Comparative biochemical analysis of synovial fluid constituents in infected cases following total knee replacement

Abstract

Introduction Biochemical parameters of synovial fluid constituents were reviewed in patients prior to total knee replacement (TKR). The diagnostic value of certain biochemical tests was identified as prognostic factors in the development of infection. Purpose Comparative biochemical analysis was performed for pathogenic microflora free synovial fluid of patients grouped according to characteristics of infectious complications prior to TKR. Material and methods Synovial fluid samples with isolated strains of Staphylососcus aureus, Klеbsiella sp. and aerobic gram-positive bacilli were excluded from the study. Total protein and its fractions, electrolytes, lipid peroxidation and catalase levels were measured in the synovial fluid. Electrolytes, lipid peroxidation and catalase were determined in the synovial fluid with exclusion of samples with identified aerobic gram-positive bacilli in bacterial culture. Results Preoperative assessment of synovial fluid showed changes in cholesterol concentration and systemic electrolyte index in TKR patients later grouped into periprosthetic infection and non-infection cases. No changes were seen in protein panel. Levels of total protein and albumin were elevated in both groups. Conclusion Our findings suggest that biochemical parameters of synovial fluid can serve as a prognostic tool for infection following TKR.

Keywords

• joint replacement
• synovial fluid
• purulent complications