CRP (C Reactive Protein ) level after total knee replacement in Indian population- Does it follow Anglo-Saxon Trend ?

Presenting Author - Sanjay B Londhe
TITLE: CRP (C Reactive Protein ) level after total knee replacement in Indian population- Does it follow Anglo-Saxon Trend ? INTRODUCTION : This study is to determine the response of CRP after TKR surgery , both unilateral and simultaneous bilateral TKR AIM : The aim of the present study is to determine the trend of CRP in Indian patients undergoing TKR, both unilateral and simultaneous bilateral TKR, To see whether it follows the trend in North American and European population and to determine whether there is a difference in the CPR pattern in unilateral versus simultaneous bilateral TKR patient MATERIAL & METHODS : Twenty six patients were included in this study . 13 patients each had unilateral TKR and simultaneous bilateral TKR. All 26 patients were female patients and the mean age in the unilateral group was 67 years and in the simultaneous bilateral TKR group was 73 years. There was no significant difference in the ages of these two groups (ANOVA, p= 0.151). CRP levels were measured pre- operatively on the 2nd post- operative day and after 8 week RESULTS : In both the groups CRP level shot up on the 2nd post-operative day. Although the rise in CRP level was significantly higher in the simultaneous bilateral TKR group as against the unilateral TKR group. This difference was statistically significant. The CRP level came back to normal in about 39% of unilateral TKR patients at 8 weeks post operatively, while in majority (12 out of 13) of bilateral simultaneous TKR patient it was still elevated at 8 weeks post-op and had not come to normal. DISCUSSION : Various North-American and European studies have shown that the CRP level increases significantly on the 1st postoperative day and the decreases from a peak on the 2nd postoperative day, attaining normal value at 6 to 8 weeks after operation. Nearly 39% of our unilateral TKR patients and majority all of our simultaneous bilateral TKR patients did not achieve a normal CRP at 8 weeks after operation. These findings are significant as CRP is often used as a very sensitive indicator of post operative joint infection. Hence we conclude that the Indian TKR patients take longer time for the CRP values to become normal and the published literature regarding the normal levels of CRP In Unilateral TKR should not be extrapolated to simultaneous bilateral TKR group.