Osteoarthritis, Knee, Prosthesis User
Conditions
Keywords
Osteoarthritis, prosthetic surgery of the knee, obesity, type 2 diabetes, bone marrow fat
Brief summary
Obesity and other associated complications promote the development and the progression of osteoarthritis. The subcutaneous and abdominal fat release several factors that alter bone and the cartilage. The role of the marrow fat in close connection with bone has not been defined yet, whereas cellular and animal models indicate that this fat depot modifies bone and cartilage. The aim of the study is to define if the marrow fat produces more joint-altering factors by comparison with subcutaneous fat. This fat depot can be characterized from removed pieces during the prosthetic surgery of the knee. Measuring before surgery the body weight, waist and hip circumferences, blood pressure, glucose, insulin and lipids in blood will also allow to determine if obesity and/or type 2 diabetes make this fat more dangerous for the joint. Such research will allow the elaboration of new therapeutic strategies in osteoarthritis.
Interventions
PROCEDUREtissue
Adipocyte isolation from distal femoral epiphysis and subcutaneous adipose tissue at the surgery site; classical piece removal during prosthetic replacement of the knee
Sponsors
MSDAVENIR Foundation
University Hospital, Lille
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Post-menopausal woman * with a symptomatic knee osteoarthritis requiring prosthesis * able to handle general anaesthesia * having given her consent * able to understand the constraints associated with the study * with health insurance * able to understand the French language
Exclusion criteria
* with refusal to participate to the study * more than 85-year-old * with bone pathologies other than osteoarthritis or osteoporosis * with active infection * with evolving cancer * with haematopoietic pathologies such as haemoglobin pathologies * with thyroid pathologies * with type 1 diabetes * with anti-osteoporotic treatments (bisphosphonates, strontium ranelate, teriparatide, denosumab) except calcium and vitamin D supplementation or hormone replacement. * with replacement of prosthesis * with previous surgery at the surgery site --with a current participation to another study * with guardianship * with deprived liberty
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Expression levels in femoral spinal adipocytes of mRNAs of 18 genes compared to those of adipocytes isolated from the subcutaneous adipose tissue in the same patient | at 3 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| the intra patients difference of the expression level of medullary adipocytes mRNA compared to that of subcutaneous adipocytes according to Obesity state (normal vs overweight vs obese) as defined using BMI | at 3 months | — |
| the intra patients difference of the expression level of medullary adipocytes mRNA compared to that of subcutaneous adipocytes according to Central obesity (yes or no) as defined using the waist-to-hip ratio | at 3 months | — |
| the intra patients difference of the expression level of medullary adipocytes mRNA compared to that of subcutaneous adipocytes according to Presence or absence of systemic insulin-resistance as measured using the HOMA-IR index | at 3 months | the Homeostatic Model Assessment of Insulin Resistance(HOMA-IR index)Healthy Range: 1.0 (0.5-1.4) Less than 1.0 means you are insulin-sensitive which is optimal. Above 1.9 indicates early insulin resistance. Above 2.9 indicates significant insulin resistance. |
| the intra patients difference of the expression level of medullary adipocytes mRNA compared to that of subcutaneous adipocytesaccording to Presence or absence of chronic uncontrolled hyperglycaemia as measured using HbA1c plasma levels | at 3 months | — |
| the intra patients difference of the expression level of medullary adipocytes mRNA compared to that of subcutaneous adipocytes according to presence or absence of metabolic syndrome | at 3 months | metabolic syndrome as defined by the presence of at least three of the following criteria: large waist circumference, decrease in HDL-cholesterol, hypertriglyceridemia, elevated fasting glycaemia, elevated blood pressure. |
Countries
France
Outcome results
None listed