Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 21:21:101138.
doi: 10.1016/j.artd.2023.101138. eCollection 2023 Jun.

Serum CD64 as a Marker for Chronic Periprosthetic Joint Infection

Dheeraj R Yalamanchili  1   2 , Zachary A Rockov  1 , Landon S Polakof  1 , Eytan M Debbi  1 , Sumire K Kitahara  3 , Guy D Paiement  1
Affiliations

Serum CD64 as a Marker for Chronic Periprosthetic Joint Infection

Dheeraj R Yalamanchili et al. Arthroplast Today. .

Abstract

Background: Serum cluster of differentiation 64 (CD64) has emerged as a diagnostic test for musculoskeletal infections. The purpose of this study was to evaluate the utility of serum CD64 in diagnosing periprosthetic joint infections (PJIs) compared to conventional markers like white blood count (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and interleukin-6 (IL-6).

Methods: A prospective case-control study on patients undergoing revision hip or knee arthroplasty surgery >6 weeks after their index surgery was performed at a single institution. Whole blood samples were drawn within 24 hours prior to revision surgery for white blood count, ESR, CRP, IL-6, and CD64. Intraoperative cultures were obtained during the revision, and PJI was defined using the major criteria from the 2018 Musculoskeletal Infection Society criteria. Two-sample Wilcoxon rank-sum test and Fisher's exact test were used to determine if there were significant differences in serum laboratory values between patients with and without infection. The sensitivity, specificity, positive predictive value (PPV), negative predictive value, and accuracy of each test were calculated.

Results: With an average age of 67 years, 39 patients with 15 revision THAs and 24 TKAs, were included. 19 patients (48.7%) were determined to have PJI. Patients with PJI had significantly higher CD64 (P = .036), CRP (P = .016), and ESR (P = .045). CD64 had the highest specificity (100%) and PPV (100%), moderate accuracy (69.2%), but low sensitivity (37.0%) and negative predictive value (62.5%).

Conclusions: Given the high specificity, PPV, and accuracy, CD64 may be an excellent confirmatory test to help diagnose PJI.

Keywords: CD64; Complications; Periprosthetic joint infection; Total hip arthroplasty; Total knee arthroplasty.

PubMed Disclaimer

Similar articles

See all similar articles

References

    1. Bozic K.J., Kurtz S.M., Lau E., Ong K., Chiu V., Vail T.P., et al. The epidemiology of revision total knee arthroplasty in the United States. Clin Orthop Relat Res. 2010;468:45–51. doi: 10.1007/s11999-009-0945-0. - DOI - PMC - PubMed
    1. Rajaee S.S., Campbell J.C., Mirocha J., Paiement G.D. Increasing burden of total hip arthroplasty revisions in patients between 45 and 64 years of age. J Bone Joint Surg Am. 2018;100:449–458. doi: 10.2106/JBJS.17.00470. - DOI - PubMed
    1. Schwartz A.M., Farley K.X., Guild G.N., Bradbury T.L. Projections and epidemiology of revision hip and knee arthroplasty in the United States to 2030. J Arthroplasty. 2020;35:S79–S85. doi: 10.1016/j.arth.2020.02.030. - DOI - PMC - PubMed
    1. Shahi A., Tan T.L., Chen A.F., Maltenfort M.G., Parvizi J. In-hospital mortality in patients with periprosthetic joint infection. J Arthroplasty. 2017;32:948–952.e1. doi: 10.1016/j.arth.2016.09.027. - DOI - PubMed
    1. Zmistowski B., Karam J.A., Durinka J.B., Casper D.S., Parvizi J. Periprosthetic joint infection increases the risk of one-year mortality. J Bone Joint Surg Am. 2013;95:2177–2184. doi: 10.2106/JBJS.L.00789. - DOI - PubMed