Knee skin temperature following uncomplicated total knee replacement

Haidar, S.G.; Charity, R.; Bassi, R. S.; Nicolai, P.; Singh, Binod Kumar

doi:10.1016/j.knee.2006.08.003

Cited by 25 publications

(24 citation statements)

References 9 publications

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“…In agreement with our findings, Mehra et al have demonstrated that skin temperature of the operated knee increases in the early postoperative period but returns to normal at 18 weeks postoperatively [21]. Haidar et al have also shown a decrease in the mean difference between the operated and contralateral knee over time [22].…”

Section: Discussionsupporting

confidence: 93%

Relationship of serum IL-6, C-reactive protein, erythrocyte sedimentation rate, and knee skin temperature after total knee arthroplasty: a prospective study

Honsawek

Deepaisarnsakul

Tanavalee

et al. 2010

International Orthopaedics (SICOT)

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Knee osteoarthritis is a common cause of severe pain and functional limitation. Total knee arthroplasty is an effective procedure to relieve pain, restore knee function, and improve quality of life for patients with end stage knee arthritis. The aim of this study was to investigate the inflammatory process in patients with primary knee osteoarthritis before surgery and in subsequent periods following total knee arthroplasty. A prospective study of 49 patients undergoing primary total knee replacements was conducted. The patients were evaluated by monitoring serum interleukin-6 (IL-6), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), knee skin temperature, and clinical status. Measurements were carried out preoperatively and postoperatively on day one and at two, six, 14, and 26 weeks during follow-up review in the knee clinic. The serum IL-6 and CRP were elevated on the first postoperative day but fell to preoperative values at two weeks postoperatively. Both returned to within the normal range by six weeks postoperatively. In addition, the postoperative ESR showed a slow rise with a peak two weeks after surgery and returned to the preoperative level at 26 weeks postoperatively. The difference in skin temperature between operated and contralateral knees had a mean value of +4.5°C at two weeks. The mean value decreased to +3.5°C at six weeks, +2.5°C at 14 weeks, and +1.0°C at 26 weeks. The difference in skin temperature decreased gradually and eventually there was no statistically significant difference at 26 weeks after surgery. A sustained elevation in serum IL-6, CRP, ESR, and skin temperature must raise the concern of early complication and may suggest the development of postoperative complication such as haematoma and/or infection.

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Section: Discussionsupporting

confidence: 93%

Relationship of serum IL-6, C-reactive protein, erythrocyte sedimentation rate, and knee skin temperature after total knee arthroplasty: a prospective study

Honsawek

Deepaisarnsakul

Tanavalee

et al. 2010

International Orthopaedics (SICOT)

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“…The change of skin temperature seemed to mirror the level of the inflammatory markers, especially the ESR, which was similar to the study of Mehra et al 22 Concerning the different skin temperature between the operated and the contralateral knee, we found that the affected Plot graph showing the mean CRP levels of patients who underwent total knee replacement without synovectomy (group I) or with synovectomy (group II) from pre-operative period to 26-week follow-up (error bars represent SDs). knee of both groups had a similarly higher temperature from two weeks until six months after surgery, which is in agreement with the findings of Haidar et al 23 The clinical outcome of the patients in this series was significantly improved in both groups with no statistical difference between the groups. From two weeks to six months after surgery, we could not demonstrate any difference in clinical outcomes, or in serial IL-6, ESR, CRP measurements and knee temperature, between patients who underwent TKR with or without synovectomy.…”

Section: Discussionsupporting

confidence: 93%

Inflammation related to synovectomy during total knee replacement in patients with primary osteoarthritis

