IL-6Level As Inflammatory Marker Of Periprosthetic Joint Infection

BackgroundTo investigate the discipline of change in serum IL-6before and aftertotal joint arthroplasty, combined with the change of CRP and ESR,wefurther analysed the differences of these three markers, and provide a guidefor diagnosing early infection after total joint arthroplasty.MothodsWe analyzed204patients who underwent total joint arthroplastybetween October2011and April2012in our institution. Identifing thedata of serum IL-6before surgery, at1day,2day,3day and5day aftertotal joint arthroplasty, we also identified the data of CRP and ESR beforesurgery, at1day,3day and5day after total joint arthroplasty, then weanalyzed these data and compared their discipline of change.ResultsThe data showd that the level of serum IL-6, CRP and ESR allincreased first and then decreased. The level of serum IL-6was elevated toa peak on the second postoperative day then fell and returned to within thenormal range by5days postoperatively. The level of serum IL-6at1day,2 day,3day after total joint arthroplasty were higher than the level beforesurgery(P <0.05),There is no significant difference between the level ofserum IL-6at5days after surgery and the preoperative level(P>0.05).Thelevel of serum CRP was elevated to a peak at2-3days after total jointarthroplasty then fell but it didn’t return to within the normal range by5days postoperatively.The level of serum ESR was elevated to a peak at4-5days after total joint arthroplasty then fell but it didn’t return to withinthe normal range by5days postoperatively.ConclusionThe level of serum IL-6after total joint arthroplasty showed a changingcharacteristics which increase fastly and then decline rapidly. The level ofserum IL-6has the fastest rate of change and returns to within the normalrange faster than that of CRP and ESR. If combining the IL-6and CRP,ESR,we can improve the diagnosis of early infections after total jointarthroplasty. The level of serum IL-6before total hip arthroplasty and totalknee arthroplasty has significant difference (P＜0.05), may be it caused bydifferent pathogenesis or different expression of IL-6receptor in twojoints.