Valores plasmáticos de proteína C reactiva (PCR) en cirugía ortopédica electiva / Plasma C reactive protein in elective orthopedic surgery

RESUMO

Background: C reactive protein (CRP) is used as a marker of inflammatory, infectious and surgical processes. Aim: To measure post operative plasma CRP levels after elective orthopedic surgery. Materials and Methods: Four groups of 25 patients each were defined according to the type of surgical procedure performed. Group I corresponded to pure arthroscopic meniscectomy. Group II to arthroscopic anterior cruciate ligament reconstruction or knee osteotomy. Group III to elective primary total hip or knee arthroplasty and group IV to instrumented elective spine surgery. Plasma CRP levels were measured prospectively at the preoperative day and at the 1st, 2nd, 3rd, 7th and 15th postoperative day. Patients that had any complication were evaluated independently. Results: In all uncomplicated patients, a similar shape and distribution of plasma CRP curves were observed, with maximum postoperative levels observed between the second and third day. Patients with more complex surgical procedures had higher CRP values. In all groups, CRP levels decreased significantly at 7th and 15th day, with respect to the higher measured value. In patients with surgical complications, PCR values were higher or did not decrease significantly at the seventh postoperative day, as in patients without complications. Conclusion: Plasma CRP levels fluctuate after elective orthopedic surgical procedures, with maximum values observed between the 2nd and 3rd postoperative day followed by an ulterior decrease. This behavior changes if postoperative complication appear. Serial measurements of CRP levels may be useful in the early detection of surgical complications.