Neutrophil to lymphocyte ratio of patients who underwent bilateral versus unilateral unicompartmental knee arthroplasty

In recent years, the neutrophil-to-lymphocyte ratio (NLR) has emerged as a sensitive index of systemic inflammation. NLR predicts serious complications, such as pulmonary embolism or cardiovascular disease risk. Our study aims to compare the inflammation rate of bilateral simultaneous UKA versus unilateral UKA by using NLR. The medical records of 27 patients who underwent unicompartmental knee arthroplasty were reviewed retrospectively. The patients were divided into two groups. Group 1 consisted of 10 patients who underwent bilateral simultaneous UKA (bUKA), whereas group 2 consisted of 17 patients who underwent unilateral UKA (uUKA). Preoperative and postoperative 1st hour blood chemistries were performed and results were extracted from the electronic database. The neutrophil-to-lymphocyte ratio (NLR) was calculated from the absolute neutrophil and lymphocyte counts. The mean preoperative and postoperative NLR and the difference in NLR between the preoperative and postoperative 1st hour was calculated. The mean preoperative NLR was 2.13 (0.51-4.54), and the mean postoperative NLR was 7.06 (0.50-15.33) in the uUKA group. NLR was significantly higher in the postoperative 1st hour (p=0.001). In the evaluation of the bilateral group (bUKA), the mean NLR was calculated as 1.61 preoperatively and 9.38 postoperatively. Hence, there was a statistically significant difference (p=0.001). The mean difference in NLR was 7.77 in Group 1 and 4.92 in Group 2. Although the increase in NLR was higher in Group 1, no statistically significant difference was found (p=0.547). Our findings revealed similarly increased rates of NLR in the bilateral and unilateral UKA groups. Our study may suggest that bilateral simultaneous application of UKA is a safe procedure in terms of NLR-associated complications.

___

1. Dennis DA. Debate: bilateral simultaneous total knee arthroplasty. Clin Orthop Relat Res. 2004;428:82-3.

2. Parvizi J, Rasouli MR. Simultaneous-bilateral TKA: double trouble - affirms. J Bone Joint Surg Br. 2012;94:90-2.

3. Sculco TP, Sculco PK. Simultaneous-bilateral TKA: double trouble - opposes. J Bone Joint Surg Br. 2012;94:93-4

4. Hersekli MA, Akpinar S, Ozalay M, et al. Comparison between single- and two-staged bilateral total knee arthroplasty operations in terms of the amount of blood loss and transfusion, perioperative complications, hospital stay, and cost-effectiveness. Acta Orthop Traumatol Turc. 2004;38:241–6.

5. Bullock DP, Sporer SM, Shirreffs Jr TG. Comparison of simultaneous bilateral with unilateral total knee arthroplasty in terms of perioperative complications. J Bone Joint Surg Am. 2003;85-A:1981–6.

6. Hart A, Antoniou J, Brin YS, et al. Simultaneous bilateral versus unilateral total knee arthroplasty: a comparison of 30-day readmission rates and major complications. J Arthroplasty. 2016;31:31–5.

7. Lombardi AV Jr, Berend KR, Walter CA, et al. Is recovery faster for mobile-bearing unicompartmental than total knee arthroplasty? Clin Orthop Relat Res. 2009;467:1450–7.

8. Berend KR, Morris MJ, Skeels MD, et al. Perioperative com-plications of simultaneous versus staged unicompartmental knee arthroplasty. Clin Orthop Relat Res. 2011;469:168–73.

9. Ma T, Tu YH, Xue HM, et al. Clinical outcomes and risks of single-stage bilateral unicompartmental knee arthroplasty via oxford phase III. ChinMed J (Engl). 2015;128:2861–5.

10. Akhtar KS, Somashekar N, Willis-Owen CA, et al. Clinical out-comes of bilateral single-stage unicompartmental knee arthroplasty. Knee. 2014;21:310–4.

11. Chen JY, Lo NN, Jiang L, et al. Simultaneous versus staged bilateral unicompartmental knee replacement. Bone Joint J. 2013;95-B:788–92.

12. Romagnoli S, Zacchetti S, Perazzo P, et al. Onsets of complications and revisions are not increased after simultaneous bilateral unicompartmental knee arthroplasty in comparison with unilateral procedures. Int Orthop. 2015;39:871–7.

13. Kayrak M, Erdogan HI, Solak Y, et al. Prognostic value of neutrophil to lymphocyte ratio in patients with acute pulmonary embolism: a retrospective study. Heart Lung Circ. 2014;23:56–62.

14. Barker T, Rogers VE, Henriksen VT, et al. Is there a link between the neutrophil-to-lymphocyte ratio and venous thromboembolic events after knee arthroplasty? A pilot study. J Orthop Traumatol. 2016;17:163–8.

15. Zahorec R. Ratio of neutrophil to lymphocyte counts—rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy. 2001;102:5–14.

16. Erturk M, Cakmak HA, Surgit O, et al. The predictive value of elevated neutrophil to lymphocyte ratio for long-term cardiovascular mortality in peripheral arterial occlusive disease. J Cardiol. 2014;64:371-6.

17. Ghaffari S, Nadiri M, Pourafkari L, et al. The predictive value of total neutrophil count and neutrophil/lymphocyte ratio in predicting in-hospital mortality and complications after STEMI. J Cardiovasc Thorac Res. 2014;6:35–41.

18. Polat AE, Polat B, Gürpınar T, et al. The effect of morbid obesity (BMI ≥ 35 kg/m2) on functional outcome and complication rate following unicompartmental knee arthroplasty: a case-control study. J Orthop Surg Res. 2019;14:266.

19. Laurencin CT, Zelicof SB, Scott RD, et al. Unicompartmental versus total knee arthroplasty in the same patient. A comparative study. Clin Orthop Relat Res. 1991;273:151–6.

