| Use of Positron Emission Tomography to Detect Infection Around Antibiotic-loaded Cement Spacers in Patients With High C-Reactive Protein Levels. | |
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MedLine Citation:
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PMID: 21956053 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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In patients who have antibiotic-loaded cement hip spacers in the interim period, the correct diagnosis of infection eradication is the major determinant before reimplantation arthroplasty. Diagnosis is usually based on clinical findings and serum C-reactive protein (CRP) levels. However, diagnosis can be challenging when the clinical findings are normal but the CRP level is high. From March 2007 to January 2008, fluorodeoxy-glucose positron emission tomography (FDG-PET) was used to detect infection around antibiotic-loaded cement spacers in 13 patients (mean age, 60 years). Although patients' clinical conditions were deemed suitable for reimplantation, their serum CRP levels were persistently elevated (mean, 54 mg/L) an average of 120 days (range, 28-413 days) after the first-stage operation. Reimplantation total hip arthroplasty (THA) was subsequently performed in 7 patients based on the negative findings of FDG-PET. In 6 patients, FDG-PET was positive for infection. The persistence of infection was confirmed in 3 of these patients by another debridement surgery. Staged reimplantation THA was delayed in 1 patient who underwent repeat debridement and in 3 patients who were treated with extended periods of oral antibiotics. Of the 11 staged reimplantation THAs, only 1 reinfection was noted at an average follow-up of 48 months. The success rate of 91% suggests FDG-PET could help in the differential diagnosis of infection around cement spacers, especially in patients with normal clinical findings but elevated CRP levels. |
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Authors:
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Ming-Jhe Huang; Pang-Hsin Hsieh; Steve W N Ueng; Kung-Chu Ho; Tzu-Chen Yen; Mel S Lee |
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Publication Detail:
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Type: Journal Article Date: 2011-10-05 |
Journal Detail:
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Title: Orthopedics Volume: 34 ISSN: 1938-2367 ISO Abbreviation: Orthopedics Publication Date: 2011 |
Date Detail:
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Created Date: 2011-09-29 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7806107 Medline TA: Orthopedics Country: United States |
Other Details:
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Languages: eng Pagination: e605-9 Citation Subset: IM |
Copyright Information:
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Copyright 2011, SLACK Incorporated. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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