| Objective:Total knee arthroplasty (TKA) has been widely used in clinical fieldfor it can obviously restore the function of knee joint, relieve pain, correct deformity,and improve the life quality of patients. Infection is one of the serious complicationsafter total knee arthroplasty and will lead to disastrous consequences, but the earlydiagnosis is difficult. In this study, we monitored the short-term changes of theperipheral skin temperature of incision,the white blood cell count (WBC), C-reactiveprotein (CRP), and erythrocyte sedimentation rate (ESR),to provide reference for theearly detection of postoperative infection after primary unilateral total knee arthroplasty.Methods:We selected34patients who had unilateral total knee arthroplasty fromNov.2013to Mar.2014in Joint Department of the First Affiliated Hospital of DalianMedical University. Then measured and observed the skin temperature of double kneedesignated area and wound healing conditions on preoperative day and postoperative2,4,6,8,10,12,14days.We also monitored and analyzed the changes of leukocyte count,C-reactive protein and erythrocyte sedimentation rate on the preoperative day andpostoperative1,3,7,10days.Results: Finally,the number of patients we monitored effectively was31cases.The results showed that, skin temperature of all patients’ postoperative ipsilateralknee incision region and the same region of the healthy knee increased, but thepostoperative ipsilateral side increased significantly.2-4days after surgery, skintemperature difference on both sides of the knee is obvious, but over time, the skintemperature on both sides will be gradually reduced and the difference will be gradually decreased.2days after surgery, the mean skin temperature difference on both sides was1.4℃,4days was1.3℃,6days was1.1℃, and8-14days after surgery the mean skintemperature difference were about0.9℃, there were significantly differences betweenthe mean skin temperature on postoperative ipsilateral knee incision region and thehealthy region on these days(P<0.05).CRP sensitivity for inflammation was good, onthe first day after surgery CRP increased significantly, on the third day CRP reached thepeak, and on7days after surgery CRP started to decrease gradually, there was stillsignificantly difference on10days after surgery between the preoperative andpostoperative indicators(P<0.05).ESR sensitivity was poor and increased solwly,onthe first day after surgery ESR was lower than the previous, on7days ESR reached thepeak, there was difference between the preoperative and postoperative indicators on10days after surgery(P<0.05).WBC changd fast, on the first postoperative day WBC couldreach the highest value, on3days after surgery WBC started to decrease, on7daysWBC has been reduced to the normal range, on10days after surgery there was nosignificant difference between the preoperative and postoperative indicators(P>0.05).But,there were possibly no obvious changes about WBC between the preoperative andpostoperative indicators on a small number of patients, their indexes were always innormal range.Conclusion:①Total knee arthroplasty surgery can cause inflammation regardlessof whether there is infection factors, then lead to skin temperature of both knees rise,but the postoperative ipsilateral side increase significantly.In short time,ipsilateral andcontralateral skin temperature difference is large, over time, both sides will graduallyreduce and the temperature difference will gradually decrease too.②Under normal circumstances, WBC, CRP and ESR index after totalknee arthroplasty surgery will rise and there are certain trends about them,overtime,these index will decrease dynamicly. |
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