High levels of CRP following total joint arthroplasty increase risk of fever

Following total knee arthroplasty (TKA) and total hip arthroplasty (THA) the first fever and maximum body temperature most commonly appeared on the Postoperative day 2 and Postoperative day 1 in the same groups. Fall in hemoglobin in THA group and high C-reactive protein in both the groups are a risk factor for postoperative fever. This study was published in the BMC Musculoskeletal Disorders.

Postoperative fever (POF) is a common problem after total joint arthroplasty (TJA). This research by MingzYang Li and peers was focused to analyze the characteristics and risk factors of fever following Total Joint Arthroplasty.

2482 patients who had primary TKA or THA surgery between January 2020 and December 2020 were investigated. Axillary temperatures of patients were measured and POF was defined as body temperature more than 38 °C. Patients in the TKA and THA groups were further divided into afebrile group and febrile group based on their body temperatures. Based on the number of patients in the febrile group, the researchers randomly selected a corresponding number of patients from the afebrile group (1:2) to establish a control group. Factors like Gender, hypertension, diabetes, anesthesia, surgical time, and some laboratory data were analyzed between both the groups.

The findings of the study were;

• 3% percent of TKA patients (45 patients) had fever, while 38% (17 patients) had maximum body temperature and fever on postoperative day 2.
• 6% of THA patients (46 patients) had fever, 65% (30 patients) had fever and maximum body temperature on POD1.
• Compared with afebrile group, febrile group has higher C-reactive protein (CRP) after surgery in the TKA group.
• Compared with the afebrile group, the patients in the febrile group had larger fall in hemoglobin (g/L), and higher CRP after surgery in the THA group.

Reference:

Li, M., Lyu, C., Fang, Y., Shao, Z., Liu, K., & Liu, N. (2022). Characteristics and risk factors of fever after total joint arthroplasty: a single-center retrospective study. In BMC Musculoskeletal Disorders (Vol. 23, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12891-022-05940-3