COMPARISON OF PERIOPERATIVE INFLAMMATORY MARKERS BETWEEN PATIENTS WITH ANKYLOSING SPONDYLITIS AND NON-INFLAMMATORY DISEASES UNDERGOING TOTAL HIP ARTHROPLASTY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIKe , ZHANGQingmeng , LIHeng , LIRui , XUChi ,  CHENJiying

Department of Orthopedics, General Hospital of Chinese PLA, Beijing, 100853, P. R. China;

Corresponding author：

CHENJiying, Email: chenjiying_301@163.com

Keywords：

Ankylosing spondylitis; Total hip arthroplasty; C-reactive protein; Interleukin-6; Erythrocyte sedimentation rate

DOI：

10.7507/1002-1892.20150261

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the inflammatory markers in patients with ankylosing spondylitis (AS) or non-inflammatory diseases undergoing total hip arthroplasty (THA) and to ascertain the variation trend of perioperative inflammatory markers and the influence of inflammation markers after THA. Methods Between January 2013 and December 2014, 153 consecutive patients with AS were included. According to the range of motion (ROM), the patients were divided into ankylosis group (ROM: 0°; group A, n=92) and stiff group (ROM: 3-46°; group B, n=61); 120 noninflammatory diseases patients having no bacterial infection and undergoing primary THA served as non-inflammatory group (group C). The inflammatory markers including C-reactive protein (CRP), interleukin-6 (IL-6), and erythrocyte sedimentation rate (ESR) concentrations were measured before operation and at 1, 3, 5, and 7 days after operation, and the complication was observed. Results Perioperative serum CRP, IL-6, and ESR increased at first after operation, and then decreased in 3 groups. There were significant differences in CRP and ESR between at pre- and post-operation (P<0.05); the IL-6 at 1, 3, and 5 days after operation were significantly higher than that at preoperation (P<0.05), but no significant difference was found between at 7 days and at preoperation (P>0.05). CRP, IL-6, and ESR of group B were significantly higher than those of group A at preoperation (P<0.05); CRP and IL-6 of groups A and B were significantly higher than those of group C at preoperation and at 1 day after operation (P<0.05); ESR of groups A and B was significantly higher than that of group C at preoperation, and at 1 day and 3 days after operation (P<0.05); and no significant difference was shown among 3 groups at the other time points (P>0.05). No inflammatory activity or increased complication was observed. Conclusion AS and non-inflammatory diseases show similar change trend of inflammatory markers at preand post-operation. The inflammatory activity of AS has no significant effect on the changes of inflammation markers and does not increase the incidence of postoperative complications.

Citation： LIKe, ZHANGQingmeng, LIHeng, LIRui, XUChi, CHENJiying. COMPARISON OF PERIOPERATIVE INFLAMMATORY MARKERS BETWEEN PATIENTS WITH ANKYLOSING SPONDYLITIS AND NON-INFLAMMATORY DISEASES UNDERGOING TOTAL HIP ARTHROPLASTY. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(10): 1199-1203. doi: 10.7507/1002-1892.20150261 Copy

