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Neutrophil-to-lymphocyte ratio (NLR) distribution shows a better kinetic pattern than C-reactive protein distribution for the follow-up of early inflammation after total knee arthroplasty

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study aimed to assess whether the neutrophil-to-lymphocyte ratio (NLR) distribution could have a better kinetic pattern than C-reactive protein (CRP) distribution to evaluate early post-operative inflammation after total knee arthroplasty (TKA).

Methods

A prospective study was performed on 587 patients. CRP and NLR were collected pre-operatively and at post-operative days 2, 4, 21 and 42. Mean peak values and distribution were compared between CRP and NLR.

Results

Mean CRP levels were 163, 161, 9 and 7 mg/L, respectively, at days 2, 4, 21 and 42. Mean NLR levels were 5, 3.5, 2.6 and 2.5, respectively, at days 2, 4, 21 and 42. At days 21 and 42, 20 % (102/503) and 21 % (93/433) of patients had not reached normal CRP levels. At day 21, there were 4.5 % (23/503) of patients with a NLR > 5 and 1 % (5/503) with an NLR > 10. At day 42, there were 5.5 % (24/433) of patients with an NLR > 5 and 0.7 % (3/433) with an NLR > 10.

Conclusion

NLR has a faster normalization than CRP. It is potentially a better biomarker to follow post-operative inflammation or early infection after TKA.

Level of evidence

II

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Acknowledgments

The authors received no specific funding for this work.

Author contributions

PES, JCY and ET designed the study protocol, collected the data, searched the literature, performed the statistical analysis and wrote the paper.

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    Authors and Affiliations

    1. Department of Internal Medicine Infectious Diseases and Perioperative Medicine, Université Catholique de Louvain, Cliniques Universitaires St-Luc, 10 Avenue Hippocrate, 1200, Brussels, Belgium

      J. C. Yombi

    2. Department of Orthopedic Surgery, Université Catholique de Louvain, Cliniques Universitaires St-Luc, 10 Avenue Hippocrate, 1200, Brussels, Belgium

      P. E. Schwab & E. Thienpont

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    1. J. C. Yombi
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    2. P. E. Schwab
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    3. E. Thienpont
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    Correspondence to J. C. Yombi.

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    The authors declare that they have no conflict of interest.

    Additional information

    J. C. Yombi and P. E. Schwab have contributed equally to this study.

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    Yombi, J.C., Schwab, P.E. & Thienpont, E. Neutrophil-to-lymphocyte ratio (NLR) distribution shows a better kinetic pattern than C-reactive protein distribution for the follow-up of early inflammation after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 24, 3287–3292 (2016). https://doi.org/10.1007/s00167-015-3921-0

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    • DOI: https://doi.org/10.1007/s00167-015-3921-0

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