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...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-03-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/11/3/434 |
| _version_ | 1797414859539742720 |
|---|---|
| author | Frank Sebastian Fröschen Sophia Schell Matthias Dominik Wimmer Gunnar Thorben Rembert Hischebeth Hendrik Kohlhof Sascha Gravius Thomas Martin Randau |
| author_facet | Frank Sebastian Fröschen Sophia Schell Matthias Dominik Wimmer Gunnar Thorben Rembert Hischebeth Hendrik Kohlhof Sascha Gravius Thomas Martin Randau |
| author_sort | Frank Sebastian Fröschen |
| collection | DOAJ |
| 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 (<i>n</i> = 74) were classified into septic (<i>n</i> = 28) and aseptic (<i>n</i> = 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. |
| first_indexed | 2024-03-09T05:40:00Z |
| format | Article |
| id | doaj.art-4d406cf07a344edbb8321adb5d9b28a2 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T05:40:00Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-4d406cf07a344edbb8321adb5d9b28a22023-12-03T12:26:00ZengMDPI AGDiagnostics2075-44182021-03-0111343410.3390/diagnostics11030434Synovial Complement Factors in Patients with Periprosthetic Joint Infection after Undergoing Revision Arthroplasty of the Hip or Knee JointFrank Sebastian Fröschen0Sophia Schell1Matthias Dominik Wimmer2Gunnar Thorben Rembert Hischebeth3Hendrik Kohlhof4Sascha Gravius5Thomas Martin Randau6Department of Orthopaedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Orthopaedics and Trauma Surgery, Ev. Waldkrankenhaus Bonn, 53177 Bonn, GermanyDepartment of Orthopaedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, GermanyInstitute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Orthopaedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, GermanyOrthopaedic and Trauma Surgery Centre, University Hospital Mannheim, Medical Faculty Mannheim of the University of Heidelberg, 68167 Mannheim, GermanyDepartment of Orthopaedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, GermanyThe 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 (<i>n</i> = 74) were classified into septic (<i>n</i> = 28) and aseptic (<i>n</i> = 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.https://www.mdpi.com/2075-4418/11/3/434synovial fluidcomplement systemperiprosthetic joint infectionrevision arthroplasty |
| spellingShingle | Frank Sebastian Fröschen Sophia Schell Matthias Dominik Wimmer Gunnar Thorben Rembert Hischebeth Hendrik Kohlhof Sascha Gravius Thomas Martin Randau Synovial Complement Factors in Patients with Periprosthetic Joint Infection after Undergoing Revision Arthroplasty of the Hip or Knee Joint Diagnostics synovial fluid complement system periprosthetic joint infection revision arthroplasty |
| 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 | synovial fluid complement system periprosthetic joint infection revision arthroplasty |
| url | https://www.mdpi.com/2075-4418/11/3/434 |
| work_keys_str_mv | AT franksebastianfroschen synovialcomplementfactorsinpatientswithperiprostheticjointinfectionafterundergoingrevisionarthroplastyofthehiporkneejoint AT sophiaschell synovialcomplementfactorsinpatientswithperiprostheticjointinfectionafterundergoingrevisionarthroplastyofthehiporkneejoint AT matthiasdominikwimmer synovialcomplementfactorsinpatientswithperiprostheticjointinfectionafterundergoingrevisionarthroplastyofthehiporkneejoint AT gunnarthorbenremberthischebeth synovialcomplementfactorsinpatientswithperiprostheticjointinfectionafterundergoingrevisionarthroplastyofthehiporkneejoint AT hendrikkohlhof synovialcomplementfactorsinpatientswithperiprostheticjointinfectionafterundergoingrevisionarthroplastyofthehiporkneejoint AT saschagravius synovialcomplementfactorsinpatientswithperiprostheticjointinfectionafterundergoingrevisionarthroplastyofthehiporkneejoint AT thomasmartinrandau synovialcomplementfactorsinpatientswithperiprostheticjointinfectionafterundergoingrevisionarthroplastyofthehiporkneejoint |