{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,22]],"date-time":"2025-02-22T00:36:48Z","timestamp":1740184608361,"version":"3.37.3"},"reference-count":13,"publisher":"Universa BV","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Orthop Belg"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:p>The treatment of prosthetic joint infections (PJI) regularly involves a two-stage surgical strategy. The second stage is generally performed when the surgeon estimates that the infection is under control based on either the treatment length or clinical and biological data. We have raised the question whether standardization of C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR) values could be either indicative of infection control or predictive of infection recurrence.\n\nThis was an analytical retrospective and monocentric cross-sectional observational study. The CRP and NLR values were recorded prior to the second-stage surgery in a sample of 100 patients who underwent a two-stage revision arthroplasty following a PJI, and these values were correlated with the absence of infectious recurrence within a 2-year follow-up.\n\nThe statistical analysis consisted of evaluating the diagnostic validity of each marker, first individually, and then in combination.\n\nCRP was shown associated with a 68% sensitivity, 40% specificity, 27% positive predictive value (PPV), and 79% negative predictive value (NPV). The ROC curve was 51.1%. The NLR displayed a 12% sensitivity, 89% specificity, 27% PPV, and 75% NPV. The ROC curve was 47.9%. The combination of the two markers did not fundamentally improve the statistical results, with only a 43% concordance of the two markers, 27% sensitivity, 84% specificity, 37% PPV, and 77% NPV.\n\nMeasuring CRP and NLR values, either individually or in combination, before the second-stage revision arthroplasty did not turn out to be predictive of either infection recurrence or cure within two years of follow-up. Therefore, an absolute test is still lacking, which would enable us to predict without failure the absence of control or the control of a PJI before or after second-stage revision.\n\nLevel of evidence: Level III, retrospective cross-sectional study.<\/jats:p>","DOI":"10.52628\/89.4.11123","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T13:13:11Z","timestamp":1704892391000},"page":"659-664","source":"Crossref","is-referenced-by-count":1,"title":["Are C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR) predictive markers of successful two-stage prosthetic joint infection management?"],"prefix":"10.52628","volume":"89","author":[{"given":"M","family":"ECKI","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"POILVACHE","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"RANDY BUZISA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"VAN CAUTER","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"RODRIGUEZ-VILLALOBOS","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.-C.","family":"YOMBI","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O","family":"CORNU","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"27062","published-online":{"date-parts":[[2024,1]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Deirmengian, C., Kardos, K., Kilmartin, P., Cameron, A., Schiller, K., & Parvizi, J. (2014). Diagnosing Periprosthetic Joint Infection: Has the Era of the Biomarker Arrived?. Clinical Orthopaedics And Related Research\u00ae, 472(11), 3254-3262. http:\/\/dx.doi.org\/10.1007\/s11999-014-3543-8","DOI":"10.1007\/s11999-014-3543-8"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Nodzo, S., Bauer, T., Pottinger, P., Garrigues, G., Bedair, H., & Deirmengian, C. et al. (2015). Conventional Diagnostic Challenges in Periprosthetic Joint Infection. Journal Of The American Academy Of Orthopaedic Surgeons, 23, S18-S25. http:\/\/dx.doi.org\/10.5435\/jaaos-d-14-00385","DOI":"10.5435\/jaaos-d-14-00385"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Ghanem, E., Azzam, K., Seeley, M., Joshi, A., & Parvizi, J. (2009). Staged