1.	Ye C, Liu R, Sun C, et al. Cementless bilateral synchronous total hip arthroplasty in ankylosing spondylitis with hip ankylosis. Int Orthop, 2014, 38(12):2473-2476.
2.	Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet, 2007, 370(9597):1508-1519.
3.	Wang W, Huang G, Huang T, et al. Bilaterally primary cementless total hip arthroplasty in patients with ankylosing spondylitis. BMC Musculoskelet Disord, 2014, 15:344.
4.	Leonard HA, Liddle AD, Burke O, et al. Single- or two-stage revision for infected total hip arthroplasty? A systematic review of the literature. Clin Orthop Relat Res, 2014, 472(3):1036-1042.
5.	Camurcu Y, Sofu H, Buyuk AF, et al. Two-stage cementless revision total hip arthroplasty for infected primary hip arthroplasties. J Arthroplasty, 2015.[Epub ahead of print].
6.	Shen H, Zhang N, Zhang X, et al. C-reactive protein levels after 4 types of arthroplasty. Acta Orthop, 2009, 80(3):330-333.
7.	Wirtz DC, Heller KD, Miltner O, et al. Interleukin-6:a potential inflammatory marker after total joint replacement. Int Orthop, 2000, 24(4):194-196.
8.	Greidanus NV, Masri BA, Garbuz DS, et al. Use of erythroeyte sedimentation rate and C-reactive protein level to diagnose infection before revision total knee arthroplasty. A Prospective evaluation. J Bone Joint Surg (Am), 2007, 89(7):1409-1416.
9.	Battistelli S, Fortina M, Carta S, et al. Serum C-reactive protein and procalcitonin kinetics in patients undergoing elective total hip arthroplasty. Biomed Res Int, 2014, 2014:565080.
10.	Jämsen E, Varonen M, Huhtala H, et al. Incidence of prosthetic joint infections after primary knee arthroplasty. J Arthroplasty, 2010, 25(1):87-92.
11.	Moll JM, Wright V. New York clinical criteria for ankylosing spondylitis. A statistical evaluation. Ann Rheum Dis, 1973, 32(4): 354-363.
12.	Ozmen M, Oktay E, Tarhan EF, et al. Serum procalcitonin levels in patients with ankylosing spondylitis. Int J Rheum Dis, 2014.[Epub ahead of print].
13.	Neumaier M, Metak G, Scherer MA. C-reactive protein as a parameter of surgical trauma. Acta Orthopaedica, 2006, 77(5):788-790.
14.	Minetto MA, Oprandi G, Saba L, et al. Serum interleukin-6 response to elective total hip replacement surgery. Int Orthop, 2006, 30(3): 172-176.
15.	Glehr M, Friesenbichler J, Hofmann G, et al. Novel biomarkers to detect infection in revision hip and knee arthroplasties. Clin Orthop Relat Res, 2013, 471(8):2621-2628.
16.	Reveille JD. Biomarkers for diagnosis, monitoring of progression, and treatment responses in ankylosing spondylitis and axial spondyloarthritis. Clin Rheumatol, 2015, 34(6):1009-1018.
17.	Claushuis TA, de Vries MK, van der Weijden MA, et al. C-reactive protein polymorphisms influence serum CRP-levels independent of disease activity in ankylosing spondylitis. Clin Exp Rheumatol, 2015, 33(2):159-165.
18.	Laiho K, Mäenpää H, Kautiainen H, et al. Rise in serum C reactive protein after hip and knee arthroplasties in patients with rheumatoid arthritis. Ann Rheum Dis, 2001, 60(3):275-277.
19.	Niskanen RO, Korkala O, Pammo H. Serum C-reactive protein levels after total hip and knee arthroplasty. J Bone Joint Surg (Br), 1996, 78(3):431-433.
20.	Parvizi J, Zmistowski B, Berbari EF, et al. New definition for periprosthetic joint infection. J Arthroplasty, 2011, 26(8):1136-1138.
21.	Schmidt AH. Inflammatory markers in patients with inflammatory arthritis:perhaps they can be helpful in diagnosing chronic periprosthetic infection. J Bone Joint Surg (Am), 2012, 94(7):e47.
22.	张亮, 徐辉, 郭晓忠, 等. 人工全髋关节置换术治疗强直性脊柱炎的中期疗效. 中国修复重建外科杂志, 2014, 28(1):1-6.
23.	徐步国, 严世贵, 王祥华, 等. 全髋关节置换术治疗强直性脊柱炎髋关节强直的中期疗效随访. 中国骨伤, 2013, 26(12):1052-1056.
24.	Sweeney S, Gupta R, Taylor G, et al. Total hip arthroplasty in ankylosing spondylitis:outcome in 340 patients. J Rheumatol, 2001, 28(8):1862-1866.
25.	Shi D, Xu X, Song K, et al. Comparison of venous thromboembolism after total hip arthroplasty between ankylosing spondylitis and osteoarthritis. Biomed Res Int, 2014, 2014:712895.

