Analysis of synovial biomarkers with a multiplex protein microarray in patients with PJI undergoing revision arthroplasty of the hip or knee joint

Fröschen, F. S., Schell, S., Schildberg, F.A., Klausing, A., Kohlhof, H., Gravius, S., and Randau, T.M. Arch. Orthop. Trauma Surg. (2020)

With increased longevity in the world population, knee and hip replacements have become common surgeries among elderly but active cohorts. A portion of patients must undergo revision surgery due to either aseptic or septic complications. The latter is known as periprosthetic joint infection (PJI) and physicians currently rely on time-consuming examinations, radiographies and microbiological methods to distinguish it from aseptic causes and determine course of action.

periprosthetic joint infection

The study quantified 12 cytokines as potential biomarkers of PJI which could be used to enhance the current toolbox available for PJI analysis. The LUNARIS™ Human 11-Plex Cytokine Kit was used to simultaneously measure IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, IL-17, GM-CSF, TNF-α, and INF-γ in synovial fluid from 14 PJI and 18 non-PJI patients undergoing revision knee or hip arthroplasty.

Fröschen and coworkers found that all evaluated cytokine levels were higher in PJI patients compared to non-PJI, a multiple regression model showed best sensitivity (100%) and specificity (88.9%) when a combination of cytokines (IL-2, IL-4, IL-5, IL6, lL-12, and GM-CS) were evaluated. As such, these results suggest that this combined measure could be a useful tool to distinguish PJI from aseptic causes of painful prosthetics.

This outcome demonstrates the value of the LUNARIS™ Technology as an advanced method to quantify cytokine levels in biological matrices with the sensitivity and specificity needed to develop potentially new diagnostic tools and to understand the pathophysiology and molecular mechanisms underlying complications in joint replacement.

Furthermore, this study expands the already broad spectrum of clinically relevant sample types that can be analyzed with the LUNARIS™ multiplex assays to include synovial fluid.

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