# Evaluating the role of fascia structure and innervation in chronic knee OA pain

> **NIH NIH UC2** · UNIVERSITY OF FLORIDA · 2023 · $510,381

## Abstract

Summary
 To improve our understanding and treatment of chronic musculoskeletal pain, NOT-AR-23-015 calls for an
expansion of rheumatic, skin, and musculoskeletal disease pain research. In response to this NOSI, we propose
to expand our parent award to evaluate myofascial contributions to chronic OA pain and disability. The parent
award - UC2AR082196 - is part of the RE-JOIN Consortium, which has the over-arching goal of defining the
sensory innervation of different articular and peri-articular tissues. Within this Consortium-wide goal, the central
objective of our parent award is to define shifts in joint innervation patterns and evaluate how these innervation
shifts relate to the development of symptomatic joint pain and disability in both preclinical models and patients.
In addition to the innervation of joint structures (bone, synovium, cartilage, fibrocartilage), chronic OA pain may
be driven by physiologic shifts occurring beyond the joint, including changes in the fascia that lines the extra-
articular muscle. Fascia is richly innervated, and pathological changes in the fascia innervation or structure could
disrupt sensory information and contribute to OA pain. Our preliminary data using ultrasound imaging support
these findings, as variations in fascial thickness, muscle echogenicity and fascia stiffness are associated with
greater overall joint pain and worse function in persons with symptomatic knee OA. As such, this supplement
application seeks to expand the aims of the parent award by adding new studies on the role of fascia on the
development of chronic knee OA. The parent UC2 study provides an extraordinary and time-sensitive opportunity
to understand how fascia structure and innervation are related and how pathologic shifts in fascia contribute to
OA-related pain and disability in the knee. We propose to test the following hypotheses in data collected from a
cohort of knee OA patients, recruited via the parent award: 1) Fascia structure (thickness, composition, stiffness)
will vary between individuals with knee OA and OA-free controls and be associated with pain and function; 2)
Fascia innervation patterns (sensory) will vary between individuals with knee OA and OA-free controls, and be
associated with pain and function; and 3) Fascia structure and innervation patterns will vary across age. These
hypotheses will be evaluated using ultrasound imaging of fascia lata (b-mode, shear wave elastography) and
analyses of fascia lata biopsies collected at the time of total knee arthroplasty. Patient pain and function will be
assessed prior to arthroplasty, as described in the parent award. Combined, these data will allow us to compare
clinically-relevant ultrasound images to microstructure changes in the fascia, while relating all of these measures
of fascia pathology to quantitative metrics of pain and disability in OA patients.

## Key facts

- **NIH application ID:** 10858190
- **Project number:** 3UC2AR082196-01S1
- **Recipient organization:** UNIVERSITY OF FLORIDA
- **Principal Investigator:** Kyle D Allen
- **Activity code:** UC2 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $510,381
- **Award type:** 3
- **Project period:** 2023-09-15 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10858190

## Citation

> US National Institutes of Health, RePORTER application 10858190, Evaluating the role of fascia structure and innervation in chronic knee OA pain (3UC2AR082196-01S1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10858190. Licensed CC0.

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