Laboratory biomarkers and radiographic osteolysis after total knee arthroplasty: a retrospective pilot study.

PURPOSE: This study aimed to identify early risk factors for periprosthetic osteolysis after total knee arthroplasty (TKA) and establish clinically useful predictive biomarkers.

METHODS

A retrospective analysis was conducted on patients who underwent TKA at our institution between January 1, 2018, and October 31, 2023. Initially, 397 patients were screened, and 375 met the inclusion criteria after applying strict eligibility standards. Patients were categorized into an osteolysis group (n = 17) and a non-osteolysis group (n = 358). Data on baseline characteristics (age, gender, BMI, diabetes, and hypertension history) and postoperative laboratory results were collected. Logistic regression analyses identified independent risk factors for osteolysis, with subgroup analyses also performed.

RESULTS

Multivariable logistic regression analysis showed that each 1-unit increase in leukocyte count (OR = 1.36, 95% CI: 1.13-1.65, P = 0.001) and each 1-unit increase in FIB-4 index (OR = 1.94, 95% CI: 1.20-3.14, P = 0.007) were associated with higher odds of osteolysis, whereas each 1-unit increase in the uric acid-to-creatinine ratio (UACR) was associated with lower odds of osteolysis (OR = 0.57, 95% CI: 0.36-0.88, P = 0.012). Subgroup analyses suggested that the strength and significance of these associations varied by sex, age, diabetes status, and hypertension status.

CONCLUSION

This study demonstrates that leukocyte count, FIB-4 index, and UACR are independent risk factors for early periprosthetic osteolysis after TKA. These findings may assist in the early identification and management of high-risk patients, thereby reducing postoperative complications and improving patient outcomes.