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Synovial Complement Factors in Patients with Periprosthetic Joint Infection after Undergoing Revision Arthroplasty of the Hip or Knee Joint

The role and diagnostic value of the synovial complement system in patients with low-grade periprosthetic joint infection (PJI) are unclear. We sought to evaluate, for the first time, the usefulness of synovial complement factors in these patients by measuring the individual synovial fluid levels of...

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Autores principales: Fröschen, Frank Sebastian, Schell, Sophia, Wimmer, Matthias Dominik, Hischebeth, Gunnar Thorben Rembert, Kohlhof, Hendrik, Gravius, Sascha, Randau, Thomas Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8002017/
https://www.ncbi.nlm.nih.gov/pubmed/33806309
http://dx.doi.org/10.3390/diagnostics11030434
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author Fröschen, Frank Sebastian
Schell, Sophia
Wimmer, Matthias Dominik
Hischebeth, Gunnar Thorben Rembert
Kohlhof, Hendrik
Gravius, Sascha
Randau, Thomas Martin
author_facet Fröschen, Frank Sebastian
Schell, Sophia
Wimmer, Matthias Dominik
Hischebeth, Gunnar Thorben Rembert
Kohlhof, Hendrik
Gravius, Sascha
Randau, Thomas Martin
author_sort Fröschen, Frank Sebastian
collection PubMed
description The role and diagnostic value of the synovial complement system in patients with low-grade periprosthetic joint infection (PJI) are unclear. We sought to evaluate, for the first time, the usefulness of synovial complement factors in these patients by measuring the individual synovial fluid levels of complement factors (C1q, C3b/iC3b, C4b, C5, C5a, C9, factor B, factor D, factor H, factor I, properdin, and mannose-binding lectin [MBL]). The patients (n = 74) were classified into septic (n = 28) and aseptic (n = 46). Receiver-operator characteristic curves and a multiple regression model to determine the feasibility of a combination of the tested cytokines to determine the infection status were calculated. The synovial fluid levels of C1q, C3b/C3i, C4b, C5, C5a, MBL, and properdin were significantly elevated in the PJI group. The best sensitivity and specificity was found for C1q. The multiple regression models revealed that the combination of C1q, C3b/C3i, C4b, C5, C5a, and MBL was associated with the best sensitivity (83.3%) and specificity (79.2%) for a cutoff value of 0.62 (likelihood ratio: 4.0; area under the curve: 0.853). Nevertheless, only a combined model showed acceptable results. The expression patterns of the complement factors suggested that PJI activates all three pathways of the complement system.
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spelling pubmed-80020172021-03-28 Synovial Complement Factors in Patients with Periprosthetic Joint Infection after Undergoing Revision Arthroplasty of the Hip or Knee Joint Fröschen, Frank Sebastian Schell, Sophia Wimmer, Matthias Dominik Hischebeth, Gunnar Thorben Rembert Kohlhof, Hendrik Gravius, Sascha Randau, Thomas Martin Diagnostics (Basel) Article The role and diagnostic value of the synovial complement system in patients with low-grade periprosthetic joint infection (PJI) are unclear. We sought to evaluate, for the first time, the usefulness of synovial complement factors in these patients by measuring the individual synovial fluid levels of complement factors (C1q, C3b/iC3b, C4b, C5, C5a, C9, factor B, factor D, factor H, factor I, properdin, and mannose-binding lectin [MBL]). The patients (n = 74) were classified into septic (n = 28) and aseptic (n = 46). Receiver-operator characteristic curves and a multiple regression model to determine the feasibility of a combination of the tested cytokines to determine the infection status were calculated. The synovial fluid levels of C1q, C3b/C3i, C4b, C5, C5a, MBL, and properdin were significantly elevated in the PJI group. The best sensitivity and specificity was found for C1q. The multiple regression models revealed that the combination of C1q, C3b/C3i, C4b, C5, C5a, and MBL was associated with the best sensitivity (83.3%) and specificity (79.2%) for a cutoff value of 0.62 (likelihood ratio: 4.0; area under the curve: 0.853). Nevertheless, only a combined model showed acceptable results. The expression patterns of the complement factors suggested that PJI activates all three pathways of the complement system. MDPI 2021-03-04 /pmc/articles/PMC8002017/ /pubmed/33806309 http://dx.doi.org/10.3390/diagnostics11030434 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Fröschen, Frank Sebastian
Schell, Sophia
Wimmer, Matthias Dominik
Hischebeth, Gunnar Thorben Rembert
Kohlhof, Hendrik
Gravius, Sascha
Randau, Thomas Martin
Synovial Complement Factors in Patients with Periprosthetic Joint Infection after Undergoing Revision Arthroplasty of the Hip or Knee Joint
title Synovial Complement Factors in Patients with Periprosthetic Joint Infection after Undergoing Revision Arthroplasty of the Hip or Knee Joint
title_full Synovial Complement Factors in Patients with Periprosthetic Joint Infection after Undergoing Revision Arthroplasty of the Hip or Knee Joint
title_fullStr Synovial Complement Factors in Patients with Periprosthetic Joint Infection after Undergoing Revision Arthroplasty of the Hip or Knee Joint
title_full_unstemmed Synovial Complement Factors in Patients with Periprosthetic Joint Infection after Undergoing Revision Arthroplasty of the Hip or Knee Joint
title_short Synovial Complement Factors in Patients with Periprosthetic Joint Infection after Undergoing Revision Arthroplasty of the Hip or Knee Joint
title_sort synovial complement factors in patients with periprosthetic joint infection after undergoing revision arthroplasty of the hip or knee joint
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8002017/
https://www.ncbi.nlm.nih.gov/pubmed/33806309
http://dx.doi.org/10.3390/diagnostics11030434
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