Activation of Complement Following Total Hip Replacement.

• Published in: Scandinavian Journal of Immunology
• Main Authors: Thordardottir, S, Vikingsdottir, T, Bjarnadottir, H, Jonsson, H, Gudbjornsson, B
• Other Authors: 1 Landspitali Univ Hosp, Dept Immunol, Reykjavik, Iceland Organization-Enhanced Name(s) Landspitali National University Hospital 2 Landspitali Univ Hosp, Dept Orthopaed, Reykjavik, Iceland Organization-Enhanced Name(s) Landspitali National University Hospital 3 Univ Iceland, Fac Med, Reykjavik, Iceland 4 Landspitali Univ Hosp, Ctr Rheumatol Res, Reykjavik, Iceland
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley-Blackwell 2016
• Subjects: Mjaðmaaðgerðir; RHE12; AAI12; ORT12; Arthroplasty; Replacement; Hip; Iceland
• Online Access: http://hdl.handle.net/2336/607761; https://doi.org/10.1111/sji.12411

To access publisher's full text version of this article click on the hyperlink at the bottom of the page 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 (CH50) and alternative pathways (AH50) was evaluated, along with the determination of serum concentrations of the complement proteins C3, C4, C3d, the soluble terminal complement complex (sTCC) sC5b-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 CH50, AH50 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 sC5b-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. Icelandic College of Rheumatology, University Hospital of Iceland University of Iceland Student Innovation Fund