The Natural Course of Serum D-Dimer, C-Reactive Protein, and Erythrocyte Sedimentation Rate Levels After Uneventful Primary Total Joint Arthroplasty

Azboy, İbrahim; Çatal, Bilgehan; Başarır, Kerem; Mutlu, Müren; Bilgen, Ömer Faruk; Parvızı, Javad

doi:10.1016/j.arth.2021.04.031

Cited by 12 publications

(17 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…According to Azboy et al (2021), CRP levels return to baseline levels after 45 d following uneventful TJA, which is in contrast to a study by Herrero et al (2008) in which the authors observed a return to baseline levels over a period of 150 d with still high levels on postoperative day 42.…”

Section: Discussioncontrasting

confidence: 65%

“…In fact, the peak of IL-6 serum levels is measured after 6 h, with a mean half-life of 15 h (Wirtz et al, 2000). The aim to identify cut-off values of serum markers with a short half-life to predict PJI in the postoperative period is further reinforced by the progressive trend towards a significantly decreased hospital length of stay due to rapid-recovery protocols (Berend et al, 2004). Based on these considerations, a standardised protocol was adapted in 2016 at the Orthopaedic Hospital Vienna-Speising, Department of Orthopaedic Surgery II to measure IL-6 levels prior to discharge on postoperative day 3 following TJA in each patient.…”

Section: Discussionmentioning

confidence: 99%

“…Prior studies have outlined CRP within the first 5 d following TKA as an inappropriate indicator for an early PJI detection (Windisch et al, 2017). Due to its considerably shorter half-life with regard to normalisation to baseline levels (Azboy et al, 2021;Herrero et al, 2008), IL-6 has gained increasing interest for PJI diagnosis. Therefore, the aim of the present study was to assess the ability of IL-6 measured prior to discharge on postoperative day 3 following TJA to predict an early onset PJI in a large subset of patients.…”

Section: Discussionmentioning

confidence: 99%

“…However, reports have showed their limited accuracy and low specificity (Sigmund et al, 2021). Previous studies have demonstrated a slow normalisation in the postoperative levels of CRP following primary TJA, representing a drawback with regard to diagnosing acute PJIs (Azboy et al, 2021). The serum levels of CRP have been reported to reach a peak during the second postoperative day.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Postoperative IL-6 levels cannot predict early onset periprosthetic hip/knee infections: an analysis of 7,661 patients at a single institution

Aichmair¹,

Frank²,

Simon³

et al. 2022

eCM

View full text Add to dashboard Cite

Prior studies have outlined C-reactive protein (CRP) within the first 5 d following total hip arthroplasty (THA) as an inappropriate indicator of an early periprosthetic joint infection (PJI). Recently, interleukin-6 (IL-6), as a potential inflammatory marker following total joint arthroplasty (TJA), has gained increasing interest, particularly due to its considerably shorter half-life. The aim of the present study was to assess IL-6 measured on postoperative day 3 following TJA as a prediction marker of early onset PJI. 7,661 patients, who underwent total hip or knee arthroplasty (THA, TKA) at a single institution between 2016 and 2019, were evaluated. Serum IL-6 values were measured on postoperative day 3 and compared between patients, with and without early onset PJI in the postoperative follow-up, matched for age, gender, Surgical Site Infection Risk Score and Charlson comorbidity index. Overall (n = 7,661), there was no statistically significant difference in serum IL-6 levels comparing patients with and without early onset PJI following THA [38.9 pg/ mL vs. 32.0 pg/mL, p = 0.116] and TKA [30.6 pg/mL vs. 28.2 pg/mL, p = 0.718]. Male gender and high body mass index were associated with an increased risk of early onset PJI following THA (p = 0.027, p = 0.002). Matched cohort analysis (n = 86) showed no statistically significant difference in serum IL-6 levels between patients with and without early onset PJI following THA (p = 0.680) and TKA (p = 0.910). Serum IL-6 values on postoperative day 3 following THA or TKA could not predict early onset PJIs.

show abstract

Section: Discussioncontrasting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Postoperative IL-6 levels cannot predict early onset periprosthetic hip/knee infections: an analysis of 7,661 patients at a single institution

