Approved Research

Identifying Genetic Polymorphisms Underlying the Arthrofibrosis Phenotype post Total Joint Arthroplasty

Lay summary

Arthrofibrosis is the formation of scar tissue around the joint after a hip or knee replacement that leads to debilitating pain, stiffness, and disability. However, it remains unclear what causes arthrofibrosis, which has limited our ability to treat the condition and its symptoms. Treatments include non-surgical options such as physical therapy or manipulation of the joint under anesthesia. When these are ineffective, surgery may be needed to break up the scar tissue, or in some cases, a second joint replacement may even be necessary. Even so, these treatments are not fully effective in improving joint function and reducing pain.

Furthermore, studies have shown that arthrofibrosis and related collagen disorders such as keloids are more common in Black and Hispanic patients, which suggest that there may be a genetic cause of these disorders, but the genes responsible have yet to be identified. Therefore, these gaps in our understanding of arthrofibrosis contribute to inequity in the outcomes of joint replacement surgery in historically disadvantaged populations. Black patients overall have worse outcomes after knee replacement than White patients and more commonly need treatment of arthrofibrosis, such as manipulation of the joint. Thus, there is a need to define patients that are at greatest risk of arthrofibrosis in order to address this inequality and reduce the risk of this burdensome complication.

The aim of this study is to compare the genetic data of patients who develop arthrofibrosis after a joint replacement with those who do not. The genes that are associated with arthrofibrosis will be used to create a risk score to predict which patients are at high risk of developing arthrofibrosis after joint replacement surgery, which may allow for targeted prevention and early diagnosis of arthrofibrosis and ultimately address disparities in racial and ethnic outcomes after joint replacement surgery. This study will last 36 months