title: Synovial C-reactive protein as a marker for chronic periprosthetic infection in total hip arthroplasty.
abstract: The aim of this study was to assess the role of synovial C-reactive protein (CRP) in the diagnosis of chronic periprosthetic hip infection. We prospectively collected synovial fluid from 89 patients undergoing revision hip arthroplasty and measured synovial CRP, serum CRP, erythrocyte sedimentation rate (ESR), synovial white blood cell (WBC) count and synovial percentages of polymorphonuclear neutrophils (PMN). Patients were classified as septic or aseptic by means of clinical, microbiological, serum and synovial fluid findings. The high viscosity of the synovial fluid precluded the analyses in nine patients permitting the results in 80 patients to be studied. There was a significant difference in synovial CRP levels between the septic (n = 21) and the aseptic (n = 59) cohort. According to the receiver operating characteristic curve, a synovial CRP threshold of 2.5 mg/l had a sensitivity of 95.5% and specificity of 93.3%. The area under the curve was 0.96. Compared with serum CRP and ESR, synovial CRP showed a high diagnostic value. According to these preliminary results, synovial CRP may be a useful parameter in diagnosing chronic periprosthetic hip infection.
authors: Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors: M
authors: M
authors: Omar
authors: Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625 Hannover, Germany.
authors: M
authors: M
authors: Ettinger
authors: Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors: M
authors: M
authors: Reichling
authors: Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors: M
authors: M
authors: Petri
authors: Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors: D
authors: D
authors: Guenther
authors: ENDO Clinic Hamburg, Holstenstr. 2, 22767 Hamburg, Germany.
authors: T
authors: T
authors: Gehrke
authors: Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors: C
authors: C
authors: Krettek
authors: Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors: P
authors: P
authors: Mommsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D019644:Arthroplasty, Replacement, Hip; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis*; D002908:Chronic Disease; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism; D016459:Prosthesis-Related Infections / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D013582:Synovial Fluid / Q000378:metabolism*
chemical_list: D002097:C-Reactive Protein
keywords: C-reactive protein; periprosthetic joint infection; synovial fluid; total hip arthroplasty