Thrombinogenesis in patients with aseptic instability of knee endoprosthesis and periprosthetic infection

Objective: To evaluate thrombinogenesis in patients with periprosthetic infection and aseptic loosening of endoprosthesis after primary knee arthroplasty. Material and Methods: 28 of 52 examined patients who suffered from the loosening of knee endoprosthesis components and 24 from periprosthetic infection; 18 healthy individuals were also engaged into the study. Thrombinogenesis was analyzed with thrombin generation assay in an automated Ceveron alpha coagulometer (Technoclone, Austria) using RB and RC-low activators containing 2 and 5 pmol/ml of tissue factor respectively. Each of the main groups of patients was divided into two subgroups: in patients of the 1st subgroups RC-low activator aggravate thrombinogenesis while in the 2nd subgroups it inhibited the process as compared to the effects of RB activator. Results: In the 1st subgroup of patients with aseptic loosening RC-low activator caused chronometric hyperthrombinogenesis, and in the 2nd - both chronometric and structural ones. In patients with periprosthetic infection the effects of RB and RC-low activators were comparable. Conclusion: In patients with aseptic loosening of the implant and stopped periprosthetic infection that developed after primary knee replacement, the thrombin generation test reveals normal, paradoxical and inert types of thrombinogenesis.