Effectiveness of two rehabilitation treatments in the modulation of inflammation during the acute phase in patients with knee prostheses and assessment of the role of the diet in determining post-surgical inflammation.

C-reactive protein (CRP) Erythrosedimentation rate (ESR) MEDIET Questionnaire Over knee oedema (EDO) Total knee aerthroplasty (TKA) Under knee oedema (EDU)

Journal

Journal of orthopaedics
ISSN: 0972-978X
Titre abrégé: J Orthop
Pays: India
ID NLM: 101233220

Informations de publication

Date de publication:
Historique:
received: 01 04 2021
accepted: 09 05 2021
entrez: 8 6 2021
pubmed: 9 6 2021
medline: 9 6 2021
Statut: epublish

Résumé

NCT04580069. Total knee arthroplasty is associated with an elevated inflammatory response both at a local and systemic level. The main objective of this study is to demonstrate the effectiveness of lymphatic drainage and connective tissue techniques in modulating systemic inflammation. Another objective is to evaluate the existence, at baseline, of a correlation between the inflammation indices and the level of adherence to the Mediterranean diet. 34 patients were recruited, and divided into three groups. The control group followed the normal rehabilitation protocol. The other two groups were subjected, in addition to the standard treatment, to manual lymphatic drainage treatment or connective tissue techniques. The outcomes were recorded in three stages: upon entering the hospital, 1 week after entry and at follow-up 21 days after surgery. The results of the study showed that both methods, compared with the standard treatment only, positively influenced the final outcomes. In regard to the systemic inflammation, lymphatic drainage and connective techniques showed equal efficacy and similar timing in modulating ESR, while they differ in how they affect CRP. With regard to the local inflammation, the effectiveness of both methods was confirmed with some differences in the location. Finally, analysis of the correlation between inflammatory T0 indices and adherence to the Mediterranean diet showed that patients with higher adhesion index have on average lower PCR, EDO and EDU values. The post-surgical inflammatory pattern can be positively modified by the rehabilitation methods analyzed, albeit with different methodologies and timing.The influence of the diet on inflammatory parameters, although less evident, seems to show encouraging results worth of further studies.

Sections du résumé

CLINICAL TRIAL NUMBER BACKGROUND
NCT04580069.
BACKGROUND BACKGROUND
Total knee arthroplasty is associated with an elevated inflammatory response both at a local and systemic level. The main objective of this study is to demonstrate the effectiveness of lymphatic drainage and connective tissue techniques in modulating systemic inflammation. Another objective is to evaluate the existence, at baseline, of a correlation between the inflammation indices and the level of adherence to the Mediterranean diet.
METHODS METHODS
34 patients were recruited, and divided into three groups. The control group followed the normal rehabilitation protocol. The other two groups were subjected, in addition to the standard treatment, to manual lymphatic drainage treatment or connective tissue techniques. The outcomes were recorded in three stages: upon entering the hospital, 1 week after entry and at follow-up 21 days after surgery.
RESULTS RESULTS
The results of the study showed that both methods, compared with the standard treatment only, positively influenced the final outcomes. In regard to the systemic inflammation, lymphatic drainage and connective techniques showed equal efficacy and similar timing in modulating ESR, while they differ in how they affect CRP. With regard to the local inflammation, the effectiveness of both methods was confirmed with some differences in the location. Finally, analysis of the correlation between inflammatory T0 indices and adherence to the Mediterranean diet showed that patients with higher adhesion index have on average lower PCR, EDO and EDU values.
CONCLUSIONS CONCLUSIONS
The post-surgical inflammatory pattern can be positively modified by the rehabilitation methods analyzed, albeit with different methodologies and timing.The influence of the diet on inflammatory parameters, although less evident, seems to show encouraging results worth of further studies.

Identifiants

pubmed: 34099953
doi: 10.1016/j.jor.2021.05.016
pii: S0972-978X(21)00124-0
pmc: PMC8165292
doi:

Banques de données

ClinicalTrials.gov
['NCT04580069']

Types de publication

Journal Article

Langues

eng

Pagination

237-243

Informations de copyright

© 2021 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.

Références

Adv Biomed Res. 2016 Aug 30;5:148
pubmed: 27656617
Rev Bras Ortop. 2017 Mar 06;52(2):176-181
pubmed: 28409135
Eur J Pain. 1999 Jun;3(3):235-244
pubmed: 10700351
Lymphat Res Biol. 2013 Dec;11(4):219-26
pubmed: 24364845
J Int Med Res. 2001 Jan-Feb;29(1):7-12
pubmed: 11277348
Cell Commun Signal. 2019 May 17;17(1):46
pubmed: 31101051
Inflamm Res. 2015 May;64(5):321-32
pubmed: 25833014
Br J Nutr. 2011 Dec;106 Suppl 3:S5-78
pubmed: 22133051
Clin Orthop Relat Res. 2008 Jan;466(1):179-88
pubmed: 18196391
Knee. 2010 Jun;17(3):200-3
pubmed: 19875297
BioDrugs. 2011 Feb 1;25(1):27-41
pubmed: 21222494

Auteurs

Sergio Rigoni (S)

Hospital of Asiago, Health Units 7 "Pedemontana", Italy.

Luca Tagliaro (L)

Rehabilitation Clinic of Mezzaselva, Italy.

Davide Baù (D)

Osteofisio2 Rehabilitation Centre, Bassano, Italy.

Mario Scapin (M)

Hospital of Asiago, Health Units 7 "Pedemontana", Italy.

Classifications MeSH