{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T19:20:07Z","timestamp":1788808807126,"version":"build-2803163510"},"reference-count":38,"publisher":"Elsevier BV","issue":"12","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004586","name":"Funda\u00e7\u00e3o Carlos Chagas Filho de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004586","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["arthroplastyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Arthroplasty"],"published-print":{"date-parts":[[2022,12]]},"DOI":"10.1016\/j.arth.2022.07.002","type":"journal-article","created":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T02:24:10Z","timestamp":1657592650000},"page":"2455-2459","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":9,"title":["Cell-free Deoxyribonucleic Acid: A Potential Biomarker of Chronic Periprosthetic Knee Joint Infection"],"prefix":"10.1016","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7315-0961","authenticated-orcid":false,"given":"Hugo A. de A.B.","family":"Cobra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5855-5808","authenticated-orcid":false,"given":"Alan P.","family":"Mozella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4193-2376","authenticated-orcid":false,"given":"Idemar M.","family":"da Palma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3978-4888","authenticated-orcid":false,"given":"Rodrigo","family":"Salim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2556-3446","authenticated-orcid":false,"given":"Ana C.","family":"Leal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.arth.2022.07.002_bib1","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1302\/0301-620X.98B1.36293","article-title":"The epidemiology of failure in total knee arthroplasty avoiding your next revision","volume":"98-B","author":"Khan","year":"2016","journal-title":"Bone Joint J"},{"key":"10.1016\/j.arth.2022.07.002_bib2","doi-asserted-by":"crossref","first-page":"2194","DOI":"10.1007\/s11999-017-5396-4","article-title":"Periprosthetic joint infection is the main cause of failure for modern knee arthroplasty: an analysis of 11,134 knees","volume":"475","author":"Koh","year":"2017","journal-title":"Clin Orthopaedics Relat Res"},{"key":"10.1016\/j.arth.2022.07.002_bib3","series-title":"The Seventh Annual Report of the AJRR on Hip and Knee Arthroplasty","year":"2020"},{"key":"10.1016\/j.arth.2022.07.002_bib4","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1016\/j.arth.2018.02.078","article-title":"The 2018 definition of periprosthetic hip and knee infection: an evidence-based and validated criteria","volume":"33","author":"Parvizi","year":"2018","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2022.07.002_bib5","doi-asserted-by":"crossref","first-page":"2057","DOI":"10.2106\/JBJS.17.01429","article-title":"Routine diagnostic tests for periprosthetic joint infection demonstrate a high false-negative rate and are influenced by the infecting organism","volume":"100","author":"Kheir","year":"2018","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2022.07.002_bib6","doi-asserted-by":"crossref","first-page":"358","DOI":"10.3390\/biomedicines8090358","article-title":"High-dimensional analysis of immune cell composition predicts periprosthetic joint infections and dissects its pathophysiology","volume":"8","author":"Korn","year":"2020","journal-title":"Biomedicines"},{"key":"10.1016\/j.arth.2022.07.002_bib7","doi-asserted-by":"crossref","first-page":"2077","DOI":"10.2106\/JBJS.17.00123","article-title":"Synovial fluid biomarkers for the diagnosis of periprosthetic joint infection: a systematic review and meta-analysis","volume":"99","author":"Lee","year":"2017","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2022.07.002_bib8","doi-asserted-by":"crossref","first-page":"635","DOI":"10.2106\/JBJS.18.00632","article-title":"Diagnostic accuracy of serum, synovial, and tissue testing for chronic periprosthetic joint infection after hip and knee replacements: a systematic review","volume":"101","author":"Carli","year":"2019","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2022.07.002_bib9","doi-asserted-by":"crossref","first-page":"69162","DOI":"10.18632\/oncotarget.19942","article-title":"Non-blood circulating tumor DNA detection in cancer","volume":"8","author":"Peng","year":"2017","journal-title":"Oncotarget"},{"key":"10.1016\/j.arth.2022.07.002_bib10","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1258\/000456303763046030","article-title":"Cell-free nucleic acids in plasma, serum and urine: a new tool in molecular diagnosis","volume":"40","author":"Chan","year":"2003","journal-title":"Ann Clin Biochem"},{"key":"10.1016\/j.arth.2022.07.002_bib11","first-page":"1659","article-title":"DNA fragments in the blood plasma of cancer patients: quantitations and evidence for their origin from apoptotic and necrotic cells 