scholarly journals The Effect of Uncomplicated Knee Arthroscopy on C-reactive Protein and Erythrocyte Sedimentation Rate

2021 ◽  
Vol 9 (A) ◽  
pp. 299-302
Author(s):  
Andrew Hannah ◽  
Graeme Ethan Hancock ◽  
James Edward Stoddard ◽  
Paul Mark Sutton

BACKGROUND: Anticipated changes in erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) following uncomplicated knee arthroscopy have not previously been described. AIM: We aim to identify these values to aid the management of patients who re-present with a suspicion of infection. MATERIALS AND METHODS: Patients between 18 and 50 years undergoing day-case arthroscopic knee surgery under the care of the senior authors were recruited. Patients undergoing any bony intervention and those with a known inflammatory arthropathy were excluded from the study. Ethical approval was granted and patients consented to the study. ESR and CRP measurements were performed immediately prior to surgery, then at 1, 7, and 14 days postoperatively. RESULTS: A total of 29 patients consented to the study. A full set of results were achieved for 17 patients. There was a significant increase in CRP on day 1 and day 7 following knee arthroscopy with a mean increase of 4.55 mg/L (P = 0.003) on day 1 and 1.78 mg/L (P = 0.026) on day 7. ESR did not change significantly at any of the measured points. The maximum value for CRP was 16 mg/L on day 1 and 11.5 mg/L on day 7. All CRP measurements had returned to baseline (<5 mg/L) by 14 days. DISCUSSION AND CONCLUSION: Our study suggests that CRP measurement is a useful tool in the investigation of possible joint infection following simple knee arthroscopy. Continued elevation of CRP beyond 14 days or any significant elevation is not usual and suggests an abnormal post-operative recovery, which should prompt further investigation.

2021 ◽  
pp. 1-7
Author(s):  
Zahra Soleimani ◽  
Fatemeh Amighi ◽  
Zarichehr Vakili ◽  
Mansooreh Momen-Heravi ◽  
Seyyed Alireza Moravveji

BACKGROUND: The diagnosis of osteomyelitis is a key step of diabetic foot management. Procalcitonin (PCT) is a novel infection marker. This study aimed to investigate the diagnostic value of procalcitonin and other conventional infection markers and clinical findings in diagnosis of osteomyelitis in diabetic foot patients. METHODS AND MATERIALS: This diagnostic value study was carried out on ninety patients with diabetic infected foot ulcers admitted in Kashan Beheshti Hospital, 2016. After obtaining consent, 10 cc blood sample was taken for measuring serum PCT, CBC, ESR, CRP and FBS. Clinical characteristics of the wounds were noted. Magnetic resonance imaging of the foot was performed in all patients to diagnose osteomyelitis. All statistical analyses were done with the use of SPSS-16. RESULTS: PCT levels were 0.13 ± 0.02 ng/mili patients with osteomyelitis (n= 45) and 0.04 ± 0.02 ng/ml in patients without osteomyelitis (n= 45). PCT, Erythrocyte sedimentation rate and C-reactive protein was found significantly higher in patients with osteomyelitis (p< 0.001). The ROC curve was calculated for PCT. The area under the ROC curve for infection identification was 1 (p< 0.001). The best cut-off value for PCT was 0.085 ng/ml. Sensitivity, specificity, and positive and negative predictive values were 100%, 97.8%,97.8% and 100%, respectively. CONCLUSION: In this group of patients, PCT was useful to discriminate patients with bone infection. Also, Erythrocyte sedimentation rate and C-reactive protein can be used as a marker of osteomyelitis in diabetic patients.


2017 ◽  
Vol 11 (2) ◽  
pp. 305-313 ◽  
Author(s):  
Tao Zhang ◽  
Lihua Ma ◽  
Xu Lan ◽  
Ping Zhen ◽  
Shiyong Wang ◽  
...  

<sec><title>Study Design</title><p>Retrospective case series.</p></sec><sec><title>Purpose</title><p>To investigate the clinical efficacy and feasibility of one-stage anterolateral debridement, bone grafting, and internal fixation for treating lumbosacral tuberculosis.</p></sec><sec><title>Overview of Literature</title><p>There has been no consensus regarding the optimal means of treating lumbosacral tuberculosis. The one-stage anterolateral extraperitoneal approach for radical debridement, bone grafting, and internal fixation for treating lumbosacral tuberculosis is rare in literature.</p></sec><sec><title>Methods</title><p>Twenty-one patients with lumbosacral tuberculosis were retrospectively analyzed. All patients underwent the surgery of anterolateral debridement after regularly antituberculous drugs therapy. We evaluated the erythrocyte sedimentation rate, C-reactive protein, radiography, computed tomography, magnetic resonance imaging, visual analogue score, and Oswestry disability index before and after surgery.</p></sec><sec><title>Results</title><p>All patients completed a follow-up survey 9–48 months after surgery. All patients' wounds healed well without chronic infection or sinus formation, and all patients with low-back pain reported relief after surgery. All cases had no tuberculosis recurrence. Solid bony fusion was achieved within 6–12 months. At final follow-up, evaluated the erythrocyte sedimentation rate decreased from 38.1±12.5 to 11.3±7.1 mm/hr, C-reactive protein decreased from 6.2±4.2 to 1.6±1.3 mg/dL, the visual analog scale score decreased from 4.6±1.1 to 1.4±1.0, the Oswestry disability index score decreased from 50.2%±11.9% to 13.0%±6.6%, and the lumbosacral angle increased from 20.0°±4.8° to 29.0°±3.9° (<italic>p</italic>&lt;0.05).</p></sec><sec><title>Conclusions</title><p>One-stage anterolateral debridement, bone grafting, and internal instrument fixation for treating lumbosacral tuberculosis is safe and effective.</p></sec>


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