development panel on total hip replacement. JAMA 273:1950\u20131956","DOI":"10.1001\/jama.273.24.1950"},{"key":"3306_CR4","doi-asserted-by":"crossref","unstructured":"Sperling JW, Kozak TK, Hanssen AD, Cofield RH (2001) Infection after shoulder arthroplasty. Clin Orthop Relat Res 206\u2013216","DOI":"10.1097\/00003086-200101000-00028"},{"issue":"Suppl 2","key":"3306_CR5","doi-asserted-by":"publisher","first-page":"S94","DOI":"10.1086\/321863","volume":"33","author":"AF Widmer","year":"2001","unstructured":"Widmer AF (2001) New developments in diagnosis and treatment of infection in orthopaedic implants. Clin Infect Dis Off Publ Infect Dis Soc Am 33(Suppl 2):S94\u2013106. doi:\n                    10.1086\/321863","journal-title":"Clin Infect Dis Off Publ Infect Dis Soc Am"},{"key":"3306_CR6","doi-asserted-by":"publisher","first-page":"672","DOI":"10.2106\/00004623-199905000-00008","volume":"81","author":"MJ Spangehl","year":"1999","unstructured":"Spangehl MJ, Masri BA, O\u2019Connell JX, Duncan CP (1999) Prospective analysis of preoperative and intraoperative investigations for the diagnosis of infection at the sites of two hundred and two revision total hip arthroplasties. J Bone Joint Surg Am 81:672\u2013683","journal-title":"J Bone Joint Surg Am"},{"key":"3306_CR7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ocl.2015.08.003","volume":"47","author":"L Matsen Ko","year":"2016","unstructured":"Matsen Ko L, Parvizi J (2016) Diagnosis of periprosthetic infection: novel developments. Orthop Clin North Am 47:1\u20139. doi:\n                    10.1016\/j.ocl.2015.08.003","journal-title":"Orthop Clin North Am"},{"key":"3306_CR8","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1302\/0301-620X.97B7.35500","volume":"97-b","author":"BA McArthur","year":"2015","unstructured":"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:939\u2013944. doi:\n                    10.1302\/0301-620x.97b7.35500","journal-title":"Bone Joint J"},{"key":"3306_CR9","doi-asserted-by":"publisher","first-page":"2244","DOI":"10.1007\/s11999-015-4142-z","volume":"473","author":"A Shahi","year":"2015","unstructured":"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 473:2244\u20132249. doi:\n                    10.1007\/s11999-015-4142-z","journal-title":"Clin Orthop Relat Res"},{"key":"3306_CR10","first-page":"385","volume":"63","author":"WV Arnold","year":"2014","unstructured":"Arnold WV, Shirtliff ME, Stoodley P (2014) Bacterial biofilms and periprosthetic infections. Instr Course Lect 63:385\u2013391","journal-title":"Instr Course Lect"},{"key":"3306_CR11","doi-asserted-by":"publisher","first-page":"1450","DOI":"10.1302\/0301-620X.95B11.33135","volume":"95-b","author":"J Parvizi","year":"2013","unstructured":"Parvizi J, Gehrke T, Chen AF (2013) Proceedings of the international consensus on periprosthetic joint infection. Bone Joint J 95-b:1450\u20131452. doi:\n                    10.1302\/0301-620x.95b11.33135","journal-title":"Bone Joint J"},{"key":"3306_CR12","doi-asserted-by":"publisher","unstructured":"Workgroup Convened by the Musculoskeletal Infection Society (2011) New definition for periprosthetic joint infection. J Arthroplast 26:1136\u20131138. doi:\n                    10.1016\/j.arth.2011.09.026","DOI":"10.1016\/j.arth.2011.09.026"},{"key":"3306_CR13","doi-asserted-by":"publisher","first-page":"2992","DOI":"10.1007\/s11999-011-2102-9","volume":"469","author":"J Parvizi","year":"2011","unstructured":"Parvizi J, Zmistowski B, Berbari EF, Bauer TW, Springer BD, Della Valle CJ, Garvin KL, Mont MA, Wongworawat MD, Zalavras CG (2011) New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society. Clin Orthop Relat Res 469:2992\u20132994. doi:\n                    10.1007\/s11999-011-2102-9","journal-title":"Clin Orthop Relat