Table 4.
Biomarkers in serum or plasma (see Table 1 for abbreviations)
| Biomarker | Effect | Implant | Groups compared (test versus control) | Test time from implantation (years) | Control time from implantation (years) | Number of test subjects | Number of control subjects | Tissue | Reference |
|---|---|---|---|---|---|---|---|---|---|
| BAP | None | THA | Aseptic loosening versus stable implants | 9.6 | 9.1 | 50 | 50 | Serum | [30] |
| BAP | None | THA | Aseptic loosening versus stable implants | 12.6 | 12.6 | 23 | 26 | Serum | [35] |
| CRP | None | THA | Osteolysis versus no osteolysis (long-term) | > 10 | > 10 | 6 | 10 | Serum | [11] |
| CRP | Elevated | THA | Osteolysis versus no osteolysis (short-term) | > 10 | 4.1 | 6 | 5 | Serum | [11] |
| CTX-I | None | THA | Aseptic loosening versus stable implants | 9.7 | 3.7 | 12 | 12 | Serum | [16] |
| CTX-I | Elevated (trend) | THA | Aseptic loosening versus stable implants | 12.6 | 12.6 | 23 | 26 | Serum | [35] |
| CTX-I | Elevated | TKA | Potentially unstable versus stable (RSA) | 0.5, 1, 2 | 0.5, 1, 2 | 15 | 25 | Serum | [17] |
| Elastase | None | THA | Aseptic loosening versus stable implants | 8.6 | 8.4 | 23 | 23 | Serum | [31] |
| GM-CSF | None | THA | Aseptic loosening versus stable implants | 8.6 | 8.4 | 23 | 23 | Serum | [31] |
| HA | Elevated | THA | Aseptic loosening versus stable implants | 5.4 | 5.6 | 9 | 13 | Serum | [20] |
| IL-1β | None | THA | Late aseptic loosening versus stable implants | 17 | 5 | 17 | 13 | Plasma | [10] |
| IL-1β | None | THA | Early aseptic loosening versus stable implants | 5 | 5 | 7 | 13 | Plasma | [10] |
| IL-1β | None | THA | Osteolysis versus no osteolysis (long-term) | > 10 | > 10 | 6 | 10 | Serum | [11] |
| IL-1β | None | THA | Osteolysis versus no osteolysis (short-term) | > 10 | 4.1 | 6 | 5 | Serum | [11] |
| IL-1β | None | THA | Osteolysis versus stable implants | 6.5 | 4.9 | 8 | 10 | Serum | [6] |
| IL-1β | Elevated | THA, TKA | Aseptic loosening versus stable implants | 10 | 11 | 50 | 50 | Plasma | [13] |
| IL-1β | None | THA | Aseptic loosening versus stable implants | 5.4 | 5.6 | 9 | 13 | Serum | [20] |
| IL-1β | None | THA | Aseptic loosening versus mechanical loosening | 9.7 | 7.2 | 43 | 30 | Plasma | [36] |
| IL-1β | Elevated | THA | Aseptic loosening versus stable implants | 9.7 | 2.2 | 43 | 16 | Plasma | [36] |
| IL-6 | None | THA | Osteolysis versus stable implants | 6.5 | 4.9 | 8 | 10 | Serum | [6] |
| IL-6 | None | THA | Aseptic loosening versus stable implants | 8.6 | 8.4 | 23 | 23 | Serum | [31] |
| IL-6 | Elevated | THA | Osteolysis versus no osteolysis (long-term) | > 10 | > 10 | 6 | 10 | Serum | [11] |
| IL-6 | Elevated | THA | Osteolysis versus no osteolysis (short-term) | > 10 | 4.1 | 6 | 5 | Serum | [11] |
| IL-6 | Elevated | THA | Osteolysis versus stable implants | 12.3 | 5.4 | 28 | 24 | Serum | [33] |
| IL-8 | Elevated | THA, TKA | Aseptic loosening versus stable implants | 10 | 11 | 50 | 50 | Plasma | [13] |
| IL-8 | Elevated | THA | Osteolysis versus stable implants | 12.3 | 5.4 | 28 | 24 | Serum | [33] |
| IL-11 | None | THA | Osteolysis versus stable implants | 6.5 | 4.9 | 8 | 10 | Serum | [6] |
| Marker panel* | Different | THA | Late aseptic loosening versus stable implants | 17 | 5 | < 31 | < 19 | Plasma | [10] |
| Marker panel* | Different (trend) | THA | Early aseptic loosening versus stable implants | 5 | 5 | < 15 | < 19 | Plasma | [10] |
| MMP-1 | None | THA | Osteolysis versus stable implants | 6.5 | 4.9 | 8 | 10 | Serum | [6] |
| NTX | Elevated | THA | Osteolysis versus stable implants | 9.6 | 2.1 | 21 | 18 | Serum | [29] |
