Does Plasma D-Dimer help diagnose periprosthetic joint infection?
Research type
Research Study
Full title
DOES PLASMA D-DIMER CONCENTRATION HELP DIAGNOSE PERIPROSTHETIC JOINT INFECTION?
IRAS ID
244158
Contact name
Andrew Gordon
Contact email
Sponsor organisation
Sheffield Teaching Hospitals NHS Foundation Trust
Duration of Study in the UK
1 years, 5 months, 30 days
Research summary
Periprosthetic joint infection (PJI) is a dreaded complications in arthroplasty due to its substantial financial burden on the NHS and the significant physical and psychological morbidity on patients. Diagnosis of PJI has proved to be difficult and no single test has been demonstrated to definitely diagnose PJI. Biomarkers such as C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR), when combined, have been shown to have a high sensitivity and specificity, along with a recent development of serum D-dimer. Alpha-defensin, tested using synovial fluid, also ha a high sensitivity and specificity but this test is expensive and not widely available.
Serum D-dimer has been shown to have a high sensitivity and specificity for confirming PJI in a previous study, and it has also been shown that synovial D-dimer is present in a high concentration in the synovial fluid of infected joints in animal studies. In Sheffield the plasma D-dimer is used to assess for thromboembolic events. This study aims to assess if plasma D-dimer is elevated in PJI and if it can be used as a diagnostic tool for PJI.
This is a prospective study which will recruit patients who have been listed for revision hip or knee surgery and have a potential infection of the joint. This blood test will be done with the patient's consent and at the same time as other blood tests, minimising inconvenience to the patient.
It is expected that plasma D-dimer is elevated in the presence of PJI and, if sensitivity and specificity of this biomarker compares to published results of other biomarkers in the literature, it will prove to be a cheap and readily available tool in the diagnosis of PJI.REC name
South West - Cornwall & Plymouth Research Ethics Committee
REC reference
18/SW/0083
Date of REC Opinion
3 May 2018
REC opinion
Further Information Favourable Opinion