Combined Measurement of D-Dimer and C-Reactive Protein Levels: Highly Accurate for Diagnosing Chronic Periprosthetic Joint Infection

Plasma Fibrinogen is a good new auxiliary diagnostic marker for periprosthetic joint infection

“…However, different from Paziuk T et al's [15] and Qin et al's [14]study, our data demonstrated that PC/MPV and D-Dimer should not be selected as the rst option for PJI diagnosis. But we think our conclusion still make sense and the reasons are: 1, we take the MSIS criterion [3] which recommend ESR 30 mm/h,CRP 10 mg/L other than Paziuk's ESR 46 mm/h CRP 1.5 mg/L as the optimum threshold value for PJI diagnosis; 2, consistent with Guangxu et al's study [25] and Cheng et al's study [26], we again showed that plasma D-dimer has limited performance for the diagnosis of PJI.…”

“…Despite coagulation markers such as Platelet Count and Mean Platelet Volume ratio [22], D-Dimer [23] and plasma Fibrinogen [24] have been used in in ammation and infection diseases diagnosis [10,11], the role of these coagulation markers in PJI diagnosis is still unknow. Although the role of D-Dimer [12][13][14] plasma Fibrinogen [16], Platelet Count and Mean Platelet Volume ratio [15] were evaluated in PJI diagnosis, and D-dimer > 1170 ng/m [14], PC/MPV > 31.70 [15] and FIB > 4.01 µg/mL [16] were recommend as the optimum threshold value for the PJI diagnosis, no subsequent studies were published thereafter.…”

“…Recently, the sensitivity and speci city of several coagulation markers including D-Dimer [12][13][14] Platelet Count and Mean Platelet Volume ratio [15] and plasma Fibrinogen [16] were compared with CRP and ESR in PJI diagnosis, and these studies showed that these commonly used coagulation markers can be selected for PJI diagnosis. However, no subsequent studies were published thereafter.…”

New developments and future challenges in prevention, diagnosis, and treatment of prosthetic joint infection

“…Recent studies have attempted to identify unique biomarkers independent of traditional SF culture or cell count for the diagnosis and prognosis of infection. CRP and D‐dimer have been examined for their increase in SF during ongoing PJI 13,93 . Their performance has generally been good‐to‐excellent with sensitivities as high as 99%, however, many wonder if they provide the sensitivity needed for identifying low‐virulence pathogens such as Staphylococcus epidermidis .…”

“…Preventive measures such as optimization of patient comorbidities, and perioperative antibiotic usage currently generate significant research interest and controversy 5–9 . Diagnosis of PJI remains challenging in certain cases due to false‐negative cultures, nondiagnostic laboratory tests, and heterogeneous patient presentation 10–13 . Improved synovial fluid (SF) diagnostic tests such as α‐defensins and nucleic acid‐based tests for serum, SF, and tissue cultures attempt to improve diagnostic accuracy and organism identification in PJI 14–19 .…”