Molecular pathology of total knee arthroplasty instability defined by RNA-seq

Eric A. Lewallen, Christopher G. Salib, William H. Trousdale, Charlotte E. Berry, Gabrielle M. Hanssen, Joseph X. Robin, Meagan E. Tibbo, Anthony Viste, Nicolas Reina, Mark E. Morrey, Joaquin Sanchez-Sotelo, Arlen D. Hanssen, Daniel J. Berry, Andre J. van Wijnen, Matthew P. Abdel

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Total knee arthroplasty (TKA) is a durable and reliable procedure to alleviate pain and improve joint function. However, failures related to flexion instability sometimes occur. The goal of this study was to define biological differences between tissues from patients with and without flexion instability of the knee after TKA. Human knee joint capsule tissues were collected at the time of primary or revision TKAs and analyzed by RT-qPCR and RNA-seq, revealing novel patterns of differential gene expression between the two groups. Interestingly, genes related to collagen production and extracellular matrix (ECM) degradation were higher in samples from patients with flexion instability. Partitioned clustering analyses further emphasized differential gene expression patterns between sample types that may help guide clinical interpretations of this complication. Future efforts to disentangle the effects of physical and biological (e.g., transcriptomic modifications) risk factors will aid in further characterizing and avoiding flexion instability after TKA.

Original languageEnglish (US)
Pages (from-to)247-256
Number of pages10
Issue number5
StatePublished - Sep 2018


  • Cell biology
  • Flexion instability
  • Molecular genetics
  • Revision total knee arthroplasty
  • Total knee arthroplasty

ASJC Scopus subject areas

  • Genetics


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