Identification of factors associated with non-responders to total joint replacement and sustained knee pain in primary osteoarthritis patients by epidemiological and multi-omic studies ...

• Main Author: Costello, Christie Alyssa
• Format: Text
• Language: English
• Published: Memorial University of Newfoundland 2023
• Subjects: Newfoundland
• Online Access: https://dx.doi.org/10.48336/h8ab-7h31; https://research.library.mun.ca/16185/

Osteoarthritis (OA) is among the most common rheumatic diseases, affecting 30% of the world’s population over 60 years. Currently, total joint replacement (TJR) is considered the most effective treatment for end-stage OA. However, up to 20% of patients do not see clinically significant improvement in pain or function after the surgery. This thesis aims to identify epidemiological, metabolic, and genetic factors which are significantly associated with non-responders to TJR and patients with sustained, treatment-resistant pain in a large cohort from Newfoundland and Labrador (NL), Canada. First, we identified a number of epidemiological factors significantly associated with non-responders to TJR including clinical depression, younger age, and multisite musculoskeletal pain (MSMP). This highlighted potential roles for altered pain perception and pain sensitization in non-responders. Subsequently, we used a targeted metabolomic approach which profiled 186 metabolites in plasma and identified three metabolite ...