Table 4
The diagnostic accuracy of CRP as biomarker in PJI.
| Study | Ghanem et al. [58] | Greidanus et al. [67] | Parvizi et al. [68] | Wang et al. [70] |
|---|---|---|---|---|
| Aim | Assess the efficacy of CRP monitoring in diagnosing persistent PJI | Evaluate diagnostic test characteristics of ESR and CRP for PJI diagnosis | Examine synovial CRP quantification for PJI diagnosis | Evaluate synovial fluid CRP as a biomarker for PJI diagnosis |
| methods | Retrospective analysis of arthroplasty database, ROC curve analysis | Prospective evaluation of patients for infection with measurement of ESR and CRP levels | Prospective collection of synovial fluid samples, comparison between septic and aseptic groups | Systematic review and meta-analysis of studies assessing CRP in PJI diagnosis |
| Results | Treatment group mean CRP values were not statistically different. AUCs were 0.46–0.73 | Specificity, sensitivity, and positive likelihood ratio make ESR and CRP good diagnostic tools | Statistically significant difference in synovial CRP between septic and aseptic groups | Combined sensitivity, specificity, diagnostic odds ratio, and AUSROC are diagnostically valuable |
| Conclusions | CRP monitoring does not indicate successful eradication of PJI | ESR and CRP provide excellent diagnostic information for PJI diagnosis | Synovial CRP assay holds promise as a diagnostic marker for PJI | Synovial fluid CRP is a good biomarker for PJI diagnosis |
| Pros | Large sample size, retrospective analysis | Prospective design, assessment of multiple diagnostic parameters | Prospective design, direct comparison between septic and aseptic groups | Meta-analysis provides comprehensive overview, high sensitivity and specificity |
| Cons | Lack of prospective design, limited to CRP monitoring | Patient selection may be biased, limited to revision total knee arthroplasty patients | Limited to synovial CRP quantification, potential variability in synovial fluid collection and analysis | Limited to studies assessing CRP, potential heterogeneity among included studies |
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