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



Firoozabadi MA ; Rezaee H ; Salkhori O ; Mortazavi SMJ
Source: Journal of Orthopedic and Spine Trauma Published:2026

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. © 2026 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.