A preoperative package of care for osteoarthritis, consisting of weight loss, orthotics, rehabilitation, and topical and oral analgesia (OPPORTUNITY): a two-centre, open-label, randomised controlled feasibility trial

Simpson, A Hamish R W; Clement, Nicholas D; Simpson, Sharon A; Pandit, Hemandt; Smillie, Susie; Leeds, Anthony R; Conaghan, Philip G; Kingsbury, Sarah R; Hamilton, David; Craig, Peter; Ray, David; Keerie, Catriona; Kinsella, Elaine; Bell-Higgs, Anna; McGarty, Arlene; Beadle, Christine; Howie, Colin R; Norrie, John

doi:10.1016/s2665-9913(23)00337-5

Cited by 4 publications

(5 citation statements)

References 32 publications

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“…Factor analysis, specifically principle component analysis (PCA), was utilized to reduce the number of identified predictors of POP based on gene expression studies in peripheral blood before surgery in patients with end-stage knee OA from the present study (n = 14) and our previous study (n = 8): cathepsins S (CTSS) and K (CTSK), Caspase 3, TNFα, IL-1β, TIMP1 (tissue inhibitor of metalloproteinase 1), MMP-9 (metalloproteinase-9), and COX2 (cyclooxygenase 2) [9]. Through the PCA, the predominant prognostic values of ACLY, CPT1A, AMPKα, SDH, Caspase 3, and IL-1β gene expressions were identified in patients who developed POP (Figure 4A).…”

Section: Protein-protein Interaction (Ppi) Network Constructionmentioning

confidence: 85%

“…The demographic and clinical characteristics of 50 patients with end-stage KOA, both male and female, were previously described in detail [9]. In summary, the K&L OA grades of these subjects ranged from III to IV (grade III: 37 patients; grade IV: 13 patients).…”

Section: Clinical Parameters Of the Examined Patients With End-stage ...mentioning

confidence: 99%

“…Nevertheless, the PCA of gene expressions in pain-free KOA patients revealed a greater number of interconnected genes, indicating stronger regulatory mechanisms associated with less severe disease (Figure 4B). TNFα, IL-1β, TIMP1 (tissue inhibitor of metalloproteinase 1), MMP-9 (metalloproteinase-9), and COX2 (cyclooxygenase 2) [9]. Through the PCA, the predominant prognostic values of ACLY, CPT1A, AMPKα, SDH, Caspase 3, and IL-1β gene expressions were identified in patients who developed POP (Figure 4A).…”

Section: Protein-protein Interaction (Ppi) Network Constructionmentioning

confidence: 99%

“…A detailed description of the patients has been presented in our previous publication related to this patient cohort [9]. In brief, the study enrolled 50 unrelated subjects with primary OA of the knee, with an average age of 67.6 ± 7.5 years and a range of 54-82 years, who underwent primary total knee arthroplasty at the Nasonova Research Institute of Rheumatology between March 2018 and June 2019.…”

Section: Patientsmentioning

confidence: 99%

“…Chronic POP can last a considerable amount of time, as it has been observed in patients up to 12 years after surgery [8]. Understanding the factors influencing the outcome of arthroplasty related to POP could provide KOA patients with a more realistic understanding of surgical results and optimize their preoperative condition [9].…”

Section: Introductionmentioning

confidence: 99%

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Metabolic Dysregulation and Its Role in Postoperative Pain among Knee Osteoarthritis Patients

