Mona Lisa Delva1, Linsen T Samuel2, Alexander J Acuña1,2, Atul F Kamath3,4. 1. School of Medicine, Case Western Reserve University, Health Education Campus, 9501 Euclid Avenue, Cleveland, OH, 44106, USA. 2. Department of Orthopaedic Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, Mail code A40, Cleveland, OH, 44195, USA. 3. Department of Orthopaedic Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, Mail code A40, Cleveland, OH, 44195, USA. kamatha@ccf.org. 4. Center for Hip Preservation, Orthopaedic and Rheumatologic Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Mail code A40, Cleveland, OH, 44195, USA. kamatha@ccf.org.
Abstract
INTRODUCTION: While presepsin has shown promise as a sepsis biomarker, it has only recently been considered in the field of orthopedic surgery. Therefore, the present review evaluates the role of presepsin in total joint arthroplasty (TJA) as well as its diagnostic and prognostic value in diagnosing PJI. METHODS: Utilizing 4 online databases, we thoroughly searched the literature for articles evaluating the role of presepsin in TJA as well as its prognostic and diagnostic value for PJI. RESULTS: Studies evaluating perioperative presepsin trends in primary TJA demonstrated that its natural course is similar to C-Reactive Protein (CRP). The area under (AUC) the receiver operating characteristic curves values for serum presepsin ranged from 0.86 to 0.926. These values were higher than the AUCs for CRP in each of their respective studies. However, synovial presepsin demonstrated a lower AUC (0.41). Prognostically, presepsin demonstrated potential in terms of infection monitoring following revision TJA for PJI. CONCLUSION: Although the data remains limited, presepsin may serve as a potential biomarker to evaluate the natural inflammatory response following TJA as well as to help diagnose PJI. The present review serves to set the foundation for future study into serum presepsin in larger patient cohorts. Further study is needed to evaluate how this biomarker compares to other laboratory values traditionally used for PJI diagnosis.
INTRODUCTION: While presepsin has shown promise as a sepsis biomarker, it has only recently been considered in the field of orthopedic surgery. Therefore, the present review evaluates the role of presepsin in total joint arthroplasty (TJA) as well as its diagnostic and prognostic value in diagnosing PJI. METHODS: Utilizing 4 online databases, we thoroughly searched the literature for articles evaluating the role of presepsin in TJA as well as its prognostic and diagnostic value for PJI. RESULTS: Studies evaluating perioperative presepsin trends in primary TJA demonstrated that its natural course is similar to C-Reactive Protein (CRP). The area under (AUC) the receiver operating characteristic curves values for serum presepsin ranged from 0.86 to 0.926. These values were higher than the AUCs for CRP in each of their respective studies. However, synovial presepsin demonstrated a lower AUC (0.41). Prognostically, presepsin demonstrated potential in terms of infection monitoring following revision TJA for PJI. CONCLUSION: Although the data remains limited, presepsin may serve as a potential biomarker to evaluate the natural inflammatory response following TJA as well as to help diagnose PJI. The present review serves to set the foundation for future study into serum presepsin in larger patient cohorts. Further study is needed to evaluate how this biomarker compares to other laboratory values traditionally used for PJI diagnosis.
Authors: Ronald E Delanois; Jaydev B Mistry; Chukwuweike U Gwam; Nequesha S Mohamed; Ujval S Choksi; Michael A Mont Journal: J Arthroplasty Date: 2017-04-06 Impact factor: 4.757
Authors: Chukwuweike U Gwam; Jaydev B Mistry; Nequesha S Mohamed; Melbin Thomas; Kevin C Bigart; Michael A Mont; Ronald E Delanois Journal: J Arthroplasty Date: 2017-02-27 Impact factor: 4.757
Authors: Steven M Kurtz; Edmund C Lau; Min-Sun Son; Ellen T Chang; Werner Zimmerli; Javad Parvizi Journal: J Arthroplasty Date: 2018-06-01 Impact factor: 4.757
Authors: Chuan Kong Koh; Irene Zeng; Saiprassad Ravi; Mark Zhu; Kelly G Vince; Simon W Young Journal: Clin Orthop Relat Res Date: 2017-06-01 Impact factor: 4.176
Authors: Jaiben George; Michael Jawad; Gannon L Curtis; Linsen T Samuel; Alison K Klika; Wael K Barsoum; Carlos A Higuera Journal: J Arthroplasty Date: 2017-12-29 Impact factor: 4.757