Rise in serum C reactive protein after hip and knee arthroplasties in patients with rheumatoid arthritis

doi:10.1136/ard.60.3.275

Annals of the Rheumatic Diseases 2001;60:275-277; doi:10.1136/ard.60.3.275

Ann Rheum Dis 2001;60:275-277 ( March )

Concise report

Rise in serum C reactive protein after hip and knee arthroplasties in patients with rheumatoid arthritis K Laiho^a, H Mäenpää^a, H Kautiainen^a, M Kauppi^a, K Kaarela^a, M Lehto^b, E Belt^a

^a Rheumatism Foundation Hospital, Heinola, Finland, ^b Tampere University Hospital, Tampere, Finland

Correspondence to: Dr K Laiho, Rheumatism Foundation Hospital, FIN-18120 Heinola, Finland markku.kauppi{at}reuma.fimnet.fi

Accepted for publication 25 July 2000

OBJECTIVE $---$ Serum C reactive protein (CRP) concentration was evaluated in patients with rheumatoid arthritis (RA) undergoing total hiparthroplasty (THA) or total knee arthroplasty (TKA) to ascertainthe postoperative CRPresponse.
METHODS $---$ Thirty seven consecutive patients with RA who had undergone THA or TKA were included in the study. The CRP concentration wasmeasured in every patient once preoperatively and every otherday for one weekpostoperatively.
RESULTS $---$ The peak median CRP concentration (94 mg/l) was achieved on the first and second day postoperatively and was seven times higherthan the median preoperative concentration (13 mg/l). CRP declinedto the preoperative concentration in about one week. The riseof the CRP concentration was significant (p< 0.001). No infectionwas encountered in thisseries.
CONCLUSION $---$ A rapid rise in the postoperative CRP concentration is normal in patients with RA treated by THA or TKA. The CRP concentrationdecreases to the preoperative value in about one week. SerialCRP measurements, including at least one preoperative measurement,are needed when the clinical significance of the postoperativeCRP values is evaluated. When the postoperative CRP concentrationremains raised for several days compared with the preoperativevalue, or even rises, it may indicate the presence of a complicationin thesepatients.

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