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Inflammatory laboratory tests after joint replacement surgery

K Kolstad1, H Levander

  • 1Department of Orthopaedic Surgery, University Hospital, Uppsala, Sweden.

Upsala Journal of Medical Sciences
|January 1, 1995
PubMed
Summary
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Postoperative inflammatory markers like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) normalize at different rates after arthroplasty. CRP normalizes within two weeks, while ESR remains elevated longer, aiding in infection assessment.

Area of Science:

  • Orthopedics
  • Infectious Disease
  • Clinical Pathology

Background:

  • Objective criteria for early postoperative infections after arthroplasty are limited.
  • Understanding the typical trajectory of inflammatory markers is crucial for accurate diagnosis.

Purpose of the Study:

  • To prospectively investigate the time course of specific inflammatory laboratory values following hip and knee arthroplasty.
  • To establish normal reference ranges for these markers in the early postoperative period.

Main Methods:

  • Prospective monitoring of nine patients undergoing hip or knee arthroplasty.
  • Serial measurement of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total blood leucocyte count, and body temperature.
  • Follow-up assessments at discharge (14 days) and four months postoperatively.

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Main Results:

  • Serum C-reactive protein (CRP) normalized within approximately two weeks.
  • Erythrocyte sedimentation rate (ESR) remained elevated at 14 days postoperatively (mean 64 mm/h) but normalized by four months.
  • Total blood leucocyte count stayed within normal limits throughout the observed period.
  • Slightly elevated morning temperatures (around 38°C) were noted in a few patients on the first two postoperative days only.

Conclusions:

  • Inflammatory markers exhibit distinct normalization patterns after arthroplasty.
  • CRP normalizes relatively quickly, while ESR shows a delayed normalization.
  • Leukocyte count and temperature generally remain within normal limits, suggesting these markers are less sensitive for early infection detection in this context.