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

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@article{4e2fbd0bb8154fe18d1a39b01fbe3837,
title = "Inflammation and Post-operative Recovery in Patients undergoing Total Knee Arthroplasty- Secondary Analysis of a Randomized Controlled Trial",
abstract = "OBJECTIVE: Reduced function persists for many patients after total knee arthroplasty (TKA). Inflammation is part of osteoarthritis' pathophysiology, and surgery induces a marked inflammatory response. We therefore wanted to explore the role of inflammation in long-term recovery after TKA, and thus conducted this secondary analysis of our randomized controlled trial of physical rehabilitation +/- progressive strength training (PST). We aimed to investigate whether A) inflammation is associated with functional performance, knee-extension strength, and knee pain before TKA; B) PST affects inflammation, and the inflammatory state over time; C) baseline or surgery-induced inflammation modifies the effect of rehabilitation +/- PST on change in 6-minute walk test (Δ6MWT); and D) baseline or surgery-induced inflammation is associated with Δ6MWT following TKA.DESIGN: In the primary trial report's per-protocol analysis, 72/82 patients were included. Sixty had ≥1 blood sample before and after TKA, and were included in this secondary analysis. Inflammation was measured by interferon γ-inducible protein (IP)-10, soluble urokinase plasminogen activator receptor (suPAR), interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-α at baseline; day 1, week 4, 8, and 26 after TKA.RESULTS: At baseline, suPAR (p=0.03) was negatively associated with 6MWT. Neither baseline nor surgery-induced inflammation modified the response to rehabilitation +/- PST. Only surgery-induced IL-10 was associated with Δ6MWT26 weeks-baseline (p=0.001), also adjusted for 6MWTbaseline, age, sex and BMI.CONCLUSION: In this secondary analysis, only increased surgery-induced IL-10 response was associated with decreased long-term functional performance after TKA. The importance of controlling the surgery-induced immune response remains to be investigated further.TRIAL IDENTIFICATION: NCT01351831.",
keywords = "Journal Article",
author = "Anne Langkilde and Jakobsen, {Thomas Linding} and Bandholm, {Thomas Quaade} and Jesper Eugen-Olsen and Thomas Blauenfeldt and Janne Petersen and Ove Andersen",
note = "Copyright {\circledC} 2017. Published by Elsevier Ltd.",
year = "2017",
month = "8",
day = "1",
doi = "10.1016/j.joca.2017.03.008",
language = "English",
volume = "25",
pages = "1265--1273",
journal = "Osteoarthritis and Cartilage",
issn = "1063-4584",
publisher = "W.B./Saunders Co. Ltd",
number = "8",

}

RIS

TY - JOUR

T1 - Inflammation and Post-operative Recovery in Patients undergoing Total Knee Arthroplasty- Secondary Analysis of a Randomized Controlled Trial

AU - Langkilde, Anne

AU - Jakobsen, Thomas Linding

AU - Bandholm, Thomas Quaade

AU - Eugen-Olsen, Jesper

AU - Blauenfeldt, Thomas

AU - Petersen, Janne

AU - Andersen, Ove

N1 - Copyright © 2017. Published by Elsevier Ltd.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - OBJECTIVE: Reduced function persists for many patients after total knee arthroplasty (TKA). Inflammation is part of osteoarthritis' pathophysiology, and surgery induces a marked inflammatory response. We therefore wanted to explore the role of inflammation in long-term recovery after TKA, and thus conducted this secondary analysis of our randomized controlled trial of physical rehabilitation +/- progressive strength training (PST). We aimed to investigate whether A) inflammation is associated with functional performance, knee-extension strength, and knee pain before TKA; B) PST affects inflammation, and the inflammatory state over time; C) baseline or surgery-induced inflammation modifies the effect of rehabilitation +/- PST on change in 6-minute walk test (Δ6MWT); and D) baseline or surgery-induced inflammation is associated with Δ6MWT following TKA.DESIGN: In the primary trial report's per-protocol analysis, 72/82 patients were included. Sixty had ≥1 blood sample before and after TKA, and were included in this secondary analysis. Inflammation was measured by interferon γ-inducible protein (IP)-10, soluble urokinase plasminogen activator receptor (suPAR), interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-α at baseline; day 1, week 4, 8, and 26 after TKA.RESULTS: At baseline, suPAR (p=0.03) was negatively associated with 6MWT. Neither baseline nor surgery-induced inflammation modified the response to rehabilitation +/- PST. Only surgery-induced IL-10 was associated with Δ6MWT26 weeks-baseline (p=0.001), also adjusted for 6MWTbaseline, age, sex and BMI.CONCLUSION: In this secondary analysis, only increased surgery-induced IL-10 response was associated with decreased long-term functional performance after TKA. The importance of controlling the surgery-induced immune response remains to be investigated further.TRIAL IDENTIFICATION: NCT01351831.

AB - OBJECTIVE: Reduced function persists for many patients after total knee arthroplasty (TKA). Inflammation is part of osteoarthritis' pathophysiology, and surgery induces a marked inflammatory response. We therefore wanted to explore the role of inflammation in long-term recovery after TKA, and thus conducted this secondary analysis of our randomized controlled trial of physical rehabilitation +/- progressive strength training (PST). We aimed to investigate whether A) inflammation is associated with functional performance, knee-extension strength, and knee pain before TKA; B) PST affects inflammation, and the inflammatory state over time; C) baseline or surgery-induced inflammation modifies the effect of rehabilitation +/- PST on change in 6-minute walk test (Δ6MWT); and D) baseline or surgery-induced inflammation is associated with Δ6MWT following TKA.DESIGN: In the primary trial report's per-protocol analysis, 72/82 patients were included. Sixty had ≥1 blood sample before and after TKA, and were included in this secondary analysis. Inflammation was measured by interferon γ-inducible protein (IP)-10, soluble urokinase plasminogen activator receptor (suPAR), interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-α at baseline; day 1, week 4, 8, and 26 after TKA.RESULTS: At baseline, suPAR (p=0.03) was negatively associated with 6MWT. Neither baseline nor surgery-induced inflammation modified the response to rehabilitation +/- PST. Only surgery-induced IL-10 was associated with Δ6MWT26 weeks-baseline (p=0.001), also adjusted for 6MWTbaseline, age, sex and BMI.CONCLUSION: In this secondary analysis, only increased surgery-induced IL-10 response was associated with decreased long-term functional performance after TKA. The importance of controlling the surgery-induced immune response remains to be investigated further.TRIAL IDENTIFICATION: NCT01351831.

KW - Journal Article

U2 - 10.1016/j.joca.2017.03.008

DO - 10.1016/j.joca.2017.03.008

M3 - Journal article

VL - 25

SP - 1265

EP - 1273

JO - Osteoarthritis and Cartilage

JF - Osteoarthritis and Cartilage

SN - 1063-4584

IS - 8

ER -

ID: 50133235