Relationship of the functional recovery after hip arthroplasty to the neuroendocrine and inflammatory responses

Br J Anaesth. 2001 Oct;87(4):537-42. doi: 10.1093/bja/87.4.537.


We studied the relationship between the neuroendocrine and inflammatory responses to hip arthroplasty and functional recovery in 102 patients undergoing elective arthroplasty for osteoarthritis. Blood samples were collected for up to 7 days after surgery and analysed for concentrations of norepinephrine, epinephrine, cortisol, interleukin-6 and C-reactive protein. The primary outcome measures were milestones in hospital, times to walk 10 and 25 m, pain on discharge from hospital, and function 1 and 6 months after surgery. Walking distances in hospital were significantly delayed in patients with greater interleukin 6 and C-reactive protein concentrations, but few neuroendocrine measures had significant correlations with functional recovery in hospital. Multivariate analysis showed that the interleukin 6 concentration on day 1 was the unique predictor of time to walk 10 and 25 m, and that the day 2 concentration of C-reactive protein was the unique predictor of pain on discharge from hospital. No significant correlations were found between the inflammatory and neuroendocrine variables and recovery at 1 and 6 months. We conclude that the inflammatory response affects immediate functional recovery after hip arthroplasty.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / rehabilitation*
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Epinephrine / blood
  • Female
  • Follow-Up Studies
  • Humans
  • Hydrocortisone / blood
  • Inflammation Mediators / blood*
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Norepinephrine / blood
  • Osteoarthritis, Hip / rehabilitation
  • Osteoarthritis, Hip / surgery*
  • Postoperative Period
  • Recovery of Function*
  • Walking / physiology


  • Biomarkers
  • Inflammation Mediators
  • Interleukin-6
  • C-Reactive Protein
  • Hydrocortisone
  • Norepinephrine
  • Epinephrine