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Sample records for joint disease osteoarthritis

  1. Osteoarthritis

    MedlinePlus

    Hypertrophic osteoarthritis; Osteoarthrosis; Degenerative joint disease; DJD; OA; Arthritis - osteoarthritis ... rubbery tissue that cushions your bones at the joints. It allows bones to glide over one another. ...

  2. Joint Instability and Osteoarthritis

    PubMed Central

    Blalock, Darryl; Miller, Andrew; Tilley, Michael; Wang, Jinxi

    2015-01-01

    Joint instability creates a clinical and economic burden in the health care system. Injuries and disorders that directly damage the joint structure or lead to joint instability are highly associated with osteoarthritis (OA). Thus, understanding the physiology of joint stability and the mechanisms of joint instability-induced OA is of clinical significance. The first section of this review discusses the structure and function of major joint tissues, including periarticular muscles, which play a significant role in joint stability. Because the knee, ankle, and shoulder joints demonstrate a high incidence of ligament injury and joint instability, the second section summarizes the mechanisms of ligament injury-associated joint instability of these joints. The final section highlights the recent advances in the understanding of the mechanical and biological mechanisms of joint instability-induced OA. These advances may lead to new opportunities for clinical intervention in the prevention and early treatment of OA. PMID:25741184

  3. Relationship between joint shape and the development of osteoarthritis

    PubMed Central

    Baker-LePain, Julie C.; Lane, Nancy E.

    2016-01-01

    Purpose of review To present an updated summary of the relationship between joint shape and the development of osteoarthritis, with a particular focus on osteoarthritis of the hip. Recent findings Osteoarthritis of the hip is highly heritable, with a genetic contribution estimated at 60%. Among the genes that have been linked to this disease are several that are involved in the development and maintenance of joint shape, including members of the Wingless (Wnt) and the bone morphogenetic protein (BMP) family. Several features of hip joint architecture, such as acetabular dysplasia, pistol grip deformity, wide femoral neck, altered femoral neck-shaft angle, appear to play an important role in the pathogenesis of osteoarthritis and may predate the development of osteoarthritis by decades. Summary Gene–environment interactions play a crucial role in the development of osteoarthritis. The architecture of joint shape is determined by a complex sequence spanning embryonic, childhood, and adult life and contributes to the pathogenesis of osteoarthritis. PMID:20644480

  4. [Sacroiliac joints: osteoarthritis or arthritis].

    PubMed

    García Díez, Ana Isabel; Tomás Batllé, Xavier; Pomés Talló, Jaume; Amo Conill, Montserrat Del

    2009-02-01

    One of the most challenging aspects of treating the sacroiliac joint (SIJ) pain is the complexity of diagnosis. Imaging methods have gained importance for the diagnosis of SIJ diseases. CT and MR exams had equal efficacy superior to radiography in staging structural changes in the SIJ due to osteoarthritis or sacroiliitis. The diagnosis of spondyloarthropaty can be delayed for several years using certain radiography studies. MR imaging reveal early cartilage changes and active inflammatory changes in the subchondral bone and surrounding ligaments in spondyloarthropaties, as well as subperiosteal and transcapsular yuxtaarticular infiltrations characteristic of septic sacroiliitis, which could not be found by either CT of radiography. T1-WI with fat suppression (FS) and STIR images improve the demonstration of erosions and inflammatory changes respectively, on MR studies. Additional T1-FS after i.v. contrast has proven valuable in demonstrating the extension of inflammatory changes and abscesses in septic sacroiliitis, and in spondyloartropaties may be useful although this is debatable. Scintigraphy gives high sensibility only in early inflammatory changes and low specificity for the diagnosis of sacroiliitis due to high bone turnover in the SIJ, although specific radioprobes are useful in confirming the septic etiology and evaluating additional foci. This complex joint of very limited mobility shows a lot of structural variations and some anatomical degenerative changes due to age, which are necessary to know to an adequate image interpretation and diagnosis of disease. PMID:21794574

  5. Osteoarthritis

    MedlinePlus

    ... Osteoarthritis in the knees can lead to disability. Hips The hips are also common sites of osteoarthritis. As with knee osteoarthritis, symptoms of hip osteoarthritis include pain and stiffness of the joint ...

  6. Osteoarthritis pathogenesis - a complex process that involves the entire joint.

    PubMed

    Man, G S; Mologhianu, G

    2014-03-15

    Osteoarthritis is the most common joint disorder and a major cause of disability with a major socio-economic impact. In these circumstances is very important to understand its pathogenesis. Although previous research focused primarily on changes in the articular cartilage, more recent studies have highlighted the importance of the subchondral bone, synovium, menisci, ligaments, periarticular muscles and nerves. Now osteoarthritis is viewed as a multifactorial disease affecting the whole joint. PMID:24653755

  7. Osteoarthritis of the spine: the facet joints.

    PubMed

    Gellhorn, Alfred C; Katz, Jeffrey N; Suri, Pradeep

    2013-04-01

    Osteoarthritis (OA) of the spine involves the facet joints, which are located in the posterior aspect of the vertebral column and, in humans, are the only true synovial joints between adjacent spinal levels. Facet joint osteoarthritis (FJ OA) is widely prevalent in older adults, and is thought to be a common cause of back and neck pain. The prevalence of facet-mediated pain in clinical populations increases with increasing age, suggesting that FJ OA might have a particularly important role in older adults with spinal pain. Nevertheless, to date FJ OA has received far less study than other important OA phenotypes such as knee OA, and other features of spine pathoanatomy such as degenerative disc disease. This Review presents the current state of knowledge of FJ OA, including relevant anatomy, biomechanics, epidemiology, and clinical manifestations. We present the view that the modern concept of FJ OA is consonant with the concept of OA as a failure of the whole joint, and not simply of facet joint cartilage. PMID:23147891

  8. Acupuncture for peripheral joint osteoarthritis

    PubMed Central

    Manheimer, Eric; Cheng, Ke; Linde, Klaus; Lao, Lixing; Yoo, Junghee; Wieland, Susan; van der Windt, Daniëlle AWM; Berman, Brian M; Bouter, Lex M

    2011-01-01

    Background Peripheral joint osteoarthritis is a major cause of pain and functional limitation. Few treatments are safe and effective. Objectives To assess the effects of acupuncture for treating peripheral joint osteoarthritis. Search strategy We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2008, Issue 1), MEDLINE, and EMBASE (both through December 2007), and scanned reference lists of articles. Selection criteria Randomized controlled trials (RCTs) comparing needle acupuncture with a sham, another active treatment, or a waiting list control group in people with osteoarthritis of the knee, hip, or hand. Data collection and analysis Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information. We calculated standardized mean differences using the differences in improvements between groups. Main results Sixteen trials involving 3498 people were included. Twelve of the RCTs included only people with OA of the knee, 3 only OA of the hip, and 1 a mix of people with OA of the hip and/or knee. In comparison with a sham control, acupuncture showed statistically significant, short-term improvements in osteoarthritis pain (standardized mean difference -0.28, 95% confidence interval -0.45 to -0.11; 0.9 point greater improvement than sham on 20 point scale; absolute percent change 4.59%; relative percent change 10.32%; 9 trials; 1835 participants) and function (-0.28, -0.46 to -0.09; 2.7 point greater improvement on 68 point scale; absolute percent change 3.97%; relative percent change 8.63%); however, these pooled short-term benefits did not meet our predefined thresholds for clinical relevance (i.e. 1.3 points for pain; 3.57 points for function) and there was substantial statistical heterogeneity. Additionally, restriction to sham-controlled trials using shams judged most likely to adequately blind participants to treatment assignment (which were also the same shams judged most likely to have physiological activity), reduced heterogeneity and resulted in pooled short-term benefits of acupuncture that were smaller and non-significant. In comparison with sham acupuncture at the six-month follow-up, acupuncture showed borderline statistically significant, clinically irrelevant improvements in osteoarthritis pain (-0.10, -0.21 to 0.01; 0.4 point greater improvement than sham on 20 point scale; absolute percent change 1.81%; relative percent change 4.06%; 4 trials;1399 participants) and function (-0.11, -0.22 to 0.00; 1.2 point greater improvement than sham on 68 point scale; absolute percent change 1.79%; relative percent change 3.89%). In a secondary analysis versus a waiting list control, acupuncture was associated with statistically significant, clinically relevant short-term improvements in osteoarthritis pain (-0.96, -1.19 to -0.72; 14.5 point greater improvement than sham on 100 point scale; absolute percent change 14.5%; relative percent change 29.14%; 4 trials; 884 participants) and function (-0.89, -1.18 to -0.60; 13.0 point greater improvement than sham on 100 point scale; absolute percent change 13.0%; relative percent change 25.21%). In the head-on comparisons of acupuncture with the ‘supervised osteoarthritis education’ and the ‘physician consultation’ control groups, acupuncture was associated with clinically relevant short- and long-term improvements in pain and function. In the head on comparisons of acupuncture with ‘home exercises/advice leaflet’ and ‘supervised exercise’, acupuncture was associated with similar treatment effects as the controls. Acupuncture as an adjuvant to an exercise based physiotherapy program did not result in any greater improvements than the exercise program alone. Information on safety was reported in only 8 trials and even in these trials there was limited reporting and heterogeneous methods. Authors' conclusions Sham-controlled trials show statistically significant benefits; however, these benefits are small, do not meet our pre-defined thresholds for clinical relevance, and are probably due at least partially to placebo effects from incomplete blinding. Waiting list-controlled trials of acupuncture for peripheral joint osteoarthritis suggest statistically significant and clinically relevant benefits, much of which may be due to expectation or placebo effects. PMID:20091527

  9. Expression of adhesion molecules on synovial fluid and peripheral blood monocytes in patients with inflammatory joint disease and osteoarthritis

    PubMed Central

    Koller, M; Aringer, M; Kiener, H; Erlacher, L; Machold, K; Eberl, G; Studnicka-Benke, A; Graninger, W; Smolen, J

    1999-01-01

    OBJECTIVE—To determine the presence of adhesion molecules on monocytes/macrophages (Mϕ) from peripheral blood (PB) and synovial fluid (SF) in patients with osteoarthritis (OA) and inflammatory joint diseases (rheumatoid (RA) and reactive arthritis (ReA)) in order to improve our understanding of the possible mechanisms underlying the inflammatory process.
METHODS—Whole blood and SF cells were stained with monoclonal antibodies against CD11a (LFA-1), CD15 s (sialyl-Lewis X), CD44, CD54, VLA-4, and HLA-DR counterstained with anti-CD14 antibodies as a Mϕ marker for dual fluorescence analysis by flowcytometry. 
RESULTS—On PB-Mϕ, CD15s was markedly increased in both RA as well as ReA compared with OA. Furthermore, in the PB LFA-1, CD44, and HLA-DR showed a higher surface density on Mϕ in ReA than in OA. Comparison between SF and PB showed significantly higher CD44 and CD54 expression on SF-Mϕ. These molecules play an important part in lymphocyte-Mϕ interaction.
CONCLUSION—In PB from patients with inflammatory joint diseases, Mϕ are activated, allowing recruitment into the synovial compartment. These disorders, in contrast with OA seem to be "systemic" in nature. Within the SF, different adhesion molecules are expressed on CD14+ Mϕ as compared with PB.

 PMID:10531076

  10. Hypertrophic differentiation of chondrocytes in osteoarthritis: the developmental aspect of degenerative joint disorders

    PubMed Central

    2010-01-01

    Osteoarthritis is characterized by a progressive degradation of articular cartilage leading to loss of joint function. The molecular mechanisms regulating pathogenesis and progression of osteoarthritis are poorly understood. Remarkably, some characteristics of this joint disease resemble chondrocyte differentiation processes during skeletal development by endochondral ossification. In healthy articular cartilage, chondrocytes resist proliferation and terminal differentiation. By contrast, chondrocytes in diseased cartilage progressively proliferate and develop hypertrophy. Moreover, vascularization and focal calcification of joint cartilage are initiated. Signaling molecules that regulate chondrocyte activities in both growth cartilage and permanent articular cartilage during osteoarthritis are thus interesting targets for disease-modifying osteoarthritis therapies. PMID:20959023

  11. Osteoarthritis

    MedlinePlus

    ... causes pain, swelling, and reduced motion in your joints. It can occur in any joint, but usually it affects your hands, knees, hips ... spine. Osteoarthritis breaks down the cartilage in your joints. Cartilage is the slippery tissue that covers the ...

  12. Inflammation in joint injury and post-traumatic osteoarthritis.

    PubMed

    Lieberthal, J; Sambamurthy, N; Scanzello, C R

    2015-11-01

    Inflammation is a variable feature of osteoarthritis (OA), associated with joint symptoms and progression of disease. Signs of inflammation can be observed in joint fluids and tissues from patients with joint injuries at risk for development of post-traumatic osteoarthritis (PTOA). Furthermore, inflammatory mechanisms are hypothesized to contribute to the risk of OA development and progression after injury. Animal models of PTOA have been instrumental in understanding factors and mechanisms involved in chronic progressive cartilage degradation observed after a predisposing injury. Specific aspects of inflammation observed in humans, including cytokine and chemokine production, synovial reaction, cellular infiltration and inflammatory pathway activation, are also observed in models of PTOA. Many of these models are now being utilized to understand the impact of post-injury inflammatory response on PTOA development and progression, including risk of progressive cartilage degeneration and development of chronic symptoms post-injury. As evidenced from these models, a vigorous inflammatory response occurs very early after joint injury but is then sustained at a lower level at the later phases. This early inflammatory response contributes to the development of PTOA features including cartilage erosion and is potentially modifiable, but specific mediators may also play a role in tissue repair. Although the optimal approach and timing of anti-inflammatory interventions after joint injury are yet to be determined, this body of work should provide hope for the future of disease modification tin PTOA. PMID:26521728

  13. Three-Dimensional Quantitative Morphometric Analysis (QMA) for In Situ Joint and Tissue Assessment of Osteoarthritis in a Preclinical Rabbit Disease Model.

    PubMed

    Stok, Kathryn S; Besler, Bryce A; Steiner, Thomas H; Villarreal Escudero, Ana V; Zulliger, Martin A; Wilke, Markus; Atal, Kailash; Quintin, Aurelie; Koller, Bruno; Müller, Ralph; Nesic, Dobrila

    2016-01-01

    This work utilises advances in multi-tissue imaging, and incorporates new metrics which define in situ joint changes and individual tissue changes in osteoarthritis (OA). The aims are to (1) demonstrate a protocol for processing intact animal joints for microCT to visualise relevant joint, bone and cartilage structures for understanding OA in a preclinical rabbit model, and (2) introduce a comprehensive three-dimensional (3D) quantitative morphometric analysis (QMA), including an assessment of reproducibility. Sixteen rabbit joints with and without transection of the anterior cruciate ligament were scanned with microCT and contrast agents, and processed for histology. Semi-quantitative evaluation was performed on matching two-dimensional (2D) histology and microCT images. Subsequently, 3D QMA was performed; including measures of cartilage, subchondral cortical and epiphyseal bone, and novel tibio-femoral joint metrics. Reproducibility of the QMA was tested on seven additional joints. A significant correlation was observed in cartilage thickness from matching histology-microCT pairs. The lateral compartment of operated joints had larger joint space width, thicker femoral cartilage and reduced bone volume, while osteophytes could be detected quantitatively. Measures between the in situ tibia and femur indicated an altered loading scenario. High measurement reproducibility was observed for all new parameters; with ICC ranging from 0.754 to 0.998. In conclusion, this study provides a novel 3D QMA to quantify macro and micro tissue measures in the joint of a rabbit OA model. New metrics were established consisting of: an angle to quantitatively measure osteophytes (σ), an angle to indicate erosion between the lateral and medial femoral condyles (ρ), a vector defining altered angulation (λ, α, β, γ) and a twist angle (τ) measuring instability and tissue degeneration between the femur and tibia, a length measure of joint space width (JSW), and a slope and intercept (m, Χ) of joint contact to demonstrate altered loading with disease progression, as well as traditional bone and cartilage and histo-morphometry measures. We demonstrate correlation of microCT and histology, sensitive discrimination of OA change and robust reproducibility. PMID:26808542

  14. Three-Dimensional Quantitative Morphometric Analysis (QMA) for In Situ Joint and Tissue Assessment of Osteoarthritis in a Preclinical Rabbit Disease Model

    PubMed Central

    Stok, Kathryn S.; Besler, Bryce A.; Steiner, Thomas H.; Villarreal Escudero, Ana V.; Zulliger, Martin A.; Wilke, Markus; Atal, Kailash; Quintin, Aurelie; Koller, Bruno; Müller, Ralph; Nesic, Dobrila

    2016-01-01

    This work utilises advances in multi-tissue imaging, and incorporates new metrics which define in situ joint changes and individual tissue changes in osteoarthritis (OA). The aims are to (1) demonstrate a protocol for processing intact animal joints for microCT to visualise relevant joint, bone and cartilage structures for understanding OA in a preclinical rabbit model, and (2) introduce a comprehensive three-dimensional (3D) quantitative morphometric analysis (QMA), including an assessment of reproducibility. Sixteen rabbit joints with and without transection of the anterior cruciate ligament were scanned with microCT and contrast agents, and processed for histology. Semi-quantitative evaluation was performed on matching two-dimensional (2D) histology and microCT images. Subsequently, 3D QMA was performed; including measures of cartilage, subchondral cortical and epiphyseal bone, and novel tibio-femoral joint metrics. Reproducibility of the QMA was tested on seven additional joints. A significant correlation was observed in cartilage thickness from matching histology-microCT pairs. The lateral compartment of operated joints had larger joint space width, thicker femoral cartilage and reduced bone volume, while osteophytes could be detected quantitatively. Measures between the in situ tibia and femur indicated an altered loading scenario. High measurement reproducibility was observed for all new parameters; with ICC ranging from 0.754 to 0.998. In conclusion, this study provides a novel 3D QMA to quantify macro and micro tissue measures in the joint of a rabbit OA model. New metrics were established consisting of: an angle to quantitatively measure osteophytes (σ), an angle to indicate erosion between the lateral and medial femoral condyles (ρ), a vector defining altered angulation (λ, α, β, γ) and a twist angle (τ) measuring instability and tissue degeneration between the femur and tibia, a length measure of joint space width (JSW), and a slope and intercept (m, Χ) of joint contact to demonstrate altered loading with disease progression, as well as traditional bone and cartilage and histo-morphometry measures. We demonstrate correlation of microCT and histology, sensitive discrimination of OA change and robust reproducibility. PMID:26808542

  15. Osteoarthritis

    MedlinePlus Videos and Cool Tools

    ... osteoarthritis include loss of flexibility, limited movement, and pain and swelling within the joint. The condition results ... the margins of the joint. Part of the pain results from these bone spurs, which can restrict ...

  16. Study of 500 patients with limb joint osteoarthritis. I. Analysis by age, sex, and distribution of symptomatic joint sites.

