The Value of Serum Ferritin and Hepcidin in Diagnosing Periprosthetic Joint Infection: A Single-Center Prospective Study

Abstract

Background:

Preoperative diagnosis of periprosthetic joint infection (PJI) in patients undergoing revision arthroplasty is crucial, so we evaluated whether serum ferritin and hepcidin contribute to this diagnosis.

Patients and methods:

Patients who underwent revision hip or knee arthroplasty were prospectively divided into those who experienced PJI or not, based on the 2013 International Consensus Meeting Criteria. The serum levels of ferritin and hepcidin, as well as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), were compared between the groups. The diagnostic values of the tested biomarkers and their combinations were compared based on the area under the receiver operating characteristic (ROC) curve using the z-test.

Results:

Of the 88 included patients, 44 were diagnosed with PJI. Serum ferritin in PJI patients was higher than that in non-PJI patients (p = 0.048), whereas there was no significant difference in serum hepcidin between the groups. The area under the ROC curve was 0.830 for CRP, 0.824 for ESR, and 0.643 for ferritin. The combination of serum ferritin with CRP and ESR did not give a higher area under the ROC curve than any pairwise combination.

Conclusion:

Serum ferritin and hepcidin are of limited value for diagnosing PJI.