The Effectiveness of C-Reactive Protein Surveillance as a Method to Monitor the Post-Operative Antibiotics Administration after Total Knee Replacement Arthroplasty

Hyun-Jong Bong; Jun-Ki Moon; Jin-Kyu Lee; Choong-Hyeok Choi

doi:10.4055/jkoa.2012.47.3.171

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Bong, Moon, Lee, and Choi: The Effectiveness of C-Reactive Protein Surveillance as a Method to Monitor the Post-Operative Antibiotics Administration after Total Knee Replacement Arthroplasty

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2012; 47(3): 171-177.

Published online: 26 June 2012

DOI: https://doi.org/10.4055/jkoa.2012.47.3.171

The Effectiveness of C-Reactive Protein Surveillance as a Method to Monitor the Post-Operative Antibiotics Administration after Total Knee Replacement Arthroplasty

Hyun-Jong Bong, M.D., Jun-Ki Moon, M.D., Jin-Kyu Lee, M.D., Choong-Hyeok Choi, M.D.

Department of Orthopedic Surgery, College of Medicine, Hanyang University, Seoul, Korea.

Correspondence to: Choong-Hyeok Choi, M.D. Department of Orthopedic Surgery, Hanyang University Seoul Hospital, College of Medicine, Hanyang University, 222, Wangsimni-ro, Seongdong-gu, Seoul 133-792, Korea. TEL: +82-2-2290-8483 or 8485, FAX: +82-2-2299-3774, chhchoi@hanyang.ac.kr

Received 9 August 2011 Revised 11 December 2011 Accepted 12 March 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the effectiveness of using C-reactive protein (CRP) surveillance as a method to monitor the effect of postoperative antibiotics for the prevention of early infection after total knee replacement arthroplasty (TKRA).

Materials and Methods

A prospective study was performed in 115 primary TKRAs. We examined the values of CRP of all cases on the 3rd, 5th, 7th, 10th and 14th days post-operatively. Some patients were administrated additional antibiotics under certain specific situations based on the pattern of CRP. The patients were divided into two groups: group I with planned period of administration and group II with administration longer than the planned period.

Results

No acute infection after TKRA due to CRP surveillance was observed. The mean duration of antibiotics administration was 5.9 days in all cases, 5 days in group I and 13.3 days in group II. Twelve cases (10.4%) were included in group II. The CRP was increased on the 5th and 10th days after operation in group II.

Conclusion

The surveillance of CRP was thought to be helpful in monitoring the effects of post-operative antibiotics and prevention of early infection after TKRA.

Keywords: knee, antibiotic prophylaxis, C-reactive protein (CRP), total knee replacement arthroplasty

Figures and Tables

Figure 1

The mean values of CRP levels during post-operative periods in group I and group II. CRP, C-reactive protein; POD, post-operative day.

Table 1

The Causes and Types of Over-Period Administration of Antibiotics after Total Knee Arthroplasty Replacement in Group II

CRP, C-reactive protein; Postop., postoperative; 1G, 1st generation; AG, aminoglycoside; 3G, 3rd generation; RFP, rifampin.

Table 2

Diagnostic Values for the Surveillance of CRP Test in Post-Operative Morbidities

CRP, C-reactive protein.

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