Abstract
BACKGROUND: This retrospective study aims to investigate whether C-reactive protein (CRP) value following debridement, antibiotics, and implant retention (DAIR) procedure is a sensitive and specific marker to monitor the clinical course and predict the outcome of the DAIR procedure. METHODS: The electronic clinical management system was used to identify patients who suffered from the first episode of periprosthetic joint infection (PJI) following a total hip or knee arthroplasty and 2) and received DAIR as their first surgical treatment in 2 tertiary hospitals. RESULTS: Sixty-five patients were included in this study. Mean age was 68.5 and 55.7% were female. Mean follow-up duration was 3.31 years. 42 (64.6%) patients had successful DAIR while 23 (35.4%) had failed DAIR. Statistical analysis was carried out. Patients with PJI within 3 months from initial arthroplasty, infected by organism without drug resistance, and symptom onset within 3 days, and who could achieve a CRP cutoff at 5 mg/dL by 2 weeks, were significantly more likely to have successful DAIR (P = .037). The area under the curve was 0.892 (95% confidence interval: 0.811-1.000). Patients with PJI more than 3 months after the initial operation were 24.9 times more likely to fail DAIR after adjustments (P = .019). CONCLUSIONS: This is the first study to report a CRP cutoff at 5 mg/dL at 2 weeks was able to assist in identifying patients at higher risk of failure following DAIR procedure.