Association between serum n-3 polyunsaturated fatty acids and quadriceps weakness immediately after total knee arthroplasty

Kubo, Yusuke; Sugiyama, S.; Takachu, Rie; Tanaka, Maki; Ikeya, Masae; Sugiura, T.; Kobori, Kaori; Kobori, Masuko

doi:10.1371/journal.pone.0228460

Cited by 7 publications

(5 citation statements)

References 38 publications

(61 reference statements)

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“…Blood transfusions were not performed. Postoperative rehabilitation was similar to that described in a previous study [ 23 ].…”

Section: Methodssupporting

confidence: 62%

Association between Preoperative Long-Chain Polyunsaturated Fatty Acids and Oxidative Stress Immediately after Total Knee Arthroplasty: A Pilot Study

Kubo¹,

Ikeya

Sugiyama³

et al. 2021

Nutrients

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Quadriceps muscle atrophy following total knee arthroplasty (TKA) can be caused by tourniquet-induced ischemia–reperfusion (IR) injury, which is often accompanied by oxidative stress and inflammatory responses. n-3 long-chain polyunsaturated fatty acids (LCPUFAs), such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), exert antioxidant and anti-inflammatory effects against IR injury, whereas n-6 LCPUFAs, particularly arachidonic acid (AA), exhibit pro-inflammatory effects and promote IR injury. This study aimed to examine whether preoperative serum EPA + DHA levels and the (EPA + DHA)/AA ratio are associated with oxidative stress immediately after TKA. Fourteen eligible patients with knee osteoarthritis scheduled for unilateral TKA participated in this study. The levels of serum EPA, DHA, and AA were measured immediately before surgery. Derivatives of reactive oxygen metabolites (d-ROMs) were used as biomarkers for oxidative stress. The preoperative serum EPA + DHA levels and the (EPA + DHA)/AA ratio were found to be significantly negatively correlated with the serum d-ROM levels at 96 h after surgery, and the rate of increase in serum d-ROM levels between baseline and 96 h postoperatively. This study suggested the preoperative serum EPA + DHA levels and the (EPA + DHA)/AA ratio can be negatively associated with oxidative stress immediately after TKA.

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“…Blood transfusions were not performed. Postoperative rehabilitation was similar to that described in a previous study [ 23 ].…”

Section: Methodssupporting

confidence: 62%

Association between Preoperative Long-Chain Polyunsaturated Fatty Acids and Oxidative Stress Immediately after Total Knee Arthroplasty: A Pilot Study

Kubo¹,

Ikeya

Sugiyama³

et al. 2021

Nutrients

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“…Data were collected by four physiotherapists with extensive training in performing measurements. Perioperative care was similar to that described in a previous study [ 24 ].…”

Section: Methodsmentioning

confidence: 97%

“…Quadriceps strength was measured using the maximum voluntary isometric contraction via a pull-type hand-held dynamometer (Mobie; Sakai Medical Co., Ltd., Tokyo, Japan) as previously described [ 24 ]. Participants were tested in a seated position with a hip angle of approximately 90° and a knee angle of 75° (0° = full extension) while gripping both sides of the couch.…”

Section: Methodsmentioning

confidence: 99%

Effects of preoperative low-intensity training with slow movement on early quadriceps weakness after total knee arthroplasty in patients with knee osteoarthritis: a retrospective propensity score-matched study

