Clin Orthop Surg.  2014 Sep;6(3):279-284. 10.4055/cios.2014.6.3.279.

Quantitative Analysis of Tissue Injury after Minimally Invasive Total Hip Arthroplasty

• Kwak S
• Chun Y
• Rhyu K
• Cha J
• Cho Y

• KMID: 1794708
• DOI: http://doi.org/10.4055/cios.2014.6.3.279

Abstract

BACKGROUND
We intended to clarify the hypothesis that minimally invasive total hip arthroplasty (MI-THA) leads to less tissue damage and inflammatory response than does conventional total hip arthroplasty (C-THA).
METHODS
We performed 30 cases of THA between September 2005 and May 2006 and evaluated these cases prospectively. We chose 15 MI-THA cases for the study group and another 15 C-THA cases for the control group. We checked skeletal muscle marker enzymes, such as serum creatinine kinase and aldolase, the pro-inflammatory cytokines, interleukin (IL)-6 and 8, and the anti-inflammatory cytokines, IL-10 and IL-1 receptor antagonist (ra) the day before surgery and at postoperative days 1, 7, and 14.
RESULTS
On postoperative days 1 and 3, the study group showed significantly lower serum creatinine kinase, IL-6, IL-10, and IL-1ra values than those in the control group. Additionally, IL-8 was significantly lower on day 7 after surgery.
CONCLUSIONS
These data show that MI-THA decreased the release of muscle marker enzymes due to tissue damage immediately after surgery and minimized the inflammatory response related to the surgery during the early postoperative period.

Keyword

Total hip arthroplasty; Minimally invasive surgery; Muscle enzyme

MeSH Terms

Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip/*adverse effects
Biological Markers/blood
Creatine Kinase/blood
Female
Fructose-Bisphosphate Aldolase/blood
Humans
Interleukin 1 Receptor Antagonist Protein/blood
Interleukin-10/blood
Interleukin-6/blood
Interleukin-8/blood
Male
Middle Aged
Minimally Invasive Surgical Procedures/adverse effects
Soft Tissue Injuries/*blood/etiology
Biological Markers
Creatine Kinase
Fructose-Bisphosphate Aldolase
Interleukin 1 Receptor Antagonist Protein
Interleukin-10
Interleukin-6
Interleukin-8

Figure

• 

  Fig. 1 Visual analog pain scale (VAS) scores for both groups show no significant differences. POD: postoperative day.

• 

  Fig. 2 Serum creatine kinase (CK) concentrations for the study group show significantly lower level than the control group on postoperative day (POD) 1 (p = 0.0) and 3 (p = 0.0).

• 

  Fig. 3 Serum aldolase concentrations for the study group show significantly lower level than the control group on postoperative day (POD) 1 (p = 0.0).

• 

  Fig. 4 Serum interleukin (IL)-6 concentrations for the study group show significantly lower level than the control group on postoperative day (POD) 1 (p = 0.0) and 3 (p = 0.0).

• 

  Fig. 5 Serum interleukin (IL)-8 concentrations for the study group show significantly lower level than the control group on postoperative day (POD) 1 (p = 0.002), 3 (p = 0.0), and 7 (p = 0.0).

• 

  Fig. 6 Serum interleukin (IL)-10 concentrations for the study group show significantly lower level than the control group on postoperative day (POD) 1 (p = 0.0) and 3 (p = 0.0).

• 

  Fig. 7 Serum interleukin 1 receptor antagonist (IL-1ra) concentrations for the study group show significantly lower level than the control group on postoperative day (POD) 1 (p = 0.0) and 3 (p = 0.0).

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