Tchetina,

Glemba,

Markova

et al. 2024

IJMS

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Knee osteoarthritis (KOA) is characterized by low-grade inflammation, loss of articular cartilage, subchondral bone remodeling, synovitis, osteophyte formation, and pain. Strong, continuous pain may indicate the need for joint replacement in patients with end-stage OA, although postoperative pain (POP) of at least a two-month duration persists in 10–40% of patients with OA. Study purpose: The inflammation observed in joint tissues is linked to pain caused by the production of proinflammatory cytokines. Since the biosynthesis of cytokines requires energy, their production is supported by extensive metabolic conversions of carbohydrates and fatty acids, which could lead to a disruption in cellular homeostasis. Therefore, this study aimed to investigate the association between POP development and disturbances in energy metabolic conversions, focusing on carbohydrate and fatty acid metabolism. Methods: Peripheral blood samples were collected from 26 healthy subjects and 50 patients with end-stage OA before joint replacement surgery. All implants were validated by orthopedic surgeons, and patients with OA demonstrated no inherent abnormalities to cause pain from other reasons than OA disease, such as malalignment, aseptic loosening, or excessive bleeding. Pain levels were assessed before surgery using the visual analogue scale (VAS) and neuropathic pain questionnaires, DN4 and PainDETECT. Functional activity was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Three and six months after surgery, pain indices according to a VAS of 30 mm or higher were considered. Total RNA isolated from whole blood was analyzed using quantitative real-time RT-PCR (qRT-PCR) for the expression of genes related to carbohydrate and fatty acid metabolism. Protein levels of the examined genes were measured using an ELISA in the peripheral blood mononuclear cells (PBMCs). We used qRT-PCR because it is the most sensitive and reliable method for gene expression analysis, while an ELISA was used to confirm our qRT-PCR results. Key findings: Among the study cohort, 17 patients who reported POP demonstrated significantly higher (p < 0.05) expressions of the genes PKM2, LDH, SDH, UCP2, CPT1A, and ACLY compared to pain-free patients with KOA. Receiver-operating characteristic (ROC) curve analyses confirmed the association between these gene expressions and pain development post-arthroplasty. A principle component analysis identified the prognostic values of ACLY, CPT1A, AMPK, SDHB, Caspase 3, and IL-1β gene expressions for POP development in the examined subjects. Conclusion: These findings suggest that the disturbances in energy metabolism, as observed in the PBMCs of patients with end-stage KOA before arthroplasty, may contribute to POP development. An understanding of these metabolic processes could provide insights into the pathogenesis of KOA. Additionally, our findings can be used in a clinical setting to predict POP development in end-stage patients with KOA before arthroplasty.

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Section: Protein-protein Interaction (Ppi) Network Constructionmentioning

confidence: 85%

Section: Clinical Parameters Of the Examined Patients With End-stage ...mentioning

confidence: 99%

Section: Protein-protein Interaction (Ppi) Network Constructionmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Metabolic Dysregulation and Its Role in Postoperative Pain among Knee Osteoarthritis Patients

Tchetina,

Glemba,

Markova

et al. 2024

IJMS

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When should we treat knee osteoarthritis and with which treatments?

Haber,

Hall

2024

The Lancet Rheumatology

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Research

2024

Bone &Amp; Joint 360

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The June 2024 Research Roundup360 looks at: Do the associations of daily steps with mortality and incident cardiovascular disease differ by sedentary time levels?; Large-scale assessment of ChatGPT in benign and malignant bone tumours imaging report diagnosis and its potential for clinical applications; Long-term effects of diffuse idiopathic skeletal hyperostosis on physical function: a longitudinal analysis; Effect of intramuscular fat in the thigh muscles on muscle architecture and physical performance in the middle-aged females with knee osteoarthritis; Preoperative package of care for osteoarthritis an opportunity not to be missed?; Superiority of kinematic alignment over mechanical alignment in total knee arthroplasty during medium- to long-term follow-up: a meta-analysis and trial sequential analysis.

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A preoperative package of care for osteoarthritis, consisting of weight loss, orthotics, rehabilitation, and topical and oral analgesia (OPPORTUNITY): a two-centre, open-label, randomised controlled feasibility trial

Cited by 4 publications

References 32 publications

Metabolic Dysregulation and Its Role in Postoperative Pain among Knee Osteoarthritis Patients

Metabolic Dysregulation and Its Role in Postoperative Pain among Knee Osteoarthritis Patients

When should we treat knee osteoarthritis and with which treatments?

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