Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Laboratory of Orthopedics, Chongqing Medical University, Chongqing, 400016, China.
J Orthop Traumatol. 2023 Jul 4;24(1):34. doi: 10.1186/s10195-023-00712-8.
The diagnosis of periprosthetic joint infection (PJI) remains a challenge in clinical practice. Many novel serum and joint fluid biomarkers have important implications for the diagnosis of PJI. The presented study evaluated the value of joint fluid interleukin-6 (IL-6) combined with the neutral polymorphonuclear leukocyte (PMN%) ratio for chronic PJI diagnosis after arthroplasty.
Sixty patients with chronic PJI or aseptic failure who underwent hip or knee revision from January 2018 to January 2020 in our department were included in this retrospective study. According to the 2013 MSIS diagnostic criteria, the 60 patients were divided into a PJI group and a non-PJI group (30 patients per group). We collected the joint fluid before surgery and determined the level of IL-6 and the PMN% by ELISA, and the differences between the two groups were compared. The diagnostic efficacy of joint fluid IL-6 combined with PMN% in chronic PJI was analyzed using a receiver operating characteristic curve (ROC curve).
The diagnosis of PJI using joint fluid IL-6 combined with PMN% presented an area under the curve of 0.983, which was more accurate than the areas under the curve for diagnosis using IL-6 and PMN% individually (0.901 and 0.914, respectively). The optimal threshold values for IL-6 and PMN% were 662.50 pg/ml and 51.09%, respectively. Their sensitivity and specificity were 96.67% and 93.33%, respectively. The accuracy of the diagnosis of PJI was 95.00%.
Joint fluid IL-6 combined with PMN% can be used as an auxiliary method to detect chronic infection around the prosthesis after hip/knee arthroplasty.
Patients who underwent hip/knee revision at the First Hospital of Chongqing Medical University for periprosthetic infection or aseptic failure of the prosthesis after hip/knee arthroplasty from January 2018 to January 2020 were included. Trial registration This study was approved by the ethics committee of the First Hospital of Chongqing Medical University on September 26, 2018 (local ethics committee number: 20187101) and registered with the China Clinical Trials Registry (registration number: ChiCTR1800020440) with an approval date of December 29, 2018.
假体周围关节感染（PJI）的诊断仍然是临床实践中的一个挑战。许多新型血清和关节液生物标志物对 PJI 的诊断具有重要意义。本研究评估了关节液白细胞介素 6（IL-6）联合中性多形核白细胞（PMN%）比值对髋关节或膝关节置换术后慢性 PJI 的诊断价值。
本回顾性研究纳入了 2018 年 1 月至 2020 年 1 月在我科因慢性 PJI 或无菌性失败而接受髋关节或膝关节翻修的 60 例患者。根据 2013 年 MSIS 诊断标准，将 60 例患者分为 PJI 组和非 PJI 组（每组 30 例）。我们收集了术前关节液，通过 ELISA 测定 IL-6 水平和 PMN%，并比较了两组之间的差异。采用受试者工作特征曲线（ROC 曲线）分析关节液 IL-6 联合 PMN%对慢性 PJI 的诊断效能。
使用关节液 IL-6 联合 PMN%诊断 PJI 的曲线下面积为 0.983，明显高于单独使用 IL-6（0.901）和 PMN%（0.914）的曲线下面积。IL-6 和 PMN%的最佳截断值分别为 662.50 pg/ml 和 51.09%，其敏感性和特异性分别为 96.67%和 93.33%，诊断 PJI 的准确率为 95.00%。
关节液 IL-6 联合 PMN%可作为髋关节/膝关节置换术后检测假体周围慢性感染的辅助方法。
纳入了 2018 年 1 月至 2020 年 1 月在重庆医科大学第一附属医院因髋关节/膝关节假体周围感染或髋关节/膝关节置换术后假体无菌性失败而接受髋关节/膝关节翻修的患者。试验注册 本研究于 2018 年 9 月 26 日经重庆医科大学第一附属医院伦理委员会批准（当地伦理委员会编号：20187101），并于 2018 年 12 月 29 日在中国临床试验注册中心（注册号：ChiCTR1800020440）注册。
