Elevated temperature trends after total knee arthroplasty

Fever after total knee arthroplasty (TKA) is a common phenomenon. However, the pattern of temperature change and its correlation with perioperative factors remain unclear. The purpose of this study was to define the trend of postoperative body temperature in patients undergoing TKA. This study also sought any factors influencing body temperature. We reviewed the charts of 186 clinically uncomplicated patients to record the changes of body temperature in the first 5 postoperative days and to determine the factors affecting it. The temperature trends of patients with acute prosthetic infection were also reviewed for comparison. In uncomplicated patients, the average peak temperature was 37.9 degrees C, a 3.3% increase from the preoperative baseline, 36.7 degrees C. The temperature elevation was most remarkable on postoperative days 1 and 2, but only 4 patients experienced fever up to 39 degrees C. Patients with lower hemoglobin loss showed higher peak temperature. Patients with postoperative infection tended to have prolonged fever and delayed presentation of peak temperature. Our study illustrated the elevated pattern of body temperature after uncomplicated TKA and determined the loss of hemoglobin might be the affecting factor. Fever up to 39 degrees C, prolonged fever, and delayed presentation of peak temperature were uncommon and should raise the clinical suspicion of infection or other complication.