Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleC-Reactive Protein and Erythrocyte Sedimentation Rate Changes After Arthroscopic Anterior Cruciate Ligament Reconstruction: Guideline to Diagnose and Monitor Postoperative Infection
Section snippets
Methods
A retrospective chart review was performed of all arthroscopic ACL reconstruction patients treated at our institution from August 2007 to July 2008. Patients with available laboratory data for both ESR and CRP level on the third and fifth postoperative days were included. All of these patients had normal preoperative CRP (<8 mg/L) and ESR (<20 mm/h) values. Patients who underwent posterior cruciate ligament reconstruction or collateral ligament repair during ACL reconstruction were excluded
Results
Of the 122 patients in total, 83 had normal joints (noninfection group) and 39 had septic joints (infection group). In the noninfection group, there were 59 male and 24 female patients with a mean age of 27.4 years (range, 15 to 60 years). There were 39 septic cases out of 7,679 ACL reconstructions from 1997 to 2010. The incidence of septic arthritis after arthroscopic ACL reconstruction was 0.51%. In the infection group, the mean age at injury was 26.8 years (range, 16 to 58 years) and 33
Discussion
The principal findings of this study showed that both CRP and ESR were helpful in determining the presence of a normal joint or septic joint. CRP is a more sensitive and reliable indicator of postoperative infection, which has a higher sensitivity and specificity than ESR.
Conclusions
Both CRP and ESR were helpful in determining the presence of a normal or septic joint. The threshold values of 41 mg/L for CRP and 32 mm/h for ESR had the most optimal sensitivity and specificity. The peak CRP level occurred earlier than the peak ESR level after treatment of postoperative infection and returned to normal more quickly. In this study CRP was more useful than ESR to evaluate the response of infection to treatment.
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2019, Journal of Foot and Ankle SurgeryCitation Excerpt :However, to the best of our knowledge, this is the first study to evaluate the utility of both ESR and CRP to distinguish OM from STI in nondiabetic foot infections. Previous studies have reported success with using ESR and CRP to diagnose vertebral OM, long bone infections and periprosthetic joint infections (6–13). Greidanus et al showed that a threshold of 22.5 mm/h for ESR and a threshold of 1.35 mg/dL for CRP provide excellent diagnostic performance for periprosthetic knee infections (7).
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The authors report that they have no conflicts of interest in the authorship and publication of this article.