Procalcitonin, C-Reactive Protein, Interleukin-6, and Soluble Intercellular Adhesion Molecule-1 as Markers of Postoperative Orthopaedic Joint Prosthesis Infections

Drago, Lorenzo; Vassena, Christian; Dozio, Elena; Corsi, Massimiliano M.; Vecchi, Elena De; Mattina, Roberto; Romanò, Carlo Luca

doi:10.1177/039463201102400216

Cited by 52 publications

(28 citation statements)

References 38 publications

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“…In our patients we observed this effect: a lower serum iron concentration was observed in septic patients than in non septic ones, while previously infected patients show a recovery in iron concentrations, reaching levels more similar to non septic ones. These observation correlates with previous observation of our group (19) indicating an increase of IL-6 and C reactive protein (CRP) in POPJI patients. In addition, during an acute phase response, there is a marked increase of ferritin in parallel with CRP levels (8).…”

Section: Discussionsupporting

confidence: 93%

Iron Status Evaluation as a Marker and Postoperative Joint Infection: A Pilot Study

Galliera

Dozio

Dogliotti

et al. 2012

Int J Immunopathol Pharmacol

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We evaluated the effect of different inflammatory conditions on iron status and, as a consequence, the possible use of iron markers as indicators of infection in the diagnosis of postoperative prosthetic orthopaedic joint infections. The study population was consisted of 26 patients undergoing revision of total hip or total knee joint arthroplasty and subdivided into three groups according to the cause of prosthesis implant failure: 10 as having had previous infection (Group A), 10 patients were categorized as having infection (Group B); and the remaining 6 (Group C) as not having infection. These patients were assayed for mean corpuscular haemoglobin concentration (MCHC) and serum values of iron (Fe), ferritin (Fer), transferrin (Tf), soluble transferrin receptor (sTiR), and transferrin saturation (sat Tf). Septic patients display statistically significant lower serum iron concentration, higher sTiR and ferritin levels, lower, but not statistically significant, MCHC compared to non septic ones. Little differences were observed for Tf, sat Tf, tibc, TiR index, among the three groups of patients. Our study suggests that iron status parameters, in particular serum iron, ferritin, sTiR and TiR index, could be useful tools for the early detection and the diagnosis of orthopaedic prosthetic joint infections.

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Section: Discussionsupporting

confidence: 93%

Iron Status Evaluation as a Marker and Postoperative Joint Infection: A Pilot Study

Galliera

Dozio

Dogliotti

et al. 2012

Int J Immunopathol Pharmacol

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“…In the case of aseptic inflammation, however, reliance on elevated laboratory infection biomarkers may lead to unnecessary and inappropriate surgery (implants unnecessarily removed or antibiotic cement spacers needlessly implanted) [12,16,35]. To optimize this diagnostic process, infection biomarkers with a fast response and high sensitivity and specificity for infection are needed [4,8,11,15].…”

Section: Introductionmentioning

confidence: 99%

Novel Biomarkers to Detect Infection in Revision Hip and Knee Arthroplasties

Glehr

Friesenbichler

Hofmann

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background 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. Questions/purposes We investigated the sensitivity and specificity of the biomarkers procalcitonin, interleukin 6 (IL-6), and interferon a (IFN-a) as compared with conventional biomarkers (C-reactive protein [CRP], leukocyte level) for a periprosthetic joint infection associated with revision arthroplasties. Methods We prospectively included and analyzed 84 patients (124 revision arthroplasties). The blood parameters of interest were procalcitonin, IL-6, IFN-a, 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. Results Considering the preoperative values of 84 patients (124 operations), procalcitonin, IL-6, CRP, and leukocyte level correlated with periprosthetic joint infection, whereas IFN-a 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%. Conclusions 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.

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“…Skin temperature was measured 1 day before surgery, on postoperative day 1 and day 3, and at week 1, week 2, and week 6 [3,5,6]. We selected white blood cell (WBC) count, CRP and IL-6 levels, and ESR as blood monitoring indicators [10]. Inflammatory cytokines were measured preoperatively, on postoperative day 3, and at week 1 and week 6.…”

Section: Experimental Design Flowmentioning

confidence: 99%

Effect of Celecoxib on Surgical Site Inflammation after Total Knee Arthroplasty: A Randomized Controlled Study

Xu¹,

Sang²,

Liu³

et al. 2018

Med Princ Pract

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Objective: To evaluate the anti-inflammatory effectiveness of celecoxib and its effect on the rehabilitation of joint function after total knee arthroplasty. Methods: 72 patients presented between 2016 and 2017 and were divided into two groups. The experimental group was given 200 mg celecoxib twice daily with tramadol hydrochloride 50 mg twice daily (as required); the control group was given tramadol hydrochloride 50 mg twice daily for 6 weeks from the first day after total knee arthroplasty. Skin temperature around the knee was measured 1 day before surgery, on postoperative days 1 and 3, and at weeks 1, 2, and 6. Inflammatory markers (white blood cell count, C-reactive protein, erythrocyte sedimentation rate, and interleukin-6) were measured preoperatively, on postoperative day 3, and at weeks 1 and 6. Knee Society Score was recorded preoperatively and at postoperative weeks 1, 2, and 6. Results: Except for preoperative skin temperature, the recorded skin temperatures of the experimental group were significantly different compared to those of the control group (p = 0.001, 0.024, 0.030, 0.041, 0.047, respectively). Levels of C-reactive protein were significantly different at the 1st and the 6th week after surgery, differing by 19.3 ± 4.64 mg/L (p < 0.001) and 2.6 ± 0.92 mg/L (p = 0.006). Levels of interleukin-6 showed a significant difference of 6.61 ± 2.36 pg/mL (p = 0.007) at the 1st week after surgery. Until the 6th week after surgery, the erythrocyte sedimentation rate in the experimental group and the control group differed by 17 ± 4.6 mm/h (p = 0.001). Conclusions: Celecoxib has a significant inhibitory effect on postoperative aseptic inflammation.

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Procalcitonin, C-Reactive Protein, Interleukin-6, and Soluble Intercellular Adhesion Molecule-1 as Markers of Postoperative Orthopaedic Joint Prosthesis Infections

Cited by 52 publications

References 38 publications

Iron Status Evaluation as a Marker and Postoperative Joint Infection: A Pilot Study

Iron Status Evaluation as a Marker and Postoperative Joint Infection: A Pilot Study

Novel Biomarkers to Detect Infection in Revision Hip and Knee Arthroplasties

Effect of Celecoxib on Surgical Site Inflammation after Total Knee Arthroplasty: A Randomized Controlled Study

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