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Serum Fibrinogen Test Performs Well for the Diagnosis of Periprosthetic Joint Infection
Geng Bin1, Yang Xinxin1, Lu Fan1
1Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, People's Republic of China.
Background:
Serum fibrinogen (FIB) is an acute-phase glycoprotein in the infection response that may stop excessive bleeding. The purposes of this study are to determine the value of FIB that can be used to differentiate between periprosthetic joint infection (PJI) and aseptic loosening of the prosthesis, and to determine the clinical significance of FIB for analyzing infection outcomes after first-stage surgery.
Methods:
This retrospective study included 90 patients undergoing total knee arthroplasty or total hip arthroplasty revision from January 2015 to August 2019. PJI was confirmed in 53 patients (group A), and the other 37 patients were diagnosed with aseptic loosening of the prosthesis (group B). Only 21 patients in group A documented the results for serum FIB, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) after spacer insertion, so the postoperative serological marker levels of the these patients were also assessed.
Results:
The FIB, CRP, and ESR levels were significantly higher in group A than in group B (P < .001). The area under the receiver operating characteristic curve was highest for FIB at 0.928. Analyses of FIB levels revealed a sensitivity of 79.25% and a specificity of 94.59%. FIB levels were significantly lower in patients with PJI after spacer insertion (P < .001).
Conclusion:
FIB is an adequate test to aid in diagnosing PJI, and it is not inferior to CRP and ESR in distinguishing between PJI and aseptic loosening of the prosthesis. It is an especially useful tool in assessing infection outcomes after first-stage surgery.
Insights
Serum fibrinogen (FIB) effectively differentiates periprosthetic joint infection (PJI) from aseptic loosening, proving valuable for assessing infection outcomes post-surgery. This glycoprotein marker shows high accuracy in clinical diagnostics.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Biochemistry
Background:
- Serum fibrinogen (FIB) is an acute-phase glycoprotein involved in infection response and hemostasis.
- Distinguishing periprosthetic joint infection (PJI) from aseptic loosening is crucial for patient management.
- Understanding the role of FIB in post-surgical infection outcomes is clinically significant.
Purpose of the Study:
- To evaluate the diagnostic value of FIB in differentiating PJI from aseptic prosthesis loosening.
- To assess the clinical significance of FIB in analyzing infection outcomes after first-stage surgery.
Main Methods:
- Retrospective study of 90 patients undergoing hip or knee arthroplasty revision.
- Patients were categorized into PJI (n=53) and aseptic loosening (n=37) groups.
- Serum FIB, CRP, and ESR levels were analyzed, particularly post-spacer insertion in PJI patients.
Main Results:
- FIB, CRP, and ESR levels were significantly higher in the PJI group compared to the aseptic loosening group (P < .001).
- FIB demonstrated a high diagnostic accuracy with an area under the ROC curve of 0.928, sensitivity of 79.25%, and specificity of 94.59%.
- Post-spacer insertion, FIB levels were significantly lower in PJI patients (P < .001).
Conclusions:
- Serum FIB is an adequate and effective biomarker for aiding in the diagnosis of PJI.
- FIB is comparable to C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in distinguishing PJI from aseptic loosening.
- FIB serves as a valuable tool for assessing infection outcomes following first-stage surgical procedures.
