Evidence map›Paper›PMID 41417243›Full record

SynthesisArchives of orthopaedic and trauma surgery2025

Diagnostic accuracy of the monocyte-to-lymphocyte ratio in periprosthetic joint infection: a systematic review and meta-analysis.

Félix Vílchez-Cavazos, Luis Alejandro Rodríguez-Corpus, Francisco Javier Arrambide-Garza, Carlos Alberto Acosta-Olivo, Mario Simental-Mendía

Abstract readSystematic ReviewMeta-AnalysisReview
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In one paragraph

Synthesis in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Félix Vílchez-CavazosOrthopedic Trauma Service, Hospital Universitario Dr. José Eleuterio González, UANL, Monterrey, Mexico.
Luis Alejandro Rodríguez-CorpusOrthopedic Trauma Service, Hospital Universitario Dr. José Eleuterio González, UANL, Monterrey, Mexico.
Francisco Javier Arrambide-GarzaOrthopedic Trauma Service, Hospital Christus Muguerza Alta Especialidad, Monterrey, Mexico.
Carlos Alberto Acosta-OlivoOrthopedic Trauma Service, Hospital Universitario Dr. José Eleuterio González, UANL, Monterrey, Mexico.
Mario Simental-MendíaOrthopedic Trauma Service, Hospital Universitario Dr. José Eleuterio González, UANL, Monterrey, Mexico. mario.simentalme@uanl.edu.mx.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeriprosthetic joint infection (PJI) is a serious complication of total joint arthroplasty (TJA). Early diagnosis is challenging, but blood cell ratios offer a cost-effective and accessible tool. This study aimed to evaluate the diagnostic accuracy of the monocyte-to-lymphocyte ratio (MLR) for PJI diagnosis

methodsA systematic review and meta-analysis were conducted using MEDLINE, Scopus, Embase, Web of Science, and Cochrane Central up to September 2024. Cross-sectional studies comparing the diagnostic accuracy of MLR to a standard reference for PJI diagnosis were included. Pooled sensitivity, specificity, likelihood ratios (LR), DOR, and summary receiver operating characteristic (SROC) curve were calculated. Quality was assessed using QUADAS-2 tool.

resultsNine studies with 3,026 participants met the inclusion criteria. The pooled sensitivity and specificity of MLR were 73% (95% CI, 66%−79%; I² = 86.2%) and 70% (95% CI, 61%−78%; I² = 89.9%), respectively. The pooled DOR was 6.51 (95% CI, 4.29−9.88; I² = 80.6%), and the AUC was 0.794. For an MLR cut-off of 0.4, sensitivity was 73% (95% CI, 66%−79%; I² = 80.1%), specificity was 78% (95% CI, 72%−82%; I² = 80.4%), LR+ was 3.21 (95% CI, 2.3−4.4; I² = 50.9%), LR− was 0.34 (95% CI, 0.24−0.49; I² = 56.7%), and DOR was 9.59 (95% CI, 5.3−17.2; I² = 87.4%)

conclusionThe MLR demonstrates moderate diagnostic accuracy for PJI, highlighting its potential as a cost-effective and accessible biomarker. Given the substantial heterogeneity, the current evidence suggests that MLR could serve as a supplementary tool within a broader diagnostic panel, rather than a standalone test. Future research should focus on standardizing cut-off values and validating its clinical application in diverse patient populations.

Indexed as

Arthroplasty, ReplacementLymphocytesMonocytesProsthesis-Related InfectionsHumansLymphocyte CountSensitivity and SpecificityAccuracyMeta-analysisMonocyte to lymphocyte ratioPeriprosthetic joint infectionSystematic review

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.