Penanda Infeksi dan Jumlah Trombosit Sebagai Prediktor Prognosis Pasca Debridement Bedah Pada Septic Arthritis Lutut: Tinjauan Sistematis

Abstract

Knee septic arthritis is an orthopedic emergency that requires prompt and appropriate management to prevent permanent joint damage and systemic complications. Inflammatory markers such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are commonly used for diagnosis and monitoring of treatment response; however, their prognostic value after surgical debridement remains variable. This systematic review aimed to evaluate the role of ESR, CRP, and platelet count as prognostic indicators following irrigation and/or surgical debridement in patients with knee septic arthritis. A literature search was conducted in January using PubMed, Google Scholar, ScienceDirect, Wiley Online Library, SpringerLink, and Semantic Scholar, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study quality was assessed using the National Heart, Lung, and Blood Institute (NHLBI) tools. Fifteen studies meeting the inclusion criteria were qualitatively analyzed. The findings indicate that elevated preoperative CRP levels and delayed postoperative CRP reduction are associated with unfavorable clinical outcomes, including failure of infection eradication and the need for repeat debridement. Although ESR is consistently elevated during the acute phase, its slower decline limits its short-term prognostic utility. Platelet count may increase as part of the systemic inflammatory response but shows inconsistent prognostic value.