Res"},{"key":"3306_CR14","doi-asserted-by":"publisher","first-page":"644","DOI":"10.2106\/JBJS.L.00205","volume":"95","author":"H Gollwitzer","year":"2013","unstructured":"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 95:644\u2013651. doi:\n                    10.2106\/jbjs.l.00205","journal-title":"J Bone Joint Surg Am"},{"key":"3306_CR15","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1302\/0301-620X.89B1.17485","volume":"89","author":"F Bottner","year":"2007","unstructured":"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 89:94\u201399. doi:\n                    10.1302\/0301-620x.89b1.17485","journal-title":"J Bone Joint Surg Br"},{"key":"3306_CR16","doi-asserted-by":"publisher","first-page":"2621","DOI":"10.1007\/s11999-013-2998-3","volume":"471","author":"M Glehr","year":"2013","unstructured":"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 471:2621\u20132628. doi:\n                    10.1007\/s11999-013-2998-3","journal-title":"Clin Orthop Relat Res"},{"key":"3306_CR17","first-page":"453","volume":"26","author":"T Hugle","year":"2008","unstructured":"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 26:453\u2013456","journal-title":"Clin Exp Rheumatol"},{"key":"3306_CR18","doi-asserted-by":"publisher","first-page":"946","DOI":"10.1007\/s11999-008-0562-3","volume":"467","author":"K Shah","year":"2009","unstructured":"Shah K, Mohammed A, Patil S, McFadyen A, Meek RM (2009) Circulating cytokines after hip and knee arthroplasty: a preliminary study. Clin Orthop Relat Res 467:946\u2013951. doi:\n                    10.1007\/s11999-008-0562-3","journal-title":"Clin Orthop Relat Res"},{"key":"3306_CR19","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1007\/s002640000136","volume":"24","author":"DC Wirtz","year":"2000","unstructured":"Wirtz DC, Heller KD, Miltner O, Zilkens KW, Wolff JM (2000) Interleukin-6: a potential inflammatory marker after total joint replacement. Int Orthop 24:194\u2013196","journal-title":"Int Orthop"},{"key":"3306_CR20","doi-asserted-by":"publisher","first-page":"2017","DOI":"10.1007\/s11999-010-1298-4","volume":"468","author":"C Deirmengian","year":"2010","unstructured":"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 468:2017\u20132023. doi:\n                    10.1007\/s11999-010-1298-4","journal-title":"Clin Orthop Relat Res"},{"issue":"7","key":"3306_CR21","doi-asserted-by":"publisher","first-page":"1630","DOI":"10.1007\/s11999-016-4710-x","volume":"474","author":"SJ Frangiamore","year":"2016","unstructured":"Frangiamore SJ, Siqueira MB, Saleh A, Daly T, Higuera CA, Barsoum WK (2016) Synovial cytokines AND the MSIS criteria are not useful for determining infection resolution after periprosthetic joint infection explantation. Clin Orthop Relat Res 474(7):1630\u20131639. doi:\n                    10.1007\/s11999-016-4710-x","journal-title":"Clin Orthop Relat Res"},{"key":"3306_CR22","doi-asserted-by":"publisher","first-page":"3254","DOI":"10.1007\/s11999-014-3543-8","volume":"472","author":"C Deirmengian","year":"2014","unstructured":"Deirmengian C, Kardos K, Kilmartin P, Cameron A, Schiller K, Parvizi J (2014) Diagnosing periprosthetic joint infection: has the era of the biomarker arrived? Clin Orthop Relat Res 472:3254\u20133262. doi:\n                    10.1007\/s11999-014-3543-8","journal-title":"Clin Orthop Relat Res"},{"key":"3306_CR23","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1128\/IAI.55.6.1365-1368.1987","volume":"55","author":"GI Greenwald","year":"1987","unstructured":"Greenwald GI, Ganz T (1987) Defensins mediate the microbicidal activity of human neutrophil granule extract against Acinetobacter calcoaceticus. Infect Immun 55:1365\u20131368","journal-title":"Infect Immun"},{"key":"3306_CR24","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1007\/s00441-010-1022-4","volume":"343","author":"L Hazlett","year":"2011","unstructured":"Hazlett