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Perspectives: How to Deal with Fever (38 °C) After Arthroplasty: The Surgeon’s Point of View

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Perioperative Medical Management for Total Joint Arthroplasty

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Abstract

As we know from the literature and from clinical practice, fever after a total hip arthroplasty and knee replacement is common in the first 3 postoperative days (POD), but the clinical importance is still unclear. The pathophysiology and the role of interleukin-1β, interleukin-6, and tumor necrosis factor are well described. The characteristics of the fever, its trend, and the risk factors were analyzed. POD fever is common from 15 to 50 % of the patients; it appears most commonly during the first or the second postoperative day. The role of diagnostic exam is controversial. There are a lot of studies showing that urinalysis, chest X-ray, and blood culture are totally useless and not cost effective in the absence of symptoms, even if in the presence of temperature of more than 38 °C. PCR and ESR became useful to find an infection when assayed after 21 days. All the authors recommend to perform a clinical examination before starting a complete workup. We also reported a sample of diagnostic algorithm.

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Authors and Affiliations

  1. Mauriziano Umberto I Hospital, University of Torino, Torino, Italy

    Federica Rosso, Lorenzo Mattei, Matteo Bruzzone, Federico Dettoni & Roberto Rossi

  2. Azienda Ospedaliera Città della Salute e della Scienza, Centro Traumatologico Ortopedico Hospital, University of Torino, Torino, Italy

    Davide Edoardo Bonasia

Authors
  1. Federica Rosso
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  2. Lorenzo Mattei
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  3. Matteo Bruzzone
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  4. Federico Dettoni
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  5. Davide Edoardo Bonasia
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  6. Roberto Rossi
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Corresponding author

Correspondence to Roberto Rossi .

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Editors and Affiliations

  1. Humanitas Clinical and Research Center, Milan, Italy

    Andrea Baldini

  2. San Donato Hospital, Arezzo, Italy

    Patrizio Caldora

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Rosso, F., Mattei, L., Bruzzone, M., Dettoni, F., Bonasia, D.E., Rossi, R. (2015). Perspectives: How to Deal with Fever (38 °C) After Arthroplasty: The Surgeon’s Point of View. In: Baldini, A., Caldora, P. (eds) Perioperative Medical Management for Total Joint Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-319-07203-6_25

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  • DOI: https://doi.org/10.1007/978-3-319-07203-6_25

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-07202-9

  • Online ISBN: 978-3-319-07203-6

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