Vitamin C and inflammatory cytokine levels in elective total knee arthroplasty

Shah, Shital; Brown, Christopher R.; Owen, John R.; Fisher, Bernard; Natarajan, Ramesh; Kates, Stephen L.

doi:10.1177/0260106020910632

Cited by 5 publications

(11 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…12,58 Recent studies have examined the role of vitamin C supplementation to potentiate patient outcomes following ACL reconstruction and total knee arthroplasty (TKA). 7,[59][60][61][62] Barker et al 62 sought to determine the effect of preoperative vitamin C supplementation on inflammation following ACL reconstruction. A total of oxidant group, receiving 500 mg vitamin C and 200 IU of vitamin E twice daily, or the matching placebo.…”

Section: Acl Reconstruction and Knee Arthroplastymentioning

confidence: 99%

“…59 The small sample size and short study period were acknowledged as limitations. 59 Vitamin C's role following TKA and ACL reconstruction is not fully understood and evidence to support its perioperative use in patients undergoing knee joint procedures remains very limited.…”

Section: Acl Reconstruction and Knee Arthroplastymentioning

confidence: 99%

“…Similarly, some studies have evaluated the role of vitamin C supplementation in the outcomes of patients who undergo knee replacement surgery 7,59–61 . Behrend et al 7 investigated whether perioperative vitamin C supplementation impacts knee range of motion and risk of arthrofibrosis (AF) following TKA.…”

Section: Introductionmentioning

confidence: 99%

“…Behrend et al 7 recognized that the study was limited by an insufficient sample size and a lack of measured biomarkers related to inflammation. Meanwhile, Shah et al 59 measured changes in vitamin C and inflammatory cytokine levels in TKA patients. Blood samples were collected from 10 patients pre‐ and postoperatively 59 .…”

Section: Introductionmentioning

confidence: 99%

“…Meanwhile, Shah et al 59 measured changes in vitamin C and inflammatory cytokine levels in TKA patients. Blood samples were collected from 10 patients pre‐ and postoperatively 59 . The authors witnessed a significant increase in inflammation, but no significant changes in serum vitamin C levels following TKA 59 .…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Vitamin C in orthopedic practices: Current concepts, novel ideas, and future perspectives

Oakes

Bolia

Weber

et al. 2021

Journal Orthopaedic Research

View full text Add to dashboard Cite

Vitamin C (ascorbic acid), is an important antioxidant that has been applied broadly in the field of orthopaedics. Current research on vitamin C examines the molecule's role in bone and tendon physiology, as well as joint replacement and Postoperative pain. Most laboratory and human studies associate the use of vitamin C with improved bone health and tendon healing. Recent literature moderately supports the use of vitamin C to improve functional outcomes, decreased postoperative pain, and prevent complex regional pain syndrome following orthopaedic procedures. The perioperative use of vitamin C in patients undergoing joint replacement surgery and anterior cruciate ligament reconstruction is still under investigation. Overall, there is need for high-quality human trials to confirm whether vitamin C can potentiate the outcomes of orthopaedic procedures and to determine optimal dosage and means of administration to maximize its proposed benefits. The purpose of this review was to summarize the application of vitamin C in orthopaedic practices and to identify potential areas for future study. K E Y W O R D S bone, orthopedics, pain management, tendons, vitamin C 1 | INTRODUCTION Vitamin C (ascorbic acid), is an important antioxidant and deficiency of this mineral is most often associated with scurvy. 1 Vitamin C is vital to the production of collagen in both bone and connective tissue and it has been associated with improved collagen synthesis and subsequent tendon healing. 2-4 It also neutralizes free radicals, which helps to decrease oxidative stress and inflammation. 5 Vitamin C has also been used as a supplement in orthopaedic patients. 6-8 Vitamin C has been linked to improved bone mineral density as well as decreased risk of bone fracture and osteoporosis. 9-11 Furthermore, there is recent evidence to suggest that vitamin C may have a protective role in osteoarthritis. 12 From a postoperative recovery perspective, vitamin C has been found to reduce the incidence of complex regional pain syndrome (CRPS) and improve functional outcomes. 5,13 However, some of these conclusions on the therapeutic effect of vitamin C continue to be debated. 14 The purpose of this review was to summarize the role of vitamin C in orthopaedic practices and to identify potential areas for future study. 1.1 | Perioperative pain management Postoperative pain exists as a common challenge to orthopaedic surgeons, as it is linked to increased risk of postoperative complications, longer hospital stays, and significant delays in the return to regular function. 15 Opioids, such as morphine, may be prescribed to limit postoperative pain in orthopedic patients; however, there are a multitude of side effects associated with their use

show abstract

Section: Acl Reconstruction and Knee Arthroplastymentioning

confidence: 99%

Section: Acl Reconstruction and Knee Arthroplastymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Vitamin C in orthopedic practices: Current concepts, novel ideas, and future perspectives

Oakes

Bolia

Weber

et al. 2021

Journal Orthopaedic Research

View full text Add to dashboard Cite

show abstract

Early Postoperative Pain Control and Inflammation for Total Knee Arthroplasty: A Retrospective Comparison of Continuous Adductor Canal Block versus Single-Shot Adductor Canal Block Combined with Patient-Controlled Intravenous Analgesia

