Related Experiment Video
Updated: Feb 22, 2026

Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
ESR and CRP are useful between stages of 2-stage revision for periprosthetic joint infection
Christopher P Lindsay1, Christopher W Olcott1, Daniel J Del Gaizo1
1Department of Orthopaedics, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Background:
Serum erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are important tests in the initial diagnosis of periprosthetic joint infection. Many surgeons also use these tests to determine if infection has resolved between stages of a 2-stage procedure, but little data exist regarding this practice.
Methods:
A retrospective review of our institutional total joint databases was conducted to determine sensitivity, specificity, and predictive values of elevated ESR and/or CRP to diagnose persistent infection between stages.
Results:
Among 16 knees and 5 hips, sensitivity was 50% for CRP, 75% for ESR, and 100% when combined. The negative predictive value of persistent infection was 100% when neither test was elevated.
Conclusions:
Results of this study support the use of CRP and ESR as indicators of the resolution of periprosthetic joint infection between stages of 2-stage revision.
Related Concept Videos
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
Urine Studies II: Urine Culture and Sensitivity Test
Acute Pyelonephritis II: Diagnostic Studies and Management
Endocarditis III: Medical Management
Pericarditis II: Clinical Features and Diagnostic Tests

