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Limited value of coagulation parameters in diagnosing periprosthetic joint infection

Xia Chen1, Jie Xie2, Yanming Li1

  • 1Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.

International Orthopaedics
|July 5, 2022
PubMed
Abstract

Insights

Coagulation parameters like fibrin degradation product (FDP) and D-dimer have limited value for diagnosing periprosthetic joint infection (PJI). Traditional biomarkers C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) demonstrated superior diagnostic performance for PJI.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Biomarkers

Background:

  • Periprosthetic joint infection (PJI) diagnosis requires reliable biomarkers.
  • Coagulation parameters are associated with infections but their role in PJI diagnosis is unclear.

Purpose of the Study:

  • To evaluate the diagnostic value of coagulation parameters for PJI.
  • Compare coagulation parameters against traditional biomarkers like CRP and ESR.

Main Methods:

  • Retrospective study of 186 patients undergoing revision hip or knee arthroplasty.
  • Coagulation parameters (FDP, D-dimer, PC, PVR) evaluated using ROC curves.
  • Comparison with C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).

Main Results:

  • Coagulation parameters showed inferior diagnostic performance compared to CRP and ESR.
  • Area under the curve (AUC) values: FDP (0.805), D-dimer (0.571), PC (0.703), PVR (0.704), CRP (0.882), ESR (0.824).
  • Performance was similar across hip and knee PJIs and not superior to CRP/ESR in culture-positive or negative cases.

Conclusions:

  • Coagulation parameters (FDP, D-dimer, PC, PVR) have limited diagnostic value for PJI in hip and knee arthroplasty patients.
  • CRP and ESR remain superior biomarkers for PJI diagnosis.
Keywords:
D-dimerDiagnosisFibrin degradation productPeriprosthetic joint infectionPlatelet countPlatelet count to mean platelet volume ratio

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