RT Journal
A1 Bauer, Thomas W.
A1 Parvizi, Javad
A1 Kobayashi, Naomi
A1 Krebs, Viktor
T1 Diagnosis of Periprosthetic Infection
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2010
FD February 1
VO 92
IS 2
SP 524
OP 525
DO 
UL http://dx.doi.org/
AB 
Dr. Pignatti correctly notes that, when we quoted Spangehl's 1999 study1, we accidentally reversed the percentages for the C-reactive protein and erythrocyte sedimentation rate predictive values and transcribed the sensitivity of C-reactive protein as 86% instead of 96%. We appreciate Dr. Pignatti bringing those details to our attention. Our interpretation that Dr. Spangehl's findings indicated the C-reactive protein level to be an overall better indication of infection than the erythrocyte sedimentation rate is correct. Additional studies have also shown that both analytes are nonspecific markers of inflammation, that there may be differences in the magnitude of elevation and the time course of normalization based on the type of operation (for example, total hip as opposed to total knee arthroplasty)2, and that the C-reactive protein level returns to normal more rapidly than the erythrocyte sedimentation rate does2-4. We agree with Dr. Spangehl's comment that, when used in the appropriate clinical context, "these investigations become useful as a safe and economical screening tool with which to exclude infection."1