ArticleJournal of medical biochemistry2026
Continuous monitoring of serum markers for early detection of periprosthetic joint infection in osteoporotic patients undergoing hip arthroplasty: A prospective cohort study.
Article in Journal of medical biochemistry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Periprosthetic joint infection (PJI) is a significant complication following hip arthroplasty, especially in osteoporotic patients. Early detection is crucial for improving outcomes but remains challenging. This study assesses the effectiveness of continuous monitoring of serum markers - C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR), D-dimer, white blood cell count (WBC), ferritin, soluble CD14 (sCD14), matrix metalloproteinase-9 (MMP-9), and serum amyloid A (SAA) - for early detection of PJI in osteoporotic patients undergoing hip arthroplasty. Methods: A prospective cohort study included 150 osteoporotic patients undergoing hip arthroplasty. Inflammatory markers were measured preoperatively and at 24-, 48-, and 72 hours post-surgery, with weekly follow-ups for 6 weeks. PJI was diagnosed based on clinical, microbiological, and imaging criteria. The diagnostic performance of individual markers was assessed using Receiver Operating Characteristic (ROC) curves. Results: Among the 150 patients, 12 (8%) developed PJI within 6 weeks. At 48 hours post-surgery, CRP PCT, ESR, D-dimer, WBC, sCD14, and SAA were significantly higher in the PJI group compared to the non-infected group (p< 0.05 for all). Ferritin and MMP-9 levels showed higher values in the infected group but did not reach statistical significance (p= 0.076 and p= 0.094, respectively). The combination of CRP D-dimer, WBC, sCD14, and SAA demonstrated 90% sensitivity and 92% specificity for PJI detection. Conclusions: Continuous monitoring of CRP, D-dimer, WBC, sCD14, and SAA offers a reliable approach for early detection of PJI in osteoporotic patients undergoing hip arthroplasty. These markers showed strong associations with infection, while ferritin and MMP-9 were less informative. This strategy may help improve early diagnosis and patient outcomes.
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