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Obese patients may experience inflammatory response, endothelial dysfunction after knee surgery
Endothelial repair may be affected in obese patients due to an inflammatory disease after surgery resulting from high levels of endothelial microparticles, a low amount of endothelial progenitor cells and increasing levels of adipokines, according to study results.
Researchers prospectively assessed 74 patients who underwent total knee arthroplasty (TKA). Patients were divided into tertiles according to BMI. Clinical findings documented included age; sex; BMI; hypertension; diabetes; hyperlipidemia; and current alcohol, smoking and medication consumption.
Utilizing flow cytometry, the researchers counted and characterized endothelial microparticles, endothelial progenitor cells and adipokines. With enzyme-linked immunosorbent assay, researchers calculated adioponectin levels. The researchers also drew 10-mL blood samples before, directly after and 72 hours after surgery.
Results showed, compared with nonobese patients, obese patients had a greater number of endothelial microparticles. All patient tertiles were observed to have an increase in endothelial microparticles after surgery. After 3 days postoperatively, endothelial progenitor cells returned to basal preoperative levels in all cases except in the most obese patients. Additionally, obese patients had a lower percentage of endothelial progenitor cells, according to the researchers.
After surgery, increased concentrations of adipokines were observed in all tertiles, but were more prominent in obese patients. Hypertension, sex, and diabetes did not significantly affect outcomes, according to the researchers. ‒ by Monica Jaramillo
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