Is Procalcitonin a more sensitive parameter than other Acute Phase Reactants for early infection in arthroplasty?

Objectives: The routine laboratory parameters for detection of early infection could be increased after surgical trauma in endoprosthesis surgery. The aim of this study was to compare the early infective complication marker Procalcitonin with routine markers. Methods: Twenty patients with primary total hip prosthesis and 30 knee prosthesis were enrolled. The changes in procalcitonin, C-reactive protein levels, white blood cell count, and erythrocyte sedimentation rate were evaluated preoperatively, at postoperative first day, postoperative fifth day and on the day of discharge. Results: Procalcitonin values of patients who developed superficial infection were statistically high in comparison with uncomplicated patients at post-op Day 1 and Day 5 (p < 0.05). The level of C-reactive protein, white blood cell count, and erythrocyte sedimentation rate peaked on postoperative Day 1. These levels decreased by postoperative Day 5 and on the day of discharge but did not reach preoperative mean values. Conclusion: Procalcitonin is a more selective parameter to predict early infection status following total endoprosthetic surgery. When factors that cause an inflammatory response were eradicated, procalcitonin levels dropped more rapidly and followed a standard postoperative kinetic pathway.