Hematological markers of periprosthetic joint infection after revision total hip arthroplasty

Abstract

Analysis of clinical and laboratory tests is essential for monitoring the course of infectious complications after total hip arthroplasty (THA). The objective was to assess the reliability of differences in hematological parameters in patients with periprosthetic joint infection (PJI) for monitoring the infectious process. Material and methods Patients with acute (lasting 21.8 days on average) and chronic (lasting for 26.3 months on average) PJI were screened for hematological parameters on admission and during treatment in order to control the course of the purulent-inflammatory process. Results Preoperative parameters demonstrated mild anemia in patients with acute PJI, and the hemoglobin concentration was normal in patients with chronic PJI. Patients of both groups showed normal total leukocyte count. ESR and C-reactive protein levels were many times higher than the threshold values. The C-reactive protein level was more than 2 times higher in patients with acute PJI than that in patients with a chronic infection. The ratio of ESR / C-reactive protein was normally greater than 5 units, from 3 to 4.5 in chronic PJI and from 1.5 to 2.3 in acute PJI. Discussion Examination of pre- and postoperative clinically significant parameters is practical for identification of the criteria to assess the risk of chronic PJI. Conclusion Patients with acute PJI need no additional clinical and laboratory examination, integral laboratory parameters can be employed for accurate assessment of the extent of inflammation in a purulent wound.

Keywords

• hip joint
• revision total hip arthroplasty
• blood
• periprosthetic joint infection