The serum and synovial fluid Procalcitonin (S-PCT and SF-PCT) did not seem to be reliable biomarkers for the differential diagnosis of periprosthetic joint infection (PJI) from aseptic loosening in total joint arthroplasty, as culminated from a prospective cohort study published in ‘BMC Musculoskeletal Disorders’.

André Busch et al. assessed the precision of S-PCT and SF-PCT as a reliable diagnostic biomarker. Medical history, relevant clinical and laboratory data of seventy individuals with painful hip, shoulder and knee arthroplasty was considered for this study. Diagnosis of PJI was made as per the Definition of periprosthetic hip and knee infection (2018). Standard quantitative PCT enzyme immunoassays were used to determine the S-PCT and SF-PCT levels.

Out of the total, 23 patients were categorized as the PJI group and 47 patients as part of the aseptic group. The PJI group had higher mean levels of S-PCT as compared to in the aseptic group. On the contrary, the aseptic group had considerably higher mean PCT values as compared to PJI group in synovial fluid. The S- PCT and SF-PCT with a cut-off level of 0.5 ng/mL, were found to have same sensitivity (13.0%) and a specificity of 91.0% and 52.0%, respectively.