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Inflammatory response in patients undergoing hip surgery due to osteoarthrosis or different types of hip fractures

M Sedlár1, Z Kudrnová, S Trca

  • 11st Department of Surgery, General Teaching Hospital and Charles University in Prague, First Faculty of Medicine, Prague, Czech Republic. mudr.sedlar@seznam.cz

Osteoarthritis and Cartilage
|August 11, 2007
PubMed

Insights

Hip fracture surgery significantly elevates inflammatory markers preoperatively, especially in intracapsular fractures. Post-surgery, both fracture types and elective hip replacements show decreased soluble adhesion molecules, requiring further study.

Area of Science:

  • Orthopedics
  • Immunology
  • Biochemistry

Background:

  • Hip surgery, including replacement and fracture repair, triggers a substantial systemic inflammatory response.
  • Understanding the nuances of this response is crucial for patient outcomes.

Purpose of the Study:

  • To compare systemic inflammation markers and soluble adhesion molecules in patients undergoing elective hip replacement versus those with intracapsular (IC) or extracapsular (EC) hip fractures.
  • To analyze the temporal changes in these markers post-surgery.

Main Methods:

  • A cohort of 65 patients was divided into elective hip replacement (EL), EC fracture, and IC fracture groups.
  • Markers including fibrinogen, orosomucoid, C-reactive protein, transferrin, white blood cells, sP-selectin, sE-selectin, and sICAM-1 were measured preoperatively and at 4h, 48h, and 7 days post-surgery.

Main Results:

  • Intracapsular hip fracture patients exhibited higher preoperative inflammatory markers (FBG, CRP, ORM, WBC) and lower transferrin compared to EC and EL groups.
  • Surgery universally increased CRP and ORM while decreasing transferrin, with slower recovery in the IC group.
  • A significant postoperative decrease in sP-selectin and sE-selectin was observed across all groups, with sE-selectin decrease correlating with hemoglobin and transfusion status.

Conclusions:

  • Hip surgery induces a marked inflammatory reaction, with preoperative elevation in hip fracture patients, particularly IC fractures.
  • The unexpected postoperative decline in sE-selectin and sP-selectin warrants further investigation to understand its clinical implications.
Abstract

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