Tanavalee¹,

Honsawek

Rojpornpradit

et al. 2011

The Journal of Bone and Joint Surgery. British volume

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We compared inflammation in the knee after total knee replacement (TKR) for primary osteoarthritis between two groups of patients undergoing joint replacement with and without synovectomy. A total of 67 patients who underwent unilateral TKR were randomly divided into group I, TKR without synovectomy, and group II, TKR with synovectomy. Clinical outcomes, serial serum inflammatory markers (including interleukin-6 (IL-6), CRP and ESR) and the difference in temperature of the skin of the knee, compared with the contralateral side, were sequentially evaluated until 26 weeks after surgery. Pre-operatively, there were no statistically different clinical parameters between groups I and II. At the 26-week follow-up, both groups had a similarly significantly improved American Knee Society clinical score (p < 0.001) and functional score (p < 0.001) with no differences between the groups. Similar changes in serial inflammatory markers were found in both groups, including mean peak levels of IL-6 (189 pg/ml (SD 53.4) versus 201 pg/ml (SD 49.4) for groups I and II, respectively) and CRP (91 mg/L (SD 24.1) versus 88 mg/L (SD 23.4), respectively) on the first post-operative day, returning to pre-operative values at two and six weeks, respectively. The mean peak level of ESR for the respective two groups was 46 mm/hr versus 48 mm/hr at two weeks, which had still not returned to its pre-operative mean value at 26 weeks. The elevation in the skin temperature appeared to mirror the peak elevation of the ESR, with a range of 2.5° C to 4.5° C with some reduction at 26 weeks but still exceeding the pre-operative value. We concluded that synovectomy at the time of TKR does not provide any benefit to the clinical outcome or shorten the duration of the inflammatory response after surgery.

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“…Local skin temperature can be used to monitor and detect inflammation associated with knee replacement (Haidar et al, 2006;Mehra et al, 2005), rheumatoid arthritis (Rajapakse et al, 1981), osteoarthritis (Denoble et al, 2010), allergies (Rokita et al, 2011), frozen shoulder (Vecchio et al, 1992) and even tendinitis (Miyakoshi et al, 1998). Mean skin temperature on the other hand, is most commonly used as an important component of overall thermal stress (Frim et al, 1990), thermal comfort (International Organisation for Standardisation, 2004) and in the calculation of mean body temperature (Colin et al, 1971).…”

Section: Introductionmentioning

confidence: 99%

The effect of using different regions of interest on local and mean skin temperature

Maniar

Bach

Stewart

et al. 2015

Journal of Thermal Biology

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The dynamic nature of tissue temperature and the subcutaneous properties, such as blood flow, fatness, and metabolic rate, leads to variation in local skin temperature. Therefore, we investigated the effects of using multiple regions of interest when calculating weighted mean skin temperature from four local sites. Twenty-six healthy males completed a single trial in a thermonetural laboratory (mean ± SD): 24.0 (1.2)°C; 56 (8%) relative humidity; <0.1 m/s air speed). Mean skin temperature was calculated from four local sites (neck, scapula, hand and shin) in accordance with International Standards using digital infrared thermography. A 50 mm × 50 mm, defined by strips of aluminium tape, created six unique regions of interest, top left quadrant, top right quadrant, bottom left quadrant, bottom right quadrant, centre quadrant and the entire region of interest, at each of the local sites. The largest potential error in weighted mean skin temperature was calculated using a combination of a) the coolest and b) the warmest regions of interest at each of the local sites. Significant differences between the six regions interest were observed at the neck (P<0.01), scapula (P<0.001) and shin (P<0.05); but not at the hand (P = 0.482). The largest difference (± SEM) at each site was as follows: neck 0.2 (0.1)°C; scapula 0.2 (0.0)°C; shin 0.1 (0.0)°C and hand 0.1 (0.1)°C. The largest potential error (mean ± SD) in weighted mean skin temperature was 0.4 (0.1)°C (P<0.001) and the associated 95% limits of agreement for these differences was 0.2-0.5 °C. Although we observed differences in local and mean skin temperature based on the region of interest employed, these differences were minimal and are not considered physiologically meaningful.

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Knee skin temperature following uncomplicated total knee replacement

Cited by 25 publications

References 9 publications

Relationship of serum IL-6, C-reactive protein, erythrocyte sedimentation rate, and knee skin temperature after total knee arthroplasty: a prospective study

Relationship of serum IL-6, C-reactive protein, erythrocyte sedimentation rate, and knee skin temperature after total knee arthroplasty: a prospective study

Inflammation related to synovectomy during total knee replacement in patients with primary osteoarthritis

The effect of using different regions of interest on local and mean skin temperature

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