Evaluation of serum levels of C-reactive protein after total knee arthroplasty☆

Barretto, João Maurício; Loures, Fabrício Bolpato; Albuquerque, Rodrigo Sattamini Pires e; Bezerra, Filipe das Neves; Faro, Rafael Vinagre; Cavanellas, Naasson Trindade

doi:10.1016/j.rboe.2016.05.009

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ORIGINAL ARTICLE • Rev. bras. ortop. 52 (2) • Mar-Apr 2017 • https://doi.org/10.1016/j.rboe.2016.05.009 copy

Evaluation of serum levels of C-reactive protein after total knee arthroplasty^{^☆} ☆ Study conducted at the Instituto Nacional de Traumatologia e Ortopedia (Into), Centro de Cirurgia do Joelho, Rio de Janeiro, RJ, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE:

To evaluate the behavior of C-reactive protein (CRP) levels in the first three weeks after total knee arthroplasty (TKA) and define the factors related to its variation.

METHODS:

We evaluated the CRP values in 103 patients undergoing primary TKA. Serum CRP was measured on the day before surgery, and on the third and twenty-first days after the procedure.

RESULTS:

PCR showed sudden increase on the third day after surgery, reaching the mean value of 111.9 mg/L, median 75.9 mg/L. Only one-third of the patients returned to normal levels in the third week. In the immediate postoperative period, CRP was not correlated with body mass index (BMI), age, gender, blood transfusion, or complications.

CONCLUSION:

Serum CRP remains high in the third week after TKA in most patients, and this change is primarily related to surgical trauma.

Keywords:
C-reactive protein; PCR; Knee; Osteoarthritis; Arthroplasty

Variable	Number	Percentage
Gender
Male	24	23.3
Female	79	76.7

Laterality
Right	60	58.3
Left	43	41.7

Ethnicity
White	35	34
Mixed-race	51	49.5
Black	17	16.5

Statistics	CRP₀ (mg/L)	CRP₃ (mg/L)	CRP₂₁ (mg/L)	Δ₁CRP (%)	Δ₂CRP (%)
Mean	15.1	111.9	27.4	3118.6	-47.5
95% CI	10.5 19.6	94.2 129.6	20.1 34.6	2048.2 4189.0	-70.4 -24.6
Median	6.4	75.9	15.4	1051.9	-73.6
Standard deviation	23.2	90.4	36.9	5476.9	117.1
Minimum	0.6	4.8	0.7	-62.8	-99.1
Maximum	132.5	384.0	263.9	25,242.5	962.5
Raw variation	131.9	379.2	263.2	25,305.3	1061.6
Correlation coefficient	1.5	0.8	1.4	1.8	-2.5

Classification	Gender		Total
	Female	Male
CRP₂₁ was normalized	21	8	29
CRP₂₁ was normalized	26.6%	33.3%	28.2%
CRP₂₁ up to 10 mg/L > CRP₀	29	7	36
CRP₂₁ up to 10 mg/L > CRP₀	36.7%	29.2%	35.0%
CRP₂₁ from 10 to 20 mg/L > CRP₀	14	3	17
CRP₂₁ from 10 to 20 mg/L > CRP₀	17.7%	12.5%	16.5%
CRP₂₁ from 20 to 50 mg/L > CRP₀	8	4	12
CRP₂₁ from 20 to 50 mg/L > CRP₀	10.1%	16.7%	11.7%
CRP₂₁ from 50 to 100 mg/L > CRP₀	4	1	5
CRP₂₁ from 50 to 100 mg/L > CRP₀	5.1%	4.2%	4.9%
CRP₂₁ more than 100 mg/L > CRP₀	3	1	4
CRP₂₁ more than 100 mg/L > CRP₀	3.8%	4.2%	3.9%
Total	79	24	103
Total	100%	100%	100%

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] ^*Corresponding author. E-mail: joao.barretto1@gmail.com (J.M. Barretto).

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Evaluation of serum levels of C-reactive protein after total knee arthroplasty☆ ☆ Study conducted at the Instituto Nacional de Traumatologia e Ortopedia (Into), Centro de Cirurgia do Joelho, Rio de Janeiro, RJ, Brazil.

ABSTRACT

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Evaluation of serum levels of C-reactive protein after total knee arthroplasty^{^☆} ☆ Study conducted at the Instituto Nacional de Traumatologia e Ortopedia (Into), Centro de Cirurgia do Joelho, Rio de Janeiro, RJ, Brazil.