Articles | Volume 7, issue 3
https://doi.org/10.5194/jbji-7-109-2022
© Author(s) 2022. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-7-109-2022
© Author(s) 2022. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
Original full-length article
| 
17 May 2022
Original full-length article |
| 17 May 2022
| 17 May 2022
Usefulness of serum D-dimer and platelet count to mean platelet volume ratio to rule out chronic periprosthetic joint infection
Ernesto Muñoz-Mahamud
CORRESPONDING AUTHOR
Department of Orthopedics and Trauma Surgery, Hospital Clinic of
Barcelona, University of Barcelona, Barcelona, Spain
Eduard Tornero
Department of Orthopedics and Trauma Surgery, Hospital Clinic of
Barcelona, University of Barcelona, Barcelona, Spain
José A. Estrada
Department of Orthopedics and Trauma Surgery, Hospital Clinic of
Barcelona, University of Barcelona, Barcelona, Spain
Jenaro A. Fernández-Valencia
Department of Orthopedics and Trauma Surgery, Hospital Clinic of
Barcelona, University of Barcelona, Barcelona, Spain
Juan C. Martínez-Pastor
Department of Orthopedics and Trauma Surgery, Hospital Clinic of
Barcelona, University of Barcelona, Barcelona, Spain
Álex Soriano
Department of Infectious Diseases, Hospital Clinic of Barcelona,
University of Barcelona, Barcelona, Spain
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Cited articles
Abdelaziz, H., Rademacher, K., Suero, E. M., Gehrke, T., Lausmann, C., Salber, J., and Citak,
M.: The 2018 International Consensus Meeting Minor Criteria for chronic hip
and Knee Periprosthetic Joint Infection: Validation From a Single Center, J.
Arthroplasty, 35, 2200–2203, 2020.
Borgen, P. O., Dahl, O. E., and Reikeras, O.: Biomarkers of coagulation and fibrinolysis
during cemented total hip arthroplasty with pre- versus postoperative start
of thromboprophylaxis, Thrombosis, 2013, 563217, https://doi.org/10.1155/2013/563217, 2013.
Busso, N. and Hamilton, J. A.: Extravascular coagulation and the plasminogen
activator/ plasmin system in rheumatoid arthritis, Arthritis Rheum.,
46, 2268–2279, 2002.
Deirmengian, C., Kardos, K., Kilmartin, P., Cameron, A., Schiller, K., and Parvizi, J.:
Diagnosing periprosthetic joint infection: has the era of the biomarker
arrived?, Clin. Orthop. Relat. Res., 472, 3254–3262, 2014.
Feldman, D. S., Lonner, J. H., Desai, P., and Zuckerman, J. D.: The role of intraoperative
frozen sections in revision total joint arthroplasty, J. Bone Joint Surg. Am.,
77, 1807–1813, 1995.
Fernandez-Sampedro, M., Salas-Venero, C., Fariñas-Álvarez, C., Sumillera,
M., Pérez-Carro, L., Fakkas-Fernandez, M., Gómez-Román, J.,
Martínez-Martínez, L., and Fariñas, M. C.: 26Postoperative diagnosis and
outcome in patients with revision arthroplasty for aseptic loosening, BMC
Infect Dis., 15, 232, https://doi.org/10.1186/s12879-015-0976-y, 2015.
Gris, J. C., Bouvier, S., Cochery-Nouvellon, E., Faillie, J. L., Lissalde-Lavigne, G.,
and Lefrant, J. Y.: Fibrin-related markers in patients with septic shock: individual
comparison of D-dimers and fibrin monomers impacts on prognosis, Thromb
Haemost., 106, 1228–1130, 2011.
Hansrani, V., Khanbhai, M., and McCollum, C.: The diagnosis and management of early
deep vein thrombosis, Adv. Exp. Med. Biol., 906, 23–31, 2017.
Hao, W., Zhichao, M., Liping, P., Heng, L., Xin, Y., and Yongping, C.: Plasma Fibrinogen
Performs Better than Plasma D-Dimer and Fibrin Degradation Product in the
Diagnosis of Periprosthetic Joint Infection and Determination of
Reimplantation Timing, J. Arthroplasty, 35, 2230–2236, 2020.
Hu, Q., Fu, Y., and Tang, L.: Serum D-dimer as a diagnostic index of PJI and
retrospective analysis of etiology in patients with PJI, Clin. Chim. Acta.,
13, 67–71, 2020.
