Assessment of reactive c proteine and vs erythrocyte sedimentation rate levels after total primary knee arthroplasty

Abstract

INTRODUCTION: Total knee replacement (TKR) is one of the most frequently performed and costly
orthopedic surgical procedures in the United States.
The diagnosis of implant-associated infection remains difficult, particularly in its acute stage due to
postoperative inflammation.
Measurement of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are useful in
differentiating septic from mechanical loosening, detecting complications, and monitoring the effects of
treatment.
OBJECTIVE: To assess the variability of the physiological response of CRP and ESR in adult patients who
undergo TKR at the Reina Fabiola University Clinic (CURF), from July 2020 to December of that year.
Determine the time of normalization of CRP and ESR values in the post
of patients undergoing TKR. Compare CRP and ESR values in the different intakes, according to age and
sex.
MATERIAL AND METHODS: This is a prospective study, observational, analytical design. A series of
RTR cases that were registered in the digital medical records, in the period July - December 2020, were
evaluated, all performed at the CURF and always by the same surgical team. Patients with knee
osteoarthritis (Ahlback Classification III-IV) were included.
CRP and ESR values were analyzed preoperatively, at 15, 45 and 90 days postoperatively. The quantitative
variables were evaluated by means of position measurements (mean or median) and dispersion (standard
deviation or quartiles). The qualitative variables were presented with N (%).
RESULTADOS: Measurements of 18 patients were included, 11 (62%) were male and 7 (38%) female.
The mean age was 66.2 (7.97) years.
The mean preoperative CRP value was 3.3 ± 1.5 mg / l and at 90 days it was 3.5 (2.0) mg / l. No significant
differences were found between both mean values (p = 0.733).
While the preoperative ESR was 6.2 (3.4) mm / h and 13.0 (6.7) mm / h at 90 days, with a statistically
significant difference (p = 0.016). In addition, the mean values of CRP and ESR confirmed their maximum
levels at 15 days postoperative CRP = 11.0 (7.4) mg / l and ESR = 20.5 (14.5) mm / h.
CONCLUSIONS: At day 90, 95% of the patients in the sample registered CRP values between 0 to 5 mg/
l, as for ESR, 44% registered values between 2 to 13 mm / h. Both CRP and ESR values found their
maximum levels 15 days after surgery.
Therefore, we consider that CRP values above 5 mg / l after 90 days of intervention could indicate the
possibility of serious complications such as infections or thrombosis, but not ESR values greater than 13
mm / h after 90 days of intervention.