Sustaining neuromuscular activation after total knee arthroplasty preserves skeletal muscle fiber size, contractility, and innervation in older adults
Knee osteoarthritis (OA) is the leading cause of physical disability in older adults. Total knee arthroplasty (TKA) is a common treatment for advanced stage knee OA that alleviates knee pain, but it is associated with precipitous reductions in physical function early after surgery that can take mont...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-10-01
|
| Series: | Experimental Gerontology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0531556525001603 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849716970404970496 |
|---|---|
| author | Michael J. Toth Patrick D. Savage Deena B. Snoke Emma R. Bellefleur Michael DeSarno Timothy W. Tourville Michael Blankstein Alexander R. Keeble Sara Gonzalez-Velez Christopher S. Fry Jennifer Stevens-Lapsley Nathaniel J. Nelms |
| author_facet | Michael J. Toth Patrick D. Savage Deena B. Snoke Emma R. Bellefleur Michael DeSarno Timothy W. Tourville Michael Blankstein Alexander R. Keeble Sara Gonzalez-Velez Christopher S. Fry Jennifer Stevens-Lapsley Nathaniel J. Nelms |
| author_sort | Michael J. Toth |
| collection | DOAJ |
| description | Knee osteoarthritis (OA) is the leading cause of physical disability in older adults. Total knee arthroplasty (TKA) is a common treatment for advanced stage knee OA that alleviates knee pain, but it is associated with precipitous reductions in physical function early after surgery that can take months or years to recover. Sustaining neuromuscular activation after surgery with neuromuscular electrical stimulation (NMES) can improve recovery of physical function, but the mechanisms underlying its benefits are unclear. To examine the unique effects of NMES on skeletal muscle, we randomized older adult patients (70 % female) to early NMES (n = 11) or no intervention (n = 12) for 5 weeks after surgery. We measured skeletal muscle (vastus lateralis) fiber size, contractility, mitochondrial content, and mRNA abundance pre-surgery and 5 weeks post-surgery. NMES diminished TKA-induced muscle fiber atrophy in fast-twitch, myosin heavy chain (MHC) IIA fibers and improved or preserved single muscle fiber contractility in MHC I and MHC IIA fibers, respectively. In MHC IIA fibers, the beneficial effects of NMES to sustain fiber force production were explained at the molecular level by preservation of strongly bound, myosin-actin crossbridges. Additionally, TKA-induced increases in markers of denervation (CHRNA1 and MYOG) in controls were prevented by NMES. Our results identify beneficial effects of sustaining neuromuscular activation early, post-TKA with NMES on skeletal muscle fiber size and function and potential molecular mechanisms underlying these effects. |
| format | Article |
| id | doaj-art-8465ee2e16354c2aaf8d4e74c8bc151c |
| institution | DOAJ |
| issn | 1873-6815 |
| language | English |
| publishDate | 2025-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Experimental Gerontology |
| spelling | doaj-art-8465ee2e16354c2aaf8d4e74c8bc151c2025-08-20T03:12:49ZengElsevierExperimental Gerontology1873-68152025-10-0120911283110.1016/j.exger.2025.112831Sustaining neuromuscular activation after total knee arthroplasty preserves skeletal muscle fiber size, contractility, and innervation in older adultsMichael J. Toth0Patrick D. Savage1Deena B. Snoke2Emma R. Bellefleur3Michael DeSarno4Timothy W. Tourville5Michael Blankstein6Alexander R. Keeble7Sara Gonzalez-Velez8Christopher S. Fry9Jennifer Stevens-Lapsley10Nathaniel J. Nelms11Department of Medicine, University of Vermont College of Medicine, Burlington, VT, United States of America; Department of Orthopaedics and Rehabilitation, University of Vermont College of Medicine, Burlington, VT, United States of America; Corresponding author at: University of Vermont College of Medicine, Firestone Biomedical Research Building Room 260, 149 Beaumont Ave, Burlington, VT 05405, United States of America.Department of Medicine, University of Vermont College of Medicine, Burlington, VT, United States of AmericaDepartment of Medicine, University of Vermont College of Medicine, Burlington, VT, United States of AmericaDepartment of Medicine, University of Vermont College of Medicine, Burlington, VT, United States of AmericaDepartment of the Biomedical Statistics Core, University of Vermont College of Medicine, United States of AmericaDepartment of Orthopaedics and Rehabilitation, University of Vermont College of Medicine, Burlington, VT, United States of America; Department of Rehabilitation and Movement Science, College of Nursing and Health Science, University of Vermont, Burlington, VT, United States of AmericaDepartment of Orthopaedics and Rehabilitation, University of Vermont College of Medicine, Burlington, VT, United States of AmericaDepartment of Athletic Training and Clinical Nutrition, College of Health Sciences, University of Kentucky, Lexington, KY, United States of AmericaDepartment of Athletic Training and Clinical Nutrition, College of Health Sciences, University of Kentucky, Lexington, KY, United States of AmericaDepartment of Athletic Training and Clinical Nutrition, College of Health Sciences, University of Kentucky, Lexington, KY, United States of AmericaDepartment of Physical Medicine and Rehabilitation, College of Medicine, University of Colorado