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.
Highlights
Knee and hip osteoarthritis (OA) are frequent conditions in elder individuals, as osteoarthritis itself is one of the most common joint disorders in the world [1]
Hip arthritis was more frequent in male patients, while knee arthritis was more frequent in female patients, but those results were not statistically significant (χ2 = 2.81, p =0.093, Table 1)
Our results show that the individually designed general rehabilitation had positive effects on the patients’ blood glucose and lipids concentrations: glucose, total cholesterol, lowdensity lipoprotein cholesterol (LDL), and TG were significantly lower and high-density lipoprotein cholesterol (HDL) levels were significantly higher when compared to their initial levels
Summary
Knee and hip osteoarthritis (OA) are frequent conditions in elder individuals, as osteoarthritis itself is one of the most common joint disorders in the world [1]. Two most frequent OA complications, are prevalent among middle-aged and elderly individuals [2]. Total hip arthroplasty and knee replacement performed in patients with end-stage arthritis become more frequent since the population is aging. The effective procedure relieves patients from pain, facilitates functional activities and promotes their return to the daily activities [3, 4]. The positive role of general rehabilitation in OA has been confirmed in numerous studies. Rehabilitation, regardless of its type, significantly reduces pain, increases range of motions and muscle strength, and reduces the use of medications [5,6,7].
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