Serum D-Dimer Test Is Promising for the Diagnosis of Periprosthetic Joint Infection and Timing of Reimplantation

Abstract

Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.

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

“…It has been reported that D-dimer sharply increases up to double levels and decrease to the baseline level within a short time during early postoperative period of TJA, and this dynamic change is more rapid than ESR and CRP [34,35]. Shahi et al [13] found that the sensitivity, specificity, and the cutoff value of plasma D-dimer were 89%, 93%, and 850 ng/mL, respectively, for detecting PJI. He considered plasma D-dimer is better than ESR and CRP in the diagnosis of PJI, and the D-dimer test has a great utility for determining the optimal timing of reimplantation [13].…”

“…Shahi et al [13] found that the sensitivity, specificity, and the cutoff value of plasma D-dimer were 89%, 93%, and 850 ng/mL, respectively, for detecting PJI. He considered plasma D-dimer is better than ESR and CRP in the diagnosis of PJI, and the D-dimer test has a great utility for determining the optimal timing of reimplantation [13]. However, they focused more on the role of D-dimer in the diagnosis of PJI and did not differentiate the role of D-dimer in the type of PJI (acute or chronic) [13,34].…”

“…He considered plasma D-dimer is better than ESR and CRP in the diagnosis of PJI, and the D-dimer test has a great utility for determining the optimal timing of reimplantation [13]. However, they focused more on the role of D-dimer in the diagnosis of PJI and did not differentiate the role of D-dimer in the type of PJI (acute or chronic) [13,34]. After all, the inflammatory response of chronic PJI is very different from that of acute PJI [36].…”

“…D-dimer is a specific marker of fibrinolysis and also increases in inflammation, thrombosis, or neoplastic disorders [12]. Recently, it has been reported that plasma D-dimer level can be used as an inflammatory factor for the diagnosis of PJI, as well as timing of reimplantation [13]. It could prove to be a valuable biomarker in chronic PJI diagnosis.…”

Current Review; Biomarkers in Diagnosing Periprosthetic Joint Infection

“…Serum D-dimer is another biomarker that has shown very promising results for diagnosing PJI. Shahi et al [30] in their prospective study showed that serum D-dimer outperforms both ESR and CRP for diagnosing PJI with a sensitivity of 89% and a specificity of 93%.…”