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Advances in Orthopedics
Volume 2017, Article ID 9679470, 7 pages
Research Article

Use of Common Inflammatory Markers in the Long-Term Screening of Total Hip Arthroprosthesis Infections: Our Experience

1Department of Orthopedics and Traumatology, Azienda Ospedaliera “Gaetano Rummo”, Benevento, Italy
2Department of Orthopedics and Traumatology, Sacro Cuore di Gesù Fatebenefratelli Hospital, Benevento, Italy
3Clinic of Traumatology, University Hospital Clinical Center Banja Luka, Banja Luka, Bosnia and Herzegovina
4Department of Orthopedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy
5Rizzoli Orthopedic Institute, University of Bologna, Bologna, Italy
6Division of Orthopedics and Trauma Surgery, University of Perugia, S. Maria della Misericordia Hospital, Perugia, Italy
7School of Medicine, Central Michigan University, Mount Pleasant, MI, USA
8Department of Orthopedics and Traumatology, Hospital “Santa Maria alla Gruccia”, Montevarchi, Arezzo, Italy

Correspondence should be addressed to Luigi Meccariello; moc.liamg@cemdrolrd

Received 11 July 2016; Accepted 16 July 2017; Published 23 August 2017

Academic Editor: Elizaveta Kon

Copyright © 2017 Gabriele Falzarano et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Orthopedic implants have become essential components of modern medicine. The risk of infection of total hip arthroplasty (THA) is 1.5%−2%. Are the C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) good markers for THA infection screenings? From February 2009 to December 2012 at our Department of Orthopedics and Traumatology, 1248 patients were treated with THA. No prosthesis was cemented. All patients received antibiotic prophylaxis. All patients were discharged approximately 7.4 days after surgery with this clinical and radiographic follow-up program at 15 days and 1, 3, 6, 12, 24, and 36 months after surgery. Blood samples to determine ESR, CRP, and PCT values were taken at 1 hour before surgery and 15 days and 1, 3, 6, 12, 24, and 36 months after surgery. During follow-ups there were 22 cases of THA infections; according the Widmer classification, infections are hematogenous ones in 16 cases, late chronic ones in 5 cases, and early postoperative ones in 1 case. In all cases the three markers were considered positive; in 6 cases there were no radiological signs of septic loosening. ESR, CRP, and PCT proved to have a greater diagnostic accuracy than X-rays in predicting late chronic and early postoperative infections. These markers are valuable support for the surgeon in monitoring the prosthetic implant lifespan.