J Korean Orthop Assoc.  2012 Apr;47(2):133-139. 10.4055/jkoa.2012.47.2.133.

Prediction of Early Postoperative Infection after Arthroplasty Using the C-Reactive Protein Level

• Suh YS
• Choi HS
• Nho JH
• Won SH
• Choi JW
• Lee JC
• Park JS

• KMID: 2185389
• DOI: http://doi.org/10.4055/jkoa.2012.47.2.133

Abstract

PURPOSE
C-reactive protein (CRP) has been shown to be useful in the diagnosis of periprosthetic infection. This study analyzed the serial CRP measurements in patients with acute postoperative infection by comparing with the serial CRP measurements in patients without postoperative infection.
MATERIALS AND METHODS
From 2004 to 2009, 33 patients with acute postoperative infection developed within 4 weeks of surgery were enrolled including 26 cases of hip arthroplasty and 7 cases of total knee arthroplasty. We measured the serial CRP levels in the groups with both deep infection and superficial infection. The CRP measurements in the group without postoperative infection were also analyzed based on the changing pattern of CRP.
RESULTS
In the non-infected group, CRP level sharply increased in 2-3 days postoperatively and it showed a continuing downward pattern till the third postoperative week. However, a bimodal curve pattern was obtained in the groups with both deep and superficial infection. The group with deep infection showed a second increase in CRP level around the 13th postoperative day and the group with superficial infection showed a second increase in CRP level around the 10th postoperative day.
CONCLUSION
If there are bimodal patterns of CRP after arthroplasty, acute postoperative infections can be suspected. We can treat them effectively without delay by detection of bimodal increase in CRP.

Keyword

hip; knee; C-reactive protein; infection; arthroplasty

MeSH Terms

Arthroplasty
C-Reactive Protein
Hip
Humans
Knee
C-Reactive Protein

Figure

• 

  Figure 1 Changing pattern of CRP in deep infection (--▲--), superficial infection (--•--) and no infection groups (‥■‥). Both the deep and superficial infection groups showed bimodal increase in the CRP level around the 3rd or 4th period. CRP, C-reactive protein.

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