Sensitivity (ability to detect PJI when present) was 81.3% for D-dimer, 90.4% for CRP, 73.9% for ESR, and 74.7% for fibrinogen. The four tests had "comparable accuracy" for the diagnosis of PJI. Immediately before surgery, all patients underwent a blood draw and the levels of D-dimer, CRP, and ESR, and fibrinogen were measured.Īfter application of the 2018 International Consensus Meeting definition of PJI, 23% of patients were found to have PJI.
Over a four-year period, the study prospectively enrolled 502 patients undergoing revision knee or hip arthroplasty regardless of their surgical indication. Parvizi and colleagues compared plasma D-dimer and other tests for the diagnosis of PJI. However, some subsequent studies have raised concerns about the diagnostic performance of D-dimer testing for PJI, and its true accuracy remains unknown. It is also a potentially useful marker of infection and has been validated for use in the diagnosis of PJI. Plasma D-dimer is a commonly used test for certain blood clot-related disorders. However, both have limitations, including a high rate of false-negative results when PJI is present. Two common markers of inflammation – C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) – are recommended as screening tests for suspected PJI. Diagnosis of PJI can be "extremely challenging," according to the authors, as no single test has "absolute accuracy" in determining whether or not PJI is present. PJI is a devastating complication of failed total hip or knee replacement and is one of the leading causes of implant failure. Plasma D-dimer measurement has "comparable diagnostic accuracy" to other commonly used tests for identifying PJI, and in some situations outperforms the standard tests, according to the new research by Javad Parvizi, MD, FRCS, and colleagues of Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia.Ĭan D-dimer help in making the difficult diagnosis of PJI? The journal is published in the Lippincott portfolio in partnership with Wolters Kluwer. Newswise - February 10, 2023 – Measurement of plasma D-dimer levels – a test more commonly used to detect blood-clotting disorders – can provide useful information when making the difficult diagnosis of periprosthetic joint infection (PJI), reports a study in The Journal of Bone & Joint Surgery.
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