Kubo¹,

Sugiyama²,

Takachu³

et al. 2020

BMC Sports Sci Med Rehabil

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Background Severe and early quadriceps weakness (QW) after total knee arthroplasty (TKA), which is caused by acute inflammation resulting from surgical trauma and tourniquet-induced ischemia-reperfusion (IR) injury, can be especially problematic. We focused on tourniquet-induced IR injury, because it has been shown to be preventable through ischemic and exercise preconditioning. Low-intensity resistance exercise with slow movement and tonic force generation (LST) share some similarities with ischemic and exercise preconditioning. The present study primarily aimed to clarify the efficacy of preoperative LST program as prehabilitation for early QW among patients with TKA using propensity score matching analysis. Methods This single-center retrospective observational study used data from patients with knee osteoarthritis (n = 277) who were scheduled to undergo unilateral TKA between August 2015 and January 2017. Those with missing outcome data due to their inability to perform tests were excluded. The LST group included participants who performed LST and aerobic exercise (LST session) more than seven times for three months prior to surgery. The control group included participants who performed less than eight LST sessions, a general and light exercise or had no exercise for three months prior to surgery. Knee circumference, thigh volume, knee pain during quadriceps strength test (QST) and timed up and go test (TUG), quadriceps strength, and TUG were measured before and 4 days after surgery. Knee swelling, thigh swelling, Δknee pain, QW, and ΔTUG were determined by comparing pre- and postoperative measurements. Results Propensity score matching generated 41 matched pairs who had nearly balanced characteristics. The LST group had a significantly lower knee and thigh swelling, QW, and ΔTUG compared to the control group (all, p < 0.05). No significant differences in Δknee pain during the QST and TUG were observed between both groups (both, p > 0.05). Conclusions The present study demonstrated the beneficial effects of preoperative LST program on knee swelling, thigh swelling, QW, and walking disability immediately after TKA.

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“…Quadriceps strength was evaluated using a pull-type hand-held dynamometer (Mobie; Sakai Medical Co., Ltd., Tokyo, Japan), as previously described 25) . The measurement consisted of three maximal isometric knee-extensor contraction (two warm-up trials and then three maximal contractions) at 75° knee flexion in a seated position separated by a 60-s pauses.…”

Section: Participants and Methodsmentioning

confidence: 99%

Effects of n-3 polyunsaturated fatty acid supplementation on quadriceps weakness immediately after total knee arthroplasty: a pilot, randomized, open-label clinical trial

Kubo¹,

Ikeya

Sugiyama³

et al. 2023

J Phys Ther Sci

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Severe quadriceps weakness immediately after total knee arthroplasty can be problematic.The n-3 long-chain polyunsaturated fatty acids have antioxidant and anti-inflammatory effects against ischemiareperfusion injury, whereas n-6 long-chain polyunsaturated fatty acids exert pro-inflammatory effects, thereby promoting ischemia-reperfusion injury. [Participants and Methods] We explored the efficacy of preoperative n-3 long-chain polyunsaturated fatty acid supplementation against early quadriceps weakness among 20 patients scheduled for total knee arthroplasty (intervention group, n=10; control group, n=10). The intervention group received 645 mg of eicosapentaenoic acid) and 215 mg of docosahexaenoic acid daily for 30 days preoperatively. Serum eicosapentaenoic acid, docosahexaenoic acid, and arachidonic acid levels were measured preoperatively. We compared serum derivatives of reactive oxygen metabolites as oxidative stress biomarkers, knee circumference, thigh volume, knee pain during the quadriceps strength test, and quadriceps strength preoperatively and 4 days postoperatively to quantify the change.[Results] Preoperative n-3 long-chain polyunsaturated fatty acid supplementation significantly increased the (eicosapentaenoic acid+docosahexaenoic acid)/arachidonic acid ratio in the intervention group. A significantly lower increase in quadriceps weakness was exhibited in the intervention group than in the control group. However, changes in oxidative stress, knee/thigh swelling, and knee pain during strength testing did not significantly differ between the two groups. [Conclusion] Preoperative n-3 long-chain polyunsaturated fatty acid supplementation exhibited beneficial effects on quadriceps weakness immediately after total knee arthroplasty.

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Association between serum n-3 polyunsaturated fatty acids and quadriceps weakness immediately after total knee arthroplasty

Cited by 7 publications

References 38 publications

Association between Preoperative Long-Chain Polyunsaturated Fatty Acids and Oxidative Stress Immediately after Total Knee Arthroplasty: A Pilot Study

Association between Preoperative Long-Chain Polyunsaturated Fatty Acids and Oxidative Stress Immediately after Total Knee Arthroplasty: A Pilot Study

Effects of preoperative low-intensity training with slow movement on early quadriceps weakness after total knee arthroplasty in patients with knee osteoarthritis: a retrospective propensity score-matched study

Effects of n-3 polyunsaturated fatty acid supplementation on quadriceps weakness immediately after total knee arthroplasty: a pilot, randomized, open-label clinical trial

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