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de Souza Borges JH, Junior PL, de Brito FF, Rezende HP, de Souza Silva MV, Oliveira M, Barin FR. Effects of amino acid supplementation on muscle mass, muscle performance and functional capacity in subjects undergoing total knee arthroplasty: a systematic review of randomized clinical trials. Eur J Orthop Surg Traumatol 2024; 34:1717-1729. [PMID: 38236398 DOI: 10.1007/s00590-023-03824-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/21/2023] [Indexed: 01/19/2024]
Abstract
The aim of the present study was to summarize the effectiveness of amino acid supplementation on muscle strength, muscle volume, and functional capacity in patients undergoing total knee arthroplasty. For this, in November 2022, a search was carried out in the PubMed, Cochrane Library, and EMBASE databases, identifying a total of 2182 documents, of which only 4 were included in the present review. The included studies had 148 participants (47 men and 101 women), with a minimum age of 53 and a maximum of 92 years, and supplementation times of 13 to 30 days (1 to 3 times a day). For the results, in relation to muscle performance, when comparing the control and experimental groups, greater muscle atrophy was observed in the pre- and post-moments of the control group, in relation to the experimental group. In addition, studies suggest a good tendency for muscle mass gain, and improvement in the functional capacities of patients who used supplementation. Therefore, the use of amino acids after TKA surgery reduces muscle atrophy, which preserves muscle mass and leads to better performance in tests of strength and functional capacity, when compared to the use of a placebo.
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Affiliation(s)
- Jose Humberto de Souza Borges
- Research and Education Institute of the Orthopedics and Specialized Medicine Hospital (IPE-HOME), SGAS Quadra 613-Conjunto C, Brasília, Distrito Federal, 70200-730, Brazil
| | - Paulo Lobo Junior
- Research and Education Institute of the Orthopedics and Specialized Medicine Hospital (IPE-HOME), SGAS Quadra 613-Conjunto C, Brasília, Distrito Federal, 70200-730, Brazil
| | - Felipe Fagundes de Brito
- Research and Education Institute of the Orthopedics and Specialized Medicine Hospital (IPE-HOME), SGAS Quadra 613-Conjunto C, Brasília, Distrito Federal, 70200-730, Brazil
| | - Heitor Paes Rezende
- Research and Education Institute of the Orthopedics and Specialized Medicine Hospital (IPE-HOME), SGAS Quadra 613-Conjunto C, Brasília, Distrito Federal, 70200-730, Brazil
| | - Marcos Vinicius de Souza Silva
- Research and Education Institute of the Orthopedics and Specialized Medicine Hospital (IPE-HOME), SGAS Quadra 613-Conjunto C, Brasília, Distrito Federal, 70200-730, Brazil
| | - Marcio Oliveira
- Research and Education Institute of the Orthopedics and Specialized Medicine Hospital (IPE-HOME), SGAS Quadra 613-Conjunto C, Brasília, Distrito Federal, 70200-730, Brazil
| | - Fabrício Reichert Barin
- Research and Education Institute of the Orthopedics and Specialized Medicine Hospital (IPE-HOME), SGAS Quadra 613-Conjunto C, Brasília, Distrito Federal, 70200-730, Brazil.
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Gordon C, Trainor J, Shah RJ, Studholme K, Gelman A, Doswell F, Sadar F, Giovannetti A, Gershenson J, Khan A, Nicholson J, Huang Z, Spurgat M, Tang SJ, Wang H, Ojima I, Carlson D, Komatsu DE, Kaczocha M. Fatty acid binding protein 5 inhibition attenuates pronociceptive cytokine/chemokine expression and suppresses osteoarthritis pain: A comparative human and rat study. Osteoarthritis Cartilage 2024; 32:266-280. [PMID: 38035977 DOI: 10.1016/j.joca.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 10/20/2023] [Accepted: 11/02/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVE Osteoarthritis (OA) is often accompanied by debilitating pain that is refractory to available analgesics due in part to the complexity of signaling molecules that drive OA pain and our inability to target these in parallel. Fatty acid binding protein 5 (FABP5) is a lipid chaperone that regulates inflammatory pain; however, its contribution to OA pain has not been characterized. DESIGN This combined clinical and pre-clinical study utilized synovial tissues obtained from subjects with end-stage OA and rats with monoiodoacetate-induced OA. Cytokine and chemokine release from human synovia incubated with a selective FABP5 inhibitor was profiled with cytokine arrays and ELISA. Immunohistochemical analyses were conducted for FABP5 in human and rat synovium. The efficacy of FABP5 inhibitors on pain was assessed in OA rats using incapacitance as an outcome. RNA-seq was then performed to characterize the transcriptomic landscape of synovial gene expression in OA rats treated with FABP5 inhibitor or vehicle. RESULTS FABP5 was expressed in human synovium and FABP5 inhibition reduced the secretion of pronociceptive cytokines (interleukin-6 [IL6], IL8) and chemokines (CCL2, CXCL1). In rats, FABP5 was upregulated in the OA synovium and its inhibition alleviated incapacitance. The transcriptome of the rat OA synovium exhibited >6000 differentially expressed genes, including the upregulation of numerous pronociceptive cytokines and chemokines. FABP5 inhibition blunted the upregulation of the majority of these pronociceptive mediators. CONCLUSIONS FABP5 is expressed in the OA synovium and its inhibition suppresses pronociceptive signaling and pain, indicating that FABP5 inhibitors may constitute a novel class of analgesics to treat OA.
