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Evaluation of inflammatory markers after orthopedic surgical intervention in children
Insights
Post-operative inflammation markers like erythrocyte sedimentation rate (ESR) and white blood cell (WBC) counts can increase in pediatric hip dysplasia and Perthes disease patients, even without infection signs.
Area of Science:
- Pediatric Orthopedics
- Inflammatory Markers
- Surgical Outcomes
Background:
- Developmental dysplasia of the hip (DDH) and Perthes disease are common pediatric hip conditions requiring surgical intervention.
- Inflammation markers are often monitored in post-operative patients to detect potential complications.
Purpose of the Study:
- To evaluate changes in C-reactive protein (CRP), erythrocyte sedimentation (ES), and white blood cell (WBC) counts in pediatric patients undergoing surgery for DDH or Perthes disease.
- To assess the correlation of these markers with patient age and their behavior after surgery.
Main Methods:
- A cohort of 43 pediatric patients (20 with DDH, 23 with Perthes disease) were studied.
- Blood samples were collected pre-operatively and 5 days post-operatively.
- ES, CRP, and WBC levels were analyzed.
Main Results:
- Elevated erythrocyte sedimentation rate (ESR) was significantly more frequent than elevated CRP or WBC (p<0.01).
- CRP values showed a significant correlation with patient age (p<0.05), unlike ESR and WBC.
- ESR was the most frequently isolated marker (34.88%), and ESR and CRP were the most frequently elevated markers together (44.19%).
Conclusions:
- Surgical procedures can elevate inflammatory marker values in pediatric patients, irrespective of clinical signs of infection.
- Clinical assessment and intensive patient follow-up are crucial alongside inflammatory marker evaluation for diagnosing post-operative infections.
Objective:
The study aim was to evaluate inflammation markers values (C-reactive protein (CRP), Erythrocite sedimentation (ES), White blood cells count (WBC)) in surgically treated pediatric patients with diagnosed developmental displasia of the hip or Perthes disease before and after operation.
Methods:
We have evaluated 43 children (20 patients were with diagnosed unilateral developmental displasia of the hip while 23 had Perthes disease). Blood samples were drown at the admission and 5 days after admission, and further inflammatory parameters were analyzed: ES (mm/hour), CRP (mg/L) and WBC (x1000/mm3) count.
Results:
Elevated erythrocite sedimentation (ESR) was significantly frequent than elevated CRP (p<0.01) and elevated WBC as well (p<0.01). Values of ESR and WBC do not correlate closely with age (FESR= 1.805; FWBC= 0.130; p>0.05) while CRP values correlate significantly with the age of the patients (FCRP= 4.948; p<0.05). The most frequently isolated marker was ESR (34.88%). The most frequent elevated two markers were ESR and CRP (44.19%).
Conclusion:
Surgical procedure could alter the values of inflammatory markers leading to the increasement even though there is no other clinical signs of infection. For estimation of the possible presence of the infection, clinical signs and patients intensive clinical follow-up after the surgery, should be done along with the evaluation of inflammatory markers.
