Biomarkers in Arthroplasty: A Systematic Review

Marty T Mertens 1, Jasvinder A Singh*, 1, 2, 3, 4
1 Rheumatology Section, Medicine Service, Minneapolis, MN, USA
2 Center for Chronic Disease Outcomes Research at the VA Medical Center, Minneapolis, MN, USA
3 Division of Rheumatology, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
4 Departments of Health Sciences Research and Orthopedics, Mayo Clinic School of Medicine, Rochester, MN, USA

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© Mertens and Singh; Licensee Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution, and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the University of Alabama, Faculty Office Tower 805B, 510 20th Street S, Birmingham, AL 35294, USA; Tel: 205-934-8158; Fax: 205-966-9685; E-mail:


We performed a systematic review of all MEDLINE-published studies of biomarkers in arthroplasty. Thirty studies met the inclusion criteria; majority evaluated biomarkers for osteolysis, aseptic prosthetic loosening, and prosthetic infections. Four studies reported an elevated Cross-linked N-telopeptides of type I collagen (urine or serum) in patients with osteolysis or aseptic prosthetic loosening when compared to appropriate controls. Two or more studies each found elevated C-reactive protein, erythrocyte sedimentation rate, and interleukin-6 in patients with infected prosthetic joints compared to controls. Most other biomarkers were either examined by single studies or had inconsistent or insignificant associations with outcomes. We conclude that the majority of the biomarkers currently lack the evidence to be considered as biomarkers for arthroplasty outcomes. Further studies are needed.

Keywords: Biomarkers, arthroplasty, systematic review.