Synovial fluid IL-1 beta appears useful for the diagnosis of
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The purpose of this study was to investigate the role of synovial fluid interleukin (IL)-1beta in diagnosing chronic periprosthetic joint infection (PJI) and to identify the optimal threshold of synovial fluid IL-1 beta or differentiating chronic PJI from aseptic failure after knee and hip arthroplasties.

Researchers prospectively included patients expected to have a revision procedure for chronic PJI or aseptic failure after complete joint arthroplasty. Then, along with normal preoperative diagnostic serum and synovial biomarkers, synovial IL-1 beta was additionally assessed. To assess diagnostic efficacy, the receiver operating characteristic (ROC) curves and area under the curve (AUC) were analysed for each biomarker.

--Of the 93 patients included, their demographic data were not found to be statistically significant.

--The median synovial IL-1beta levels were significantly higher in the chronic PJI group than in the aseptic group (894.73 pg/mL vs. 34.49 pg/mL).

--The AUC for synovial fluid IL-1beta was 0.991, which was higher than serum ESR (0.627) and CRP (0.712). The optimal threshold value for detecting chronic PJI of synovial IL-1 beta was 312.7 pg/mL, with a sensitivity of 97.3% and a specificity of 94.64%.

--And the combined measurement of synovial fluid IL-1 beta and synovial fluid PMN% can led to a specificity of 1, and a negative predictive value (NPV) of 1.

Conclusively, the present study demonstrated that synovial fluid IL-1 beta is a valuable biomarker for detection of chronic PJI. The combination of synovial fluid IL-1 beta and PMN% led to an improvement in specificity compared with evaluation of each single index.