Serological markers can lead to false negative diagnoses of periprosthetic infections following total knee arthroplasty View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2011-11

AUTHORS

Aaron J. Johnson, Michael G. Zywiel, Alex Stroh, David R. Marker, Michael A. Mont

ABSTRACT

Periprosthetic infections following total knee arthroplasty (TKA) are diagnostically challenging. We evaluated the sensitivity and specificity of ESR and CRP, false negative rates, whether false negative rates differed between early post-operative and late infections, and the predictive ability of ESR and CRP to differentiate infected patients. Between 2000 and 2007, a prospectively collected database was reviewed to identify patients with suspected periprosthetic infections, and who had ESR and CRP laboratory values. One hundred and thirteen patients were identified. False negative rates were calculated. Finally, receiver operating characteristic curves were used to determine the predictive ability of ESR and CRP to differentiate infected from non-infected patients. CRP had a sensitivity of 95% and specificity of 20%. ESR had a sensitivity of 91% and a specificity of 33%. The false negative rate was 9.2% for ESR, 5.3% for CRP, and 11.1% for combined ESR and CRP. False negative rates were higher for early post-operative infections. Although ESR and CRP can be excellent adjunctive diagnostic tools, we emphasise that because some patients may not mount a sufficient immune response, the entire clinical picture must be evaluated, and periprosthetic infection should not be ruled out on the basis of ESR and CRP results alone. More... »

PAGES

1621-1626

References to SciGraph publications

  • 2010-01. Prosthetic Joint Infection Risk after TKA in the Medicare Population in CLINICAL ORTHOPAEDICS AND RELATED RESEARCH®
  • 2008-11. Diagnosis of Infected Total Knee: Findings of a Multicenter Database in CLINICAL ORTHOPAEDICS AND RELATED RESEARCH®
  • 2009-07. Staged Revision for Knee Arthroplasty Infection: What Is the Role of Serologic Tests Before Reimplantation? in CLINICAL ORTHOPAEDICS AND RELATED RESEARCH®
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00264-010-1175-5

    DOI

    http://dx.doi.org/10.1007/s00264-010-1175-5

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1014042369

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/21181540


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