20. Pandit H, Jenkins C, Barker K, et al. The Oxford medial unicompartmental knee replacement using a minimally-invasive approach. J Bone Joint Surg (Br). 2006;88:54–60.

21. Rougraff BT, Heck DA, Gibson AE. A comparison of tricompartmental and unicompartmental arthroplasty for the treatment of gonarthrosis. Clin Orthop Relat Res. 1991;273:157–64.

22. Cross MB, Berger R. Feasibility and safety of performing outpatient unicompartmental knee arthroplasty. Int Orthop. 2014;38:443–7.

23. Duman Y, Sevimli R. Investigation of the Presence of Pantone-Valentine Leukocidin in Staphylococcus aureus Strains Isolated from Orthopedic Surgical Site Infections. Mikrobiyol Bul. 2018;52:340-7.

24. Sevimli R, Aslanturk O, Ertem K, et al. An investigation of infection rate and seasonal effect level in total joint replacement cases. Med Sci. 2018;7:210-3.

25. Levy YD, Hardwick ME, Copp SN, et al. Thrombosis incidence in unilateral vs. simultaneous bilateral total knee arthroplasty with compression device prophylaxis. J Arthroplasty. 2012;28:474–8.

26. March LM, Cross M, Tribe KL, et al. Patient costs and outcomes following bilateral and unilateral total knee joint replacement surgery for OA. Osteoarthr Cartil. 2004;12:400–8.

27. Memtsoudis SG, Ma Y, González Della Valle A, et al. Perioperative outcomes after unilateral and bilateral total knee arthroplasty. Anesthesiology. 2009;111:1206–16.

28. Ritter MA, Harty LD, Davis KE, et al. Simultaneous bilateral, staged bilateral, and unilateral total knee arthroplasty. A survival analysis. J Bone Joint Surg Am. 2003;85:1532–7.

29. Chan WCW, Musonda P, Cooper AS, et al. One-stage versus two-stage bilateral unicompartmental knee replacement: a comparison of immediate post-operative complications. J Bone Joint Surg (Br). 2009;91-B: 1305–9.

30. Horne BD, Anderson JL, John JM, et al. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol. 2005;45:1638–43.

31. Shah N, Parikh V, Patel N, et al. Neutrophil lymphocyte ratio significantly improves the Framingham risk score in prediction of coronary heart disease mortality: insights from the national health and nutrition examination survey-III. Int J Cardiol. 2014;171:390–7.

32. Mantilla CB, Horlocker TT, Schroeder DR, et al. Risk factors for clinically relevant pulmonary embolism and deep venous thrombosis in patients undergoing primary hip or knee arthroplasty. Anesthesiology. 2003;99:552–560.

33. Pedersen AB, Mehnert F, Johnsen SP, et al. Venous thromboembolism in patients having knee replacement and receiving thromboprophylaxis: a Danish population- based follow-up study. J Bone Joint Surg Am. 2011;93:1281–17.

34. Brookenthal KR, Freedman KB, Lotke PA, et al. A meta-analysis of thromboembolic prophylaxis in total knee arthroplasty. J Arthroplasty. 2001;16:293–300.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
Sayıdaki Diğer Makaleler

Is C-type natriuretic peptid level can be an early ındicator for acute kidney ınjury?

Ilker AKAR, Muzaffer KATAR

Surgeon factor in pediatric supracondylar humerus fractures

Ali YUCE, Niyazi IGDE, Yunus IMREN, Suleyman Semih DEDOGLU, Hakan GURBUZ

The effects of anaesthesia induction with propofol or ketofol on cerebral oxygenation in patients above 60 years of age

Harun Tolga DURAN, Ersin KOKSAL, Yasemin Burcu USTUN, Sezgin BİLGİN, Fatih OZKAN

Evaluation of the relationship between the level of spinal vertebra injuries due to traffic accidents and additional injuries

Celil ALKAN, Hatice Seyma AKCA, Kamil KOKULU, Serdar OZDEMİR, Serkan Emre EROGLU, Mehmet Necdet YİLDİZ

Evaluation of the effects of pterygium surgery on visual acuity and anterior segment measurements using corneal topography

Fikriye ORDULU, Halit OGUZ, Cetin AKPOLAT, Muhammed Mustafa KURT

Life advices in patients with tracheostomy: Rational antibiotic use and cerebro-vascular prophylaxis-physiotherapy

Eylem ACARTURK TUNCAY, Ozlem Yazicioglu MOCİN, Sinem GUNGOR, Nezihe Ciftaslan GOKSENOGLU, Feyza KARGİN, Huriye Berk TAKİR, Emine Ebru AKSOY, Gokay GUNGOR, Nalan ADİGUZEL, Zuhal KARAKURT, Ilim IRMAK, Cuneyt SALTURK, Mustafa AY, Veysel Garani SOYLU

The relationship between spiritual well-being and hopelessness levels of substance users

Pinar SOYLAR, Ufuk DOGAN

Successful cruciate incision of the minor papilla in a patient with acute pancreatitis due to pancreas divisum: A case report

Takako TASAKİ, Hideki ONO, Kazunari MURAKAMİ

Changes in thiol/disulfide homeostasis in patients with chronic kidney disease

Ibrahim SOLAK, Seher MERCAN, Ibrahim GUNEY, Ozcan EREL, Salim NESELİOGLU, Cigdem Damla CETİNKAYA, Mehmet Ali ERYILMAZ

A retrospecti̇ve evaluation of the epitelial lesions / neoplasms of the gallbladder in Uşak city and determination of the visual frequency

Sirin KUCUK, Cengiz KOCAK, Ersoy ERCİHAN, Asli Ucar UNCU, Mehmet GUNDOGAN