Neopterin, Interleukin-6, Procalcitonin, C-Reactive Protein And PET-CT Staining As Markers In Infected Total Knee...

Area of Science:

• Orthopedics
• Infectious Diseases
• Diagnostic Imaging

Background:

• Prosthetic joint infections pose diagnostic challenges due to variable symptoms and non-specific tests.
• Standard inflammatory markers often yield false positives, necessitating more specific diagnostic tools.

Purpose of the Study:

• To evaluate the sensitivity and specificity of various diagnostic tools for prosthetic joint infections.
• To compare the diagnostic accuracy of serum markers and PET-CT imaging.

Main Methods:

• Analyzed white blood cell count, erythrocyte sedimentation rate, C-reactive protein, neopterin, interleukin-6, and procalcitonin in 45 infected patients and 40 controls.
• Utilized Shapiro-Wilk test, Mann-Whitney U test, and ROC curve analysis for statistical assessment.
• Included PET-CT imaging as part of the diagnostic workup for infected patients.

Main Results:

• All tested parameters showed significant differences between infected patients and controls (p < 0.05).
• A combination of interleukin-6 and C-reactive protein achieved the highest sensitivity (99%) and specificity (98%).
• PET-CT imaging demonstrated a diagnostic accuracy of 93.3%.

Conclusions:

• Interleukin-6 and C-reactive protein combination provides accurate diagnosis for prosthetic joint infections.
• PET-CT imaging is a valuable modality for detecting prosthesis infections.
• Alpha defensin was found to be neither sensitive nor specific for periprosthetic infection diagnosis in this study.