The change of coagulation profile in two-staged arthroplasty for periprosthetic joint infection patients: a retrospective cohort study

Journal of Orthopaedic Surgery and Research

Chi Xu¹  Rui Li¹  Wei Chai¹  Jiying Chen¹  L. L. Li²  Hao Li³ 

[1] Department of Orthopedic Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, People’s Republic of China;Medical School of Chinese PLA, Beijing, People’s Republic of China;Medical School of Chinese PLA, Beijing, People’s Republic of China;Department of Orthopedic Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, People’s Republic of China;

关键词: Periprosthetic joint infection;    Total joint arthroplasty;    Two-staged arthroplasty;    Coagulation profile;    Activated partial thromboplastin time;   

DOI  :  10.1186/s13018-021-02477-4

来源: Springer

【 摘 要 】

AimsPeriprosthetic joint infection (PJI) is a serious complication of total joint arthroplasty. We performed a retrospective cohort study to evaluate (1) the change of coagulation profile in two-staged arthroplasty patients and (2) the relationship between coagulation profile and the outcomes of reimplantation.MethodBetween January 2011 and December 2018, a total of 202 PJI patients who were operated on with two-staged arthroplasty were included in this study initially. This study continued for 2 years and the corresponding medical records were scrutinized to establish the diagnosis of PJI based on the 2014 MSIS criteria. The coagulation profile was recorded at two designed points, (1) preresection and (2) preimplantation. The difference of coagulation profile between preresection and preimplantation was evaluated. Receiver operating characteristic curves (ROC) were used to evaluate the diagnostic efficiency of the coagulation profile and change of coagulation profile for predicting persistent infection before reimplantation.ResultsThe levels of APTT, INR, platelet count, PT, TT, and plasma fibrinogen before spacer implantation were significantly higher than before reimplantation. No significant difference was detected in the levels of D-dimer, ACT, and AT3 between the two groups. The AUC of the combined coagulation profile and the change of combined coagulation profile for predicting persistent infection before reimplantation was 0.667 (95% CI 0.511, 0.823) and 0.667 (95% CI 0.526, 0.808), respectively.ConclusionThe coagulation profile before preresection is different from before preimplantation in two-staged arthroplasty and the coagulation markers may play a role in predicting infection eradication before reimplantation when two-stage arthroplasty is performed.Level of evidenceLevel III, diagnostic study.

【 授权许可】

CC BY