    PubMed Central

    Cushnaghan, J; Dieppe, P

    1991-01-01

    Five hundred subjects with symptomatic limb joint osteoarthritis, who had been referred to a rheumatologist, were enrolled into a continuing study. They comprised 342 women (mean age 65.3) and 158 men (mean age 59.7), with a mean symptom duration of 15.4 years at entry. Only 31 patients (6%) had symptomatic osteoarthritis of one joint alone; however, in a further 205 (41%) the disease was limited to one site. One hundred and eighty two (36.4%) had two sites affected and 82 (16.4%) three or more sites of symptomatic osteoarthritis. Of 847 affected joints the most commonly involved were 349 (41.2%) knees, 254 (30%) hands, and 161 (19%) hips. Hip disease stood out as a separate entity, often occurring alone, and having a stronger male preponderance and different associations than osteoarthritis at other joint sites. Knee and hand disease were significantly associated in women. Obesity, hypertension, and Heberden's nodes were common. The number of sites affected, as well as the distribution, was strongly related to age as well as sex, suggesting that polyarticular osteoarthritis arises from slow acquisition of new joint sites in a non-random distribution. 'Generalised' osteoarthritis did not emerge as a distinct entity. PMID:1994877

  17. Etiology of osteoarthritis: genetics and synovial joint development.

    PubMed

    Sandell, Linda J

    2012-02-01

    Osteoarthritis (OA) has a considerable hereditary component and is considered to be a polygenic disease. Data derived from genetic analyses and genome-wide screening of individuals with this disease have revealed a surprising trend: genes associated with OA tend to be related to the process of synovial joint development. Mutations in these genes might directly cause OA. In addition, they could also determine the age at which OA becomes apparent, the joint sites involved, the severity of the disease and how rapidly it progresses. In this Review, I propose that genetic mutations associated with OA can be placed on a continuum. Early-onset OA is caused by mutations in matrix molecules often associated with chondrodysplasias, whereas less destructive structural abnormalities or mutations confer increased susceptibility to injury or malalignment that can result in middle-age onset. Finally, mutations in molecules that regulate subtle aspects of joint development and structure lead to late-onset OA. In this Review, I discuss the genetics of OA in general, but focus on the potential effect of genetic mutations associated with OA on joint structure, the role of joint structure in the development of OA--using hip abnormalities as a model--and how understanding the etiology of the disease could influence treatment. PMID:22231237

  18. Tests on hypotheses about osteoarthritis and hip joints.

    PubMed Central

    Afoke, N Y; Byers, P D; Hutton, W C

    1992-01-01

    Hypotheses suggesting that hip joints which develop osteoarthritis are congruent, have a single area of peak pressure, and have peak pressure which exceeds normal values were tested. Of 100 hip joints examined on necropsy; two showed an early stage of osteoarthritis and the geometry and pressure distribution under load were assessed in these joints. One joint was congruent, in agreement with the hypotheses, but the other was incongruent. In both joints there were several areas of high pressure, the number and location of which depended on the orientation of the joint. The measured values of pressure in the congruent joint exceeded values found previously in normal hip joints. In the incongruent hip joint the peak pressures were within normal limits. Images PMID:1586245

  19. Humoral immunity to link protein in patients with inflammatory joint disease, osteoarthritis, and in non-arthritic controls.

    PubMed Central

    Austin, A K; Hobbs, R N; Anderson, J C; Butler, R C; Ashton, B A

    1988-01-01

    Cartilage link protein of high purity was prepared and used in an enzyme linked immunosorbent assay (ELISA). Antibodies to link protein were sought in the sera of 98 patients with rheumatic disorders; 38 with rheumatoid arthritis (RA), 29 with osteoarthritis (OA), 13 with psoriatic arthritis (PA), nine with ankylosing spondylitis (AS), nine with systemic lupus erythematosus (SLE), and in 83 healthy controls. Antibodies were detected in all groups with the following prevalences: 21/83 normals, 9/38 RA, 7/29 OA, 7/13 PA, 3/9 AS, and 4/9 SLE. No statistically significant differences existed between the groups with regard to either prevalence or mean titre of anti-link antibodies. Serum antibodies to proteoglycan link protein appear to be no more common in patients with rheumatic disorders than in healthy controls. Images PMID:3207372

  20. [Imaging of osteoarthritis of the peripheral joints].

    PubMed

    Zacher, J; Carl, H D; Swoboda, B; Backhaus, M

    2007-05-01

    Pain and loss of function are the clinical signs of osteoarthritis (OA). Conventional x-rays confirm the diagnosis or provide important hints for differential diagnosis. In the natural course of OA, x-rays are performed at longer intervals when pain increases or therapy is without effect, especially if more invasive therapies, or even surgery, becomes necessary. The advantages of x-rays are worldwide availability, cost effectiveness, very long experience with this imaging method and the possibility of storing the images for long periods of time. The typical findings of OA can be detected only roughly by quantitative methods. In many patients, grading of OA does not correlate well with the clinical symptoms. X-ray changes are part of the American College of Rheumatology (ACR) classification criteria for OA of the hand, hip and knee. Ordinary s-rays can depicting bone with a higher local resolution than any other imaging technique. Soft tissues and cartilage can be visualized only indirectly. In OA, ultrasound is the method to depict intra-articular effusion at an early stage. Osteophytes or the degree of synovitis are also visible. Concomitant changes in tendons, bursae or cartilage, such as structures in the hip, shoulder and knee, can be evaluated. MRI is an appropriate tool for describing changes in cartilage volume and concomitant soft-tissue alterations. For qualitative cartilage imaging, MRI has, to date, not been fully validated. Bone scans (bone scintigraphy) allow the differentiation of inflammatory from degenerative joint affections and may add information on the activity of the subchondral bone, which may develop to a prognostic marker of OA. This survey represents recommendations of the Commission "Imaging Techniques" of the German Rheumatology Society regarding the technical and individual conditions, indications, practical guidance and the typical findings of imaging in OA. PMID:17051361

  1. Osteoarthritis of the knee joint: an eight year prospective study.

    PubMed Central

    Massardo, L; Watt, I; Cushnaghan, J; Dieppe, P

    1989-01-01

    Thirty one patients (25 women, six men, mean age 71.7 years) with established osteoarthritis (OA) of the knee were examined clinically and radiologically on two occasions, eight years apart. Four patients thought they had got better, two of whom had striking functional improvement. Seven remained the same and 20 patients got worse, two needing knee surgery and many developing severe disabilities. Most of the patients had a history of slow acquisition of OA at new joint sites, hand disease emerging as the commonest other site of involvement. Changes in symptoms, disability, and radiographs did not correlate. Three of the four patients who improved symptomatically lost range of motion at the knee and developed more severe changes on their radiographs. Chondrocalcinosis of the knee was seen in five patients, including two of those who improved. PMID:2596881

  2. What Is Osteoarthritis?

    MedlinePlus

    ... of Publications for the Public Osteoarthritis is a joint disease that mostly affects cartilage. Cartilage is the slippery ... It occurs most often in the hands, knees, hips, and spine. Warning signs of osteoarthritis are:  Stiffness ...

  3. Spontaneously developed osteoarthritis in the temporomandibular joint in STR/ort mice

    PubMed Central

    KUMAGAI, KENICHI; SUZUKI, SATSUKI; KANRI, YORIAKI; MATSUBARA, RYOTA; FUJII, KEISUKE; WAKE, MASAHIRO; SUZUKI, RYUJI; HAMADA, YOSHIKI

    2015-01-01

    Temporomandibular joint (TMJ) osteoarthritis is typically a slowly progressive asymmetric disease. Little is known regarding the natural destruction of TMJ articular tissues. The aim of the present study was to investigate morphological changes in the TMJ of STR/ort mice, known to be the model for spontaneous osteoarthritis in the knee joint, and to evaluate STR/ort mice as a suitable animal model for TMJ osteoarthritis. TMJs from 32 STR/ort mice euthanized at 30, 40, 50 or 60 weeks of age, and from 6 CBA mice euthanized at 30, 40 or 60 weeks of age were examined. Toluidine blue and tartrate-resistant acid phosphatase staining were used to assess histological changes in the articular cartilage. Morphological changes in the articular cartilage of the TMJ were evaluated using microcomputed tomography. At the age of 40–50 weeks, 17 (68%) of the 25 STR/ort mice had loss of articular cartilage on histology, with cavitation and erosion of the exposed bone and gradual changes in condylar shape. Furthermore, osteoarthritic morphological changes, and structural alterations were observed by microcomputed tomography. The STR/ort mouse strain appears to develop spontaneous osteoarthritis-like lesions in the TMJ with age, and would be a useful model to study the pathogenesis of TMJ osteoarthritis. PMID:26171147

  4. Bone alterations are associated with ankle osteoarthritis joint pain.

    PubMed

    Nakamura, Yukio; Uchiyama, Shigeharu; Kamimura, Mikio; Komatsu, Masatoshi; Ikegami, Shota; Kato, Hiroyuki

    2016-01-01

    The etiology of ankle osteoarthritis (OA) is largely unknown. We analyzed 24 ankle OA of 21 patients diagnosed by plain radiographs using magnetic resonance imaging (MRI). Ankle joint pain disappeared in 22 out of 24 joints by conservative treatment. MRI bone signal changes in and around the ankle joints were observed in 22 of 24 joints. Bone signal changes along the joint line were seen in 10 of 11 joints as a Kellgren-Lawrence (KL) grade of II to IV. Such signal changes were witnessed in only 4 of 13 joints with KL grade 0 or I. In the talocrural joint, bone alterations occurred in both tibia and talus bones through the joint line in cases of KL grade III or IV, while focal bone alterations were present in the talus only in KL grade I or II cases. Sixteen of 24 joints exhibited intraosseous bone signal changes, which tended to correspond to joint pain of any ankle OA stage. Our results suggest that bone alterations around the ankle joint might be one of the etiologies of OA and associated with ankle joint pain. PMID:26776564

  5. Bone alterations are associated with ankle osteoarthritis joint pain

    PubMed Central

    Nakamura, Yukio; Uchiyama, Shigeharu; Kamimura, Mikio; Komatsu, Masatoshi; Ikegami, Shota; Kato, Hiroyuki

    2016-01-01

    The etiology of ankle osteoarthritis (OA) is largely unknown. We analyzed 24 ankle OA of 21 patients diagnosed by plain radiographs using magnetic resonance imaging (MRI). Ankle joint pain disappeared in 22 out of 24 joints by conservative treatment. MRI bone signal changes in and around the ankle joints were observed in 22 of 24 joints. Bone signal changes along the joint line were seen in 10 of 11 joints as a Kellgren-Lawrence (KL) grade of II to IV. Such signal changes were witnessed in only 4 of 13 joints with KL grade 0 or I. In the talocrural joint, bone alterations occurred in both tibia and talus bones through the joint line in cases of KL grade III or IV, while focal bone alterations were present in the talus only in KL grade I or II cases. Sixteen of 24 joints exhibited intraosseous bone signal changes, which tended to correspond to joint pain of any ankle OA stage. Our results suggest that bone alterations around the ankle joint might be one of the etiologies of OA and associated with ankle joint pain. PMID:26776564

  6. Is early osteoarthritis associated with differences in joint congruence?

    PubMed Central

    Conconi, Michele; Halilaj, Eni; Castelli, Vincenzo Parenti; Crisco, Joseph J.

    2014-01-01

    Previous studies suggest that osteoarthritis (OA) is related to abnormal or excessive articular contact stress. The peak pressure resulting from an applied load is determined by many factors, among which is shape and relative position and orientation of the articulating surfaces or, referring to a more common nomenclature, joint congruence. It has been hypothesized that anatomical differences may be among the causes of OA. Individuals with less congruent joints would likely develop higher peak pressure and thus would be more exposed to the risk of OA onset. The aim of this work was to determine if the congruence of the first carpometacarpal (CMC) joint differs with the early onset of OA or with sex, as the female population has a higher incidence of OA. 59 without and 38 with early OA were CT-scanned with their dominant or arthritic hand in a neutral configuration. The proposed measure of joint congruence is both shape and size dependent. The correlation of joint congruence with pathology and sex was analyzed both before and after normalization for joint size. We found a significant correlation between joint congruence and sex due to the sex-related differences in size. The observed correlation disappeared after normalization. Although joint congruence increased with size, it did not correlate significantly with the onset of early OA. Differences in joint congruence in this population may not be a primary cause of OA onset or predisposition, at least for the CMC joint. PMID:25468667

  7. Osteoarthritis pathogenesis – a complex process that involves the entire joint

    PubMed Central

    Man, GS; Mologhianu, G

    2014-01-01

    Abstract Osteoarthritis is the most common joint disorder and a major cause of disability with a major socio-economic impact. In these circumstances is very important to understand its pathogenesis. Although previous research focused primarily on changes in the articular cartilage, more recent studies have highlighted the importance of the subchondral bone, synovium, menisci, ligaments, periarticular muscles and nerves. Now osteoarthritis is viewed as a multifactorial disease affecting the whole joint. Abbreviations: TNF-α – tumor necrosis factor alpha, IL-1 – interleukin -1, IL-6 – interleukin-6, COMP- cartilage oligomeric matrix protein, BSP - bone sialoprotein, MRI - magnetic resonance imaging, NTx - cross-linked N-telopeptide of type I collagen, CTx – C-telopeptide-cross-linked collagen type I, TGF-β – transforming growth factor beta, MMPs- matrix metaloproteinases, VEGF-vascular endothelial growth factor, bFGF - basic fibroblast growth factor. PMID:24653755

  8. A Dual Role for NOTCH Signaling in Joint Cartilage Maintenance and Osteoarthritis

    PubMed Central

    Liu, Zhaoyang; Chen, Jianquan; Mirando, Anthony; Wang, Cuicui; Zuscik, Michael J.; O’Keefe, Regis J.; Hilton, Matthew J.

    2015-01-01

    Loss of NOTCH signaling in postnatal murine joints results in osteoarthritis (OA), indicating a requirement for NOTCH during joint cartilage maintenance. Unexpectedly, NOTCH components are significantly up-regulated in human and murine post-traumatic OA, suggesting either a reparative or pathological role for NOTCH activation in OA. Here we investigated the potential dual role for NOTCH in joint maintenance and OA by generating two mouse models overexpressing the NOTCH1 intracellular domain within postnatal joint cartilage; one with sustained NOTCH activation that likely resembles pathological NOTCH signaling and one with transient NOTCH activation that more closely reflects physiological NOTCH signaling. Sustained NOTCH signaling in joint cartilage leads to an early and progressive OA pathology, while on the contrary, transient NOTCH activation enhances cartilage matrix synthesis and promotes joint maintenance under normal physiological conditions. Using RNA-seq, immunohistochemical, and biochemical approaches we identified several novel targets potentially responsible for NOTCH-mediated cartilage degradation, fibrosis, and OA progression, including components of the IL6/STAT3 and ERK/p38 MAPK pathways; factors that may also contribute to post-traumatic OA development. Collectively, these data demonstrate a dual role for the NOTCH pathway in joint cartilage and identify important downstream NOTCH effectors as potential targets for disease modifying osteoarthritis drugs (DMOADs). PMID:26198357

  9. Alternative therapies for traditional disease states: osteoarthritis.

    PubMed

    Morelli, Vincent; Naquin, Christopher; Weaver, Victor

    2003-01-15

    Americans spend more on natural remedies for osteoarthritis than for any other medical condition. In treating osteoarthritis, glucosamine and chondroitin sulfate, two of the molecular building blocks found in articular cartilage, are the most commonly used alternative supplements. In randomized trials of variable quality, these compounds show efficacy in reducing symptoms, but neither has been shown to arrest progression of the disease or regenerate damaged cartilage. Although few clinical trials on S-adenosylmethionine exist, preliminary evidence indicates that it relieves pain to a degree similar to that of nonsteroidal anti-inflammatory drugs but with fewer side effects. Clinical trials of dimethyl sulfoxide offer conflicting results. Neither ginger nor cetyl myristoleate has proven clinical usefulness. PMID:12562155

  10. Managing joint pain in osteoarthritis: safety and efficacy of hylan G-F 20

    PubMed Central

    Conduah, Augustine H; Baker, Champ L; Baker, Champ L

    2009-01-01

    The use of intra-articular viscosupplementation in the nonoperative management of patients with osteoarthritis has become quite popular. Recent clinical data have demonstrated that the anti-inflammatory and chondroprotective actions of hyaluronic acid viscosupplementation reduce pain while improving patient function. We review the basic science and development of viscosupplementation and discuss the mounting evidence in support of the efficacy and safety profile of hylan G-F 20. Recent evidence suggesting a disease-modifying effect of hylan G-F 20 is also assessed. Furthermore, although the primary focus of this article is on treatment of osteoarthritis of the knee, we also discuss the use of viscosupplementation in other joints, such as the hip, ankle, and shoulder. PMID:21197297

  11. Role of Agnikarma in Sandhigata Vata (osteoarthritis of knee joint)

    PubMed Central

    Jethava, Nilesh G.; Dudhamal, Tukaram S.; Gupta, Sanjay Kumar

    2015-01-01

    Introduction: Sandhigata Vata is one of Vata Vyadhi characterized by the symptoms such as Sandhishoola (joint pain) and Sandhishopha (swelling of joint). Osteoarthritis (OA) is degenerative joint disorder, represents failure of the diarthrodial (movable, synovial-lined) joint. OA of knee joint comes under the inflammatory group which is almost identical to Sandhigata Vata described in Ayurveda with respect to etiology, pathology, and clinical features. Agnikarma (therapeutic heat burn) is one which gives instant relief from pain by balancing local Vata and Kapha Dosha without any untoward effects. Aim: To evaluate the efficacy of Agnikarma with Rajata and Loha Dhatu Shalaka in the management of Janugata Sandhivata (OA of knee joint). Materials and Methods: A total of 28 diagnosed patients of Janugata Sandhivata were registered and randomly divided into two groups. In Group-A, Agnikarma was done with Rajata Shalaka while in Group-B Agnikarma was performed by Loha Shalaka in four sittings. Assessment in relief of signs and symptoms was done by weekly interval, and Student's t-test was applied for statistical analysis. Results: Group-A provided 76.31% relief in pain while Group-B provided 83.77% relief. Relief from crepitus was observed in 57.13% of patients of Group-A, while 57.92% of patients of Group-B. There was statistically insignificant difference between both the groups. Loha Shalaka provided better result in pain relief than Rajata Shalaka. Conclusion: Agnikarma is effective nonpharmacological, parasurgical procedure for pain management in Sandhigata Vata (OA of knee joint). PMID:26730134

  12. Exercise therapy for the management of osteoarthritis of the hip joint: a systematic review

    PubMed Central

    McNair, Peter J; Simmonds, Marion A; Boocock, Mark G; Larmer, Peter J

    2009-01-01

    Introduction Recent guidelines pertaining to exercise for individuals with osteoarthritis have been released. These guidelines have been based primarily on studies of knee-joint osteoarthritis. The current study was focused on the hip joint, which has different biomechanical features and risk factors for osteoarthritis and has received much less attention in the literature. The purpose was to conduct a systematic review of the literature to evaluate the exercise programs used in intervention studies focused solely on hip-joint osteoarthritis, to decide whether their exercise regimens met the new guidelines, and to determine the level of support for exercise-therapy interventions in the management of hip-joint osteoarthritis. Methods A systematic literature search of 14 electronic databases was undertaken to identify interventions that used exercise therapy as a treatment modality for hip osteoarthritis. The quality of each article was critically appraised and graded according to standardized methodologic approaches. A 'pattern-of-evidence' approach was used to determine the overall level of evidence in support of exercise-therapy interventions for treating hip osteoarthritis. Results More than 4,000 articles were identified, of which 338 were considered suitable for abstract review. Of these, only 6 intervention studies met the inclusion criteria. Few well-designed studies specifically investigated the use of exercise-therapy management on hip-joint osteoarthritis. Insufficient evidence was found to suggest that exercise therapy can be an effective short-term management approach for reducing pain levels, improving joint function and the quality of life. Conclusions Limited information was available on which conclusions regarding the efficacy of exercise could be clearly based. No studies met the level of exercise recommended for individuals with osteoarthritis. High-quality trials are needed, and further consideration should be given to establishing the optimal exercises and exposure levels necessary for achieving long-term gains in the management of osteoarthritis of the hip. PMID:19555502

  13. Hylan G-F 20: Review of its Safety and Efficacy in the Management of Joint Pain in Osteoarthritis

    PubMed Central

    Migliore, A.; Giovannangeli, F.; Granata, M.; Laganà, B.