L, Wu M (2011) Defensins in innate immunity. Cell Tissue Res 343:175\u2013188. doi:\n                    10.1007\/s00441-010-1022-4","journal-title":"Cell Tissue Res"},{"key":"3306_CR25","first-page":"276","volume":"171","author":"RI Lehrer","year":"1992","unstructured":"Lehrer RI, Ganz T (1992) Defensins: endogenous antibiotic peptides from human leukocytes. Ciba Found Symp 171:276\u2013290, discussion 290\u2013273","journal-title":"Ciba Found Symp"},{"key":"3306_CR26","doi-asserted-by":"crossref","first-page":"3086","DOI":"10.1182\/blood.V96.9.3086","volume":"96","author":"B Agerberth","year":"2000","unstructured":"Agerberth B, Charo J, Werr J, Olsson B, Idali F, Lindbom L, Kiessling R, Jornvall H, Wigzell H, Gudmundsson GH (2000) The human antimicrobial and chemotactic peptides LL-37 and alpha-defensins are expressed by specific lymphocyte and monocyte populations. Blood 96:3086\u20133093","journal-title":"Blood"},{"key":"3306_CR27","doi-asserted-by":"publisher","first-page":"1778","DOI":"10.1182\/blood-2003-08-2820","volume":"104","author":"A Chalifour","year":"2004","unstructured":"Chalifour A, Jeannin P, Gauchat JF, Blaecke A, Malissard M, N\u2019Guyen T, Thieblemont N, Delneste Y (2004) Direct bacterial protein PAMP recognition by human NK cells involves TLRs and triggers alpha-defensin production. Blood 104:1778\u20131783. doi:\n                    10.1182\/blood-2003-08-2820","journal-title":"Blood"},{"key":"3306_CR28","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1128\/AAC.49.1.269-275.2005","volume":"49","author":"B Ericksen","year":"2005","unstructured":"Ericksen B, Wu Z, Lu W, Lehrer RI (2005) Antibacterial activity and specificity of the six human {alpha}-defensins. Antimicrob Agents Chemother 49:269\u2013275. doi:\n                    10.1128\/aac.49.1.269-275.2005","journal-title":"Antimicrob Agents Chemother"},{"key":"3306_CR29","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1002\/biot.200700148","volume":"2","author":"C Verma","year":"2007","unstructured":"Verma C, Seebah S, Low SM, Zhou L, Liu SP, Li J, Beuerman RW (2007) Defensins: antimicrobial peptides for therapeutic development. Biotechnol J 2:1353\u20131359. doi:\n                    10.1002\/biot.200700148","journal-title":"Biotechnol J"},{"key":"3306_CR30","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1189\/jlb.0507295","volume":"82","author":"M Rodriguez-Garcia","year":"2007","unstructured":"Rodriguez-Garcia M, Oliva H, Climent N, Garcia F, Gatell JM, Gallart T (2007) Human immature monocyte-derived dendritic cells produce and secrete alpha-defensins 1\u20133. J Leukoc Biol 82:1143\u20131146. doi:\n                    10.1189\/jlb.0507295","journal-title":"J Leukoc Biol"},{"key":"3306_CR31","doi-asserted-by":"publisher","first-page":"2229","DOI":"10.1007\/s11999-015-4152-x","volume":"473","author":"C Deirmengian","year":"2015","unstructured":"Deirmengian C, Kardos K, Kilmartin P, Gulati S, Citrano P, Booth RE Jr (2015) The Alpha-defensin test for periprosthetic joint infection responds to a wide spectrum of organisms. Clin Orthop Relat Res 473:2229\u20132235. doi:\n                    10.1007\/s11999-015-4152-x","journal-title":"Clin Orthop Relat Res"},{"key":"3306_CR32","doi-asserted-by":"publisher","first-page":"1439","DOI":"10.2106\/JBJS.M.01316","volume":"96","author":"C Deirmengian","year":"2014","unstructured":"Deirmengian C, Kardos K, Kilmartin P, Cameron A, Schiller K, Parvizi J (2014) Combined measurement of synovial fluid alpha-Defensin and C-reactive protein levels: highly accurate for diagnosing periprosthetic joint infection. J Bone Joint Surg Am 96:1439\u20131445. doi:\n                    10.2106\/jbjs.m.01316","journal-title":"J Bone Joint Surg Am"},{"key":"3306_CR33","doi-asserted-by":"publisher","first-page":"4006","DOI":"10.1007\/s11999-014-3900-7","volume":"472","author":"J