Wouthuyzen-Bakker et al reported the CRIME80 score for evaluating a patient with an acute periprosthetic joint infection. This can help to identify a patient who may benefit from debridement and implant retention. The authors are from multiple institutions from around the world.
Patient selection: acute prosthetic infection
Outcome: debridement, antibiotics, implant retention (DAIR)
Parameters:
(1) COPD (C)
(2) CRP in mg/L (C)
(3) rheumatoid arthritis (R)
(4) arthroplasty indication (I)
(5) male (M)
(6) exchange of mobile components (E)
(7) age in years (80)
Parameter
Finding
Points
COPD
no
0
yes
2
serum CRP
<= 150 mg/L
0
> 150 mg/L
1
rheumatoid arthritis
no
0
yes
3
indication for arthroplasty
fracture
3
other
0
sex
female
0
male
1
exchange of mobile components
no
0
yes
-1
age in years
<= 80 years
0
> 80 years
2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -1
• maximum score: 12
• A score >= 3 may be an indication for implant removal, especially if Staphylococcus aureus is the infecting organism.
Total Score
Failure (Boyer and Cazorla)
-1
22%
0
28%
1 or 2
40%
3 or 4
64%
>= 5
79%
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