The Effect Of Levels Of ESR And CRP After Primary Total Knee Arthroplasty Using Antibiotic-impregnated Cement

Objective To study the clinical significance of the changes of C - reactive protein(CRP) values and erythrocyte sedimentation rates(ESR ) after primary total knee replacement(primary TKA) in patients who were normal or abnormal in fasting blood glucose with primary osteoarthritis who use antibiotic-impregnated cement.Methods A randomized controlled trials(RCT) study was designed to divide the patients into two groups:the diabetes group and the normal group according to the FBG level first and then divide each group into trial group and control group at the ratio of 1:1 randomly.The trail group used antibiotic-impregnated cement and the control group used cement without antibiotic,antibiotic-impregnated cement is vancomycin 1.Og mixed into PMMA by manual operation.Levels of CRP and ESR were evaluated in patients with osteoarthritis before and at 1-7 days,2 weeks,2,6 months after primary TKA.46 cases received follow-up.There are 24 males and 22 females with average of 70.5 years,ranging from 60 to 80 years.Results In both groups serum level of CRP increased rapidly after surgery, peaking at day 2 and dropped gradually to pre-operative values at the end of the second month in TKR patients and serum level of ESR peaked at day 5 after operation in TKR patients and dropped to pre-operative values at the end of the sixth month in TKR patients.In the normal group,levels of CRP and ESR have no significant statistically difference between the trial group and the control group(p＞0.05).The values at the 14 days (P=0.021) and the end of the second(P=0.009) and the sixth month (P=0.016)of levels of CRP have statistically difference between the trial group and the control group.Conclusion It is useful to return to normal levels of ESR and CRP more quickly for the diabetes patients who use antibiotic-impregnated cement, for which it is taken into considerable that we use antibiotic-impregnated cement to reduce inflammation and prevent infection.The serum CRP levels changed more rapidly than ESR and returned to normal more rapidly. CRP can reflect the status of inflammation so dynamic observation contribute to diagnose and intervene early infection.