Analysis of synovial biomarkers with a multiplex protein microarray in patients with PJI undergoing revision arthroplasty of the hip or knee joint
| Autor: | A Klausing, Thomas M. Randau, S Schell, Hendrik Kohlhof, Sascha Gravius, Frank A. Schildberg, Frank S. Fröschen |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Prosthesis-Related Infections Knee Joint medicine.medical_treatment Arthroplasty Replacement Hip Protein Array Analysis Periprosthetic Prosthesis Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine Internal medicine Synovial Fluid Medicine Synovial fluid Humans Orthopedics and Sports Medicine Multiplex Prospective Studies Arthroplasty Replacement Knee Aged 030222 orthopedics Arthritis Infectious Receiver operating characteristic business.industry 030229 sport sciences General Medicine Middle Aged Arthroplasty ROC Curve Orthopedic surgery Cytokines Surgery Female Hip Prosthesis business Knee Prosthesis Biomarkers |
| Zdroj: | Archives of orthopaedic and trauma surgery. 140(12) |
| ISSN: | 1434-3916 |
| Popis: | Diagnosing a (low-grade) periprosthetic joint infection (PJI) after hip or knee arthroplasty remains a diagnostic challenge. The aim of this study was to evaluate the utility of using a novel multiplex protein microarray system for synovial biomarkers in determining PJI in patients undergoing revision knee or hip arthroplasty. The individual synovial fluid levels of 12 cytokines (IL-1b, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, IL-17, GM-CSF, TNF-α, and INF-γ) were analysed with a novel multiplex protein microarray system in 32 patients undergoing revision hip (n = 22) or knee (n = 10) arthroplasty. Cases were classified into septic and aseptic groups on basis of pre- and interoperative findings: [PJI (n = 14) vs. non-PJI (n = 18)]. Receiver operator characteristic (ROC) curves were calculated to assess the discriminatory strength of the individual parameters. A multiple regression model was used to determine the utility of using a combination of the tested cytokines to determine the infection status. The levels of all of the evaluated cytokines were significantly elevated in the PJI-group. Best sensitivity and specificity were found for IL-6, followed by IL-1b, IL-10, and IL-17. The multiple regression models revealed a combination of IL-2, IL-4, IL-5, IL6, lL-12, and GM-CSF to be associated with the best sensitivity (100%) and specificity (88.9%) for a cut-off value of 0.41, with a likelihood ratio of 9.0. Analysis of individual synovial fluid cytokine levels showed both high sensitivity and high specificity in diagnosing PJI. A combined model using several cytokines showed even higher sensitivity and specificity in diagnosing PJI and could thus be a useful predictive tool to determine the probability of PJI in patients with a painful prosthesis. Diagnostic IV. |
| Databáze: | OpenAIRE |
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