Screening of markers of infection after total knee replacement
Objective:To compare the inflammatory markers of Staphylococcus aureus infection after total knee arthroplasty(TKA)with those of rheumatoid arthritis(RA).Methods:Thirty New Zealand white rabbits were randomly divided into TKA group,RA group,and control group using a random number table.The circumference at 2 cm above and below the patella of the affected knee was measured before surgery and on days 1,3,and 5 post-surgery to quantify the degree of knee joint swelling and record changes in knee joint swelling.Serum levels of C-reactive protein(CRP),procalcitonin(PCT),interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-17(IL-17),soluble intercellular adhesion molecule-1(sICAM-1),and soluble vascular cell adhesion molecule-1(sVCAM-1)were detected using enzyme-linked immunosorbent assay(ELISA);erythrocyte sedimentation rate(ESR)was analyzed using an automatic erythrocyte sedimentation rate analyzer.Results:There were no statistically significant differences in the circumference at 2 cm above and below the patella of the control group rabbits at 24 hours before modeling,24 hours after modeling,24 hours after inoculation,and 48 hours after inoculation(all P>0.05);however,there were statistically significant differences in the TKA and RA groups at the same time points(all P<0.05).Before modeling,there were no statistically significant differences in the circumference at 2 cm above and below the patella among the three groups of rabbits(all P>0.05);however,at 24 hours after modeling,24 hours after inoculation,and 48 hours after inoculation,there were statistically significant differences(all P<0.05).The levels of CRP,ESR,sVCAM-1,sICAM-1,IL-1β,IL-6,IL-17,and PCT in the control group rabbits showed no statistically significant differences at 24 hours before modeling,24 hours after modeling,24 hours after inoculation,and 48 hours after inoculation(all P>0.05).The levels of CRP,ESR,sVCAM-1,sICAM-1,IL-1β,IL-6,IL-17,and PCT in the TKA group rabbits showed statistically significant differences at all time points(all P<0.05).The levels of CRP in the RA group rabbits showed no statistically significant differences at 24 hours before modeling,24 hours after modeling,24 hours after inoculation,and 48 hours after inoculation(all P>0.05);however,the levels of ESR,sVCAM-1,sICAM-1,IL-1β,IL-6,IL-17,and PCT showed statistically significant differences at all time points(all P<0.05).At 24 hours before modeling and 24 hours after modeling,there were no statistically significant differences in the levels of CRP,ESR,sVCAM-1,sICAM-1,IL-1β,IL-6,IL-17,and PCT among the three groups of rabbits(all P>0.05);however,at 24 hours and 48 hours after inoculation,there were statistically significant differences(all P<0.05).Conclusion:The inflammatory response caused by Staphylococcus aureus infection after TKA is reflected by a significant increase in specific inflammatory factor levels,which differs from the inflammatory markers of rheumatoid arthritis.This suggests that diagnostic and treatment strategies should be based on personalized markers to reduce the risk of infection and improve the success rate of surgery.
Total Knee ArthroplastyPostoperative InfectionInfection Marker
NETL
NSTL
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