Synovasure® Alpha Defensin Lateral Flow Test Kit for the assessment of periprosthetic joint infection

Health Technology Wales
Record ID 32018000702
English
Authors' objectives: Periprosthetic Joint Infection isn’t common, but it’s a serious complication that can happen after hip and knee replacement surgery. It can be difficult to diagnose in some people, but straightforward in others. HTW assessed the Synovasure® Alpha Defensin Test to help decide whether it should be made available to NHS Wales for diagnosing periprosthetic joint infection.
Authors' results and conclusions: Synovasure® has the potential to give more people the correct diagnosis than current tests. This could mean that more people get the care they need, without delay. Synovasure® could be particularly useful in people who are hard to diagnose using the tests we currently use. However, there needs to be more evidence to prove this.
Authors' recommendations: The use of Synovasure® alpha defensin testing shows promise in the diagnosis of peri-prosthetic hip and knee infection but the evidence does not currently support routine adoption. Synovasure® has the potential to further the diagnosis in patients with equivocal results from conventional testing but more convincing evidence is needed. HTW therefore recommends further research in this group of patients to define diagnostic accuracy, clinical outcomes and cost consequences of the use of synovasure® in addition to standard investigations.
Authors' methods: The Evidence Appraisal Report is based on a literature search (strategy available on request) for published clinical and economic evidence on the health technology of interest. It is not a full systematic review but aims to identify the best available evidence on the health technology of interest. Researchers critically evaluate and synthesise this evidence. We include the following clinical evidence in order of priority: systematic reviews; randomised trials; non-randomised trials. We only include evidence for “lower priority” evidence where outcomes are not reported by a “higher priority” source. We also search for economic evaluations or original research that can form the basis of an assessment of costs/cost comparison. We carry out various levels of economic evaluation, according to the evidence that is available to inform this.
Authors' identified further research: Further diagnostic studies are needed which compare the diagnostic accuracy of the laboratory based Synovasure® package of tests with standard practice and the use of Synovasure® in patients that have equivocal results after standard testing. These studies should include the gathering of patient related outcomes and costs so that the relative value of the different tests can be assessed in an economic evaluation.
Details
Project Status: Completed
Year Published: 2019
URL for published report: https://www.healthtechnology.wales/reports-guidance/synovasure-alpha-defensin-lateral-flow-test-kit/
English language abstract: An English language summary is available
Publication Type: Rapid Review
Country: Wales, United Kingdom
MeSH Terms
  • Arthroplasty, Replacement, Hip
  • Arthroplasty, Replacement, Knee
  • Prosthesis-Related Infections
  • alpha-Defensins
Keywords
  • Hip replacement
  • Knee replacement
  • Periprosthetic joint infection
  • Alpha defensin
Contact
Organisation Name: Health Technology Wales
Contact Address: Floor 3, 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ
Contact Name: Susan Myles, PhD
Contact Email: healthtechnology@wales.nhs.uk
Copyright: Health Technology Wales
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.