Perioperative Mild Hypothermia Modulates Inflammatory Response and Coagulation Pathways in Hip Arthroplasty: A...

Hip arthroplasty is a common surgical procedure for end-stage osteoarthritis and other degenerative hip joint conditions. Despite its established efficacy, postoperative complications, such as excessive inflammation, coagulation disturbances, and inadequate pain control, can hinder recovery and increase the risk of adverse outcomes. Mild hypothermia, involving controlled temperature reduction, has emerged as a potential strategy to mitigate these complications, but its impact on hip arthroplasty outcomes remains insufficiently explored.

This study aims to evaluate the effects of mild hypothermia on inflammation, coagulation profiles, pain management, and long-term functional recovery in patients undergoing hip arthroplasty.

This prospective, single-center, randomized controlled trial included 100 patients undergoing primary unilateral hip arthroplasty. Participants were randomly assigned to either the normothermia or mild hypothermia group, with the latter maintained at 34 °C to 35 °C during surgery. Inflammatory markers, coagulation profiles, and pain scores were measured preoperatively, 24 hours, and 72 hours postoperatively. Long-term functional recovery was assessed at 1-year follow-up using the Hospital for Special Surgery score.

The mild hypothermia group exhibited a significant reduction in postoperative inflammation, with lower levels of white blood cell count, C-reactive protein, erythrocyte sedimentation rate, tumor necrosis factor-alpha, and interleukin-6 compared with the normothermia group. Coagulation profiles were significantly altered in the mild hypothermia group, evidenced by prolonged prothrombin time and activated partial thromboplastin time. Postoperative pain at 24 hours was significantly lower in the mild hypothermia group, as measured by the visual analog scale, though this difference was not sustained at 7 days. No significant difference in long-term functional outcomes was observed between the two groups at the 1-year follow-up.

Mild hypothermia during hip arthroplasty significantly reduces postoperative inflammation and alters coagulation pathways, promoting faster early recovery. However, it does not provide long-term benefits in functional recovery. These findings support the use of mild hypothermia for improving perioperative outcomes but suggest that further investigation is needed to fully understand its role in orthopedic surgery.