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Bone Joint Res. 2013 Apr 10;2(4):70-8. doi: 10.1302/2046-3758.24.2000151. Print 2013.

Muscle 'regenerative potential' determinesphysical recovery following total knee replacement.

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1
University of Edinburgh, Departmentof Orthopaedics, Chancellor's Building, LittleFrance Crescent, Edinburgh EH16 4SB, UK.

Abstract

OBJECTIVES:

Lower limb muscle power is thought to influence outcome following total knee replacement (TKR). Post-operative deficits in muscle strength are commonly reported, although not explained. We hypothesised that post-operative recovery of lower limb muscle power would be influenced by the number of satellite cells in the quadriceps muscle at time of surgery.

METHODS:

Biopsies were obtained from 29 patients undergoing TKR. Power output was assessed pre-operatively and at six and 26 weeks post-operatively with a Leg Extensor Power Rig and data were scaled for body weight. Satellite cell content was assessed in two separate analyses, the first cohort (n = 18) using immunohistochemistry and the second (n = 11) by a new quantitative polymerase chain reaction (q-PCR) protocol for Pax-7 (generic satellite cell marker) and Neural Cell Adhesion Molecule (NCAM; marker of activated cells).

RESULTS:

A significant improvement in power output was observed post-operatively with a mean improvement of 19.7 W (95% confidence interval (CI) 14.43 to 30.07; p < 0.001) in the first cohort and 27.5 W (95% CI 13.2 to 41.9; p = 0.002) in the second. A strong correlation was noted between satellite cell number (immunohistochemistry) and improvement in patient power output (r = 0.64, p = 0.008). Strong correlation was also observed between the expression of Pax-7 and power output (r = 0.79, p = 0.004), and the expression of NCAM and power output (r = 0.84, p = 0.001). The generic marker explained 58% of the variation in power output, and the marker of activated cells 67%.

CONCLUSIONS:

Muscle satellite cell content may determine improvement in lower limb power generation (and thus function) following TKR.

KEYWORDS:

Muscle; Outcome; Regenerative potential; Satellite cell; TKR; Total knee replacement; q-PCR

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