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dc.contributor.authorAltin, Recep
dc.contributor.authorYesil, Murat
dc.contributor.authorOzcan, Ozal
dc.contributor.authorKaraca, Çigdem
dc.contributor.authorSen, Serkan
dc.contributor.authorFirat, Fatma
dc.date.accessioned2023-10-20T13:23:04Z
dc.date.available2023-10-20T13:23:04Z
dc.date.issued2023en_US
dc.identifier.citationAn investigation into the cellular-level adverse effects of tourniquet use on the infrapatellar fat pad in primary total knee arthroplasty: A prospective randomized studyen_US
dc.identifier.issn2589-1294
dc.identifier.urihttps://dx.doi.org/10.5152/j.aott.2023.22164.
dc.identifier.urihttps://hdl.handle.net/20.500.12933/1659
dc.description.abstractObjective: This study aimed to examine the cellular-level adverse effects of tourniquet use on the infrapatellar fat pad (IPFP) in patients undergoing primary total knee arthroplasty (TKA). Methods: Infrapatellar fat pad samples were collected in a prospective, randomized design to compare 2 groups of primary TKA patients with a tourniquet (T) and without a tourniquet (NT). The study included 80 knees of 58 patients with a mean age of 65.91 ± 9.04 years. The authors collected 3 samples from the T group (after exposure to the fat pad "t1," just before deflating the tourniquet "t2," just before fascia closure "t3") and 2 samples from the NT group (t1 and t3) for each patient. BAX, Bcl-2, and HIF-1α staining showed the extent of cellular hypoxia and apoptosis in IPFP cells, whereas the oxidative stress index (OSI) was determined using a biochemical method. The Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Society Score (KSS), and Kujala score were used as clinical outcome measures. Results: The mean HIF-1α, BAX/Bcl-2, and OSI scores across all time points were significantly higher in the T group than in the NT group (p<0.001) (d=1.16, 2.9, and 0.9, respectively). The mean BAX/Bcl-2 (P=.030) and HIF-1α (P < .001) scores significantly peaked at t2 in the T group (d=-1.2 and -3.9, respectively). The OSI had higher levels at t1 (P=.011) and t3 (P=.073) (d=0.2 and 0.1, respectively) than at t2 in the T group. The third-month postoperative follow-up revealed that the mean KOOS, KSS, and Kujala score improved significantly compared to the baseline preoperative values (P < .001); however, there was no difference between the T and NT groups regarding the maximum and total knee range of motion or clinical outcome scores. Conclusion: Evidence from this study has shown that tourniquet use during primary TKA may be associated with significantly increased cellular hypoxia, oxidative stress, and apoptosis in the IPFP. Level of evidence: Level I, Therapeutic study.en_US
dc.language.isoengen_US
dc.publisherTurkish Association of Orthopaedics and Traumatology with publishing services by AVESen_US
dc.relation.isversionof10.5152/j.aott.2023.22164.en_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.titleAn investigation into the cellular-level adverse effects of tourniquet use on the infrapatellar fat pad in primary total knee arthroplasty: A prospective randomized studyen_US
dc.typearticleen_US
dc.authorid0000-0003-4386-9120en_US
dc.departmentAFSÜen_US
dc.contributor.institutionauthorAltin, Recep
dc.contributor.institutionauthorYesil, Murat
dc.contributor.institutionauthorOzcan, Ozal
dc.contributor.institutionauthorKaraca, Çigdem
dc.contributor.institutionauthorFirat, Fatma
dc.relation.journalActa orthopaedica et traumatologica turcicaen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US


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