knee osteoarthritis knee arthroplasty ischemia and reperfusion injury knee arthroplasty coenzyme q10 ischemic preconditioning
Conditions
Interventions
A patient will receive oral placebo for 28 days with preoperative sham ischemic preconditioning,A patient will receive oral coenzyme Q10 supplement for 28 days with preoperative sham ischemic precondi
No Intervention No treatment,Experimental Dietary Supplement,Experimental Procedure/Surgery,Experimental Procedure/Surgery
CONTROL,COQ10,IPC,COQ10+IPC
Sponsors
None listed
Eligibility
Sex/Gender
All
Age
60 Years to 80 Years
Inclusion criteria
Inclusion criteria: Osteoarthritis of knee joint patients with ASA classification I-III who are scheduled for elective unilateral total knee arthoplasty
Exclusion criteria
Exclusion criteria: 1. Body mass index ≤ 35 kg/m2 2. Presentation of any conditions that may interfere the oxidative stress levels including any malignant diseases, any infectious diseases, neurodegenerative diseases, atherosclerotic disease, peripheral arterial disease, chronic kidney disease and active heavy smoking 3. Antioxidant use within 4 weeks 4. Glucocorticoid use within 3 months 5. Presentation of contraindications of regional anesthesia including coagulopathy and increased intracranial pressure 6. Allergy to any medications in the study protocol 7. Presentation of any conditions that may interfere clinical assessment including preoperative immobility, preoperative delirium or cognitive dysfunction 8. Perioperative blood transfusion
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Mitochondrial oxygen consumption 2 wk before surgery, 30 min of TQ inflation, 120 min and 1 day after TQ release, 2 wk after surgery Measure mitochondrial function of peripheral blood mononuclear cells isolated from blood sample | — |
Secondary
| Measure | Time frame |
|---|---|
| Apoptotic proteins 2 wk before surgery, 30 min of TQ inflation, 120 min and 1 day after TQ release, 2 wk after surgery Measure levels of Caspase3 protein expression of blood mononuclear and skeletal muscle cells,Mitochondrial dynamics 2 wk before surgery, 30 min of TQ inflation, 120 min and 1 day after TQ release, 2 wk after surgery Measure levels of Drp1, Mfn1, Mfn2, OPA1 protein expression of blood mononuclear and skeletal muscle,Plasma antioxidant levels 2 wk before surgery, 30 min of TQ inflation, 120 min and 1 day after TQ release, 2 wk after surgery Measure levels of superoxide dismutase and reduced glutathione in plasma,Plasma inflammatory cytokines 2 wk before surgery, 30 min of TQ inflation, 120 min and 1 day after TQ release, 2 wk after surgery Measure levels of TNF-a and IL-10 in plasma,Inflammatory proteins 2 wk before surgery, 30 min of TQ inflation, 120 min and 1 day after TQ release, 2 wk after surgery Measure levels of NLRP3, p-NFkB and NFkB protein expression of blood mononuclear and skeletal muscle,Muscle strength 2 weeks before and 2 weeks after surgery Measure strength of quadriceps and hamstring muscles using isokinetic machine,Knee joint function 2 weeks before and 2 weeks after surgery Measure pain, stiffness and function of the knee using Thai version of WOMAC index,Surgical knee pain Postoperative day 0-2 Measure postoperative pain of the operated knee using visual analogue scale,Mental status 2 weeks before surgery, postoperative day 0-5 and 2 weeks after surgery Measure for postoperative delirium using Thai version of confusion assessment method,Cognitive function 2 weeks before and 2 weeks after surgery Measure cognitive function using Thai version of Mini-Cog screening test,Quality of life 2 weeks before and 2 weeks after surgery Measure quality of life using Thai version of 5-level EQ-5D | — |
Countries
Thailand
Contacts
Public ContactPrangmalee Leurcharusmee
Faculty of Medicine, Chiang Mai University
Outcome results
None listed