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Periprostetik eklem enfeksiyonlarında preoperatif kan parametrelerinin tanısal değeri

Yıl 2023, , 133 - 138, 27.03.2023
https://doi.org/10.47582/jompac.1257586

Öz

Amaç: Periprostetik eklem enfeksiyonunun (PEE) tanısı kolay değildir ve tek bulgu yerine kombine bulguların sunulması ile konur. Bu çalışmanın amacı, PJI tanısında kan parametrelerinin rolünü araştırmaktır.
Gereç ve yöntem: Bu çalışmaya 2008-2018 yılları arasında aynı cerrah tarafından gerçekleştirilen total diz protezi ve total kalça protezi revizyonları dahil edildi. Hastaların ameliyat öncesi kan parametreleri kaydedildi. Hastalarla benzer demografik özelliklere sahip 69 primer artroplasti hastası da kontrol grubu olarak alındı.
Bulgular: Bu çalışmaya %79.0'u kadın (n=169) olmak üzere 214 artroplasti hastası dahil edildi. Hastalar 3 gruba ayrıldı; %32,2'si primer artroplasti, %36,9'u aseptik revizyon artroplastisi ve %30,8'i septik revizyon artroplastisi idi. Üç grup arasında demografik özellikler açısından fark yoktu. İkili karşılaştırmalarda preoperatif eritrosit sedimantasyon hızı (ESR), C-reaktif protein (CRP), lenfosit ve trombosit-lenfosit hızı (PLR) parametrelerinin septik grupta her iki aseptik gruba göre anlamlı olarak farklı olduğu bulundu. ve birincil artroplasti grubu. PJI'de aseptik hastalara göre ESR, CRP, lenfosit ve PLR'nin tanısal performanslarını değerlendirmek için çalışma karakteristik eğrilerini çizerek ileri analizler yapıldı.
Sonuç: Lenfosit, PLR, ESR ve CRP, PJI'yi öngörmede tanısal değere sahip olabilir. Bu nedenle, bu parametreler PJI için revizyon artroplastisine karar vermede yardımcı olabilir.

Kaynakça

  • Kurtz SM, Lau E, Watson H, Schmier JK, Parvizi J. Economic burden of periprosthetic joint infection in the United States. J Arthroplasty 2012; 27: 61-5.
  • Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 2007; 89: 780-5.
  • Kurtz SM, Ong KL, Lau E, Bozic KJ, Berry D, Parvizi J. Prosthetic joint infection risk after TKA in the Medicare population. Clin Orthop Relat Res 2010; 468: 52-6
  • Pulido L, Ghanem E, Joshi A, Purtill JJ, Parvizi J. Periprosthetic joint infection: the incidence, timing, and predisposing factors. Clin Orthop Relat Res 2008; 466: 1710-5.
  • Vanhegan IS, Malik AK, Jayakumar P, Ul Islam S, Haddad FS. A financial analysis of revision hip arthroplasty: the economic burden in relation to the national tariff. J Bone Joint Surg Br 2012; 94: 619-23
  • Peel TN, Dowsey MM, Buising KL, Liew D, Choong PF. Cost analysis of debridement and retention for management of prosthetic joint infection. Clin Microbiol Infect 2013; 19: 181-6.
  • Klouche S, Sariali E, Mamoudy P. Total hip arthroplasty revision due to infection: a cost analysis approach. Orthop Traumatol Surg Res 2010; 96: 124-32
  • Thiele K, Perka C, Matziolis G, Mayr HO, Sostheim M, Hube R. Current failure mechanisms after knee arthroplasty have changed: polyethylene wear is less common in revision surgery. J Bone Joint Surg Am 2015; 97: 715-20.
  • Jafari SM, Coyle C, Mortazavi SM, Sharkey PF, Parvizi J. Revision hip arthroplasty: infection is the most common cause of failure. Clin Orthop Relat Res 2010; 468 :2046-51.
  • Shang GQ, Xiang S, Guo CC, et al. Diagnostic value of platelet associated biomarkers in chronic periprosthetic joint infection. Zhonghua wai ke za zhi 2021; 59: 767-72.
  • Parvizi J, Zmistowski B, Berbari EF, et al. New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society. Clin Orthop Relat Res 2011; 469: 2992-94.
  • Parvizi J, Tan TL, Goswami K, et al. The 2018 definition of periprosthetic hip and knee infection: an evidence-based and validated criteria. J Arthroplasty 2018; 33: 1309-14.
  • Lee YS, Koo KH, Kim HJ, et al. Synovial fluid biomarkers for the diagnosis of periprosthetic joint infection: a systematic review and meta-analysis. J Bone Joint Surg Am 2017 ;99: 2077-84.
  • Shohat N, Tan TL, Della Valle CJ, et al. Development and Validation of an Evidence-Based Algorithm for Diagnosing Periprosthetic Joint Infection. J Arthroplasty 2019;
  • 342730-36.
  • Parvizi J, Ghanem E, Sharkey P, Aggarwal A, Burnett RS, Barrack R. Diagnosis of infected total knee: findings of a multicenter database. Clin Orthop Relat Res 2008 ;466: 2628-33.
  • Akgün D, Müller M, Perka C, Winkler T. The serum level of C-reactive protein alone cannot be used for the diagnosis of prosthetic joint infections, especially in those caused by organisms of low virulence. Bone Joint J 2018; 100: 1482-86.
  • Wyatt MC, Beswick AD, Kunutsor SK, Wilson MJ, Whitehouse MR, Blom AW. The alpha-defensin immunoassay and leukocyte esterase colorimetric strip test for the diagnosis of periprosthetic infection: a systematic review and meta-analysis. J Bone Joint Surg Am 2016; 98: 992-1000.
  • Tirumala V, Klemt C, Xiong L, Chen W, van den Kieboom J, Kwon YM. Diagnostic utility of platelet count/lymphocyte count ratio and platelet count/mean platelet volume ratio in periprosthetic joint infection following total knee arthroplasty. J Arthroplasty 2021; 36: 291-97.
  • Paziuk T, Rondon AJ, Goswami K, Tan TL, Parvizi J. A novel adjunct indicator of periprosthetic joint infection: platelet count and mean platelet volume. J Arthroplasty 2020; 35: 836-39.
  • Xu H, Xie J, Yang J, Chen G, Huang Q, Pei F. Plasma fibrinogen and platelet count are referable tools for diagnosing periprosthetic joint infection: a single-center retrospective cohort study. J Arthroplasty 2020; 35: 1361-67.