Anschutz Medical Campus, United States of America; VA Eastern Colorado Geriatric Research Education and Clinical Center, Denver, CO, United States of AmericaDepartment of Orthopaedics and Rehabilitation, University of Vermont College of Medicine, Burlington, VT, United States of AmericaKnee osteoarthritis (OA) is the leading cause of physical disability in older adults. Total knee arthroplasty (TKA) is a common treatment for advanced stage knee OA that alleviates knee pain, but it is associated with precipitous reductions in physical function early after surgery that can take months or years to recover. Sustaining neuromuscular activation after surgery with neuromuscular electrical stimulation (NMES) can improve recovery of physical function, but the mechanisms underlying its benefits are unclear. To examine the unique effects of NMES on skeletal muscle, we randomized older adult patients (70 % female) to early NMES (n = 11) or no intervention (n = 12) for 5 weeks after surgery. We measured skeletal muscle (vastus lateralis) fiber size, contractility, mitochondrial content, and mRNA abundance pre-surgery and 5 weeks post-surgery. NMES diminished TKA-induced muscle fiber atrophy in fast-twitch, myosin heavy chain (MHC) IIA fibers and improved or preserved single muscle fiber contractility in MHC I and MHC IIA fibers, respectively. In MHC IIA fibers, the beneficial effects of NMES to sustain fiber force production were explained at the molecular level by preservation of strongly bound, myosin-actin crossbridges. Additionally, TKA-induced increases in markers of denervation (CHRNA1 and MYOG) in controls were prevented by NMES. Our results identify beneficial effects of sustaining neuromuscular activation early, post-TKA with NMES on skeletal muscle fiber size and function and potential molecular mechanisms underlying these effects.http://www.sciencedirect.com/science/article/pii/S0531556525001603DisablementMyosinDenervationRehabilitation |
| spellingShingle | Michael J. Toth Patrick D. Savage Deena B. Snoke Emma R. Bellefleur Michael DeSarno Timothy W. Tourville Michael Blankstein Alexander R. Keeble Sara Gonzalez-Velez Christopher S. Fry Jennifer Stevens-Lapsley Nathaniel J. Nelms Sustaining neuromuscular activation after total knee arthroplasty preserves skeletal muscle fiber size, contractility, and innervation in older adults Experimental Gerontology Disablement Myosin Denervation Rehabilitation |
| title | Sustaining neuromuscular activation after total knee arthroplasty preserves skeletal muscle fiber size, contractility, and innervation in older adults |
| title_full | Sustaining neuromuscular activation after total knee arthroplasty preserves skeletal muscle fiber size, contractility, and innervation in older adults |
| title_fullStr | Sustaining neuromuscular activation after total knee arthroplasty preserves skeletal muscle fiber size, contractility, and innervation in older adults |
| title_full_unstemmed | Sustaining neuromuscular activation after total knee arthroplasty preserves skeletal muscle fiber size, contractility, and innervation in older adults |
| title_short | Sustaining neuromuscular activation after total knee arthroplasty preserves skeletal muscle fiber size, contractility, and innervation in older adults |
| title_sort | sustaining neuromuscular activation after total knee arthroplasty preserves skeletal muscle fiber size contractility and innervation in older adults |
| topic | Disablement Myosin Denervation Rehabilitation |
| url | http://www.sciencedirect.com/science/article/pii/S0531556525001603 |
| work_keys_str_mv | AT michaeljtoth sustainingneuromuscularactivationaftertotalkneearthroplastypreservesskeletalmusclefibersizecontractilityandinnervationinolderadults AT patrickdsavage sustainingneuromuscularactivationaftertotalkneearthroplastypreservesskeletalmusclefibersizecontractilityandinnervationinolderadults AT deenabsnoke sustainingneuromuscularactivationaftertotalkneearthroplastypreservesskeletalmusclefibersizecontractilityandinnervationinolderadults AT emmarbellefleur sustainingneuromuscularactivationaftertotalkneearthroplastypreservesskeletalmusclefibersizecontractilityandinnervationinolderadults AT michaeldesarno sustainingneuromuscularactivationaftertotalkneearthroplastypreservesskeletalmusclefibersizecontractilityandinnervationinolderadults AT timothywtourville sustainingneuromuscularactivationaftertotalkneearthroplastypreservesskeletalmusclefibersizecontractilityandinnervationinolderadults AT michaelblankstein sustainingneuromuscularactivationaftertotalkneearthroplastypreservesskeletalmusclefibersizecontractilityandinnervationinolderadults AT alexanderrkeeble sustainingneuromuscularactivationaftertotalkneearthroplastypreservesskeletalmusclefibersizecontractilityandinnervationinolderadults AT saragonzalezvelez sustainingneuromuscularactivationaftertotalkneearthroplastypreservesskeletalmusclefibersizecontractilityandinnervationinolderadults AT christophersfry sustainingneuromuscularactivationaftertotalkneearthroplastypreservesskeletalmusclefibersizecontractilityandinnervationinolderadults AT jenniferstevenslapsley sustainingneuromuscularactivationaftertotalkneearthroplastypreservesskeletalmusclefibersizecontractilityandinnervationinolderadults AT nathanieljnelms sustainingneuromuscularactivationaftertotalkneearthroplastypreservesskeletalmusclefibersizecontractilityandinnervationinolderadults |