[Significance of postoperative fever after hip prosthesis implantation]

Postoperative fever is a phenomenon well-known by every orthopedic surgeon, yet its etiological background and its relation to wound infections is still unclear. The number of publications related to this topics in general and in the special field of orthopedics is quite limited.

The incidence of postoperative fever in 177 patients who underwent total hip replacement was investigated; its nature and connections to possible bacterial wound infections are described. Moreover, the effectiveness of antibiotic therapy was also taken into consideration.

In 39% of the sample, fever exceeding 38 degrees C was noted in the immediate postoperative period; in 87% of these cases, the fever was of unknown etiology, its background could not be specified by clinical tests and examinations. In four cases of the total 177 patients, microbiologically proven wound infection occurred during the period of hospital stay, but only three of these patients had fever. The results of patients treated with antibiotics because of fever did not differ significantly from those of patients who did not receive antibiotics. This was true from the aspect of both the disappearance of fever and the frequency of complications.

The results emphasise that postoperative fever is only a minor predictive factor of wound infections; at the same time absence of fever does not mean absence of septic complications. In the case of immediate postoperative fever of unknown etiology and without clinical symptoms, it is inexpedient to start antibiotic treatment or to increase the prophylactic antibiotic dosage.