Value of knee skin temperature measured by infrared thermography and soluble intercellular adhesion molecule-1 in the diagnosis of periprosthetic knee infection in Chinese individuals following total knee arthroplasty
Value of knee skin temperature measured by infrared thermography and soluble intercellular adhesion molecule-1 in the diagnosis of periprosthetic knee infection in Chinese individuals following total knee arthroplasty
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DOI：
10.3760/cma.j.issn.0366-6999.20140482
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发表时间：
2014-09-05
影响因子：
6.1
通讯作者：
He Rongxin
中科院分区：
文献类型：
--
作者：
Yishake, Mumingjiang;Zhou Xindie;He Rongxin
背景全膝关节置换术（TKA）是骨科手术中一种成功且经常进行的手术。TKA后人工关节感染的诊断仍然具有挑战性。本研究估计的有用性膝关节皮肤温度（红外热成像测量）和血清可溶性细胞间粘附分子-1（sICAM-1）在术后膝关节pen-prosthetic infection.Methods患者被分为三组：21例患者进行简单的TKA，7假体感染，和三个进行TKA修订。分别于术前、术后第1、7天、术后第1、3、6个月测量血清白细胞介素-6（IL-6）、C反应蛋白（CRP）、红细胞沉降率（ESR）、sICAM-1以及局部膝关节皮肤温度。结果第1组患者术后IL-6、CRP、ESR、膝关节皮肤温度均明显升高，但在术后6个月内恢复至基线水平。sICAM-1水平无显著差异。第1组和第2组之间的平均温差（MDT）和siCAM-1、IL-6、CRP和ESR水平存在显著差异。MDT已恢复正常组3 6个月postoperation.Conclusions IL-6，CRP，ESR，MDT在接受TKA的患者可能是一个正常的反应，手术创伤，但持续升高可能是并发症的指标。膝关节皮温和sICAM-1可作为TKA术后膝关节假体感染的诊断指标。
Background Total knee arthroplasty (TKA) is a successful and frequently performed procedure in orthopedic surgery. The diagnosis of pen-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 pen-prosthetic infection.Methods Patients were divided into three groups: 21 patients undergoing uncomplicated TKAs, seven with prosthesis infection, and three undergoing TKA revisions. The serum levels of interleukin-6 (IL-6), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and sICAM-1 as well as the local knee skin temperature were measured pre-operatively and on Days 1 and 7 and at 1, 3, and 6 months post-operatively in Groups 1 and 3. The same parameters were measured in Group 2 at the time of prosthesis infection diagnosis.Results In Group 1, the levels of IL-6, CRP, ESR, and knee skin temperature were significantly elevated post-operatively, but returned to baseline levels within 6 months. The sICAM-1 levels were not significantly different. The mean differential temperature (MDT) and levels of siCAM-1, IL-6, CRP, and ESR differed significantly between Groups 1 and 2. The MDT had returned to normal in Group 3 by 6 months post-operatively.Conclusions Elevations 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-1 may be used as indicators in the diagnosis of knee prosthesis infection following TKA.