ESR and CRP are useful between stages of 2-stage revision for periprosthetic joint infection

Abstract Background Serum erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are important tests in the initial diagnosis of periprosthetic joint infection. Many surgeons also use these tests to determine if infection has resolved between stages of a 2-stage procedure, but little data exist regarding this practice. Methods A retrospective review of our institutional total joint databases was conducted to determine sensitivity, specificity, and predictive values of elevated ESR and/or CRP to diagnose persistent infection between stages. Results Among 16 knees and 5 hips, sensitivity was 50% for CRP, 75% for ESR, and 100% when combined. The negative predictive value of persistent infection was 100% when neither test was elevated. Conclusions Results of this study support the use of CRP and ESR as indicators of the resolution of periprosthetic joint infection between stages of 2-stage revision.