Background: The anesthesia procedure in tumor-type total knee arthroplasty (TKA) may contribute to systemic inflammatory response. Therefore, we aim to investigate the effectiveness and safety of general and spinal anesthesia in patients with tumor-type TKA.
Patients and methods: Twenty-five patients with tumors around the knee undergoing primary unilateral TKA were randomly divided into the general anesthesia group (n = 13) and spinal anesthesia group (n = 12). Knee joint HSS scores and Western Ontario and McMaster University osteoarthritis index (WOMAC osteoarthritis) were recorded before surgery and 12 months after surgery. Visual analogue scale, C-reactive protein (CPR), tumor necrosis factor-α (TNF-α), and interleukin-8 (IL-8) concentration were measured preoperatively (T0), on the day of the operation (T1), and on the first day (T2) after the operation. Complications in the two groups were recorded.
Results: The operative time, intraoperative blood loss, postoperative drainage, tourniquet time, and complication rate were not significantly different between the general anesthesia and spinal anesthesia groups (all p > 0.05). There were no significant differences in CPR (7.6 ± 3.1, 8.1 ± 4.1, 91.3 ± 24.2 vs. 7.1 ± 2.9, 7.6 ± 3.8, 85.1 ± 19.3 pg/mL, respectively), IL-8 (12.2 ± 6.6, 13.4 ± 7.3, 19.2 ± 10.5 vs. 11.9 ± 5.7, 12.9 ± 8.6, 22.2 ± 12.4 pg/mL, respectively), and TNF-α (2.5 ± 1.7, 2.2 ± 1.9, 2.8 ± 2.1 vs. 2.4 ± 1.3, 2.7 ± 2.1, 2.9 ± 1.6 pg/mL, respectively) between the two groups at T0, T1, and T2 (all p > 0.05). There were no statistical differences in pre- and postoperative HSS knee scores (39.78 ± 11.3, 90.24 ± 15.3 vs. 42.68 ± 12.5, 91.21 ± 16.3) and WOMAC indexes (49.89 ± 7.9, 25.12 ± 6.2 vs. 51.3 ± 8.3, 23.15 ± 5.3) between the two groups (p > 0.05).
Conclusion: General anesthesia and spinal anesthesia in patients with tumor-type TKA had the same effectiveness and safety.
Keywords: General anesthesia; Knee joint; Osteoarthritis; Spinal anesthesia; Total knee arthroplasty.
© 2020 S. Karger AG, Basel.