title: Serum C-reactive protein and procalcitonin kinetics in patients undergoing elective total hip arthroplasty.
abstract: BACKGROUND
  The sensitivity and the specificity of different methods to detect periprosthetic infection have been questioned. The current study aimed to investigate the kinetics of C-reactive protein (CRP) and procalcitonin (PCT) in patients undergoing uncomplicated elective total hip arthroplasty (THA), to provide a better interpretation of their levels in noninfectious inflammatory reaction.
  
  
  METHODS
  A total of 51 patients were included. Serum CRP and PCT concentrations were obtained before surgery, on the 1st, 3rd, and 7th postoperative days and after discharge on the 14th and 30th days and at 2 years.
  
  
  RESULTS
  Both markers were confirmed to increase after surgery. The serum CRP showed a marked increase on the 3rd postoperative day while the peak of serum PCT was earlier, even if much lower, on the first day. Then, they declined slowly approaching the baseline values by the second postoperative week. PCT mean values never exceed concentrations typically related to bacterial infections.
  
  
  CONCLUSIONS
  CRP is very sensitive to inflammation. It could be the routine screening test in the follow-up of THA orthopaedic patients, but it should be complemented by PCT when there is the clinical suspicion of periprosthetic infection.
authors.affiliation: Department of Surgery, University Hospital of Siena, Viale Bracci No. 16, 53100 Siena, Italy.
authors.forename: Sandra
authors.initials: S
authors.lastname: Battistelli
authors.affiliation: Orthopaedics and Traumatology Clinic, University Hospital of Siena, Viale Bracci No. 16, 53100 Siena, Italy.
authors.forename: Mattia
authors.initials: M
authors.lastname: Fortina
authors.affiliation: Orthopaedics and Traumatology Clinic, University Hospital of Siena, Viale Bracci No. 16, 53100 Siena, Italy.
authors.forename: Serafino
authors.initials: S
authors.lastname: Carta
authors.affiliation: Department of Internal Medicine, University Hospital of Siena, Viale Bracci No. 16, 53100 Siena, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Guerranti
authors.affiliation: Orthopaedics and Traumatology Clinic, University Hospital of Siena, Viale Bracci No. 16, 53100 Siena, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Nobile
authors.affiliation: Orthopaedics and Traumatology Clinic, University Hospital of Siena, Viale Bracci No. 16, 53100 Siena, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Ferrata
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D002097:C-Reactive Protein / Q000378:metabolism*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D013997:Time Factors
chemical_list: C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide