Correlation between progress of D-Dimer following total joint arthroplasty and early postoperative wound and joint infection

Abstract

. Postoperative infection after joint arthroplasty is a bad complication with incontrovertible incidence and early detection is essential. The purpose of this retrospective study was to evaluate postoperative change of D-Dimer level after joint arthroplasty along with other proinflammatory mediators and to determine the correlation between progress of D-Dimer and early postoperative infection. From January 2017 until March 2018, a retrospective evaluation of 121 patients operated for elective primary total hip arthroplasty (49 patients) or total knee arthroplasty (72 patients) was conducted. CRP, INR, troponin and D-Dimer level were noted on the preoperative day 1, postoperative days 1, 3, 7, 14 and perioperative changes compared. All patients were followed up for infection. 121 patients included in the study. The variability of postoperative CRP and INR values was similar. D-Dimer showed a more rapid rise and fall than CRP in early postoperative period. Early wound infections were detected in 24 patients (19.8%) and 70% of the patients with wound infection had early postoperative D-Dimer increase and also a significant relationship was found between the patients with wound infection in the early period and the increase in CRP level (p<0.05). The fluctuation and instability of D-Dimer values during the postoperative follow-up period suggests that it may be unlikely to be used as a strong indicator of infection. If only the D-Dimer levels combined with other inflammatory mediators like CRP etc. then it might be effective in early detection of wound infection after joint arthroplasty.