Localized cytokine responses to total knee arthroplasty and total knee revision complications

Abstract

Background: The study of localized immune-related factors has proven beneficial for a variety of conditions, and one area of interest in the field of orthopaedics is the impact of implants and localized infections on immune response. Several cytokines have shown increased systemic concentrations (in serum/plasma) in response to implants and infection, but tissue-level cytokines have not been investigated as thoroughly. Methods: This exploratory study investigated tissue-level cytokines in a cohort of patients (N = 17) in response to total knee arthroplasty and total knee revision to better understand the immune response to implants and localized infection (e.g., prosthetic joint infection). The overall goal of this study was to provide insight into the localized cytokine response of tissues and identify tissue-level markers specific to inflammation caused by implants vs. inflammation caused by infection. Tissues were collected across several anatomical locations and assayed with a panel of 20 human inflammatory cytokines to understand spatial differences in cytokine levels. Results: In this study, six cytokines were elevated in implanted joints, as compared to native joints: IL-10, IL-12p70, IL-13, IL-17A, IL-4, and TNF-α (p < 0.05). Seven cytokines showed infection-dependent increases in localized tissues: IL-1α, IL-1β, IL-6, IL-8, MCP-1, MIP-1α, and MIP-1β (p < 0.05). Conclusions: This study demonstrated that differences exist in tissue-level cytokines in response to presence of implant, and some cytokines were specifically elevated for infection; these responses may be informative of overall tissue health. These results highlight the utility of investigating localized cytokine concentrations to offer novel insights for total knee arthroplasty and total knee revision procedures, as well as their complications. Ultimately, this information could provide additional, quantitative measurements of tissue to aid clinical decision making and patient treatment options.

[Retracted] Video‐Assisted Health Education Promotes Rehabilitation Training of Total Knee Arthroplasty Patients and Reduces Stress and Burnout in Nurses Compared to Oral Education

“…Elevated immune response was observed following TKA procedures. Increased immune response, systematic or localized, to acute oxidative stress and levels of cytokines after surgery was reported [7,8]. Postoperative complications such as postoperative orthostatic intolerance [9] and deep vein thrombosis [10] could contribute to the stress and thus lead to a slow recovery of patients.…”

Biofilm formation and inflammatory potential of Staphylococcus saccharolyticus: A possible cause of orthopedic implant-associated infections

“…It has been shown in previous studies that staphylococci associated with OIAIs induce significant local increases in pro-inflammatory cytokine levels ( Gollwitzer et al, 2013 ; Prince et al, 2020 ). In this study, levels of important pro-inflammatory cyto- and chemokines (IL-8, IL-6, and TNF-alpha) were determined in THP-1 cell culture experiments upon exposure to S. saccharolyticus .…”

Effects of Parecoxib Sodium Application Combined with Enhanced Recovery After Surgery Nursing on Inflammatory Factors and Knee Joint Function in Elderly Patients After Total Knee Arthroplasty

“…Lesser postoperative inflammation in peripheral blood leads to lesser postoperative pain, that is, a better analgesic effect, and a better analgesic effect helps to reduce the inflammatory reaction caused by TKA and also reduce tissue exudation and edema. It can reduce the amount of hidden and dominant bleeding in the perioperative period, promote wound healing, and accelerate the functional recovery of the affected knee joint (27)(28)(29).…”