Creating a Tissue Bank of Knee Capsules
A contracture is a pathological condition limiting range and function of joints. Contractures of large and small joints alike will affect one's ability to independently perform daily activities such as eating, dressing or walking. Current treatments for contractures include physical stretching, the use of assistive devices or, rarely, surgery. Despite prolonged treatments, patients with contractures rarely regain complete mobility. Progress in preventing and treating contractures will be possible only through an understanding of the biological and molecular processes involved. Our group has established and validated an animal model to study the histological events and the molecular mechanisms involved in joint contractures. We have provided evidence for capsule stiffness, characterized cartilage degeneration, and identified four genes whose expression is altered in the cartilage of a knee joint with contracture. The work we propose in the current study aims at finding genes and pathways in the joint capsule associated with knee joint contractures. The results will identify new avenues for treating the large number of patients suffering from contractures.
Knee Joint Contractures
|Study Design:||Observational Model: Cohort
Time Perspective: Retrospective
|Official Title:||Knee Joint Contractures: Reversibility and Molecular Pathways|
- development of contracture post total knee arthroplasty [ Time Frame: Within 1 year ] [ Designated as safety issue: No ]1.3% of subjects are expected to develop a contracture post toal knee arthroplasty within a year of the surgery.
Biospecimen Retention: Samples With DNA
A blood sample will be drawn from each subject and stored with the capsule tissue.
|Study Start Date:||March 2011|
|Estimated Study Completion Date:||December 2014|
|Estimated Primary Completion Date:||December 2014 (Final data collection date for primary outcome measure)|
osteoarthritis, total knee arthroplasty
The main cohort will have a total knee arthroplasty and will not develop a contracture post surgery. We will analyze differntial gene expression in all subjects.
contracture post arthroplasty
A small group (1.3%) will develop a contracture post total knee arthroplasty. A second sample will be taken at the time of corrective surgery. The 2 samples will be compared for gene expression in the same subject. This group will also be compared to the main cohort for differential gene expression.
We propose to constitute a bank of capsule samples from people with osteoarthritis undergoing primary total knee arthroplasty. It is expected that about 1.3% of people will develop a contracture post arthroplasty. A second sample will be taken from those that require surgery for release of contracture or revision. We will study histological characteristics and compare gene expression between the primary sample and the contracture sample in the same patient. In order to determine whether intrinsic genetic factors influence the develpment of joint contractures in the osteoarthritis population, all specimens will be analyzed for differential gene expression between patients with and without knee contractures post arthroplasty.
The remaining capsule tissue not used for this study will be banked and made available to other researchers.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01320124
|The Ottawa Hospital|
|Ottawa, Ontario, Canada, K1H 8M2|
|Principal Investigator:||Guy Trudel, MD||University of Ottawa|