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[The course of inflammatory mediators after elective orthopedic interventions]
J P Giehl1, T Kluba, C Lebherz
1Orthopädische Klinik und Poliklinik, Eberhard-Karls-Universität Tübingen.
Purpose Of The Study:
The aim of the study was to characterize the changes of C-reactive protein, erythrocyte sedimentation rate, white blood count and body temperature by serial measurements after different types of uncomplicated orthopedic surgery.
Methods:
The uncomplicated course of 180 patients after elective total hip and knee arthroplasties, ventral and dorsal spinal fusions and diagnostic knee and shoulder arthroscopies were analyzed.
Results:
The maximal CRP-values were recorded on the second or third day after operation. The peak levels correlated with the extent of the procedures and reached 1.28-17.71 mg/dl. The ESR increased to maximal rates five to six days after surgery and remained elevated during the 14 days of the investigation period. WBC and body temperature showed a slow and uncharacteristic increase followed by a slow and irregular decrease.
Conclusion:
Awareness of the typical pattern of CRP, ESR, WBC and body temperature may help to evaluate the early postoperative course. The CRP is a sensitive marker. ESR, WBC and body temperature are less costly but a poor diagnostic aid for the early detection of postoperative complications especially infections.