Values of synovial fluid HBP,CRP,erythrocyte sedimentation rate and miR-146a in diagnosis of postoperative periprosthetic joint infection in elderly patients undergoing joint replacement

OBJECTIVE To explore the values of synovial fluid heparin-binding protein (HBP), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and microRNA (miR)-146a in diagnosis of postoperative periprosthetic joint infection (PJI) in the elderly patients undergoing joint replacement. METHODS A total of 196 elderly patients who underwent joint replacement in Qingyang People's Hospital from Oct 2019 to Mar 2021 were enrolled in the study and were divided into the infection group with 36 cases and the no infection group with 160 cases according to the status of postoperative PJI, the related data of the patients were retrospectively analyzed. The levels of synovial fluid HBP, CRP, ESR and miR-146a were detected and compared between the two groups of patients, and the values of the above indexes in diagnosis of PJI and assessment of curative effect were observed. RESULTS The levels of synovial fluid HBP, CRP, ESR and miR-146a of the infection group were significantly higher than those of the no infection group (P＜0.05). The areas under curves (AUCs) of synovial fluid HBP, CRP, ESR and miR-146a were respectively 0.693, 0.697, 0.692 and 0.786 in diagnosis of PJI, the AUC of the joint detection of the four indexes was 0.931 in diagnosis of PJI. The levels of synovial fluid HBP, CRP, ESR and miR-146a of the ineffective treatment group were significantly higher than those of the effective treatment group (P＜0.05). The AUCs of synovial fluid HBP, CRP, ESR and miR-146a were respectively 0.738, 0.741, 0.647 and 0.794 in prediction of the curative effect on the PJI patients, and the AUC of the joint detection of the indexes was 0.900 in prediction of the curative effect on the PJI patients. CONCLUSION The elderly joint replacement patients with postoperative PJI show abnormal rise of synovial fluid HBP, CRP, ESR and miR-146a. The joint detection of the four indexes had certain values in diagnosis of PJI and assessment of the curative effect.