Investigation of a Possible Association Between Dynamic Thiol/Disulfide Homeostasis and Pain in Knee Arthroplasty Patients

Abstract

Objective: Dynamic thiol/disulfide homeostasis plays a pivotal role in many physiologic mechanisms. In the present study, we aimed to elucidate the relationship between postoperative pain and thiol/disulfide homeostasis in patients who underwent primary total knee arthroplasty for primary knee osteoarthritis.Methods: This prospective uncontrolled study included 28 patients (10 male, 18 female) with a diagnosis of primary gonarthrosis who underwent primary total knee arthroplasty and met the study inclusion criteria. Venous blood samples were taken from the patients and pain values were recorded simultaneously using the visual analog scale (VAS) preoperatively and at the 4th postoperative week. Thiol/disulfide hemostasis levels were measured using a new fully-automated and spectrophotometric method developed by Erel and Neselioglu.Results: The average age of the patients participating in the study was 66.25 ± 8.29 years and 18 (64.3%) of the patients were female. B values for preoperative native/total thiol (+7,652), preoperative disulfide/native thiol (+10,550), and postoperative total thiol (+128), positively affected the difference in VAS values. B values for preoperative disulfide (-219), postoperative disulfide (-1,297), postoperative native/total thiol (-4,238), and postoperative disulfide/native thiol (-3,316) negatively affected the difference in VAS values.Conclusion: The disulfide level, an oxidized form in thiol/disulfide homeostasis, appears to be a valuable marker for evaluating the effect of oxidative stress on postoperative pain.