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Comparison of D-dimer with CRP and ESR for diagnosis of periprosthetic joint infection

Longjiang Xiong1,2, Siyun Li2, Min Dai3

  • 1Nanchang University, Nanchang, 330003, China.

Journal of Orthopaedic Surgery and Research
|July 31, 2019
PubMed
Abstract

Insights

Serum D-dimer is not a superior biomarker for diagnosing periprosthetic joint infection (PJI). Further large-scale trials are needed to confirm its diagnostic value in PJI cases.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Biomarker Research

Background:

  • Diagnosing periprosthetic joint infection (PJI) remains challenging despite available biomarkers.
  • Serum D-dimer, a marker of fibrinolytic activity, is explored for its inflammatory properties and diagnostic potential in PJI.

Purpose of the Study:

  • To evaluate the diagnostic efficiency of serum D-dimer compared to erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) for periprosthetic joint infection (PJI).

Main Methods:

  • A prospective study included patients undergoing revision arthroplasty with suspected PJI.
  • Serum D-dimer, ESR, and CRP levels were measured preoperatively.
  • Diagnostic efficiency was assessed using Musculoskeletal Infection Society criteria for PJI.

Main Results:

  • Serum D-dimer levels were significantly higher in PJI patients versus aseptic failure (p < 0.001).
  • D-dimer showed 80.77% sensitivity and 79.63% specificity, not outperforming CRP or ESR in diagnostic accuracy for PJI.

Conclusions:

  • Serum D-dimer's utility as a diagnostic marker for PJI requires further investigation.
  • Larger-scale clinical trials are necessary to establish the role of D-dimer in PJI diagnosis.
Keywords:
BiomarkersC-reactive proteinD-dimerErythrocyte sedimentation ratePeriprosthetic joint infection

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