Diagnostic Value Of Serum CRP,ESR And D Dimer Test In Periprosthetic Joint Infection

Objective:To compare the diagnostic value of serum C-reactive protein(CRP),erythrocyte sedimentation rate(ESR)and D-dimer for diagnosis of periprosthetic infection and differential aseptic loosening by detecting in patients undergoing hip and knee revision surgery in our hospital.Methods:The clinical data of 46 patients who underwent revision of hip and knee prosthesis in Xinjiang Autonomous Region People’s Hospital from March 2013 to March 2018were analyzed.All patients were examined for erythrocyte sedimentation rate(ESR),blood C-reactive protein(CRP)and D-dimer before operation.According to the test results,PJI was diagnosed with a unified standard.The data were analyzed by t-test,independent sample median test and X2 test.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of different test methods were calculated by the receiver operating characteristic.The diagnostic value of each index for PJI was measured by AUC value.Results:There was no significant difference in gender,age and surgical site between PJI patients and non-infected patients(?~2=0.199,?~2=0.199,t=-1.205,?~2=1.246,P>0.05),and the levels of ESR,CRP and D dimer in PJI patients were higher than those in non-infected patients(?=13.7,17.5,7.6,P<0.05).TheAUC values of ESR,CRP,D dimer and combined diagnosis were 0.75,0.774,0.915and 0.873,respectively,with P<0.05.Conclusion:D-dimer detection before hip and knee revision is of the highest diagnostic value for periprosthetic infection,while CRP and ESR are of moderate diagnostic value for periprosthetic infection.However,the three combinations can significantly improve the diagnostic value of periprosthetic infection,which is conducive to the development of correct treatment for revision surgery.