ArticleBone & joint research2020
Is D-dimer a reliable biomarker compared to ESR and CRP in the diagnosis of periprosthetic joint infection?
Article in Bone & joint research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 16 citations in OpenAlex.
- Diagnostic accuracy of serum and synovial biomarker thresholds for diagnosing periprosthetic joint infection: a QUADAS-C-guided systematic review and meta-analysis.Arthroplasty (London, England) · 2026Review
- Analysis of Serum and Synovial Inflammatory Markers in Periprosthetic Joint Infections: A Narrative Review.Cureus · 2024Review
- Clinical applications of metagenomic next-generation sequencing in the identification of pathogens in periprosthetic joint infections: a retrospective study.Journal of orthopaedic surgery and research · 2024Article
- Significance of serum protein electrophoresis in the diagnosis of Tsukayama type IV periprosthetic joint infection.Frontiers in cellular and infection microbiology · 2024Article
- A Machine Learning Model Based on CT Imaging Metrics and Clinical Features to Predict the Risk of Hospital-Acquired Pneumonia After Traumatic Brain Injury.Infection and drug resistance · 2024Article
- Utility of D-dimer in total joint arthroplasty.World journal of orthopedics · 2023Review
- Limited value of coagulation parameters in diagnosing periprosthetic joint infection.International orthopaedics · 2022Article
- Application ofBone & joint research · 2022Article
- Diagnostic value of platelet indices in infected nonunion: a retrospective study.Journal of orthopaedic surgery and research · 2022Article
- The poor accuracy of D-dimer for the diagnosis of prosthetic joint infection but its potential usefulness in early postoperative infections following revision arthroplasty for aseptic loosening.BMC infectious diseases · 2022Article
- Combination of Synovial Fluid IL-4 and Polymorphonuclear Cell Percentage Improves the Diagnostic Accuracy of Chronic Periprosthetic Joint Infection.Frontiers in surgery · 2022Article
- D-Dimer Levels Are Not Elevated in SARS-CoV-2 IgG Positive Patients Undergoing Elective Orthopedic Surgery.Journal of clinical medicine · 2021Article
- Different diagnostic performance of plasma fibrinogen and D-dimer in periprosthetic joint infection: a propensity score matched study.BMC musculoskeletal disorders · 2021Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsThe diagnosis of periprosthetic joint infection (PJI) has always been challenging. Recently, D-dimer has become a promising biomarker in diagnosing PJI. However, there is controversy regarding its diagnostic value. We aim to investigate the diagnostic value of D-dimer in comparison to ESR and CRP.
methodsPubMed, Embase, and the Cochrane Library were searched in February 2020 to identify articles reporting on the diagnostic value of D-dimer on PJI. Pooled analysis was conducted to investigate the diagnostic value of D-dimer, CRP, and ESR.
resultsSix studies with 1,255 cases were included (374 PJI cases and 881 non-PJI cases). Overall D-dimer showed sensitivity of 0.80 (95% confidence interval (CI) 0.69 to 0.87) and specificity of 0.76 (95% CI 0.63 to 0.86). Sub-group analysis by excluding patients with thrombosis and hyper-coagulation disorders showed sensitivity of 0.82 (95% CI 0.70 to 0.90) and specificity of 0.80 (95% CI 0.70 to 0.88). Serum D-dimer showed sensitivity of 0.85 (95% CI 0.76 to 0.92), specificity of 0.83 (95% CI 0.74 to 0.90). Plasma D-dimer showed sensitivity of 0.67 (95% CI 0.60 to 0.73), specificity of 0.58 (95% CI 0.45 to 0.72). CRP showed sensitivity of 0.78 (95% CI 0.72 to 0.83), specificity of 0.81 (95% CI 0.72 to 0.87). ESR showed sensitivity of 0.68 (95% CI 0.63 to 0.73), specificity of 0.83 (95% CI 0.78 to 0.87).
conclusionIn patients without thrombosis or a hyper-coagulation disorder, D-dimer has a higher diagnostic value compared to CRP and ESR. In patients with the aforementioned conditions, D-dimer has higher sensitivity but lower specificity compared to ESR and CRP. We do not recommend the use of serum D-dimer in patients with thrombosis and hyper-coagulation disorders for diagnosing PJI. Serum D-dimer may perform better than plasma D-dimer. Further studies are needed to compare serum D-dimer and plasma D-dimer in arthroplasty patients. Cite this article:
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