Prosthetic Joint Infection (PJI) is one of the severe complications following arthroplasty. With the global aging population, the number of patients undergoing primary joint replacement surgeries is increasing, leading to a rise in PJI cases. Although the incidence of PJI is generally low, the impact on patients can be catastrophic. Once an infection occurs, it is further complicated by the rising global antibiotic resistance, imposing a significant economic burden on patients. Therefore, improving the diagnostic rate of PJI is crucial. Currently, various infection markers are used in the diagnosis of PJI. However, there is still a lack of highly sensitive and specific markers to effectively diagnose PJI, necessitating the exploration of new infection markers. This study aims to investigate novel infection markers for the diagnosis of PJI, providing evidence for its diagnosis and subsequent treatment. In this research, we will prospectively collect data from patients undergoing primary joint replacement and those developing PJI from June 2024 to December 2026. These patients will be categorized into non-infection and infection groups. By collecting and analyzing general patient data, surgery-related information, and infection-related indicators from preoperative joint fluid and blood samples, we aim to further evaluate the predictive value of these infection markers for PJI.
Study Type
OBSERVATIONAL
Enrollment
200
Joint puncture to extract joint fluid.
Joint fluid target protein detection
To detect new target proteins by elisa test.
Time frame: One day before surgery or one day after surgery
X-ray
X-ray of surgery site.
Time frame: One day before surgery and two years after surgery
Erythrocyte sedimentation rate (ESR)
It measures the rate at which red blood cells settle to the bottom of a test tube within one hour. Normal ranges: Male: 0 to 15 millimeters per hour (mm/hr) Female: 0 to 20 millimeters per hour (mm/hr)
Time frame: One day before sugery and two year after surgery
C-reactive protein (CRP)
C-reactive protein (CRP) is a protein produced by the liver that significantly increases in response to inflammation or infection. Normal range for CRP is less than 10 milligrams per liter (mg/L).
Time frame: One day before sugery and two year after surgery
Synovial fluid white blood cell count (SF-WBC)
Synovial fluid white blood cell count (SF-WBC)
Time frame: One day before surgery and one day after surgery
Synovial fluid polymorphonuclear cells (SF-PMN)
Polymorphonuclear neutrophil percentage in synovial fluid refers to the proportion or percentage of polymorphonuclear neutrophils (PMN) present in the synovial fluid. This measurement is important in the assessment of joint health and inflammation, particularly in conditions such as arthritis and infections affecting the joints. Normal range: Less than 80%.
Time frame: One day before surgery and one day after surgery
Doppler lower extremity vascular color ultrasound
Doppler lower extremity vascular color ultrasound to evaluate the deep vein thrombus development
Time frame: One day before surgery and three day after surgery
American Knee Society Score (AKS score)
American Knee Society Score is used to evaluate the outcomes of knee replacement surgery. This scoring system consists of two main components: the knee score and the function score. Knee Score: This primarily assesses the condition of the knee joint itself, including pain, stability, and range of motion. The higher of the score, the better of the functional result.
Time frame: One day before surgery, two years after surgery
The Hip Harris Score (HHS)
The Harris Hip Score (HHS) is a widely used clinical tool for assessing the outcomes of hip surgeries, particularly hip replacements. Developed by Dr. William Harris in 1969, it evaluates various aspects of hip function and pain to provide an overall score that reflects the patient's condition. The higher the score, the better the result is.
Time frame: One day before surgery, two years after surgery
Alanine Aminotransferase (ALT)
An enzyme found in the liver that helps convert proteins into energy. Elevated levels indicate liver damage. Normal range: 10 to 40 units per liter (U/L)
Time frame: One day before surgery and one day after surgery
Aspartate Aminotransferase (AST)
An enzyme found in the liver and other tissues. High levels can indicate liver damage but are less specific than ALT. Normal range: 10 to 40 units per liter (U/L)
Time frame: One day before surgery and one day after surgery
Serum Creatinine
Measures the level of creatinine in the blood. Elevated levels can indicate impaired kidney function. Normal range: 62 to 115 micromoles per liter (µmol/L).
Time frame: One day before surgery and one day after surgery
Blood Urea Nitrogen （BUN）
Measures the amount of nitrogen in the blood that comes from urea. Elevated BUN levels can indicate impaired kidney function. Normal range: 2.5 to 7.1 millimoles per liter (mmol/L).
Time frame: One day before surgery and one day after surgery
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