The Significance Of IL-6 In The Diagnosis Of Periprosthetic Joint Infection-a Meta-analysis

Background:periprosthetic joint infection(PJI) remains one of the most severe complications of TJA. Standard radiographs and the laboratory blood analyses that are used as first-line tests to determine the presence of periprosthetic infection, namely, the erythrocyte sedimentation rate, C-reactive protein serum level, and white blood cell count, are not consistently reliable.we need new marker with the diagnosis sensitivity and specificity higher for PJI. In the recent literature it has been suggested that interleukin-6 is marker for bacterial infections.Objective:This study evaluates the diagnostic value of interleukin-6 for the diagnosis of deep infection of implants in patients with failed total joint replacement.Materials and Methods:All studies indexed in Ovid, EMBASE, Pubmed and Scopus databases from inception until February 29, 2016, that evaluated interleukin-6 as markers for total hip or total knee arthroplasty infection were identified. The bibliographies of relevant articles were further cross-checked to search for articles not referenced in the search. And We supplemented our searches by reviewing manually the references of all inclusion literature, at last. According to the evaluation method of Cochrane system, Search strategy, quality assessment, data extraction, statistical analysis, heterogeneity analysis and bias analysis were performed.Results:A total of 9 studies met the selection criteria for inclusion in the analysis. The pooled estimates for sensitivity, specificity, PPV,NPV,DOR and the area under the curve(AUC) for the IL6 assay were 0.839(95% CI 0.786–0.883),0.800(95% CI 0.759–0.838), and 4.81(95% CI 2.85-8.11),0.24(95% CI 0.12-0.46),22.545(95% CI 9.775- 51.997),0.8972±0.0304 respectively.Conclusion: The diagnostic value of serum IL6 in PJI is good, compared with that of Serum CRP,the diagnostic value is higher. In the process of screening and diagnosis of PJI,,serum IL6 has guiding significance.