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Erschienen in:
01.12.2010 | Symposium: Papers Presented at the 2009 Closed Meeting of the International Hip Society
Combining C-reactive Protein and Interleukin-6 May Be Useful to Detect Periprosthetic Hip Infection
Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 12/2010
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Background
The sensitivity and specificity to detect periprosthetic infection of the different methods have been questioned, and no single laboratory test accurately detects infection before revision arthroplasty.
Questions/purposes
We asked whether preoperative C-reactive protein (CRP) and interleukin-6 (IL-6) could lead to similar sensitivity, specificity, and predictive values as our previous results obtained with intraoperative frozen section (FS) in revision total hip arthroplasty (THA).
Methods
We prospectively followed 69 patients who had undergone revision THA for failure of a primary THA. The definitive diagnosis of an infection was determined on the basis of positive histopathologic evidence of infection or growth of bacteria on culture.
Results
Eleven of the 69 hips were infected. The combination of an elevated CRP and IL-6 was correlated with deep infection in all the cases and showed a sensitivity of 0.57 (0.13–1.00), a specificity of 1.00 (0.99–1.00), a positive predictive value of 1.00 (0.87–1.00), and a negative predictive value of 0.94 (0.87–1.00). FS showed a sensitivity of 0.81 (0.54–1.00), a specificity of 0.98 (0.94–1.00), a positive predictive value of 0.90 (0.66–1.00), and a negative predictive value of 0.96 (0.91–1.00). Combining CRP and IL-6 provided similar sensitivity, specificity, and positive predictive values as the FSs.
Conclusions
Our data suggest the combination of CRP and IL-6 would be a useful serologic tool to complement others when diagnosing periprosthetic infection.
Level of Evidence
Level I, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.