Use of Common Inflammatory Markers in the Long-Term Screening of Total Hip Arthroprosthesis Infections: Our Experience

Orthopedic implants have become essential components of modern medicine. The risk of infection of total hip arthroplasty (THA) is 1.5%−2%. Are the C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) good markers for THA infection screenings? From February 2009...

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Main Authors: Gabriele Falzarano, Antonio Piscopo, Predrag Grubor, Giuseppe Rollo, Antonio Medici, Valerio Pipola, Michele Bisaccia, Auro Caraffa, Elizabeth Mary Barron, Francesco Nobile, Raffaele Cioffi, Luigi Meccariello
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Advances in Orthopedics
Online Access:http://dx.doi.org/10.1155/2017/9679470
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author Gabriele Falzarano
Antonio Piscopo
Predrag Grubor
Giuseppe Rollo
Antonio Medici
Valerio Pipola
Michele Bisaccia
Auro Caraffa
Elizabeth Mary Barron
Francesco Nobile
Raffaele Cioffi
Luigi Meccariello
author_facet Gabriele Falzarano
Antonio Piscopo
Predrag Grubor
Giuseppe Rollo
Antonio Medici
Valerio Pipola
Michele Bisaccia
Auro Caraffa
Elizabeth Mary Barron
Francesco Nobile
Raffaele Cioffi
Luigi Meccariello
author_sort Gabriele Falzarano
collection DOAJ
description Orthopedic implants have become essential components of modern medicine. The risk of infection of total hip arthroplasty (THA) is 1.5%−2%. Are the C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) good markers for THA infection screenings? From February 2009 to December 2012 at our Department of Orthopedics and Traumatology, 1248 patients were treated with THA. No prosthesis was cemented. All patients received antibiotic prophylaxis. All patients were discharged approximately 7.4 days after surgery with this clinical and radiographic follow-up program at 15 days and 1, 3, 6, 12, 24, and 36 months after surgery. Blood samples to determine ESR, CRP, and PCT values were taken at 1 hour before surgery and 15 days and 1, 3, 6, 12, 24, and 36 months after surgery. During follow-ups there were 22 cases of THA infections; according the Widmer classification, infections are hematogenous ones in 16 cases, late chronic ones in 5 cases, and early postoperative ones in 1 case. In all cases the three markers were considered positive; in 6 cases there were no radiological signs of septic loosening. ESR, CRP, and PCT proved to have a greater diagnostic accuracy than X-rays in predicting late chronic and early postoperative infections. These markers are valuable support for the surgeon in monitoring the prosthetic implant lifespan.
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spelling doaj-art-e476bc49a0434f1fbaf1e21800827d092025-08-20T02:21:34ZengWileyAdvances in Orthopedics2090-34642090-34722017-01-01201710.1155/2017/96794709679470Use of Common Inflammatory Markers in the Long-Term Screening of Total Hip Arthroprosthesis Infections: Our ExperienceGabriele Falzarano0Antonio Piscopo1Predrag Grubor2Giuseppe Rollo3Antonio Medici4Valerio Pipola5Michele Bisaccia6Auro Caraffa7Elizabeth Mary Barron8Francesco Nobile9Raffaele Cioffi10Luigi Meccariello11Department of Orthopedics and Traumatology, Azienda Ospedaliera “Gaetano Rummo”, Benevento, ItalyDepartment of Orthopedics and Traumatology, Sacro Cuore di Gesù Fatebenefratelli Hospital, Benevento, ItalyClinic of Traumatology, University Hospital Clinical Center Banja Luka, Banja Luka, Bosnia and HerzegovinaDepartment of Orthopedics and Traumatology, Vito Fazzi Hospital, Lecce, ItalyDepartment of Orthopedics and Traumatology, Azienda Ospedaliera “Gaetano Rummo”, Benevento, ItalyRizzoli Orthopedic Institute, University of Bologna, Bologna, ItalyDivision of Orthopedics and Trauma Surgery, University of Perugia, S. Maria della Misericordia Hospital, Perugia, ItalyDivision of Orthopedics and Trauma Surgery, University of Perugia, S. Maria della Misericordia Hospital, Perugia, ItalySchool of Medicine, Central Michigan University, Mount Pleasant, MI, USADepartment of Orthopedics and Traumatology, Hospital “Santa Maria alla Gruccia”, Montevarchi, Arezzo, ItalyDepartment of Orthopedics and Traumatology, Azienda Ospedaliera “Gaetano Rummo”, Benevento, ItalyDivision of Orthopedics and Trauma Surgery, University of Perugia, S. Maria della Misericordia Hospital, Perugia, ItalyOrthopedic implants have become essential components of modern medicine. The risk of infection of total hip arthroplasty (THA) is 1.5%−2%. Are the C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) good markers for THA infection screenings? From February 2009 to December 2012 at our Department of Orthopedics and Traumatology, 1248 patients were treated with THA. No prosthesis was cemented. All patients received antibiotic prophylaxis. All patients were discharged approximately 7.4 days after surgery with this clinical and radiographic follow-up program at 15 days and 1, 3, 6, 12, 24, and 36 months after surgery. Blood samples to determine ESR, CRP, and PCT values were taken at 1 hour before surgery and 15 days and 1, 3, 6, 12, 24, and 36 months after surgery. During follow-ups there were 22 cases of THA infections; according the Widmer classification, infections are hematogenous ones in 16 cases, late chronic ones in 5 cases, and early postoperative ones in 1 case. In all cases the three markers were considered positive; in 6 cases there were no radiological signs of septic loosening. ESR, CRP, and PCT proved to have a greater diagnostic accuracy than X-rays in predicting late chronic and early postoperative infections. These markers are valuable support for the surgeon in monitoring the prosthetic implant lifespan.http://dx.doi.org/10.1155/2017/9679470
spellingShingle Gabriele Falzarano
Antonio Piscopo
Predrag Grubor
Giuseppe Rollo
Antonio Medici
Valerio Pipola
Michele Bisaccia
Auro Caraffa
Elizabeth Mary Barron
Francesco Nobile
Raffaele Cioffi
Luigi Meccariello
Use of Common Inflammatory Markers in the Long-Term Screening of Total Hip Arthroprosthesis Infections: Our Experience
Advances in Orthopedics
title Use of Common Inflammatory Markers in the Long-Term Screening of Total Hip Arthroprosthesis Infections: Our Experience
title_full Use of Common Inflammatory Markers in the Long-Term Screening of Total Hip Arthroprosthesis Infections: Our Experience
title_fullStr Use of Common Inflammatory Markers in the Long-Term Screening of Total Hip Arthroprosthesis Infections: Our Experience
title_full_unstemmed Use of Common Inflammatory Markers in the Long-Term Screening of Total Hip Arthroprosthesis Infections: Our Experience
title_short Use of Common Inflammatory Markers in the Long-Term Screening of Total Hip Arthroprosthesis Infections: Our Experience
title_sort use of common inflammatory markers in the long term screening of total hip arthroprosthesis infections our experience
url http://dx.doi.org/10.1155/2017/9679470
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