Leukocyte Esterase Strip Test: The Game-Changer in Early Detection and Prevention of Prosthetic Joint Infections

Mohammad Ayati  Firoozabadi; Hesan  Rezaee; Omid  Salkhori; Seyed Mohammad Javad  Mortazavi

doi:10.18502/jost.v12i1.21116

Mohammad Ayati Firoozabadi Associate Professor, Department of Orthopedic Surgery, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Hesan Rezaee Assistant Professor, Department of Orthopedic Surgery, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Omid Salkhori Associate Professor, Department of Orthopedic Surgery, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Seyed Mohammad Javad Mortazavi Professor, Department of Orthopedic Surgery, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jost.v12i1.21116

Keywords: Total Hip Arthroplasty; Knee Arthroplasty; Leukocytes; Esterase

Abstract

Background: This study aimed to assess the diagnostic performance and preventive utility of the leukocyte esterase (LE) strip test in periprosthetic joint infections (PJIs) associated with hip and knee arthroplasty.

Methods: A comprehensive literature search was performed in PubMed, Scopus, and Web of Science databases for studies published between 2000 and 2024. Search terms included “leukocyte esterase”, “strip test”, “prosthetic joint infection”, and “synovial fluid biomarkers”. Relevant studies were reviewed to evaluate LE testing methodologies and diagnostic accuracy.

Results: The LE strip test is a rapid and inexpensive bedside tool that offers results within minutes. It demonstrates high specificity as a rule-out test preoperatively and reliable sensitivity for PJI confirmation postoperatively. The accuracy of the test is enhanced by sample centrifugation and glucose testing.

Conclusion: The LE strip test is a valuable tool for preoperative screening and postoperative diagnosis of PJI, especially when incorporated into comprehensive diagnostic algorithms.