Analysis of Complete Blood Count-Derived Inflammatory Biomarkers in Patients Underwent Total Knee Arthroplasty: A Retrospective Study

Background: Pain, bleeding, and anemia are frequent complications of total knee arthroplasty (TKA). Objective: To analyze CBC-derived biomarkers in patients who underwent TKA to predict postoperative complications. Methods: This retrospective study evaluated neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), platelet-monocyte ratio (PMR), hemoglobin-platelet ratio (HPR), hemoglobin-lymphocyte ratio (HLR). Results: A total of 99 patients’ records were investigated; their average age was 64.57±8.4. Significant differences in NLR and HLR were noted between the patients who needed <5 days and ≥ 5 days of opioid analgesic (OPA). Hence, the patients with higher NLR and HLR needed longer OPA (≥ 5 days) than the patients with lower NLR and HLR. Likewise, NLR, MLR, PLR, and HLR were significantly higher in the patients who needed longer non-OPA (>20 days). Additionally, the duration of non-OPA usage had a significantly high positive correlation (r= 0.967, p<0.0001) with NLR, and a moderate positive correlation with PLR (r=0.535, p<0.0001) and HLR (r= 0.6216, p<0.0001). On the other hand, the pre-operative NLR, MLR, PLR, and HLR of the patients who needed blood transfusion ≥ 1.0 pint (0.47 L) was significantly higher than those who did not need blood transfusion. Blood transfusion showed a significantly positive correlation (r=0.8419, p<0.0001) with NLR; also, there was a moderate positive correlation with PLR (r=0.5257, p<0.0001) and HLR (r=0.5841, p<0.0001). Conclusions: CBC-derived biomarkers can be utilized for predicting the duration and need for postoperative analgesics and blood transfusion.