ArticleBMC musculoskeletal disorders2021
Combined serum and synovial C-reactive protein tests: a valuable adjunct to the diagnosis of chronic prosthetic joint infection.
Article in BMC musculoskeletal disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 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
- 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
- The diagnostic role of albumin-based ratio markers for periprosthetic joint infection.Frontiers in cellular and infection microbiology · 2026Article
- Beyond Cultures: The Evolving Role of Molecular Diagnostics, Synovial Biomarkers and Artificial Intelligence in the Diagnosis of Prosthetic Joint Infections.Journal of clinical medicine · 2025Review
- Periprosthetic joint infection after arthroplasty: advances and future prospects.Journal of orthopaedic surgery and research · 2025Review
- The diagnostic accuracy of blood C-reactive protein and erythrocyte sedimentation rate in periprosthetic joint infections - A 10-year analysis of 1510 revision hip and knee arthroplasties from a single orthopaedic center.Journal of orthopaedic surgery and research · 2025Article
- Differential synovial fluid white blood cell count for the diagnosis of chronic peri-prosthetic joint infection - a systematic review and meta-analysis.Journal of bone and joint infection · 2025Article
- Periprosthetic joint infections: state-of-the-art.Archives of orthopaedic and trauma surgery · 2024Review
- Diagnostics in Late Periprosthetic Infections-Challenges and Solutions.Antibiotics (Basel, Switzerland) · 2024Review
- Current Status and Perspectives of Diagnosis and Treatment of Periprosthetic Joint Infection.Infection and drug resistance · 2024Review
- Synovial Fluid C-reactive Protein Clinical Decision Limit and Diagnostic Accuracy for Periprosthetic Joint Infection.Cureus · 2024Article
- Joint aspiration for diagnosis of chronic periprosthetic joint infection: when, how, and what tests?Arthroplasty (London, England) · 2023Review
- Diagnosis of Periprosthetic Joint Infection: The Utility of Biomarkers in 2023.Antibiotics (Basel, Switzerland) · 2023Review
- Profiling the Immune Response to Periprosthetic Joint Infection and Non-Infectious Arthroplasty Failure.Antibiotics (Basel, Switzerland) · 2023Review
- Simple and inexpensive synovial fluid biomarkers for the diagnosis of prosthetic joint infection according to the new EBJIS definition.Journal of bone and joint infection · 2023Article
- Predicting the Exception-CRP and Primary Hip Arthroplasty.Journal of clinical medicine · 2021Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiagnosis of periprosthetic joint infection (PJI), especially chronic PJI, is very confusing and challenging. The value of C-reactive protein (CRP) in infectious diseases has been recognized, but the diagnostic value of CRP in chronic PJI is unknown. Our aim was to investigate the diagnostic value of synovial CRP in chronic PJI and to explore the role of combined serum and synovial CRP in distinguishing chronic PJI from aseptic failure after knee and hip arthroplasties.
methodsWe prospectively enrolled patients scheduled to have a revision surgery for chronic PJI or aseptic loosening from January 2019 to December 2020, in which synovial CRP was additionally measured along with routine preoperative diagnostic serum ((ESR, CRP) and synovial (PMN%) biomarkers. The receiver operating characteristic (ROC) curves and area under the curve (AUC) were analyzed for each biomarker to determine diagnostic efficacy.
resultsThere were no statistically significant differences between the infection (n = 39) and aseptic (n = 58) groups, including 61 hips and 36 knees. The synovial CRP levels were significantly higher in the infection group than in the aseptic group (median: 9.93 mg/l vs 3.58 mg/l; p < .001). The optimal cut-off value for detecting chronic PJI of Synovial fluid (SF) CRP was of 7.26 mg/l with a sensitivity of 84.62%, a specificity of 93.10%. The combined model I (Serum CRP > 10.2 mg/l OR SF CRP > 7.26 mg/l) had a negative predictive value (NPV) of 96.67%, and a sensitivity of 97.44%. The combined model II (Serum CRP > 10.2 mg/l AND Synovial CRP > 7.26 mg/l) led to a specificity of 1, and a positive predictive value (PPV) of 1.
conclusionsThe present study demonstrated that the combination of serum and synovial CRP can be used as an adjunct to the diagnosis of chronic PJI.
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