Background and purpose Postoperative C-reactive protein (CRP) levels in serum appear to reflect surgical trauma. We examined CRP levels after 4 types of arthroplasty.Material and methods We investigated 102 patients who had total knee arthroplasty (TKA), computer navigation-assisted total knee arthroplasty (NAV-TKA), hip resurfacing arthroplasty (metal on metal, MMSA) and total hip arthroplasty (THA), respectively. CRP levels were estimated before surgery and postoperatively at 2 and 7 days.Results Postoperatively, the peak CRP levels were highest on the second day after surgery in each of the groups. The peak CPR levels after hip resurfacing were lower than those after conventional primary THA. The peak CRP levels after computer navigation-assisted TKA were lower than those after conventional primary TKA.Interpretation The extent of bone and bone marrow injury rather than the region of surgery or the amount of soft tissue damage appears to determine the extent of the postoperative CRP response.

Objective The correlation between the signal/noise quotient values of an anterior cruciate ligament graft and the International Knee Documentation Committee Subjective Knee Form 2000 scores after anterior cruciate ligament reconstruction was evaluated. Design Magnetic resonance imaging and clinical evaluation using International Knee Documentation Committee scores were used to calculate the signal intensity of the graft maturity at the 6-mo and 12-mo follow-up points postoperatively. The associations between the signal/noise quotient values at the 6-mo follow-up point and International Knee Documentation Committee scores at the 12-mo follow-up point were evaluated. Results A total of 42 male patients completed our trial and returned to normal activity level before the surgery. The mean ± SD age of these patients was 29.07 ± 8.11 yrs (range, 17–47 yrs). The mean ± SD body mass index was 26.00 ± 2.59 kg/m2. Notably, the Pearson correlation analysis showed that the International Knee Documentation Committee scores obtained at 12 mos were significantly associated with the signal/noise quotient values measured in the sixth month and twelfth month, respectively (r = −0.454, P = 0.003; r = −0.478, P = 0.001). Conclusions According to this study, early measurement of graft maturity might predict the clinical outcome afterward. The sensitive predictive value of signal/noise quotient could be used to maximize the patient outcomes.

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Recently, favorable outcomes of primary anterior cruciate ligament (ACL) repair have been reported in patients with proximal tears and good tissue quality. If the tear involves the midsubstance of the ACL fibers or Sherman type II or III injury, independent primary repair will cause a higher failure rate at long-term follow-up. For these cases, we conduct primary repair and apply an internal brace and single-bundle reconstruction as hybrid augmentation. This hybrid repair technique encourages natural healing of the primary ligament by the internal brace and single-bundle graft as a provisional scaffold during the healing phase, as well as early mobilization. We describe our ACL hybrid repair technique, using a video and illustrations.