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Journal of Bone and Joint Infection An open-access journal of the European Bone and Joint Infection Society and the MusculoSkeletal Infection Society
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Determining whether periprosthetic joint infections are acute or chronic can be a challenge for the arthroplasty surgeon. We present data that support the use of the ratio between the ESR and CRP in patients with PJI. Using this simple calculation of the ESR / CRP ratio, surgeons may have more confidence in determining whether an infection is acute or chronic, which can aid in treatment decisions.
JBJI | Articles | Volume 6, issue 6
J. Bone Joint Infect., 6, 229–234, 2021
https://doi.org/10.5194/jbji-6-229-2021
J. Bone Joint Infect., 6, 229–234, 2021
https://doi.org/10.5194/jbji-6-229-2021

Original full-length article 08 Jun 2021

Original full-length article | 08 Jun 2021

Acute or chronic periprosthetic joint infection? Using the ESR ∕ CRP ratio to aid in determining the acuity of periprosthetic joint infections

Zachary K. Christopher et al.

Cited articles

Azzam, K. A., Seeley, M., Ghanem, E., Austin, M. S., Purtill, J. J., and Parvizi, J.: Irrigation and Debridement in the Management of Prosthetic Joint Infection: Traditional Indications Revisited, J. Arthroplasty, 25, 1022–1027, https://doi.org/10.1016/j.arth.2010.01.104, 2010. 
Bedair, H., Ting, N., Jacovides, C., Saxena, A., Moric, M., Parvizi, J., and Della Valle, C. J.: The Mark Coventry Award: Diagnosis of Early Postoperative TKA Infection Using Synovial Fluid Analysis, Clin. Orthop. Relat. Res., 469, 34–40, https://doi.org/10.1007/s11999-010-1433-2, 2011. 
Berend, K. R., Lombardi, A. V., Morris, M. J., Bergeson, A. G., Adams, J. B., and Sneller, M. A.: Two-stage Treatment of Hip Periprosthetic Joint Infection Is Associated With a High Rate of Infection Control but High Mortality, Clin. Orthop. Relat. Res., 471, 510–518, https://doi.org/10.1007/s11999-012-2595-x, 2013. 
Bingham, J. S., Hassebrock, J. D., Christensen, A. L., Beauchamp, C. P., Clarke, H. D., and Spangehl, M. J.: Screening for Periprosthetic Joint Infections With ESR and CRP: The Ideal Cutoffs, J. Arthroplasty, 35, 1351–1354, https://doi.org/10.1016/j.arth.2019.11.040, 2020. 
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Short summary
Determining whether periprosthetic joint infections are acute or chronic can be a challenge for the arthroplasty surgeon. We present data that support the use of the ratio between the ESR and CRP in patients with PJI. Using this simple calculation of the ESR / CRP ratio, surgeons may have more confidence in determining whether an infection is acute or chronic, which can aid in treatment decisions.
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