The Course of Inflammatory Factors after Elective Orthopedic Surgery

Complications, specially infection after orthopedic surgery, can result in severe disability in patients. Efforts have been done to use inflammatory factors such as Erythrocyte Sedimentation Rate(ESR), C-Reactive Protein(CRP) and White Blood Cell Count(CBC) to predict infection after surgery and to indicate that the course of these factors are predictable. The aim of the present study was to characterize the changes of CRP, ESR and WBC after elective orthopedic surgery. In 94 patients who underwent elective orthopedic surgery and had normal values of inflammatory factors such as ESR, WBC and CRP serial measurements of CRP, ESR and WBC were done before and 1, 3, 5, 7, 14, 28 and 59 days after surgery from December 2002 to February 2003. The results indicated a maximal count of WBC on the first day after surgery, maximal CRP values on the third day and maximal ESR rates on the fifth day after surgery. Changes of WBC were irregular, but ESR and CRP, after achieving maximal values on mentioned days, became respectively normal after 28 and 14 days following post-operation. Age and sex did not influence the pattern of changes but extensive surgeries were accompanied with higher values of ESR and CRP. Pattern of changes in CRP and ESR values are so typical that any deviation from this pattern can indicate occurance of complications such as infection. CRP was sensitive than ESR in this regard.