Impact on red blood cell immunity patterns in postoperative phase following total hip arthroplasty

Objective: In this study, we aimed to measure changes in red blood cell (RBC) immunity and cytokine levels after performing total hip replacement surgery. Material and methods: Twenty patients receiving total hip arthroplasty were investigated by measuring presurgical and postoperative RBC natural tumor erythrocyte rosette rate (NTERR), RBC C3b receptor rosette rate (RC3bRR), RBC membrane CD35, CD58 and CD59 expression and cytokine levels [including tumor necrosis factor cc (TNF-alpha), interleukin 2 (IL-2), interferon gamma (IFN-gamma), interleukin 10 (IL-10) and prostaglandin E-2 (PGE(2))]. Blood samples were collected on the day before surgery and on the first day after hip arthroplasty. Results: Postoperative NTERR and RC3bRR were significantly lower than presurgical levels (p < 0.05). The RBC membrane CD35, CD58 and CD59 expressions were significantly decreased in the postoperative phase compared to pre-operative levels. Importantly, RBC promoting lymphocyte proliferation rates were significantly reduced after surgery. In addition, postoperative TNF-alpha, IL-2 and IFN-gamma levels in RBC and lymphocyte culture fluid were lower than those pre-operation, whereas IL-10 and PGE(2) were significantly increased compared to presurgical levels (p < 0.05). Conclusions: The modification of RBC immune function may be involved in the occurrence and development of the infection following hip arthroplasty, and this suggests a novel strategy to prevent such infection.