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Inflammation Biomarkers ID Prosthetic Joint Infection

Interleukin-6, C-reactive protein, and others can detect undiagnosed infection prior to surgery

THURSDAY, Sept. 9 (HealthDay News) -- Several inflammation biomarkers, including interleukin-6, C-reactive protein level, erythrocyte sedimentation rate, and white blood-cell count, can effectively diagnose prosthetic joint infection at the time of total hip or knee arthroplasty, according to a meta-analysis published in the Sept. 1 issue of the Journal of Bone & Joint Surgery.

Elie Berbari, M.D., of the Mayo Clinic College of Medicine in Rochester, Minn., and colleagues screened 327 studies from 1950 to 2009 and pooled data from 30 studies involving 3,909 revision total hip or knee arthroplasties to evaluate the accuracy of several inflammation markers -- white blood-cell count (15 studies), erythrocyte sedimentation rate (25 studies), serum C-reactive protein level (23 studies), and serum interleukin-6 (three studies) -- for the diagnosis of prosthetic joint infection.

There was a 32.5 percent prevalence of prosthetic joint infection in the pooled patient populations. The researchers calculated the diagnostic odds ratios associated with the selected inflammation markers as follows: for interleukin-6, 314.7; for C-reactive protein, 13.1; for erythrocyte sedimentation rate, 7.2; and for white blood-cell count, 4.4.

"The diagnostic accuracy for prosthetic joint infection was best for interleukin-6, followed by C-reactive protein level, erythrocyte sedimentation rate, and white blood-cell count. Given the limited numbers of studies assessing interleukin-6 levels, further investigations assessing the accuracy of interleukin-6 for the diagnosis of prosthetic joint infection are warranted," the authors write.

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