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rheumatoid arthritis, endoprosthesis, bone marrow stromal cells, bone tissue regenerative potential, microbial factor, prognosis

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Liutko, O., Panchenko, L., Gerasimenko, S., Polulyakh, M., Babko, A., Gerasimenko, S., & Avtomeenko, E. (2020). INFLUENCE OF MICROBIAL CONTAMINATION OF BONE TISSUE ON ITS REGENERATOR POTENTIAL IN TOTAL ARTROPLASTY IN PATIENTS WITH RHEUMATOID ARTHRITIS. Medical Science of Ukraine (MSU), 16(1), 31-39.


Relevance. Total arthroplasty of large joints in patients with RA in some cases lead to the development of infectious postoperative complications. Treatment of patients with systemic inflammatory pathology of the connective tissue - the process is long and has certain features. Among others, we were interested in the persistence of an autoimmune inflammatory process and associated pathologies, including osteopenia or osteoporosis. Therefore, research into the effects of microbial contamination on bone repair processes is relevant.

Objective. To identify correlation relationships between bone regenerative potential and microbial factor in identical biopsies of surgical material from RA patients with primary total endoprosthesis (PTE) and to determine their effect on surgical results

Materials and methods. The data of microbiological researches of operative material after 151 surgical interventions from 118 patients with RA about PTE of joints (337 samples), executed according to the operating methods, are analyzed. 280 bone marrow specimens were examined and 400 cultures of bone marrow stromal fibroblasts were grown from these patients.

Results. Microorganisms in the culture from surgical material were isolated in 55.4% of RA patients with knee and hip joints PTE. The nature of the microflora was determined: these are staphylococci, streptococci, Corynebacterium spp., Anaerobic non-spore-forming, gram-negative microorganisms. There is a strong (almost functional) linear inverse correlation (coefficient r = ─ 0.98) between osteogenic activity of bone marrow stromal bone marrow cells and data from microbiological studies of surgical material in patients with RA. Contamination of bone spongiosis by microorganisms is likely to reduce the activity of colony-forming units of bone marrow fibroblasts by an average of 81.0% in the depression, by 53.0% in the femoral head and by 64.8% in the intervertebral area. Microbial contamination inhibits osteogenic potential by an average of 30.4%, or almost 2 times, revealing one of the mechanisms of occurrence of probable complications and directing measures for their prevention (changes in postoperative antibiotic therapy).

Conclusion. The higher the contamination with microorganisms, the lower the osteogenic activity of bone marrow stromal cells of bones forming the knee and hip joints in RA patients.
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1. Lіutko OB, Gerasimenko AS. [The role of microbial factor in the prediction of the results of orthopedic treatment of patients with rheumatoid arthritis with primary total endoprosthesis] // Bulletin of orthopedics, traumatology and prosthetics. 2015; 2 (85): 34-9. [in Ukrainian]. Mode access:
2. Willis-Owen C.A., Konyves A., Martin D.K. Factors affecting the incidence of infection in hip and knee replacement: an analysis of 5277 cases // J. Bone Joint Surg. Br. 2010; 92 (8):1128-33. / 0301-620X.92B8.24333
3. Schweizer M., Perencevich E.,McDanel J., et all. Effectiveness of a bundled intervention of decolonization and prophylaxis to decrease Gram positive surgical site infections after cardiac or orthopedic surgery: systematic review and metaanalysis // BMJ. 2013; 346: f2743.
4. Bidnenko SI, Lіutko OB, Gerasimenko SI. [Microbiological aspects of the development of rheumatoid arthritis] // Ukrainian Rheumatological Journal. 2007; 4 (30): 59-63. [in Ukrainian]. URL:
5. Dusad A., Pedro S., Mikuls T.R., Hartman C.W., Garvin K.L., O'Dell J.R., Michaud K. Impact of Total Knee Arthroplasty as Assessed Using Patient-Reported Pain and Health-Related Quality of Life Indices: Rheumatoid Arthritis Versus Osteoarthritis // Arthritis Rheumatol. 2015; 67 (9): 2503-11. / art.39221
6. Astakhova V.S. Osteogenic cells – the precursors of human bone marrow. – Kiev: Fenix, 2000. 176 с.
7. Maslyanko RP, Lavrov P.Yu. Microflora of body biotopes in the system of immune homeostasis // Scientific Bulletin of Lviv National University of Veterinary Medicine. S.Z. Gzycki. Part 1. 2013; 15 (3): 222-8. [in Ukrainian]. URL:
8. Gerasimenko SI, Lіutko OB, Guzhevsky IV, Gerasimenko AS Contamination of bone tissue and the risk of septic complications in knee joint replacement in patients with rheumatoid arthritis // Collection of scientific papers on materials of the All-Ukrainian Scientific-Practical Conference "Modern Research in Orthopedics and Traumatology". KharkivХарків. 14-15.04.2016. P. 120. [in Ukrainian].
9. Grigorovsky VV, Lіutko OB, Panchenko LM, Gerasimenko AS. Correlation dependences of histomorphometric indices of head spongiosis and distal femur epiphysis, some clinical and laboratory data in patients with rheumatoid arthritis // Proceedings of the 17th Congress of Orthopedists – Traumatologists of Ukraine. 2016. P. 223-5. [in Ukrainian]. Mode access:
10. Boric K.J., Lau E., Kurtz S., et all. Patient-related risk factors for periprosthetic joint infection and postoperative mortality following total hip arthroplasty in Medicare patients // J. Bone Joint Surg. Am. 2012; 94 (9): 794-800. / JBJS.K.00072
11. Schrama J.C., Espehang B., Hallan G., Engesaeter L.B., Furnes O., Havelin L.I., Fevang B.T. Risk of revision for infection in primary total hip and knee arthroplasty in patients with rheumatoid arthritis compared with osteoarthritis: a prospective population-based study on 108,786 hip and knee joint arthroplasties from the Norwegian Arthroplasty Register / J.C. Schrama // Arthritis Care Res. (Hoboken). 2010; 62 (4): 473-9. / acr.20036
12. Cordtz R.L., Zobbe K., Højgaard P., Kristensen L.E., Overgaard S., Odgaard A., Lindegaard H., Dreyer L. Predictors of revision, prosthetic joint infection and mortality following total hip or total knee arthroplasty in patients with rheumatoid arthritis: a nationwide cohort study using Danish healthcare registers / R.L. Cordtz // Ann Rheum Dis. 2018; 77 (2): 281-8.
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