Diagnostic value of preoperative blood parameters in periprosthetic joint infections

Yıl 2023, , 133 - 138, 27.03.2023
https://doi.org/10.47582/jompac.1257586

Öz

Aim: Diagnosis of periprosthetic joint infection (PJI) is not easy and it is made by presenting of combined findings rather than a single finding. The aim of this study is to investigate the role of blood parameters in diagnosing PJI.
Material and Method: Revisions of total knee replacement and total hip replacement operated by the same surgeon between 2008 and 2018 were included in this study. Preoperative blood parameters of the patients were recorded. 69 primary arthroplasty patients with similar demographic characteristics to the patients were also included as the control group.
Results: 214 arthroplasty patients, 79.0% of whom were female (n=169), were included in this study. The patients were divided into 3 groups; 32.2% were primary arthroplasty, 36.9% were aseptic revision arthroplasty, and 30.8% were septic revision arthroplasty. There was no difference between the three groups in terms of demographic characteristics. In pairwise comparisons, preoperative erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), lymphocyte, and platelet-to-lymphocyte rate (PLR) parameters were found to be significantly different in the septic group when compared to both the aseptic group and the primary arthroplasty group. Further analyzes were performed to evaluate the diagnostic performances of ESR, CRP, lymphocyte, and PLR in PJI relative to aseptic patients by plotting to receive operating characteristic curves.
Conclusion: Lymphocyte, PLR, ESR, and CRP may have diagnostic value in predicting PJI. Therefore, these parameters may be helpful in deciding on revision arthroplasty for PJI.

