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C-reactive protein is not a screening tool for late periprosthetic joint infection

Authors
  • Fink, Bernd1, 2
  • Schlumberger, Michael1
  • Beyersdorff, Julian2
  • Schuster, Philipp1, 3
  • 1 Orthopaedic Clinic Markgröningen, Kurt-Lindemann-Weg 10, Markgröningen, 71706, Germany , Markgröningen (Germany)
  • 2 University Hospital Hamburg-Eppendorf, Hamburg, Germany , Hamburg (Germany)
  • 3 Paracelsus Medical Private University, Nuremberg, Germany , Nuremberg (Germany)
Type
Published Article
Journal
Journal of Orthopaedics and Traumatology
Publisher
Springer International Publishing
Publication Date
Feb 24, 2020
Volume
21
Issue
1
Identifiers
DOI: 10.1186/s10195-020-0542-2
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundPreoperative diagnosis of periprosthetic joint infection (PJI) is important because of the therapeutic consequences. The aim of the present study is to investigate whether the serum C-reactive protein (CRP) level can be used as a screening tool for late PJI.Materials and methodsA cohort of 390 patients with revision surgery of total hip prostheses (200) or total knee prostheses (190) was assessed for late PJI by determining CRP serum level and performing preoperative aspiration with cultivation and intraoperative tissue analyses with cultivation and histologic examination, using the Musculoskeletal Infection Society (MSIS) and International Consensus Meeting (ICM) criteria.ResultsA total of 180 joints were rated as PJI (prevalence 46%). Of these, 42.8% (77) showed a CRP level below 10 mg/L and 28.3% (51) showed a normal CRP level of less than 5 mg/L. The 76.9% of the cases with slow-growing bacteria showed a CRP level below 10 mg/L, and 61.5% showed a normal CRP level.ConclusionsSerum CRP level should not be used as a screening tool to rule out late PJI.Level of evidenceLevel 2 (diagnostic study).

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