Li, R., Shao, H. Y., Hao, L. B., Yu, B. Z., Qu, P. F., Zhou, Y. X., and Chen, J. Y.:
Plasma fibrinogen exhibits better performance than plasma D-dimer in
the diagnosis of periprosthetic joint infection: a multicenter retrospective
study, J. Bone Joint Surg. Am., 3, 613–619, 2019.
Mirra, J. M., Amstutz, H. C., Matos, M., and Gold, R.: The pathology of the joint tissues
and its clinical relevance in prosthesis failure, Clin. Orthop. Relat. Res., 117,
221–240, 1976.
Pannu, T. S., Villa, J. M., Patel, P. D., Riesgo, A. M., Barsoum, W. K., and Higuera, C. A.: The Utility
of Serum D-dimer for the Diagnosis of Periprosthetic Joint Infection in
Revision Total Hip and Knee Arthroplasty, J. Arthroplasty.,
35, 1692–1695, 2020a.
Pannu, T. S., Villa, J. M., Riesgo, A. M., Patel, P. D., Barsoum, W. K., and Higuera-Rueda, C. A.:
Serum D-Dimer in the Diagnosis of Periprosthetic Knee Infection: Where Are
We Today?, J. Knee Surg., 33, 106–110, 2020b.
Parvizi, J. and Della Valle, C. J.: AAOS clinical practice guideline: diagnosis and
treatment of periprosthetic joint infections of the hip and knee, J. Am. Acad.
Orthop. Surg., 18, 771–772, 2010.
Parvizi, J., Tan, T. L., Goswami, K., Higuera, C., Della Valle, C., Chen, A. F., and Shohat, N.:
The 2018 definition of periprosthetic hip and knee infection: an evidence-based and validated criteria, J. Arthroplasty., 33, 1309–1314,
2018.
Paziuk, T., Rondon, A. J., Goswami, K., Tan, T. L., and Parvizi, J.: A Novel Adjunct Indicator
of Periprosthetic Joint Infection: Platelet Count and Mean Platelet Volume,
J. Arthroplasty., 35, 836–839, 2020.
Ribera, T., Monreal, L., Armengou, L., Ríos, J., and Prades, M.: Synovial fluid
D-dimer concentration in foals with septic joint disease, J. Vet. Intern. Med.,
25, 1113–1117, 2011.
Schwameis, M., Steiner, M. M., Schoergenhofer, C., Lagler, H., Buchtele, N., Jilma-Stohlawetz, P., Boehm, T., and Jilma, B.: D-dimer and histamine in early stage
bacteremia: a prospective controlled cohort study, Eur. J. Intern. Med.,
26, 782–786, 2015.
Shahi, A., Kheir, M. M., Tarabichi, M., Hosseinzadeh, H. R. S., Tan, T. L., and Parvizi, J.: Serum
D- dimer test is promising for the diagnosis of periprosthetic joint
infection and timing of reimplantation, J. Bone Joint Surg. Am., 99, 1419e27, https://doi.org/10.2106/JBJS.16.01395,
2017.
Staats, K., Kolbitsch, P., Sigmund, I. K., Hobusch, G. M., Holinka, J., and Windhager, R.:
Outcome of Total Hip and Total Knee Revision Arthroplasty With Minor
Infection Criteria: A Retrospective Matched-Pair Analysis, J Arthroplasty.,
32, 1266–1271, 2017.
Vargas-Reverón, C., Soriano, A., Fernández-Valencia, J. A.,
Martínez-Pastor, J. C., Morata, L., and Muñoz-Mahamud, E.: Prevalence and
Impact of Positive Intraoperative Cultures in Partial Hip or Knee Revision,
J. Arthroplasty., 35, 1912–1916, 2020.
Wang, R., Zhang, H., Ding, P., and Jiao, Q.: The accuracy of D-dimer in the diagnosis of
periprosthetic infections: a systematic review and meta-analysis, J. Orthop.
Surg. Res., 16, 99, https://doi.org/10.1186/s13018-022-03001-y, 2022.
Xu, H., Xie, J., Huang, Q., Lei, Y., Zhang, S., and Pei, F.: Plasma fibrin degradation
product and D-dimer are of limited value for diagnosing periprothetic joint
infection, J. Arthroplasty., 34, 2454–2460, 2019.
Short summary
A patient with normal D-dimer value has a low risk of prosthetic joint infection, so serum D-dimer assessment should always be considered as a useful test to rule out chronic prosthetic joint infection (especially in those cases caused by low-virulence microorganisms in which conventional tests may lead to misdiagnosis). Conversely, the platelet count to mean platelet volume ratio may be of limited value for accurately diagnosing prosthetic joint infection.
A patient with normal D-dimer value has a low risk of prosthetic joint infection, so serum...
