Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
Sci Rep. 2022 Apr 6;12(1):5777. doi: 10.1038/s41598-022-09724-6.
The preoperative detection of prosthetic joint infection (PJI) prior to revision of total hip or knee arthroplasty is still a challenge. Serum Calprotectin (CP) is a heterodimer of two calcium-binding proteins present in the cytoplasm of neutrophils that is released in inflammatory processes and infections. The objective of this study is to determine the reliability of serum CP in the diagnosis of chronic PJI. 81 patients (40 women, 41 men) that presented a potential indication for revision arthroplasty of the hip (THA; n = 18) or knee (TKA, n = 63) at a single institution were prospectively evaluated. The joints were diagnosed as chronically infected or aseptic based on the musculoskeletal infection society (MSIS) criteria of 2018. Receiver operating characteristics and the Youden's index were used to define an ideal cutoff value. The median serum CP level was significantly higher in the group with chronic PJI (15,120 vs. 4980 ng/ml; p < 0.001) compared to the aseptic cases. The calculated optimal cut-off value was 9910 ng/ml (AUC 0.899, 95% CI 0.830-0.968) with a specificity of 91% and sensitivity of 81%. The present investigation suggests that serum CP has a high specificity and good sensitivity to diagnose chronic PJI after TJA of the knee or hip.
术前检测全髋关节或膝关节置换术后假体关节感染（PJI）仍然是一个挑战。血清钙卫蛋白（CP）是中性粒细胞细胞质中存在的两种钙结合蛋白的异二聚体，在炎症过程和感染中释放。本研究的目的是确定血清 CP 在慢性 PJI 诊断中的可靠性。在一家机构前瞻性评估了 81 名患者（40 名女性，41 名男性），他们有髋关节（THA；n = 18）或膝关节（TKA，n = 63）翻修的潜在指征。关节根据肌肉骨骼感染学会（MSIS）2018 年的标准被诊断为慢性感染或无菌性。使用接收者操作特征和 Youden 的指数来定义理想的截断值。与无菌病例相比，慢性 PJI 组的血清 CP 水平明显更高（中位数 15120 比 4980ng/ml；p < 0.001）。计算出的最佳截断值为 9910ng/ml（AUC 0.899，95%CI 0.830-0.968），特异性为 91%，敏感性为 81%。本研究表明，血清 CP 对诊断膝关节或髋关节 TJA 后慢性 PJI 具有较高的特异性和良好的敏感性。
