DOI: https://doi.org/10.22141/1608-1706.6.19.2018.152230

Biochemical and immunological blood markers of patients after knee and hip replacement for early diagnosis of periprosthetic infection

V.A. Filipenko, A.P. Maruschak, F.S. Leontyeva, D.V. Morozenko

Abstract


Background. In modern medical practice, there is no clear list of hematological, biochemical and immunological tests for both primary assessment of patients’ condition and monitoring the dynamics of metabolic status after joint arthroplasty. The purpose of the study was to determine the diagnostic sensitivity of biochemical and immunological blood markers in the dynamics of the postoperative period in patients after hip and knee replacement for early diagnosis of periprosthetic infection. Materials and methods. The study was performed in 53 patients (16 men and 37 women aged 35 to 79 years) who underwent 61 operations on the knee and hip joints. Knee (n = 41) and hip (n = 14) arthroplasty was preformed, as well as debridement (n = 6), including 42 primary and 13 revision surgeries. All patients were divided into three groups. Group I consisted of patients who were diagnosed with periprosthetic infection within 4 weeks after surgery (n = 7); group II — persons whose infection was diagnosed when they went to the clinic, but the postoperative period after revision intervention was without complications (n = 8); group III — patients who had a normal course of the postoperative period (n = 46). In the blood serum, the content of total protein, glycoproteins, chondroitin sulfates, glucose, C-reactive protein, interleukins (IL-1β and IL-6) was determined. Diagnostic sensitivity (DS) of laboratory parameters was calculated according to the formula: DS = (TP / D) × 100 %, where TP — truly positive results of the study, D — number of patients in the group. Results. In all groups of patients, the presence of inflammatory-destructive disorders in the body was revealed in terms of glycoprotein, chondroitin sulfate, IL-1β and IL-6 content, which had highest rates of DS. Conclusions. In patients of all study groups, regardless of the detection of periprosthetic infection, acute inflammatory-destructive processes were observed in the form of an increase in the blood levels of glycoproteins, chondroitin sulfates, C-reactive protein, IL-1β and IL-6 after hip and knee replacement. Biochemical and immunological markers of the blood have no specificity for the diagnosis of periprosthetic infection. DS in all groups of patients in the postoperative period was highest in glycoproteins, chondroitin sulfates, C-reactive protein, IL-1β and IL-6, which allows the use of these laboratory markers to assess the degree of inflammation in the body of orthopedic patients after hip and knee replacement.


Keywords


biochemical markers; interleukins; periprosthetic infection; endoprosthetics; hip and knee joints; glycoproteins; chondroitin sulfates; diagnostic sensitivity

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