Secondary analysis to examine inflammation and post-operative recovery among patients undergoing total knee arthroplasty

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Secondary analysis to examine inflammation and post-operative recovery among patients undergoing total knee arthroplasty

Recently, the secondary analysis of a randomized controlled trial was conducted to explore the role of inflammation in long-term recovery after Total Knee Arthroplasty (TKA). A secondary analysis of a randomized controlled trial of physical rehabilitation ± progressive strength training (PST) was done.

During the study, researchers investigated 1) Association of inflammation with knee pain, functional performance and knee-extension strength before TKA; 2) PST effect on inflammation; 3) Baseline or surgery-induced inflammation modifies the effect of rehabilitation ± PST on change in 6-min walk test (Δ6MWT) and 4) Relation of baseline or surgery-induced inflammation to Δ6MWT following TKA.

A total of 72 patients were included in the primary trial report's per-protocol analysis. Out of which, sixty patients who had ≥1 blood sample before and after TKA, were considered for secondary analysis. Further, the inflammation was measured at different levels. These were at baseline, Day 1, Week 4th, 8th and 26th after TKA. The measurements were done by tumor necrosis factor (TNF)-α, interferon γ-inducible protein (IP)-10, interleukin (IL)-6, IL-10 and soluble urokinase plasminogen activator receptor (suPAR).

The results showed that suPAR at baseline was negatively related with 6MWT. Only surgery-induced IL-10 was related to 6MWT 26 weeks’ baseline. This further was adjusted for 6MWT baseline, age, sex and body mass index (BMI). It was also found that neither baseline nor surgery-induced inflammation modified the response to rehabilitation ± PST.

Hence, only the increased surgery-induced IL-10 response was found to be associated with decreased long-term functional performance after TKA. The necessity of controlling the surgery-induced immune response remains to be investigated further.

Source:

Osteoarthritis Cartilage. 2017 Mar 16

Link to the source:

https://www.ncbi.nlm.nih.gov/pubmed/28323139

Original title of article:

Inflammation and Post-operative Recovery in Patients undergoing Total Knee Arthroplasty- Secondary Analysis of a Randomized Controlled Trial

Authors:

   Sarah Miller and Manjit Matharu

SearchTags: 
Exploratory, Osteoarthritis, Knee, Randomized Controlled Trial, Δ6MWT
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