CLINICAL UTILITY OF SEROLOGICAL AND GENETIC BIOMARKERS IN ORTHOPEDIC INFECTIONS: ADVANCES IN DIAGNOSIS AND TREATMENT MONITORING

Orthopedic infections such as osteomyelitis and prosthetic joint infections (PJIs) are difficult to diagnose and treat. The conventional diagnosis methods, i.e., microbiological cultures and imaging studies, are usually restricted by prolongation of results and false-negative results. In the recent past, the clinical value of serological and genetic biomarkers has emerged for enhancing the specificity of diagnosis, treatment efficacy, and monitoring disease activity in
orthopedic infections. These biomarkers, including inflammatory markers, cytokines, and genetic signatures, provide a faster and more accurate alternative to traditional diagnostic techniques. Serological biomarkers, such as C-reactive protein (CRP), procalcitonin (PCT), and interleukins, may predict the severity of infection and inform therapy. Genetic biomarkers, especially those involving microbial resistance or host immune responses, reflect
the behavior of the pathogen and the immune profile of the patient and help form more tailored treatment plans. Progress in genomics and proteomics is further facilitating the discovery of new biomarkers that would make effective diagnostic and prognostic markers. Additionally, these biomarkers are critical for the identification of recurrences, monitoring the efficacy of interventions, and forecasting long-term outcomes. This review documents
recent progress in serological and genetic biomarkers, their applications in enhancing diagnostic efficacy, informing treatment options, and improving patient outcomes in orthopedic infections. Although these biomarkers show great promise, more clinical
validation is needed for them to have standardized protocols and be widely used in clinical settings.

Keywords: Orthopedic Infections, Osteomyelitis, Prosthetic Joint Infections, Serological Biomarkers, Genetic Biomarkers, Procalcitonin, Precision Medicine.