25dkou344 10.3205/25dkou344 urn:nbn:de:0183-25dkou3447 Meeting Abstract CRP and fibrinogen as indicators of reinfection risk after explantation in two-stage prosthetic joint revision Straub Straub Jennifer J
Univ. Klinik für Orthopädie und Unfallchirurgie, AKH Wien, Wien, Österreich
author Willmann Willmann Laurenz L
Univ. Klinik für Orthopädie und Unfallchirurgie, AKH Wien, Wien, Österreich
author Sigmund Sigmund Irene Katharina IK
Univ. Klinik für Orthopädie und Unfallchirurgie, AKH Wien, Wien, Österreich
author Staats Staats Kevin K
Univ. Klinik für Orthopädie und Unfallchirurgie, AKH Wien, Wien, Österreich
author Windhager Windhager Reinhard R
Univ. Klinik für Orthopädie und Unfallchirurgie, AKH Wien, Wien, Österreich
author Böhler Böhler Christoph C
Univ. Klinik für Orthopädie und Unfallchirurgie, AKH Wien, Wien, Österreich
author German Medical Science GMS Publishing House
Düsseldorf
 610 20251031 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0634 344 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie Deutsche Gesellschaft für Unfallchirurgie Berufsverband für Orthopädie und Unfallchirurgie Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2025) Abstracts | AG Evidenzbasierte Medizin | Primär- und Revisionsendoprothetik – perioperativer Verlauf Berlin 20251028 20251031 AB52-4291 TextObjectives and questions: Periprosthetic joint infections are a major complication after total joint arthroplasty. This study evaluated the early postoperative changes in C-reactive protein (CRP) and fibrinogen after explantation in two-stage revision surgeries and their potential to predict early treatment failure.Material and methods: Patients undergoing 2-stage hip or knee prosthesis exchange between June 2012 and September 2023, diagnosed per EBJIS criteria, were retrospectively analyzed. They were grouped by outcomes: no failure or early failure (within one year post-reimplantation or requiring spacer exchange). Propensity score matching created two groups of 72 patients each. Absolute and relative CRP and fibrinogen levels were analyzed preoperatively and on postoperative days 1, 3, and 5, as well as the area under the curves (AUC) of their postoperative trajectories. Further, ROC analysis was performed.Results: Significant differences in absolute CRP were observed preoperatively (p=0.03) and on postoperative day 1 (p=0.01). Fibrinogen showed significant differences on days 1 (p=0.01) and 3 (p=0.01, cf. Figure 1 ). Relative and absolute CRP changes differed significantly on day 3, while fibrinogen changes were significant on day 5. The relative fibrinogen AUC demonstrated the highest prognostic value for early failure with an AUC of 0.75 (sensitivity=0.81, specificity=0.70).Discussion and conclusions: Fibrinogen, as opposed to CRP, has the potential to serve as a predictive marker of early treatment failure after explantation in two-stage revision for PJI. 0
1 1 Figure 1: Course of absolute CRP (mg/dl) and fibrinogen (mg/dl) levels with 95%-confidence Intervals.
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