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Comparative Study
. 2019 Jul 29;14(1):240.
doi: 10.1186/s13018-019-1282-y.

Comparison of D-dimer with CRP and ESR for diagnosis of periprosthetic joint infection

Longjiang Xiong  1   2 , Siyun Li  2 , Min Dai  3
Affiliations
Comparative Study

Comparison of D-dimer with CRP and ESR for diagnosis of periprosthetic joint infection

Longjiang Xiong et al. J Orthop Surg Res. .

Abstract

Background: Despite the availability of several biomarkers, the diagnosis of periprosthetic joint infection (PJI) continues to be challenging. Serum D-dimer assessment is a widely available test that detects fibrinolytic activities and has been reported as an inflammatory biomarker. However, quite a few articles have reported the diagnostic efficiency of D-dimer for PJI.

Methods: This prospective study enrolled patients who had undergone total joint arthroplasty, were suspected of PJI, and also prepared for revision arthroplasty. PJI was defined using the Musculoskeletal Infection Society criteria. In all patients, serum D-dimer level, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) level were measured preoperatively. We then compared the diagnostic efficiency of these three biomarkers.

Results: The median D-dimer level was significantly higher (p < 0.001) for the patients with PJI than for the patients with aseptic failure. With a sensitivity of 80.77% (95% CI, 65.62 to 95.92%) and a specificity of 79.63% (95% CI, 68.89 to 90.37%), the diagnostic efficiency of D-dimer did not outperform serum CRP (with a sensitivity of 84.61% and specificity of 64.81%) and ESR (with a sensitivity of 73.08% and specificity of 90.47%).

Conclusions: Serum D-dimer as a marker for the diagnosis of PJI still requires more large-scale and detailed clinical trials.

Keywords: Biomarkers; C-reactive protein; D-dimer; Erythrocyte sedimentation rate; Periprosthetic joint infection.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Serum D-dimer (a), CRP (b), and ESR (c) significantly increased in PJI group, compared with the non-PJI group (p < 0.001)
See this image and copyright information in PMC

References

    1. Parvizi J, Cavanaugh PK, Diaz-Ledezma C. Periprosthetic knee infection: ten strategies that work. Knee Surg Relat Res. 2013;25(4):155–164. doi: 10.5792/ksrr.2013.25.4.155. - DOI - PMC - PubMed
    1. Parvizi J, Shohat N, Gehrke T. Prevention of periprosthetic joint infection: new guidelines. Bone Joint J. 2017;99-B(4 Supple B):3–10. doi: 10.1302/0301-620X.99B4.BJJ-2016-1212.R1. - DOI - PubMed
    1. Parvizi J, Della Valle CJ. AAOS Clinical Practice Guideline: diagnosis and treatment of periprosthetic joint infections of the hip and knee. J Am Acad Orthop Surg. 2010;18(12):771–772. doi: 10.5435/00124635-201012000-00007. - DOI - PubMed
    1. Deirmengian C, Kardos K, Kilmartin P, et al. Diagnosing periprosthetic joint infection: has the era of the biomarker arrived? Clin Orthop Relat Res. 2014;472(11):3254–3262. doi: 10.1007/s11999-014-3543-8. - DOI - PMC - PubMed
    1. Kim TW, Kim DH, Oh WS, et al. Analysis of the causes of elevated C-reactive protein level in the early postoperative period after primary total knee arthroplasty. J Arthroplast. 2016;31(9):1990–1996. doi: 10.1016/j.arth.2016.02.037. - DOI - PubMed

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