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BioMed Research International
Volume 2014 (2014), Article ID 565080, 6 pages
Clinical Study

Serum C-Reactive Protein and Procalcitonin Kinetics in Patients Undergoing Elective Total Hip Arthroplasty

1Department of Surgery, University Hospital of Siena, Viale Bracci No. 16, 53100 Siena, Italy
2Orthopaedics and Traumatology Clinic, University Hospital of Siena, Viale Bracci No. 16, 53100 Siena, Italy
3Department of Internal Medicine, University Hospital of Siena, Viale Bracci No. 16, 53100 Siena, Italy

Received 5 February 2014; Revised 7 April 2014; Accepted 16 April 2014; Published 4 May 2014

Academic Editor: Akihiro Sudo

Copyright © 2014 Sandra Battistelli 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.


Background. The sensitivity and the specificity of different methods to detect periprosthetic infection have been questioned. The current study aimed to investigate the kinetics of C-reactive protein (CRP) and procalcitonin (PCT) in patients undergoing uncomplicated elective total hip arthroplasty (THA), to provide a better interpretation of their levels in noninfectious inflammatory reaction. Methods. A total of 51 patients were included. Serum CRP and PCT concentrations were obtained before surgery, on the 1st, 3rd, and 7th postoperative days and after discharge on the 14th and 30th days and at 2 years. Results. Both markers were confirmed to increase after surgery. The serum CRP showed a marked increase on the 3rd postoperative day while the peak of serum PCT was earlier, even if much lower, on the first day. Then, they declined slowly approaching the baseline values by the second postoperative week. PCT mean values never exceed concentrations typically related to bacterial infections. Conclusions. CRP is very sensitive to inflammation. It could be the routine screening test in the follow-up of THA orthopaedic patients, but it should be complemented by PCT when there is the clinical suspicion of periprosthetic infection.