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Higher pyruvate levels after Achilles tendon rupture surgery could be used as a prognostic biomarker of an improved patient outcome.
Knee Surgery, Sports Traumatology, Arthroscopy ( IF 3.8 ) Pub Date : 2020-05-06 , DOI: 10.1007/s00167-020-06037-x
Gianluigi Capone 1, 2, 3, 4 , Simon Svedman 1, 2 , Robin Juthberg 1 , Gunnar Edman 5 , Paul W Ackermann 1, 2
Affiliation  

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.

中文翻译:

跟腱断裂手术后较高的丙酮酸水平可用作改善患者预后的预后生物标志物。

目的 本研究的主要目的是评估跟腱断裂 (ATR) 后愈合肌腱中代谢物乳酸和丙酮酸与患者报告的 6 个月和 12 个月结果之间的关系。第二个目的是评估哪些潜在因素调节乳酸和丙酮酸的浓度。方法 在术后两周,对 109 名患者(90 名男性,19 名女性;平均年龄 40 ± 7.9 岁)的愈合和健康跟腱中的乳酸和丙酮酸浓度进行了测量。研究了患者人口统计学、身体活动程度、手术时间、手术时间、患者报告的负荷和步数与代谢物浓度的关系。在 6 个月和 12 个月时,使用跟腱总断裂评分 (ATRS) 问卷来评估患者的预后。结果 术后第 1-10 天所采取的平均步数是唯一与乳酸 (R2 = 0.34, p = 0.038) 和丙酮酸 (R2 = 0.46, p = 0.006) 平均浓度显着相关的因素。使用多元线性回归证明丙酮酸是与 ATRS 在 6 个月(R2 = 0.32,p = 0.003)和 12 个月(R2 = 0.37,p = 0.004)显着相关的唯一因素。结论 早期 ATR 愈合过程中丙酮酸的平均浓度可预测术后 6 个月和 12 个月的患者预后,并可能用作愈合的生物标志物。采取增加步骤数量的早期动员是改善愈合过程中代谢物浓度的重要临床策略。证据水平 III.
更新日期:2020-05-06
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