Microbiological and serological verification of paraendoprosthetic complications of hip and knee arthroplasty in patients with deforming osteoarthritis

P.O. Korol


Background. To date, the problem of joint replacement has a number of achievements: the manufacture of artificial joint components, modern methods of performing this procedure, the availability of new quality techniques for the manufacture of prostheses. However, the issue of verifying paraendoprosthetic complications of the hip and knee arthroplasty in patients with deforming osteoarthritis remains unsolved, which are diagnosed using radiation imaging techniques. The purpose of our study was to identify microbiological and serological methods for verifying paraendoprosthetic complications of hip and knee arthroplasty in patients with deforming osteoarthritis. Materials and methods. Microbiological verification of 115 samples of surgical material obtained with sanitizing interventions involving removal of endoprosthetic components was performed in 26 patients with implant-associated infection. With aim of serological verification, the detection of the level of antibo­dies to Staphylococcus aureus and Streptococcus pyogenes was used by means of enzyme immunoassay and direct hemagglutination in paired sera, as well as the presence of a C-reactive protein in the blood components. Sixty five patients were examined, 196 variants of serum were verified, 796 serological tests were performed. Results. Comprehensive microbiological and microscopic research allowed to characterize the spectrum of expected pathogens in 90 % of the examined patients with implant-associated infection. Preoperative microbiological examination allows in many patients to establish an etiological factor of suppuration in case of Gram-positive microorganisms, especially staphylococci and streptococci. High levels of antistaphylococcal antibodies were observed in 18.6 % of patients, as well as of ASL-O. This fact not only confirmed the presence of infection of a certain origin, but also indicated the probability of the hematogenous pathway of infection of periprosthetic tissues, as a result of the septic state. The detection of C-reactive protein in the blood serum indicated an inflammatory process before the ope-ration in 68.4% of patients. Conclusions. In patients with defor-
ming osteoarthritis and diagnosed paraendoprosthetic complications, similar bacteria were plated, with dominance of the Gram-positive flora. Elevated values of antibodies to Staphylococcus aureus and Streptococcus pyogenes are of diagnostic importance in case of preoperative paraendoprosthetic complications and clinical observation of patients after surgery.


microbiological and serological verification; paraendoprosthetic complications; deforming osteoarthritis; hip and knee joints


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