    2010-01-01

    Background: Osteoarthritis (OA) is a chronic degenerative joint disease that is a clinically and economically important disease. The increased prevalence of OA with aging, coupled to the demographics of aging populations, make OA a high priority health care problem. Viscosupplementation (VS) is a well-established treatment option in knee OA that is included in the professional guidelines for treatment of this joint disease, and could potentially provide a useful alternative in treating such patients with painful OA. Theoretically VS is an approach that should apply to all synovial joints. Objectives: The aim of this review is to assess the efficacy and safety of viscosupplementation with Hylan GF-20 (Synvisc®) in the management of joint pain in osteoarthritis. Methods: The following databases were searched: Medline, Database of Abstract on Reviews and Effectiveness, Cochrane Database of Systematic Reviews. Furthermore, the lists of references of retrieved publications were manually checked for additional references. The search terms Review, Viscosupplementation, Osteoarthritis, Hyaluronic acid, Hyaluronan, Sodium Hyaluronate, Hylan GF-20, Synvisc, intra-articular injection were used to identify all studies relating to the use of Synvisc® viscosupplementation therapy in OA. Results: Hylan GF-20 is a safe and effective treatment for decreasing pain and improving function in patients suffering from knee and hip OA but new evidences are emerging for its use in other joints. PMID:21151854

  14. Early osteoarthritis of the trapeziometacarpal joint is not associated with joint instability during typical isometric loading.

    PubMed

    Halilaj, Eni; Moore, Douglas C; Patel, Tarpit K; Ladd, Amy L; Weiss, Arnold-Peter C; Crisco, Joseph J

    2015-11-01

    The saddle-shaped trapeziometacarpal (TMC) joint contributes importantly to the function of the human thumb. A balance between mobility and stability is essential in this joint, which experiences high loads and is prone to osteoarthritis (OA). Since instability is considered a risk factor for TMC OA, we assessed TMC joint instability during the execution of three isometric functional tasks (key pinch, jar grasp, and jar twist) in 76 patients with early TMC OA and 44 asymptomatic controls. Computed tomography images were acquired while subjects held their hands relaxed and while they applied 80% of their maximum effort for each task. Six degree-of-freedom rigid body kinematics of the metacarpal with respect to the trapezium from the unloaded to the loaded task positions were computed in terms of a TMC joint coordinate system. Joint instability was expressed as a function of the metacarpal translation and the applied force. We found that the TMC joint was more unstable during a key pinch task than during a jar grasp or a jar twist task. Sex, age, and early OA did not have an effect on TMC joint instability, suggesting that instability during these three tasks is not a predisposing factor in TMC OA. PMID:25941135

  15. Metabolic stress-induced joint inflammation and osteoarthritis.

    PubMed

    Courties, A; Gualillo, O; Berenbaum, F; Sellam, J

    2015-11-01

    Osteoarthritis (OA) is a heterogeneous disorder with several risk factors. Among them, obesity has a major impact on both loading and non-loading joints. Mechanical overload and activity of systemic inflammatory mediators derived from adipose tissue (adipokines, free fatty acids (FFA), reactive oxygen species (ROS)) provide clues to the increased incidence and prevalence of OA in obesity. Recently, research found greater OA prevalence and incidence in obese patients with cardiometabolic disturbances than "healthy" obese patients, which led to the description of a new OA phenotype - metabolic syndrome (MetS)-associated OA. Indeed, individual metabolic factors (diabetes, dyslipidemia, and hypertension) may increase the risk of obesity-induced OA. This review discusses hypotheses based on pathways specific to a metabolic factor in MetS-associated OA, such as the role of advanced glycation end products (AGEs) and glucose toxicity. A better understanding of these phenotypes based on risk factors will be critical for designing trials of this specific subset of OA. PMID:26033164

  16. [Rheumatic joint diseases in the elderly].

    PubMed

    Kondo, Yuya; Yokosawa, Masahiro; Kaneko, Shunta; Sumida, Takayuki

    2014-10-01

    The most frequent rheumatic joint disease in the elderly is rheumatoid arthritis (RA). Recent advances in the treatment of RA improve prognosis, and gradually increase the elderly patients with RA. There are some differences in clinical features between the patients with elderly onset RA and young onset RA, such as systemic symptoms and distribution of affected joints. In addition, it is occasionally difficult to differentiate elderly onset RA from the other rheumatic diseases like polymyalgia rheumatica and RS3PE syndrome, pseudogout, and osteoarthritis. Since elderly patients tend to have more co-morbidity and co-existing diseases requiring treatment with other drugs, a risk/benefit profile must always be taken into consideration when choosing the treatment in elderly patients with rheumatic joint diseases. PMID:25509802

  17. CLINICAL APPLICATION OF SPHARM-PDM TO QUANTIFY TEMPOROMANDIBULAR JOINT OSTEOARTHRITIS

    PubMed Central

    Paniagua, Beatriz; Cevidanes, Lucia; Walker, David; Zhu, Hongtu; Guo, Ruixin; Styner, Martin

    2011-01-01

    The severe bone destruction and resorption that can occur in Osteoarthritis of the Temporomandibular Joint (TMJ) is associated with significant pain and limited joint mobility. However, there is no validated method for the quantification of discrete changes in joint morphology in early diagnosis or assessment of disease progression or treatment effects. To achieve this, the objective of this cross-sectional study was to use simulated bone resorption on cone-beam CT (CBCT) to study condylar morphological variation in subjects with temporomandibular joint (TMJ) osteoarthritis (OA). The first part of this study assessed the hypothesis that the agreement between the simulated defects and the shape analysis measurements made of these defects would be within 0.5mm (the image’s spatial resolution). One hundred seventy-nine discrete bony defects measuring 3mm and 6mm were simulated on the surfaces of 3D models derived from CBCT images of asymptomatic patients using ITK-Snap software. SPHARM shape correspondence was used to localize and quantify morphological differences of each resorption model with the original asymptomatic control. The size of each simulated defect was analyzed and the values obtained compared to the true defect size. The statistical analysis revealed very high probabilities that mean shape correspondence measured defects within 0.5mm of the true defect size. 95% confidence intervals (CI) were (2.67,2.92) and (5.99,6.36) and 95% prediction intervals (PI) were (2.22,3.37) and (5.54, 6.82), respectively for 3mm and 6mm simulated defects. The second part of this study applied shape correspondence methods to a longitudinal sample of TMJ OA patients. The mapped longitudinal stages of TMJ OA progression identified morphological variants or subtypes, which may explain the heterogeneity of the clinical presentation. This study validated shape correspondence as a method to precisely and predictably quantify 3D condylar resorption. PMID:21185694

  18. Associations Between Frontal Plane Joint Stiffness and Proprioceptive Acuity in Knee Osteoarthritis

    PubMed Central

    Cammarata, Martha L; Dhaher, Yasin Y

    2012-01-01

    Objective It has been proposed that proprioceptive impairments observed in knee osteoarthritis (OA) may be associated with disease-related changes in joint mechanics. The aim of this study was to quantify joint proprioception and stiffness in the frontal plane of the knee in persons with and without knee OA and to report the associations between these two metrics. Methods Thirteen persons with knee OA and fourteen healthy age-matched subjects participated. Proprioceptive acuity was assessed in varus and valgus using the threshold to detection of movement (TDPM). Passive joint stiffness was estimated as the slope of the normalized torque-angle relationship at 0° joint rotation (neutral) and several rotations in varus and valgus. Analyses of variance were performed to determine the effect of OA and gender on each metric. Linear regression was used to assess the correlation between TDPM and joint stiffness. Results TDPM was significantly higher (P<0.05) in the OA group compared to controls for both varus and valgus, but significant gender differences were observed. Passive joint stiffness was significantly reduced (P<0.05) in OA participants compared to the control group in neutral and valgus, but not varus, and significantly reduced in females compared to males. A weak negative correlation was observed between TDPM and stiffness estimates, suggesting that poorer proprioception was associated with less joint stiffness. Conclusions While both joint stiffness and proprioception were reduced in the OA population, they were only weakly correlated. This suggests that other neurophysiological factors play a larger role in the proprioceptive deficits in knee OA. PMID:22213576

  19. An in Silico Analysis of Ankle Joint Loads in Secondary Ankle Osteoarthritis. Case Study.

    PubMed

    Lorkowski, Jacek; Mrzygłód, Mirosław W; Grzegorowska, Oliwia; Kotela, Ireneusz

    2015-01-01

    Secondary, post-traumatic, degenerative lesions of the ankle joint remain a serious clinical challenge. This paper presents the case of a 66-year-old patient with secondary, post-traumatic ankle osteoarthritis and subchondral cysts. The use of rapid computer modelling FEM 2D enabled optimization of surgical treatment. A FEM 2D model of biomechanical changes in bones may help in streamlining treatment as well as improve our understanding of the pathomechanism of osteoarthritis. PMID:26248632

  20. Abnormal loading of the major joints in knee osteoarthritis and the response to knee replacement.

    PubMed

    Metcalfe, Andrew; Stewart, Caroline; Postans, Neil; Barlow, David; Dodds, Alexander; Holt, Cathy; Whatling, Gemma; Roberts, Andrew

    2013-01-01

    Knee osteoarthritis is common and patients frequently complain that they are 'overloading' the joints of the opposite leg when they walk. However, it is unknown whether moments or co-contractions are abnormal in the unaffected joints of patients with single joint knee osteoarthritis, or how they change following treatment of the affected knee. Twenty patients with single joint medial compartment knee osteoarthritis were compared to 20 asymptomatic control subjects. Gait analysis was performed for normal level gait and surface EMG recordings of the medial and lateral quadriceps and hamstrings were used to investigate co-contraction. Patients were followed up 12 months post-operatively and the analysis was repeated. Results are presented for the first 14 patients who have attended follow-up. Pre-operatively, adduction moment impulses were elevated at both knees and the contra-lateral hip compared to controls. Co-contraction of hamstrings and quadriceps was elevated bilaterally. Post-operatively, moment waveforms returned to near-normal levels at the affected knee and co-contraction fell in the majority of patients. However, abnormalities persisted in the contra-lateral limb with partial or no recovery of both moment waveforms and co-contraction in the majority. Patients with knee osteoarthritis do experience abnormal loads of their major weight bearing joints bilaterally, and abnormalities persist despite treatment of the affected limb. Further treatment may be required if we are to protect the other major joints following joint arthroplasty. PMID:22841587

  1. Utilisation of joint movement range in arboreal primates compared with human subjects: an evolutionary frame for primary osteoarthritis.

    PubMed Central

    Alexander, C J

    1994-01-01

    OBJECTIVE--To determine whether an arboreal lifestyle required full use of movement ranges underutilised in nine joint groups in humans, because under-utilisation of available movement range may be associated with susceptibility to primary osteoarthritis. METHODS--Utilisation of the nine joint groups was studied in two species of primate exercising in a simulated arboreal environment, using 'focal animal' observation techniques supplemented by telephoto photography and by review of archival material from other sources. Fifteen apes were observed over a total observation period of 20.2 man-hours and 152 films were analysed for utilisation of movement range. RESULTS--With one exception, all the movement ranges reported to be under-utilised in humans were fully utilised by the apes in climbing activities. The exception, metacarpophalangeal extension, was an essential component of the chimpanzee ground progression mode of knuckle walking. CONCLUSIONS--The underused movement range in several human joints is explicable as residual capacity from a semiarboreal lifestyle. If the correlation with primary osteoarthritis is confirmed, it suggests that the disease may reflect a disparity between inherited capacity and current need. The significance of the result lies in its implication that primary osteoarthritis may be preventable. Images PMID:7826133

  2. Clarification on Mechanical Characteristic in State of Stress of Osteoarthritis of the Hip Joint Using Stress Freezing Method

    NASA Astrophysics Data System (ADS)

    Maezaki, Nobutaka; Ezumi, Tsutomu; Hachiya, Masashi

    In this research, the Osteoarthritis of Hip Joint was pick up, the 3-dimensional stress freezing method of photoelastic method was applied, and the state of the stress in the normality hip joint and the transformable hip joint was examined. The direction and the singular point of principal stress and stress distribution were experimentally examined. At result, The Osteoarthritis of Hip Joint touches by 2 points, Osteoarthritis of Hip Joint occurrence of the new singular point with flat of the femoral head, They change the direction of the principal stress line in an existing singular point is cause.

  3. Arthrodesis of the talocalcaneal joint for the treatment of two horses with talocalcaneal osteoarthritis.

    PubMed

    Pauwels, F E; Adams, S B; Blevins, W B

    2005-01-01

    Two horses with lameness due to tolocalcaneal osteoarthritis that failed to respond to conservative management were treated by tolocalcaneal arthrodesis using cortex screws placed in lag fashion. The affected joint of one horse was arthrodesed by compressing and stabilizing the medial facet of the joint with three screws. In the second horse, the medial and lateral facets of the affected tolocalcaneal joint were each compressed and stabilized with two screws. The lameness of both horses improved markedly following surgery. PMID:16594210

  4. Osteoarthritis of the glenohumeral joint: nonsurgical treatment options.

    PubMed

    Carfagno, David G; Ellenbecker, Todd S

    2002-04-01

    Glenohumeral osteoarthritis is a relatively uncommon type of osteoarthritis characterized by loss of anterior or forward flexion. Assessing range of motion, impingement, and strength, combined with radiologic imaging, can help determine the extent of damage. Published studies focus primarily on surgical treatment, but commonly used nonsurgical approaches include anti-inflammatory medications, oral and injectable viscosupplementation, and physical therapy. These conservative measures can be very effective for active patients and also appeal to their physicians who consider shoulder surgery as a last resort. PMID:20086520

  5. Osteoarthritis in the XXIst Century: Risk Factors and Behaviours that Influence Disease Onset and Progression

    PubMed Central

    Musumeci, Giuseppe; Aiello, Flavia Concetta; Szychlinska, Marta Anna; Di Rosa, Michelino; Castrogiovanni, Paola; Mobasheri, Ali

    2015-01-01

    Osteoarthritis (OA) is a growing public health problem across the globe, affecting more than half of the over 65 population. In the past, OA was considered a wear and tear disease, leading to the loss of articular cartilage and joint disability. Nowadays, thanks to advancements in molecular biology, OA is believed to be a very complex multifactorial disease. OA is a degenerative disease characterized by “low-grade inflammation” in cartilage and synovium, resulting in the loss of joint structure and progressive deterioration of cartilage. Although the disease can be dependent on genetic and epigenetic factors, sex, ethnicity, and age (cellular senescence, apoptosis and lubricin), it is also associated with obesity and overweight, dietary factors, sedentary lifestyle and sport injuries. The aim of this review is to highlight how certain behaviors, habits and lifestyles may be involved in the onset and progression of OA and to summarize the principal risk factors involved in the development of this complicated joint disorder. PMID:25785564

  6. [Non-surgical treatment of osteoarthritis of large joints - new aspects].

    PubMed

    Wagner, Ernst

    2009-01-01

    A large number of treatment options exist for osteoarthritis of the knee and hip. The choice of therapy depends on clinical symptomatology, preexisting risk factors (e.g. obesity), and disease stage. This review includes the novel aspects of symptomatic conservative treatment (physical medicine and drugs), especially pain management (electrotherapy), and rehabilitational aspects. Rehabilitation is essential, as osteoarthritis is a chronic condition, that requires lifelong intervention, and a causal cure has not been identified yet. New aspects of hyaluronic acid, slow-acting symptomatic drugs in osteoarthritis (chondroitin sulfate, glucosamine sulfate, and diacerein), and experimental drugs, which claim the properties of disease modification in osteoarthritis (bisphosphonates, calcitonin, and interleukin-1 antagonists), are discussed. PMID:19247594

  7. Is running associated with degenerative joint disease

    SciTech Connect

    Panush, R.S.; Schmidt, C.; Caldwell, J.R.; Edwards, N.L.; Longley, S.; Yonker, R.; Webster, E.; Nauman, J.; Stork, J.; Pettersson, H.

    1986-03-07

    Little information is available regarding the long-term effects, if any, of running on the musculoskeletal system. The authors compared the prevalence of degenerative joint disease among 17 male runners with 18 male nonrunners. Running subjects (53% marathoners) ran a mean of 44.8 km (28 miles)/wk for 12 years. Pain and swelling of hips, knees, ankles and feet and other musculoskeletal complaints among runners were comparable with those among nonrunners. Radiologic examinations (for osteophytes, cartilage thickness, and grade of degeneration) also were without notable differences among groups. They did not find an increased prevalence of osteoarthritis among the runners. Our observations suggest that long-duration, high-mileage running need to be associated with premature degenerative joint disease in the lower extremities.

