Change of coagulation profile in two-staged arthroplasty for
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A retrospective cohort study was performed to evaluate (1) the change of coagulation profile in two-staged arthroplasty patients and (2) the relationship between coagulation profile and the outcomes of reimplantation. Periprosthetic joint infection (PJI) is a serious complication of total joint arthroplasty.

A total of 202 PJI patients who were operated on with two-staged arthroplasty were included in this study initially. This study continued for 2 years and the corresponding medical records were scrutinized to establish the diagnosis of PJI. The coagulation profile was recorded at two designed points, (1) preresection and (2) preimplantation.

The difference of coagulation profile between preresection and preimplantation was evaluated. Receiver operating characteristic curves (ROC) were used to evaluate the diagnostic efficiency of the coagulation profile and change of coagulation profile for predicting persistent infection before reimplantation.

Results:
--The levels of APTT, INR, platelet count, PT, TT, and plasma fibrinogen before spacer implantation were significantly higher than before reimplantation.

--No significant difference was detected in the levels of D-dimer, ACT, and AT3 between the two groups.

--The AUC of the combined coagulation profile and the change of combined coagulation profile for predicting persistent infection before reimplantation was 0.667 and 0.667, respectively.

Finally, the coagulation profile before preresection differs from that before preimplantation in two-staged arthroplasty, and coagulation markers can help predict infection eradication before reimplantation in two-staged arthroplasty.

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02477-4
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