Another retrospective study on 318 patients (129 PJI and 189 aseptic mechanical failure) conducted by Xu et al. [16] showed that the sensitivity and specificity of d-dimer in PJI diagnosis were only 68.29% and 50.70%, respectively, which were significantly inferior to traditional biomarkers, such as ESR and CRP. This evidence concerns the gene ESR1 and juvenile polyposis syndrome.