Published online Jul 18, 2023. doi: 10.5312/wjo.v14.i7.547
First decision: March 1, 2023
Revised: March 9, 2023
Accepted: June 12, 2023
Article in press: June 12, 2023
Published online: July 18, 2023
Processing time: 206 Days and 14.4 Hours
Periprosthetic joint infections (PJIs) are a relevant cause of prosthetic surgery revision, accounting for 15% of failed total hip arthroplasties (THA).
Presepsin (PS) is released into the circulation following bacterial phagocytosis and the activation of other innate defence mechanisms. In a previous preliminary study, our research group defined the normal perioperative plasmatic levels of presepsin at 96 h postoperatively in 50 patients undergoing primary cementless THA and primary cemented total knee arthroplasties.
This paper aims at depicting e normal postoperative PS plasmatic curve, in patients undergoing primary cementless THA, at 12-mo follow-up.
Patients undergoing primary THA were prospectively recruited. All the procedures were performed by the same anaesthesia and surgical équipe. The recruited patients underwent serial blood tests, including complete blood count, PS and C-reactive protein 24 h before arthroplasty and at 24, 48, 72 and 96 h postoperatively and at 3, 6 and 12-mo follow-up.
Ninety-six patients (51 female; mean age = 65.74 years old) were included in the present study. The mean PS values were: 137.54 pg/mL before surgery, 192.08 pg/mL at 24 h post-op; 254.85 pg/mL at 48 h post-op; 259 pg/mL at 72 h post-op; 248.6 pg/mL at 96-h post-op; 140.52 pg/mL at 3-mo follow-up; 135.55 pg/mL at 6-mo follow-up and 130.11 pg/mL at 12-mo follow-up.
The assessment of plasmatic PS concentration is highly recommended in patients undergoing THA in the preoperative phase, to rule out any unknown infection. The PS plasmatic concentration should be also assessed at 72 h after surgery, to quantify the higher postoperative PS value, and at 96 h after surgery, when a decrease in PS should be found. The lack of a presepsin decrease at 96 h after surgery might predict a local infection.
Presepsin is an emerging biomarker in the diagnosis of PJIs. However, further studies with bigger samples are awaited to better define the role of serum and synovial PS in the diagnosis of PJI.