title: Evaluation of postoperative fever and leukocytosis in patients after total hip and knee arthroplasty.
abstract: Fever and leukocytosis are common after joint arthroplasty, often resulting in additional studies. This study was conducted to determine the incidence of fever and leukocytosis after joint arthroplasty and the use of tests. We retrospectively reviewed records (n = 426) of patients who underwent knee or hip arthroplasty between February 2006 and April 2008 to determine the incidence of fever and leukocytosis, tests, and results. Sixty-four had fever, and 247 had postoperative leukocytosis. Sixty additional tests were performed; 6 (10%) of 60 tests were clinically relevant. After joint arthroplasty, more than half of patients developed leukocytosis, and nearly 15% developed fever. Diagnostic testing should be based on physical examination or symptomatic findings and not solely on laboratory values or vital signs, decreasing the patient discomfort and potentially lower costs.
authors.affiliation: Department of Orthopaedic Surgery, Mount Carmel Health System, Columbus, OH 43222, USA.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Czaplicki
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Borger
authors.forename: Joel R
authors.initials: JR
authors.lastname: Politi
authors.forename: Bryan T
authors.initials: BT
authors.lastname: Chambers
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Taylor
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D003955:Diagnostic Tests, Routine; D005260:Female; D005334:Fever / Q000453:epidemiology* / Q000209:etiology*; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D007720:Knee Prosthesis / Q000009:adverse effects; D007964:Leukocytosis / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000209:etiology; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000209:etiology; D055815:Young Adult