Blood cytokine pattern and clinical outcome in knee arthroplasty patients: comparative analysis 5 years after standard versus 'hypoallergenic' surface coated prosthesis implantation

Autor: Peter Thomas, Philipp Hisgen, Hartmuth Kiefer, Ulf Schmerwitz, Andreas Ottersbach, Dominique Albrecht, Burkhard Summer, Christian Schinkel
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Acta Orthopaedica, Vol 89, Iss 6, Pp 646-651 (2018)
Druh dokumentu: article
ISSN: 1745-3674
1745-3682
17453674
DOI: 10.1080/17453674.2018.1518802
Popis: Background and purpose — Metal sensitivity might provoke complications after arthroplasty. Correspondingly, coated “hypoallergenic” implants are of interest but long-term follow-up data are missing. Thus, we assessed immunological and clinical parameters in such patients. Patients and methods — 5 years’ follow-up data were obtained from 3 centers, which used either a standard total knee replacement (TKR) or the identical implant with multilayer surface zirconium nitride based coating. Of the 196 patients (mean age 68 years (44–84), 110 females) 97 had arthroplasty with a coated surface, and 99 were treated by a standard TKR of the same type. Investigations were Knee Society Score (KSS), Knee injury and Osteoarthritis Outcome Score (KOOS), radiographic analysis, and cytokine measurement in peripheral blood. Pro- and anti-inflammatory cytokines were evaluated by cytometric beads assay and RT-PCR. Results — Survival rate (Kaplan–Meier) was 98% for coated and 97% for uncoated implants after 5 years. Mechanical axis and KSS pain score (42 vs. 41 (0–50)) were comparable. Most serum cytokine levels were comparable, but mean interleukin-8 and interleukin-10 levels were higher in the group with an uncoated implant. IL-8: 37 (SD 7.5) pg/mL vs. 1.1 (SD 4.3) (p < 0.001); IL-10: 3.6 (SD 2.5) vs. 0.3 (SD 1.8) pg/mL (p < 0.001). Interpretation — There was similar clinical outcome 5 years after standard and surface-coated TKR. In peripheral blood there was an increased pro-inflammatory status, i.e., significant elevation of IL-8 and the anti-inflammatory IL-10, after standard uncoated prosthesis. Any long-term effects of these cytokine changes are unknown.
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