Synovial fluid cytokine levels in diagnosis of indolent prosthetic shoulder joint infection

Periprosthetic joint infection is one of the most serious complications associated with arthroplasty surgery and poses great diagnostic difficulty. Traditional diagnostic methods used to diagnose infection in the lower extremity are less accurate for shoulder prosthetic joint infection due to the indolent nature of the most common pathogen, Propionibacterium acnes. In addition to preoperative lab work and intraoperative tissue cultures, a more recent tool for the evaluation of periprosthetic infection has been analysis of synovial fluid for antimicrobial peptides and cytokines. Investigation of synovial biomarkers such as α-defensin and interleukins offers improved ability to more accurately diagnose prosthetic shoulder joint infection.