The diagnosis of infectious complications in joint prosthetics remains a pressing issue, especially in cases where pathogens do not grow during the seeding of biological material. This study analyzed the potential use of synovial biomarkers for the diagnosis of periprosthetic infections (PPI), based on literature data. The aim was to determine the significance of synovial C-reactive protein (CRP), interleukin-6 (IL-6), and presepsin in diagnosing PPI. Materials and methods: A prospective, single-center, blinded study was conducted on patients undergoing revision arthroplasty for both infectious and aseptic inflammation in the endoprosthetic area. The study included 66 patients, divided into two groups: Group I included 17 patients with periprosthetic infection diagnosed according to the ICM Philly criteria of 2018; and Group II included 49 patients with aseptic inflammation in the endoprosthetic region.Synovial fluid samples from all participants were analyzed for bacteriological and cytological analysis to determine the levels of CRP, IL-6, and presepsin. Receiver operating characteristic (ROC) analysis was performed to determine sensitivity, specificity, and accuracy, as well as thresholds for laboratory data. Results: The greatest reliability for diagnosing infectious and aseptic inflammations was shown for the number of leukocytes in synovial fluids, with an area under the curve (AUC) of 0,928 (95% confidence interval [CI]: 0,837-0,977; p0,0001), as well as for synovial CRP with an AUC of 0,776 (95% CI: 0,656-0,87; p=0,0004), and IL-6 with an AUC of 0,712 (95% CI: 0,583-0,82, p=0,0048). While the presepsin level was significantly different between groups, AUC was 0,582 (95% CI: 0,453-0,703, p=0,3344). Threshold values were calculated for CRP at 5,6 mg/L and presepsin – 1212,0 pg/mL and IL-6 – 988,5 pg/mL. The sensitivity, specificity, and accuracy of the diagnosis of PPI were 62,5%, 85,71%, and 80%, respectively for CRP; 68,5%, 63,04%, and 68,7% for IL-6; and 43,75%, 79,59%, and 70,77% for presepsin. Conclusion: IL-6 has the highest sensitivity for PPI, but it has lower accuracy and specificity than CRP. Presepsin has the lowest sensitivity, specificity and accuracy for the diagnosis of PPI.