Aichmair¹,

Frank²,

Simon³

et al. 2022

eCM

View full text Add to dashboard Cite

show abstract

“…However, it slowly rose again approximately 2 weeks after surgery, thus reaching a second peak. In a prospective study enrolling 81 patients undergoing primary TJA, Azboy et al 30 also found that the D-Dimer level reached its peak on day 1 after surgery and quickly dropped to the baseline level on day 3 after surgery. Meanwhile, the second D-Dimer peak appeared on day 15 after surgery.…”

Section: The Normal Trajectory Of Plasma Fibrinogen and D-dimer In Th...mentioning

confidence: 96%

What Is the Normal Trajectory of C‐Reactive Protein, Erythrocyte Sedimentation Rate, Plasma Fibrinogen and D‐Dimer after Two‐Stage Exchange for Periprosthetic Joint Infection?

Zhou

Liu

et al. 2022

Orthopaedic Surgery

View full text Add to dashboard Cite

Objective C‐reactive protein (CRP), erythrocyte sedimentation rate (ESR), plasma fibrinogen and D‐Dimer are used as diagnostic biomarkers of prosthetic joint infection (PJI) after total joint arthroplasty (TJA). The purpose of the study was to investigate the normal trajectory of CRP, ESR, plasma fibrinogen and D‐Dimer at different time points after two‐stage exchange arthroplasty for PJI. Methods We studied 53 patients undergoing two‐stage exchange for PJI at five time points: preoperatively (T0), duration of hospital stays (T1), 30 days (T2), 30–90 days (T3), and 90–180 days (T4) after surgery. The medical records of all patients were well documented and carefully reviewed. The Shapiro–Wilk test was utilized to compare the normal distribution for continuous variables, and the nonnormally distributed data were used for Friedmann's one‐way repeat measures analysis of variances. Post hoc Dunnett's test was used to compare each pair of data to find differences from baseline. Results Compare with T0 point, the levels of CRP and ESR increased significantly and reached peak values at T1 point (all P < 0.001), with median values of 56.40 mg/L (range, 5.54–161.0 mg/L) and 49.00 mm/h (range, 13.00–113.0 mm/h), respectively. In addition, the levels of plasma fibrinogen and D‐Dimer increased significantly and reached peak values at T1 point (all P < 0.001), with median values of 4.13g/L (range, 2.27–6.80 mg/L) and 4.00 mg/L (range, 0.19–14.01 mg/L), respectively. CRP and ESR rapidly declined at the T2 point with significantly compared with T0 point (P = 0.001 and P < 0.001). The levels of CRP, ESR, plasma fibrinogen and D‐Dimer returned to preoperative levels of 5.23 mg/L (range, 1.01–21.70 mg/L), 19.00 mm/h (range, 6.00–60.00 mm/h), 3.38g/L (range, 1.71–5.10 g/L) and 2.33 mm/h (range, 0.19–6.87 mg/L) at T4 point, and there was no significant difference compared with T0 point (all P > 0.05). Conclusions The study demonstrated the normal trajectory of CRP, ESR, plasma fibrinogen and D‐Dimer at five time points in patients who underwent two‐stage exchange for PJI. Thus, the results have the possibility of providing signs of infection after the patient receives two‐stage exchange arthroplasty for PJI, which can benefit from early treatment.

show abstract

Efficacy analysis of clinical serological indicators in the diagnosis of postoperative periprosthetic joint infection in patients with rheumatoid arthritis or osteoarthritis

Zhao,

Li,

Wang

et al. 2024

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

The Natural Course of Serum D-Dimer, C-Reactive Protein, and Erythrocyte Sedimentation Rate Levels After Uneventful Primary Total Joint Arthroplasty

Cited by 12 publications

References 25 publications

Postoperative IL-6 levels cannot predict early onset periprosthetic hip/knee infections: an analysis of 7,661 patients at a single institution

Postoperative IL-6 levels cannot predict early onset periprosthetic hip/knee infections: an analysis of 7,661 patients at a single institution

What Is the Normal Trajectory of C‐Reactive Protein, Erythrocyte Sedimentation Rate, Plasma Fibrinogen and D‐Dimer after Two‐Stage Exchange for Periprosthetic Joint Infection?

Efficacy analysis of clinical serological indicators in the diagnosis of postoperative periprosthetic joint infection in patients with rheumatoid arthritis or osteoarthritis

Contact Info

Product

Resources

About