Prosthetic Joint Infection Diagnosis

C-Reactive Protein Erythrocyte Sedimentation Rate

January 2010

In the absence of underlying inflammatory conditions, C-reactive protein is the most useful preoperative blood test.  Although C-reactive protein and erythrocyte sedimentation rate are both elevated after uncomplicated arthroplasty surgery, C-reactive protein returns to preoperative levels earlier than does the erythrocyte sedimentation rate.  We recently examined preoperative C-reactive protein and erythrocyte sedimentation rate in 582 patients with knee, hip or shoulder implant failure.  Both were statistically significantly higher in the groups with prosthetic knee or hip infection compared to those with aseptic implant failure.  However, in the shoulder implant group, the erythrocyte sedimentation rate was not significantly different in the groups with prosthetic shoulder infection versus aseptic shoulder implant failure, and the C-reactive protein was minimally elevated in the former compared to the latter group.

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Jump to section:

• Introduction
• Total Hip and Knee Replacement Procedures United States 1990-2006
• Body Diagram
• Prosthetic Hip and Knee Infections United States 1990-2004
• Surgical Management of Prosthetic Hip or Knee Infection
• Common Causes Hip and Knee Arthroplasty Infection
• Unusual Causes of Prosthetic Joint Infection³
• Diagram
• Criteria for Diagnosis of Prosthetic Joint Infection
• Prosthetic Joint Infection Clinical Presentation
• C-Reactive Protein Erythrocyte Sedimentation Rate
• C-Reactive Protein Erythrocyte Sedimentation Rate
• Images
• ¹⁸F-fluoro-2-deoxyglucose Positron Emission Tomography/Computed Tomography Increased Activity Around the Bone-Prosthesis Interface
• Synovial Fluid Leukocyte/Differential Prosthetic Knee
• Studies of Intrasurgical Frozen-Section Histopathologic Findings of Acute Inflammation in Prosthetic Joint Infection Diagnosis
• Prospective Vortexing/Sonication Clinical Study Hip or Knee Implants⁶
• Staphylococcus epidermidis Biofilm on Polycarbonate Coupons Scanning Electron Microscopy
• Periprosthetic Tissue and Sonicate Fluid Culture
• Prospective Vortexing/Sonication Clinical Study Hip or Knee Implants⁶
• Definition of Prosthetic Hip and Knee Infection
• Number of Microorganisms Detected by Sonicate Fluid Culture
• Results Prosthetic Hip or Knee Infection
• Effect of Preoperative Antimicrobial Therapy on Culture Sensitivity in Patients with Prosthetic Hip or Knee Infection
• Diagram
• Prospective Clinical Study Shoulder Implants
• Prospective Clinical Study Shoulder Implants
• Definition of Definite Prosthetic Shoulder Infection
• Prospective Clinical Study Shoulder Implants
• Shoulder Arthroplasty Infection
• Acknowledgments
• References
• Questions?
• Disclosure