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Effects of tourniquet use on muscle cells during total knee arthroplasty (151.11)
Author(s) -
Wu Brian,
Hocker Austin,
Gilbert Paul,
Yi Anthony,
Rao Ravi,
Damodar Dhanur,
Hatch George,
Schroeder E.,
Dreyer Hans
Publication year - 2014
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.28.1_supplement.151.11
Subject(s) - tourniquet , medicine , creatine kinase , muscle atrophy , skeletal muscle , muscle damage , tibialis anterior muscle , atrophy , ischemia , muscle hypertrophy , surgery , anesthesia
Skeletal muscle atrophy occurs at a rate of approximately 1% per day within the first 2 weeks following total knee arthroplasty (TKA). We have previously shown that signaling pathways regulating translation initiation are downregulated while catabolic pathways are up regulated while stress‐activated protein kinases (JNK) and all three arms of the endoplasmic‐reticulum stress pathway are activated. While we have attributed these alterations to tourniquet use during surgery causing ischemia‐reperfusion injury, definitive studies demonstrating cause and effect have not been performed. In order to investigate the differences in muscle cells based on tourniquet use, 36 men and women (15 males, 21 females, avg age=67.8 yrs) who underwent TKA were randomized to receive tourniquet, no tourniquet, or tourniquet during cementing only. Muscle biopsies were obtained before and after TKA from the vastus lateralis muscle. Preliminary results suggest upregulation of cleaved caspase 3 with tourniquet vs. no‐tourniquet. Further analysis is needed in order to determine the effects of tourniquet use on muscle cell stress pathways during TKA.