Inflammatory response in 85 patients with loosened hip prostheses: A prospective study comparing inflammatory markers in patients with aseptic and septic prosthetic loosening
2007 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 78, no 5, 629-639 p.Article in journal (Refereed) Published
Over the past decades, prosthetic hip joints have improved the quality oflife for many patients. The most common complications are aseptic biornechanical failures and prosthetic joint infections. For prosthetic hip joints, delayed low-grade infections are seen most often and they are also most difficult to distinguish from aseptic mechanical failures. A prospective study was conducted to campare inilammatory markers in patients diagnosed with aseptic or septic prosthetic loosenffig. The diagnostic criteria were based on the decisions of experienced orthoperlic surgeons and microbiological analys is of periprosthetic tissue samplestaken perioperatively. Coagulase-negative staphylococci were the most common pathogens in the infected patients. Pre- or perioperative results for C-reactive protein and erytlu-ocyte sedimentation rate were valuable tools for diagnosing most, hut not all, low virulence infections. White blood cell count in synavial fluid was an important marker of infection, which was not the case for lactate. Levels of the cytokines turnor necrosis factor-α, interleukin-1 ß. and interleukin-6 in synavial fluid were significantly higher in the infected group. Patterus of inilammatory cell infiltration in periprosthetic tissue differed significantly between the groups, and infiltration of polymorphonuclear cells proved to be the best marker of distinguish between septic and aseptic loosenffig. Treatment and outcome are described for the infected patients.
Place, publisher, year, edition, pages
2007. Vol. 78, no 5, 629-639 p.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-81959DOI: 10.1080/17453670710014329OAI: oai:DiVA.org:liu-81959DiVA: diva2:556861