There was no difference in sensitivity (I2 = 0, P = 0.777; I2 = 0, P = 0.798) or specificity (I2 = 0, P = 0.325; I2 = 0, P = 0.476) for the diagnosis of PJI; CRP and ESR, as the most commonly used serological indicators of infection, provide a good response to the overall infection status of the body, and D-dimer is similar to them in terms of diagnostic performance. This evidence concerns the gene ESR1 and infection.