Bingham","year":"2014","unstructured":"Bingham J, Clarke H, Spangehl M, Schwartz A, Beauchamp C, Goldberg B (2014) The alpha defensin-1 biomarker assay can be used to evaluate the potentially infected total joint arthroplasty. Clin Orthop Relat Res 472:4006\u20134009. doi:\n                    10.1007\/s11999-014-3900-7","journal-title":"Clin Orthop Relat Res"},{"key":"3306_CR34","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1016\/j.arth.2015.09.035","volume":"31","author":"SJ Frangiamore","year":"2016","unstructured":"Frangiamore SJ, Gajewski ND, Saleh A, Farias-Kovac M, Barsoum WK, Higuera CA (2016) Alpha-defensin accuracy to diagnose periprosthetic joint infection-best available test? J Arthroplasty 31:456\u2013460. doi:\n                    10.1016\/j.arth.2015.09.035","journal-title":"J Arthroplasty"},{"key":"3306_CR35","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1007\/s11999-014-3722-7","volume":"473","author":"C Deirmengian","year":"2015","unstructured":"Deirmengian C, Kardos K, Kilmartin P, Cameron A, Schiller K, Booth RE Jr, Parvizi J (2015) The alpha-defensin test for periprosthetic joint infection outperforms the leukocyte esterase test strip. Clin Orthop Relat Res 473:198\u2013203. doi:\n                    10.1007\/s11999-014-3722-7","journal-title":"Clin Orthop Relat Res"},{"key":"3306_CR36","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1016\/j.jse.2014.12.021","volume":"24","author":"SJ Frangiamore","year":"2015","unstructured":"Frangiamore SJ, Saleh A, Grosso MJ, Kovac MF, Higuera CA, Iannotti JP, Ricchetti ET (2015) Alpha-defensin as a predictor of periprosthetic shoulder infection. J Shoulder Elb Surge \/ Am Shoulder Elb Surg 24:1021\u20131027. doi:\n                    10.1016\/j.jse.2014.12.021","journal-title":"J Shoulder Elb Surge \/ Am Shoulder Elb Surg"},{"key":"3306_CR37","doi-asserted-by":"publisher","first-page":"63","DOI":"10.2106\/JBJS.N.00104","volume":"97","author":"SJ Frangiamore","year":"2015","unstructured":"Frangiamore SJ, Saleh A, Kovac MF, Grosso MJ, Zhang X, Bauer TW, Daly TM, Ricchetti ET, Iannotti JP (2015) Synovial fluid interleukin-6 as a predictor of periprosthetic shoulder infection. J Bone Joint Surg Am 97:63\u201370. doi:\n                    10.2106\/jbjs.n.00104","journal-title":"J Bone Joint Surg Am"}],"container-title":["International Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00264-016-3306-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00264-016-3306-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00264-016-3306-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,2,17]],"date-time":"2020-02-17T22:05:41Z","timestamp":1581977141000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s00264-016-3306-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10,7]]},"references-count":37,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2016,12]]}},"alternative-id":["3306"],"URL":"https:\/\/doi.org\/10.1007\/s00264-016-3306-0","relation":{},"ISSN":["0341-2695","1432-5195"],"issn-type":[{"value":"0341-2695","type":"print"},{"value":"1432-5195","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,10,7]]},"assertion":[{"value":"17 July 2016","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 September 2016","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 October 2016","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Ethical approval was not required for this paper as it is a review and not original research involving humans or animals.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics statement"}},{"value":"The authors declare that they have no financial, institutional, or other relevant relationships that would constitute a potential competing interest with this review.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}}]}}