Diagnostic accuracy of intra-articular C-reactive protein assay in periprosthetic knee joint infection – a preliminary study

Abstract Background Periprosthetic joint infection often raises diagnostic challenges, as the published criteria are heterogeneous. New markers for predicting periprosthetic infection have been evaluated. Here, we assessed one of these markers, C-reactive protein (CRP), in joint fluid. Hypothesis We...

Full description

Saved in:
Bibliographic Details
Published in:Orthopaedics & traumatology, surgery & research surgery & research, 2014-04, Vol.100 (2), p.221-224
Main Authors: Ronde-Oustau, C, Diesinger, Y, Jenny, J.-Y, Antoni, M, Gaudias, J, Boeri, C, Sibilia, J, Lessinger, J.-M
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Knee
Biomarkers - blood
C-Reactive Protein - analysis
Female
Humans
Intra-articular CRP
Knee Prosthesis - adverse effects
Life Sciences
Male
Orthopedics
Periprosthetic infection
Prospective Studies
Prosthesis-Related Infections - blood
Prosthesis-Related Infections - diagnosis
Sensitivity and Specificity
Surgery
Surgical site infection
Total joint infection
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background Periprosthetic joint infection often raises diagnostic challenges, as the published criteria are heterogeneous. New markers for predicting periprosthetic infection have been evaluated. Here, we assessed one of these markers, C-reactive protein (CRP), in joint fluid. Hypothesis We hypothesised that intra-articular CRP levels would perform better than serum CRP concentrations in diagnosing knee prosthesis infection. Patients and methods We prospectively included 30 patients including 10 with native-knee effusions, 11 with prosthetic-knee aseptic effusions, and 11 with prosthetic-knee infection defined using 2011 Musculoskeletal Society criteria. Serum CRP was assayed using turbidimetry or nephelometry and intra-articular CRP using nephelometry. Appropriate statistical tests were performed to compare the three groups; P values  2.78 mg/L suggested possible infection (100% sensitivity and 82% specificity) and a value > 5.37 mg/L probable infection (90% sensitivity and 91% specificity). Discussion Our findings suggest a possible role for intra-articular CRP assay in diagnosing knee prosthesis infection and perhaps periprosthetic infection at any site. Level of evidence Level III, diagnostic study, development of a diagnostic criterion in consecutive patients comparatively to a reference standard.
ISSN:1877-0568
1877-0568
DOI:10.1016/j.otsr.2013.10.017