General, 21-Day Postoperative Rehabilitation Program Has Beneficial Effect on Oxidative Stress Markers in Patients after Total Hip or Knee Replacement

Abstract

Imbalance in prooxidant-antioxidant equilibrium plays an important role in the progression of osteoarthritis (OA). Postoperative rehabilitation significantly improves the functional activity of patients with OA. We aimed to assess the effect of the general 21-day postoperative rehabilitation on the oxidative stress markers in patients after total hip arthroplasty or knee replacement. Patients (n =41) started individually designed postoperative rehabilitation ca. 90 days after endoprosthesis implantation. We used the six-minute walk test (6MWT) to quantify the changes in their exercise capacity. We analyzed the oxidative stress markers: total antioxidant capacity (TAC), total superoxide dismutase (SOD), Cu-Zn-superoxide dismutase (CuZnSOD) and ceruloplasmin (Cp) activity, malondialdehyde (MDA) and lipofuscin (LPS) concentration in patients serum to asses changes in the oxidative stress intensity. We found that after 21-days postoperative rehabilitation program: the average distance walked by patients increased by 69 m; TAC increased by 0.20 ± 0.14 mmol/l; both SOD isoforms activities increased by 1.6 (±1.7) and 1.72 (±1.5) NU/ml, respectively; but Cp activity decreased by 1.8 (0.7-3.7) mg/dl. Also, we observed lower concentrations of lipid peroxidation markers: by 19.6 ± 24.4 μmol/l for MDA and by 0.4 ± 0.5 RF for LPS. A 21-day postoperative rehabilitation program effectively reduces oxidative processes, which helps the patients after total hip or knee replacement in a successful recovery.

Risk Factors and a Nomogram Model Establishment for Postoperative Delirium in Elderly Patients Undergoing Arthroplasty Surgery: A Single-Center Retrospective Study

“…Currently, knee and hip arthroplasty are taking up an increasing proportion of orthopedic surgery, and the demand especially from those patients mainly over 60 years old will continue to grow [ 1 , 2 ]. Evidence has indicated that postoperative delirium (POD) is a relatively common and serious complication in patients undergoing hip and knee arthroplasty, and the probability of occurrence is up to 17.6% [ 3 ].…”

General Rehabilitation Program after Knee or Hip Replacement Significantly Influences Erythrocytes Oxidative Stress Markers and Serum ST2 Levels

“…Our previous work presented the biochemical and morphological characteristics of the blood of patients before and after the 21-day general rehabilitation program [ 40 ]. Here, we assessed whether the biochemical parameters analyzed in the patients' serum changed compared to the laboratory norm [ 55 ].…”

“…Before starting and after completing the 21-day general rehabilitation program, each patient underwent the 6-minute walk test (6MWT) [ 44 ] to track changes in the patient's functional exercise capacity and assess the effectiveness of the rehabilitation program [ 45 , 46 ]. The results of the 6-minute walk test (6MWT) after a 21-day general rehabilitation in the studied patients were presented in Skrzep-Poloczek et al [ 40 ].…”

“…The American Heart Association and American College of Cardiology indicated ST2 as an important factor of heart failure: it predicts hospitalization and death in patients and, together with natriuretic peptides, shows a prognostic value [ 39 ]. Our previous study reported that a 21-day general rehabilitation significantly improved patients' physical efficiency and exercise capacity after hip or knee replacement [ 40 ]. Rheumatic diseases are chronic inflammatory disorders in which the immune system attacks itself and the body's organs [ 41 ].…”

“…However, changes in erythrocytes' properties can lead to impaired oxygen transport and result in cell and tissue hypoxia [ 42 ]. Our previous work presented significant changes in the plasma parameters related to the 21-day postoperative general rehabilitation [ 40 ]. Since, selected in this work, oxidative stress markers and also ST2 are important and sensitive indicators of inflammatory, prooxidative, and cardiac status, we aimed to observe the effects of 21-day general rehabilitation program on the erythrocytes' redox status and changes in ST2 serum levels in patients after knee or hip surgical replacement in the course of osteoarthritis.…”