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Affiliation(s)
- Chris Gordon
- Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - James Trainor
- Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Rohan J Shah
- Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Keith Studholme
- Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Alex Gelman
- Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Faniya Doswell
- Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Faisal Sadar
- Department of Orthopaedics and Rehabilitation, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Allessio Giovannetti
- Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Josh Gershenson
- Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Ayesha Khan
- Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - James Nicholson
- Department of Orthopaedics and Rehabilitation, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - ZeYu Huang
- Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, People's Republic of China
| | - Michael Spurgat
- Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Shao-Jun Tang
- Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA; Stony Brook University Pain and Analgesia Research Center (SPARC), Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Hehe Wang
- Department of Chemistry, Stony Brook University, Stony Brook, NY, USA
| | - Iwao Ojima
- Department of Chemistry, Stony Brook University, Stony Brook, NY, USA; Institute of Chemical Biology and Drug Discovery, Stony Brook University, Stony Brook, NY, USA
| | - David Carlson
- Genomics Core Facility and Institute for Advanced Computational Sciences, Stony Brook University, Stony Brook, NY, USA
| | - David E Komatsu
- Department of Orthopaedics and Rehabilitation, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA.
| | - Martin Kaczocha
- Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA; Stony Brook University Pain and Analgesia Research Center (SPARC), Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA; Institute of Chemical Biology and Drug Discovery, Stony Brook University, Stony Brook, NY, USA.
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Marinova M, Sundaram A, Holtham K, Ebert JR, Wysocki D, Meyerkort D, Radic R. The role of a cryocompression device following total knee arthroplasty to assist in recovery: a randomised controlled trial. Knee Surg Sports Traumatol Arthrosc 2023; 31:4422-4429. [PMID: 37464101 PMCID: PMC10471706 DOI: 10.1007/s00167-023-07455-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 05/13/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE The study sought to investigate the effectiveness of a cryocompression Game Ready™ (GR) versus usual care protocol (UC) on early post-operative recovery following total knee arthroplasty. METHODS This study prospectively randomised 72 total knee arthroplasties to a 2-week (from day 0) intervention of GR treatment (n = 36, 63.9% females) or UC of ice with static compression (n = 36, 45.7% females). Knee flexion and extension range of motion (ROM), a visual analogue pain scale and limb circumference were documented at day 1, 2 and 14, as well as 6 weeks post-surgery. Medication usage and length of hospital stay were documented. Patient-reported outcome measures (PROMs) included the Knee Injury and Osteoarthritis Outcome Score and a Patient Satisfaction Questionnaire. Statistical analysis using linear mixed modelling and analysis of variance table with Satterthwaite's method were used along with two-tailed t-tests. RESULTS There were no significant group-by-time interactions regarding any of the outcomes. The GR group had 19% lost to follow-up at 2 weeks, while the UC group had 8%. The GR group demonstrated significantly better knee extension ROM at day 1 (p = 0.048) and day 14 (p = 0.007) compared with the UC group. There were no group differences (n.s.) observed in pain, flexion ROM, limb circumference, opioid use or PROMs. Overall, higher pain levels resulted in increased opioid intake (p = 0.002), older patients used significantly less opioids (p < 0.001) and males reported significantly less pain than females (p = 0.048). No adverse effects were observed due to either protocol. CONCLUSION Despite patients gaining significantly more knee extension during the initial two-week intervention period when using GR compared to UC, this effect was likely due to chance. No further significant differences were observed between the groups during or after cession of the intervention. LEVEL OF EVIDENCE Level 2.
