Letter to the Editor on “Combined Measurement of D-Dimer and C-Reactive Protein Levels: Highly Accurate for Diagnosing Chronic Periprosthetic Joint Infection”

Recently, D-dimer has gained traction as an inflammatory marker to improve diagnostic accuracy of periprosthetic joint infection (PJI). Several studies have investigated (either serum or plasma D-dimer), but the evidence is still conflicting regarding for diagnosis PJI [[1]Xu H. Xie J. Huang Q. Lei Y. Zhang S. Pei F. Plasma fibrin degradation product and are limited value diagnosing infection.J Arthroplasty. 2019; 34: 2454-2460https://doi.org/10.1016/j.arth.2019.05.009Abstract Full Text PDF PubMed Scopus (49) Google Scholar,[2]Pannu T.S. Villa J.M. Patel P.D. Riesgo A.M. Barsoum W.K. Higuera C.A. The utility in revision total hip knee arthroplasty.J 2020; 35: 1692-1695https://doi.org/10.1016/j.arth.2020.01.034Abstract (32) Scholar]. Through this investigation, authors further evaluated diagnosis. Nevertheless, there certain missing details study which need emphasizing hopefully establish a clear methodology that will allow reproducibility future studies:1.The been multiple However, not single elaborated on exact method used assessment D-dimer, present investigation repeats same inadequacy. did mention assay used, whether it was homogeneous all included patients. Today, most commonly technique measurement immunoturbidimetric [[3]Pannu Higuera-Rueda Serum infection: where we today?.J Knee Surg. 33: 106-110https://doi.org/10.1055/s-0039-1698467Crossref (11) Only with these details, results study, even any previous investigations subject, can be replicable future.2.The clearly prefix ‘serum’ front D-dimer. Overall, literature setting published either ‘plasma’ Not only that, earlier year, meta-analyses already comparing sensitivity, specificity, predictive values between [[4]Li C. Margaryan D. Ojeda-Thies Perka Trampuz A. Meta-analysis and/or Orthop Surg Res. 15: 1-9https://doi.org/10.1186/s13018-020-01808-1Crossref (9) It important question validity terminology (serum versus plasma) before gets too late. reporting actuality, depends laboratory assessment. Unfortunately, including case series, emphasis never laid by orthopedic surgeons methodology. There several test kits available market [[5]Riley R.S. Gilbert A.R. Dalton J.B. Pai McPherson R.A. Widely types clinical applications assay.Lab Med. 2016; 47: 90-102https://doi.org/10.1093/labmed/lmw001Crossref (63) To quote from our personal experience, ‘Innovance D-Dimer’ ‘Siemens’ Scholar] comes instructions manual step-by-step technique. Citrate reagent blood sample vial. Consequently, inhibits coagulation, eventual would always represent From coagulation cascade point view, possible if left coagulate measured supernatant (serum). Now, almost case. In other words, kit includes addition citrate, Considering standard laboratories, strongly suspect might misleading literature. We recommend readers consider possibility reported till today could instead, request focus brand. Download .pdf (.07 MB) Help pdf files Conflict Interest Statement Pannu (.06 (.08 Combined Measurement D-Dimer C-Reactive Protein Levels: Highly Accurate Diagnosing Chronic Periprosthetic Joint InfectionThe Journal ArthroplastyVol. 35Issue 1PreviewDiagnosis chronic (PJI) challenging elusive absence gold standard. plays role inflammation occurs during infections therefore valuable biomarker PJI. This aims investigate sensitivity specificity detecting through combined C-reactive protein (CRP)/erythrocyte sedimentation rate. Full-Text Response Letter Editor “Combined Infection”The 36Issue 2PreviewD-dimer recognized many useful identification [1–5]. newly defined criteria MSIS also elevated minor indicator [6]. some debate source plasma, exactly how detect it. view researcher's question, main purpose reply elaborate detailed steps research center conducting detection.