Kaynakça

  • Kurtz SM, Lau E, Watson H, Schmier JK, Parvizi J. Economic burden of periprosthetic joint infection in the United States. J Arthroplasty 2012; 27: 61-5.
  • Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 2007; 89: 780-5.
  • Kurtz SM, Ong KL, Lau E, Bozic KJ, Berry D, Parvizi J. Prosthetic joint infection risk after TKA in the Medicare population. Clin Orthop Relat Res 2010; 468: 52-6
  • Pulido L, Ghanem E, Joshi A, Purtill JJ, Parvizi J. Periprosthetic joint infection: the incidence, timing, and predisposing factors. Clin Orthop Relat Res 2008; 466: 1710-5.
  • Vanhegan IS, Malik AK, Jayakumar P, Ul Islam S, Haddad FS. A financial analysis of revision hip arthroplasty: the economic burden in relation to the national tariff. J Bone Joint Surg Br 2012; 94: 619-23
  • Peel TN, Dowsey MM, Buising KL, Liew D, Choong PF. Cost analysis of debridement and retention for management of prosthetic joint infection. Clin Microbiol Infect 2013; 19: 181-6.
  • Klouche S, Sariali E, Mamoudy P. Total hip arthroplasty revision due to infection: a cost analysis approach. Orthop Traumatol Surg Res 2010; 96: 124-32
  • Thiele K, Perka C, Matziolis G, Mayr HO, Sostheim M, Hube R. Current failure mechanisms after knee arthroplasty have changed: polyethylene wear is less common in revision surgery. J Bone Joint Surg Am 2015; 97: 715-20.
  • Jafari SM, Coyle C, Mortazavi SM, Sharkey PF, Parvizi J. Revision hip arthroplasty: infection is the most common cause of failure. Clin Orthop Relat Res 2010; 468 :2046-51.
  • Shang GQ, Xiang S, Guo CC, et al. Diagnostic value of platelet associated biomarkers in chronic periprosthetic joint infection. Zhonghua wai ke za zhi 2021; 59: 767-72.
  • Parvizi J, Zmistowski B, Berbari EF, et al. New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society. Clin Orthop Relat Res 2011; 469: 2992-94.
  • Parvizi J, Tan TL, Goswami K, et al. The 2018 definition of periprosthetic hip and knee infection: an evidence-based and validated criteria. J Arthroplasty 2018; 33: 1309-14.
  • Lee YS, Koo KH, Kim HJ, et al. Synovial fluid biomarkers for the diagnosis of periprosthetic joint infection: a systematic review and meta-analysis. J Bone Joint Surg Am 2017 ;99: 2077-84.
  • Shohat N, Tan TL, Della Valle CJ, et al. Development and Validation of an Evidence-Based Algorithm for Diagnosing Periprosthetic Joint Infection. J Arthroplasty 2019;
  • 342730-36.
  • Parvizi J, Ghanem E, Sharkey P, Aggarwal A, Burnett RS, Barrack R. Diagnosis of infected total knee: findings of a multicenter database. Clin Orthop Relat Res 2008 ;466: 2628-33.
  • Akgün D, Müller M, Perka C, Winkler T. The serum level of C-reactive protein alone cannot be used for the diagnosis of prosthetic joint infections, especially in those caused by organisms of low virulence. Bone Joint J 2018; 100: 1482-86.
  • Wyatt MC, Beswick AD, Kunutsor SK, Wilson MJ, Whitehouse MR, Blom AW. The alpha-defensin immunoassay and leukocyte esterase colorimetric strip test for the diagnosis of periprosthetic infection: a systematic review and meta-analysis. J Bone Joint Surg Am 2016; 98: 992-1000.
  • Tirumala V, Klemt C, Xiong L, Chen W, van den Kieboom J, Kwon YM. Diagnostic utility of platelet count/lymphocyte count ratio and platelet count/mean platelet volume ratio in periprosthetic joint infection following total knee arthroplasty. J Arthroplasty 2021; 36: 291-97.
  • Paziuk T, Rondon AJ, Goswami K, Tan TL, Parvizi J. A novel adjunct indicator of periprosthetic joint infection: platelet count and mean platelet volume. J Arthroplasty 2020; 35: 836-39.
  • Xu H, Xie J, Yang J, Chen G, Huang Q, Pei F. Plasma fibrinogen and platelet count are referable tools for diagnosing periprosthetic joint infection: a single-center retrospective cohort study. J Arthroplasty 2020; 35: 1361-67.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Research Articles [en] Araştırma Makaleleri [tr]
Yazarlar

İzzet Korkmaz 0000-0001-7327-3809

Yayımlanma Tarihi 27 Mart 2023
Yayımlandığı Sayı Yıl 2023

Kaynak Göster

AMA Korkmaz İ. Diagnostic value of preoperative blood parameters in periprosthetic joint infections. J Med Palliat Care / JOMPAC / Jompac. Mart 2023;4(2):133-138. doi:10.47582/jompac.1257586

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