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Affiliation(s)
- Mira Marinova
- Perth Orthopaedic and Sports Medicine Research Institute, 31 Outram St, West Perth, WA, 6005, Australia.
- Department of Orthopaedics, Royal Perth Hospital, Perth, WA, Australia.
| | - Abayasankar Sundaram
- Perth Orthopaedic and Sports Medicine Research Institute, 31 Outram St, West Perth, WA, 6005, Australia
- Perth Orthopaedic and Sports Medicine Centre, 31 Outram St, West Perth, WA, 6005, Australia
| | - Katie Holtham
- Sports Physiotherapist, Beatty Park Physiotherapy, North Perth, Australia
| | - Jay R Ebert
- Perth Orthopaedic and Sports Medicine Research Institute, 31 Outram St, West Perth, WA, 6005, Australia
- Perth Orthopaedic and Sports Medicine Centre, 31 Outram St, West Perth, WA, 6005, Australia
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Crawley, WA, Australia
| | - David Wysocki
- Perth Orthopaedic and Sports Medicine Research Institute, 31 Outram St, West Perth, WA, 6005, Australia
- Perth Orthopaedic and Sports Medicine Centre, 31 Outram St, West Perth, WA, 6005, Australia
| | - Daniel Meyerkort
- Perth Orthopaedic and Sports Medicine Research Institute, 31 Outram St, West Perth, WA, 6005, Australia
| | - Ross Radic
- Perth Orthopaedic and Sports Medicine Research Institute, 31 Outram St, West Perth, WA, 6005, Australia
- Perth Orthopaedic and Sports Medicine Centre, 31 Outram St, West Perth, WA, 6005, Australia
- Division of Surgery, School of Medicine, University of Western Australia, Crawley, WA, Australia
- Department of Orthopaedics, Royal Perth Hospital, Perth, WA, Australia
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王 晶, 李 玲, 赵 春, 杨 雪, 袁 邻. [Postoperative Sleep Disturbance in Patients Undergoing Arthroplasty: Risk Prediction Modeling Based on Logistic Regression]. Sichuan Da Xue Xue Bao Yi Xue Ban 2023; 54:759-764. [PMID: 37545070 PMCID: PMC10442638 DOI: 10.12182/20230760301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Indexed: 08/08/2023]
Abstract
Objective To construct a risk predictive model for postoperative sleep disturbance (PSD) in patients undergoing arthroplasty by using logistic regression. Methods We retrospectively collected the data of 4286 patients who underwent joint replacement surgeries at a tertiary-care hospital in Chengdu, China between January 1, 2017 and September 30, 2021. With 3001 cases in the training set and 1285 cases in the test set, we constructed the model by using a logistic regression algorithm to screen for predictors in Matlab, displaying the predicted risks of postoperative sleep disturbance with nomographs. The performance of the model was assessed by the area under the curve ( AUC) of the receiver operating characteristic curve, accuracy, precision, recall, F1 value, and calibration curve. Results A total of 9 predictors, including post-admission preoperative sleep disturbance, ward type, body mass index, smoking status, range of diseases, joint mobility (flexion), joint mobility (extension), preoperative last hemoglobin, and type of surgery, were eventually included in the study for predictive modeling . The performance assessment findings of the predictive model were as follows, AUC value, 0.708 (95% confidence interval: 0.677-0.740), accuracy, 75.20%, precision, 65.80%, recall, 43.70%, and F1 value, 0.525. The calibration curve showed good agreement between the predicted probabilities and the actual data. Conclusion The model constructed in the study has good predictive efficacy and the nomographs are simple and easy to use. With this model, health workers can make preoperative prediction of the risk of PSD in arthroplasty patients based on the predictors, which facilitates early prevention and reduces the risk of postoperative sleep disturbance in patients.
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Affiliation(s)
- 晶 王
- 四川大学华西医院/ 四川大学华西护理学院 (成都 610041)West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
| | - 玲利 李
- 四川大学华西医院/ 四川大学华西护理学院 (成都 610041)West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
| | - 春林 赵
- 四川大学华西医院/ 四川大学华西护理学院 (成都 610041)West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
| | - 雪 杨
- 四川大学华西医院/ 四川大学华西护理学院 (成都 610041)West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
| | - 邻雁 袁
- 四川大学华西医院/ 四川大学华西护理学院 (成都 610041)West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
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