Postoperative Serum Cytokine Levels Are Associated With Early Stiffness After Total Knee Arthroplasty: A Prospective Cohort Study.
Postoperative Serum Cytokine Levels Are Associated With Early Stiffness After Total Knee Arthroplasty: A Prospective Cohort Study.
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DOI：
10.1016/j.arth.2020.02.046
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发表时间：
2020-06
期刊：
影响因子：
--
通讯作者：
Kirksey M
中科院分区：
文献类型：
--
作者：
Malahias MA;Birch GA;Zhong H;Sideris A;Gonzalez Della Valle A;Sculco PK;Kirksey M
炎症细胞因子与器官纤维化有关，但其在全膝关节置换术(TKA)后发生关节纤维化中的作用尚未得到很好的研究。这项研究的目的是评估围手术期滑液或血浆细胞因子水平是否与TKA术后早期活动范围(ROM)减少有关。179名接受全膝关节置换术的终末期特发性骨关节炎患者参加了这项前瞻性队列研究。分别于术前、术后第1、2天在急诊病房(PACU)、术后第1天、第2天采集滑液和血浆，并于术后6周(±2周)用角度计测量≤95°活动度。162例患者中32例(19.8%)术后6周僵硬。在POD1和/或POD2，僵硬患者和非僵硬患者术后血浆中9种细胞因子(Eoaxin3、IL5、IL1223p40、IP10、VEGF、IL7、IL12p70、IL16、IL17A)水平差异有统计学意义。未检测到术前血浆和滑液细胞因子水平与术后僵硬发展之间的关联。这项研究的结果表明，在TKA术后6周出现僵硬的患者有明显的急性术后细胞因子反应特征。术后头两天9种细胞因子水平的显著差异是这一特征。这些结果确定了细胞因子是TKA术后早期僵硬风险的潜在生物标志物，并可能在这一结果的病理生理学中发挥作用。
Inflammatory cytokines have been implicated in organ fibrosis, however their role in the development of arthrofibrosis after total knee arthroplasty (TKA) has not been well explored. The purpose of this study was to assess whether perioperative synovial fluid or blood plasma cytokine levels are associated with reduced early post-TKA range of motion (ROM). 179 patients with end-stage idiopathic osteoarthritis undergoing TKA were enrolled in this prospective cohort study. Synovial fluid and blood plasma were collected pre-arthrotomy and plasma was collected longitudinally in the Post-Acute Care Unit (PACU) and on post-operative days (PODs) 1 and 2. Stiffness was defined as ≤ 95° ROM measured with a goniometer at 6 weeks (± 2 weeks). Thirty-two out of 162 (19.8%) patients analyzed were stiff at 6 weeks postoperatively. Postoperative plasma levels of 9 cytokines (Eotaxin3, IL5, Il12_23p40, IP10, VEGF, IL7, IL12p70, IL16, IL17a) were significantly different between stiff and non-stiff patients on POD 1 and/or POD2. An association between preoperative plasma and synovial fluid cytokine levels and the development of postoperative stiffness was not detected. The results of this study suggest that there is a distinct acute postoperative cytokine response profile in patients who develop stiffness 6 weeks after TKA. This profile was characterized by significant differences in levels of 9 cytokines over the first two postoperative days. These results identify cytokines that are potential biomarkers for risk of early stiffness after TKA and may play a role in the pathophysiology of this outcome.
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影响因子：
14.9
作者：
Ritchie ME;Phipson B;Wu D;Hu Y;Law CW;Shi W;Smyth GK
通讯作者：
Smyth GK
影响因子：
3.6
作者：
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DOI：
10.1007/s11420-007-9053-4
发表时间：
2007-09-01
期刊：
HSS journal : the musculoskeletal journal of Hospital for Special Surgery
影响因子：
--
作者：
Gonzalez Della Valle, Alejandro;Leali, Alejandro;Haas, Steven
通讯作者：
Haas, Steven
影响因子：
7
作者：
Inacio, M. C. S.;Paxton, E. W.;Nemes, S.
通讯作者：
Nemes, S.
DOI：
10.1186/1755-1536-3-17
发表时间：
2010-09-01
期刊：
Fibrogenesis & tissue repair
影响因子：
--
作者：
Freeman TA;Parvizi J;Dela Valle CJ;Steinbeck MJ
通讯作者：
Steinbeck MJ