Systemic and local cytokine kinetics after total hip replacement surgery.
BACKGROUND
Trauma induces local and subsequent systemic inflammatory reactions. Aberrant reactions can lead to a systemic inflammatory response syndrome, with a potentially lethal outcome. Our aim was to investigate the early local cytokine kinetic compared to systemic changes in a standardized surgical trauma.


METHODS
In 7 patients with total hip replacement, drained blood samples and venous blood samples were taken 3 times within the first day after the operation. Interleukin (IL) release was assessed by a multiplex antibody bead kit and compared to pre-operative values.


RESULTS
The major findings were significant increases in systemic levels of IL-6 and in local levels of IL-6, IL-8 and IL-1 receptor antagonist (IL-1Ra), and that the local levels of these cytokines were significantly higher than the systemic ones after surgery. Besides, there were only modest changes in local and systemic levels of tumour necrosis factor alpha, IL-1 beta, IL-2, IL-2Ra, IL-4, IL-5, IL-7, IL-10, IL-12, IL-13, IL-15 and IL-17.


CONCLUSIONS
The acute sterile inflammation after major orthopaedic surgery is principally characterized by significantly increased local and systemic levels of IL-6 and significantly increased local levels of IL-8 and IL-1Ra. Furthermore, the concentrations are higher at the local site of injury. Hence, we conclude that systemic cytokine levels might not reflect local reactions.
Bastian
D
D
Department of Orthopaedics, Rikshospitalet University Clinic, University of Oslo, Oslo, Norway. daniel.bastian@rikshospitalet.no
Tamburstuen
M V
MV
Lyngstadaas
S P
SP
Reikerås
O
O
D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000097:blood; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D016207:Cytokines; D053590:Interleukin 1 Receptor Antagonist Protein; D053583:Interleukin-1beta; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha