Document Detail


Use of Positron Emission Tomography to Detect Infection Around Antibiotic-loaded Cement Spacers in Patients With High C-Reactive Protein Levels.
MedLine Citation:
PMID:  21956053     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article     Date:  2011-10-05
Journal Detail:
Title:  Orthopedics     Volume:  34     ISSN:  1938-2367     ISO Abbreviation:  Orthopedics     Publication Date:  2011  
Date Detail:
Created Date:  2011-09-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806107     Medline TA:  Orthopedics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e605-9     Citation Subset:  IM    
Copyright Information:
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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