Total Knee Arthroplasty with a Ti6Al4V/PEEK Prosthesis on an Osteoarthritis Rat Model: Behavioral and Neurophysiological Analysis

Abstract

Arthroplasty is a surgical procedure to restore the function of the joint of patient suffering from knee osteoarthritis. However, postoperative functional deficits are reported even after a rehabilitation program. In order to determine the origin of functional deficits of patient suffering from knee osteoarthritis and total knee arthroplasty, we developed a rodent model including a chemicallyinduced-osteoarthritis and designed a knee prosthesis (Ti6Al4V/PEEK) biomechanically and anatomically adapted to rat knee joint. Dynamic Weight-Bearing, gait kinematics, H-reflex from vastus medialis muscle and activities from metabosensitive III and IV afferent fibers in femoral nerve were assessed at 1 and 3 months post-surgery. Results indicate that knee osteoarthritis altered considerably the responses of afferent fibers to their known activators (i.e., lactic acid and potassium chloride) and consequently their ability to modulate the spinal sensorimotor loop, although, paradoxically, motor deficits seemed relatively light. On the contrary, results indicate that, after the total knee arthroplasty, the afferent responses and the sensorimotor function were slightly altered but that motor deficits were more severe. We conclude that neural changes attested by the recovery of the metabosensitive afferent activity and the sensorimotor loop were induced when a total knee replacement was performed and that these changes may disrupt or delay the locomotor recovery. Osteoarthritis (OA) is a common degenerative joint disease, characterized by a failure of cartilage self-repair. It originates from a stress occurring on the synovial joint tissues including joint cartilage, subchondral bone, ligaments, menisci, periarticular muscles, peripheral nerves or synovium and leads to inflammatory reaction 1-3. Mainly, OA involves hands and weight bearing joints, especially the knee which appears to be the most affected 4. The main symptoms of knee OA are pain and motor limitations related to joint deformity and weakness of surrounding muscles 1,5,6. When these symptoms become unsustainable, patients often resort to total knee arthroplasty (TKA) also called total knee replacement which is the gold standard treatment for end-stage knee OA.

Early-stage knee OA induced by MIA and MMT compared in the murine model via histological and topographical approaches

“…When decalcification was achieved, samples were washed in deionized water, dehydrated in alcohol baths of increasing concentration ( , , , ), and finally cleaned with tissue clearing agent (Histo-Clear-II, National diagnostics, Atlanta, USA). Knee joints were infiltrated in three successive baths of liquid paraffin during 4 h and embedded in paraffin (polyisobutylene mixture, Paraplast plus, Sigma-Aldrich) 23 .

Figure 4 Sample decalcification during histological protocol monitored by X-ray imaging.

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A Novel Rat Model to Study Postsurgical Pain After Joint Replacement Surgery

“…We assessed the ratio of weight-bearing distribution calculated as left/right hind paw, as previously reported. 18 Stimulus-evoked responses, such as the von Frey test, have been widely used in pain research to assess pain-related behavior. However, we selected DWB in this study because asymmetric weight distribution partially reflects spontaneous pain during free walking in unilateral paw pain models, [25][26][27] which appears to be more relevant and clinically important for assessing our novel JR model.…”

“…13,14 To develop a more effective treatment strategy, it is essential to clarify the basic mechanisms underlying postsurgical pain in the acute phase. There have been some reports of animal models exhibiting JR, [8][9][10][16][17][18] but the authors have made no mention of postsurgical pain. Among them, very few studies [16][17][18] reported on the JR model using rodents, which have been most extensively used for pain research.…”

“…There have been some reports of animal models exhibiting JR, [8][9][10][16][17][18] but the authors have made no mention of postsurgical pain. Among them, very few studies [16][17][18] reported on the JR model using rodents, which have been most extensively used for pain research. Therefore, we decided to develop a novel animal model of JR using rats.…”

Acute postoperative pain and dorsal root ganglia transcriptomic signatures following total knee arthroplasty (TKA) in rats: An experimental study

“…Elucidation of such pathways necessitates a preclinical TKA model that closely mimics the clinical procedure as well as outcomes including acute postoperative pain and recovery of function. While several TKA models have been reported in rats [14][15][16][17], none of these have demonstrated responsiveness to analgesia and complete restoration of knee function as reported in clinical studies. Herein, we describe a new preclinical model of TKA in rats that is accompanied by behaviors indicative of acute postoperative pain responsive to clinically employed analgesics, and exhibits functional recovery and pain resolution as observed in TKA patients.…”