Acute Postoperative Pain and Dorsal Root Ganglia Transcriptomic Signatures Following Total Knee Arthroplasty (TKA) in Rats: An Experimental Study

Authors, Author Information and Article Contact

Justice Achonu, MD1; David E. Komatsu, PhD1; Sardar MZ Uddin, PhD1; Chris Gordon, BS2; Martha P. Kanjiya, BS2; Diane Bogdan, PhD2; Adriana DiBua2, Hira Iftikhar2, Amanda Ackermann2, Rohan J. Shah2, Jason Shieh3, Agnieszka B. Bialkowska3, and Martin Kaczocha, PhD2

1Department of Orthopaedics and Rehabilitation, Stony Brook University 

2Department of Anesthesiology, Stony Brook University

3Department of Medicine, Stony Brook University

Disclosure Statement

None of the authors has any funding sources, commercial, or financial conflicts of interest to declare.

Citation  

Achonu J, Komatsu DE, Uddin SMZ, et al: Acute Postoperative Pain and Dorsal Root Ganglia Transcriptomic Signatures Following Total Knee Arthroplasty (TKA) in Rats: An Experimental Study.  Stony Brook Medicine Journal of Scholarship, Innovation, and Quality Improvement - Orthopaedics 2023-2024, 18:7-19.

Keywords
Total knee arthroplasty, osteoarthritis, rat model
Abstract

Total knee arthroplasty (TKA) is the final treatment option for patients with advanced knee osteoarthritis (OA) . Unfortunately, TKA surgery is accompanied by acute postoperative pain that is more severe than arthroplasty performed in other joints . Elucidating the molecular mechanisms specific to post-TKA pain necessitates an animal model that replicates clinical TKA procedures, induces acute postoperative pain, and leads to complete functional recovery . Here, we present a new preclinical TKA model in rats and report on functional and behavioral outcomes indicative of pain, analgesic efficacy, serum cytokine levels, and dorsal root ganglia (DRG) transcriptomes during the acute postoperative period . Following TKA, rats exhibited marked deficits in weight bearing that persisted for 28 days . Home cage locomotion, rearing, and gait were similarly impacted and recovered by day 14 . Cytokine levels were elevated on postoperative days one and/or two . Treatment with morphine, ketorolac, or their combination improved weight bearing while gabapentin lacked efficacy . When TKA was performed in rats with OA, similar functional defi- cits and comparable recovery time courses were observed . Analysis of DRG transcriptomes revealed upregulation of transcripts linked to multiple molecular pathways including inflammation, MAPK signaling, and cytokine signaling and production . In summary, we developed a clinically relevant rat TKA model characterized by resolution of pain and functional recovery within five weeks and with pain-associated behavioral deficits that are partially alleviated by clinically administered analgesics, mirroring the postoperative experience of TKA patients .

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