| Objective: to monitor the trend of skin temperature changes around the same area around the injured side and the healthy side after primary unilateral total knee replacement and the peripheral blood white blood cell count(white blood cell count,WBC),C-reactive protein(C-reactive protein,CRP)and erythrocyte sedimentation rate(erythrocyte sedimentation rate).Short term changes of SR provide reference for early detection of infection after total knee arthroplasty.Methods: Choosing between July 2017-2018 year in February in the Department of orthopedics of Sichuan Provincial People's Hospital underwent primary unilateral total knee arthroplasty patients with a total of 33 cases in 1 days before surgery,after first,third,fifth,7,9 days of basal body temperature,skin temperature measurement of the ipsilateral knee,the measurement time is 12 noon,before the measurement in room temperature environment the full 20 minutes of exposure(avoid ice),measuring position for 9 area ipsilateral knee joint(see Figure 2);the contralateral knee skin temperature measurement time and position with the affected side.At the same time,preoperative routine examination of WBC,CRP,ESR,postoperative time with temperature measurement.Statistical method: the SPSS20.0 software was used to analyze the data,and the measurement data were expressed as mean standard deviation(?X ±SD).The results of bilateral skin temperature and WBC,CRP and ESR before and 1,3,5,7 and 9 days after operation were compared by paired t test,correlation analysis between mean value of three laboratory indicators and mean value of skin temperature difference,P<0.05 difference was statistically significant.Results: 1.the number of effective cases was completed in 30 cases.1 days before operation of bilateral knee skin showed no significant difference(P > 0.05),around the postoperative knee joint incision and contralateral regional skin temperature were increased,but the affected side was significantly increased,compared with the healthy side,after 1,3,5,7,9 days of ipsilateral skin temperature there was statistical significance(P <0.05);after first,third,fifth,7 days,9 knees average skin temperature difference mean 0.06±0.34??0.12±0.07??0.08±0.56??0.05±0.27? ? 0.04±0.42?.On the third day after operation,the temperature difference between bilateral skin is bigger.As time goes on,the temperature of bilateral skin will gradually decrease,and the skin temperature difference will gradually decrease,.At the same time on the third postoperative day compared with the regional average skin incision,incision in the area found the most significant temperature(P=0.000).2.compared with preoperative,1,3,5,7 and 9 days after operation,CRP increased significantly(P<0.05).It began to increase on the first day after operation,and reached a high value on third days,and decreased gradually on fifth,seventh,ninth days after operation.Compared with preoperative,ESR at 1,3,5,7 and 9 days after operation increased(P<0.05).It increased at first days after operation,increased on third days,reached peak at fifth days,and decreased gradually on seventh,ninth days.Compared with white blood cell count before surgery,7 days after operation,first,third,fifth were increased(P<0.05),mean ninth days was not statistically significant(P > 0.05);the first day after operation,reached the highest value,3 days after surgery,postoperative fifth,seventh days continued to decline,until the 9 day after operation than before operation no significant difference.3.Correlation analysis results: after TKA,the temperature difference of double knee skin was positively correlated with CRP(r=0.926 P=0.008),and had no linear correlation with white blood cell count and ESR.Conclusion: The increase of skin temperature around the incision is caused by TKA trauma.As the postoperative inflammatory response gradually subsided,the skin temperature of the incision was gradually the same as that of the healthy side.The trend of skin temperature change after operation was basically the same as that of CRP,ESR and WBC.If the skin temperature changes after TKA are found to be relatively high in clinic,it is necessary for clinicians to pay attention to possible infection. |
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