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An accurate diagnosis of PJI preoperatively does not exist. Alpha-defensin (AD) is a proven and common indicator. The diagnostic marker of leukocyte esterase (LE) promises some advantages: feasibility, availability, and fast result reporting. The aim of this study was the evaluation of the predictive quality and correlation between both diagnostic tools in the diagnosis of PJI.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A prospective study was conducted between April 2018 and August 2022. All patients with suspicion of PJI on hip and knee joint were included and underwent a routine and standardized joint punction. For laboratory diagnostics of AD, the synovial liquid was analyzed by ELISA. The sample was additionally applied to a LE test strip (Combur 10 Test, Roche Diagnostics, Mannheim, Germany).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 249 patients were examined (mean age 67.12\u2009\u00b1\u200911.89; gender distribution man\/woman 139 (55.8%)\/110(44.2%), hip\/knee 71(28.5%)\/178 (71.5%). According to EBJIS criteria, PJI was diagnosed in 54 (21.7%) patients. AD showed excellent results with an AUC of 0.930 (sensitivity\/specificity 0.870\/0.990). LE yielded very good results with an AUC of 0.820 (sensitivity\/specificity 0.722\/0.918). Both parameters showed a strong positive correlation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>LE is a rapidly available alternative in PJI diagnostics. The simultaneous determination of both markers may enhance diagnostic reliability. A routine usage may shorten the time from diagnosis to treatment of PJI.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00264-023-05914-7","type":"journal-article","created":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T01:02:33Z","timestamp":1692147753000},"page":"2663-2668","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Leukocyte esterase and alpha-defensin in periprosthetic joint infection: predictive quality and correlation in a prospective study"],"prefix":"10.1007","volume":"47","author":[{"given":"Leonard","family":"Gr\u00fcnwald","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Schmidutz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"D\u00f6ttger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0877-9018","authenticated-orcid":false,"given":"Felix","family":"Erne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Janine","family":"Schreiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Hemmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,8,16]]},"reference":[{"key":"5914_CR1","doi-asserted-by":"publisher","first-page":"1622","DOI":"10.1097\/CORR.0000000000001214","volume":"478","author":"M Rupp","year":"2020","unstructured":"Rupp M, Lau E, Kurtz SM, Alt V (2020) Projections of primary TKA and THA in Germany from 2016 through 2040. 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