Erythrocyte Sedimentation Rate
Limited strength evidence does not support the use of ESR, alone, to rule in and rule out surgical site infections due to conflicting data.
Management of Surgical Site Infections
Endorsed by: POSNA, AANA, APTA, MIS, OTA
Rationale
Multiple high-quality studies (Bottner et al 2007, Cipriano et al 2012, Panousis et al 2005) have demonstrated moderate to weak ability of ESR as a solitary test to diagnose or exclude surgical site infection. It is felt to be too variable with respect to time from surgery and in the presence of other confounding factors (such as inflammatory arthropathy) to be considered an accurate tool in diagnosis alone but may be considered as a tool to be used in conjunction with other tests.
- Bottner,F., Wegner,A., Winkelmann,W., Becker,K., Erren,M., Gotze,C. Interleukin-6, procalcitonin and TNF-alpha: markers of peri-prosthetic infection following total joint replacement. J Bone Joint Surg Br 2007/1; 1: 94-99
- Cipriano,C.A., Brown,N.M., Michael,A.M., Moric,M., Sporer,S.M., Della Valle,C.J. Serum and synovial fluid analysis for diagnosing chronic periprosthetic infection in patients with inflammatory arthritis. J Bone Joint Surg Am 2012/4/4; 7: 594-600
- Panousis,K., Grigoris,P., Butcher,I., Rana,B., Reilly,J.H., Hamblen,D.L. Poor predictive value of broad-range PCR for the detection of arthroplasty infection in 92 cases. Acta Orthop 2005/6; 3: 341-346