| NTX | None | THA | Late aseptic loosening versus stable implants | 17 | 5 | 29 | 14 | Plasma | [10] |
| NTX | None | THA | Early aseptic loosening versus stable implants | 5 | 5 | 7 | 14 | Plasma | [10] |
| OPG | Elevated | THA | Aseptic loosening versus stable implants | 9.3 | 2.7 | 36 | 33 | Serum | [8] |
| OPG | None | THA | Late aseptic loosening versus stable implants | 17 | 5 | 29 | 12 | Plasma | [10] |
| OPG | None | THA | Early aseptic loosening versus stable implants | 5 | 5 | 14 | 12 | Plasma | [10] |
| OPG/RANKL ratio | Elevated | THA | Aseptic loosening versus stable implants | 9.3 | 2.7 | 36 | 33 | Serum | [8] |
| Osteocalcin | Elevated | TKA | Potentially unstable versus stable (RSA) | 1 | 1 | 15 | 25 | Serum | [17] |
| Osteocalcin | Elevated | THA | Aseptic loosening versus stable implants | 9.6 | 9.1 | 50 | 50 | Serum | [30] |
| Osteocalcin | None | THA | Aseptic loosening versus stable implants | 12.6 | 12.6 | 23 | 26 | Serum | [35] |
| PGE2 | None | THA | Osteolysis versus stable implants | 6.5 | 4.9 | 8 | 10 | Serum | [6] |
| PICP | None | TKA | Potentially unstable versus stable (RSA) | 0.5, 1, 2 | 0.5, 1, 2 | 15 | 25 | Serum | [17] |
| PICP | Depressed | THA | Osteolysis versus stable implants | 9.6 | 2.1 | 21 | 18 | Serum | [29] |
| PICP | None | THA | Late aseptic loosening versus stable implants | 17 | 5 | 18 | 11 | Plasma | [10] |
| PICP | None | THA | Early aseptic loosening versus stable implants | 5 | 5 | 13 | 11 | Plasma | [10] |
| PICP | None | THA | Aseptic loosening versus stable implants | 9.6 | 9.1 | 50 | 50 | Serum | [30] |
| PIIINP | None | THA | Aseptic loosening versus stable implants | 5.4 | 5.6 | 9 | 13 | Serum | [20] |
| PINP | Elevated (trend) | THA | Aseptic loosening versus stable implants | 12.6 | 12.6 | 23 | 26 | Serum | [35] |
| RANKL | Depressed | THA | Aseptic loosening versus stable implants | 9.3 | 2.7 | 36 | 33 | Serum | [8] |
| RANKL | None | THA | Late aseptic loosening versus stable implants | 17 | 5 | 20 | 18 | Plasma | [10] |
| RANKL | None | THA | Early aseptic loosening versus stable implants | 5 | 5 | 9 | 18 | Plasma | [10] |
| sIL-2r | None | THA | Aseptic loosening versus stable implants | 8.6 | 8.4 | 23 | 23 | Serum | [31] |
| TGF-β | None | THA | Osteolysis versus stable implants | 6.5 | 4.9 | 8 | 10 | Serum | [6] |
| TNF-α | None | THA | Late aseptic loosening versus stable implants | 17 | 5 | 29 | 11 | Plasma | [10] |
| TNF-α | None | THA | Early aseptic loosening versus stable implants | 5 | 5 | 9 | 11 | Plasma | [10] |
| TNF-α | None | THA | Osteolysis versus no osteolysis (long-term) | > 10 | > 10 | 6 | 10 | Serum | [11] |
| TNF-α | None | THA | Osteolysis versus no osteolysis (short-term) | > 10 | 4.1 | 6 | 5 | Serum | [11] |
| TNF-α | None | THA | Osteolysis versus stable implants | 6.5 | 4.9 | 8 | 10 | Serum | [6] |
| TNF-α | Elevated | THA, TKA | Aseptic loosening versus stable implants | 10 | 11 | 50 | 50 | Plasma | [13] |
| TNF-α | None | THA | Aseptic loosening versus mechanical loosening | 9.7 | 7.2 | 43 | 30 | Plasma | [36] |
| TNF-α | Elevated | THA | Aseptic loosening versus stable implants | 9.7 | 2.2 | 43 | 16 | Plasma | [36] |
| TNF-α | None | THA | Osteolysis versus stable implants | 12.3 | 5.4 | 28 | 24 | Serum | [33] |
| TRAP-5b | Elevated | THA | Aseptic loosening versus stable implants | 5.2 | 8.8 | 27 | 19 | Serum | [28] |
| TRAP-5b | Elevated | THA | Aseptic loosening versus stable implants | 9.7 | 3.7 | 12 | 12 | Serum | [16] |
* Combination score based on IL-1β, NTx, OPG, PICP, RANKL, and TNF-α.