What Is the Normal Trajectory of Interleukin-6 and C-reactive Protein in the Hours and Days Immediately After TKA?

Clinical Orthopaedics and Related Research
Rajesh N ManiarAniruddh Agrawal

Abstract

Some patients with early periprosthetic joint infection (PJI) can be treated successfully using open débridement with polyethylene exchange rather than two-stage revision; however, the challenge is to diagnose PJI early. In late infection, C-reactive protein (CRP) and interleukin-6 (IL-6) are elevated, but shortly after surgery, CRP is difficult to interpret because it may be elevated even in the absence of infection, and we know little about the normal trajectory of IL-6 immediately after arthroplasty. If a deviation of biomarkers from their normal trajectory is seen, it may help guide the clinician toward early knee aspiration. We studied the normal trajectories of IL-6 and CRP in the immediate hours and days after uncomplicated TKA and examined whether one or the other normalizes more quickly. We studied serum IL-6 and CRP levels in 50 patients undergoing primary TKA at five time points: 12 hours preoperatively and postoperatively at 12 hours, 48 hours, 4 days, and 2 weeks. One surgeon operated on all patients using the same approach and postoperative management. The same laboratory methods were used each time. Results are presented as median and range. Repeated-measures analysis was done using Friedman's (nonparametric) tes...Continue Reading

References

Feb 1, 1990·The Biochemical Journal·P C HeinrichT Andus
Oct 13, 1998·The Journal of Bone and Joint Surgery. British Volume·J WhiteR Dunsmuir
Nov 18, 2000·International Orthopaedics·D C WirtzJ M Wolff
Mar 30, 2001·The Journal of International Medical Research·O BilgenM S Bilgen
Sep 6, 2005·The Journal of Bone and Joint Surgery. American Volume·Paul E Di CesareChuan-ju Liu
Jan 16, 2008·Clinical Orthopaedics and Related Research·Kwan Kyu ParkKyoung Un Park

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Citations

Feb 8, 2021·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Serkan ErkusOnder Kalenderer
Oct 29, 2020·BMC Musculoskeletal Disorders·Bao-Zhan YuJi-Ying Chen
Jan 27, 2021·The Journal of Bone and Joint Surgery. American Volume·Kazuhisa HatayamaHiroshi Higuchi
Mar 19, 2021·Journal of Orthopaedic Surgery and Research·Mohammad Naghi TahmasebiHamid Rabie
Mar 24, 2021·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Hannah SlovacekWilliam Hopkinson

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