Endothelin‐1 is secreted after total knee arthroplasty regardless of the use of a tourniquet
- 1 March 2005
- journal article
- Published by Wiley in Journal of Orthopaedic Research
- Vol. 23 (2), 392-396
- https://doi.org/10.1016/j.orthres.2004.08.021
Abstract
Early infections and wound healing disorders after implantation of a total knee replacement occur regardless of the intraoperative use of a tourniquet. The biochemical regulatory processes responsible for the disturbances in microcirculation and thus the potential therapeutic options have yet to be elucidated. The hypothesis of the present paper was that endothelin-1 (ET-1), a mediator of microcirculation disturbances in parenchymatous organs, also is released after major operations on peripheral joints. The concentration of ET-1 in the plasma was determined preoperatively and at 10 postoperative time points (5 min-48 h) with (group A, n=10) and without the use of a tourniquet (group B, n=10). The ET-1 concentration achieved its maximum 6h after opening the tourniquet, which corresponded to 3.3 times the preoperative value. Without a tourniquet, the concentration maximum (2.9 times the baseline value) was achieved already 1.5 h after the end of the operation. However, the total amount of ET-1 secreted over 24 h was identical in both groups (p>0.5). We conclude that the tissue hypoxia resulting from the use of a tourniquet modulates ET-1 secretion, but that traumatization during the operation has a much stronger influence on the total amount secreted. ET-1 antagonists thus should be discussed for the drug prophylaxis of wound healing disorders, regardless of the use of a tourniquet.This publication has 35 references indexed in Scilit:
- Endothelin-receptor blockade mitigates the adverse effect of preretrieval warm ischemia on posttransplantation renal function in rats1Transplantation, 2003
- Endothelin receptor antagonist bosentan improves microcirculatory blood flow in splanchnic organs in septic shockCritical Care Medicine, 2003
- Tourniquet-induced wound hypoxia after total knee replacementThe Journal of Bone and Joint Surgery. British volume, 2001
- Endothelin inhibition improves cerebral blood flow and is neuroprotective in pneumococcal meningitisAnnals of Neurology, 2000
- Endothelin Receptor Antagonist SB209670 Decreases Lung Allograft Apoptosis and Improves Lung Graft Function After Prolonged IschemiaJournal of Cardiovascular Pharmacology, 2000
- Time Course of Endothelin-1 Plasma Level in Patients with Acute Coronary SyndromesCardiology, 1999
- Articular nociception induced by endothelin-1, carrageenan and LPS in naive and previously inflamed knee-joints in the rat: inhibition by endothelin receptor antagonistsPain, 1998
- Endothelin‐1 is upregulated during skeletal muscle ischemia and reperfusionJournal of Orthopaedic Research, 1998
- Autoregulation of endothelin-1 secretion by cultured human keratinocytes via the endothelin B receptorBiochimica et Biophysica Acta (BBA) - Molecular Cell Research, 1994
- The control of endothelin-1 secretionGeneral Pharmacology: The Vascular System, 1994