Gianluigi Capone1,2,3,4, Simon Svedman5,6, Robin Juthberg5, Gunnar Edman7, Paul W Ackermann5,6. 1. Integrative Orthopedic Laboratory, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. gianluigi.capone@eoc.ch. 2. Department of Orthopedic Surgery, Karolinska University Hospital, Stockholm, Sweden. gianluigi.capone@eoc.ch. 3. Orthopaedic and Traumatology Unit, Ospedale Regionale di Lugano, EOC, Lugano, Switzerland. gianluigi.capone@eoc.ch. 4. Faculty of Pharmacy and Medicine, Sapienza University of Rome, Rome, Italy. gianluigi.capone@eoc.ch. 5. Integrative Orthopedic Laboratory, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. 6. Department of Orthopedic Surgery, Karolinska University Hospital, Stockholm, Sweden. 7. Department of Psychiatry, Tiohundra AB, Norrtälje, Sweden.
Abstract
PURPOSE: The primary aim of this study was to assess the relationship between the metabolites lactate and pyruvate in the healing tendon after Achilles tendon rupture (ATR) and patient-reported outcome at 6 and 12 months. A secondary aim was to evaluate which underlying factors regulate lactate and pyruvate concentrations. METHODS: Lactate and pyruvate concentrations were measured two weeks post-operatively in both the healing- and healthy Achilles tendon in 109 patients (90 men, 19 women; mean age 40 ± 7.9 years). Patient demographics, degree of physical activity, timing of surgery, operation time, patient-reported loading and step counts were investigated in relation to metabolite concentrations. At 6 and 12 months, the Achilles tendon Total Rupture Score (ATRS) questionnaire was used to assess patient outcome. RESULTS: The mean number of steps taken during the post-operative days 1-10 was the only factor significantly related to the mean concentration of lactate (R2 = 0.34, p = 0.038), and pyruvate (R2 = 0.46, p = 0.006). Pyruvate was demonstrated as the only factor significantly associated with ATRS at both 6 months (R2 = 0.32, p = 0.003) and at 12 months (R2 = 0.37, p = 0.004) using multiple linear regression. CONCLUSION: The mean concentration of pyruvate during early ATR healing may predict patient outcome at 6 and 12 months post-operatively and possibly be used as a biomarker of healing. Early mobilization with an increased number of steps taken is an important clinical strategy to improve the metabolite concentrations during healing. LEVEL OF EVIDENCE: III.
PURPOSE: The primary aim of this study was to assess the relationship between the metabolites lactate and pyruvate in the healing tendon after Achilles tendon rupture (ATR) and patient-reported outcome at 6 and 12 months. A secondary aim was to evaluate which underlying factors regulate lactate and pyruvate concentrations. METHODS:Lactate and pyruvate concentrations were measured two weeks post-operatively in both the healing- and healthy Achilles tendon in 109 patients (90 men, 19 women; mean age 40 ± 7.9 years). Patient demographics, degree of physical activity, timing of surgery, operation time, patient-reported loading and step counts were investigated in relation to metabolite concentrations. At 6 and 12 months, the Achilles tendon Total Rupture Score (ATRS) questionnaire was used to assess patient outcome. RESULTS: The mean number of steps taken during the post-operative days 1-10 was the only factor significantly related to the mean concentration of lactate (R2 = 0.34, p = 0.038), and pyruvate (R2 = 0.46, p = 0.006). Pyruvate was demonstrated as the only factor significantly associated with ATRS at both 6 months (R2 = 0.32, p = 0.003) and at 12 months (R2 = 0.37, p = 0.004) using multiple linear regression. CONCLUSION: The mean concentration of pyruvate during early ATR healing may predict patient outcome at 6 and 12 months post-operatively and possibly be used as a biomarker of healing. Early mobilization with an increased number of steps taken is an important clinical strategy to improve the metabolite concentrations during healing. LEVEL OF EVIDENCE: III.
Authors: S Peter Magnusson; Anne-Sofie Agergaard; Christian Couppé; René B Svensson; Susan Warming; Michael R Krogsgaard; Michael Kjaer; Pernilla Eliasson Journal: Clin Orthop Relat Res Date: 2020-05 Impact factor: 4.755
Authors: Simon Svedman; Olof Westin; Susanna Aufwerber; Gunnar Edman; Katarina Nilsson-Helander; Michael R Carmont; Jón Karlsson; Paul W Ackermann Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-06-21 Impact factor: 4.342
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