1","volume":"61","author":"Jahr","year":"2001","journal-title":"Cancer Res"},{"key":"10.1016\/j.arth.2022.07.002_bib12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/cc11466","article-title":"Prognostic utility and characterization of cell-free DNA in patients with severe sepsis","volume":"16","author":"Dwivedi","year":"2012","journal-title":"Crit Care"},{"key":"10.1016\/j.arth.2022.07.002_bib13","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s40635-019-0251-4","article-title":"Comparison of the source and prognostic utility of cfDNA in trauma and sepsis","volume":"7","author":"Jackson Chornenki","year":"2019","journal-title":"Intensive Care Med Exp"},{"key":"10.1016\/j.arth.2022.07.002_bib14","doi-asserted-by":"crossref","first-page":"1759","DOI":"10.1177\/0961203320957717","article-title":"Cell-free DNA profiling in patients with lupus nephritis","volume":"29","author":"Truszewska","year":"2020","journal-title":"Lupus"},{"key":"10.1016\/j.arth.2022.07.002_bib15","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1111\/brv.12413","article-title":"The diverse origins of circulating cell-free DNA in the human body: a critical re-evaluation of the literature","volume":"93","author":"Aucamp","year":"2018","journal-title":"Biol Rev"},{"key":"10.1016\/j.arth.2022.07.002_bib16","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1002\/jor.20911","article-title":"Diagnostic accuracy of neutrophil-derived circulating free DNA (cf-DNA\/NETs) for septic arthritis","volume":"27","author":"Logters","year":"2009","journal-title":"J\u00a0Orthop Res"},{"key":"10.1016\/j.arth.2022.07.002_bib17","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1111\/j.1365-2559.2009.03313.x","article-title":"Twenty-three neutrophil granulocytes in 10 high-power fields is the best histopathological threshold to differentiate between aseptic and septic endoprosthesis loosening","volume":"54","author":"Morawietz","year":"2009","journal-title":"Histopathology"},{"key":"10.1016\/j.arth.2022.07.002_bib18","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1038\/nri3561","article-title":"Concepts of tissue injury and cell death in inflammation: a historical perspective","volume":"14","author":"Wallach","year":"2014","journal-title":"Nat Rev Immunol"},{"key":"10.1016\/j.arth.2022.07.002_bib19","doi-asserted-by":"crossref","first-page":"2012","DOI":"10.1182\/blood.V80.8.2012.2012","article-title":"Modulation of granulocyte survival and programmed cell death by cytokines and bacterial products","volume":"80","author":"Colotta","year":"1992","journal-title":"Blood"},{"key":"10.1016\/j.arth.2022.07.002_bib20","doi-asserted-by":"crossref","first-page":"1067413","DOI":"10.1155\/2018\/1067413","article-title":"Bacterial extracellular DNA production is associated with outcome of prosthetic joint infections","volume":"2018","author":"Zatorska","year":"2018","journal-title":"Biomed Res Int"},{"key":"10.1016\/j.arth.2022.07.002_bib21","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1177\/039139881003300906","article-title":"Destruction of bacterial biofilms by polymorphonuclear neutrophils: relative contribution of phagocytosis, DNA release, and degranulation","volume":"33","author":"Meyle","year":"2010","journal-title":"Int J Artif Organs"},{"key":"10.1016\/j.arth.2022.07.002_bib22","doi-asserted-by":"crossref","first-page":"e0253879","DOI":"10.1371\/journal.pone.0253879","article-title":"Mycobacterium tuberculosis-derived circulating cell-free DNA in patients with pulmonary tuberculosis and persons with latent tuberculosis infection","volume":"16","author":"Pan","year":"2021","journal-title":"PLoS One"},{"key":"10.1016\/j.arth.2022.07.002_bib23","article-title":"Toward the development of a circulating free DNA-based in\u00a0vitro diagnostic test for infectious diseases: a review of evidence for tuberculosis","volume":"57","author":"Leticia Fern\u00e1ndez-Carballo","year":"2019","journal-title":"J\u00a0Clin Microbiol"},{"key":"10.1016\/j.arth.2022.07.002_bib24","first-page":"365","article-title":"Diagnosis of sepsis with cell-free DNA by next-generation sequencing technology in ICU patients","volume":"47","author":"Long","year":"2016","journal-title":"Arch\u00a0Med Res"},{"key":"10.1016\/j.arth.2022.07.002_bib25","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.2106\/JBJS.20.02229","article-title":"Sequencing of circulating microbial cell-free DNA can identify pathogens in periprosthetic joint infections","volume":"103","author":"Echeverria","year":"2021","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2022.07.002_bib26","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1128\/CMR.00111-13","article-title":"Prosthetic joint infection","volume":"27","author":"Tande","year":"2014","journal-title":"Clin Microbiol Rev"},{"key":"10.1016\/j.arth.2022.07.002_bib27","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1016\/j.amjmed.2004.06.022","article-title":"Synovial