  8. Osteoarthritis of the Manubriosternal Joint: An Uncommon Cause of Chest Pain.

    PubMed

    Vaishya, Raju; Vijay, Vipul; Rai, Bibek K

    2015-01-01

    Osteoarthritis of the manubriosternal joint is a rare cause of chest pain. The diagnosis is difficult, and other serious causes of chest pain have to be ruled out first. We report one case that was treated with fusion of the manubriosternal joint using an iliac crest bone graft with a cervical locking plate and screws with excellent results. Preoperative CT scan images were used to measure the screw length and the drill stop depth. In this case report, we have shown that arthrodesis can be an effective way of treating osteoarthritis of the manubriosternal joint when other measures fail. Furthermore, the use of a cervical locking plate with appropriate and careful preoperative planning affords a safe surgical technique, rapid pain relief, and ultimately, sound and asymptomatic union of the joint. PMID:26677420

  9. Gluteus medius muscle atrophy is related to contralateral and ipsilateral hip joint osteoarthritis.

    PubMed

    Amaro, A; Amado, F; Duarte, J A; Appell, H-J

    2007-12-01

    In order to understand the role of the GLUTEUS MEDIUS muscle (GM) in hip joint osteoarthritis, the objective of this study was to analyze the correlation between morphometric data of GM samples with osteoarthritis scores of ipsilateral and contralateral hips in 41 patients. GM samples obtained during unilateral hip replacement surgery were used to evaluate muscle fibers in the cross-sectional area (CSA) and other features indicative for muscle aging. Clinical symptoms were assessed by the Lequesne pain score. Hip osteoarthritis was graded by the Kellgren score and by measuring the sum joint space width (sumJSW) at three different articular locations and minimal JSW in a. p. radiographs. Varying degrees of GM muscle atrophy correlated with the pain score; pain score also correlated with radiographic signs of osteoarthritis. GM CSA was significantly correlated with all radiographic signs of the contralateral hip, but only with the sumJSW in the ipsilateral hip. It can be concluded that a weak GM may be the result of ipsilateral osteoarthitis, but may especially predispose the contralateral hip to develop osteoarthritis. This can be associated with an impaired GM capacity to avoid the shock impact in the load transfer during gait. Muscle strengthening is therefore recommended. PMID:17534787

  10. Three-dimensional diffuse optical tomography of osteoarthritis: a study of 38 finger joints

    NASA Astrophysics Data System (ADS)

    Zhang, Qizhi; Yuan, Zhen; Sobel, Eric S.; Jiang, Huabei

    2009-02-01

    Our previous work has shown that near-infrared diffuse optical tomography has the potential to be a clinical tool in diagnosis of osteoarthritis. Here we report a study of 38 joints from 38 females, including 20 OA and 18 healthy joints. The quantitative results obtained show that there exists clear difference between OA and healthy joints in terms of the ratio of optical properties of the joint soft tissues to that of the associated bone. Statistic analysis of these clinical data is also presented.

  11. Joint Mobilization Enhances Mechanisms of Conditioned Pain Modulation in Individuals With Osteoarthritis of the Knee.

    PubMed

    Courtney, Carol A; Steffen, Alana D; Fernández-de-Las-Pñas, César; Kim, John; Chmell, Samuel J

    2016-03-01

    Study Design An experimental laboratory study with a repeated-measures crossover design. Background Treatment effects of joint mobilization may occur in part by decreasing excitability of central nociceptive pathways. Impaired conditioned pain modulation (CPM) has been found experimentally in persons with knee and hip osteoarthritis, indicating impaired inhibition of central nociceptive pathways. We hypothesized increased effectiveness of CPM following application of joint mobilization, determined via measures of deep tissue hyperalgesia. Objective To examine the effect of joint mobilization on impaired CPM. Methods An examination of 40 individuals with moderate/severe knee osteoarthritis identified 29 (73%) with impaired CPM. The subjects were randomized to receive 6 minutes of knee joint mobilization (intervention) or manual cutaneous input only, 1 week apart. Deep tissue hyperalgesia was examined via pressure pain thresholds bilaterally at the knee medial joint line and the hand at baseline, postintervention, and post-CPM testing. Further, vibration perception threshold was measured at the medial knee epicondyle at baseline and post-CPM testing. Results Joint mobilization, but not cutaneous input intervention, resulted in a global increase in pressure pain threshold, indicated by diminished hyperalgesic responses to pressure stimulus. Further, CPM was significantly enhanced following joint mobilization. Diminished baseline vibration perception threshold acuity was enhanced following joint mobilization at the knee that received intervention, but not at the contralateral knee. Resting pain was also significantly lower following the joint intervention. Conclusion Conditioned pain modulation was enhanced following joint mobilization, demonstrated by a global decrease in deep tissue pressure sensitivity. Joint mobilization may act via enhancement of descending pain mechanisms in patients with painful knee osteoarthritis. J Orthop Sports Phys Ther 2016;46(3):168-176. Epub 1 Jan 2016. doi:10.2519/jospt.2016.6259. PMID:26721229

  12. Age-related joint space narrowing independent of the development of osteoarthritis of the shoulder

    PubMed Central

    Kircher, Jrn; Kuerner, Konstanze; Morhard, Markus; Krauspe, Rdiger; Habermeyer, Peter

    2014-01-01

    Purpose: It is commonly accepted that the glenohumeral joint space remains unchanged until the onset of osteoarthritis, at which point progressive degenerative changes, and joint space narrowing occur. The aim of this study was to evaluate the radiographic width of the glenohumeral joint space in patients of different ages: Those with otherwise normal radiographs, those with a history of instability, those with calcific tendonitis, and those with a radiologic diagnosis of osteoarthritis. Materials and Methods: In this retrospective study, two independent investigators measured the glenohumeral joint width on true anteroposterior and axillary views of standardized shoulder radiographs taken from 2002 to 2009. The digital image resolution was 0.01 mm. Group I comprised 60 patients with normal shoulder radiographs, Group II comprised 53 patients with instability but normal radiographs, Group III comprised 109 patients with radiologically proven calcific tendonitis, and Group IV comprised 120 patients with manifest osteoarthritis. Results: The interobserver reliability (r) was 0.621-0.862. The mean joint space width was significantly different among Groups I-IV (central anteroposterior: 4.28 0.75 mm, 3.12 0.73 mm, 2.87 0.80 mm, and 1.47 1.07 mm, respectively; P = 0.001; central axillary: 6.12 1.09 mm, 3.92 0.77 mm, 3.34 0.84 mm, and 1.08 1.12 mm, respectively; P = 0.001). There was a significant negative correlation between the joint space width and age at all measured levels in both projections (P < 0.001). Conclusions: The glenohumeral joint space width decreases with increasing age beginning in early adulthood, and this effect is enhanced by osteoarthritis. Level of Evidence: Level II, retrospective study. PMID:25538427

  13. Clinical study on Laksha Guggulu, Snehana, Swedana & Traction in Osteoarthritis (Knee joint)

    PubMed Central

    Rajoria, Kshipra; Singh, Sarvesh Kumar; Sharma, R.S.; Sharma, S.N.

    2010-01-01

    The objective of the present research was to study the efficacy of Laksha Guggulu, Snehana, Swedana & Traction in the management of Osteoarthritis (Knee joint). For the present work, 30 clinically diagnosed patients were selected and randomly divided into three groups. Group A treated with Laksha Guggulu orally, Group B treated with snehana & swedana traction, Group C treated with Laksha Guggulu, Snehana, Swedana & Knee Joint Traction. The various criteria worked upon were joint pain, oedema, tenderness, restriction of joint movement, stiffness, local crepitation, walking distance. Significant results were obtained on pain in joint movement, restriction in joint movement, joint stiffness , local crepitation nearly in all the groups with best result in combined group or group C. PMID:22131690

  14. The Influence of Radiographic Severity on the Relationship between Muscle Strength and Joint Loading in Obese Knee Osteoarthritis Patients

    PubMed Central

    Aaboe, Jens; Bliddal, Henning; Alkjaer, Tine; Boesen, Mikael; Henriksen, Marius

    2011-01-01

    Objective. To investigate the relationship between knee muscle strength and the external knee adduction moment during walking in obese knee osteoarthritis patients and whether disease severity influences this relationship. Methods. This cross-sectional study included 136 elderly obese (BMI > 30) adults with predominant medial knee osteoarthritis. Muscle strength, standing radiographic severity as measured by the Kellgren and Lawrence scale, and the peak external knee adduction moment were measured at self-selected walking speed. Results. According to radiographic severity, patients were classified as “less severe” (KL 1-2, N = 73) or “severe” (KL 3-4, N = 63). A significant positive association was demonstrated between the peak knee adduction moment and hamstring muscle strength in the whole cohort (P = .047). However, disease severity did not influence the relationship between muscle strength and dynamic medial knee joint loading. Severe patients had higher peak knee adduction moment and more varus malalignment (P < .001). Conclusion. Higher hamstring muscle strength relates to higher estimates of dynamic knee joint loading in the medial compartment. No such relationship existed for quadriceps muscle strength. Although cross sectional, the results suggest that hamstrings function should receive increased attention in future studies and treatments that aim at halting disease progression. PMID:22046519

  15. cGMP levels in chronic cadmium disease and osteoarthritis.

    PubMed Central

    Kagamimori, S.; Williams, W. R.; Watanabe, M.

    1986-01-01

    To investigate the effect of cadmium on guanyl cyclase activity, urine levels of the nucleotide cGMP were measured in patients with bone and renal lesions resulting from chronic cadmium exposure, in patients with osteoarthritis and in a normal age-matched control population. The effects of cadmium, zinc and mercury salts on blood mononuclear cell cGMP production were also studied in vitro. The two patient groups exhibited clear differences in cGMP excretion. Lower urine cGMP (59%, P less than 0.01) and creatinine values (43%, P less than 0.01) were found in cadmium-exposed patients and higher cGMP values (56%, P less than 0.05) in patients with osteoarthritis, compared to the control group. Creatinine adjusted cGMP values were also lower in cadmium-exposed patients (28%, P less than 0.05) and higher in patients with osteoarthritis (130%, P less than 0.01). In vitro, a 10 h exposure of mononuclear cells to cadmium or mercury salts depressed guanyl cyclase activity in most experiments. At 10(-4) M, mercury was consistently more inhibitory in all cultures (95%, P less than 0.01). As cadmium has a potential for inhibiting guanyl cyclase activity in human tissue, the low urine cGMP values found in patients with cadmium disease may be attributable to chronic cadmium exposure. High guanyl cyclase activity in patients with osteoarthritis may be associated with inflammation. PMID:2874827

  16. TRPV4 as a therapeutic target for joint diseases.

    PubMed

    McNulty, Amy L; Leddy, Holly A; Liedtke, Wolfgang; Guilak, Farshid

    2015-04-01

    Biomechanical factors play a critical role in regulating the physiology as well as the pathology of multiple joint tissues and have been implicated in the pathogenesis of osteoarthritis. Therefore, the mechanisms by which cells sense and respond to mechanical signals may provide novel targets for the development of disease-modifying osteoarthritis drugs (DMOADs). Transient receptor potential vanilloid 4 (TRPV4) is a Ca(2+)-permeable cation channel that serves as a sensor of mechanical or osmotic signals in several musculoskeletal tissues, including cartilage, bone, and synovium. The importance of TRPV4 in joint homeostasis is apparent in patients harboring TRPV4 mutations, which result in the development of a spectrum of skeletal dysplasias and arthropathies. In addition, the genetic knockout of Trpv4 results in the development of osteoarthritis and decreased osteoclast function. In engineered cartilage replacements, chemical activation of TRPV4 can reproduce many of the anabolic effects of mechanical loading to accelerate tissue growth and regeneration. Overall, TRPV4 plays a key role in transducing mechanical, pain, and inflammatory signals within joint tissues and thus is an attractive therapeutic target to modulate the effects of joint diseases. In pathological conditions in the joint, when the delicate balance of TRPV4 activity is altered, a variety of different tools could be utilized to directly or indirectly target TRPV4 activity. PMID:25519495

  17. TRPV4 as a Therapeutic Target for Joint Diseases

    PubMed Central

    McNulty, Amy L.; Leddy, Holly A.; Liedtke, Wolfgang; Guilak, Farshid

    2014-01-01

    Biomechanical factors play a critical role in regulating the physiology as well as the pathology of multiple joint tissues, and have been implicated in the pathogenesis of osteoarthritis. Therefore, the mechanisms by which cells sense and respond to mechanical signals may provide novel targets for the development of disease-modifying osteoarthritis drugs (DMOADs). Transient receptor potential vanilloid 4 (TRPV4) is a Ca2+-permeable cation channel that serves as a sensor of mechanical or osmotic signals in several musculoskeletal tissues, including cartilage, bone, and synovium. The importance of TRPV4 in joint homeostasis is apparent in patients harboring TRPV4 mutations, which result in the development of a spectrum of skeletal dysplasias and arthropathies. In addition, the genetic knockout of Trpv4 results in the development of osteoarthritis and decreased osteoclast function. In engineered cartilage replacements, chemical activation of TRPV4 can reproduce many of the anabolic effects of mechanical loading to accelerate tissue growth and regeneration. Overall, TRPV4 plays a key role in transducing mechanical, pain, and inflammatory signals within joint tissues, and thus is an attractive therapeutic target to modulate the effects of joint diseases. In pathological conditions in the joint, when the delicate balance of TRPV4 activity is altered, a variety of different tools could be utilized to directly or indirectly target TRPV4 activity. PMID:25519495

  18. Osteoarthritis of the temporo-mandibular joint in free-living Soay sheep on St Kilda.

    PubMed

    Arthur, Colin; Watt, Kathryn; Nussey, Daniel H; Pemberton, Josephine M; Pilkington, Jill G; Herman, Jeremy S; Timmons, Zena L; Clements, Dylan N; Scott, Philip R

    2015-01-01

    Osteoarthritis (OA) is a common degenerative disease of synovial joints with the potential to cause pathology and welfare issues in both domestic and wild ruminants. Previous work has identified OA of the elbow joint in domestic sheep, but the prevalence of OA of the jaw and in particular the temporomandibular joint (TMJ) has not been previously reported. Following up a previous report of a single case of TMJ OA in a free-living population of Soay sheep on St Kilda in the Outer Hebrides, an archive of 2736 jaw bones collected from this population between 1985 and 2010 was surveyed. Evidence of TMJ OA was found in 35 sheep. Of these, 15 cases were unilateral (11 right side, 4 left side) and the remaining 20 were bilateral. TMJ pathology was much more common in females than males: only 3/35 cases were in males, with overall prevalence at 2.3% for females and 0.2% in males. Radiographic examination of TMJ with OA revealed extensive bone re-modelling with osteophytosis, particularly of the condyle of the mandible. There was a highly significant age-dependence in TMJ OA incidence among age classes: 30/35 cases occurred in geriatric sheep (aged 7 years or more; 11.1% prevalence within this age class), four in adults (2-6 years old; 0.9% prevalence), one in yearlings (0.3% prevalence) and none in lambs. The low incidence in males was confounded by sex differences in longevity: while 18% of females sampled died in the geriatric age class, only 2% of males did so. Although the low prevalence of the pathology limited the ability to test its association with other traits, it was possible to examine relationships with reproductive performance measures amongst geriatric females with and without TMJ OA. Although there were trends towards lower fecundity and lower lamb birth weight in the breeding season prior to death, these were not statistically significant. PMID:25458883

  19. Imaging osteoarthritis in the knee joints using x-ray guided diffuse optical tomography

    NASA Astrophysics Data System (ADS)

    Zhang, Qizhi; Yuan, Zhen; Sobel, Eric S.; Jiang, Huabei

    2010-02-01

    In our previous studies, near-infrared (NIR) diffuse optical tomography (DOT) had been successfully applied to imaging osteoarthritis (OA) in the finger joints where significant difference in optical properties of the joint tissues was evident between healthy and OA finger joints. Here we report for the first time that large joints such as the knee can also be optically imaged especially when DOT is combined with x-ray tomosynthesis where the 3D image of the bones from x-ray is incorporated into the DOT reconstruction as spatial a priori structural information. This study demonstrates that NIR light can image large joints such as the knee in addition to finger joints, which will drastically broaden the clinical utility of our x-ray guided DOT technique for OA diagnosis.

  20. Multimodal Ayurvedic management for Sandhigatavata (Osteoarthritis of knee joints)

    PubMed Central

    Sharma, Manisha R.; Mehta, Charmi S.; Shukla, Dipali J.; Patel, Kalapi B.; Patel, Manish V.; Gupta, Shiv Narayan

    2013-01-01

    Vata is the governing factor in the maintenance of equilibrium in the universe as well as in the body. As age advances, the influence of Vata Dosha progresses, resulting in the process of gradual degeneration of the body. Sandhigatavata (osteoarthritis) is one of the consequences of this process, which is common in the elderly people. This is one of the major causes of chronic disability, affecting the quality of life. Prevalence of osteoarthritis in India is more among menopausal women. This study has been conducted to evaluate the efficacy of Ayurvedic multimodal management in Sandhigatavata and to provide better options to Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). In present clinical trial, 50 patients of Sandhigatavata have been registered and have been given Snehana, Svedana, Mriduvirechana, Matrabasti, and Jalaukavacharana, along with oral medications like Yogaraja Guggulu and Ashvagandha Churna. This multimodal therapy is being used in P.D. Patel Ayurved Hospital, Nadiad, since years, providing good relief to patients with Sandhigatavata. The results have been analyzed statistically by using the Student paired‘t’ test. The therapy showed highly significant (P < 0.001) beneficial effect on the clinical features of Sandhigatavata. On overall effect of therapy, 4% of the patients were relieved completely, while 24% have shown marked improvement, 50% moderate improvement, and 22% mild improvement. Results of follow-up showed that marked improvement decreased, but moderate improvement was steady. Continuing the study on a larger number of patients, with inclusion of more objective parameters to get better conclusions is suggested at the end of the study. PMID:24049405

  1. Multimodal Ayurvedic management for Sandhigatavata (Osteoarthritis of knee joints).

    PubMed

    Sharma, Manisha R; Mehta, Charmi S; Shukla, Dipali J; Patel, Kalapi B; Patel, Manish V; Gupta, Shiv Narayan

    2013-01-01

    Vata is the governing factor in the maintenance of equilibrium in the universe as well as in the body. As age advances, the influence of Vata Dosha progresses, resulting in the process of gradual degeneration of the body. Sandhigatavata (osteoarthritis) is one of the consequences of this process, which is common in the elderly people. This is one of the major causes of chronic disability, affecting the quality of life. Prevalence of osteoarthritis in India is more among menopausal women. This study has been conducted to evaluate the efficacy of Ayurvedic multimodal management in Sandhigatavata and to provide better options to Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). In present clinical trial, 50 patients of Sandhigatavata have been registered and have been given Snehana, Svedana, Mriduvirechana, Matrabasti, and Jalaukavacharana, along with oral medications like Yogaraja Guggulu and Ashvagandha Churna. This multimodal therapy is being used in P.D. Patel Ayurved Hospital, Nadiad, since years, providing good relief to patients with Sandhigatavata. The results have been analyzed statistically by using the Student paired't' test. The therapy showed highly significant (P < 0.001) beneficial effect on the clinical features of Sandhigatavata. On overall effect of therapy, 4% of the patients were relieved completely, while 24% have shown marked improvement, 50% moderate improvement, and 22% mild improvement. Results of follow-up showed that marked improvement decreased, but moderate improvement was steady. Continuing the study on a larger number of patients, with inclusion of more objective parameters to get better conclusions is suggested at the end of the study. PMID:24049405

  2. Osteoarthritis of the temporomandibular joint in southern sea otters (Enhydra lutris nereis).

    PubMed

    Arzi, B; Winer, J N; Kass, P H; Verstraete, F J M

    2013-11-01

    Museum skull specimens (n = 1,008) of southern sea otters (Enhydra lutris nereis) were examined macroscopically according to defined criteria for the presence, severity and characteristics of temporomandibular joint osteoarthritis (TMJ-OA). The specimens were from stranded young adult to adult animals. Overall, 4.1% of the specimens had findings consistent with TMJ-OA. Of these, 61.0% were from females and 39.0% were from males. In addition, 85.4% of the affected specimens were from adults and 14.6% were from young adults. However, there was no significant association between age and sex with the presence or severity of TMJ-OA. Lesion severity was mild in 41.5%, moderate in 19.5% and severe in 39.0% of affected specimens. The most prominent changes were the presence of osteophytes and subchondral bone defects and porosity. The mandibular condylar process and fossa were affected equally. The lengths of the right and left mandibular heads were significantly associated with age (P = 0.002 and P = 0.003, respectively) and sex (P = 0.0009 and P = 0.001, respectively), but not with the presence of TMJ-OA. The significance of this disease in sea otters remains elusive, but this condition may play an important role in survival of these animals. PMID:23721871

  3. Accurate joint space quantification in knee osteoarthritis: a digital x-ray tomosynthesis phantom study

    NASA Astrophysics Data System (ADS)

    Sewell, Tanzania S.; Piacsek, Kelly L.; Heckel, Beth A.; Sabol, John M.

