Alterations of biomarkers in assessing the prognosis of osteoarthritis in patients with total knee replacement: A cross-sectional study

Introduction: Osteoarthritis (OA) is a chronic disorder characterized by inflammation, cartilage degeneration and bone remodelling with molecular derangements followed by anatomic and physiologic elements. The aim of the study was to assess the alterations of biomarkers in patients who underwent total knee replacement (TKR) for OA. Methods: A cross-sectional retrospective analysis was carried out on 206 participants who underwent either unilateral or bilateral TKR for knee OA from January 2017 to December 2020. Data regarding medical and surgical history, demographic characteristics, X-ray findings, complete blood count (CBC), plasma glucose and high-sensitive C-reactive protein (hsCRP) were collected and analysed. Ethics approval was obtained. Based on the normality of distribution appropriate statistical tools were used. P value≤0.05 was considered statistically significant. Results: Body mass index was significantly higher in participants who underwent bilateral TKR rather than unilateral TKR. Females were affected at a younger age compared to males. Hypothyroid participants had unilateral than bilateral TKR. Neutrophil lymphocyte ratio was higher in bilateral rather than unilateral TKR (P=0.038). Males had higher monocyte lymphocyte ratio (P≤0.001), especially in individuals 61-80 years of age as well as in obese individuals. Conclusion: The use of markers such as total leukocyte count, differential count, neutrophil to lymphocyte (NLR), monocyte to lymphocyte ratios (MLR) and hsCRP are cost-effective and could predict the severity of the disease. These markers could be used to screen individuals at risk for developing OA of the knee and help in assessing the prognosis; thus allowing surgeons to decide on the appropriate management of the disease.