Changes of related cytokine levels before and after minimally invasive total hip replacement / 中国组织工程研究

ABSTRACT

BACKGROUND: Compared with conventional total hip replacement, minimally invasive total hip replacement has some advantages, such as small incision, less blood loss, light pain, low incidence of dislocation, and short rehabilitation period. However, changes in post-displacement stress and in vivo metabolism-related serological indicators have not been systematically reported. OBJECTIVE: To observe cytokines and curative effect before and after minimally invasive total hip replacement and conventional total hip replacement. METHODS: We selected 178 patients who underwent unilateral total hip replacement in the Department of Bone and Joint Surgery, Affiliated Hospital of Southwest Medical University from January 2015 to January 2017. They were randomly divided into observation group (89 cases) and control group (89 cases). The control group was treated by total hip arthroplasty through the standard invasive posterolateral approach. The observation group was treated by total hip arthroplasty through the minimally invasive anterolateral approach. The related operation indexes were recorded in two groups. Harris score was analyzed preoperatively, 1, 3, 6 and 12 months after surgery. The serum levels of interleukin (IL)-1, IL-6, IL-10, tumor necrosis factor (TNF)-α and procalcitonin were measured by enzyme linked immunosorbent assay preoperatively, 1 and 3 days after surgery. RESULTS AND CONCLUSION: (1) All patients were followed up for 12 months. (2) Age, sex, body mass index and joint replacement site were not significantly different in both groups (P > 0.05). (3) The operation time, hospital stay and incision length in the observation group were shorter than those in the control group. The blood loss, blood transfusion, and postoperative drainage in the observation group were less than those in the control group (P < 0.05). (4) Harris Score increased at various time points after replacement in both groups. Harris score was significantly higher in the observation group than in the control group at 1 and 3 months after surgery (P < 0.05). (5) The serum levels of IL-1, IL-6, IL-10, TNF-α and procalcitonin in the observation group were significantly lower than in the control group 1 and 3 days after surgery. (6) These findings confirm that minimally invasive total hip arthroplasty has better curative effect than conventional total hip arthroplasty, and can reduce related cytokine levels, and is more conducive to the rapid recovery of lower extremity motor function.