    2011-03-01

    The current imaging standard for diagnosis and monitoring of knee osteoarthritis (OA) is projection radiography. However radiographs may be insensitive to markers of early disease such as osteophytes and joint space narrowing (JSN). Relative to standard radiography, digital X-ray tomosynthesis (DTS) may provide improved visualization of the markers of knee OA without the interference of superimposed anatomy. DTS utilizes a series of low-dose projection images over an arc of +/-20 degrees to reconstruct tomographic images parallel to the detector. We propose that DTS can increase accuracy and precision in JSN quantification. The geometric accuracy of DTS was characterized by quantifying joint space width (JSW) as a function of knee flexion and position using physical and anthropomorphic phantoms. Using a commercially available digital X-ray system, projection and DTS images were acquired for a Lucite rod phantom with known gaps at various source-object-distances, and angles of flexion. Gap width, representative of JSW, was measured using a validated algorithm. Over an object-to-detector-distance range of 5-21cm, a 3.0mm gap width was reproducibly measured in the DTS images, independent of magnification. A simulated 0.50mm (+/-0.13) JSN was quantified accurately (95% CI 0.44-0.56mm) in the DTS images. Angling the rods to represent knee flexion, the minimum gap could be precisely determined from the DTS images and was independent of flexion angle. JSN quantification using DTS was insensitive to distance from patient barrier and flexion angle. Potential exists for the optimization of DTS for accurate radiographic quantification of knee OA independent of patient positioning.

  4. Joint sparing treatments in early ankle osteoarthritis: current procedures and future perspectives.

    PubMed

    Castagnini, Francesco; Pellegrini, Camilla; Perazzo, Luca; Vannini, Francesca; Buda, Roberto

    2016-12-01

    Ankle osteoarthritis (AOA) is a severe pathology, mostly affecting a post-traumatic young population. Arthroscopic debridement, arthrodiastasis, osteotomy are the current joint sparing procedures, but, in the available studies, controversial results were achieved, with better outcomes in case of limited degeneration. Only osteotomy in case of malalignment is universally accepted as a joint sparing procedure in case of partial AOA. Recently, the biological mechanism of osteoarthritis has been intensively studied: it is a whole joint pathology, affecting cartilage, bone and synovial membrane. In particular, the first stage is characterized by a reversible catabolic activity with a state of chondropenia. Thus, biological procedures for early AOA were proposed in order to delay or to avoid end stage procedures. Mesenchymal stem cells (MSCs) may be a good solution to prevent or reverse degeneration, due to their immunomodulatory features (able to control the catabolic joint environment) and their regenerative osteochondral capabilities (able to treat the chondral defects). In fact, MSCs may regulate the cytokine cascade and the metalloproteinases release, restoring the osteochondral tissue as well. After interesting reports of mesenchymal stem cells seeded on scaffold and applied to cartilage defects in non-degenerated joints, bone marrow derived cells transplantation appears to be a promising technique in order to control the degenerative pathway and restore the osteochondral defects. PMID:26915003

  5. Non-terminal animal model of post-traumatic osteoarthritis induced by acute joint injury

    PubMed Central

    Boyce, Mary K.; Trumble, Troy N.; Carlson, Cathy S.; Groschen, Donna M.; Merritt, Kelly A.; Brown, Murray P.

    2013-01-01

    Objective Develop a non-terminal animal model of acute joint injury that demonstrates clinical and morphological evidence of early post-traumatic osteoarthritis (PTOA). Methods An osteochondral (OC) fragment was created arthroscopically in one metacarpophalangeal (MCP) joint of 11 horses and the contralateral joint was sham operated. Eleven additional horses served as unoperated controls. Every 2 weeks, force plate analysis, flexion response, joint circumference, and synovial effusion scores were recorded. At weeks 0 and 16, radiographs (all horses) and arthroscopic videos (OC injured and sham joints) were graded. At week 16, synovium and cartilage biopsies were taken arthroscopically from OC injured and sham joints for histologic evaluation and the OC fragment was removed. Results Osteochondral fragments were successfully created and horses were free of clinical lameness after fragment removal. Forelimb gait asymmetry was observed at week 2 (P=0.0012), while joint circumference (P<0.0001) and effusion scores (P<0.0001) were increased in injured limbs compared to baseline from weeks 2 to 16. Positive flexion response of injured limbs was noted at multiple time points. Capsular enthesophytes were seen radiographically in injured limbs. Articular cartilage damage was demonstrated arthroscopically as mild wear-lines and histologically as superficial zone chondrocyte death accompanied by mild proliferation. Synovial hyperemia and fibrosis were present at the site of OC injury. Conclusion Acute OC injury to the MCP joint resulted in clinical, imaging, and histologic changes in cartilage and synovium characteristic of early PTOA. This model will be useful for defining biomarkers of early osteoarthritis and for monitoring response to therapy and surgery. PMID:23467035

  6. Local ASIC3 modulates pain and disease progression in a rat model of osteoarthritis

    PubMed Central

    2012-01-01

    Background Recent data have suggested a relationship between acute arthritic pain and acid sensing ion channel 3 (ASIC3) on primary afferent fibers innervating joints. The purpose of this study was to clarify the role of ASIC3 in a rat model of osteoarthritis (OA) which is considered a degenerative rather than an inflammatory disease. Methods We induced OA via intra-articular mono-iodoacetate (MIA) injection, and evaluated pain-related behaviors including weight bearing measured with an incapacitance tester and paw withdrawal threshold in a von Frey hair test, histology of affected knee joint, and immunohistochemistry of knee joint afferents. We also assessed the effect of ASIC3 selective peptide blocker (APETx2) on pain behavior, disease progression, and ASIC3 expression in knee joint afferents. Results OA rats showed not only weight-bearing pain but also mechanical hyperalgesia outside the knee joint (secondary hyperalgesia). ASIC3 expression in knee joint afferents was significantly upregulated approximately twofold at Day 14. Continuous intra-articular injections of APETx2 inhibited weight distribution asymmetry and secondary hyperalgesia by attenuating ASIC3 upregulation in knee joint afferents. Histology of ipsilateral knee joint showed APETx2 worked chondroprotectively if administered in the early, but not late phase. Conclusions Local ASIC3 immunoreactive nerve is strongly associated with weight-bearing pain and secondary hyperalgesia in MIA-induced OA model. APETx2 inhibited ASIC3 upregulation in knee joint afferents regardless of the time-point of administration. Furthermore, early administration of APETx2 prevented cartilage damage. APETx2 is a novel, promising drug for OA by relieving pain and inhibiting disease progression. PMID:22909215

  7. Establishment of a rat model of adjuvant-induced osteoarthritis of the lumbar facet joint.

    PubMed

    Shuang, Feng; Zhu, Jialiang; Song, Keran; Hou, Shuxun; Liu, Yan; Zhang, Chunli; Tang, Jiaguang

    2014-12-01

    To study the establishment of adjuvant-induced osteoarthritis of the lumbar facet joint in a rat model. Complete Freund's adjuvant (experimental group) and saline (control group) were randomly injected into the right and left side of rat, respectively. The rats were killed, and degeneration of lumbar facet joint was evaluated at macroscopic level and scored based on OARSI scores system. Moreover, Interleukin-1β and tumor necrosis factor-α levels in the synovium were measured. The macroscopic scores and OARSI scores of experimental group were higher than the control group (P < 0.05). The concentration of tumor necrosis factor-α was significantly increased only on 3- and 7-day post-surgery when compared with controls, and interleukin-1β was increased on days 3,7 and 14 post-surgery (P < 0.05). The rat model of adjuvant can induce degeneration of the lumbar facet joint. It can be useful for studies on mechanisms and treatment of lumbar facet joint osteoarthritis. PMID:24973958

  8. Effects of proprioceptive circuit exercise on knee joint pain and muscle function in patients with knee osteoarthritis

    PubMed Central

    Ju, Sung-Bum; Park, Gi Duck; Kim, Sang-Soo

    2015-01-01

    [Purpose] This study applied proprioceptive circuit exercise to patients with degenerative knee osteoarthritis and examined its effects on knee joint muscle function and the level of pain. [Subjects] In this study, 14 patients with knee osteoarthritis in two groups, a proprioceptive circuit exercise group (n = 7) and control group (n = 7), were examined. [Methods] IsoMed 2000 (D&R Ferstl GmbH, Hemau, Germany) was used to assess knee joint muscle function, and a Visual Analog Scale was used to measure pain level. [Results] In the proprioceptive circuit exercise group, knee joint muscle function and pain levels improved significantly, whereas in the control group, no significant improvement was observed. [Conclusion] A proprioceptive circuit exercise may be an effective way to strengthen knee joint muscle function and reduce pain in patients with knee osteoarthritis. PMID:26357422

  9. Stem cell application for osteoarthritis in the knee joint: A minireview.

    PubMed

    Uth, Kristin; Trifonov, Dimitar

    2014-11-26

    Knee osteoarthritis is a chronic, indolent disease that will affect an ever increasing number of patients, especially the elderly and the obese. It is characterized by degeneration of the cartilage substance inside the knee which leads to pain, stiffness and tenderness. By some estimations in 2030, only in the United States, this medical condition will burden 67 million people. While conventional treatments like physiotherapy or drugs offer temporary relief of clinical symptoms, restoration of normal cartilage function has been difficult to achieve. Moreover, in severe cases of knee osteoarthritis total knee replacement may be required. Total knee replacements come together with high effort and costs and are not always successful. The aim of this review is to outline the latest advances in stem cell therapy for knee osteoarthritis as well as highlight some of the advantages of stem cell therapy over traditional approaches aimed at restoration of cartilage function in the knee. In addition to the latest advances in the field, challenges associated with stem cell therapy regarding knee cartilage regeneration and chondrogenesis in vitro and in vivo are also outlined and analyzed. Furthermore, based on their critical assessment of the present academic literature the authors of this review share their vision about the future of stem cell applications in the treatment of knee osteoarthritis. PMID:25426260

  10. Daily sesame oil supplement attenuates joint pain by inhibiting muscular oxidative stress in osteoarthritis rat model.

    PubMed

    Hsu, Dur-Zong; Chu, Pei-Yi; Jou, I-Ming

    2016-03-01

    Osteoarthritis (OA) is the most common form of arthritis, affecting approximately 15% of the population. The aim of this study was to evaluate the efficacy of sesame oil in controlling OA pain in rats. Rat joint pain was induced by medial meniscal transection in Sprague-Dawley rats and assessed by using hindlimb weight distribution method. Muscular oxidative stress was assessed by determining lipid peroxidation, reactive oxygen species and circulating antioxidants. Sesame oil significantly decreased joint pain compared with positive control group in a dose-dependent manner. Sesame oil decreased lipid peroxidation in muscle but not in serum. Further, sesame oil significantly decreased muscular superoxide anion and peroxynitrite generations but increased muscular glutathione and glutathione peroxidase levels. Further, sesame oil significantly increased nuclear factor erythroid-2-related factor (Nrf2) expression compared with positive control group. We concluded that daily sesame oil supplement may attenuate early joint pain by inhibiting Nrf2-associated muscular oxidative stress in OA rat model. PMID:26895663

  11. Noninvasive imaging of hemoglobin concentration and oxygen saturation for detection of osteoarthritis in the finger joints using multispectral three-dimensional quantitative photoacoustic tomography

    NASA Astrophysics Data System (ADS)

    Sun, Yao; Sobel, Eric; Jiang, Huabei

    2013-05-01

    We present quantitative imaging of hemoglobin concentration and oxygen saturation in in vivo finger joints and evaluate the feasibility of detecting osteoarthritis (OA) in the hand using three-dimensional (3D) multispectral quantitative photoacoustic tomography (3D qPAT). The results show that both the anatomical structures and quantitative chromophore concentrations (oxy-hemoglobin and deoxy-hemoglobin) of different joint tissues (hard phalanges and soft cartilage/synovial fluid between phalanges) can be imaged in vivo with the multispectral 3D qPAT. Enhanced hemoglobin concentrations and dropped oxygen saturations in osteoarthritic phalanges and soft joint tissues in joint cavities have been observed. This study indicates that the multispectral 3D qPAT is a promising approach to detect the angiogenesis and hypoxia associated with OA disease and a potential clinical tool for early OA detection in the finger joints.

  12. New developments in osteoarthritis. Sex differences in magnetic resonance imaging-based biomarkers and in those of joint metabolism

    PubMed Central

    2010-01-01

    Sex differences in the prevalence, incidence, and severity of osteoarthritis (OA) have long been known. Some differences in the evaluation of this issue across studies may be related to differences in study design, sampling, study size, study populations, targeted joint sites, and definitions of OA. This report highlights recent studies of sex differences in individual joint components imaged by magnetic resonance imaging and in systemic biomarkers of joint metabolism. Particularly important are those studies that examine this issue in young unaffected adults and children before the development of disease. Despite some variation across studies, women appear for the most part to have a thinner and more reduced volume of cartilage in the knee than men, and this may occur from early childhood. It is not clear whether women have a more accelerated rate of cartilage volume loss than men. Few data exist on sex differences in systemic biomarkers of joint metabolism. In these studies, it is critically important to characterize the total body burden of OA and the presence of comorbid conditions likely to influence a given biomarker. Lastly, future research should dovetail studies of sex differences in imaging and biochemical biomarkers with genetics to maximize insight into the mechanisms behind observed sex differences. PMID:20701741

  13. Effect of underwater treadmill exercise on postural sway in horses with experimentally induced carpal joint osteoarthritis.

    TOXLINE Toxicology Bibliographic Information

    King MR; Haussler KK; Kawcak CE; McIlwraith CW; Reiser Ii RF

    2013-07-01

    OBJECTIVE: To evaluate the effect of underwater treadmill exercise on static postural sway in horses with experimentally induced carpal joint osteoarthritis under various stance conditions.ANIMALS: 16 horses.PROCEDURES: On day 0, osteoarthritis was induced arthroscopically in 1 randomly selected middle carpal joint of each horse. Beginning on day 15, horses were assigned to either underwater or overground (without water) treadmill exercise at the same speed, frequency, and duration. Two serial force platforms were used to collect postural sway data from each horse on study days -7, 14, 42, and 70. Horses were made to stand stationary on the force platforms under 3 stance conditions: normal square stance, base-narrow placement of the thoracic limbs, and removal of visual cues (blindfolded) during a normal square stance. The mean of 3 consecutive, 10-second trials in each condition was calculated and used for analysis.RESULTS: Displacement of the center of pressure differed significantly depending on the stance condition. Among horses exercised on the underwater treadmill, postural stability in both the base-narrow and blindfolded stance conditions improved, compared with findings for horses exercised on the overground treadmill. Horses exercised on the overground treadmill were only successful at maintaining a stable center of pressure during the normal square stance position.CONCLUSIONS AND CLINICAL RELEVANCE: Variations in stance position had profound effects on the mechanics of standing balance in horses with experimentally induced carpal joint osteoarthritis. Underwater treadmill exercise significantly improved the horses' postural stability, which is fundamental in providing evidence-based support for equine aquatic exercise.

  14. Fixed-flexion radiography of the knee provides reproducible joint space width measurements in osteoarthritis.

    PubMed

    Kothari, Manish; Guermazi, Ali; von Ingersleben, Gabriele; Miaux, Yves; Sieffert, Martine; Block, Jon E; Stevens, Randall; Peterfy, Charles G

    2004-09-01

    The validity of a non-fluoroscopic fixed-flexion radiographic acquisition and analysis protocol for measurement of joint space width (JSW) in knee osteoarthritis is determined. A cross-sectional study of 165 patients with documented knee osteoarthritis participating in a multicenter, prospective study of chondroprotective agents was performed. All patients had posteroanterior, weight-bearing, fixed-flexion radiography with 10 degrees caudal beam angulation. A specially designed frame (SynaFlexer) was used to standardize the positioning. Minimum medial and lateral JSW were measured manually and twice by an automated analysis system to determine inter-technique and intra-reader concordance and reliability. A random subsample of 30 patients had repeat knee radiographs 2 weeks apart to estimate short-term reproducibility using automated analysis. Concordance between manual and automated medial JSW measurements was high (ICC=0.90); lateral compartment measurements showed somewhat less concordance (ICC=0.72). There was excellent concordance between repeated automated JSW measurements performed 6 months apart for the medial (ICC=0.94) and lateral (ICC=0.86) compartments. Short-term reproducibility for the subsample of 30 cases with repeat acquisitions demonstrated an average SD of 0.14 mm for medial JSW (CV=4.3%) and 0.23 mm for lateral JSW (CV=4.0%). Fixed-flexion radiography of the knee using a positioning device provides consistent, reliable and reproducible measurement of minimum JSW in knee osteoarthritis without the need for concurrent fluoroscopic guidance. PMID:15150666

  15. Recent advances and future directions in the management of knee osteoarthritis: Can biological joint reconstruction replace joint arthroplasty and when?

