Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Glehr, M; Friesenbichler, J; Hofmann, G; Bernhardt, GA; Zacherl, M; Avian, A; Windhager, R; Leithner, A.
Novel Biomarkers to Detect Infection in Revision Hip and Knee Arthroplasties.
Clin Orthop Relat Res. 2013; 471(8):2621-2628
Doi: 10.1007/s11999-013-2998-3
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- Führende Autor*innen der Med Uni Graz
- Glehr Mathias
- Co-Autor*innen der Med Uni Graz
- Avian Alexander
- Bernhardt Gerwin
- Friesenbichler Jörg
- Hofmann Guenter
- Leithner Andreas
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- Abstract:
- A periprosthetic joint infection is one of the most challenging complications associated with THA and TKA. In the diagnostic process for detecting a periprosthetic joint infection, one of the most important steps is analysis of laboratory infection biomarkers. We investigated the sensitivity and specificity of the biomarkers procalcitonin, interleukin 6 (IL-6), and interferon alpha (IFN-alpha) as compared with conventional biomarkers (C-reactive protein [CRP], leukocyte level) for a periprosthetic joint infection associated with revision arthroplasties. We prospectively included and analyzed 84 patients (124 revision arthroplasties). The blood parameters of interest were procalcitonin, IL-6, IFN-alpha, leukocyte level, and CRP. Samples were taken preoperatively and on the first, third, and seventh postoperative days. The sensitivity and specificity of these biomarkers then were calculated. Considering the preoperative values of 84 patients (124 operations), procalcitonin, IL-6, CRP, and leukocyte level correlated with periprosthetic joint infection, whereas IFN-alpha did not. A procalcitonin cut-off level of 0.35 ng/mL revealed a sensitivity of 80% and specificity of 37%. An IL-6 cut-off level of 2.55 pg/mL had a sensitivity of 92% and specificity of 59%. In this study procalcitonin and IL-6 were helpful for detecting periprosthetic joint infections in revision arthroplasties, although CRP generally was superior. Procalcitonin and IL-6 may be considered adjuvant tests when the diagnosis of a periprosthetic joint infection is in doubt. This study showed, in addition to conventional biomarkers such as CRP and leukocyte level, procalcitonin and IL-6 were helpful for detecting infections associated with revision arthroplasties. Level II, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Arthroplasty, Replacement, Hip - adverse effects
- Arthroplasty, Replacement, Knee - adverse effects
- Biological Markers - blood
- C-Reactive Protein - metabolism
- Calcitonin - blood
- Female -
- Hip Prosthesis - adverse effects
- Humans -
- Inflammation Mediators - blood
- Interferon-alpha - blood
- Interleukin-6 - blood
- Knee Prosthesis - adverse effects
- Leukocyte Count -
- Male -
- Middle Aged -
- Predictive Value of Tests -
- Prospective Studies -
- Prosthesis-Related Infections - blood
- Protein Precursors - blood
- Reoperation -
- Sensitivity and Specificity -
- Time Factors -