TY  - JOUR
AB  - D-dimer has been included in the criteria by the Musculoskeletal Infection Society in 2018 as a novel parameter to diagnose prosthetic joint infection (PJI). However, it is unclear how D-dimer levels change in between stages of a two-stage exchange. We prospectively investigated 30 patients who underwent a two-stage exchange using a spacer for PJI. D-Dimer, CRP and IL-6 were collected before first and second stage surgery and the difference (Δ) in between stages was calculated. The levels of plasma D-Dimer did not change from first to second stage surgery (2770 ng/ml (IQR, 1600–3770 ng/ml) versus 2340 ng/ml (IQR, 1270–4100 ng/ml); p = 0.8) while CRP (4.0 mg/dl (IQR, 1.7–5.5 mg/dl) versus 0.6 mg/dl (IQR, 0.5–0.8 mg/dl); p < 0.001) and IL-6 (21 pg/ml (IQR, 10–29 pg/ml) versus 6 pg/ml (4–9 pg/ml); p < 0.001) decreased. The ΔD-dimer between both stages was 300 ng/ml (range: − 2820 to 4280 ng/ml), the median ΔCRP was − 3.4 mg/dl (IQR, − 1.2 to − 4.8 mg/dl) and ΔIL-6 was − 13 pg/ml (IQR, − 4 to − 20 pg/ml). In 15 of 30 cases (50%) the D-dimer level increased between both stages, whereas the level of CRP (93%; 28/30) and IL-6 (96%; 28/29) decreased in most patients. As the level of serum D-dimers varies greatly, lacks a uniform decrease and does not identify persisting infection, surgeons should be cautious when using it at the timing of reimplantation.
AU  - Ackmann, Thomas
AU  - Schwarze, Jan
AU  - Gosheger, Georg
AU  - Schmidt-Bräkling, Tom
AU  - Schneider, Kristian Nikolaus
AU  - Dieckmann, Ralf
AU  - Klingebiel, Sebastian
AU  - Möllenbeck, Burkhard H. M.
AU  - Theil, Jan-Christoph
DA  - 2021-04-01
DO  - 10.17879/32049570554
KW  - Biomarkers
KW  - Diagnostic markers
LA  - eng
N1  - Scientific Reports 11 (2021) 7323, 1-6
N1  - Finanziert über die DEAL-Vereinbarung mit Wiley 2019-2022.
PY  - 2021-04-01
TI  - The change in plasma D-dimer does not help to guide the timing of reimplantation in two stage exchange for periprosthetic joint infection
UR  - https://nbn-resolving.org/urn:nbn:de:hbz:6-82039732830
Y2  - 2024-11-22T03:28:04
ER  -