    PubMed Central

    Paschos, Nikolaos K

    2015-01-01

    In this article, a concise description of the recent advances in the field of osteoarthritis management is presented. The main focus is to highlight the most promising techniques that emerge in both biological joint replacement and artificial joint arthroplasty. A critical view of high quality evidence regarding outcome and safety profile of these techniques is presented. The potential role of kinematically aligned total knee replacement, navigation, and robotic-assisted surgery is outlined. A critical description of both primary and stem cell-based therapies, the cell homing theory, the use of biologic factors and recent advancements in tissue engineering and regenerative medicine is provided. Based on the current evidence, some thoughts on a realistic approach towards answering these questions are attempted. PMID:26495242

  16. Neuromuscular exercise prior to joint arthroplasty in patients with osteoarthritis of the hip or knee.

    PubMed

    Villadsen, Allan

    2016-04-01

    Osteoarthritis (OA) is a degenerative joint disease affecting the whole joint and peri-articular structures like the muscles. The hallmark of OA is cartilage loss. The main symptoms are pain and decreased physical function leading to a reduced quality of life. OA ranks eight in leading causes of disability worldwide and it generates a heavy economic burden for society. The prevalence of OA increases with age and 10-18% aged above 60 years are affected. Currently there is no cure for OA and the various treatment modalities aim at addressing symptoms, i.e. reducing pain, improving physical function and preventing further progression of the disease. Exercise has proven to be a viable treatment option with regard to reducing pain and improving physical function in patients with mild to moderate knee OA and is today regarded a cornerstone in the treatment. The documentation is less clear for hip OA. Patients with severe OA of the hip or knee are treated with total joint arthroplasty (TJA). Although, in general, it is a very successful procedure, there are still challenges to overcome in this patient group, as approximately 10% of those having hip arthroplasty and 20% of those having knee arthroplasty have persistent symptoms. The evidence on the efficacy of exercise prior to TJA is sparse. It is based on insufficiently powered trials and with interventions of questionable validity. Two recent systematic reviews and meta-analyses reach conflicting conclusions and highlight the need for high quality trials with sufficient sample sizes. In this dissertation, I wanted to evaluate the effects of an individualised neuromuscular exercise programme (NEMEX-TJR) when administered prior to joint arthroplasty in patients with severe OA of the hip or knee joint. This intervention was previously found to be feasible with regard to pain level during exercise and it was possible to progress the training level in this patient group. The main question asked was: Does the addition of neuromuscular exercise prior to TJA result in further improvement in self-reported outcomes during the first three months? To answer this, a randomised controlled trial (RCT) enrolling patients with severe symptomatic OA scheduled for TJA was conducted. Self-reported ADL was the primary outcome of the trial and self-reported pain and quality of life were the main secondary outcomes. A test battery of three functional performance measures and four lower extremity muscle power tests was chosen to complement the questionnaires and to explore the physical function in these patients. In the first study, the test battery was evaluated with regard to agreement and reliability. Identification of the smallest detectable differences in the tests was needed to assist in the interpretation of the RCT results and aid clinicians in future evaluation of patients in their daily clinical practice. A cohort of 20 patients with severe symptomatic OA of the hip or knee (56-79 years, 50% women) was evaluated in the test battery on two occasions separated by one week. We found that muscle power can safely be evaluated with poor to good agreement and good to excellent reliability. Hence, some measures (20 m walk, chair stands) are more reliable to detect change over time, e.g. longitudinal research, whereas others may be useful in a daily clinical setting to evaluate to what extent the patient's muscle function is affected  (single- and multi-joint muscle power). Seen as a whole, the entire test battery is time-consuming (1½-2 hours) and not suited for evaluation of larger cohorts. The enrollment of patients in the RCT began in January 2010. A cohort of 165 hip and knee OA patients (43-89 years, 56% women, 84 hip OA) was enrolled after approximately one year. This sample size would also allow stratified analysis, e.g. evaluation of possible differences in the treatment effect between hip or knee OA patients. The intervention group participated in an eight week neuromuscular exercise programme prior to TJA in addition to the usual care (information leaflets and a three-hour information session by health professionals) provided in Svendborg Hospital, Odense University Hospital, Denmark. Patients were assessed at baseline, one week prior to surgery, six weeks and three months after surgery (primary end-point). Two essential questions of interest were identified prior the development of the statistical analysis plan. Firstly: Does the addition of neuromuscular exercise prior to TJA improve the post-operative outcome? The initiation of rehabilitation prior to surgery was thought to be of general interest to the health community. Secondly: What are the effects of neuromuscular exercise when evaluated as a treatment option for patients with severe osteoarthritis? This question is most likely to be of interest to health professionals with a specific interest in exercise rehabilitation and OA research. In the second study, the cohort served as a model for patients with severe OA (regardless of the following operation). Patients were evaluated immediately after the intervention (one week). We found that participation in neuromuscular exercise for eight weeks according to the NEMEX-TJR programme improves activities of daily living, objective functional performance, and quality of life and reduces pain in patients with severe OA. The effect is greater in patients with hip OA than in patients with knee OA. The study confirms previous findings from non-randomised studies that neuromuscular exercise is feasible and safe for patients with severe OA. In the third study, the efficacy of NEMEX-TJR as an adjunct treatment to TJA was evaluated. At the primary end-point three months after surgery, there was no additional effect of an eight-week preoperative neuromuscular exercise programme in combination with total joint arthroplasty compared with total joint arthroplasty alone. However, from baseline to < three months after surgery the overall longitudinal improvements seen in physical function and pain were statistically significantly greater and occurred earlier after surgery in the intervention group receiving preoperative neuromuscular exercise compared with the control group receiving care-as-usual only. From this dissertation, I conclude that neuromuscular exercise according to NEMEX-TJR can serve as adjunct therapy to hip or knee arthroplasty of interest to individual OA patients willing to engage in preoperative exercise to achieve an earlier onset of post-operative recovery. At three months however, the effects of preoperative exercise are no longer evident.  Furthermore, for patients with severe OA of the hip joint, neuromuscular exercise may serve as a safe and viable treatment option with improvement in ADL, functional performance and a reduction in pain. Whether implementation of this adjunct therapy in clinical practice is feasible and cost-effective remains to be evaluated. PMID:27034190

  17. The rate of joint replacement in osteoarthritis depends on the patient's socioeconomic status.

    PubMed

    Wetterholm, Malin; Turkiewicz, Aleksandra; Stigmar, Kjerstin; Hubertsson, Jenny; Englund, Martin

    2016-06-01

    Background and purpose - Assessment of potential disparities in access to care is a vital part of achieving equity in health and healthcare. We have therefore studied the effect of socioeconomic status (SES) on the rates of knee and hip replacement due to osteoarthritis. Methods - This was a cohort study in Skåne, Sweden. We included all residents aged ≥ 35 years with consultations between 2004 and 2013 for hip or knee osteoarthritis. We retrieved individual information on income, education, and occupation and evaluated the rates of knee and hip replacement according to SES, with adjustment for age and sex. Professionals, legislators, senior officials, and managers, and individuals with the longest education, served as the reference group. Results - We followed 50,498 knee osteoarthritis patients (59% women) and 20,882 hip osteoarthritis patients (58% women). The mutually adjusted rate of knee replacement was lower in those with an elementary occupation (hazard ratio (HR) = 0.81, 95% CI: 0.72-0.92), in craft workers and those with related trades (HR = 0.88, CI: 0.79-0.98), and in skilled agricultural/fishery workers (HR = 0.83, CI: 0.72-0.96), but higher in the 2 least educated groups (HR = 1.2 in both). The rate of hip replacement was lower in those with an elementary occupation (HR = 0.77, 95% CI: 0.68-0.87), in plant and machine operators/assemblers (HR = 0.83, CI: 0.75-0.93), and service workers/shop assistants (HR = 0.88, CI: 0.80-0.96). The rate of hip replacement was higher in the highest income group (HR = 1.1, 95% CI: 1.0-1.2). Interpretation - There was a lower rate of joint replacement in osteoarthritis patients working in professions often associated with lower socioeconomic status, suggesting inequity in access to care. However, the results are not unanimous, as the rate of knee replacement was higher in the least educated groups. PMID:26982799

  18. Managing osteoarthritis.

    PubMed

    Yu, Shirley P; Hunter, David J

    2015-08-01

    Management of osteoarthritis should be based on a combination of non-drug and drug treatments targeted towards prevention, modifying risk and disease progression. Obesity is the most important modifiable risk factor, so losing weight in addition to land- and water-based exercise and strength training is important. While paracetamol can be tried, guidelines recommend non-steroidal anti-inflammatory drugs as first-line treatment for osteoarthritis. If there are concerns about the adverse effects of oral treatment, particularly in older patients or those with comorbidities, topical non-steroidal anti-inflammatory drugs can be used. Glucosamine does not appear to be any better than placebo for pain. Its effect on the structural progression of disease when taken alone or in combination with chondroitin is uncertain. Fish oil has not been found to reduce the structural progression of knee arthritis. Surgical interventions should be avoided in the first instance, with arthroscopic procedures not showing benefit over sham procedures or optimised physical and medical therapy. Joint replacement surgery should be considered for severe osteoarthritis. PMID:26648637

  19. Managing osteoarthritis

    PubMed Central

    Yu, Shirley P; Hunter, David J

    2015-01-01

    Summary Management of osteoarthritis should be based on a combination of non-drug and drug treatments targeted towards prevention, modifying risk and disease progression. Obesity is the most important modifiable risk factor, so losing weight in addition to land- and water-based exercise and strength training is important. While paracetamol can be tried, guidelines recommend non-steroidal anti-inflammatory drugs as first-line treatment for osteoarthritis. If there are concerns about the adverse effects of oral treatment, particularly in older patients or those with comorbidities, topical non-steroidal anti-inflammatory drugs can be used. Glucosamine does not appear to be any better than placebo for pain. Its effect on the structural progression of disease when taken alone or in combination with chondroitin is uncertain. Fish oil has not been found to reduce the structural progression of knee arthritis. Surgical interventions should be avoided in the first instance, with arthroscopic procedures not showing benefit over sham procedures or optimised physical and medical therapy. Joint replacement surgery should be considered for severe osteoarthritis. PMID:26648637

  20. Osteoarthritis: What is Osteoarthritis? | NIH MedlinePlus the Magazine

    MedlinePlus

    ... turn Javascript on. Feature: Osteoarthritis Osteoarthritis Basics: The Joint and Its Parts Past Issues / Winter 2013 Table of Contents A Healthy Joint A Healthy Joint. Click for larger view. Illustration: ...

  1. Insights into osteoarthritis from MRI.

    PubMed

    Tan, York Kiat; Conaghan, Philip G

    2012-02-01

    Magnetic resonance imaging (MRI) has added a new dimension to the study of osteoarthritis, a long-known degenerative joint disease with limited therapeutic options. It has advanced our understanding of joint pathophysiology and identifying that osteoarthritis as a simple 'wear and tear' process of the articular cartilage has indeed become a thing of the past. Recent work has focused on the study and validation of MRI scoring/quantification systems, as well as the identification of MRI predictors of symptoms/disease progression. The latter may serve to identify patients at greater risk for osteoarthritis disease progression to be enrolled in clinical trials. Like all imaging tools, MRI use has its associated problems. Structural changes seen in patients with osteoarthritis are often seen in asymptomatic subjects and this makes an MRI definition of osteoarthritis less straightforward. The ability to pick up multiple structural abnormalities simultaneously and high sensitivity in delineating structural changes can makes interpretation of true pathology more complicated. Although there has been much progress in the field of MRI in osteoarthritis, there remain many clinical/technical issues that need to be addressed. Until more data are obtained from clinical trials, the question of whether MRI is useful in therapeutics intervention in osteoarthritis remains unanswered. PMID:22324940

  2. Non-invasive Loading Model of Murine Osteoarthritis.

    PubMed

    Poulet, Blandine

    2016-07-01

    Osteoarthritis is the commonest degenerative joint disease, leading to joint pain and disability. The mouse has been the primary animal used for research, due to its size, relatively short lifespan, and the availability of genetically modified animals. Importantly, they show pathogenesis similar to osteoarthritis in humans. Mechanical loading is a major risk factor for osteoarthritis, and various mouse models have been developed to study the role and effects of mechanics on health and disease in various joints. This review describes the main mouse models used to non-invasively apply mechanical loads on joints. Most of the mouse models of osteoarthritis target the knee, including repetitive loading and joint injury such as ligament rupture, but a few studies have also characterised models for elbow, temporomandibular joint, and whole-body vibration spinal loading. These models are a great opportunity to dissect the influences of various types of mechanical input on joint health and disease. PMID:27177901

  3. Endothelial dysfunction in joint disease.

    PubMed

    Prati, Clément; Demougeot, Céline; Guillot, Xavier; Godfrin-Valnet, Marie; Wendling, Daniel

    2014-10-01

    Inflammatory joint diseases and autoimmune diseases with joint manifestations are associated with premature and accelerated atherogenesis. Patients with rheumatoid arthritis (RA) have a 5- to 10-year decrease in life expectancy compared to the general population, and those exhibiting extraarticular manifestations have the greatest excess mortality. RA is now established as an independent cardiovascular risk factor. Complex interactions linking conventional cardiovascular risk factors, systemic inflammation, and vascular function may explain the increased cardiovascular risk among RA patients. Endothelial dysfunction is now recognized as both the key step in early atherogenesis and a contributor to atheroma plaque progression at later stages. Endothelial dysfunction is defined as impaired endothelium-dependent blood-vessel dilation in response to a stimulus. The underlying mechanisms remain speculative. Over the last decade, a role for endothelial dysfunction in the cardiovascular complications of inflammatory joint disease has been hypothesized and several maintenance drugs targeting this phenomenon have been tested, with promising results. PMID:24565889

  4. Inflammatory response to therapeutic gold bead implantation in canine hip joint osteoarthritis.

    PubMed

    Lie, K-I; Jæger, G; Nordstoga, K; Moe, L

    2011-11-01

    Inflammatory changes associated with periarticular pure gold bead implants were studied in dogs involved in a clinical trial investigating motor dysfunction and chronic pain owing to hip joint dysplasia and osteoarthritis. Gold beads were percutaneously implanted via a needle into different locations surrounding the greater trochanter of the femur. Nine dogs with implants were necropsied. In all examined animals, characteristic histologic lesions were observed in the tissue surrounding the gold implants--namely, a fibrous capsule composed of concentric fibroblasts intermixed with a variable number of inflammatory cells and a paucicellular innermost layer of collagen with a few fibrocyte-like cells in empty lacunae. Lymphocytes dominated the inflammatory infiltrate, with rarely observed macrophages present in close proximity to the implant site. No giant cells were observed. Immunohistochemistry showed mixed populations of lymphocytes, both CD3 positive (T cells) and CD79a positive (B cells), which in some cases formed lymphoid follicles. Diffuse inflammatory changes were present to a minor extent in the perimysium and surrounding fascia. The inflammation observed in dogs is similar to that observed with gold implants in humans. It is possible that the clinically beneficial effect of gold beads for chronic osteoarthritis depends on sustained localized inflammation with localized release of soluble mediators. The encapsulation of the implant by a paucicellular and poorly vascularized fibrous capsule may help prevent an exaggerated inflammatory reaction by sequestering the gold bead from the surrounding tissue. PMID:20861497

  5. Diacerein protects against iodoacetate-induced osteoarthritis in the femorotibial joints of rats

    PubMed Central

    Jain, Achint; Singh, Royana; Singh, Saurabh; Singh, Sanjay

    2015-01-01

    Abstract The present study was undertaken to investigate the effect of diacerein on the histopathology of articular cartilage and subchondral bone of the femorotibial joint in rats. Osteoarthritis was induced in rats after single intra-articular injection of sodium iodoacetate. Rats were sacrificed 1, 2, 4, and 8 weeks post intra-articular injection to evaluate the progression of histopathogenesis of osteoarthritis. Diacerein was orally administered (15 mg/kg) once daily post 1 and 2 weeks of iodoacetate injection in two groups, respectively, for up to 12 weeks. Articular cartilage and subchondral bone of the rats of both groups were examined after 8 and 12 weeks, respectively. Quantitative histological analyses were performed by scoring these sections as per the OARSI system. Chondroitin sulfate was also estimated in articular cartilage by decrease in absorbance of methylene blue on complexation with chondroitin sulfate using a spectrophotometer. Intra-articular injection of iodoacetate induced loss of articular cartilage with progressive subchondral bone sclerosis and degeneration. Based on histopathological and biochemical findings, diacerein treatment showed chondroprotective effect. Furthermore, the chondroprotective effect of diacerein was found to be more pronounced after 12 weeks as compared to 8 weeks in both cases (i.e., post 1 and 2 weeks of iodoacetate injection). Similar results were observed by investigation of chondroitin sulfate during biochemical study, showing the chondroprotective effect. In conclusion, diacerein exhibits chondroprotective effect in rats with late onset of action. PMID:26442595

  6. Messenger RNA delivery of a cartilage-anabolic transcription factor as a disease-modifying strategy for osteoarthritis treatment

    PubMed Central

    Aini, Hailati; Itaka, Keiji; Fujisawa, Ayano; Uchida, Hirokuni; Uchida, Satoshi; Fukushima, Shigeto; Kataoka, Kazunori; Saito, Taku; Chung, Ung-il; Ohba, Shinsuke

    2016-01-01

    Osteoarthritis (OA) is a chronic degenerative joint disease and a major health problem in the elderly population. No disease-modifying osteoarthritis drug (DMOAD) has been made available for clinical use. Here we present a disease-modifying strategy for OA, focusing on messenger RNA (mRNA) delivery of a therapeutic transcription factor using polyethylene glycol (PEG)-polyamino acid block copolymer-based polyplex nanomicelles. When polyplex nanomicelles carrying the cartilage-anabolic, runt-related transcription factor (RUNX) 1 mRNA were injected into mouse OA knee joints, OA progression was significantly suppressed compared with the non-treatment control. Expressions of cartilage-anabolic markers and proliferation were augmented in articular chondrocytes of the RUNX1-injected knees. Thus, this study provides a proof of concept of the treatment of degenerative diseases such as OA by the in situ mRNA delivery of therapeutic transcription factors; the presented approach will directly connect basic findings on disease-protective or tissue-regenerating factors to disease treatment. PMID:26728350

  7. Decreased Knee Joint Loading Associated With Early Knee Osteoarthritis After Anterior Cruciate Ligament Injury

    PubMed Central

    Wellsandt, Elizabeth; Gardinier, Emily S.; Manal, Kurt; Axe, Michael J.; Buchanan, Thomas S.; Snyder-Mackler, Lynn

    2015-01-01

    Background Anterior cruciate ligament (ACL) injury predisposes individuals to early-onset knee joint osteoarthritis (OA). Abnormal joint loading is apparent after ACL injury and reconstruction. The relationship between altered joint biomechanics and the development of knee OA is unknown. Hypothesis Altered knee joint kinetics and medial compartment contact forces initially after injury and reconstruction are associated with radiographic knee OA 5 years after reconstruction. Study Design Case-control study; Level of evidence, 3. Methods Individuals with acute, unilateral ACL injury completed gait analysis before (baseline) and after (posttraining) preoperative rehabilitation and at 6 months, 1 year, and 2 years after reconstruction. Surface electromyographic and knee biomechanical data served as inputs to an electromyographically driven musculoskeletal model to estimate knee joint contact forces. Patients completed radiographic testing 5 years after reconstruction. Differences in knee joint kinetics and contact forces were compared between patients with and those without radiographic knee OA. Results Patients with OA walked with greater frontal plane interlimb differences than those without OA (nonOA) at baseline (peak knee adduction moment difference: 0.00 ± 0.08 N·m/kg·m [nonOA] vs −0.15 ± 0.09 N·m/kg·m [OA], P = .014; peak knee adduction moment impulse difference: −0.001 ± 0.032 N·m·s/kg·m [nonOA] vs −0.048 ± 0.031 N·m·s/kg·m [OA], P = .042). The involved limb knee adduction moment impulse of the group with osteoarthritis was also lower than that of the group without osteoarthritis at baseline (0.087 ± 0.023 N·m·s/kg·m [nonOA] vs 0.049 ± 0.018 N·m·s/kg·m [OA], P = .023). Significant group differences were absent at posttraining but reemerged 6 months after reconstruction (peak knee adduction moment difference: 0.02 ± 0.04 N·m/kg·m [nonOA] vs −0.06 ± 0.11 N·m/kg·m [OA], P = .043). In addition, the OA group walked with lower peak medial compartment contact forces of the involved limb than did the group without OA at 6 months (2.89 ± 0.52 body weight [nonOA] vs 2.10 ± 0.69 body weight [OA], P = .036). Conclusion Patients who had radiographic knee OA 5 years after ACL reconstruction walked with lower knee adduction moments and medial compartment joint contact forces than did those patients without OA early after injury and reconstruction. PMID:26493337