fluid leukocyte count and differential for the diagnosis of prosthetic knee infection","volume":"117","author":"Trampuz","year":"2004","journal-title":"Am J Med"},{"key":"10.1016\/j.arth.2022.07.002_bib28","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1007\/s12178-018-9503-2","article-title":"Low-virulence organisms and periprosthetic joint infection-biofilm considerations of these organisms","volume":"11","author":"Boyle","year":"2018","journal-title":"Curr Rev Musculoskelet Med"},{"key":"10.1016\/j.arth.2022.07.002_bib29","doi-asserted-by":"crossref","first-page":"e0060","DOI":"10.2106\/JBJS.OA.17.00060","article-title":"Culture-negative periprosthetic joint infection","volume":"3","author":"Tan","year":"2018","journal-title":"JBJS Open Access"},{"key":"10.1016\/j.arth.2022.07.002_bib30","doi-asserted-by":"crossref","first-page":"3257","DOI":"10.1016\/j.arth.2018.05.018","article-title":"How reliable is the cell count analysis in the diagnosis of prosthetic joint infection?","volume":"33","author":"Zahar","year":"2018","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2022.07.002_bib31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ocl.2015.08.003","article-title":"Diagnosis of periprosthetic infection: novel developments","volume":"47","author":"Matsen Ko","year":"2016","journal-title":"Orthop Clin North Am"},{"key":"10.1016\/j.arth.2022.07.002_bib32","doi-asserted-by":"crossref","first-page":"753","DOI":"10.2106\/JBJS.16.00123","article-title":"Synovial fluid cell count for diagnosis of chronic periprosthetic hip infection","volume":"99","author":"Higuera","year":"2017","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2022.07.002_bib33","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1007\/s11999.0000000000000244","article-title":"Does the alpha-defensin immunoassay or the lateral flow test have better diagnostic value for\u00a0periprosthetic joint infection? A meta-analysis","volume":"476","author":"Eriksson","year":"2018","journal-title":"Clin Orthop Relat\u00a0Res"},{"key":"10.1016\/j.arth.2022.07.002_bib34","doi-asserted-by":"crossref","first-page":"3039","DOI":"10.1007\/s00167-018-4904-8","article-title":"A\u00a0meta-analysis of synovial biomarkers in periprosthetic joint infection: synovasure\u2122 is less effective than the ELISA-based alpha-defensin test","volume":"26","author":"Ahmad","year":"2018","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.arth.2022.07.002_bib35","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1373\/clinchem.2018.298323","article-title":"Guidelines for the preanalytical conditions for analyzing circulating cell-free DNA","volume":"65","author":"Meddeb","year":"2019","journal-title":"Clin Chem"},{"key":"10.1016\/j.arth.2022.07.002_bib36","doi-asserted-by":"crossref","first-page":"819","DOI":"10.3390\/cells10040819","article-title":"Quantification of circulating cell free mitochondrial dna in extracellular vesicles with picogreenTM in liquid biopsies: fast assessment of disease\/trauma severity","volume":"10","author":"Marcatti","year":"2021","journal-title":"Cells"},{"key":"10.1016\/j.arth.2022.07.002_bib37","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1093\/ckj\/sfaa115","article-title":"Cell-free DNA as a marker for the outcome of end-stage renal disease patients on haemodialysis","volume":"14","author":"Coimbra","year":"2021","journal-title":"Clin Kidney J"},{"key":"10.1016\/j.arth.2022.07.002_bib38","doi-asserted-by":"crossref","first-page":"68","DOI":"10.3892\/br.2021.1444","article-title":"Verification of performance of a direct fluorescent assay for cell-free DNA quantification, stability according to pre-analytical storage conditions, and the effect of freeze-thawing","volume":"15","author":"Kim","year":"2021","journal-title":"Biomed Rep"}],"container-title":["The Journal of Arthroplasty"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883540322006908?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883540322006908?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:42:44Z","timestamp":1760121764000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0883540322006908"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12]]},"references-count":38,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["S0883540322006908"],"URL":"https:\/\/doi.org\/10.1016\/j.arth.2022.07.002","relation":{},"ISSN":["0883-5403"],"issn-type":[{"value":"0883-5403","type":"print"}],"subject":[],"published":{"date-parts":[[2022,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Cell-free Deoxyribonucleic Acid: A Potential Biomarker of Chronic Periprosthetic Knee Joint Infection","name":"articletitle","label":"Article Title"},{"value":"The Journal of Arthroplasty","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arth.2022.07.002","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2022 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}