Stiffness post-total knee replacement: a proof of principle study investigating the effect of gene expression analysis of markers of fibrosis.:Gene expression of stiffness post-TKR

Mann, Charles, Bradley, Anne, Jones, Eleanor, MacNamara, Iain, Smith, Toby and Riley, Graham (2019) Stiffness post-total knee replacement: a proof of principle study investigating the effect of gene expression analysis of markers of fibrosis.:Gene expression of stiffness post-TKR. The Knee, 26 (4). pp. 914-922. ISSN 0968-0160

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Abstract

BACKGROUND: To establish proof of principle of a link between phenotypic expression and stiffness after TKR. METHODS: From 100 patients, genetic expression of markers of fibrosis were performed for 15 synovial samples from patients categorised as ‘best post-operative range of movement (ROM)’ and 15 samples from patients with ‘worst ROM’. These markers included Matrix Metalloproteinases (MMPs), A Disintegrin and Metalloproteinases with Thrombospondin (ADAMTs) and Tissue Inhibitors of Matrix Metalloproteinases (TIMPs). Genetic marker data were compared to Oxford Knee Scores (OKS) and Pain Catastrophizing Scores (PCS). RESULTS: Quantitative markers for gene expression demonstrated more outliers in stiff compared to non-stiff knees, suggesting a greater imbalance in pro- and anti-fibrotic markers in stiff knees. Whilst there was a significant difference in the range of post-operative knee flexion (p=0.001) and extension (p=0.001), there was no statistically significant difference between stiff and non-stiff knees in pre-operative or post-operative OKS (p≥0.06). There was no difference in the individual components of the individual PCS score items nor the PCS total scores when stiff and non-stiff knees were compared (p>0.05). CONCLUSION: Biological factors, namely gene expression of MMPs, TIMPs and ADAMTs, may contribute towards post-TKR stiffness. This now warrants further investigation to better understand this relationship based on larger, multi-centre, cohorts.

Item Type: Article
Uncontrolled Keywords: knee arthroplasty,limited range,arthrofibrosis,gene expression,case-control
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Faculty of Science > School of Biological Sciences
Depositing User: LivePure Connector
Date Deposited: 08 May 2019 09:30
Last Modified: 18 Mar 2020 03:07
URI: https://ueaeprints.uea.ac.uk/id/eprint/70868
DOI: 10.1016/j.knee.2019.05.005

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