The use of receiver operating characteristics analysis in determining erythrocyte sedimentation rate and C-reactive protein levels in diagnosing periprosthetic infection prior to revision total hip arthroplasty

Abstract

The gold standard for diagnosing PPI remains bacterial culture, but sensitivity is negatively affected by prior antibiotic exposure, strongly adherent bacteria, slow growing persisters, and biofilms. ESR and CRP are reflective of systemic changes in infection and pose an attractive, less invasive alternative with reasonable sensitivity and specificity. The current study is the first to identify ideal cut-off values for ESR and CRP in THA patients, providing an optimum balance between sensitivity and specificity based on ROC curves.