Value Of Knee Skin Temperature And SICAM-1in The Diagnosis Of Peri-prosthetic Knee Infection In Chinese Individuals Following Total Knee Arthroplasty

BackgroundTotal knee arthroplasty (TKA) is a successful and frequently performed procedure in orthopedic surgery. The diagnosis of peri-prosthetic joint infection following TKA remains challenging. The present study estimated the usefulness of knee skin temperature (measured by infrared thermography) and serum soluble intercellular adhesion molecule-1(sICAM-1) in the diagnosis of post-operative knee peri-prosthetic infection.MethodsPatients were divided into three groups:21patients undergoing uncomplicated TKAs,7with prosthesis infection, and3undergoing TKA revisions. The serum levels of interleukin-6(IL-6), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and sICAM-1as well as the local knee skin temperature were measured pre-operatively and on days1and7and at1,3, and6months post-operatively in groups1and3. The same parameters were measured in group2at the time of prosthesis infection diagnosis. ResultsIn group1, the levels of IL-6, CRP, ESR, and knee skin temperature were significantly elevated post-operatively, but returned to baseline levels within6months. The siCAM-1levels were not significantly different. The mean differential temperature (MDT) and levels of siCAM-1, IL-6, CRP, and ESR differed significantly between groups1and2. The MDT had returned to normal in group3by6months post-operatively.ConclusionElevations in IL-6, CRP, ESR, and MDT in patients undergoing TKA could be a normal response to surgical trauma, but sustained elevations may be indicative of complications. The knee skin temperature and sICAM-1may be used as indicators in the diagnosis of knee prosthesis infection following TKA.