Bizzoca D, Piazzolla A, Moretti L, Vicenti G, Moretti B, Solarino G. Physiologic postoperative presepsin kinetics following primary cementless total hip arthroplasty: A prospective observational study. World J Orthop 2023; 14(7): 547-553 [PMID: 37485426 DOI: 10.5312/wjo.v14.i7.547]
Corresponding Author of This Article
Giuseppe Solarino, MD, PhD, Associate Professor, Di BraiN, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, Bari 70124, Italy. giuseppe.solarino@uniba.it
Research Domain of This Article
Orthopedics
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Jul 18, 2023; 14(7): 547-553 Published online Jul 18, 2023. doi: 10.5312/wjo.v14.i7.547
Physiologic postoperative presepsin kinetics following primary cementless total hip arthroplasty: A prospective observational study
Davide Bizzoca, Andrea Piazzolla, Lorenzo Moretti, Giovanni Vicenti, Biagio Moretti, Giuseppe Solarino
Davide Bizzoca, Andrea Piazzolla, Lorenzo Moretti, DAI Neuroscienze, Organi di Senso e Apparato Locomotore, AOU Consorziale Policlinico di Bari, Bari 70124, Italy
Giovanni Vicenti, Biagio Moretti, Giuseppe Solarino, Di BraiN, University of Bari "Aldo Moro", Bari 70124, Italy
Author contributions: Bizzoca D, Moretti B and Solarino G designed the research study; Bizzoca D and Vicenti G performed the research; Bizzoca D wrote the manuscript; Moretti L and Piazzolla A revised the manuscript; all authors have read and approved the final manuscript.
Institutional review board statement: The study was approved by the local Ethics Committee of AOU Policlinico di Bari (No. 6919).
Informed consent statement: Written informed consent was obtained from the patients.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at giuseppe.solarino@uniba.it.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—a checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed following the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Giuseppe Solarino, MD, PhD, Associate Professor, Di BraiN, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, Bari 70124, Italy. giuseppe.solarino@uniba.it
Received: December 23, 2022 First decision: March 1, 2023 Revised: March 9, 2023 Accepted: June 12, 2023 Article in press: June 12, 2023 Published online: July 18, 2023
ARTICLE HIGHLIGHTS
Research background
Periprosthetic joint infections (PJIs) are a relevant cause of prosthetic surgery revision, accounting for 15% of failed total hip arthroplasties (THA).
Research Motivation
Presepsin (PS) is released into the circulation following bacterial phagocytosis and the activation of other innate defence mechanisms. In a previous preliminary study, our research group defined the normal perioperative plasmatic levels of presepsin at 96 h postoperatively in 50 patients undergoing primary cementless THA and primary cemented total knee arthroplasties.
Research objectives
This paper aims at depicting e normal postoperative PS plasmatic curve, in patients undergoing primary cementless THA, at 12-mo follow-up.
Research methods
Patients undergoing primary THA were prospectively recruited. All the procedures were performed by the same anaesthesia and surgical équipe. The recruited patients underwent serial blood tests, including complete blood count, PS and C-reactive protein 24 h before arthroplasty and at 24, 48, 72 and 96 h postoperatively and at 3, 6 and 12-mo follow-up.
Research results
Ninety-six patients (51 female; mean age = 65.74 years old) were included in the present study. The mean PS values were: 137.54 pg/mL before surgery, 192.08 pg/mL at 24 h post-op; 254.85 pg/mL at 48 h post-op; 259 pg/mL at 72 h post-op; 248.6 pg/mL at 96-h post-op; 140.52 pg/mL at 3-mo follow-up; 135.55 pg/mL at 6-mo follow-up and 130.11 pg/mL at 12-mo follow-up.
Research conclusions
The assessment of plasmatic PS concentration is highly recommended in patients undergoing THA in the preoperative phase, to rule out any unknown infection. The PS plasmatic concentration should be also assessed at 72 h after surgery, to quantify the higher postoperative PS value, and at 96 h after surgery, when a decrease in PS should be found. The lack of a presepsin decrease at 96 h after surgery might predict a local infection.
Research perspectives
Presepsin is an emerging biomarker in the diagnosis of PJIs. However, further studies with bigger samples are awaited to better define the role of serum and synovial PS in the diagnosis of PJI.
