Preoperatively elevated serum inflammatory markers increase the risk of periprosthetic joint infection following total knee arthroplasty in patients with osteoarthritis

Figures & data

Table 1 Patient demographics based on the grouping of ESR and CRP values

	Both normal	Either high	Both high	P-value
Number of patients	140	108	32
Age, year (mean ± SD)	65.2±7.3	65.1±7.9	62.8±8.9	0.310
Female, n (%)	76 (54.3)	59 (54.6)	19 (59.4)	0.868
BMI, kg/m^2 (mean ± SD)	27.8±3.1	27.9±3.6	27.2±4.3	0.543
Diabetes mellitus, n (%)	22 (15.7)	16 (14.8)	5 (15.6)	0.980
Current smoking, n (%)	4 (2.9)	4 (3.7)	2 (6.2)	0.644
Prior joint injection, n (%)	56 (40.0)	44 (40.7)	11 (34.4)	0.805
ESR, mm/h (mean ± SD)	15.4±6.6	33.9±20.8	48.4±13.0	<0.001
CRP, mg/dL (mean ± SD)	5.0±2.3	18.7±22.4	41.0±28.1	<0.001
Anesthesia type, n (%)				0.021
General	128 (91.4)	98 (90.7)	24 (75.0)
Regional	12 (8.6)	10 (9.3)	8 (25.0)

Abbreviations: BMI, body mass index; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate.

Figure 1 Bar graph showing the rate of PJI in 3 groups after a mean follow-up of 43 months.

Abbreviation: PJI, periprosthetic joint infection.

Table 2 Univariate and multivariable logistic regression analysis

	Nonadjusted HR (95% CI)	P-value	Adjusted HR (95% CI)	P-value
Both normal ESR and CRP	Ref		Ref
Either high ESR or CRP	1.34 (0.08–21.48)	0.835	1.21 (0.07–20.00)	0.893
Both high ESR and CRP	16.88 (1.88–151.2)	0.012	18.5 (1.86–184.1)	0.013

Note: Adjusted for age, sex, BMI, diabetes, smoking, prior joint injection, and anesthesia type.

Abbreviations: BMI, body mass index; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate.

Figure 2 Kaplan–Meier graph illustrating the cumulative PJI rate in 3 groups.

Abbreviation: PJI, periprosthetic joint infection.