Premium
Activation of Complement Following Total Hip Replacement
Author(s) -
Thordardottir S.,
Vikingsdottir T.,
Bjarnadottir H.,
Jonsson H.,
Gudbjornsson B.
Publication year - 2016
Publication title -
scandinavian journal of immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.934
H-Index - 88
eISSN - 1365-3083
pISSN - 0300-9475
DOI - 10.1111/sji.12411
Subject(s) - complement system , albumin , medicine , osteoarthritis , total hip replacement , surgery , complement (music) , chemistry , immunology , pathology , biochemistry , antibody , alternative medicine , complementation , gene , phenotype
Abstract The aim of this study was to investigate whether complement activation, via the classical and alternative pathways, occurs following a cemented total hip replacement ( THR ) surgery due to osteoarthritis. Blood samples were collected systematically from 12 patients – six male and six women, with a median age of 75 (range: 59–90 years) – preoperatively, 6 h post‐operatively and on the first, second and third post‐operative day. Total function of classical ( CH 50) and alternative pathways ( AH 50) was evaluated, along with the determination of serum concentrations of the complement proteins C3, C4, C3d, the soluble terminal complement complex ( sTCC ) sC 5b‐9, as well as C‐reactive protein ( CRP ) and albumin. Measurements of CRP and albumin levels elucidated a marked inflammatory response following the operation. The CH 50, AH 50 and C3 and C4 levels were significantly lower 6 h after the surgery compared with the preoperative levels, but elevated above the preoperative levels during the following 3 days. The complement activation product C3d levels increased continually during the whole observation period, from 13.5 AU/ml (range: 8–19 AU/ml) preoperative to 20 AU/ml (range: 12–34 AU/ml) on the third post‐operative day. Furthermore, we observed an increase in the sC 5b‐9 levels between the preoperative and the third post‐operative day. These results demonstrate a significant activation of the complement system following cemented THR . Further studies are needed to elucidate the time frame and the pathogenic role of this observed complement activation.