Abstract
The metabolic response of trauma may mimic infection and the reliability of serological parameters for diagnosing infection may be questionable. We prospectively assessed the changes in the acute inflammatory markers, febrile response and the immune profiles of 101 patients following primary hip arthroplasty and their association with infection. Method: The clinical outcome of 101 patients was monitored. Serological analysis was performed pre-operatively and on the second and 8th post-operative day as well as in an out patient clinic 6 weeks following surgery. The serological markers included total white blood cell count along with T and B lymphocyte function. Levels of CD4, CD8 and CD56 were analysed for T helper, T Cytotoxic cell and Natural Killer cell activity. Inflammatory makers included plasma viscosity and CRP. Serological titres of Staph. Aureus and Staph. Epidermis were performed preoperatively and on day 8 and week 6 following surgery. Results: post-operative complications included 19 UTI, 11 chest infections and three URTI and six a confirmed deep vein thrombosis. Twenty patients had elevated ASO titres and 19 patients had raised Staph. Epidermis titres. Statistical comparison of WBC, Plasma viscosity, temperature profiles and T helper, T cytotoxic cell and NK cell assays is not different between patients with and without systemic infection or raised titres of Staph. Aureus or Staph. Epidermis. Conclusion: The acute phase responses following surgery and metabolic response to trauma obscures the changes seen in infective complications up to six weeks post-operatively. Their use in diagnosing infection appears unjustified.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
