ArticleJournal of clinical orthopaedics and trauma
Normal CRP and WBC values in total hip arthroplasty (THA) with signs of loosening. Do we need a joint aspiration?
Article in Journal of clinical orthopaedics and trauma. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Reliable Diagnostic Tests and Thresholds for Preoperative Diagnosis of Non-Inflammatory Arthritis Periprosthetic Joint Infection: A Meta-analysis and Systematic Review.Orthopaedic surgery · 2022Pooled it
- Feasibility of mNGS in joint replacement patients exhibiting elevated ESR and CRP levels without an underlying diagnosis.European journal of medical research · 2024Article
- Nuclear imaging does not have clear added value in patients with low a priori chance of periprosthetic joint infection. A retrospective single-center experience.Journal of bone and joint infection · 2022Article
- Article
- Percutaneous cementoplasty of periprosthetic loosening: can interventional radiologists offer an alternative to revision surgery?European radiology · 2021Article
- The role of fibrinogen in predicting reinfection after DAIR for periprosthetic joint infections.BMC musculoskeletal disorders · 2021Article
- Are Cement Spacers and Beads Loaded with the Correct Antibiotic(s) at the Site of Periprosthetic Hip and Knee Joint Infections?Antibiotics (Basel, Switzerland) · 2021Article
- Current Clinical Methods for Detection of Peri-Prosthetic Joint Infection.Surgical infections · 2020Review
- Loosening of total knee arthroplasty - always aseptic?Journal of clinical orthopaedics and trauma · 2020Article
- Positive Microbiological Findings at the Site of Presumed Aseptic Revision Arthroplasty Surgery of the Hip and Knee Joint: Is a Surgical Revision Always Necessary?BioMed research international · 2020Article
- Possible risk factors for acute and chronic deep periprosthetic joint infections in primary total knee arthroplasty. Do BMI, smoking, urinary tract infections, gender, and ASA classification have an impact?Journal of orthopaedicsArticle
- Aseptic Loosening after THA and TKA - Do gender, tobacco use and BMI have an impact on implant survival time?Journal of orthopaedicsArticle
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeOverall Total hip arthroplasty (THA) is a very successful procedure. However, in case of complication dedicated management is required. Two major complications of THA failures are aseptic loosening (AL) and periprosthetic joint infection (PJI). The primary hypothesis of this study was that joint aspirations in patients with signs of loosening after THA are capable to detect PJI in suspected AL with negative serologic testing.
methodsIn this study a total of 108 symptomatic patients with radiographic signs of prosthetic loosening and hip pain in THA were included. Based on a standardized algorithm all patients underwent serological testing followed by joint aspiration preoperatively. Intraoperatively harvested samples were subjected to microbiological testing and served as the gold standard in differential diagnosis. Demographics, as well as the results of serologic and microbiological testing were collected from the medical records.
resultsOf the included patients 85 were finally diagnosed with an AL and 23 with PJI. Within the patients with PJI 13 (56%) patients demonstrated elevated CRP and WBC counts, as well as positive synovial cultures after joint aspiration. In ten patients (44%) diagnosed with PJI neither CRP nor WBC were abnormal.
conclusionThe diagnosis of PJI can be difficult in THA with radiographic signs of loosening. Clinical features including pain, fever, and local sings of infection are uncommon especially a long period after index operation. First-line screening testing relies on serological evaluation of CRP and WBC. However, normal CRP and WBC values cannot rule out a PJI. These cases can be detected by joint aspiration and synovial cultures reliably.
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