Tai Ta-Wei, Chang Chih-Wei, Lin Chii-Jeng, Lai Kuo-An, Yang Chyun-Yu
Department of Orthopedics, National Cheng Kung University Medical Center, Tainan, Taiwan.
Orthopedics. 2009 Dec;32(12):886. doi: 10.3928/01477447-20091020-05.
Fever after total knee arthroplasty (TKA) is a common phenomenon. However, the pattern of temperature change and its correlation with perioperative factors remain unclear. The purpose of this study was to define the trend of postoperative body temperature in patients undergoing TKA. This study also sought any factors influencing body temperature. We reviewed the charts of 186 clinically uncomplicated patients to record the changes of body temperature in the first 5 postoperative days and to determine the factors affecting it. The temperature trends of patients with acute prosthetic infection were also reviewed for comparison. In uncomplicated patients, the average peak temperature was 37.9 degrees C, a 3.3% increase from the preoperative baseline, 36.7 degrees C. The temperature elevation was most remarkable on postoperative days 1 and 2, but only 4 patients experienced fever up to 39 degrees C. Patients with lower hemoglobin loss showed higher peak temperature. Patients with postoperative infection tended to have prolonged fever and delayed presentation of peak temperature. Our study illustrated the elevated pattern of body temperature after uncomplicated TKA and determined the loss of hemoglobin might be the affecting factor. Fever up to 39 degrees C, prolonged fever, and delayed presentation of peak temperature were uncommon and should raise the clinical suspicion of infection or other complication.
全膝关节置换术（TKA）后发热是一种常见现象。然而，体温变化模式及其与围手术期因素的相关性仍不明确。本研究的目的是确定接受TKA患者术后体温的变化趋势。本研究还探寻了影响体温的任何因素。我们回顾了186例临床无并发症患者的病历，记录术后前5天的体温变化，并确定影响体温的因素。还回顾了急性假体感染患者的体温变化趋势以作比较。在无并发症的患者中，平均最高体温为37.9摄氏度，比术前基线体温36.7摄氏度升高了3.3%。体温升高在术后第1天和第2天最为显著，但只有4例患者体温高达39摄氏度。血红蛋白损失较少的患者最高体温较高。术后感染的患者往往发热时间延长且最高体温出现延迟。我们的研究阐明了无并发症TKA后体温升高的模式，并确定血红蛋白损失可能是影响因素。体温高达39摄氏度、发热时间延长以及最高体温出现延迟并不常见，应引起对感染或其他并发症的临床怀疑。
