Arthrocentesis Study

NCT ID: NCT02530229

Last Updated: 2015-08-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

400 participants

Study Classification

OBSERVATIONAL

Study Start Date

2014-11-30

Study Completion Date

2016-11-30

Brief Summary

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The purpose of this study is to analyze pre- and intra-operative joint aspirates of native joints and joints with suspicion of periprosthetic joint infection (PJI) of the hip, knee and shoulder acquired in clinical routine. Joint aspirates are then analyzed with new diagnostic methods (microcalorimetry, PCR, alpha-defensin, etc.). Diagnostic speed and accuracy of these methods is compared to standard diagnostic methods in clinical routine, such as blood cultures of joint aspirates, cell count/differential, intra-operative tissue culture and histology and sonication.

Detailed Description

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In this study, joint aspirate of patients that undergo joint aspiration in the context of routine pre- and intra-operative clinical diagnosis of a hip, knee or shoulder joint is collected. Routine joint punctures at our clinic are regularly performed in the emergency room, in the outpatient clinic and intra-operatively during diagnostic and revision surgery. A minimum of 5 ml aspiration fluid was required for inclusion in this study. Empty or diluted aspirations were excluded.

Joint aspirations are performed by orthopaedic surgeons with an 18-gauge needle according to standardized aseptic technique. Intraoperative punctures are performed prior to arthrotomy. A minimum of 1ml of joint aspirate is immediately transferred to a native study vial for our study, a native vial for gram stain and culture and a native vial for polarization microscopy, respectively. A minimum of 1 ml joint aspirate is transferred to an ethylenediaminetetraacetic acid (EDTA) vial for the determination of leucocyte count. Finally, a minimum of 1 ml is inoculated into a paediatric blood culture bottle.

Standard microbiological methods are performed in an external laboratory that routinely collaborates with our clinic. Leucocyte count is performed automatically with the mentioned EDTA vial. Polarization microscopy is performed at our pathohistological department in order to detect crystals and signs of infection in joint aspirate.

If written informational consent has been signed by the patient, the study vial is immediately transported to our internal laboratory for analysis with new diagnostic methods (microcalorimetry, PCR, etc.). When an immediate transportation was not feasible, the vial is stored in a cooling fridge at +3° C until transportation was possible.

Each case is individually reviewed and classified by an experienced infectiologist taking the case's clinical history and laboratory results into account.

Conditions

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Periprosthetic Joint Infection Septic Arthritis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Periprosthetic joint infection

Patients with suspected periprosthetic joint infection of the hip, knee and shoulder

No interventions assigned to this group

Septic arthritis

Patients with suspected septic arthritis of a native joint of the hip, knee and shoulder

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* adult of 18 or more years
* written consent to participate in study
* suspicion of septic arthritis or periprosthetic joint infection
* joint aspirate minimum of 5 ml

Exclusion Criteria

* is not able to understand the aim or purpose of this study
* empty joint aspirate
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Berlin Institute of Health

OTHER

Sponsor Role collaborator

Charite University, Berlin, Germany

OTHER

Sponsor Role lead

Responsible Party

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Andrej Trampuz

Head Septic Surgery Unit

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Andrej Trampuz, MD

Role: PRINCIPAL_INVESTIGATOR

Charité University Berlin

Locations

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Charité University Berlin

Berlin, State of Berlin, Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Maren Engel, Study nurse

Role: CONTACT

+4930450652416

Christian Morgenstern, MD, PhD

Role: CONTACT

+4930450652206

Facility Contacts

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Andrej Trampuz, MD

Role: primary

+4930450615073

References

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Yusuf E, Hugle T, Daikeler T, Voide C, Borens O, Trampuz A. The potential use of microcalorimetry in rapid differentiation between septic arthritis and other causes of arthritis. Eur J Clin Microbiol Infect Dis. 2015 Mar;34(3):461-5. doi: 10.1007/s10096-014-2248-y. Epub 2014 Sep 25.

Reference Type BACKGROUND
PMID: 25252631 (View on PubMed)

Corvec S, Portillo ME, Pasticci BM, Borens O, Trampuz A. Epidemiology and new developments in the diagnosis of prosthetic joint infection. Int J Artif Organs. 2012 Oct;35(10):923-34. doi: 10.5301/ijao.5000168.

Reference Type BACKGROUND
PMID: 23138706 (View on PubMed)

Trampuz A, Hanssen AD, Osmon DR, Mandrekar J, Steckelberg JM, Patel R. Synovial fluid leukocyte count and differential for the diagnosis of prosthetic knee infection. Am J Med. 2004 Oct 15;117(8):556-62. doi: 10.1016/j.amjmed.2004.06.022.

Reference Type BACKGROUND
PMID: 15465503 (View on PubMed)

Zimmerli W, Trampuz A, Ochsner PE. Prosthetic-joint infections. N Engl J Med. 2004 Oct 14;351(16):1645-54. doi: 10.1056/NEJMra040181. No abstract available.

Reference Type BACKGROUND
PMID: 15483283 (View on PubMed)

Karbysheva S, Cabric S, Koliszak A, Bervar M, Kirschbaum S, Hardt S, Perka C, Trampuz A. Clinical evaluation of dithiothreitol in comparison with sonication for biofilm dislodgement in the microbiological diagnosis of periprosthetic joint infection. Diagn Microbiol Infect Dis. 2022 Jun;103(2):115679. doi: 10.1016/j.diagmicrobio.2022.115679. Epub 2022 Mar 12.

Reference Type DERIVED
PMID: 35395437 (View on PubMed)

Morgenstern C, Renz N, Cabric S, Maiolo E, Perka C, Trampuz A. Thermogenic diagnosis of periprosthetic joint infection by microcalorimetry of synovial fluid. BMC Musculoskelet Disord. 2020 Jun 3;21(1):345. doi: 10.1186/s12891-020-03366-3.

Reference Type DERIVED
PMID: 32493292 (View on PubMed)

Sigmund IK, Renz N, Feihl S, Morgenstern C, Cabric S, Trampuz A. Value of multiplex PCR for detection of antimicrobial resistance in samples retrieved from patients with orthopaedic infections. BMC Microbiol. 2020 Apr 14;20(1):88. doi: 10.1186/s12866-020-01741-7.

Reference Type DERIVED
PMID: 32290833 (View on PubMed)

Morgenstern C, Renz N, Cabric S, Perka C, Trampuz A. Multiplex Polymerase Chain Reaction and Microcalorimetry in Synovial Fluid: Can Pathogen-based Detection Assays Improve the Diagnosis of Septic Arthritis? J Rheumatol. 2018 Nov;45(11):1588-1593. doi: 10.3899/jrheum.180311. Epub 2018 Sep 15.

Reference Type DERIVED
PMID: 30219763 (View on PubMed)

Other Identifiers

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EA1/306/14

Identifier Type: -

Identifier Source: org_study_id

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