Xia Chen1, Jie Xie2, Yanming Li1, Zijuan Jian1, Hongling Li1, Qun Yan3,4. 1. Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China. 2. Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China. 3. Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China. yanqun@csu.edu.cn. 4. National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China. yanqun@csu.edu.cn.
Abstract
PURPOSE: Exploring biomarkers for easy and reliable diagnosis of periprosthetic joint infection (PJI) has attracted an increasing attention. Coagulation parameters have been found to be associated with infections, but their role in diagnosing PJI is not well understood. The aim of this study was to explore the diagnostic value of coagulation parameters in PJI. METHODS: We retrospectively recruited patients who underwent revision total hip arthroplasty (THA) and total knee arthroplasty (TKA) from January 2014 to December 2020. Patients were grouped into PJIs or non-PJIs, and PJIs were further divided into culture positive and culture negative groups. The diagnostic value of coagulation parameters including fibrin degradation product (FDP), D-dimer, platelet count (PC), and platelet count to mean platelet volume ratio (PVR) was evaluated by using receiver operating characteristic curve, in comparison with traditional biomarkers C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). RESULTS: A total of 186 patients including 136 THA and 50 TKA were studied. There were 105 PJI and 81 non-PJI patients. The coagulation parameters showed an inferior performance to CRP and ESR, with the area under the curve (AUC) of FDP, D-dimer, PC, PVR, CRP, and ESR being 0.805, 0.571, 0.703, 0.704, 0.882, and 0.824, respectively. The diagnostic performance of those coagulation parameters was similar in THA and TKA PJIs and was not superior to ESR or CRP in either culture-positive or culture-negative PJIs. CONCLUSION: Coagulation parameters FDP, D-dimer, PC, and PVR are of limited value for the diagnosis of periprosthetic joint infection in both THA and TKA patients.
PURPOSE: Exploring biomarkers for easy and reliable diagnosis of periprosthetic joint infection (PJI) has attracted an increasing attention. Coagulation parameters have been found to be associated with infections, but their role in diagnosing PJI is not well understood. The aim of this study was to explore the diagnostic value of coagulation parameters in PJI. METHODS: We retrospectively recruited patients who underwent revision total hip arthroplasty (THA) and total knee arthroplasty (TKA) from January 2014 to December 2020. Patients were grouped into PJIs or non-PJIs, and PJIs were further divided into culture positive and culture negative groups. The diagnostic value of coagulation parameters including fibrin degradation product (FDP), D-dimer, platelet count (PC), and platelet count to mean platelet volume ratio (PVR) was evaluated by using receiver operating characteristic curve, in comparison with traditional biomarkers C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). RESULTS: A total of 186 patients including 136 THA and 50 TKA were studied. There were 105 PJI and 81 non-PJI patients. The coagulation parameters showed an inferior performance to CRP and ESR, with the area under the curve (AUC) of FDP, D-dimer, PC, PVR, CRP, and ESR being 0.805, 0.571, 0.703, 0.704, 0.882, and 0.824, respectively. The diagnostic performance of those coagulation parameters was similar in THA and TKA PJIs and was not superior to ESR or CRP in either culture-positive or culture-negative PJIs. CONCLUSION: Coagulation parameters FDP, D-dimer, PC, and PVR are of limited value for the diagnosis of periprosthetic joint infection in both THA and TKA patients.
Authors: Venkat Boddapati; Michael C Fu; David J Mayman; Edwin P Su; Peter K Sculco; Alexander S McLawhorn Journal: J Arthroplasty Date: 2017-09-23 Impact factor: 4.757
Authors: Bhaveen H Kapadia; Richard A Berg; Jacqueline A Daley; Jan Fritz; Anil Bhave; Michael A Mont Journal: Lancet Date: 2015-06-28 Impact factor: 79.321
Authors: Steven M Kurtz; Genymphas B Higgs; Edmund Lau; Richard R Iorio; P Maxwell Courtney; Javad Parvizi Journal: J Arthroplasty Date: 2021-11-08 Impact factor: 4.757