Association of blood parameters and ratios with aseptic loosening after total knee arthroplasty: A retrospective cohort study
Medicine (United States), cilt.105, sa.38, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 105 Sayı: 38
- Basım Tarihi: 2026
- Doi Numarası: 10.1097/md.0000000000050825
- Dergi Adı: Medicine (United States)
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals
- Anahtar Kelimeler: knee prosthesis, knee surgery, loosening
- Akdeniz Üniversitesi Adresli: Evet
Özet
This study aimed to evaluate the association of blood parameters and ratios with knee prosthesis loosening in patients after knee arthroplasty. A total of 221 patient files having knee prosthesis attempting to our clinic between 2018 and 2022 were retrospectively examined. Patients were divided into 2 groups as loosening (n = 108; 48.9%) and not loosening (n = 113; 51.1%) groups. Monocyte/high-density lipoprotein (HDL) ratio monocyte-to-HDL ratio (MHR), Neutrophil/lymphocyte ratio, Albumin/ C-reactive protein (CRP) ratio, albumin-to-C-reactive protein ratio (ACR), Eosinophile-to- lymphocyte ratio, mean platelet volume /PLT ratio mean platelet volume-to-platelet ratio, Monocyte -to-lymphocyte ratio, Platelet/lymphocyte ratio (PLR) and Hemoglobin/Platelet ratio (HPR) parameters of patients were evaluated. HDL, albumin, hemoglobin, ACR, PLR and HPR levels were significantly higher in loosening patients (P < .05). CRP, neutrophile, lymphocyte, monocyte and MHR means were significantly higher in no-loosening patients (P < .05). Loosening was significantly correlated with gender (R = 0.141; P < .05), HDL (R = 0.474; P < .01), albumin (R = 0.349; P < .01), CRP (r = −0.466; P < .01), neutrophile (r = −0.167; P < .05), lymphocyte (r = −0.240; P < .01), monocyte (r = −0.380; P < .01), hemoglobin (R = 0.254; P < .01), MHR (r = −0.513; P < .01), ACR (R = 0.496; P < .01), PLR (R = 0.142; P < .05) and HPR (R = 0.204; P < .01). Binary logistic regression analysis showed that MHR (B = −0.415; P < .01), ACR (B = 0.048; P < .01), and HPR (B = 30.640; P < .05) were significantly associated with knee prosthesis loosening at the multivariate level. ROC analysis demonstrated statistically significant discriminative performance for MHR, area under the curve ([AUC] = 0.798; P < .01), ACR (AUC = 0.786; P < .01), and HPR (AUC = 0.618; P < .01). For MHR 6.2481 cutoff level, sensitivity was 72.2% and specificity was 10.6%. For ACR 8.6380 cutoff level, sensitivity was 84.3% and specificity was 59.3%. For HPR 0.0506 cutoff level, sensitivity was 63.9% and specificity was 54.0%. MHR, ACR, and HPR were significantly associated with aseptic loosening after total knee arthroplasty and may be considered potential associated markers rather than definitive predictors.