Inflammatory markers in postoperative cognitive dysfunction for patients undergoing total hip arthroplasty: a meta-analysis

Objective. Logistic regression was adopted to analyze the risk factors of traumatic arthritis after total hip arthroplasty (THA) in the treatment of acetabular fractures, and the clinical treatment was enhanced. Methods. A total of 200 patients with acetabular fractures treated in our hospital from February 2019 to April 2021 were enrolled for THA. According to the occurrence of traumatic arthritis after operation, the patients were divided into control group and study group. The control group was patients without traumatic arthritis ( n = 165 ), and the study group was patients with traumatic arthritis after operation ( n = 35 ). The general data were analyzed, the risk factors of traumatic arthritis after THA for acetabular fractures were analyzed by logistic regression, and the clinical treatment methods were promoted. Results. First of all, there exhibited no significant difference in the general data such as sex, age, medical history, and operation site ( P > 0.05 ). There were significant differences in the general data of whether the patients had a job, rehabilitation exercise, and osteoarthritis before operation ( P < 0.05 ). Secondly, we compared the curative effects between two groups. The effective rate in the study group was higher compared to the control group ( P < 0.05 ). After treatment, the Harris hip function score of the study group at discharge, 1 month, 3 months, and 6 months after discharge was higher compared to that of the control group ( P < 0.05 ). The incidence of postoperative complications in the study group was significantly higher compared to that in the control group ( P < 0.05 ). The presence of osteoarthritis, curative effect, poor reduction of fracture, injury of articular cartilage, entry of internal fixation into the joint, avascular necrosis of the femoral head, and infection before operation were significantly correlated with traumatic arthritis after THA in the treatment of acetabular fractures ( P < 0.05 ). Logistic regression analysis indicated that poor reduction, curative effect, articular cartilage injury, entry of internal fixation into the joint, avascular necrosis of the femoral head, infection, and preoperative osteoarthritis were the risk factors of traumatic arthritis after THA in the treatment of acetabular fractures ( P < 0.05 ). Conclusion. Poor fracture reduction, curative effect, articular cartilage injury, internal fixation into the joint, avascular necrosis of the femoral head, infection, and the presence of osteoarthritis before operation are the risk factors of traumatic arthritis after THA in the treatment of acetabular fractures. When performing THA for patients with acetabular fracture, attention should be paid to the presence of osteoarthritis before operation, and for those with poor curative effect, attention should be paid to the occurrence of poor fracture reduction, articular cartilage injury, internal fixation into the joint, avascular necrosis of the femoral head, and combined infection, and timely intervention measures should be taken to reduce the risk of traumatic arthritis after operation.

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“…Because of hip fixation after hip fusion, it is often not acceptable to patients. At present, THA is often adopted [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Logistic Regression Analysis of Risk Factors and Improvement of Clinical Treatment of Traumatic Arthritis after Total Hip Arthroplasty (THA) in the Treatment of Acetabular Fractures

Zhang

Feng²

2022

Computational and Mathematical Methods in Medicine

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“…Last, inflammatory factors can stimulate actin in cells other than neurons in the brain, resulting in actin regeneration, a change that plays an important role in neurodegeneration ( 29 , 30 ). Previous studies had showed that postoperative serum inflammatory cytokines were elevated in THA patients, and serum IL-1β and IL-6 levels were associated with the occurrence of POCD ( 31 , 32 ). In the present study, the serum levels of IL-1β in patients of the Outside group at 1 and 6 h after surgery are significantly higher than those in the Inside group, and the serum levels of IL-6 in patients of the Outside group after surgery are significantly higher than those in the Inside group.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic Effect of the Fascia Iliaca Compartment Block with Different Approaches on Total Hip Arthroplasty and Its Effect on Postoperative Cognitive Dysfunction and Inflammation

et al. 2022

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ObjectiveThe objective of this article is to make a comparison of the anesthetic effects of the inside and outside fascia iliaca compartment block (FICB) in total hip arthroplasty (THA) and to study the effect of the different approaches of the FICB on postoperative cognitive dysfunction (POCD) and serum inflammatory cytokines in THA patients.MethodsA total of 60 patients who received THA treatment from January 2021 to December 2021 were divided into two groups, namely, Inside group (inside approach of the FICB) and Outside group (outside approach of the FICB), according to the different approaches of the FICB. Forty-eight hours after surgery, we compared the use of ropacaine dosage, visual analogue scale (VAS) score, the use of patient-controlled analgesia (PCA), mini-mental state examination (MMSE) score, the incidence of POCD, and the serum levels of IL-1, IL-6. Secondary indicators include surgical indicators and the quality of anesthesia cannula.ResultsThe ratio of re-fix the catheter, intubation time, and the use of ropacaine dosage at 48 h after surgery in the Outside group were significantly higher than that in the Inside group (p < 0.05), while the depth of cannulation in the Outside group was significantly lower than that in the Inside group (p < 0.05). VAS scores were comparable between the Inside and the Outside groups, except at 24 h after surgery. The use of PCA from 24 to 48 h after surgery in the Outside group was significantly higher than that in the Inside group (p < 0.05). The MMSE score and the incidence of POCD in the Outside group were higher than that in the Inside group. At the same time, the serum IL-1β levels at 1 and 6 h after surgery and the serum IL-6 levels at 1, 6, 24, and 48 h after surgery in the Outside group were significantly higher than that in the Inside group (p < 0.05).ConclusionCompared with the outside approach of the FICB, the inside approach of the FICB has better anesthetic effect, better postoperative analgesia, fewer postoperative analgesics, lower incidence of POCD, and lower serum cytokines during the treatment of THA patients.

