Plasma d-Dimer Levels in Non-prosthetic Orthopaedic Implant Infection: Can it Aid Diagnosis?

d-Dimer estimation has been proposed as a reliable biomarker in prosthetic joint infections. Its role in non-prosthetic orthopaedic implant infections has, however, not been studied. The objectives of this study were to assess the levels of plasma d-Dimer in non-prosthetic orthopaedic implant infection. The diagnostic efficiency of d-dimer on orthopaedic implant-related infection was evaluated.

The study was designed as a cross-sectional comparative study. Patients who presented with orthopaedic implant-related infection as diagnosed by modified MSIS criteria were allocated to case group (n = 49) and patients who underwent surgical procedures with orthopaedic implants with no evidence of infection at 6 weeks postoperatively were allocated to the control group (n = 48). Serum d-Dimer levels were assessed quantitatively using immunoturbidimetric assays in both groups and compared between both groups.

The mean (± SD) value of serum d-Dimer in case group was 0.64 (± 0.45) μg/ml and control group was 0.77 (± 0.47) μg/ml. No significant difference was found in serum d-Dimer levels between cases and control groups (p value = 0.183). The diagnostic accuracy of d-dimer in orthopaedic implant-related infection also could not be demonstrated.

The findings of d-dimer as a marker for the diagnosis of prosthetic joint infections cannot be extrapolated to non-prosthetic orthopaedic implant infection.