Serum concentrations of interleukin-6 in patients following unilateral versus bilateral total knee arthroplasty.
BACKGROUND
Surgical stress is known to affect body temperature, white blood cell (WBC) count, C-reactive protein (CRP), and interleukin-6 (IL-6). The aim of the present study was to investigate which parameter is most suitable for quantitative analysis of surgical stress.


METHODS
Unilateral total knee arthroplasty (U-TKA) and bilateral TKA (B-TKA) were selected for the subjects of this study because the B-TKA creates approximately double the surgical stress of the U-TKA. The temperature, WBC count, CRP, and IL-6 in the blood were measured pre- and postoperatively in both groups. The IL-6 in the drainage fluid was also measured after the operation.


RESULTS
The temperature, WBC count, CRP, and IL-6 in the blood significantly increased on the first day after the operation in both groups. There were significant differences between the two groups in the WBC count (P < 0.05) and the IL-6 level in the blood (P < 0.05) on the first day after the surgery. There were no significant differences between the two groups for the CRP and IL-6 levels in the drainage fluid. The relative proportions--(B-TKA/U-TKA) x 100 (%)--were 170.4% for the operating time, 219.4 % for total blood loss, 200.0% for blood transfusion, 100.3% for temperature, 128.9% for WBC count, 127.4% for CRP, and 246.5% for the IL-6 level in the blood.


CONCLUSIONS
The serum IL-6 level may best reflect surgical stress and could therefore be a quantitative marker of surgical stress.
Kugisaki
Hajime
H
Department of Orthopedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Japan.
Sonohata
Motoki
M
Komine
Mitsunori
M
Tsunoda
Kenji
K
Someya
Shinsuke
S
Honke
Hidefumi
H
Mawatari
Masaaki
M
Hotokebuchi
Takao
T
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007958:Leukocyte Count; D020370:Osteoarthritis, Knee / Q000097:blood / Q000601:surgery*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis; D011336:Probability; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013312:Stress, Physiological
D015415:Biomarkers; D015850:Interleukin-6; D002097:C-Reactive Protein