Akademik Veri Yönetim Sistemi
JOURNAL OF ARTHROPLASTY, cilt.40, sa.6, ss.1613-1621, 2025 (SCI-Expanded, Scopus)
Background: Periprosthetic joint infection (PJI) is a severe complication following total joint arthroplasty. This study aimed to investigate the dynamics of synovial fluid markers following single-stage exchange arthroplasty or debridement, combined with antibiotics and implant retention with topical antibiotic infusion for PJI. Methods: This retrospective study analyzed patient records at a tertiary hospital from March 1, 2018, to May 1, 2023. Patients who received single-stage exchange arthroplasty or debridement, combined with antibiotics and implant retention, followed by intra-articular antibiotic infusion for PJI, were included. Basic demographic details, comorbidities, Charlson Comorbidity Index scores, microorganism profile, presence of sinus tract, and antibiotic treatment type were collected. Synovial fluid samples were collected preoperatively and postoperatively every two days for 14 days to quantify synovial white blood cell (WBC) count and polymorphonu clear cell percentage (PMN%). Results: The study included 140 patients who had a mean age of 63 years and a mean body mass index of 25. The results showed a steady decrease in synovial WBC count from preoperative levels to day 14 postoperatively. Patients who had successful outcomes had significantly higher preoperative WBC counts compared to those who had a treatment failure. The synovial PMN% initially increased postoperatively, peaking at days one to two, and then gradually declined. Patients who had successful outcomes showed a faster decline in PMN% compared to those who had persistent infections. Different bacteria exhibited varying preoperative synovial WBC counts and PMN%, but these differences were not statistically significant.