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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 12/2010

01-12-2010 | Symposium: Papers Presented at the 2009 Closed Meeting of the International Hip Society

Combining C-reactive Protein and Interleukin-6 May Be Useful to Detect Periprosthetic Hip Infection

Authors: Martin A. Buttaro, MD, Ignacio Tanoira, MD, Fernando Comba, MD, Francisco Piccaluga, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 12/2010

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Abstract

Background

The sensitivity and specificity to detect periprosthetic infection of the different methods have been questioned, and no single laboratory test accurately detects infection before revision arthroplasty.

Questions/purposes

We asked whether preoperative C-reactive protein (CRP) and interleukin-6 (IL-6) could lead to similar sensitivity, specificity, and predictive values as our previous results obtained with intraoperative frozen section (FS) in revision total hip arthroplasty (THA).

Methods

We prospectively followed 69 patients who had undergone revision THA for failure of a primary THA. The definitive diagnosis of an infection was determined on the basis of positive histopathologic evidence of infection or growth of bacteria on culture.

Results

Eleven of the 69 hips were infected. The combination of an elevated CRP and IL-6 was correlated with deep infection in all the cases and showed a sensitivity of 0.57 (0.13–1.00), a specificity of 1.00 (0.99–1.00), a positive predictive value of 1.00 (0.87–1.00), and a negative predictive value of 0.94 (0.87–1.00). FS showed a sensitivity of 0.81 (0.54–1.00), a specificity of 0.98 (0.94–1.00), a positive predictive value of 0.90 (0.66–1.00), and a negative predictive value of 0.96 (0.91–1.00). Combining CRP and IL-6 provided similar sensitivity, specificity, and positive predictive values as the FSs.

Conclusions

Our data suggest the combination of CRP and IL-6 would be a useful serologic tool to complement others when diagnosing periprosthetic infection.

Level of Evidence

Level I, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Metadata
Title
Combining C-reactive Protein and Interleukin-6 May Be Useful to Detect Periprosthetic Hip Infection
Authors
Martin A. Buttaro, MD
Ignacio Tanoira, MD
Fernando Comba, MD
Francisco Piccaluga, MD
Publication date
01-12-2010
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 12/2010
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-010-1451-0

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