Duran TOPAK, Ahmet SALAN, Fatih DOĞAR, Selçuk NAZİK

İnflamatuvar belirteçlerin periprostetik enfeksiyonların belirlenmesinde rolü var mıdır?

Amaç: Total kalça veya diz artroplastisi sonrası periprostetik eklem enfeksiyonu en korkulan komplikasyonlardan biridir. Bu çalışmanın amacı, inflamatuvar biyobelirteçlerin periprostetik eklem enfeksiyonunun tanımlanmasındaki etkinliğini değerlendirmektir.Yöntemler: Çalışma kesitsel ve iki merkezli planlandı. Protez enfeksiyonundan şüphelenilen ve üç fazlı kemik sintigrafisi uygulanan 131 hasta dahil edildi. Hastalar Kas İskelet Enfeksiyonları Derneği kriterlerine ve sintigrafik çalışma sonuçlarına göre üç gruba ayrıldı: Grup 1 protez enfeksiyonu olan olgular, Grup 2 aseptik gevşemesi olan olgular, Grup 3 sağlıklı protezleri olan olgulardan oluşmaktadır.Bulgular: Beyaz küre sayısı ortalaması grup 1'de 11,5 (3,2) 109/L, grup 2'de 8,3 (2,1) 109/L ve grup 3'de 7,9 (2,1) 109/L bulundu. Beyaz küre sayısı değerleri grup 1'de diğer gruplara göre istatistiksel olarak anlamlı derecede yüksek bulundu (P<0,001, P<0,001), grup 2 ve 3 arasında anlamlı fark yoktu (P=0,753). C reactive protein değerleri grup 1'de 46,6 (50,0) mg/L, grup 2'de 18,8 (17,5) mg/L ve grup 3'de 15,3 (17,1) mg/L olarak bulundu ve C reactive protein değerleri gruplar arasında karşılaştırıldığında istatistiksel olarak anlamlı derecede yüksek bulundu. Grup 1'de diğer gruplara göre (P<0,001, P<0,001) ve grup 2 ile 3 arasında anlamlı fark yoktu (P=0,876). Ortalama eritrosit sedimantasyon hızı değerleri karşılaştırıldığında gruplar arasında anlamlı fark bulunmadı.Sonuç Üç fazlı kemik sintigrafisi, C reactive protein ve beyaz küre sayısı gibi inflamatuvar biyobelirteçlerin kullanılmasının, protez enfeksiyonunu öngörümede etkili olduğu gösterilmiştir.

Anahtar Kelimeler:

Beyaz küre sayısı, Biyobelirteç, C-reaktif protein, Protez enfeksiyonu

Do inflammatory markers play a role in the detection of periprosthetic infections?

Aim: Periprosthetic joint infection after total hip or knee arthroplasty is one of the most feared complications. The aim of this study was to evaluate the efficacy of inflammatory biomarkers in identifying periprosthetic joint infection.Methods: This cross-sectional and bi-centered study included 131 patients, who had suspected prosthesis infection and underwent three-phase bone scintigraphy. Patients were divided into three groups according to the Musculoskeletal Infection Society criteria and scintigraphic study results: Group 1 comprised cases with prosthetic infection, Group 2 included aseptic loosening cases and Group 3 included cases with healthy prostheses.Results: White blood cell average was 11.5 (3.2) 109/L in group 1, 8. (2.1) 109/L in group 2 and 7.9 (2.1) 109/L in group 3, among which it was significantly higher in Group 1 compared to Groups 2 and 3, (P<0.001, P<0.001), while there was no significant difference between groups 2 and 3 (P=0.753). C reactive protein values (CRP) were 46.6 (50.0) mg/L in group 1, 18.8 (17.5) mg/L in group 2 and 15.3 (17.1) mg/L in group 3, significantly higher in group 1 than the other groups (P<0.001, P<0.001), and similar in Groups 2 and 3 (P=0.876). The mean erythrocyte sedimentation rate values did not differ significantly between the groups. Conclusion: The use of three-phase bone scintigraphy and inflammatory biomarkers such as C reactive protein and white blood cell have been shown to be effective in predicting prosthetic infection.

Keywords:

White blood cell, Biomarker, C-reactive protein, Prosthetic infection,

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