IMMUNOGENETIC PARAMETERS IN PATIENTS AFTER ENDOPROSTHETICS OF LARGE JOINTS AND THEIR SIGNIFICANCE IN PREDICTING THE DEVELOPMENT OF PERIPROSTHETIC INFECTION

The aim of the study is to determine the relationships between immunogenetic parameters in patients after endoprosthetics of large joints with primary osteoarthritis and to identify prognostic criteria for the development of periprosthetic infection. Materials and methods . The study included 182 unrelated patients of middle (45–59) and elderly (60–74) age with primary osteoarthritis of large joints stage III who underwent total joint arthroplasty. Group 1 (n = 92) – patients with uncomplicated course. Group 2 (n = 90) – patients with development of periprosthetic infection. Control group – 92 practically healthy individuals. Research methods: clinical; laboratory (immunological – determination of IL-2, IL-4, IL-6, IL-17A, TNFα, IFNγ; genetic – polymorphism of the gene IL-2 (T330G), IL-4 (C589T), IL-6 (C174G), IL-17A (G197A), TNFα (G308A)); instrumental (radiography). Statistical processing of the research results was carried out using the IBM SPSS Statistics Version 25.0 software package (IBM, USA). Results . The normalized importance was 54,2% for the IL-2 gene SNP (T330G), 100% for the IL-4 gene SNP (C589T), 24,5% for the IL-6 gene SNP (C174G), 13,7% for the IL-17A gene SNP (G197A), and 59,6% for the TNFα gene SNP (G308A). The prediction accuracy of the prognostic model was 97,3%, sensitivity 96,7%, specificity 97,8%, p < 0.001. Conclusion . The interactions of immunogenetic indicators revealed the prognostic value of determining the SNP of genes of immunoregulatory molecules in predicting periprosthetic infection in patients after endoprosthetics of large joints in primary osteoarthritis, without a significant decrease in the significance of the prognosis, both in the complex (IL-4 (C589T) x TNFα (G308A) x IL-17A (G197A) x IL-2 (T330G) x IL-6 (C174G), and in their more simplified interactions – IL-4 (C589T) x TNFα (G308A) and IL-4 (C589T) x TNFα (G308A) x IL-2 (T330G).