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Title: Investigating the role of bone marrow lesions in osteoathritic pain
Author: Kuttapitiya , Anasuya
ISNI:       0000 0004 7427 0521
Awarding Body: St George's, University of London
Current Institution: St George's, University of London
Date of Award: 2017
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Bone marrow lesions (BML) are well described in osteoarthritis (OA) using magnetic resonance imaging (MRI) and are associated with pain, however little is known about their pathological characteristics and gene expression. This study evaluated BMLs using tissue analysis tools to gain a deeper understanding of how they mediate pain. A total of 117 participants were recruited, 74 with advanced OA requiring total knee replacement (TKR), 23 with mild OA, 7 healthy controls and 13 non-OA tissue comparator controls. A multidimensional approach was taken to investigate how clinical, radiological and molecular changes in OA knee joints correlate with pain perception. Pain scoring (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Pain DETECT) and quantitative sensory testing (QST) were used to characterise the pain experienced by participant. To assess structural changes MR images were scored using MRI Osteoarthritis Knee Score (MOAKS) by two independent scorers. The MRI scans were used to localise BMLs for whole transcriptomic analysis, qPCR for array validation, histological evaluation, scanning electron microscopy and quantitative protein expression. Serum samples obtained at baseline visits were used for biomarker investigation. The result demonstrates that BMLs are regions of increased cellular and metabolic activity and correlated with increased pain and sensitisation. The findings contribute to the understanding of OA pathogenesis and could help lead to the development of new diagnostic tools and future therapies for the improved management of this increasingly prevalent condition.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available