Creating a Tissue Bank of Knee Capsules

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Knee Joint Contractures: Reversibility and Molecular Pathways

Conditions
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Osteoarthritis, Knee Joint Contractures

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Osteoarthritis, booked for a total knee arthroplasty Exclusion Criteria: Transmissible disease (e.g., HIV infection, hepatitis B or C) Suspected neoplasia Suspected infection (which can cause arthrofibrosis) Hypertrophic scarring

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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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| osteoarthritis, total knee arthroplasty<br>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<br>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. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| development of contracture post total knee arthroplasty | 1.3% of subjects are expected to develop a contracture post toal knee arthroplasty within a year of the surgery. | Within 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Contractures, Total knee arthroplasty, Tissue bank, Osteoarthritis, Gene expressions