Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Nov 30;9(12):3893.
doi: 10.3390/jcm9123893.

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

Sebastian Klingebiel  1 , Jan Christoph Theil  1 , Georg Gosheger  1 , Kristian Nikolaus Schneider  1 , Maximilian Timme  2 , Dominik Schorn  3 , Dennis Liem  4 , Carolin Rickert  1
Affiliations

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

Sebastian Klingebiel et al. J Clin Med. .

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.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Mean C-reactive protein levels and trend following shoulder arthroplasty in the total study group, illustrating the characteristic trajectory from the first to the seventh postoperative day.
Figure 2
Figure 2
Box-and-whisker plot showing C-reactive protein levels and trend following shoulder arthroplasty in the overall group, illustrating the mean values on days 1 until 7. The blue boxes show the interquartile range (IQR). IQR is the span of the first and third quartiles and is therefore only slightly influenced by outliers. As the IQR refers to the first to third quartiles, a total of 50% of the data are herewith included. The black line indicates the median and the whiskers show the maximum and minimum scattering. Generally, the centrally located median indicates a symmetrical distribution of the values.
Figure 3
Figure 3
Sex-specific mean C-reactive protein levels and trend following shoulder arthroplasty.
Figure 4
Figure 4
Box-and-whisker plot showing sex-specific C-reactive protein levels and trends following shoulder arthroplasty. Left: Males, right: Females. The blue boxes show the interquartile range (IQR). IQR is the span of the first and third quartiles and is therefore only slightly influenced by outliers. As the IQR refers to the first to third quartiles, a total of 50% of the data are herewith included.
Figure 5
Figure 5
Prosthesis-specific mean C-reactive protein levels and trends following shoulder arthroplasty.
Figure 6
Figure 6
Body-mass-index-specific mean C-reactive protein levels and trends following shoulder arthroplasty. BMI: body mass index.
Figure 7
Figure 7
Mean C-reactive protein levels and trends following shoulder arthroplasty depending on the operating time.
Figure 8
Figure 8
Mean C-reactive protein levels and trends following shoulder arthroplasty depending on application of bone cement.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Neumaier M., Metak G., Scherer M.A. C-reactive protein as a parameter of surgical trauma: CRP response after different types of surgery in 349 hip fractures. Acta Orthop. 2006;77:788–790. doi: 10.1080/17453670610013006. - DOI - PubMed
    1. Battistelli S., Fortina M., Carta S., Guerranti R., Nobile F., Ferrata P. Serum C-Reactive Protein and Procalcitonin Kinetics in Patients Undergoing Elective Total Hip Arthroplasty. [(accessed on 21 December 2017)];BioMed Res. Int. 2014 :1–6. doi: 10.1155/2014/565080. Available online: https://www.hindawi.com/journals/bmri/2014/565080/citations/. - DOI - PMC - PubMed
    1. Choudhry R., Rice R., Triffitt P., Harper W., Gregg P. Plasma viscosity and C-reactive protein after total hip and knee arthroplasty. J. Bone Jt. Surg. Br. 1992;74:523–524. doi: 10.1302/0301-620X.74B4.1624508. - DOI - PubMed
    1. Black S., Kushner I., Samols D. C-reactive Protein. J. Biol. Chem. 2004;279:48487–48490. doi: 10.1074/jbc.R400025200. - DOI - PubMed
    1. Pepys M.B., Hirschfield G.M. C-reactive protein: A critical update. J. Clin. Investig. 2003;111:1805–1812. doi: 10.1172/JCI200318921. - DOI - PMC - PubMed