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Year 2017 Vol. 25 No 6

TRAUMATOLOGY & ORTHOPEDICS

Z.S. NAUMENKO, M.V. CHEPELEVA, N.V. GODOVYKH

CYTOKINES AND MICROBIOCENOSIS IN PREDICTING THE POSTOPERATIVE PERIOD COURSE IN PATIENTS WITH PERIPROSTHETIC INFECTION OF THE HIP JOINT AFTER REMOVAL OF THE INFECTED IMPLANT

FSBE “Russian Ilizarov Scientific Center “Restorative Traumatology and Orthopaedics” of the RF, Ministry of Health, Kurgan,
The Russian Federation

Objective. To study microbiocenosis and the dynamics of the main cytokines in order to predict the postoperative period course after the hip joint implant removing in patients with the periprosthetic infection.
Methods. All the patients underwent debridement of the hip joint with the infected implant removal. The patients were retrospectively divided into two groups: group I included 29 patients with uncomplicated postoperative period course, group II – 20 patients with the infection recurrence in the immediate postoperative period due to hematoma infection in the residual cavity of the femoral medullary canal after the removal of the implant stem. Study of the concentrations of IL-1β, IL-6, IL-10, IL-8, TNF&alfa;, IFNγ was carried out by the enzyme-linked immunosorbent method before the surgery, on the 3, 7, 21, 30 days after surgery. Microbiocenosis was analyzed before the surgery, intraoperatively and postoperatively.
Results. It was found out, that the pathogens represented by monocultures (mainly Staphylococcus aureus, S. epidermidis) prevailed in Group I patients, and mixed infections prevailed in Group II patients. Microbiocenosis of Group II patients was characterized by the increase in the proportion of Gram-negative bacterii (Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumanii) postoperatively.
Dynamically, there was a tendency for Group I cytokines to decrease, and for those in Group II – to increase. In Group I statistically significant differences were observed 30 days after surgery, comparing with the preoperative period, for IL-1β, IL-8, IL-10 the concentrations of which decreased. In Group II, IL-1β, IL-6, IL-10 significantly increased at this time. In Group I the complex dynamics of serum cytokines evidenced in favor of infection process stopping, in Group II – in favor of pyoinflammatory complications.
Conclusions. The changes in microbiocenosis structure as well as the comprehensive investigation of cytokine concentrations can be used as additional predictive criteria of infection recurrences in patients with periprosthetic infection after the hip joint implant removal.

Keywords: the hip joint, arthroplasty, periprosthetic infection, Staphylococcus aureus, cytokines, microbiocenosis, recurrence
p. 605-612 of the original issue
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Address for correspondence:
640014, Russian Federation,
Kurgan, M. Ulyanova str., 6,
FSBE “Russian Ilizarov Scientific
Center “Restorative Traumatology
and Orthopaedics”,
Clinical Laboratory of Microbiology
and Immunology,
tel. office: +7 352 2 45-16-54,
e-mail: zinaida_n@inbox.ru,
Zinaida S. Naumenko
Information about the authors:
Naumenko Z.S., PhD, Head of the Scientific and Clinical Laboratory of Microbiology and Immunology of FSBE “Russian Ilizarov Scientific Center “Restorative Traumatology and Orthopaedics”.
Chepeleva M.V., PhD, Senior Researcherof the Scientific and Clinical Laboratory of Microbiology and Immunology of FSBE “Russian Ilizarov Scientific Center “Restorative Traumatology and Orthopaedics”.
Godovykh N.V., Junior Researcher of the Scientific and Clinical Laboratory of Microbiology and Immunology of FSBE “Russian Ilizarov Scientific Center “Restorative Traumatology and Orthopaedics”.
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