title: Comparison of procalcitonin and C-reactive protein for the diagnosis of periprosthetic joint infection before revision total hip arthroplasty.
abstract: OBJECTIVE
  To compare the clinical informative value of procalcitonin (PCT) and C-reactive protein (CRP) serum concentrations in the diagnosis of periprosthetic joint infection (PJI) before revision total hip arthroplasty (THA).
  
  
  METHODS
  We conducted a prospective observational study of 71 consecutive patients (74 hips) undergoing revision THA. Procalcitonin and CRP serum concentrations and white blood cell (WBC) count were measured pre-operatively. Diagnostic accuracy was analyzed by the receiver-operating characteristic (ROC) curve and the area under the curve (AUC).
  
  
  RESULTS
  The PJI incidence was 35.2% in patients with revision THA. Procalcitonin and CRP serum concentrations and WBC count were statistically higher in the PJI cohort compared with the no PJI cohort (p<0.05). The AUCs for PCT, CRP, and WBC count were 0.851 (95% confidence interval [CI] 0.773-0.929), 0.830 (95% CI 0.751-0.910), and 0.633 (95% CI 0.518-0.747), respectively. Serum PCT and CRP showed a significantly higher diagnostic ability than WBC count (p<0.05). No significant difference was found between serum PCT and CRP (p=0.367).
  
  
  CONCLUSIONS
  Procalcitonin does not offer an advantage over CRP in diagnosing PJI. However, PCT and CRP proved to be more reliable than WBC count.
authors: 1 Department of Orthopedics, Nantong First People's Hospital , Nantong City, China .
authors: Kun
authors: K
authors: Yuan
authors: Wei-Dong
authors: WD
authors: Li
authors: Ying
authors: Y
authors: Qiang
authors: Zhi-Ming
authors: ZM
authors: Cui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data*; D002097:C-Reactive Protein / Q000032:analysis*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D011498:Protein Precursors / Q000097:blood*; D012086:Reoperation / Q000706:statistics & numerical data
chemical_list: C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide