Role of Bone in Knee Osteoarthritis (OA)

Study Overview
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Brief Summary
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The purpose of the study is to investigate protein and gene expression among damaged knee tissues. We will perform MRI's on subjects prior to total knee replacement to identify the location of bone marrow lesions. Connective tissues including tendon, ligament, and meniscus specimens normally discarded from total joint replacements will be used for live cell harvest, and protein and gene expression analyses of tissue or cultured cells.

Detailed Description
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BACKGROUND AND SIGNIFICANCE: Although the presence of bone marrow lesions (BML) on MRI is strongly associated with osteoarthritis (OA) progression and pain in some studies, the mechanism for this relation and the underlying pathology is not well established. The lack of knowledge on what these lesions constitute hampers their clinical utility both with regards to measurement and targeting for therapeutic intervention. Our preliminary data has localized specific changes in bone mineralization, remodeling and defects within BML features that are adjacent to the subchondral plate. BMLs appear to be sclerotic compared to unaffected regions; however, the mineral density in these lesions is reduced and may render this area to be mechanically compromised, and thus susceptible to attrition. Limited histological analysis of BMLs reveal thrombi, diffuse fibrinoid necrosis and hyperplasia of blood vessel walls - all indicative of infarction-like pathology. The aim of this research proposal is to create more specific targets and improve our understanding of the pathology in BMLs. Specific Aim 1: - To collect tissue to evaluate protein and gene expression of these tissues and cultured cells.

Official Title
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The Role of Bone and Its Measurement in Knee Osteoarthritis

Conditions
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Osteoarthritis, Knee

Intervention / Treatment
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* Radiation: MRI
* Procedure: Primary Total Knee Replacement


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: subjects having primary knee replacement surgery with 1 participating surgeon at NEBH (principal investigator) Exclusion Criteria: subjects having a revision knee replacement instead of a primary knee replacement contraindications for MRI pregnancy

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Radiation: MRI|1.5T MRI exam of signal knee with knee coil (estimated time: 35 minutes)|
|Procedure: Primary Total Knee Replacement|Fluid, bone, and meniscus specimens obtained from total joint replacement will be collected.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants With Viable Specimens for Genetic Analysis |  | Tissue samples collected at time of surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Bone Marrow Lesion, BML, Arthroplasty, Replacement, Knee, Discarded tissue