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Hematologic Expression After Shoulder Surgery: Normalization Curve of Serum Inflammatory Markers
Sung-Min Rhee1, Myung Seo Kim2, Jong Dae Kim1
1Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Korea.
Summary
Post-shoulder surgery, inflammatory markers like C-reactive protein (CRP) normalize faster after rotator cuff repair than arthroplasty. More invasive surgeries lead to higher peak inflammatory marker levels and slower normalization.
Area of Science:
- Orthopedic Surgery
- Surgical Outcomes
- Inflammatory Markers
Background:
- Postoperative monitoring of serologic markers is crucial for assessing recovery after shoulder surgery.
- Understanding the normalization patterns of white blood cell (WBC) count, WBC differential for segmented neutrophil (WBC seg.), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) is essential.
Purpose of the Study:
- To establish normalization curves for key serologic markers following elective shoulder surgery.
- To compare hematologic differences in marker normalization across various shoulder surgical procedures.
Main Methods:
- Compared 77 arthroscopic rotator cuff repairs (RCR), 44 open RCR, and 84 shoulder arthroplasties.
- Monitored WBC count, WBC seg., ESR, and CRP preoperatively and at multiple time points up to 1 year post-surgery.
- Defined normal ranges for each serologic marker.
Main Results:
- WBC count and seg. peaked on postoperative day 1, normalizing within 1-2 months.
- ESR peaked at 2 weeks, normalizing within 1-3 months.
- CRP peaked on postoperative day 2, normalizing within 2 weeks (RCR) to 1 month (arthroplasty); showed consistent normalization values.
Conclusions:
- C-reactive protein (CRP) demonstrates the most consistent normalization pattern among the studied markers.
- More invasive shoulder surgeries, such as arthroplasty, result in higher peak inflammatory marker levels and slower normalization compared to rotator cuff repair.
