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Inflammatory Biomarkers Following Orthopedic Surgery: Current Evidence, Clinical Applications, and Future
Anna Perek1, Tomasz Reysner2, Jowita Rosada-Kurasińska2
1Department of Clinical Anesthesiology and Pain Management, Poznan University of Medical Sciences, 61-545 Poznań, Poland.
Journal of Clinical Medicine
|July 28, 2026
Summary
Monitoring inflammation in orthopedic surgery is crucial for recovery. New complete blood count (CBC)-derived inflammatory biomarkers show promise for risk assessment, but require standardization and combined interpretation for clinical utility.
Area of Science:
- Orthopedic Surgery
- Inflammatory Response
- Biomarker Discovery
Background:
- Orthopedic procedures induce inflammation vital for healing but can lead to complications if dysregulated.
- Accurate perioperative monitoring of inflammatory activity is essential in orthopedic surgery.
- Traditional biomarkers (CRP, IL-6, TNF-α, PCT, D-dimers) are used, but emerging CBC-derived indices offer new insights.
Purpose of the Study:
- To review current evidence on traditional and emerging inflammatory biomarkers in orthopedic surgery.
- To evaluate the clinical utility of these biomarkers in various orthopedic contexts.
- To highlight the potential of CBC-derived indices for perioperative risk stratification.
Main Methods:
- A narrative review of literature from PubMed, Scopus, and Web of Science (2000-2026).
- Summarized evidence on traditional inflammatory biomarkers and CBC-derived indices (NLR, MLR, PLR, SII, SIRI, AISI).
- Focused on clinical utility in orthopedic trauma, fracture healing, arthroplasty, and complication detection.
Main Results:
- CBC-derived indices offer a practical, cost-effective approach for risk stratification and prognosis.
- These emerging biomarkers show potential in orthopedic trauma, fracture healing, and joint arthroplasty.
- Interpreting multiple inflammatory indices together and assessing biomarker kinetics is more valuable than isolated measurements.
Conclusions:
- Composite CBC-derived indices show promise for perioperative risk assessment in orthopedics.
- Standardization of cutoff values and consideration of patient factors are crucial for interpretation.
- Future research should focus on validation, standardization, and integration into personalized perioperative care.