Abstract
Infection after implant arthroplasty is a most serious complication. For diagnosing postoperative infection, we measured pre-and postoperative white blood cell (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and fever in 64 cases of total hip arthroplasty (THA), 20 cases of bipolar endoprosthesis (EP) and 61 cases of total knee arthroplasty (TKA) for osteoarthritis (OA) or rheumatoid arthritis (RA). All cases were uncomplicated after surgery.
In 55 OA-THA·EP cases, WBC was normalized one week after surgery, while the CRP value was 3.08±2.67mg/dl after one week, then decreased gradually. ESR changed about one week after the change in CRP. Fever above 37C° was not observed after one week. The changes in WBC, CRP and ESR in 34 OA-TKA were the same as those in OA-THA·EP. In 29 RA-THA cases, CRP was 85±68% of the preoperative value one week after surgery, a minimal value after two weeks and then increased gradually to the preoperative level. ESR was 76±30mm as the maximal value one week after surgery and was minimal after three weeks, then increased gradually. In 27 RA-TKA cases, the course of changes was the same as that RA-THA.
We conclude that uneventful recovery after implant arthroplasty is indicated as followed; one week after surgery, the CRP value is under 6.0mg/dl in OA or 150% of preoperative level in RA and fever above 37C° is not observed.
