Urinary neopterin and total neopterin measurements allow monitoring of oxidative stress and inflammation levels of knee and hip arthroplasty patients.

Gary Hooper,Elena Moltchanova,Gregory Baxter-Parker,Siddarth Raajasekar,Jay Jefferies,Lloyd Roffe,Steven P. Gieseg

doi:10.1371/journal.pone.0256072

Gary Hooper, Elena Moltchanova + Show 5 more

Open Access

https://doi.org/10.1371/journal.pone.0256072

Copy DOI

Journal: PloS one	Publication Date: Aug 17, 2021
Citations: 4	License type: CC BY 4.0

Affiliation: University of Otago, University of Canterbury

Abstract

Knee and hip arthroplasty are common surgeries within an aging population. Some data has suggested that knee arthroplasty is more traumatic to the body than hip arthroplasty due to the increased complexity and load bearing nature of the joint. Here, we compare the stress of the two surgeries by measuring urinary neopterin and total neopterin as biomarkers of oxidative stress and inflammation. Urinary neopterin and total neopterin (neopterin + 7,8-dihydroneopterin) levels were analysed in 28 knee and 22 hip arthroplasty patients pre- and post-operatively to determine oxidative stress and inflammation levels. Total neopterin was 31.1% higher with knee arthroplasty (p<0.05). Urinary neopterin was 32.8% higher in the knee arthroplasty group versus hips. The increase in neopterin and total neopterin following a post-surgical decrease in levels was significant in both groups. Levels of neopterin and total neopterin were varied between patients, but all increased following surgery and subsided by day 28. The increased levels of urinary neopterin and total neopterin from knee arthroplasty indicate that knee osteoarthritis and arthroplasty is a more significant trauma to the body than hip osteoarthritis and arthroplasty surgery. This is also shown by faster inflammatory resolution following hip arthroplasty.

Highlights

Surgery is deliberate but controlled trauma to the body and as a result, sets off a range of stress responses including inflammatory cascades
Urinary neopterin and total neopterin were measured to determine the levels of oxidative stress and inflammation in knee and hip arthroplasty patients
Pre-surgical urinary neopterin and total neopterin levels were higher in knee arthroplasty patients than hip patients

Summary

Introduction

Surgery is deliberate but controlled trauma to the body and as a result, sets off a range of stress responses including inflammatory cascades. The levels of tissue disruption from the surgical trauma is expected to be reflected in the scale of the body’s response especially in the level of inflammation. Hip arthroplasty is often reported by surgeons to be less traumatic to the body than knee arthroplasty, which is reflected in poorer functional outcomes after 5 years and decreased reported quality of life [1,2]. Urinary neopterin levels of knee and hip arthroplasty patients.

Methods

Results

Discussion

Conclusion