C-reactive protein as a parameter of surgical trauma - CRP response after different types of surgery in 349 hip fractures

Postoperative C-reactive protein (CRP) levels in serum appear to reflect surgical trauma. We examined CRP levels after different types of surgery in hip fractures. Methods We studied the CRP response after 349 operative procedures in proximal femur fractures with a normal postoperative course. 5 different operative techniques were used: 3-4 percutaneous cancellous screws, dynamic hip screw (DHS), proximal femur nail (PFN), hemiarthroplasty (HA), and total hip arthroplasty (THA). Results Peak CRP levels were reached on the second postoperative day in each group (medians: screws 8.7, DHS 12, PFN 14, HA 16, THA 16 mg/dL). Significant differences were found between screws and all others, and between DHS and arthroplasties. Interpretation CRP levels following surgical trauma can be used to quantify the degree of tissue damage and invasiveness of a procedure and reflect the perioperative stress experienced by the patient.