Neutrophil-to-lymphocyte ratio (NLR) distribution shows an advantage compared to C-reactive protein (CRP) for the early inflammation monitoring after total hip arthroplasty


Total hip arthroplasty (THA) ; C-reactive protein (CRP) ; Neutrophil-to-lymphocyte ratio (NLR) ; inflammation.

Published online: Feb 13 2021

M. Mundama, M. Van Cauter, C. Detrembleur, O. Cornu, J.E. Dubuc, J.C.Yombi

From the Department of Orthopedic Surgery, Université Catholique de Louvain, Cliniques Universitaires St-Luc, Brussels, Belgium


C-reactive protein (CRP) distribution has been used to monitor early inflammation after total hip arthroplasty (THA). Neutrophil to lymphocyte ratio (NLR) is a new and cheap inflammatory marker. This study aimed to verify whether Neutrophil to lymphocyte ratio (NLR) distribution has an advantage when compared to C-reactive protein (CRP) distribution for the inflammation monitoring after total hip arthroplasty (THA).

116 THA patients were retrospectively selected over a 2 years period. They all had available blood tests preoperatively and at postoperative days 2, 4 and 42. Median peak values were compared between CRP and NLR. The effect of demographics on CRP and NLR was tested.

At days 4 and 42, 100% and 16.3% of patients had not reached normal CRP (< 10mg/L) while 56.8% and 6.8% of patients had not reached normal NLR (<5) respectively. There was no effect of demographics on NLR except for age. Older patients had higher NLR (p 0.037).

NLR showed a quicker return to normal than CRP. Our results show that NLR seems to be a better marker to follow inflammation after THA than CRP.