Age related muscle weakness Sarcopenia
Conditions
Interventions
None listed
Sponsors
Leids Universitair Medisch Centrum
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: PHASE 1: Inclusion: •patients undergoing either total knee replacement or knee periarticular reconstruction (fracture repair, corrective osteotomy, capsular ligament reconstruction) that provide for an open surgery in the lateral part of distal femur; or total/partial hip replacement or proximal femur osteosynthesis. PHASE 2: Inclusion: • healthy young: age ranges 18-30 years; • elderly: age 70-80 years, free living, ADL independent
Exclusion criteria
Exclusion criteria: PHASE 1:;Exclusion: • patients less than 20 years • patients that underwent previous open surgery in parts concerned the biopsy collection • patients with rheumatoid diseases (RA, polymyositis, dermatomyositis etc) • patients that undergo insulin therapy • patients with haemocoagulative syndromes in which collection could cause strong bleeding • patients with serious neuromuscular disease (flabby and spastic paralysis of legs, myasthenia, myodystrophia • patients with serious hepatorenal failure • patients with serious infectious disease and active malignant neoplasia • patients with serious psychiatric disorders, chronic abuse of alcohol and drugs • patients that use steroidal medicines • patients unable to give a personal consent • Participating in other ongoing research projects.;PHASE 2: Exclusion: • Participating in other ongoing research projects. • patients unable to give a personal consent • walking distance 250m and less; • MMSE 23 and lower; • GDS 5 and higher; • institutionalized; • comorbidity: neurological disorders (stroke, M. Parkinson, dementia, muscle disease), metabolic diseases (insuline dependent DM), arthritis: rheumatoid arthritis, severe (pain and functional limitation) osteoarthritis (hip and knee), cancer: diagnosis and treatment of cancer within the last year, polymyalgia rheumatic, heart failure (NYHA 3-4), COPD (Gold 3-4), chronic pain syndrome (fibromyalgia, complex regional pain syndrome etc); haemocoagulative syndromes in which biopsy could cause strong bleeding. • medication: immunosuppressive drugs (e.g. prednisone, methotrexat, biologicals (TNF-alpha antagonists etc)), insulin, anticoagulantia, e.g. coumarines, carbaspirin calcium. • fracture last year; • hip and knee replacement in medical history last 2 years; • hip and knee replacement causing pain and physical limitation; • amputation; • immobilization for 1 week during the last 3 months; • sports on a highly competitive level • severe hearing impairment. • severe visual impairment ..
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| PHASE I Muscle biopsies: Myoblastic proliferative capacity; muscle histology: number of satellite cells, proportion of the different types of fibres and the volume of fibres as well as the number of nuclei/fibres, proportion between fibres to adipocytes;, protein/RNA/DNA characteristics Percutaneous muscle biopsy will be used to compare with muscle material taken by open surgery (if comparable). Blood: Haematological measurements (Hb, MCV, Leukocytes, Thrombocytes), cytokine assays, PBMCs, LPS/Pam3Cys whole blood stimulation assays, CRP, albumine, kreatinine, GH, IGF-1 and BMP-4, pro as well as anti inflammatory cytokines (IL-12, IFNγ, IL-6, TNFa) Number of B cells, T cell subsets, monocytes and natural killer cells. Naïve, memory and regulatory T cell subsets. Skin and fat biopsies: proliferative capacity (comparison with myoblasts); skin histology: number of senescent cells (comparison with myoblast culture and muscle histology), inflammatory phenotype (comparison with blood stimulation and stimulation of myoblasts), protein/RNA/DNA characteristics (comparison with muscle tissue). Anthropometric measures Length, arm span, weight and waist circumference. PHASE II Blood: haematological measurements (Hb, MCV, Leukocytes, Thrombocytes), cytokine assays, PBMCs, LPS/Pam3Cys whole blood stimulation assays, CRP, albumine, kreatinine, Calcium, Vitamin D, GH, IGF-1 and BMP-4, pro as well as anti inflammatory cytokines (IL-12, IFNγ, IL-6, TNFa) Number of B cells, T cell subsets, monocytes and natural killer cells. Naïve, memory and regulatory T cell subsets; glucose tolerance (mmol/L), Questionnaires: QoL; present and past education, employment and levels of physical activity, medical history and current medication. ADL dependency DEXA: Muscle mass/ fat content of the upper and lower limbs; bone mineral density Lungfunction: FEV1 (L/s), FEV (L), FEV1/FEV ratio (%), Total lung capacity (L), Tidal Volume (L) Grip strength (Kg) Gross | — |
Secondary
| Measure | Time frame |
|---|---|
| Not applicable. | — |
Countries
Netherlands
Outcome results
None listed