Value Of New Diagnostic Criteria In Chronic Periprosthetic Joint Infection After Total Joint Arthroplasty

Objective: In recent years,some researches have suggested that the Platelet count(PLT),Platelet count / mean Platelet Volume Ratio(PVR),Fibrinogen(FIB)and Albumin to Globulin Ratio(A/G)could be used for the diagnosis of chronic periprosthetic joint infection after joint arthroplasty.The purpose of this research is to explore the value of these new diagnostic criteria in the diagnosis of chronic periprosthetic joint infection after total joint arthroplasty.Methods: There are no significant difference in the basic data(age,gender)among the three groups(P > 0.05).Clinical data was collected from 303 individuals diagnosed in our department between January 2017 and March 2022.Patients were divided into three groups according to their preoperative diagnosis(primary joint arthroplasty group,aseptic loosening group and chronic periprosthetic joint infection group).The test results of preoperative blood routine,erythrocyte sedimentation rate,C—reactive protein,coagulation items and liver function have been collected.Receiver Operating Characteristic Curve(ROC)was used to calculate the Youden Index,sensitivity and specificity of each criterion,and the diagnostic value of each diagnostic criterion has been compared according to their Youden Index.Results: The CRP,ESR,FIB,PLT and PVR in chronic periprosthetic joint infection group were significantly higher than those in primary joint arthroplasty group and aseptic loosening group(P < 0.001).A/G was significantly lower than that of the primary joint arthroplasty group and aseptic loosening group(P < 0.001).All the laboratory test parameters were of diagnostic value in the diagnosis of periprosthetic joint infection(P < 0.05).The order of youden index was FIB > A/G > CRP > ESR > PLT > PVR.The Youden Index of FIB and A/G were significantly higher than CRP and ESR.Further analysis showed that FIB,A/G,CRP and ESR had no significant difference in the diagnosis of chronic periprosthetic joint infection(P > 0.05).However,when the FIB is combined with A/G,CRP and ESR,The diagnostic accuracy was better than that of CRP and ESR alone.The Youden Index of PLT and PVR were lower than CRP and ESR.Further analysis showed that PLT,PVR and CRP,ESR has significant difference in the diagnosis of chronic periprosthetic joint infection(P > 0.05).When PLT,PVR and CRP,ESR are combined for diagnosis,the diagnostic accuracy can be further improved.Conclusion:(1)FIB and A/G have the equivalent diagnostic value as CRP and ESR in the diagnosis of chronic periprosthetic joint infection.When the FIB combined with A/G,CRP and ESR,the diagnostic accuracy can be further improved.FIB and A/G can be used as important indicators in the diagnosis of chronic periprosthetic joint infection.(2)The diagnostic value of PLT and PVR in the diagnosis of chronic periprosthetic joint infection is lower than that of CRP and ESR.When the PLT combined with PVR,CRP and ESR,the diagnostic accuracy can be further improved.PLT and PVR can be used as reference indexes in the diagnosis of chronic periprosthetic joint infection.