  8. The role of meniscal tissue in joint protection in early osteoarthritis.

    PubMed

    Verdonk, Rene; Madry, Henning; Shabshin, Nogah; Dirisamer, Florian; Peretti, Giuseppe M; Pujol, Nicolas; Spalding, Tim; Verdonk, Peter; Seil, Romain; Condello, Vincenzo; Di Matteo, Berardo; Zellner, Johannes; Angele, Peter

    2016-06-01

    It is widely accepted that partial meniscectomy leads to early onset of osteoarthritis (OA). A strong correlation exists between the amount and location of the resected meniscus and the development of degenerative changes in the knee. On the other hand, osteoarthritic changes of the joint alter the structural and functional integrity of meniscal tissue. These alterations might additionally compromise the limited healing capacity of the meniscus. In young, active patients without cartilage damage, meniscus therapy including partial meniscectomy, meniscus suture, and meniscus replacement has proven beneficial effects in long-term studies. Even in an early osteoarthritic milieu, there is a relevant regenerative potential of the meniscus and the surrounding cartilage. This potential should be taken into account, and meniscal surgery can be performed with the correct timing and the proper indication even in the presence of early OA. PMID:27085362

  9. Early knee osteoarthritis

    PubMed Central

    Favero, Marta; Ramonda, Roberta; Goldring, Mary B; Goldring, Steven R; Punzi, Leonardo

    2015-01-01

    Concepts regarding osteoarthritis, the most common joint disease, have dramatically changed in the past decade thanks to the development of new imaging techniques and the widespread use of arthroscopy that permits direct visualisation of intra-articular tissues and structure. MRI and ultrasound allow the early detection of pre-radiographic structural changes not only in the peri-articular bone but also in the cartilage, menisci, synovial membrane, ligaments and fat pad. The significance of MRI findings such as cartilage defects, bone marrow lesions, synovial inflammation/effusions and meniscal tears in patients without radiographic signs of osteoarthritis is not fully understood. Nevertheless, early joint tissue changes are associated with symptoms and, in some cases, with progression of disease. In this short review, we discuss the emerging concept of early osteoarthritis localised to the knee based on recently updated knowledge. We highlight the need for a new definition of early osteoarthritis that will permit the identification of patients at high risk of osteoarthritis progression and to initiate early treatment interventions. PMID:26557380

  10. Is Lifelong Knee Joint Force from Work, Home, and Sport Related to Knee Osteoarthritis?

    PubMed Central

    Ratzlaff, Charles R.; Koehoorn, Mieke; Cibere, Jolanda; Kopec, Jacek A.

    2012-01-01

    Purpose. To investigate the association of cumulative lifetime knee joint force on the risk of self-reported medically-diagnosed knee osteoarthritis (OA). Methods. Exposure data on lifetime physical activity type (occupational, household, sport/recreation) and dose (frequency, intensity, duration) were collected from 4,269 Canadian men and women as part of the Physical Activity and Joint Heath cohort study. Subjects were ranked in terms of the “cumulative peak force index”, a measure of lifetime mechanical knee force. Multivariable logistic regression was conducted to obtain adjusted effects for mean lifetime knee force on the risk of knee OA. Results. High levels of total lifetime, occupational and household-related force were associated with an increased in risk of OA, with odds ratio's ranging from approximately 1.3 to 2. Joint injury, high BMI and older age were related to risk of knee OA, consistent with previous studies. Conclusions. A newly developed measure of lifetime mechanical knee force from physical activity was employed to estimate the risk of self-reported, medically-diagnosed knee OA. While there are limitations, this paper suggests that high levels of total lifetime force (all domains combined), and occupational force in men and household force in women were risk factors for knee OA. PMID:22848225

  11. Applications of Proteomics to Osteoarthritis, a Musculoskeletal Disease Characterized by Aging

    PubMed Central

    Mobasheri, Ali

    2011-01-01

    The incidence of age-related musculoskeletal impairment is steadily rising throughout the world. Musculoskeletal conditions are closely linked with aging and inflammation. They are leading causes of morbidity and disability in man and beast. Aging is a major contributor to musculoskeletal degeneration and the development of osteoarthritis (OA). OA is a degenerative disease that involves structural changes to joint tissues including synovial inflammation, catabolic destruction of articular cartilage and alterations in subchondral bone. Cartilage degradation and structural changes in subchondral bone result in the production of fragments of extracellular matrix molecules. Some of these biochemical markers or “biomarkers” can be detected in blood, serum, synovial fluid, and urine and may be useful markers of disease progression. The ability to detect biomarkers of cartilage degradation in body fluids may enable clinicians to diagnose sub-clinical OA as well as determining the course of disease progression. New biomarkers that indicate early responses of the joint cartilage to degeneration will be useful in detecting early, pre-radiographic changes. Systems biology is increasingly applied in basic cartilage biology and OA research. Proteomic techniques have the potential to improve our understanding of OA physiopathology and its underlying mechanisms. Proteomics can also facilitate the discovery of disease-specific biomarkers and help identify new therapeutic targets. Proteomic studies of cartilage and other joint tissues may be particularly relevant in diagnostic orthopedics and therapeutic research. This perspective article discusses the relevance and potential of proteomics for studying age-related musculoskeletal diseases such as OA and reviews the contributions of key investigators in the field. PMID:22207853

  12. [Amyloid deposition in chronic joint disease].

    PubMed

    Saitou, H

    1994-07-01

    As a screening procedure for the detection of amyloidosis secondary to rheumatoid arthritis, abdominal subcutaneous fat tissues were aspirated, and were examined after Congo red staining by polarized microscopy. Positive amyloid deposits were found in 7.1 percent of the rheumatoid patients, and the amyloid in the subcutaneous fat was determined to be AA type by permanganate oxidation. The occurrence of amyloid deposition was significantly correlated with the duration of the articular symptoms, the progression of the class, and also with proteinuria. Additionally the joint capsules, including the synovium and synovial fluid sediment, from patients with rheumatoid arthritis and osteoarthritis were examined for amyloid deposition. Deposits of amyloid in the hip and knee joints were found more frequently in those with rheumatoid arthritis than in those with osteoarthritis. In osteoarthritis, the frequency of amyloid deposition tended to increase with advancing age. However these amyloid deposits in the joint structure were discovered to be resistant to permanganate oxidation. Therefore it was suspected that these amyloid deposits were of a type different from AA amyloid. PMID:8071579

  13. Correlation of Clinical Disease Severity to Radiographic Thumb Osteoarthritis Index

    PubMed Central

    Ladd, Amy L; Messana, Joseph; Berger, Aaron J.; Weiss, Arnold-Peter C.

    2014-01-01

    Purpose To determine if a slight modification of the 1987 Eaton-Glickel staging and interpreting 4 standardized radiographs for trapeziometacarpal arthritis improved analysis, to determine if a quantifiable index measurement from a single Robert (pronated anteroposterior) view enhanced reproducibility, and to examine whether improved radiographic staging correlated to clinically relevant disease and thus support validity. Methods We analyzed 4 thumb radiographs (posteroanterior, lateral, a Robert, and stress views) in 60 consecutive subjects representing an adult population spectrum of asymptomatic to advanced disease. Two experienced hand surgeons, 1 chief resident, and 1 medical student performed the analysis on each subject’s radiographs. We analyzed all 4 radiographs for Eaton and modified Eaton staging and then later analyzed only the Robert view for the thumb osteoarthritis (ThOA) index measurement. The radiographs were randomized and re-read a week later for each classification at separate times. Surgically excised trapeziums from 20/60 subjects were inspected for first metacarpal surface disease and correlated to the 3 classifications. Results All 3 staging classifications demonstrated high reproducibility, with the intraclass correlation coefficient averaging 0.73 for the Eaton, 0.83 for the modified Eaton, and 0.95 for the ThOA index. Articular wear and metacarpal surface eburnation correlated highest to the ThOA index, with advanced disease ≥ 1.55 correlating to Eaton III/IV and modified Eaton stage 3/4 in a linear relationship. Discussion The ThOA index based on a Robert view provided a measurable alternative to Eaton staging and correlated to severity of surgically relevant thumb TMC OA. Clinical Relevance A simple reproducible radiographic measurement may enhance TMC OA classification and provide a reliable means to predict clinical disease. Level of Evidence Level of Evidence II/Diagnostic PMID:25617217

  14. Exercising with Osteoarthritis

    MedlinePlus

    ... people with osteoarthritis benefit from regular exercise and physical activity. For people with osteoarthritis, regular exercise can help: l Maintain healthy and strong muscles l Preserve joint mobility l Maintain range of motion l Improve sleep ...

  15. Dietary polyphenols and mechanisms of osteoarthritis.

    PubMed

    Shen, Chwan-Li; Smith, Brenda J; Lo, Di-Fan; Chyu, Ming-Chien; Dunn, Dale M; Chen, Chung-Hwan; Kwun, In-Sook

    2012-11-01

    Osteoarthritis is a condition caused in part by injury, loss of cartilage structure and function, and an imbalance in inflammatory and anti-inflammatory pathways. It primarily affects the articular cartilage and subchondral bone of synovial joints and results in joint failure, leading to pain upon weight bearing including walking and standing. There is no cure for osteoarthritis, as it is very difficult to restore the cartilage once it is destroyed. The goals of treatment are to relieve pain, maintain or improve joint mobility, increase the strength of the joints and minimize the disabling effects of the disease. Recent studies have shown an association between dietary polyphenols and the prevention of osteoarthritis-related musculoskeletal inflammation. This review discusses the effects of commonly consumed polyphenols, including curcumin, epigallocatechin gallate and green tea extract, resveratrol, nobiletin and citrus fruits, pomegranate, as well as genistein and soy protein, on osteoarthritis with an emphasis on molecular antiosteoarthritic mechanisms. PMID:22832078

  16. Effect of Sri Lankan traditional medicine and Ayurveda on Sandhigata Vata (osteoarthritis of knee joint)

    PubMed Central

    Perera, Pathirage Kamal; Perera, Manaram; Kumarasinghe, Nishantha

    2014-01-01

    Reported case was a 63-year-old female with end-stage osteoarthritis (OA) (Sandhigata Vata) of the left knee joint accompanied by exostoses. Radiology (X-ray) report confirmed it as a Kellgren-Lawrence grade III or less with exostoses. At the beginning, the Knee Society Rating System scores of pain, movement and stability were poor, and function score was fair. Srilankan traditional and Ayurveda medicine treatment was given in three regimens for 70 days. After 70 days, external treatment of oleation and 2 capsules of Shallaki (Boswellia serrata Triana and Planch) and two tablets of Jeewya (comprised of Emblica officinalis Gaertn., Tinospora cordifolia [Willd.] Millers. and Terminalia chebula Retz.), twice daily were continued over 5 months. Visual analogue scale for pain, knee scores in the Knee Society online rating system and a Ayurveda clinical assessment criteria was used to evaluate the effects of treatments in weekly basis. After treatment for 70 days, the Knee Society Rating System scores of pain, movement and stability were also improved up to good level and function score was improved up to excellent level. During the follow-up period, joint symptoms and signs and the knee scores were unchanged. In conclusion, this OA patient's quality of life was improved by the combined treatment of Sri Lankan traditional medicine and Ayurveda. PMID:26195904

  17. Effect of Sri Lankan traditional medicine and Ayurveda on Sandhigata Vata (osteoarthritis of knee joint).

    PubMed

    Perera, Pathirage Kamal; Perera, Manaram; Kumarasinghe, Nishantha

    2014-01-01

    Reported case was a 63-year-old female with end-stage osteoarthritis (OA) (Sandhigata Vata) of the left knee joint accompanied by exostoses. Radiology (X-ray) report confirmed it as a Kellgren-Lawrence grade III or less with exostoses. At the beginning, the Knee Society Rating System scores of pain, movement and stability were poor, and function score was fair. Srilankan traditional and Ayurveda medicine treatment was given in three regimens for 70 days. After 70 days, external treatment of oleation and 2 capsules of Shallaki (Boswellia serrata Triana and Planch) and two tablets of Jeewya (comprised of Emblica officinalis Gaertn., Tinospora cordifolia [Willd.] Millers. and Terminalia chebula Retz.), twice daily were continued over 5 months. Visual analogue scale for pain, knee scores in the Knee Society online rating system and a Ayurveda clinical assessment criteria was used to evaluate the effects of treatments in weekly basis. After treatment for 70 days, the Knee Society Rating System scores of pain, movement and stability were also improved up to good level and function score was improved up to excellent level. During the follow-up period, joint symptoms and signs and the knee scores were unchanged. In conclusion, this OA patient's quality of life was improved by the combined treatment of Sri Lankan traditional medicine and Ayurveda. PMID:26195904

  18. Infrapatellar fat pad volume is greater in individuals with patellofemoral joint osteoarthritis and associated with pain.

    PubMed

    Cowan, Sallie M; Hart, Harvi F; Warden, Stuart J; Crossley, Kay M

    2015-08-01

    There is relatively little research specifically investigating patellofemoral joint osteoarthritis (PFJ OA). In particular, the source of pain in PFJ OA has not been established. One structure that may be an important contributor is the infrapatellar fat pad (IPFP). This cross-sectional study aimed to: (1) compare IPFP volume in individuals with and without PFJ OA and (2) assess the relationship between IPFP volume and pain in individuals with PFJ OA. Thirty-five participants with symptomatic and radiographic PFJ OA and 11 asymptomatic controls with no radiographic signs of OA were recruited. IPFP volume was measured in both groups from magnetic resonance images, and pain in the PFJ OA group was determined using the pain subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS-pain). The PFJ OA group had 23.6 % greater IPFP volume than the control group (p = 0.04). After the inclusion of covariates, IPFP volume remained 19.6 % greater in the PFJ OA group (p = 0.03). IPFP volume explained 20.1 % of the variance in KOOS-pain in the PFJ OA group, with a larger IPFP being associated with worse pain (p < 0.01). Individuals with PFJ OA had a larger IPFP than controls, and IPFP volume was directly related to PFJ OA pain. These data suggest a role for the IPFP in PFJ OA and highlight a need for further investigation into the casual relationship between IPFP and PFJ changes. PMID:25782586

  19. Racial and Gender Differences in Willingness to Undergo Total Joint Replacement: The Johnston County Osteoarthritis Project

    PubMed Central

    Allen, Kelli D.; Golightly, Yvonne M.; Callahan, Leigh F.; Helmick, Charles G.; Ibrahim, Said A.; Kwoh, C. Kent; Renner, Jordan B.; Jordan, Joanne M.

    2014-01-01

    Objective Using data from the community-based Johnston County Osteoarthritis Project (JoCo OA), we examined race and gender variations in willingness to undergo, and perceptions regarding, total joint replacement (TJR). Methods Analyses were conducted for the total sample who participated in a follow-up measurement period from 2006-2010 (n=1,522) and a subsample with symptomatic hip and / or knee osteoarthritis (sOA; n=445). Participants indicated how willing they would be to have TJR (hip or knee) if their doctor recommended it; responses were categorized as “definitely” or “probably” willing vs. “unsure,” “probably not” or “definitely not” willing, or “don't know.” Participants answered seven questions regarding perceptions of TJR outcomes. Multivariable logistic regression models of willingness included participant characteristics (including socioeconomic status) and TJR perception variables that were associated with willingness at the p<0.1 level in bivariate analyses. Results African Americans had lower odds of willingness to undergo TJR than Caucasians in the total sample (adjusted OR = 0.57, 95% CI = 0.44-0.74) and the sOA subsample (adjusted OR = 0.39, 95% CI = 0.25-0.62). There were no gender differences in willingness. African Americans expected poorer TJR outcomes than Caucasians, but gender differences were minimal; perceptions of TJR outcomes were not significantly associated with willingness. Conclusions In this community sample, racial differences in TJR willingness and perceptions were substantial, but gender differences were small. Perceptions of TJR did not appear to affect willingness or explain racial differences in willingness. PMID:24470235

  20. Older asymptomatic women exhibit patterns of thumb carpometacarpal joint space narrowing that precede changes associated with early osteoarthritis.

    PubMed

    Halilaj, Eni; Moore, Douglas C; Patel, Tarpit K; Laidlaw, David H; Ladd, Amy L; Weiss, Arnold-Peter C; Crisco, Joseph J

    2015-10-15

    In small joints, where cartilage is difficult to image and quantify directly, three-dimensional joint space measures can be used to gain insight into potential joint pathomechanics. Since the female sex and older age are risk factors for carpometacarpal (CMC) joint osteoarthritis (OA), the purpose of this in vivo computed tomography (CT) study was to determine if there are any differences with sex, age, and early OA in the CMC joint space. The thumbs of 66 healthy subjects and 81 patients with early stage CMC OA were scanned in four range-of-motion, three functional-task, and one neutral positions. Subchondral bone-to-bone distances across the trapezial and metacarpal articular surfaces were computed for all the positions. The joint space area, defined as the articular surface that is less than 1.5mm from the mating bone, was used to assess joint space. A larger joint space area typically corresponds to closer articular surfaces, and therefore a narrower joint space. We found that the joint space areas are not significantly different between healthy young men and women. Trends indicated that patients with early stage OA have larger CMC joint space areas than healthy subjects of the same age group and that older healthy women have larger joint space areas than younger healthy women. This study suggests that aging in women may lead to joint space narrowing patterns that precede early OA, which is a compelling new insight into the pathological processes that make CMC OA endemic to women. PMID:26323995

  1. KNEE-JOINT LOADING IN KNEE OSTEOARTHRITIS: INFLUENCE OF ABDOMINAL AND THIGH FAT

    PubMed Central

    Messier, Stephen P.; Beavers, Daniel P.; Loeser, Richard F.; Carr, J. Jeffery; Khajanchi, Shubham; Legault, Claudine; Nicklas, Barbara J.; Hunter, David J.; DeVita, Paul

    2014-01-01

    Purpose Using three separate models that included total body mass, total lean and total fat mass, and abdominal and thigh fat as independent measures, we determined their association with knee-joint loads in older overweight and obese adults with knee osteoarthritis (OA). Methods Fat depots were quantified using computed tomography and total lean and fat mass determined with dual energy x-ray absorptiometry in 176 adults (age = 66.3 yr., BMI = 33.5 kg·m−2) with radiographic knee OA. Knee moments and joint bone-on-bone forces were calculated using gait analysis and musculoskeletal modeling. Results Higher total body mass was significantly associated (p ≤ 0.0001) with greater knee compressive and shear forces, compressive and shear impulses (p < 0.0001), patellofemoral forces (p< 0.006), and knee extensor moments (p = 0.003). Regression analysis with total lean and total fat mass as independent variables revealed significant positive associations of total fat mass with knee compressive (p = 0.0001), shear (p < 0.001), and patellofemoral forces (p = 0.01) and knee extension moment (p = 0.008). Gastrocnemius and quadriceps forces were positively associated with total fat mass. Total lean mass was associated with knee compressive force (p = 0.002). A regression model that included total thigh and total abdominal fat found both were significantly associated with knee compressive and shear forces (p ≤ 0.04). Thigh fat was associated with the knee abduction (p = 0.03) and knee extension moment (p = 0.02). Conclusions Thigh fat, consisting predominately of subcutaneous fat, had similar significant associations with knee joint forces as abdominal fat despite its much smaller volume and could be an important therapeutic target for people with knee OA. PMID:25133996

  2. Novel therapeutic targets in osteoarthritis: Narrative review on knock-out genes involved in disease development in mouse animal models.

