ArticlePloS one2021
Albumin and the fibrinogen-to-albumin ratio: Biomarkers for the acute phase response following total knee arthroplasty.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 12 citations in OpenAlex.
- Association between fibrinogen-albumin ratio and erectile dysfunction: a retrospective cross-sectional study.BMC urology · 2026Article
- Optimization of perioperative nutrition management based on the ERAS protocol for improving postoperative recovery in patients undergoing total knee arthroplasty: a prospective comparative study.Frontiers in nutrition · 2026Article
- Inflammatory phenotypes after total knee arthroplasty: a testable framework for biomarker-stratified enhanced recovery and precision rehabilitation.Frontiers in medicine · 2026Article
- Improving Total Joint Outcomes: A Survey of Surgeon Implementation of Perioperative Optimization Protocols.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Article
- Acute phase proteins as potent early biomarkers for the detection ofOpen veterinary journal · 2025Article
- Preoperative Albumin and Postoperative CRP/Albumin Ratio (CARS) are Independent Predictive Factors in Estimating 1-Year Mortality in Patients Operated for Proximal Femoral Metastasis with Endoprosthesis.Indian journal of orthopaedics · 2024Article
- Establishment and validation of a predictive nomogram for gestational diabetes mellitus during early pregnancy term: A retrospective study.Frontiers in endocrinology · 2023Observational
- Fibrinogen-to-Albumin Ratio and Blood Urea Nitrogen-to-Albumin Ratio in COVID-19 Patients: A Systematic Review and Meta-Analysis.Tropical medicine and infectious disease · 2022Review
- Combination of early Interleukin-6 and -18 levels predicts postoperative nosocomial infection.Frontiers in endocrinology · 2022Article
- Seven Genes Associated With Lymphatic Metastasis in Thyroid Cancer That Is Linked to Tumor Immune Cell Infiltration.Frontiers in oncology · 2021Article
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeComplications following total knee arthroplasty (TKA) lead to patient morbidity and cost. While acute phase reactants, such as c-reactive protein (CRP) and fibrinogen, have been used to predict complications following TKA, the extent and duration of changes in albumin levels following TKA are unknown. It is hypothesized that like CRP and fibrinogen, albumin, and the fibrinogen/albumin ratio (FAR) represent useful measures of the acute phase response (APR) following TKA. The purpose of this study was to describe the longitudinal course of albumin and FAR in healthy patients following TKA, relative to established biomarkers, and examine if the variance in albumin or FAR correlates with patient comorbidities.
methodsThis retrospective cohort study of patients undergoing TKA at a tertiary medical center. CRP, fibrinogen, and albumin values were collected pre- and post-operatively. An age-adjusted Charlson comorbidity index (CCI) was utilized as a measure of patient comorbidity status.
resultsThe median preoperative albumin value was 4.3 g/dL, which dropped to 3.6 g/dL on postoperative day 1 following TKA. The albumin value returned to 93% of the baseline by postoperative week 2. The course of albumin inversely mirrored the course of CRP (r = -0.41). Median preoperative FAR was 0.087 g/L, which rose to 0.130 g/L by postoperative week 2 and returned to baseline by postoperative week 6. While preoperative FAR strongly correlated with postoperative week 2 values (r = 0.74), there was a weak positive correlation between age-adjusted CCI and pre-operative FAR (r = 0.24) in patients undergoing primary TKA.
conclusionAlbumin levels follow a predictable postoperative decline that inversely correlates with CRP in healthy patients following TKA. Given the low cost and abundance of laboratories offering albumin levels, direct albumin levels and/or albumin ratios such as FAR may be underutilized biomarkers for monitoring the APR following TKA.
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