The Effect Of Preoperative CRP Level On Knee Joint Function Recovery In Old Patients Who Underwent Total Knee Arthroplasty

Objective:Among the elderly in China,knee osteoarthritis(KOA)is a leading cause of disability,and it can be a painful condition that may limit the movement of the joints effected.The overall impact of KOA depends on the severity of pain,the magnitude of loss of functional ability.Among the elderly in China,the joint most commonly affected by osteoarthritis(OA)is the knee,and it can affect the normal ability of a person to carry out regular physical activities and the individual’s quality of life.Therefore,due to the high number of individuals suffering from KOA,exploration of the optimal treatments for OA is worthwhile.Total knee arthroplasty(TKA)is the most common form of KOA,the treatment effect of KOA is also very positive.It can obviously alleviate the patient’s pain,the revision rate is with less than3% within five years.Several studies have shown that a variety of patients have received functional improvements,improved health-related quality of life,and significant pain relief after TKA.C-Reactive Protein(CRP)is an acute phase protein produced by the liver and is part of the non-specific immune mechanism of the body.It can activates alexin,enhances leukocyte phagocytosis,regulates phagocytosis of lymphocytes or monocytes.Normal serum levels of CRP are low,inflammation,trauma,and surgery can make CRP elevate.The increasing degree of CRP reflects the degree of activity of inflammatory tissue and has a good correlation with disease activity in acute inflammation or infection.It has been reported that preoperative CRP≥3 times significantly increased the risk of early postoperative infection and other related complications.It has been reported that preoperative CRP≥3 times significantly increased the risk of early postoperative infection and other relatedcomplications.It has reported that a proposed value,CRP>13.5 mg / L,have a risk for the diagnosis of knee joint infection after TKA,while the sensitivity for diagnosis of post-TKA infection was 76.0% and the specificity was 93.3 for CRP>16.5 mg / L%.The relationship between CRP and postoperative infection has been reported,but it is no reports for the factors affecting the recovery of knee function after TKA.To investigate the effect of preoperative serum CRP level on functional recovery of knee joint after TKA in elderly obese patients,we present this study that the effect of preoperative CRP level on recovery of joint function in old fat patients who underwent TKA.Methods:The clinical data of 124 old fat OA patients who received primary total knee arthroplasty were retrospectively reviewed.We record the preoperative CRP level,the preoperative neutrophil absolute value,the preoperative lymphocyte absolute value,time of knee flexion to 90 degree,time to walk and the length of hospital stay,and assess AKS score(American Knee Society Score)and HSS score(The Hospital for Special Surgery Score)in postoperative seventh day.Recovery of joint function were compared in different CRP level.Results:Preoperative CRP levels of TKA patients with AKS<70 score、HSS<70score of postoperative seventh day increasing significantly compared with AKS≥70score,HSS≥70 score of postoperative seventh day(P<0.05).The Receiver-OperatingCharacteristics curve(ROC curve)indicated that sensitivity and specificity of CRP level to evaluate the AKS<70 score、HSS<70 score of postoperative seventh day were0.68、0.63,respectively.We divided patients into normal CRP group(CRP<0.5mg/dl)and high CRP group(CRP≥0.5mg/dl)by cutoff value of CRP level 0.5.The rate of patients with AKS,HSS<70socre of postoperative seventh day in elevated CRP level group were 94.24%(49/52),96.16%(50/52),respectively,which was significantly high than the rate of patients with AKS,HSS≥70socre of postoperative seventh day in normal CRP level group were 22.23%(16/72),69.45%(50/72),respectively.Cox survival analysis indicated that preoperative high CRP level was an independent risk factor for AKS<70socre,HSS<70score of postoperative seventh day.Conclusion : Preoperative CRP level of old fat patients may be a marker to evaluate TKA postoperative degree of knee joint function recovery,the more higher preoperative CRP level elevate,the more poorer TKA postoperative knee joint function recover.