Oxidative stress in bilateral total knee replacement, under ischaemic tourniquet

Y. J. Cheng, C. T. Chien, C. F. Chen

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Free radicals, such as reactive oxygen species (ROS) which are released abruptly after deflation of an ischaemic tourniquet, cause reperfusion injuries. Ischaemic precondition (IPC), however, can reduce the injury. In clinical practice, the sequential application and release of tourniquets is often used in bilateral total knee replacement (TKR) to obtain a clearer operative field, but the effects on the production of free radicals and lipid peroxidation have not been studied. In this study, we have observed the production of free radicals and the subsequent lipid peroxidation in bilateral TKR with sequential application of a tourniquet to examine the effect of IPC. Patients undergoing elective TKR under intrathecal anaesthesia were studied. Blood samples were obtained after spinal anaesthesia, one minute before and five and 20 minutes after release of each tourniquet. We used the lucigenin chemiluminescence analysis and the phosphatidylcholine hydroperoxide (PCOOH) assay to measure the production of ROS and lipid peroxidation. Our results showed that production of ROS significantly increased at five and 20 minutes after release of the first tourniquet and at five minutes after release of the second tourniquet, but returned to normal at 20 minutes after the second reperfusion. The peak production of ROS was at 20 minutes after the first reperfusion; lipid peroxidation did not change significantly. We conclude that in spite of significant production of ROS after the release of tourniquet, the IPC phenomenon occurs during bilateral TKR with sequential application of a tourniquet.

Original languageEnglish
Pages (from-to)679-682
Number of pages4
JournalJournal of Bone and Joint Surgery - Series B
Volume85
Issue number5
Publication statusPublished - 2003 Jul 1

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Tourniquets
Knee Replacement Arthroplasties
Oxidative Stress
Reactive Oxygen Species
Lipid Peroxidation
Free Radicals
Reperfusion
Spinal Anesthesia
Luminescence
Reperfusion Injury
Anesthesia
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Oxidative stress in bilateral total knee replacement, under ischaemic tourniquet. / Cheng, Y. J.; Chien, C. T.; Chen, C. F.

In: Journal of Bone and Joint Surgery - Series B, Vol. 85, No. 5, 01.07.2003, p. 679-682.

Research output: Contribution to journalArticle

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