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“…Previous research showed that patients with POCD after cytoreductive surgery had higher serum levels of HMGB1 than those without POCD [25] . As an essential pro-inflammatory cytokine, enhanced IL-6 levels are associated with surgical trauma and can cause cognitive deficits [26] . Postoperative IL-6 levels were significantly higher in POCD patients after total hip arthroplasty than in non-POCD patients [26] .…”

Section: Discussionmentioning

confidence: 99%

Effects of anterior approach to quadratus lumborum block on postoperative cognitive function following hip surgery in elderly patients: A randomized controlled clinical trial

Zhu

Mei

Zhou

et al. 2023

Preprint

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Background: Peripheral nerve block, including the quadratus lumborum block (QLB), has been used for postoperative analgesia in hip surgery. However, the effects of QLB on cognitive function after hip surgery remain unknown. This study aimed to assess the effects of the anterior approach to QLB on postoperative cognitive function in elderly patients undergoing hip surgery. Methods: Sixty elderly patients who underwent hip surgery from May 2021 to May 2022 were randomly divided into the QLB (n = 30) and control groups (n = 30). The Montreal Cognitive Assessment (MoCA) score was measured one day preoperatively and seven and 30 days postoperatively. The incidence of postoperative cognitive dysfunction (POCD) was examined seven and 30 days postoperatively. The visual analog scale (VAS) scores at rest and Bruggrmann comfort scale (BCS) scores 6 h (t1), 12 h (t2), 24 h (t3), and 48 h (t4) after surgery were assessed. The plasma high mobility group box protein 1 (HMGB1) and levels of interleukin-6 (IL-6) were evaluated 1 h preoperatively (baseline) and 24 h postoperatively (day 1). The requirement for rescue analgesia, time to first off-bed activity, and adverse effects after surgery were also recorded. Results: Compared with the control group, the incidence of POCD was significantly lower in the QLB group seven days postoperatively (10.7% vs. 34.5%, P = 0.033), but no difference at 30 days postoperatively (3.6% vs. 10.3%, P = 0.317). There was no significant difference in MoCA scores between the two groups at one day preoperatively and 30 days postoperatively. However, the MoCA scores at seven days postoperatively were higher in the QLB group than in the control group (P < 0.05). In the QLB group, the VAS scores at t1, t2, and t3 were lower, and the BCS scores at t1, t2, and t3 were higher than those in the control group (P < 0.05). The patients in the QLB group reported significantly fewer requirements for rescue analgesia (P < 0.05). The plasma levels of HMGB1 and IL-6 at 24 h postoperatively in the QLB group were significantly lower than in the control group (P < 0.05). The time to first off-bed activity was shorter in the QLB group (P < 0.05). There was no significant difference in the incidence of postoperative complications between the two groups. Conclusions: Anterior QLB given to elderly patients undergoing hip surgery could promote early postoperative cognitive function recovery, provide adequate postoperative analgesia, and inhibit the release of inflammatory factors. Trial registration: Chictr.org.cn identifier ChiCTR2000040724 (Date of registry: 08/12/2020, prospectively registered).

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Inflammatory markers in postoperative cognitive dysfunction for patients undergoing total hip arthroplasty: a meta-analysis

Cited by 21 publications

References 58 publications

Logistic Regression Analysis of Risk Factors and Improvement of Clinical Treatment of Traumatic Arthritis after Total Hip Arthroplasty (THA) in the Treatment of Acetabular Fractures

Logistic Regression Analysis of Risk Factors and Improvement of Clinical Treatment of Traumatic Arthritis after Total Hip Arthroplasty (THA) in the Treatment of Acetabular Fractures

Anesthetic Effect of the Fascia Iliaca Compartment Block with Different Approaches on Total Hip Arthroplasty and Its Effect on Postoperative Cognitive Dysfunction and Inflammation

Effects of anterior approach to quadratus lumborum block on postoperative cognitive function following hip surgery in elderly patients: A randomized controlled clinical trial

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