[The influence of surgery upon leucocyte function (author's transl)]

Area of Science:

• Immunology
• Surgical Medicine
• Orthopedics

Background:

• Postoperative infections remain a concern after total hip replacement.
• Polymorphonuclear leucocytes (PMNs) play a crucial role in the immune response to infection.
• Understanding PMN function post-surgery is vital for infection risk assessment.

Purpose of the Study:

• To investigate the impact of total hip replacement on PMN chemotactic and phagocytic functions.
• To determine if surgical impairment of PMN function correlates with infection risk.

Main Methods:

• Utilized a chemotaxis assay in modified Boyden chambers to assess PMN migration.
• Employed the nitroblue-tetrazolium assay to evaluate PMN phagocytic capacity.
• Compared 14 patients undergoing hip replacement with 25 healthy controls, with measurements taken preoperatively and on postoperative days 1, 3, and 6.

Main Results:

• Phagocytic function of PMNs remained unchanged throughout the study period.
• Chemotactic function of PMNs was significantly depressed on the first postoperative day.
• A consistent defect in PMN chemotaxis was observed in patients post-surgery.

Conclusions:

• Total hip replacement surgery leads to a significant, temporary impairment of PMN chemotaxis.
• This impairment in leukocyte chemotaxis, even with normal phagocytosis, may contribute to an increased risk of postoperative infections.
• Further research is warranted to explore strategies to mitigate this chemotactic defect and reduce infection rates.