Muscle inflammation susceptibility: a prognostic index of recovery potential after hip arthroplasty?

Abstract

While elective total hip arthroplasty (THA) for end-stage osteoarthritis (OA) improves pain, mobility function, and quality of life in most cases, a large proportion of patients suffer persistent muscle atrophy, pain, and mobility impairment. Extensive skeletal muscle damage is unavoidable in these surgical procedures, and it stands to reason that poor recovery and long-term mobility impairment among some individuals after THA is linked to failed muscle regeneration and regrowth following surgery and that local muscle inflammation susceptibility (MuIS) is a major contributing factor. Here we present results of two integrated studies. In study 1, we compared muscle inflammation and protein metabolism signaling in elective THA (n=15) vs. hip fracture/trauma (HFX; n=11) vs. nonsurgical controls (CON; n=19). In study 2, we compared two subgroups of THA patients dichotomized into MuIS⁺ (n=7) or MuIS⁻ (n=7) based on muscle expression of TNF-like weak inducer of apoptosis (TWEAK) receptor (Fn14). As expected, HFX demonstrated overt systemic and local muscle inflammation and hypermetabolism. By contrast, no systemic inflammation was detected in elective THA patients; however, local muscle inflammation in the perioperative limb was profound in MuIS⁺ and was accompanied by suppressed muscle protein synthesis compared with MuIS⁻. Muscle from the contralateral limb of MuIS⁺ was unaffected, providing evidence of a true inflammation susceptibility localized to the muscle surrounding the hip with end-stage OA. We suggest MuIS status assessed at the time of surgery may be a useful prognostic index for muscle recovery potential and could therefore provide the basis for a personalized approach to postsurgery rehabilitation.

• Authors: Marcas M Bamman, Arny A Ferrando, Richard P Evans, Michael J Stec, Neil A Kelly, Johannes M Gruenwald, Katie L Corrick, Jesse R Trump, Jasvinder A Singh
• Journal: American journal of physiology. Endocrinology and metabolism (Am J Physiol Endocrinol Metab) Vol. 308 Issue 8 Pg. E670-9 (Apr 15 2015) ISSN: 1522-1555 [Electronic] United States
• PMID: 25670829 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)

Chemical References

• Biomarkers
• Cytokines
• Receptors, Tumor Necrosis Factor
• TNFRSF12A protein, human
• TWEAK Receptor

Topics

• Arkansas
• Arthroplasty, Replacement, Hip (adverse effects, rehabilitation)
• Biomarkers (metabolism)
• Biopsy, Needle
• Cytokines (blood)
• Disease Susceptibility
• Early Diagnosis
• Female
• Hospitals, University
• Humans
• Male
• Middle Aged
• Myositis (diagnosis, etiology, immunology, metabolism)
• Osteoarthritis, Hip (physiopathology, rehabilitation, surgery)
• Outpatient Clinics, Hospital
• Postoperative Complications (diagnosis, etiology, immunology, metabolism)
• Precision Medicine
• Predictive Value of Tests
• Prognosis
• Quadriceps Muscle (immunology, metabolism, pathology)
• Receptors, Tumor Necrosis Factor (genetics, metabolism)
• Reoperation (adverse effects, rehabilitation)
• TWEAK Receptor