title: A simple, cost-effective screening protocol to rule out periprosthetic infection.
abstract: The differential diagnosis of pain after total knee arthroplasty includes infection. Effective screening tools should have high sensitivity and are cost-effective. We evaluated 296 patients who underwent total knee revision at our institution. One hundred sixteen patients (39%) were classified as infected and 180 patients (61%) were considered noninfected. The mean erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) of the infected patients were 85 mm/h and 110 mg/L, respectively. The mean ESR and CRP of the noninfected patients were 22 mm/h and 7 mg/L, respectively. Five patients (4%) in the infected group had both normal ESR and CRP. Infection was suspected in all 5 patients, and an organism was cultured in 4 of the 5 cases. Erythrocyte sedimentation rate and CRP, when used in combination, serve as a useful screening tool in patients with a painful total knee arthroplasty.
authors.affiliation: Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Rothman Institute, Philadelphia, PA 19107, USA.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Austin
authors.forename: Elie
authors.initials: E
authors.lastname: Ghanem
authors.forename: Ashish
authors.initials: A
authors.lastname: Joshi
authors.forename: Adam
authors.initials: A
authors.lastname: Lindsay
authors.forename: Javad
authors.initials: J
authors.lastname: Parvizi
mesh_terms: D000368:Aged; D001799:Blood Sedimentation; D002097:C-Reactive Protein; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects* / Q000191:economics; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000191:economics; D012680:Sensitivity and Specificity
chemical_list: D002097:C-Reactive Protein