Postoperative creatine kinase elevation following hip arthroscopy and associated risk factors

Abstract

ObjectiveThe aim of this study was to investigate postoperative CK and risk factors for CK elevation after hip arthroscopy.MethodsThis retrospective study reviewed 122 patients (50 males, 72 females; mean age, 44.1 years) who underwent hip arthroscopy from September 2012 to March 2018. For all patients, CK was investigated preoperatively, on postoperative days 1 and 3, and at postoperative weeks 1 and 2. Univariate and multivariate analysis was performed for parameters including sex, age, body mass index, preoperative glomerular filtration rate, diagnosis, duration of surgery, and duration of traction to determine the risk factors for CK > 10 upper limit of normal (CK > 10 ULN; 1900 IU/L for males and 1500 IU/L for females) after surgery.ResultsMean CK was 104.7 ± 68.7 IU/L preoperatively and 839.2 ± 2214.0, 523.9 ± 1449.4, 186.0 ± 690.7, and 122.0 ± 307.1 IU/L on postoperative days 1 and 3 and at postoperative weeks 1 and 2, respectively. CK was significantly higher on postoperative days 1 and 3 than before surgery. In total, 11 patients (9.0%), including 8 males (16.0%) and 3 females (4.2%), had CK > 10 ULN. Younger age and longer duration of traction are independent risk factors for CK > 10 ULN.ConclusionAfter hip arthroscopy, CK levels should be monitored, especially in young patients and cases of prolonged duration of traction during surgery.Level of evidenceLevel IV, therapeutic study.

Changes In Serum Creatine Kinase In Patient After Total Hip Arthroplasty

“…An accurate assessment of the pain cause is extremely difficult to construct and a complete differential diagnosis is fundamental. We assess all the possible causes of hip pain after THA and we divide them depending on the presence or absence of radiographic signs (Tonotsuka, 2019). Total hip arthroplasty (THA) is one of the most clinically successful and cost-effective interventions in health care, with excellent longterm results in terms of reducing pain and improving function and quality of life in patients with debilitating hip disease.…”

“…An accurate assessment of the pain cause is extremely difficult to construct and a complete differential diagnosis is fundamental. We assess all the possible causes of hip pain after THA and we divide them depending on the presence or absence of radiographic signs (Tonotsuka, 2019) Results from a Danish nationwide study found that 12.1% of patients 12-18 months after hip arthroplasty were significantly impaired in their daily activities by chronic pain. The occurrence of pain following a technically satisfactory arthroplasty is of concern for both the orthopaedic surgeon and the patient.…”

“…A smaller incision but cause more trauma to soft tissue is not less invasive than a bigger incision with less trauma. Using laboratory data in serum to measure muscle damage provide an objective method to evaluate the invasiveness between different surgical techniques and approaches (Tonotsuka, 2019). Creatine phosphokinase (CPK) also known as creatine kinase is an enzyme which catalyzes the conversion of creatine and utilizes adenosine triphosphate (ATP) to create phosphocreatine (PCr) and adenosine diphosphate (ADP).…”

Intraoperative traction has a negligible time-dependent influence on patient-reported outcomes after hip arthroscopy: a cohort study

“…The majority of these problems resolve after a few weeks; however, in extreme cases, it can cause semi-permanent to permanent disabilities [ 3 ]. Furthermore, studies have demonstrated an association between gross traction and rising levels of creatine kinase and d -dimer [ 6 , 7 ]. These studies suggest physiologic changes that may expose patients to systemic complications, although no clinical correlation is yet made.…”