Systemic and local cytokine patterns during total hip surgery.
OBJECTIVE
Increased levels of inflammatory cytokines have been described in musculoskeletal injury. Total hip replacement is major musculoskeletal surgery, and in the present study this operation was used to investigate systemic and local cytokine patterns during musculoskeletal trauma.


METHODS
Blood was sampled before, during and after surgery in 10 patients given total hip replacement. Samples of arterial blood and local blood from the femoral canal were analysed for proinflammatory and anti-inflammatory cytokines.


RESULTS
Surgery induced significant increases in arterial and local levels of interleukin 6 (IL-6) (p = 0.000, respectively) with the highest levels at 4 h after operation. There were significantly higher local levels of IL-6 than arterial levels. Interleukin 1beta (IL-1beta) was not significantly influenced by surgery at any time (p = 0.800 and 0.300 for local and arterial levels, respectively), nor was tumour necrosis factor alpha (TNFalpha) (p = 0.375 and 0.547 for local and arterial levels, respectively). Local levels were higher than arterial levels for IL-1beta and for TNFalpha. At the end of the operation, local levels of interleukin 10 (IL-10) were significantly reduced (p = 0.036), while surgery did not influence the arterial levels of IL-10 (p = 0.235). There were no significant differences in local and arterial levels of IL-10 (p = 0.558).


CONCLUSIONS
The study indicates that a major musculoskeletal operation on otherwise healthy patients is associated with fairly modest reactions of inflammation, both systemically and locally.
Clementsen
T
T
Department of Orthopedics, Rikshospitalet University Clinic, Oslo, Norway.
Krohn
C D
CD
Reikerås
O
O
D000293:Adolescent; D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007375:Interleukin-1 / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D016207:Cytokines; D018836:Inflammation Mediators; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10