Clinical and immunological parallels in periprosthetic infection after total large joints arthroplasty

Aim. To study peripheral blood lymphocytes and monocytes subpopulations and evaluate synthesis of serum autoantibodies in patients with periprosthetic infection after large joints arthroplasty.

Methods. The study included 40 patients with infectious and inflammatory complications that developed at different times after knee or hip arthroplasty. All patients were divided into three groups according to the Coventry-Fitzgerald-Tsukayama classification. The number of cells expressing the CD3, CD4, CD8, CD19, CD14, CD16 and CD56 antigens, the expression of the activation markers HLA-DR, CD25 on lymphocytes and monocytes, the number of peripheral blood CD4+CD45RA+, CD4+CDRO+ cells, and the level of serum antibodies to double-stranded deoxyribonucleic acid (DNA) and anti-neutrophil antibodies were evaluated.

Results. It is found that in acute development of infectious and inflammatory process in peripheral blood a significant increase in the number and functional activity of T-cells occur. For long-term low-grade infectious and inflammation process significant increase in the number of B-cells and memory T-cells, decrease in the number of naive T-cells are characteristic. Monocyte HLA-DR expression and the amount of B-lymphocytes correlate with the severity of inflammation. In seven patients elevated levels of antibodies to double-stranded DNA, in six - antineutrophil antibodies were revealed in blood serum.

Conclusion. The assessment of lymphocytes subpopulations and the monocyte HLA-DR expression can be used as additional laboratory criteria for the diagnosis of infectious and inflammatory processes after large joints arthroplasty; the role of autoantibodies to double stranded DNA and anti-neutrophil antibodies, which were found in some patients, remains unclear.