What serum test(s) have the best diagnostic accuracy for periprosthetic joint infection (PJI)? Does the combination of any number of tests increase the diagnostic accuracy?

Authors: Qiaojie Wang, Sreeram Penna, AliSina Shahi

RECOMMENDATION: Several serum biomarkers have been used as diagnostic tools for PJI with C‐reactive protein (CRP) and erythrocyte sedimentation rate (ESR) being the most commonly‐accepted screening tests. CRP and ESR are well‐researched screening tests and have high sensitivity when used alone. Serum D‐dimer for the diagnosis of PJI is being actively evaluated with encouraging early results. Combining serological tests have shown to improve diagnostic accuracy, but further work is needed to identify the optimal combination. It should also be noted that diagnosis of PJI cannot be based solely on serological tests at this time.


DELEGATE VOTE: Agree: 92%, Disagree: 5%, Abstain: 3% (Super Majority, Strong Consensus)