fMRI and Central Sensitization in Chronic Knee Osteoarthritis. A Pre and Post TKR Study

University of Nottingham

Status: Unknown

Conditions: Postoperative Pain; Osteoarthritis; Surgery; Pain

Treatments: Procedure: Total Knee Replacement Surgery

Study type: Observational

Funder types: Other

Identifiers

NCT03126279

10093

Details and patient eligibility

About

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

Enrollment: 50 estimated patients

Sex: All

Ages: 40+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• OA Group

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

Trial design

50 participants in 2 patient groups

Preoperative Chronic Knee OA Patients

Description:

Patients will be recruited from orthopaedic preoperative clinics from those awaiting total knee replacement surgery.

Treatment:

Procedure: Total Knee Replacement Surgery

Healthy Volunteers

Description:

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.