Periprostetik Eklem Enfeksiyonu Tanısında C-Reaktif ve Procalcitonin Sensitivite ve Spesifiteleri

GİRİŞ ve AMAÇ: Periprostetik enfeksiyonların tanısında laboratuar testlerinin değeri halen tartışmalıdır. Bu çalışmanın amacı enfekte total kalça ve diz artroplastisi hastalarında pozitif ve negatif mikrobiyolojik kültür sonuçları ile mukayeseli olarak CRP ve PCT değerlerinin tanı koymadaki duyarlılık ve özgüllüğünü değerlendirmektir. YÖNTEM ve GEREÇLER: Bu çalışmada enfekte total kalça veya total diz artroplastisi tanısı ile tedavi edilmiş toplam 40 hastanın klinik verileri retrospektif olarak değerlendirildi. Serum CRP ve PCT değerleri ile birlikte cerrahi olarak elde edilmiş mikrobiyolojik kültür sonuçları kaydedildi. Kültür sonuçları da pozitif ve negatif olarak sınıflandı. Buna göre her iki gruptaki hastalarda CRP ve PCT nin sensitivite ve spesifitesi dğerlendirildi. BULGULAR: Çalışmada elde edilen verilere göre periprostetik enfeksiyon tanısında CRP’nin duyarlılığı %100 ve özgüllüğü %52.6; PCT’nin ise duyarlılığı %85.7 ve özgüllüğü %95.7 tespit edilmiştir. TARTIŞMA ve SONUÇ: CRP periprostetik enfeksiyon tanısında yüksek duyarlılığa PCT ise yüksek spesifitye sahip değerli serolojik belirteçlerdir. Ortopedik cerrahlar periprostetik eklem enfeksiyonlarının tanısında bu iki belirteci göz önünde bulundurmalı ve gerekirse bir arada kullanmalıdır.

C-Reactive Protein and Procalcitonin Sensitivity and Specificities in the Diagnosis of Periprosthetic Joint Infections

INTRODUCTION: The value of laboratory tests in the diagnosis of periprosthetic infections is still controversial. The aim of this study was to evaluate the sensitivity and specificity of CRP and PCT values in comparison with the positive and negative microbiological culture results in infected total hip and knee arthroplasty patients.METHODS: In this study, clinical data of a total of 40 patients with infected total hip or total knee arthroplasty were evaluated retrospectively. Microbiological culture results that were obtained surgically together with serum CRP and PCT values were recorded. Culture results were also classified as positive and negative. Accordingly, sensitivity and specificity of CRP and PCT were evaluated in both groups.RESULTS: According to the data obtained in the study, thesensitivity of CRP in the diagnosis of periprosthetic infectionwas 100% and the specificity was 52.6%; PCT sensitivity was85.7% and specificity was 95.7%.DISCUSSION and CONCLUSION: CRP with high sensitivity and PCT with high specificity, are valuable serological markers with in the diagnosis of periprosthetic infection. Orthopedic surgeons should consider these two markers in the diagnosis of periprosthetic joint infections and use them together if necessary.

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