Jurnalul de Chirurgie
 Jurnalul de chirurgie
Aparitie trimestriala in a doua luna a trimestrului
Published quarterly in the second month of the quarter
ISSN: 1584 - 9341 Vol.10 Nr.3 - Iulie-Septembrie 2014 | luni, 22 aprilie 2019
ISSN: 1584 - 9341 Vol.10 No.3 - July-September 2014
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APPRECIATION OF INFLAMMATORY AND NEUROENDOCRINE STRESS IN TWO TYPES OF SURGICAL APPROACH IN TOTAL KNEE ARTHROPLASTY
Maria Stoica (1), D. Grecu (2), V. Șurlin (3), Daniela Cernea (1), F. Purcaru (1)
(1) Intensive Care Department, University of Medicine and Pharmacy Craiova
(2) Ortopedy and Traumatology Clinic, University of Medicine and Pharmacy Craiova
(3) First Surgical Clinic, University of Medicine and Pharmacy Craiova
Jurnalul de chirurgie 2011; 7 (3): 394-400
Full text:
Format PDF (Română/Romanian)

Abstract:

Introduction.
Total knee arthroplasty (TKA) is one of the major orthopedic surgical interventions, causing a severe inflammatory and neuroendocrine response. There are permanent preoccupations to elect a surgical technique capable to reduce the proportions of such response. Objective. The authors compared the endocrine and inflammatory stress after two types of surgical approach in knee replacement: internal parapatellar approach and subvastus medialis. Material & methods. The study is analyzing a number of 18 patients divided in two groups: group A interior parapatellar approach (IPA) - 8 patients and group B - subvastus medialis approach (SMA) - 10 patients. In both groups IL-6 and serum cortisol levels pre-, intra and at 24 h postoperatory, pre and postoperatory levels of: CRP, Hb, leucocytes and lymphocytes were measured. In the same time, parameters related to surgery were recorded: incision length, blood loss, blood transfusions, drug use. Results. Serum values of IL-6 increased immediately after surgery, with peak at 24 hours postoperatively, and presented significant differences between the two groups later after surgery. Immediate after surgery, serum cortisol level decreased, concomitant with the increase of IL-6 values, particularly in API group; after 24 hours a positive correlation exists between the two markers. CRP values are increasing significantly at 24 hours after TKA in both groups, with a small advantage for group A. Conclusion. Stress response in TKA is less when using subvastus medialis approach comparing to internal parapatellar approach.

KEY WORDS: INTERLEUKIN-6, CORTISOL, KNEE, ARTHROPLASTY

Correspondence to: Valeriu Șurlin, MD, PhD, Address: Calea București A8b 3/10, 200484, Craiova, Dolj, Romania, Tel: 0040740182346, e-mail:



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Jurnalul de chirurgie [Journal of Surgery] by Editorial Board, Department of Surgery University of Medicine and Pharmacy Iasi, E. Tarcoveanu, R. Moldovanu is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
Based on a work at www.jurnaluldechirurgie.ro.