Evaluation of serum levels of C-reactive protein after total knee arthroplasty in patients with rheumatoid arthritis
Published 2023-01-03
Keywords
- Knee,
- Arthroplasty,
- CPR,
- Osteoarthritis,
- Rheumatoid arthritis
How to Cite
Copyright (c) 2022 Brazilian Journal of Health and Biomedical Sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
Objective: The objective of this study is to evaluate the serum levels of C-reactive protein in the first three weeks after total knee arthroplasty, in patients with knee osteoarthritis secondary to rheumatoid arthritis and a control group. Methods: This is a prospective study evaluating 30 patients with knee osteoarthritis secondary to rheumatoid arthritis who underwent total knee arthroplasty between January 2015 and March 2017. A control group of patients submitted to total knee arthroplasty by primary osteoarthritis was created with data from the institution’s database. The proportion was of three controls for each case and the criteria used for pairing were age, gender, ethnicity and body mass index. Serum C-reactive protein was measured on the day before, and on the third and twenty-first days after the procedure in all patients. Results: No statistically significant changes were found between the case and control groups for the C-reactive protein levels evaluated nor their variations. The results suggest that the presence of rheumatoid arthritis does not interfere in the postoperative response of C-reactive protein. Conclusion: The serum values of C-reactive protein after TKA do not differ between patients with primary or secondary osteoarthritis to RA. Thus, the reference values can be considered equal in both cases.
Metrics
References
- da Mota LM, Cruz BA, Brenol CV, et al. Brazilian Society of Rheumatology, Consensus of the Brazilian Rheumatology Society for diagnosis and early assessment of rheumatoid arthritis. Rev Bras Reumatol. 2011;51(3):199-219.
- Abernethy PJ. Surgery of the rheumatoid knee. Ann Rheum Dis.1990; 49(Suppl 2):830–6.
- Lee JK, Choi CH. Total knee arthroplasty in rheumatoid arthritis. Knee Surg Relat Res. 2012;24(1):1-6.
- Black S, Kushner I, Samols D. C-reactive protein. J Biol Chem. 2004; 279:48487–90.
- Aguiar FJ, Ferreira-Júnior M, Sales MM, et al. C-reactive protein: clinical applications and proposals for a rational use. Rev Assoc Med Bras. 2013;59(1):85-92.
- Mitaka C. Clinical laboratory differentiation of infectious versus non-infectious systemic inflammatory response syndrome. Clin Chim Acta. 2005;351(1-2):17-29.
- Greidanus NV, Masri BA, Garbuz DS, et al. Use of erythrocyte sedimentation rate and C-reactive protein level to diagnose infection before revision total knee arthroplasty. A prospective evaluation. J Bone Joint Surg Am. 2007;89(7):1409-16.
- Chandrashekara S. C - reactive protein: an inflammatory marker with specific role in physiology, pathology, and diagnosis. Int J Rheumatol Clin Immunol. 2014;2(S1):SR3.
- Ansar W, Ghosh S. C-reactive protein and the biology of disease. Immunol Res. 2013;56(1):131-42.
- Mager DE, Lin SX, Blum RA, et al. Dose equivalency evaluation of major corticosteroids: pharmacokinetics and cell trafficking and cortisol dynamics. J Clin Pharmacol. 2003;43(11):1216-27.
- Maniar RN, Navaneedhan G, Ranvir S, et al. What Is the Normal Trajectory of Interleukin-6 and C-reactive Protein in the Hours and Days Immediately After TKA?. Clin Orthop Relat Res. 2019;477(1):41-6.
- Larsson S, Thelander U, Friberg S. C-reactive protein (CRP) levels after elective orthopedic surgery. Clin Orthop Relat Res. 1992;(275):237-42.
- Laiho K, Mäenpää H, Kautiainen H, et al. Rise in serum C reactive protein after hip and knee arthroplasties in patients with rheumatoid arthritis. Ann Rheum Dis. 2001;60(3):275-7.
- Mäenpää H, Laiho K, Kauppi M, et al. A comparison of postoperative C-reactive protein changes in primary and revision hip arthroplasty in patients with rheumatoid arthritis. J Arthroplasty. 2002;17(1):108-10.
- Maury CP, Teppo AM, Raunio P. Control of the acute-phase serum amyloid A and C-reactive protein response: comparison of total replacement of the hip and knee. Eur J Clin Invest. 1984;14(5):323-8.
- Loures FB, de Araújo Góes RF, Labronici PJ, et al. Evaluation of body mass index as a prognostic factor in osteoarthrosis of the knee. Rev Bras Ortop. 2016;51(4):400-4.
- Liu JZ, Saleh A, Klika AK, et al. Serum inflammatory markers for periprosthetic knee infection in obese versus non-obese patients. J Arthroplasty. 2014;29(10):1880-3.
- Ravi B, Escott B, Shah PS, et al. A systematic review and meta-analysis comparing complications following total joint arthroplasty for rheumatoid arthritis versus for osteoarthritis. Arthritis Rheum. 2012;64(12):3839-49.
- Mysler E, Psioni C, Tate P, et al. Influence of corticosteroids on C-reactive protein in patients with rheumatoid arthritis. Arthritis Res Ther. 2004;6 (Suppl 3): 57.
- Laiho K, Belt E, Mäenpää H, et al. Effect of daily corticosteroid treatment on CRP response to hip or knee replacement in patients with RA. Ann Rheum Dis. 2001;60(10):989.
- Barretto JM, Loures FB, Albuquerque RS, et al. Evaluation of serum levels of C-reactive protein after total knee arthroplasty. Rev Bras Ortop. 2017;52(2):176-81.