Synovial C-reactive protein as a marker for chronic periprosthetic infection in total hip arthroplasty.
The aim of this study was to assess the role of synovial C-reactive protein (CRP) in the diagnosis of chronic periprosthetic hip infection. We prospectively collected synovial fluid from 89 patients undergoing revision hip arthroplasty and measured synovial CRP, serum CRP, erythrocyte sedimentation rate (ESR), synovial white blood cell (WBC) count and synovial percentages of polymorphonuclear neutrophils (PMN). Patients were classified as septic or aseptic by means of clinical, microbiological, serum and synovial fluid findings. The high viscosity of the synovial fluid precluded the analyses in nine patients permitting the results in 80 patients to be studied. There was a significant difference in synovial CRP levels between the septic (n = 21) and the aseptic (n = 59) cohort. According to the receiver operating characteristic curve, a synovial CRP threshold of 2.5 mg/l had a sensitivity of 95.5% and specificity of 93.3%. The area under the curve was 0.96. Compared with serum CRP and ESR, synovial CRP showed a high diagnostic value. According to these preliminary results, synovial CRP may be a useful parameter in diagnosing chronic periprosthetic hip infection.
['Omar|M|M|', 'Ettinger|M|M|', 'Reichling|M|M|', 'Petri|M|M|', 'Guenther|D|D|', 'Gehrke|T|T|', 'Krettek|C|C|', 'Mommsen|P|P|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D019540:Area Under Curve D019644:Arthroplasty, Replacement, Hip D001799:Blood Sedimentation D002097:C-Reactive Protein D002908:Chronic Disease D005260:Female D006622:Hip Prosthesis D006801:Humans D007958:Leukocyte Count D008297:Male D008875:Middle Aged D009504:Neutrophils D016459:Prosthesis-Related Infections D012680:Sensitivity and Specificity D013582:Synovial Fluid
C-reactive protein total hip arthroplasty synovial fluid periprosthetic joint infection