1. Ye C, Liu R, Sun C, et al. Cementless bilateral synchronous total hip arthroplasty in ankylosing spondylitis with hip ankylosis. Int Orthop, 2014, 38(12):2473-2476.
2. Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet, 2007, 370(9597):1508-1519.
3. Wang W, Huang G, Huang T, et al. Bilaterally primary cementless total hip arthroplasty in patients with ankylosing spondylitis. BMC Musculoskelet Disord, 2014, 15:344.
4. Leonard HA, Liddle AD, Burke O, et al. Single- or two-stage revision for infected total hip arthroplasty? A systematic review of the literature. Clin Orthop Relat Res, 2014, 472(3):1036-1042.
5. Camurcu Y, Sofu H, Buyuk AF, et al. Two-stage cementless revision total hip arthroplasty for infected primary hip arthroplasties. J Arthroplasty, 2015.[Epub ahead of print].
6. Shen H, Zhang N, Zhang X, et al. C-reactive protein levels after 4 types of arthroplasty. Acta Orthop, 2009, 80(3):330-333.
7. Wirtz DC, Heller KD, Miltner O, et al. Interleukin-6:a potential inflammatory marker after total joint replacement. Int Orthop, 2000, 24(4):194-196.
8. Greidanus NV, Masri BA, Garbuz DS, et al. Use of erythroeyte sedimentation rate and C-reactive protein level to diagnose infection before revision total knee arthroplasty. A Prospective evaluation. J Bone Joint Surg (Am), 2007, 89(7):1409-1416.
9. Battistelli S, Fortina M, Carta S, et al. Serum C-reactive protein and procalcitonin kinetics in patients undergoing elective total hip arthroplasty. Biomed Res Int, 2014, 2014:565080.
10. Jämsen E, Varonen M, Huhtala H, et al. Incidence of prosthetic joint infections after primary knee arthroplasty. J Arthroplasty, 2010, 25(1):87-92.
11. Moll JM, Wright V. New York clinical criteria for ankylosing spondylitis. A statistical evaluation. Ann Rheum Dis, 1973, 32(4): 354-363.
12. Ozmen M, Oktay E, Tarhan EF, et al. Serum procalcitonin levels in patients with ankylosing spondylitis. Int J Rheum Dis, 2014.[Epub ahead of print].
13. Neumaier M, Metak G, Scherer MA. C-reactive protein as a parameter of surgical trauma. Acta Orthopaedica, 2006, 77(5):788-790.
14. Minetto MA, Oprandi G, Saba L, et al. Serum interleukin-6 response to elective total hip replacement surgery. Int Orthop, 2006, 30(3): 172-176.
15. Glehr M, Friesenbichler J, Hofmann G, et al. Novel biomarkers to detect infection in revision hip and knee arthroplasties. Clin Orthop Relat Res, 2013, 471(8):2621-2628.
16. Reveille JD. Biomarkers for diagnosis, monitoring of progression, and treatment responses in ankylosing spondylitis and axial spondyloarthritis. Clin Rheumatol, 2015, 34(6):1009-1018.
17. Claushuis TA, de Vries MK, van der Weijden MA, et al. C-reactive protein polymorphisms influence serum CRP-levels independent of disease activity in ankylosing spondylitis. Clin Exp Rheumatol, 2015, 33(2):159-165.
18. Laiho K, Mäenpää H, Kautiainen H, et al. Rise in serum C reactive protein after hip and knee arthroplasties in patients with rheumatoid arthritis. Ann Rheum Dis, 2001, 60(3):275-277.
19. Niskanen RO, Korkala O, Pammo H. Serum C-reactive protein levels after total hip and knee arthroplasty. J Bone Joint Surg (Br), 1996, 78(3):431-433.
20. Parvizi J, Zmistowski B, Berbari EF, et al. New definition for periprosthetic joint infection. J Arthroplasty, 2011, 26(8):1136-1138.
21. Schmidt AH. Inflammatory markers in patients with inflammatory arthritis:perhaps they can be helpful in diagnosing chronic periprosthetic infection. J Bone Joint Surg (Am), 2012, 94(7):e47.
22. 张亮, 徐辉, 郭晓忠, 等. 人工全髋关节置换术治疗强直性脊柱炎的中期疗效. 中国修复重建外科杂志, 2014, 28(1):1-6.
23. 徐步国, 严世贵, 王祥华, 等. 全髋关节置换术治疗强直性脊柱炎髋关节强直的中期疗效随访. 中国骨伤, 2013, 26(12):1052-1056.
24. Sweeney S, Gupta R, Taylor G, et al. Total hip arthroplasty in ankylosing spondylitis:outcome in 340 patients. J Rheumatol, 2001, 28(8):1862-1866.
25. Shi D, Xu X, Song K, et al. Comparison of venous thromboembolism after total hip arthroplasty between ankylosing spondylitis and osteoarthritis. Biomed Res Int, 2014, 2014:712895.

Chinese Journal of Reparative and Reconstructive Surgery

COMPARISON OF PERIOPERATIVE INFLAMMATORY MARKERS BETWEEN PATIENTS WITH ANKYLOSING SPONDYLITIS AND NON-INFLAMMATORY DISEASES UNDERGOING TOTAL HIP ARTHROPLASTY

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