Laboratory techniques for diagnosing and risk evaluation for complications after arthroplasty of large joints. An analytical review

The authors analyzed the information value of the laboratory tests used for diagnosis and that of evaluating the risk of complications after arthroplasty of large joints (ALJ): aseptic loosening, periprosthetic infrection, heterotopic ossification. They revealed that by now the use of the following laboratory signs for early diagnosis and evaluation of aseptic loosening risk in subjects after ALJ is quite convincing: the increase in the level of N-terminal telopeptide of Type I collagen (NTx) in urine, the increase in the activity of tartrate-resistant acid phosphatase in blood serum, the increase in the concentration of Type I collagen (CTX-I) C-terminal telopeptide in blood serum, as well as the increase in urine desoxypyridinoline (DPYR) and blood osteoprotegerin (OPG). The following clinically significant signs are evidential for laboratory diagnosing periprosthetic infection in patients after ALJ: the increase in the level of C-reactive protein, procalcitonin and interleukin-6 in blood serum, as well as erythrocyte sedimentation rate (ESR) increasing. The authors demonstrated the possibility of using the techniques of laboratory diagnosis for prediction and evaluation of the degree of developing heterotopic ossification in patients after ALJ.