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| Name | Class |
|---|---|
| Aalborg University | OTHER |
| Medical Research Council | OTHER_GOV |
| Arthritis Research UK | OTHER |
| Royal College of Surgeons of Edinburgh |
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Painful osteoarthritis (OA) is the 4th largest cause of disability in the UK. Preoperative temporal summation, a measure of central pain facilitation, has been shown to predict postoperative pain after total knee replacement surgery (TKR). The assessment of the brain's response to noxious stimuli using non-invasive functional MRI (fMRI) may be key in identifying imaging biomarkers within the brain that map central sensitization changes seen in OA. fMRI may help explain why up to 20% of patients undergoing TKR surgery develop persistent post-operative pain. To test these concepts the study aims to functionally characterise the brain activity related to temporal summation of pain in healthy individuals and OA patients using a novel fMRI cuff algometer. Assessment of outcomes in terms of pain and function will be performed 6 months post TKR surgery
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Preoperative Chronic Knee OA Patients | Patients will be recruited from orthopaedic preoperative clinics from those awaiting total knee replacement surgery. |
| |
| Healthy Volunteers | Healthy volunteers will be recruited that are aged match to our OA patient cohort so meaningful comparisons regarding brain activity and pain sensitisation characteristics can be assessed. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Total Knee Replacement Surgery | Procedure | All chronic knee osteoarthritis patients will be recruited as they are on the NHS waiting list for a total knee replacement. Only this group will undergo the procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Brain activity related to temporal summation of pain in healthy individuals and OA patients using a novel fMRI cuff algometer. | Using BOLD fMRI we aim to assess the difference in neural brain activity between patients with chronic knee OA pain and a group of healthy volunteers and to assess the reversal of this activity pattern 6 months post TKR surgery | 6 months post total knee replacement surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Assessment of knee pain using the Visual Analogue Scale for Pain (0-10) | Pain using visual analogue scale | 6 months post total knee replacement surgery |
| Assessment of improvement in the Oxford Knee Score |
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Inclusion Criteria:
Unilateral Knee OA No previous knee surgery Able to give informed consent Age > 40 years
- Healthy Volunteers Group
No OA or knee pain Able to give informed consent Age > 40 years
Exclusion Criteria:
-OA Group
Major medical, psychiatric, neurological Cx Other chronic pain condition (fibromyalgia) Contraindications to MRI Active Cancer Neuropathic drug treatment
-Healthy Volunteers Group
Pregnancy Lower limb pain or previous knee surgery Contraindications to MRI Active Cancer Major medical, psychiatric, neurological condition
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Patients with predominelaty unilateral knee osteoarthritis awaiting for total knee replacement surgery for pain will be included. Patients will recruited from Nottingham University Hospitals NHS Trust. Healthy volunteers will also be recruited as part of this study and they will be recruited from posters and advertisement within the university.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Thomas Kurien, BMBS | Contact | thomas.kurien@nottingham.ac.uk | ||
| Brigitte E Scammell, FRCS | Contact | b.scammell@nottingham.ac.uk |
| Name | Affiliation | Role |
|---|---|---|
| Dorothee P Auer, PhD | The University of Nottingham | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Academic Division of Trauma, Orthopaedics and Sports Medicine | Recruiting | Nottingham | Nottinghamshire | NG7 2UH | United Kingdom |
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| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D010146 | Pain |
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
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| OTHER |
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|
pain and function outcome measure
| 6 months post total knee replacement surgery |
| Assessment of change in healthy related quality of life measure using the EQ5D-5L questionnaire | quality of life index measure | 6 months post total knee replacement |
| D009461 |
| Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |