Perioperative Assessment of Muscle Inflammation Susceptibility in Patients with End-Stage Osteoarthritis - PubMed

• Updated on: 2024-05-28
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doi: 10.1152/japplphysiol.00428.2021. Online ahead of print.
Perioperative Assessment of Muscle Inflammation Susceptibility in Patients with End-Stage Osteoarthritis
Affiliations
1 UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL, United States.
2 Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, United States.
3 Florida Institute for Human and Machine Cognition, Pensacola, FL, United States.
4 Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, United States.
5 Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, United States.
6 Birmingham Veterans' Affairs Medical Center, Birmingham, AL, United States.
7 Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL; Comprehensive Arthritis, Musculoskeletal, Bone, and Autoimmunity Center, University of Alabama at Birmingham, Birmingham, AL, United States.
8 Department of Geriatrics and Center for Translational Research in Aging and Longevity, University of Arkansas for Medical Sciences, Little Rock, AR, United States.
9 Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States.
10 Department of Medicine, Hospital for Special Surgery, New York, NY, United States.
11 Division of Rheumatology, Weill Cornell Medical Center, New York, NY, United States.
PMID: 35238652
Perioperative Assessment of Muscle Inflammation Susceptibility in Patients with End-Stage Osteoarthritis
Devin J Drummer et al. J Appl Physiol (1985).
2022
doi: 10.1152/japplphysiol.00428.2021. Online ahead of print.
Authors
Affiliations
1 UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL, United States.
2 Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, United States.
3 Florida Institute for Human and Machine Cognition, Pensacola, FL, United States.
4 Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, United States.
5 Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, United States.
6 Birmingham Veterans' Affairs Medical Center, Birmingham, AL, United States.
7 Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL; Comprehensive Arthritis, Musculoskeletal, Bone, and Autoimmunity Center, University of Alabama at Birmingham, Birmingham, AL, United States.
8 Department of Geriatrics and Center for Translational Research in Aging and Longevity, University of Arkansas for Medical Sciences, Little Rock, AR, United States.
9 Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States.
10 Department of Medicine, Hospital for Special Surgery, New York, NY, United States.
11 Division of Rheumatology, Weill Cornell Medical Center, New York, NY, United States.
PMID: 35238652
Format
Abstract
Many individuals with end-stage osteoarthritis (OA) undergo elective total hip/knee arthroplasty (THA/TKA) to relieve pain, improve mobility and quality of life. However, ~35% suffer long-term mobility impairment following surgery. This may be in part due to muscle inflammation susceptibility (MuIS+), an overt proinflammatory pathology localized to skeletal muscle surrounding the diseased joint, present in some TKA/THA patients.
Purpose: We interrogated the hypothesis that MuIS+ status results in a perturbed perioperative gene expression profile and decreases skeletal muscle integrity in patients with end-stage OA.
Methods: Samples were leveraged from the two-site, randomized, controlled trial R01HD084124, NCT02628795 . Participants were dichotomized based on surgical (SX) muscle gene expression of TNFRSF1A (TNF-aR). MuIS+/- samples were probed for gene expression and fibrosis. Paired and independent two-tailed t-tests were used to determine differences between contralateral (CTRL) and surgical (SX) limbs and between-subject comparisons respectively. Significance was declared at P<0.05.
Results: 70 participants (26M/44F; mean age 62.41±8.86yrs; mean body mass index 31.10±4.91kg/m2) undergoing THA/TKA were clustered as MuIS+ (n=24) or MuIS- (n=46). Lower skeletal muscle integrity (greater fibrosis) exists on the SX vs CTRL limb (P<0.001). Further, MuIS+ vs MuIS- muscle exhibited higher proinflammatory (IL-6R, TNF-a) and catabolic (TRIM63) gene expression (P<0.001, P=0.004, and 0.024 respectively), with a trend for greater fibrosis (P=0.087).
Conclusions: MuIS+ patients exhibit more inflammation and catabolic gene expression in skeletal muscle of the SX limb, accompanied by decreased skeletal muscle integrity (Trend). This highlights the impact of MuIS+ status emphasizing the potential value of perioperative MuIS assessment to inform optimal post-surgical care.
Keywords: Inflammation; Osteoarthritis; Rehabilitation; Skeletal Muscle.