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Organism profile and C-reactive protein (CRP) response are different in periprosthetic joint infection in patients with hepatitis

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

Hepatitis B and C are important and relatively common health issues. It is known that many patients who underwent total knee and hip arthroplasty were also diagnosed with hepatitis. These patients are at higher risk of periprosthetic joint infection (PJI). This study aimed to investigate the differences in PJI cases in hepatitis B and C patients.

Methods

This is a retrospective case-controlled single-center study. A total of 270 patients with hepatitis and non-hepatitis (control group) who underwent one-stage septic exchange to the hip and knee joints were included in the study. All patients' previous surgical histories, infective organisms, C-reactive protein (CRP) values before septic exchange, and demographic data were evaluated. All microbiological and laboratory evaluations were performed separately for knee and hip arthroplasty.

Results

The mean CRP levels of Hep B- and C-positive patients, who underwent one-stage septic exchange in the knee joint, were 23.6 mg/L. In the control group, this value was 43.1 mg/L and a statistically significant difference was found between the groups (p = 0.004). Gram-negative organisms were identified in a larger proportion of patients with hepatitis who developed PJI in both hip and knee joints and underwent one-stage septic exchange (p = 0.041/p = 0.044).

Conclusion

PJIs caused by Gram-negative bacteria are encountered more frequently in patients with hepatitis than in the control group. In addition, the CRP rise is less in patients with hepatitis compared to PJI cases in the control group. Patient-specific evaluation is required in cases of PJI in patient groups with co-existing hepatitis.

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Availability of data and materials

The data that support the findings of this study are available on request from the corresponding author [MC]. The data are not publicly available, because their containing information that could compromise the privacy of research participants.

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Funding

There is no funding for this study.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Helios ENDO-Klinik, Holstenstr. 2, 22767, Hamburg, Germany

    Mustafa Akkaya, Serhat Akcaalan, Fabio Luigi Perrone, Thorsten Gehrke & Mustafa Citak

  2. Joint Reconstruction Unit, Southland Hospital, Invercargill, New Zealand

    Nemandra Sandiford

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  1. Mustafa Akkaya
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  2. Serhat Akcaalan
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  5. Thorsten Gehrke
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Contributions

The authors’ contribution to the manuscript is declared in detail in the following: conceptualization—MA, MC; methodology—MA, SA, FLP, MC; validation—all authors; formal analysis—SA, MA.; writing—original draft preparation—MA, SA, NS; review and editing—all authors; visualization—NS, MA, TG; supervision—MC, TG; project administration—MC. All authors have read and agreed to the final version of this manuscript. All authors have approved the submission of this manuscript. The authors declare that the manuscript in its current (or in any other) form has not been published previously, is not under consideration for publication in another journal at this time, and will not be published anywhere else in this form or following translation.

Corresponding author

Correspondence to Mustafa Citak.

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Conflict of interest

The authors declare that they have no conflict of interest regarding this manuscript. Independent from the submitted manuscript, received royalities/payments of all authors are listed: payments for presentations from Waldemar Link, Hamburg, Germany. Zimmer Biomet Inc., Warsaw, USA. Heraeus. Ceramtec Co.

Ethical approval

The study design was approved by the local ethics committee (2021-300086_1-WF and informed consent was obtained from each patient.

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All patients gave informed consent to participate in the study, and agreed having their data published in a journal article.

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Akkaya, M., Akcaalan, S., Perrone, F.L. et al. Organism profile and C-reactive protein (CRP) response are different in periprosthetic joint infection in patients with hepatitis. Arch Orthop Trauma Surg 144, 341–346 (2024). https://doi.org/10.1007/s00402-023-05059-7

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  • DOI: https://doi.org/10.1007/s00402-023-05059-7

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