Diagnostic Performance of Platelet-To-Mean Platelet Volume Ratio (Pvr) in Periprosthetic Joint Infection: A Systematic Review and Meta-Analysis Publisher

Summary: Can a blood platelet ratio detect joint implant infections? A meta-analysis found PVR had poor accuracy after hip or knee replacement, limiting its use alone. #Orthopedics #Diagnostics

Moradi A ; Ganjpour Sales J ; Sadeghpour Teymourlou A ; Jafari Zare M A ; Yahyazadeh H ; Akbari Aghdam H ; Elmi A ; Aslani M R
Source: International Journal of Clinical Practice Published:2026

Abstract

Purpose: Studies have explored the role of biomarkers, including the platelet–mean platelet volume ratio (PVR), in detecting periprosthetic joint infection (PJI) following total hip arthroplasty (THA) and total knee arthroplasty (TKA). The objective of this research was to perform an update systematic review and meta-analysis to evaluate the diagnostic effectiveness of PVR in detecting PJI. Methods: To identify studies concerning the use of the PVR in diagnosing PJI, a review of databases such as Scopus, PubMed, and Web of Science was conducted. The evaluations covered sensitivity and specificity as well as positive/negative likelihood ratios, area under the curve (AUC), and diagnostic odds ratios. Results: A comprehensive review included 9223 patients across 17 different studies dedicated to TKA and THA. An estimated 30.11% of the participants, which equals 2777 individuals, mentioned having experienced PJI. For the combination of the PVR, sensitivity was recorded as 0.63 and specificity as 0.76. The analysis of subgroups indicated that increased sensitivity was observed with a patient population under 200, a PVR cutoff value of below 28, samples specifically from THA or TKA, and when applying the MSIS/EBJIS criteria. Conclusion: The findings showed that PVR had poor diagnostic accuracy in relation to the incidence of PJI, but further research is needed to fine-tune the threshold criteria. Copyright © 2026 Amin Moradi et al. International Journal of Clinical Practice published by John Wiley & Sons Ltd.