Plasma Fibrinogen is a good new auxiliary diagnostic marker for periprosthetic joint infection

Abstract

Background: To test the meaning of serum CRP, ESR, Platelet Count and Mean Platelet Volume ratio (PC/MPV), plasma Fibrinogen and D-Dimer in periprosthetic joint infection diagnosis (PJI). Methods: Clinical data of 149 patients diagnosed with osteoarthritis (Group A), PJI (Group B) and aseptic loosening after joint arthroplasy (Group C) were retrospectively studied. General data and preoperative serum CRP, ESR, Platelet Count and Mean Platelet Volume ratio (PC/MPV), plasma Fibrinogen and D-Dimer levels were analyzed. The sensitivity and specificity of serum CRP, ESR, Platelet Count and Mean Platelet Volume ratio (PC/MPV), plasma Fibrinogen and D-Dimer in PJI diagnosis were compared.Results: Expression level of serum CRP, ESR, PC/MPV and plasma Fibrinogen in Group B are higher than Group A and C. Expression level of plasma D-Dimer in Group B are higher than Group A but similar with Group C. When PC/MPV>31.70, plasma Fibrinogen > 4.01 μg/mL and plasma D-Dimer > 1.17 mg/L were set as the threshold value for the diagnosis of PJI, the sensitivity of PC/MPV in PJI diagnosis is lower than ESR and Plasma Fibrinogen. Whereas, there are no statistically significant differences when compared specificity of serum CRP, ESR, PC/MPV, plasma Fibrinogen and D-Dimer in PJI diagnosis.Conclusion: PC/MPV and plasma D-Dimer should not be used as the first screen markers for PJI diagnosis, whereas, the plasma Fibrinogen can be used as a new auxiliary marker for PJI diagnosis.