The effect of MPV and neutrophil/lenfosite ratio to outcome parameters in hip and knee artroplasty surgery

Arthroplasty is an important treatment method for reconstruction the joint by using prothesis which is applied to severe joint damages in patients who cannot respond to conservative medical treatment such as oral medications, intra-articular injections, activity arrangements, physical therapy and other treatment methods. Studies showing the effect of NLR, which is a simple indicator of inflammation, on mortality and other adverse outcomes are intense but there are few studies in orthopedic patients and especially in arthroplasty patients. MPV is considered to be a relatively reliable indicator of thrombopoiesis and platelet function. There is increasing evidence that MPV may be a prognostic indicator in both proinflammatory and prothrombotic conditions. The aim of this study is to evaluate the effects of perioperative changes of these two indicators, which have the potential to affect prognosis and outcomes and offer objective data in hip and knee prothesis. For this purpose, the parameters used in risk assessment in arthroplasty operations were examined and the effect to the early postoperative liver and kidney function tests and hospital stay were evaluated. In our retrospective single-centered study, 489 patients who underwent hip and knee arthroplasty between January 1, 2014 – December 31, 2017 in the operation theaters in the Hospital of Medical School of Akdeniz University, Block B, were evaluated retrospectively. Data of 459 patients other than 12 THA and 18 TKA patients were collected from hospital data system, patient files and anesthesia forms and recorded in data forms. 226 TKA and 223 THA patients were enrolled in our study. All patients who underwent knee and hip arthroplasty were examined for this study but only patients with oncologic and hematologic diseases and the patients whose data were not accessible were excluded from the study. 73 Postoperative – intraoperative NLR values of all patients were evaluated and there was an increase in postoperatively which was found significant. (p<0.05) According to the operation type, the change in the preoperative – postoperative NLR value was found much more in the THA. When the both types of surgeries were evaluated, it was detected that the change in MPV and NLR preoperative – postoperatively had no effect on renal and liver functions and discharge time. In conclusion; the presence of the indexes showing the risks of complications and side effects is important in terms of determining the possible complications and mortality risk and the planning of treatment beforehand by investigating the MPV and N/L ratio.