Variations of inflammatory markers levels (ESR and CRP) in the perioperative period of total knee arthroplasty

Abstract

Background: The preferred method of treatment for severe osteoarthritis of the knee is total knee arthroplasty (TKA). TKA has been linked to a significant increase in inflammatory markers such as erythrocyte sedimentation rate (ESR)—a test that measures how quickly red blood cells settle to the bottom of a test tube—and C-reactive protein (CRP)—a protein made by the liver that increases when there’s inflammation in the body. Aim: Assessment of the typical time trend and physiological kinetics of CRP and ESR during the early postoperative period over 4 weeks Methods: The study was conducted in the Basrah arthroplasty center, from June 2022 to October 2023. The study sample consisted of patients undergoing TKA operations with no history of inflammation, infection, uncontrolled chronic disease, or any autoimmune disease. We enrolled 34 uncomplicated cases. ESR and CRP were measured over time. Results: The highest mean CRP values (123.2 ± 101.0) mg/L were in the first week and then started to decrease; the ESR highest reading was in the second week (66.4 ± 31.2) mm/h and then declined. The difference was significant from the baseline reading for both markers. Conclusion: In the initial postoperative period, CRP remains a better acute phase reactant than ESR and has a more expected pattern.