Increased Synovial Inflammatory Markers in Aseptic Total Hip Arthroplasty Dislocation |
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| Institution: | 1. Department of Orthopaedic surgery and Traumatology, Charité University Hospital, Berlin, Germany;2. Walter Reed National Military Medical Center, Bethesda, MD;3. Department for Orthopaedics and Orthopaedic Surgery, University of Greifswald, Greifswald, Germany;1. Department of Orthopaedic Surgery, Medical University Innsbruck, Innsbruck, Austria;2. Department of Orthopaedic Surgery-Experimental Orthopaedics, Medical University Innsbruck, Innsbruck, Austria;3. Department of Clinical Epidemiology of Tirol Kliniken GmbH, Innsbruck, Austria;1. Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio;2. Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio;1. Division of Orthopaedic Surgery, University of Toronto, Toronto, Ontario, Canada;2. Division of Orthopaedic Surgery, University Hospital, London Health Sciences Centre, Western University, London, Ontario, Canada;1. Joint Replacement Center, Seoul Metropolitan SeoNam Hospital, Seoul, Republic of Korea;2. Department of Orthopedic Surgery, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea;1. Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA;2. Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA |
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| Abstract: | BackgroundIn cases of total hip arthroplasty (THA) dislocation, a synovial fluid aspiration is often performed to evaluate for periprosthetic joint infection (PJI). It is currently unclear how aseptic dislocation of a THA influences synovial fluid white blood cell (WBC) count and polymorphonuclear percentage (PMN%). The primary aim of this study is to investigate the influence of THA dislocation on synovial WBC count and PMN%.MethodsTwenty-eight patients who underwent a synovial aspiration of a THA between 2014 and 2019 were identified and enrolled in our case-control study. Patients with an aseptic THA dislocation and synovial hip aspiration were matched against patients without dislocation, patients undergoing hip aspiration before aseptic THA revision surgery, and patients undergoing hip aspiration before septic THA revision surgery.ResultsSynovial WBC count was significantly increased in the dislocation vs aseptic THA revision group (P = .015), as well as between the septic revision group vs dislocation and aseptic THA revision group (both P < .001). The PMN% did not differ significantly between the dislocation and aseptic revision groups (P = .294). Mean C-reactive protein values were 12.4 ± 14.9 mg/dL in THA dislocation, 24.1 ± 37.7 mg/dL in THA without infection compared to 85.7 ± 84.9 mg/dL in THA infection group (P < .001).ConclusionThis study shows that THA dislocation has a significant impact on synovial WBC count in joint aspiration. Our data suggest that in the setting of THA dislocation, synovial WBC and PMN% may not be the best method to evaluate for PJI. Further research should be performed to establish new thresholds for these synovial inflammatory markers in the setting of THA dislocation and PJI.Level of evidenceLevel III; retrospective trial. |
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| Keywords: | total hip arthroplasty aspiration infection cell count inflammatory marker |
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