Revision for Knee Arthroplasty Infection: What Is the Role of Serologic Tests Before Reimplantation?. Clinical Orthopaedics And Related Research\u00ae, 467(7), 1699-1705. http:\/\/dx.doi.org\/10.1007\/s11999-009-0742-9","DOI":"10.1007\/s11999-009-0742-9"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Deirmengian, C., Kardos, K., Kilmartin, P., Cameron, A., Schiller, K., & Parvizi, J. (2014). Combined Measurement of Synovial Fluid -Defensin and C-Reactive Protein Levels: Highly Accurate for Diagnosing Periprosthetic Joint Infection. The Journal Of Bone & Joint Surgery, 96(17), 1439-1445. http:\/\/dx.doi.org\/10.2106\/jbjs.m.01316","DOI":"10.2106\/jbjs.m.01316"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Forget, Patrice ; Moreau, Nicolas ; Engel, Harald ; Cornu, Olivier ; Boland, Beno\u00eet ; et. al. The neutrophil-to-lymphocyte ratio (NLR) after surgery for hip fracture (HF). In: Archives of Gerontology and Geriatrics, Vol. 60, no. 2, p. 366-371 (2015)","DOI":"10.1016\/j.archger.2014.11.008"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Go\u0308lge, UH., Kaymaz, B., Pazarc\u0131, O\u0308 ., K\u0131l\u0131nc\u0327, S., O\u0308 ztemur, Z., Bulut, O. (2015). Neutrophil to Lym- phocyte Ratio May Be a Diagnostic Marker for Prosthetic Joint Infection. J Clin Anal Med. DOI: 10.4328\/JCAM.3918.","DOI":"10.4328\/JCAM.3918"},{"key":"ref6","unstructured":"Oschner, P., Borens, O., Bodler, P-M., Broger, I., Eich, G., Hefti, F., Maurer, T., No\u0308tzli, H., Seiler, S., Suva\u0300, D., Trampuz, A., Uc\u0327kay, I., Vogt, M., & Zimmerli, W. (2014). Infections of the musculoskeletal system : Basic principles, prevention, diagnosis and treatement. Granvaux, Switzerland: Swiss orthopaedics in-house publisher."},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Ghanem, E., Azzam, K., Seeley, M., Joshi, A., & Parvizi, J. (2009). Staged Revision for Knee Arthroplasty Infection: What Is the Role of Serologic Tests Before Reimplantation?. Clinical Orthopaedics And Related Research\u00ae, 467(7), 1699-1705. http:\/\/dx.doi.org\/10.1007\/s11999-009-0742-9","DOI":"10.1007\/s11999-009-0742-9"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Schindler, M., Christofilopoulos, P., Wyssa, B., Belaieff, W., Garzoni, C., & Bernard, L. et al. (2010). Poor performance of microbiological sampling in the prediction of recurrent arthroplasty infection. International Orthopaedics, 35(5), 647- 654. http:\/\/dx.doi.org\/10.1007\/s00264-010-1014-8","DOI":"10.1007\/s00264-010-1014-8"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Bilgen, O., Atici, T., Durak, K., Karaeminogullari, O., Bilgen, MS. (2001). C-reactive protein values and erythrocyte sedi- mentation rates after total hip and total knee arthroplasty. J Int Med Res 29:7-12.","DOI":"10.1177\/147323000102900102"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Thienpont, E., Grosu, I., Jonckheere, S., & Yombi, J. (2012). C-reactive protein (CRP) in different types of minimally invasive knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy, 21(11), 2603-2610. http:\/\/dx.doi.org\/10.1007\/s00167-012-2345-3","DOI":"10.1007\/s00167-012-2345-3"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Yombi, J., Schwab, P., & Thienpont, E. (2015). Neutro-phil- to-lymphocyte ratio (NLR) distribution shows a better kinetic pattern than C-reactive protein distribution for the follow-up of early inflammation after total knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy, 24(10), 3287-3292. http:\/\/dx.doi.org\/10.1007\/s00167-015-3921-0","DOI":"10.1007\/s00167-015-3921-0"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Go\u0308lge, UH., Kaymaz, B., Pazarc\u0131, O\u0308 ., K\u0131l\u0131nc\u0327, S., O\u0308 ztemur, Z., Bulut, O. (2015). Neutrophil to Lym- phocyte Ratio May Be a Diagnostic Marker for Prosthetic Joint Infection. J Clin Anal Med. 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