Title: Evaluation of neutrophil gelatinase-associated lipocalin precision in periprosthetic joint infection diagnosis

Authors: Ting Fu; Huhu Wang; Qiaolong Hu; Shuai Ding; Jiaming He

Addresses: Department of Gynecology, Yulin Hospital, Yulin, Shaanxi, 719000, China; Affiliated to: Xi'an Jiaotong University, China ' Department of Orthopaedics, Yulin Hospital, Yulin, Shaanxi, 719000, China; Affiliated to: Xi'an Jiaotong University, China ' Department of Orthopaedics, Yulin Hospital, Yulin, Shaanxi, 719000, China; Affiliated to: Xi'an Jiaotong University, China ' Department of Intensive Care Medicine, Yulin Hospital, Yulin, Shaanxi, 719000, China; Affiliated to: Xi'an Jiaotong University, China ' Department of Orthopaedics, Yulin Hospital, Yulin, Shaanxi, 719000, China; Affiliated to: Xi'an Jiaotong University, China

Abstract: This study assesses neutrophil gelatinase-associated lipocalin (NGAL) as a diagnostic biomarker for periprosthetic joint infection (PJI). A comprehensive search in multiple databases (Cochrane Library, Scopus, OVID, PubMed, Web of Science, and Embase) identified relevant studies on NGAL for PJI diagnosis until September 2023. Pooled sensitivity and specificity for NGAL, alongside other biomarkers (CRP, ESR, SF-WBC, D-dimer, and PCT), were analysed. Across nine studies, NGAL showed high diagnostic accuracy with pooled sensitivity of 0.93 and specificity of 0.90. Other markers showed lower sensitivity (ESR: 0.81, CRP: 0.75, SF-WBC: 0.91, D-dimer: 0.43, PCT: 0.65) and specificity (ESR: 0.90, CRP: 0.93, SF-WBC: 0.86, D-dimer: 0.93, PCT: 0.93). The diagnostic odds ratio (DOR) for NGAL (132.89) surpassed other markers, supporting NGAL as a superior diagnostic tool for PJI.

Keywords: periprosthetic joint infection; PJI; neutrophil gelatinase-associated lipocalin; NGAL; diagnosis.

DOI: 10.1504/IJDMB.2025.148959

International Journal of Data Mining and Bioinformatics, 2025 Vol.29 No.4, pp.381 - 401

Received: 04 Jan 2024
Accepted: 16 May 2024
Published online: 06 Oct 2025 *

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