Biomarkers in arthroplasty: a systematic review

Area of Science:

• Orthopedic Surgery
• Biochemistry
• Medical Diagnostics

Background:

• Arthroplasty is a common surgical procedure.
• Accurate diagnosis of complications like osteolysis, aseptic loosening, and infection is crucial.
• Biomarkers offer potential for non-invasive monitoring of arthroplasty outcomes.

Purpose of the Study:

• To systematically review existing literature on biomarkers used in arthroplasty.
• To evaluate the evidence supporting the use of various biomarkers for diagnosing key arthroplasty complications.

Main Methods:

• Systematic review of MEDLINE-published studies.
• Inclusion of studies evaluating biomarkers related to osteolysis, aseptic prosthetic loosening, and prosthetic infections.
• Analysis of reported biomarker levels in patients versus controls.

Main Results:

• Four studies showed elevated Cross-linked N-telopeptides of type I collagen in osteolysis or aseptic loosening.
• Elevated C-reactive protein, erythrocyte sedimentation rate, and interleukin-6 were found in infected prosthetic joints.
• Most other biomarkers lacked consistent or significant associations with arthroplasty outcomes.

Conclusions:

• The current evidence base is insufficient to establish most biomarkers for routine arthroplasty outcome assessment.
• Further rigorous research is required to validate potential biomarkers.
• Cross-linked N-telopeptides of type I collagen show promise for osteolysis and loosening, while inflammatory markers are indicative of infection.