Biochemical markers in total joint arthroplasty: electrophoresis of joint fluid proteins as a new diagnostic tool for prosthetic performance
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Despite the advances in prosthetic materials and surgical procedures, osteolysis and aseptic loosening are the most common cause of orthopedic implant failure in total joint arthroplasty. Because of risk factors diversity and complexity of cellular and biochemical mechanisms of osteolysis, the challenge is to identify new biochemical markers, more specific and sensitive, for early detection of biochemical changes in joint fluid and screening of patient with high risk for aseptic loosening. Current systemic markers of implant wear include markers of bone turnover (propeptides and telopeptides of collagen) and inflammatory reactions (interleukins), as well as products of wear process (metal ions). The multitude of interferences, the great amounts of biological fluid necessary for analysis, and the viscosity of joint fluid limit their clinical value. Electrophoresis of joint fluid proteins using Hyrys-Hydrasys SEBIA France system enriches the panel of biochemical tests available for assessment of aseptic loosening. The multitude of proteins that can be separated using a small quantity of joint fluid with minor interferences is the main advantage of this investigation technique. The electrophoretic biomarkers as well as their diagnostic and prognostic value in aseptic loosening are presented.
KeywordsArthroplasty Aseptic loosening Electrophoresis Proteins Joint fluid
Conflict of interest
No conflict of interest to declare. No benefits in any form have been or will be received from a commercial part related directly or indirectly to the subject of this manuscript.
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