For citation purposes: Costa L, Soares D, Aido R, Sousa R. The value of monitoring inflammatory markers after total joint arthroplasty. Hard Tissue 2013 Mar 09;2(2):17.

Critical Review

Trauma & Orthopaedics

The value of monitoring inflammatory markers after total joint arthroplasty

L Costa, D Soares, R Aido, R Sousa

Authors affiliations

Department of Orthopaedics, Centro Hospitalar do Porto – Hospital de Santo António, Porto, Portugal

* Corresponding author Email:



Periprosthetic joint infection is a frequent and dreadful complication after total joint arthroplasty. Serological inflammatory markers such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are widely available and easy to use. As such, they are often used as preliminary diagnostic as well as follow-up tools during the course of treatment.

The information they carry is not the same in every clinical scenario, and they should be interpreted accordingly. This review confronts the reader with different doubtful clinical situations and then provides the necessary tools to interpret ESR and CRP in each of them: the immediate postoperative period, the chronic painful arthroplasty and between two-staged revision of infected cases.


Serological inflammatory markers have different diagnostic thresholds in acute and chronic situations. Follow-up measurements during treatment are informative, but complete normalization is not a mandatory requirement for successful outcome.

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