Abstract
Introduction: It has been shown in several studies that cytokine (IL-6, TNF-alpha, IL-10, IL-8 etc) concentrations in the peripheral blood are associated with inflammatory activity and surgical trauma. These exhibit more rapid rise and quicker return-to-normal values than either the CRP or the ESR (few hours to few days) and have also been found to be better predictors of postoperative infection compared to CRP/ESR in some studies. Threshold levels of IL-6 after joint replacement surgery have been determined, but levels of other potentially useful cytokines (TNF-alpha, IL-8, IL-10 etc) are not yet known.
Aim: We sought to measure the serum levels of 25 different cytokines before and after hip/knee replacement surgery and identify those associated with postoperative inflammation.
Method: Peripheral venous blood samples were collected from 80 patients undergoing hip/knee replacement. Each patient had one preoperative and three postoperative (total four) blood samples. Samples were stored at −70 degree before being analysed by laser chromatography.
Results: Three out of the 25 cytokines we measured had a significant relationship with postoperative inflammation. The relationship of these three cytokines with a single case of deep infection in our study appeared to be of clinical significance.
Conclusion: It may be possible to use the serum levels of these three cytokines to diagnose periprosthetic infections in the early postoperative period when the CRP and ESR are elevated.
Correspondence should be addressed to Mr John Hodgkinson, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
