Variations in ESR and CRP in total knee arthroplasty and total hip arthroplasty in Iranian patients from 2009 to 2011

Abstract

Background:Implantation of joint prosthesis, either in the knee or in the hip, may cause some problems such as an infection, so that a timely treatment is essential. In this respect, discovering a marker detecting the incidence of an infection is one of the requirements of arthroplasty. The present study was conducted to determine variations of two markers in arthroplasty and infection incidence in Iranian patients.Materials and Methods:This prospective study was carried out in Isfahan’s educational treatment centers from 2009 to 2011 on patients undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA) surgical operations. The erythrocyte sedimentation rate (ESR) was measured by Sed rate device (Lena) and C-reactive protein (CRP) by autoanalyzer device (Erba) with the unit of ng/dL. The patients underwent ESR and CRP tests the day before operation, the day of operation, and 1, 2, 5, and 15 days and 1, 3, 6, and 12 months after operation.Results:Mean ESR increased during the first 5 days then decreased gradually lasting for 3 months. After 1 year it increased to a level higher than before the operation. The variations in ESR values were 19.1 ± 12.9 before the operation and 21.14 ± 10.8 after 1 year with significant difference (P < 0.001). The level of CRP had an upward trend from the first day after operation and reached its maximum on the second day, then had a downward trend up to 1 month after the operation; however, it did not reach its preoperative level during 1 year.Conclusion:ESR and CRP and their variations can be suitable factors to detect probable infections in patients undergoing TKA and THA operations.

Factors associated with the length of stay in total knee arthroplasty patients with the enhanced recovery after surgery model

“…ESR is a sensitive inflammatory indicator in serum, which can be used to predict the probability of infection. However, it cannot clearly indicate the clearance of the infection and direct the implant timing of the prosthesis [19][20][21]. Our study indicated that preoperative ESR ≥ 15 mm/h could lead to the prolongation of LOS.…”

C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR) Trends following Total Hip and Knee Arthroplasties in an Indian Population – A Prospective Study

“…While ESR continues to remain elevated for a longer duration in the post-operative period following a replacement surgery, CRP does follow a regular pattern with an immediate peak at 2nd post-operative day followed by a gradual decline over a period of time 9 , 12 , 13 . However, the time taken for the normalisation of CRP values to its pre-operative level may vary and differs among various studies involving different populations 14 , 15 . It is important to realise that a single CRP or ESR reading holds very limited value and that a trend must be observed to maximise its full usefulness.…”

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

“…The CRP values in mg/dL with mean±SD were 1.64±2. 23 [24] in 35 TKA patients found that the preoperative & 2 nd postoperative day ESR values (in mm/hr) with mean±SD were 19.1±12.9 and 75.33±28.1 and CRP values on preoperative vs postoperative day 1 & 2were 4.07±2.9 ,58.5±24.5 and 68.2±15.3 respectively. Both the above studies have followed up ESR and CRP levels for at least ninety days at various intervals and maximum values of ESR and CRP were noted on 5 th and 2 nd postoperative day respectively As the standard deviation in the data pool of the Korean study, Iranian study and our study are grossly different, a quantitative comment on percent change of preoperative and postoperative change of ESR and CRP cannot be derived with confidence.…”