To study the inflammatory markers in the perioperative period in total knee arthroplasty

Abstract

Background: Osteoarthritis (OA) of knee is a degenerative disorder characterized by the softening, ulceration and focal loss of articular cartilage, sclerosis of the subchondral bone, marginal osteophyte formation and a range of morphological and biochemical changes in the synovium & capsule of the knee joint. Total knee arthroplasty (TKA) has been the treatment of choice for advanced osteoarthritis of knee. TKA is associated with significant post-operative pain. The aim of this study is an evaluation of inflammatory markers (ESR, CRP, INR, TLC) following TKA with use of tourniquet in the perioperative period. Methods: Sample size (n=30) was taken A standard automatic pneumatic tourniquet was used during the surgery. Data on demographics, duration of surgery, Erythrocyte sedimentation rate (ESR), C-Reactive Protein (CRP), Total leukocyte count (TLC), Coagulation profile (INR) and limb circumference were analysed. P-values < 0.05 are considered to be statistically significant. The entire data was statistically analysed using Statistical Package for Social Sciences (SPSS version 21.0, IBM Corporation, USA). Results: The distribution of mean 6-hr post-op and 48-hr post-op ESR is significantly higher compared to mean pre-op ESR (P-value<0.001 for both). The mean% change at 48-hr post-op compared to pre-op in CRP is 1404.89% which was statistically significant. The change in preoperative INR versus postoperative 6 th hr INR is not significant (P value>0.05) as well as the preoperative versus 48 th hour. The mean% change at 48-hr post-op compared to pre-op in TLC is 96.24% with p value <0.001. Conclusions: In this study it was found that there is a significant increase in inflammatory markers (ESR, CRP, TLC) in the post-operative period which is consistent with studies in the past. Due to small sample size of the study, the data generated can be utilized as a baseline to study correlation between pain and inflammatory marker levels on a larger scale at multicentric levels.