Plasma viscosity and C-reactive protein after total hip and knee arthroplasty

Choudhry, R.; Rice, R; Triffitt, P. D.; Harper, W. M.; Gregg, P. J.

doi:10.1302/0301-620x.74b4.1624508

Cited by 48 publications

(37 citation statements)

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“…Previous studies (Ellitsgaad et al 1991, Choudhry et al 1992, Kragsbjerg et al 1995 have reported that CRP levels depend on the region of trauma, with the maximum levels on the second postoperative day. Reliable data exist for hip fractures (Okafor and Maclellan 1998) and arthroplasty of the hip (Niskanen et al 1996, White et al 1998, reaching values of about 10-16 mg/dL for standard procedures, using a posterolateral or anterolateral approach.…”

Section: Discussionmentioning

confidence: 90%

C-reactive protein as a parameter of surgical trauma: CRP response after different types of surgery in 349 hip fractures

Metak²,

2006

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Background Postoperative C-reactive protein (CRP) levels in serum appear to reflect surgical trauma. We examined CRP levels after different types of surgery in hip fractures.Methods We studied the CRP response after 349 operative procedures in proximal femur fractures with a normal postoperative course. 5 different operative techniques were used: 3-4 percutaneous cancellous screws, dynamic hip screw (DHS), proximal femur nail (PFN), hemiarthroplasty (HA), and total hip arthroplasty (THA).Results Peak CRP levels were reached on the second postoperative day in each group (medians: screws 8.7, DHS 12, PFN 14, HA 16, THA 16 mg/dL). Significant differences were found between screws and all others, and between DHS and arthroplasties.Interpretation CRP levels following surgical trauma can be used to quantify the degree of tissue damage and invasiveness of a procedure and reflect the perioperative stress experienced by the patient.

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Section: Discussionmentioning

confidence: 90%

C-reactive protein as a parameter of surgical trauma: CRP response after different types of surgery in 349 hip fractures

Metak²,

2006

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“…and some studies involved TKA and THA, which reportedly differ in postoperative levels of CRP and ESR [2,5,8,10,14,20,22,25,30]. Despite the well-known wide variations in postoperative levels of CRP and ESR, some previous studies report temporal patterns based on the mean values but without detailed normative data [2,5,8,10,20,22,25] and the proportion of cases not following the typical temporal pattern was not reported in these series. Also, these studies did not explore the association between preoperative and postoperative levels of CRP and ESR.…”

Section: Introductionmentioning

confidence: 78%

“…Finally, the dominance of female patients in the current series should be considered. Erythrocyte sedimentation rate levels vary with gender [3,35], whereas CRP levels do not have a similar variation [5,29].…”

Section: Discussionmentioning

confidence: 99%

“…Some of the previous studies used a very small series of fewer than 50 arthroplasties [1,2,8,10,25,32,34]. and some studies involved TKA and THA, which reportedly differ in postoperative levels of CRP and ESR [2,5,8,10,14,20,22,25,30]. Despite the well-known wide variations in postoperative levels of CRP and ESR, some previous studies report temporal patterns based on the mean values but without detailed normative data [2,5,8,10,20,22,25] and the proportion of cases not following the typical temporal pattern was not reported in these series.…”

Section: Introductionmentioning

confidence: 99%

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Normative Temporal Values of CRP and ESR in Unilateral and Staged Bilateral TKA

Park

Kim

Chang

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) play helpful roles in determining the presence of infection after TKA. To provide baseline values, we documented normative temporal values of CRP and ESR in unilateral and staged bilateral TKAs for osteoarthritis. Levels of CRP and ESR were evaluated before surgery and on the first, second, fifth, seventh, fourteenth, forty-second, and ninetieth postoperative days in 320 uncomplicated primary TKAs. C-reactive protein and ESR levels were compared in three groups: unilateral (108 knees), first knee bilateral (106 knees), and second knee bilateral (106 knees) groups. All three groups exhibited similar temporal patterns. Mean CRP levels increased rapidly, reaching a peak on the second day and decreased to less than the normal reference level on the forty-second day. They returned to preoperative levels on the ninetieth day. Mean ESR levels peaked on the fifth day and returned close to the preoperative levels only on the ninetieth day. Wide variations were observed and many cases (43%) did not follow the typical patterns. C-reactive protein had greater fold changes, less frequent atypical temporal patterns, and lower correlation between preoperative and postoperative levels than ESR. Our findings should help surgeons interpret CRP and ESR to determine the presence of infection after TKA.

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“…CRP is a marker of general tissue damage in addition to inflammation, which is also used in cardiology (Ledue and Rifai 2003). It is superior to the conventional parameters (leukocyte counts, erythrocyte sedimentation rate) in highlighting surgical complications with bacterial infection (Ellitsgaad et al 1991, Choudhry et al 1992). However, CRP was not found to be predictive of organ failure and sepsis in a small number of patients (Giannoudis et al 1998).…”

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confidence: 99%