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Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_III | Pages 551 - 551
1 Aug 2008
Shah K Hullin M McFadyen A Meek D
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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.