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International Orthopaedics

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01-12-2014 | Original Paper

Interleukin-6 and other inflammatory markers in diagnosis of periprosthetic joint infection

Authors: Adham Elgeidi, Abd Elrahman Elganainy, Noha Abou Elkhier, Shirien Rakha

Published in: International Orthopaedics | Issue 12/2014

Abstract

Purpose

The purpose of this study was to evaluate the diagnostic value of interleukin-6 (IL-6) and other inflammatory markers including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell count (WCC) in diagnosis of PJI.

Methods

The study group included 40 patients (21 males, 19 females) admitted for surgical intervention after knee or hip arthroplasties. Patients were subjected to careful history taking, thorough clinical examination and pre-operative laboratory investigations including serum IL-6, CRP, WCC and ESR. Peri-implant tissue specimens were subjected to microbiological culture and histopathological examination.

Results

The mean age of patients was 58.4 years (range, 38–72 years). Intra-operative cultures and histopathological examination revealed 11 patients had been infected (PJI) and 29 patients were aseptic failure of prosthesis. Four presumed markers of infection were tested preoperatively: ESR, CRP, WCC, and IL-6. ESR (p = 0.0001), CRP (p = 0.004), WCC (0.0001), and IL-6 (p = 0.0001) were significantly higher in patients with septic revision than those with aseptic failure of the prosthesis. Serum IL-6 (>10.4 pg/ml) reportedly had a sensitivity of 100 %, a specificity of 90.9 %, a PPV of 79 %, a NPV of 100 %, and accuracy of 92.5 %.

Conclusions

The present study demonstrated that IL-6 has been found to be the most accurate laboratory marker for diagnosing PJI when compared to ESR, CRP, and WCC. IL-6 above 10.4 pg/ml and CRP level above 18 mg/L will identify all patients with PJI and the combination of CRP + IL-6 is an excellent screening test to identify all such patients (sensitivity 100 %, NPV 100 %).

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Title: Interleukin-6 and other inflammatory markers in diagnosis of periprosthetic joint infection
Authors: Adham Elgeidi
Abd Elrahman Elganainy
Noha Abou Elkhier
Shirien Rakha
Publication date: 01-12-2014
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 12/2014
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-014-2475-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Interleukin-6 and other inflammatory markers in diagnosis of periprosthetic joint infection

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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