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Article

Synovial Fluid Interleukin Levels Cannot Distinguish between Prosthetic Joint Infection and Active Rheumatoid Arthritis after Hip or Knee Arthroplasty

by
Leilei Qin
1,2,†,
Chengcheng Du
1,2,†,
Jianye Yang
1,2,
Hai Wang
1,2,
Xudong Su
1,2,
Li Wei
1,2,
Chen Zhao
1,2,
Cheng Chen
1,2,
Hong Chen
1,2,
Ning Hu
1,2,* and
Wei Huang
1,2,*
1
Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
2
Orthopedic Laboratory, Chongqing Medical University, Chongqing 400016, China
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Diagnostics 2022, 12(5), 1196; https://doi.org/10.3390/diagnostics12051196
Submission received: 7 April 2022 / Revised: 26 April 2022 / Accepted: 4 May 2022 / Published: 11 May 2022
(This article belongs to the Special Issue Diagnosis and Treatment of Periprosthetic Joint Infections)
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Abstract

Inflammatory arthritis affects the level of synovial inflammatory factors, which makes it more difficult to diagnose prosthetic joint infection (PJI) patients with inflammatory arthritis. The aim of this study was to analyze synovial interleukin levels to distinguish between PJI and active rheumatoid arthritis (RA) after a hip or knee arthroplasty. From September 2019 to September 2021, we prospectively enrolled patients with joint pain after arthroplasty due to aseptic prosthesis loosening (n = 39), acute RA (n = 26), and PJI (n = 37). Synovial fluid from the affected joint is obtained and tested with a standard enzyme-linked immunosorbent assay. Receiver operating characteristic curve (ROC) was analyzed for each biomarker. Interleukin (IL)-1β, IL-6, and IL-8 showed promising value in differentiating of aseptic loosening from PJI, with areas under the curves (AUCs) of 0.9590, 0.9506, and 0.9616, respectively. Synovial IL-1β, IL-6, and IL-8 showed limited value in distinguishing between PJI and acute episodes of RA after arthroplasty, with AUCs of 0.7507, 0.7069, and 0.7034, respectively. Interleukins showed satisfactory efficacy in differentiating aseptic loosening from PJI. However, when pain after arthroplasty results from an acute episode of RA, current synovial interleukin levels do not accurately rule out the presence of PJI.
Keywords: prosthetic joint infection; synovial fluid; inflammatory marker; interleukins; rheumatoid arthritis prosthetic joint infection; synovial fluid; inflammatory marker; interleukins; rheumatoid arthritis

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MDPI and ACS Style

Qin, L.; Du, C.; Yang, J.; Wang, H.; Su, X.; Wei, L.; Zhao, C.; Chen, C.; Chen, H.; Hu, N.; et al. Synovial Fluid Interleukin Levels Cannot Distinguish between Prosthetic Joint Infection and Active Rheumatoid Arthritis after Hip or Knee Arthroplasty. Diagnostics 2022, 12, 1196. https://doi.org/10.3390/diagnostics12051196

AMA Style

Qin L, Du C, Yang J, Wang H, Su X, Wei L, Zhao C, Chen C, Chen H, Hu N, et al. Synovial Fluid Interleukin Levels Cannot Distinguish between Prosthetic Joint Infection and Active Rheumatoid Arthritis after Hip or Knee Arthroplasty. Diagnostics. 2022; 12(5):1196. https://doi.org/10.3390/diagnostics12051196

Chicago/Turabian Style

Qin, Leilei, Chengcheng Du, Jianye Yang, Hai Wang, Xudong Su, Li Wei, Chen Zhao, Cheng Chen, Hong Chen, Ning Hu, and et al. 2022. "Synovial Fluid Interleukin Levels Cannot Distinguish between Prosthetic Joint Infection and Active Rheumatoid Arthritis after Hip or Knee Arthroplasty" Diagnostics 12, no. 5: 1196. https://doi.org/10.3390/diagnostics12051196

APA Style

Qin, L., Du, C., Yang, J., Wang, H., Su, X., Wei, L., Zhao, C., Chen, C., Chen, H., Hu, N., & Huang, W. (2022). Synovial Fluid Interleukin Levels Cannot Distinguish between Prosthetic Joint Infection and Active Rheumatoid Arthritis after Hip or Knee Arthroplasty. Diagnostics, 12(5), 1196. https://doi.org/10.3390/diagnostics12051196

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