Diagnostic value of preoperative blood parameters in periprosthetic joint infections

Abstract

Aim: Diagnosis of periprosthetic joint infection (PJI) is not easy and it is made by presenting of combined findings rather than a single finding. The aim of this study is to investigate the role of blood parameters in diagnosing PJI.
 Material and Method: Revisions of total knee replacement and total hip replacement operated by the same surgeon between 2008 and 2018 were included in this study. Preoperative blood parameters of the patients were recorded. 69 primary arthroplasty patients with similar demographic characteristics to the patients were also included as the control group.
 Results: 214 arthroplasty patients, 79.0% of whom were female (n=169), were included in this study. The patients were divided into 3 groups; 32.2% were primary arthroplasty, 36.9% were aseptic revision arthroplasty, and 30.8% were septic revision arthroplasty. There was no difference between the three groups in terms of demographic characteristics. In pairwise comparisons, preoperative erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), lymphocyte, and platelet-to-lymphocyte rate (PLR) parameters were found to be significantly different in the septic group when compared to both the aseptic group and the primary arthroplasty group. Further analyzes were performed to evaluate the diagnostic performances of ESR, CRP, lymphocyte, and PLR in PJI relative to aseptic patients by plotting to receive operating characteristic curves.
 Conclusion: Lymphocyte, PLR, ESR, and CRP may have diagnostic value in predicting PJI. Therefore, these parameters may be helpful in deciding on revision arthroplasty for PJI.