Yang

Dong

Xiong

et al. 2022

Emergency Medicine International

View full text Add to dashboard Cite

Objective. The aim of this study was to compare pain control and inflammation among patients who received a continuous adductor canal block (CACB) versus single-shot adductor canal block (SACB) combined with patient-controlled intravenous analgesia (PCIA) for total knee arthroplasty (TKA) analgesia in the first two days after surgery. Design. Matched cohort retrospective study. Setting. University hospital. Patients. One hundred fifty-six patient charts were included in this study: 78 patients with CACB in Group A and 78 patients with SACB combined with PCIA in Group B. Patients were matched according to age, body mass index, and American Society of Anesthesiologists class. Measurements. The primary outcome of the study was Visual Analogue Scale (VAS) pain scores before operation (Pre) and at postoperative 6 (POH6), 12 (POH12), 24 (POH24), 30 (POH30), 36 (POH36), and 48 hours (POH48). Secondary outcomes included patient-controlled bolus, time of first postoperative ambulation, range of knee flexion and extension, inflammation cytokines on Pre and POH48, percentage of remedial analgesics treatment, incidence of adverse events and complications, hospital stay and cost, and Numerical Rating Scale (NRS) satisfaction scores at discharge. Main Results. Mean VAS scores at rest and with motion were lower in Group B than in Group A on all postoperative hours. At POH30, compared with Group A (1.1 ± 0.6), mean VAS scores at rest in Group B (0.9 ± 0.4) were lower ( P = 0.048 ), and compared with Group A (2.6 ± 0.7), mean VAS scores with motion in Group B (2.2 ± 0.8) were lower ( P = 0.001 ). The number of patient-controlled bolus was 4.3 ± 1.6 (95% CI 3.9–4.6) in Group A and 3.1 ± 1.3 (95% CI 2.8–3.4) in Group B, respectively ( P < 0.001 ). Patients in Group B displayed better functional recovery and inflammation results at POH48 than Group A with respect to range of knee flexion and extension (117.8 ± 10.9° vs. 125.2 ± 9.4°, P < 0.001 ) and inflammation cytokines, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and interleukin-6 (IL-6) ((43.8 ± 16.1) vs. (36.8 ± 13.2), P = 0.003 ; (34.9 ± 9.4 mg/L) vs. (29.6 ± 10.6 mg/L), P = 0.001 ; (21.3 ± 8.7 pg/ml) vs. (14.0 ± 7.0 pg/ml), P < 0.001 )). Conclusion. SACB combined with PCIA in the first two days of patients undergoing TKA has better analgesic and beneficial effects on functional recovery and inflammation.

show abstract

Functional and biochemical improvement following total knee arthroplasty in early postoperative period

Erden

Emirzeoğlu

CANLI

et al. 2022

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

OBJECTIVE: There are very few studies about total knee arthroplasty biomechanical and biochemical effects in the early postoperative period. The aim of this study was to investigate the effect of total knee arthroplasty on pain intensity, knee joint valgus angle, malalignment, functional status, knee joint position sense, and cytokine levels. METHODS: A total of 29 patients (female/male: 24/5) who underwent total knee arthroplasty were included in the late-stage knee osteoarthritis group, and 22 patients (female/male: 13/9) with grade 4 osteoarthritis were included in the early-stage knee osteoarthritis group. The visual analog scale and the Western Ontario and McMaster Universities Osteoarthritis Index were used to evaluate the pain intensity and functional status. Alignment and knee position sense measurements were also calculated. Systemic venous blood samples were taken to evaluate the interleukin-6, tumor necrosis factor-alpha, and interleukin-1 beta cytokine levels. RESULTS: In the study group, there were positive improvements in pain intensity, functional status, valgus angle, malalignment, amount of joint position sense deviation at 70° knee flexion angle parameters, and interleukin-6 of patients at the postoperative 6th week compared to the preoperative period (p<0.05). The patients in the study group had similar or better results in pain intensity, functional status, valgus angle, malalignment, amount of joint position sense deviation at 35°, 55°, and 70° knee flexion angles parameters, and in interleukin-6, compared to the control group at postoperative 6th week. CONCLUSION: Total knee arthroplasty provides improvements in pain, function, valgus angle, joint position sense, and interleukin-6 in the early postoperative period.

show abstract

Vitamin C and inflammatory cytokine levels in elective total knee arthroplasty

Cited by 5 publications

References 19 publications

Vitamin C in orthopedic practices: Current concepts, novel ideas, and future perspectives

Vitamin C in orthopedic practices: Current concepts, novel ideas, and future perspectives

Early Postoperative Pain Control and Inflammation for Total Knee Arthroplasty: A Retrospective Comparison of Continuous Adductor Canal Block versus Single-Shot Adductor Canal Block Combined with Patient-Controlled Intravenous Analgesia

Functional and biochemical improvement following total knee arthroplasty in early postoperative period

Contact Info

Product

Resources

About