Abstract
BACKGROUND: Periprosthetic joint infection (PJI) after total hip and knee arthroplasty is challenging to differentiate from similar afflictions. Platelet count-to-mean platelet volume (PC/MPV) ratio has been proposed, but requires validation. This study evaluated PC/MPV and other potential serological biomarkers for diagnosing PJI prior to reimplantation arthroplasty of the hip and knee. MATERIAL AND METHODS: Medical records were retrospectively reviewed of patients who received hip and knee revision, and there were 88 PJI patients and 156 non-PJI patients met the modified 2018 criteria for inclusion. Receiver operating characteristic curves (ROCs) were used to analyze and compare the diagnostic performances of PC/MPV, fibrinogen (FIB), C-reactive protein (CRP), platelet count (PLT), erythrocyte sedimentation rate (ESR), and serum white blood cell (WBC) count. RESULTS: Compared with the control group, the patients with PJI had significantly higher PC/MPV, FIB, ESR, CRP, serum WBC, and PLT, respectively, and the areas under the ROC curve were 0.787, 0.917, 0.832, 0.934, 0.685, and 0.778; that of FIB and CRP were similar. Regarding PC/MPV, the optimal cutoff was 27.81, and the sensitivity, specificity, and positive and negative predictive values were 0.807, 0.673, 0.582, and 0.861. CONCLUSIONS: The best diagnostic performance was achieved by CRP and FIB, and we recommend that these tests should be prioritized. Serum WBC, PC/MPV and PLT were insufficient to predict PJI prior to reimplantation arthroplasty of the hip and knee; however, CRP combined with FIB or PC/MPV best serves to obtain the most accurate prediction of PJI in our study.