Correlation between tourniquet duration and the increase of interleukin-1 (IL-1), interleukin-6 (IL-6), and malondialdehyde (MDA) before and after using tourniquet in total knee replacement procedure

Introduction: Total Knee Replacement (TKR) is a final therapeutic recourse for knee osteoarthritis (OA) when conservative treatments are ineffective. Tourniquet application can precipitate complications, including an augmented inflammatory response characterized by elevated levels of IL-6 due to tissue trauma during surgery and ischemic reperfusion. This study aims to assess the changes in MDA, IL-1, and IL-6 levels before and after 15 minutes of tourniquet application and to investigate their correlation with the duration of tourniquet use. Methods: This study used a longitudinal observational with a repeated cross-sectional design. The sample for this study consisted of patients who underwent TKR at Prof. Dr. IGNG Ngoerah Hospital and met the inclusion and exclusion criteria set by the researchers. Results: This study found that there was a significant increase before and after 15 minutes of the tourniquet use in MDA levels (3.22; SD 0.5), IL-6 (64.18 + 19.40) but not significant IL-1 (65.86; SD 19.60). With the Spearman correlation test, there was no significant correlation between the duration of tourniquet use with an increase in IL-6 levels (r = 0.27, p> 0.05) and an increase in MDA levels (r = -0.21, p> 0.05), with an increase in IL-1 levels (r = 0.442;(p> 0.0 .5) respectively. Conclusion: The study found increased levels of MDA, IL-1, and IL-6 before and after 15 minutes of tourniquet use, but no correlation with duration of use. Inflammatory mediators persist locally during ischemia-reperfusion; IL-6 peaks up to 24 hours post-tourniquet release, suggesting delayed systemic effects beyond the studied timeframe.