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

Cited 46 time in Web of Science Cited 52 time in Scopus

Park, Kwan Kyu; Kim, Tae Kyun; Chang, Chong Bum; Yoon, Su Won; Park, Kyoung Un

Issue Date
Lippincott, Williams & Wilkins
Clin Orthop Relat Res. 2008;466(1):179-188
Arthroplasty, Replacement, Knee/adverse effects/*methodsBlood SedimentationC-Reactive Protein/*analysisFemaleHumansMaleProspective StudiesProsthesis-Related Infections/*blood/etiologyReference ValuesTime Factors
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. LEVEL OF EVIDENCE: Level I, diagnostic study.
0009-921X (Print)
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College of Medicine/School of Medicine (의과대학/대학원)Orthopedic Surgery (정형외과학전공)Journal Papers (저널논문_정형외과학전공)
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