Early acute phase response following total hip replacement
Journal Title: Ortopedia Traumatologia Rehabilitacja - Year 2009, Vol 11, Issue 4
Abstract
Introduction: Total joint replacement is a major surgical procedure with considerable tissue injury and the implantation of a bulky foreign body. The acute phase proteins are commonly used universal markers of systemic inflammatory response. An inflammatory response is associated with changes in both the concentration and the glycosylation profile of these proteins.The aim of the study was to evaluate the acute phase response before and in the first 6 months following THR. A secondary aim was to establish whether the type of hip replacement device affects the acute phase response. Material: The study group consisted of 40 patients who underwent THA using uncemented (20) and cemented (20) endoprostheses at the Department of Orthopaedics and Traumatology, Poznań University of Medical Sciences. The mean age of recipients of cementless endoprostheses was 52 years (range: 42-68) and in the group of recipients of cemented endoprostheses it was 72 years (range: 65-79) Methods: The concentrations of C-reactive protein (CRP), alpha 1-acid glycoprotein (AGP), and alpha-1-antichymotripsin (ACT), and microheterogeneity of AGP were evaluated. Results: The blood levels of the acute phase proteins CRP, AGP, ACT rose significantly at 2 and 14 days after the surgery to return to preoperative values at 6 months after the surgery. The V3 variant of microheterogeneity of AGP, absent under normal conditions, and representative of acute inflammation, was found in a few patients preoperatively. In postoperative evaluations, it was found in the vast majority of the patients. Conclusions: Analysis of the microheterogeneity profiles of AGP indicates the presence of acute inflammatory response during the first few days following total hip replacement. This response later changes into persistent chronic inflammation in response to a foreign body and is more pronounced in recipients of cemented endoprostheses.
Authors and Affiliations
Jacek Markuszewski , Małgorzata Wierusz-Kozłowska , Waldemar Woźniak , Kinga Leśniewska , Magdalena Sobieska
Keywords
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