Postoperative Trends of Serum C-Reactive Protein Levels after Primary Shoulder Arthroplasty-Normal Trajectory and Influencing Factors

Sebastian Klingebiel; Jan Christoph Theil; Georg Gosheger; Kristian Nikolaus Schneider; Maximilian Timme; Dominik Schorn; Dennis Liem; Carolin Rickert

doi:10.3390/jcm9123893

Postoperative Trends of Serum C-Reactive Protein Levels after Primary Shoulder Arthroplasty-Normal Trajectory and Influencing Factors

J Clin Med. 2020 Nov 30;9(12):3893. doi: 10.3390/jcm9123893.

Authors

Sebastian Klingebiel¹, Jan Christoph Theil¹, Georg Gosheger¹, Kristian Nikolaus Schneider¹, Maximilian Timme², Dominik Schorn³, Dennis Liem⁴, Carolin Rickert¹

Affiliations

¹ Department of Orthopedics and Tumororthopedics, University Hospital Muenster, 48149 Münster, Germany.
² Department of Forensic Medicine, Institute for Legal Medicine, University Hospital Muenster, 48149 Münster, Germany.
³ Department for Shoulder and Elbow Surgery, Paracelsus Clinic Bremen, 28329 Bremen, Germany.
⁴ Sporthopaedicum Berlin, Medical Practice, 10627 Berlin, Germany.

Abstract

Background-Postoperative serum C-reactive protein (CRP) is an important diagnostic parameter for systemic inflammation and reflects surgical trauma. While trends and normal trajectories after total knee (TKA) or hip arthroplasty (THA) are established, there is no reference standard for shoulder arthroplasty (SA). Therefore, the aim of this study was to research CRP trends and influencing factors following SA. Methods-This retrospective study analyzed postoperative serum CRP levels and trajectories in 280 patients following SA. Influence of prosthesis design, sex, operating time, BMI, and humeral augmentation with bone cement were analyzed using descriptive statistics and (non-) parametric testing. Results-There is a CRP trend with a peak on day two or three, with a subsequent decrease until day seven. Reverse and stemmed prostheses show a statistically higher CRP peak than stemless prostheses or hemiarthroplasties (HA). There was no influence of gender, body mass index (BMI), operating time, or bone cement. Conclusion-The presented findings may contribute to a better understanding of the postoperative CRP course after SA. The results of this retrospective study should be validated by a prospective study design in the future.

Keywords: C-reactive protein; PJI; RSA; TSA; glenohumeral joint replacement; hemiarthroplasty; laboratory diagnostics; normal curve; periprosthetic joint infection; postoperative CRP course; reverse shoulder arthroplasty; total shoulder arthroplasty; trajectory; trend.