    PubMed

    Veronesi, Francesca; Della Bella, Elena; Cepollaro, Simona; Brogini, Silvia; Martini, Lucia; Fini, Milena

    2016-05-01

    Osteoarthritis (OA) can affect every joint, especially the knee. Given the complexity of this pathology, OA is difficult to treat with current therapies, which only relieve pain and inflammation and are not capable of restoring tissues once OA has started. Currently, researchers focus on finding a therapeutic strategy that may help to arrest disease progression. The present narrative review gives an overview of the genes involved in the development and progression of OA, assessing in vivo studies performed in knock-out mice affected by OA, to suggest new therapeutic strategies. The article search was performed on the PubMed database and www.webofknowledge.com website with the following keywords: "knee osteoarthritis" AND "knockout mice". The included studies were in English and published from 2005 to 2015. Additional papers were found within the references of the selected articles. In the 55 analyzed in vivo studies, genes mainly affected chondrocyte homeostasis, inflammatory processes, extracellular matrix and the relationship between obesity and OA. Genes are defined as inducing, preventing and not influencing OA. This review shows that joint homeostasis depends on a variety of genetic factors, and preventing or restoring the loss of a gene encoding for protective proteins, or inhibiting the expression of proteins that induce OA, might be a potential therapeutic approach. However, conclusions cannot be drawn because of the wide variability concerning the technique used for OA induction, the role of the genes, the method for tissue evaluations and the lack of assessments of all joint tissues. PMID:27059198

  3. Conditional Deletion of Fgfr3 in Chondrocytes leads to Osteoarthritis-like Defects in Temporomandibular Joint of Adult Mice

    PubMed Central

    Zhou, Siru; Xie, Yangli; Li, Wei; Huang, Junlan; Wang, Zuqiang; Tang, Junzhou; Xu, Wei; Sun, Xianding; Tan, Qiaoyan; Huang, Shuo; Luo, Fengtao; Xu, Meng; Wang, Jun; Wu, Tingting; chen, Liang; Chen, Hangang; Su, Nan; Du, Xiaolan; Shen, Yue; Chen, Lin

    2016-01-01

    Osteoarthritis (OA) in the temporomandibular joint (TMJ) is a common degenerative disease in adult, which is characterized by progressive destruction of the articular cartilage. To investigate the role of FGFR3 in the homeostasis of TMJ cartilage during adult stage, we generated Fgfr3f/f; Col2a1-CreERT2 (Fgfr3 cKO) mice, in which Fgfr3 was deleted in chondrocytes at 2 months of age. OA-like defects were observed in Fgfr3 cKO TMJ cartilage. Immunohistochemical staining and quantitative real-time PCR analyses revealed a significant increase in expressions of COL10, MMP13 and AMAMTS5. In addition, there was a sharp increase in chondrocyte apoptosis at the Fgfr3 cKO articular surface, which was accompanied by a down-regulation of lubricin expression. Importantly, the expressions of RUNX2 and Indian hedgehog (IHH) were up-regulated in Fgfr3 cKO TMJ. Primary Fgfr3 cKO chondrocytes were treated with IHH signaling inhibitor, which significantly reduced expressions of Runx2, Col10, Mmp13 and Adamts5. Furthermore, the IHH signaling inhibitor partially alleviated OA-like defects in the TMJ of Fgfr3 cKO mice, including restoration of lubricin expression and improvement of the integrity of the articular surface. In conclusion, our study proposes that FGFR3/IHH signaling pathway plays a critical role in maintaining the homeostasis of TMJ articular cartilage during adult stage. PMID:27041063

  4. Conditional Deletion of Fgfr3 in Chondrocytes leads to Osteoarthritis-like Defects in Temporomandibular Joint of Adult Mice.

    PubMed

    Zhou, Siru; Xie, Yangli; Li, Wei; Huang, Junlan; Wang, Zuqiang; Tang, Junzhou; Xu, Wei; Sun, Xianding; Tan, Qiaoyan; Huang, Shuo; Luo, Fengtao; Xu, Meng; Wang, Jun; Wu, Tingting; Chen, Liang; Chen, Hangang; Su, Nan; Du, Xiaolan; Shen, Yue; Chen, Lin

    2016-01-01

    Osteoarthritis (OA) in the temporomandibular joint (TMJ) is a common degenerative disease in adult, which is characterized by progressive destruction of the articular cartilage. To investigate the role of FGFR3 in the homeostasis of TMJ cartilage during adult stage, we generated Fgfr3(f/f); Col2a1-CreER(T2) (Fgfr3 cKO) mice, in which Fgfr3 was deleted in chondrocytes at 2 months of age. OA-like defects were observed in Fgfr3 cKO TMJ cartilage. Immunohistochemical staining and quantitative real-time PCR analyses revealed a significant increase in expressions of COL10, MMP13 and AMAMTS5. In addition, there was a sharp increase in chondrocyte apoptosis at the Fgfr3 cKO articular surface, which was accompanied by a down-regulation of lubricin expression. Importantly, the expressions of RUNX2 and Indian hedgehog (IHH) were up-regulated in Fgfr3 cKO TMJ. Primary Fgfr3 cKO chondrocytes were treated with IHH signaling inhibitor, which significantly reduced expressions of Runx2, Col10, Mmp13 and Adamts5. Furthermore, the IHH signaling inhibitor partially alleviated OA-like defects in the TMJ of Fgfr3 cKO mice, including restoration of lubricin expression and improvement of the integrity of the articular surface. In conclusion, our study proposes that FGFR3/IHH signaling pathway plays a critical role in maintaining the homeostasis of TMJ articular cartilage during adult stage. PMID:27041063

  5. Celecoxib: considerations regarding its potential disease-modifying properties in osteoarthritis

    PubMed Central

    2011-01-01

    Osteoarthritis (OA) is a degenerative joint disease characterized by progressive loss of articular cartilage, subchondral bone sclerosis, osteophyte formation, and synovial inflammation, causing substantial physical disability, impaired quality of life, and significant health care utilization. Traditionally, non-steroidal anti-inflammatory drugs (NSAIDs), including selective cyclooxygenase (COX)-2 inhibitors, have been used to treat pain and inflammation in OA. Besides its anti-inflammatory properties, evidence is accumulating that celecoxib, one of the selective COX-2 inhibitors, has additional disease-modifying effects. Celecoxib was shown to affect all structures involved in OA pathogenesis: cartilage, bone, and synovium. As well as COX-2 inhibition, evidence indicates that celecoxib also modulates COX-2-independent signal transduction pathways. These findings raise the question of whether celecoxib, and potentially other coxibs, is more than just an anti-inflammatory and analgesic drug. Can celecoxib be considered a disease-modifying osteoarthritic drug? In this review, these direct effects of celecoxib on cartilage, bone, and synoviocytes in OA treatment are discussed. PMID:21955617

  6. Corroboration of in vivo cartilage pressures with implications for synovial joint tribology and osteoarthritis causation

    PubMed Central

    Morrell, Kjirste C.; Hodge, W. Andrew; Krebs, David E.; Mann, Robert W.

    2005-01-01

    Pressures on normal human acetabular cartilage have been collected from two implanted instrumented femoral head hemipros-theses. Despite significant differences in subjects' gender, morphology, mobility, and coordination, in vivo pressure measurements from both subjects covered similar ranges, with maximums of 5-6 MPa in gait, and as high as 18 MPa in other movements. Normalized for subject weight and height (nMPa), for free-speed walking the maximum pressure values were 25.2 for the female subject and 24.5 for the male subject. The overall maximum nMPa values were 76.2 for the female subject during rising from a chair at 11 months postoperative and 82.3 for the male subject while descending steps at 9 months postoperative. These unique in vivo data are consistent with corresponding cadaver experiments and model analyses. The collective results, in vitro data, model studies, and now corroborating in vivo data support the self-pressurizing “weeping” theory of synovial joint lubrication and provide unique information to evaluate the influence of in vivo pressure regimes on osteoarthritis causation and the efficacy of augmentations to, and substitutions for, natural cartilage. PMID:16203974

  7. Injecting vascular endothelial growth factor into the temporomandibular joint induces osteoarthritis in mice

    PubMed Central

    Shen, Pei; Jiao, ZiXian; Zheng, Ji Si; Xu, Wei Feng; Zhang, Shang Yong; Qin, An; Yang, Chi

    2015-01-01

    It is unclear whether vascular endothelial growth factor (VEGF) can initiate osteoarthritis (OA) in the temporomandibular joint (TMJ). In this study we evaluated the effects of intra-articular injection of exogenous VEGF in the TMJ in mice on the early stage. Forty-eight male Sprague-Dawley mice were equally divided into 3 groups. In the vegf group, the mice received an injection of VEGF solution (50 μL) in the TMJ once a week over a period of 4 weeks. In the sham group, the mice received an injection of saline (50 μL). The control group did not receive any injection. Four mice from each group were sacrificed at 1, 2, 4, and 8 weeks. Gradual prominent cartilage degeneration was observed in the vegf group. Additionally, this group showed higher expressions of metalloproteinase (MMP)-9, MMP-13, receptor activator of nuclear factor-kappa-B ligand (RANKL), and a higher number of apoptotic chondrocytes and VEGF receptor 2 (VEGFR2)-positive chondrocytes. Micro-computed tomography (CT) revealed prominent subchondral bone resorption in the vegf group, with a high number of osteoclasts in the subchondral bone. In vitro study demonstrated that VEGF can promote osteoclast differentiation. In conclusion, our study found that VEGF can initiate TMJ OA by destroying cartilage and subchondral bone. PMID:26531672

  8. Depression and the Overall Burden of Painful Joints: An Examination among Individuals Undergoing Hip and Knee Replacement for Osteoarthritis

    PubMed Central

    Gandhi, Rajiv; Zywiel, Michael G.; Mahomed, Nizar N.; Perruccio, Anthony V.

    2015-01-01

    The majority of patients with hip or knee osteoarthritis (OA) report one or more symptomatic joints apart from the one targeted for surgical care. Therefore, the purpose of the present study was to investigate the association between the burden of multiple symptomatic joints and self-reported depression in patients awaiting joint replacement for OA. Four hundred and seventy-five patients at a single centre were evaluated. Patients self-reported joints that were painful and/or symptomatic most days of the previous month on a homunculus, with nearly one-third of the sample reporting 6 or more painful joints. The prevalence of depression was 12.2% (58/475). When adjusted for age, sex, education level, hip or knee OA, body mass index, chronic condition count, and joint-specific WOMAC scores, each additional symptomatic joint was associated with a 19% increased odds (odds ratio: 1.19 (95% CI: 1.08, 1.31, P < 0.01)) of self-reported depression. Individuals reporting 6 or more painful joints had 2.5-fold or greater odds of depression when compared to those patients whose symptoms were limited to the surgical joint. A focus on the surgical joint alone is likely to miss a potentially important determinant of postsurgical patient-reported outcomes in patients undergoing hip or knee replacement. PMID:25861476

  9. Radiographic assessment of the femorotibial joint of the CCLT rabbit experimental model of osteoarthritis

    PubMed Central

    2010-01-01

    Background The purposes of the study were to determine the relevance and validity of in vivo non-invasive radiographic assessment of the CCLT (Cranial Cruciate Ligament Transection) rabbit model of osteoarthritis (OA) and to estimate the pertinence, reliability and reproducibility of a radiographic OA (ROA) grading scale and associated radiographic atlas. Methods In vivo non-invasive extended non weight-bearing radiography of the rabbit femorotibial joint was standardized. Two hundred and fifty radiographs from control and CCLT rabbits up to five months after surgery were reviewed by three readers. They subsequently constructed an original semi-quantitative grading scale as well as an illustrative atlas of individual ROA feature for the medial compartment. To measure agreements, five readers independently scored the same radiographic sample using this atlas and three of them performed a second reading. To evaluate the pertinence of the ROA grading scale, ROA results were compared with gross examination in forty operated and ten control rabbits. Results Radiographic osteophytes of medial femoral condyles and medial tibial condyles were scored on a four point scale and dichotomously for osteophytes of medial fabella. Medial joint space width was scored as normal, reduced or absent. Each ROA features was well correlated with gross examination (p < 0.001). ICCs of each ROA features demonstrated excellent agreement between readers and within reading. Global ROA score gave the highest ICCs value for between (ICC 0.93; CI 0.90-0.96) and within (ICC ranged from 0.94 to 0.96) observer agreements. Among all individual ROA features, medial joint space width scoring gave the highest overall reliability and reproducibility and was correlated with both meniscal and cartilage macroscopic lesions (rs = 0.68 and rs = 0.58, p < 0.001 respectively). Radiographic osteophytes of the medial femoral condyle gave the lowest agreements while being well correlated with the macroscopic osteophytes (rs = 0.64, p < 0.001). Conclusion Non-invasive in vivo radiography of the rabbit femorotibial joint is feasible, relevant and allows a reproducible grading of experimentally induced OA lesion. The radiographic grading scale and atlas presented could be used as a template for in vivo non invasive grading of ROA in preclinical studies and could allow future comparisons between studies. PMID:20089151

  10. Osteoarthritis: epidemiology.

    PubMed

    Arden, Nigel; Nevitt, Michael C

    2006-02-01

    Osteoarthritis (OA) is the most common joint disorder in the world. In Western populations it is one of the most frequent causes of pain, loss of function and disability in adults. Radiographic evidence of OA occurs in the majority of people by 65 years of age and in about 80% of those aged over 75 years. In the US it is second only to ischaemic heart disease as a cause of work disability in men over 50 years of age, and accounts for more hospitalizations than rheumatoid arthritis (RA) each year. Despite this public health impact, OA remains an enigmatic condition to the epidemiologist. In this chapter, we will review the definition and classification of OA, its prevalence, incidence, risk factors and natural history. PMID:16483904

  11. Design and Evaluation of a New Type of Knee Orthosis to Align the Mediolateral Angle of the Knee Joint with Osteoarthritis

    PubMed Central

    Esrafilian, Amir; Karimi, Mohammad Taghi; Eshraghi, Arezoo

    2012-01-01

    Background. Osteoarthritis (OA) is a disease which influences the performance of the knee joint. Moreover, the force and moments applied on the joint increase in contrast to normal subjects. Various types of knee orthoses have been designed to solve the mentioned problems. However, there are other problems in terms of distal migration during walking and the alignment of the orthosis which cannot be changed following the use of brace. Therefore, the main aim of the research was to design an orthosis to solve the aforementioned problems. Method. A new type of knee orthosis was designed with a modular structure. Two patients with knee OA participated in this research project. The force applied on the foot, moment transmitted through the knee joint, and spatiotemporal gait parameters were measured by use of a motion analysis system. Results. The results of the research showed that the adduction moment applied on the knee joint decreased while subjects walked with the new knee orthosis (P-value < 0.05). Conclusion. The new design of the knee brace can be used as an effective treatment to decrease the loads applied on the knee joint and to improve the alignment whilst walking. PMID:22577565

  12. An Orthopedic Perspective. Does Running Cause Osteoarthritis?

    ERIC Educational Resources Information Center

    Pascale, Mark; Grana, William A.

    1989-01-01

    Discusses the development of osteoarthritis and whether running and other impact loading sports promote it. Although these sports do not cause arthritis in normal weight bearing limbs, they can accelerate it in damaged joints. It is important to identify people with preeexisting joint disease so they can choose nonimpact-loading aerobic exercise.

  13. An Orthopedic Perspective. Does Running Cause Osteoarthritis?

    ERIC Educational Resources Information Center

    Pascale, Mark; Grana, William A.

    1989-01-01

    Discusses the development of osteoarthritis and whether running and other impact loading sports promote it. Although these sports do not cause arthritis in normal weight bearing limbs, they can accelerate it in damaged joints. It is important to identify people with preeexisting joint disease so they can choose nonimpact-loading aerobic exercise.…

  14. Self-perceived weather sensitivity and joint pain in older people with osteoarthritis in six European countries: results from the European Project on OSteoArthritis (EPOSA)

    PubMed Central

    2014-01-01

    Background People with osteoarthritis (OA) frequently report that their joint pain is influenced by weather conditions. This study aimed to examine whether there are differences in perceived joint pain between older people with OA who reported to be weather-sensitive versus those who did not in six European countries with different climates and to identify characteristics of older persons with OA that are most predictive of perceived weather sensitivity. Methods Baseline data from the European Project on OSteoArthritis (EPOSA) were used. ACR classification criteria were used to determine OA. Participants with OA were asked about their perception of weather as influencing their pain. Using a two-week follow-up pain calendar, average self-reported joint pain was assessed (range: 0 (no pain)-10 (greatest pain intensity)). Linear regression analyses, logistic regression analyses and an independent t-test were used. Analyses were adjusted for several confounders. Results The majority of participants with OA (67.2%) perceived the weather as affecting their pain. Weather-sensitive participants reported more pain than non-weather-sensitive participants (M = 4.1, SD = 2.4 versus M = 3.1, SD = 2.4; p < 0.001). After adjusting for several confounding factors, the association between self-perceived weather sensitivity and joint pain remained present (B = 0.37, p = 0.03). Logistic regression analyses revealed that women and more anxious people were more likely to report weather sensitivity. Older people with OA from Southern Europe were more likely to indicate themselves as weather-sensitive persons than those from Northern Europe. Conclusions Weather (in)stability may have a greater impact on joint structures and pain perception in people from Southern Europe. The results emphasize the importance of considering weather sensitivity in daily life of older people with OA and may help to identify weather-sensitive older people with OA. PMID:24597710

  15. Picking a bone with WISP1 (CCN4): new strategies against degenerative joint disease

    PubMed Central

    Maiese, Kenneth

    2016-01-01

    As the world’s population continues to age, it is estimated that degenerative joint disease disorders such as osteoarthritis will impact at least 130 million individuals throughout the globe by the year 2050. Advanced age, obesity, genetics, gender, bone density, trauma, and a poor level of physical activity can lead to the onset and progression of osteoarthritis. However, factors that lead to degenerative joint disease and involve gender, genetics, epigenetic mechanisms, and advanced age are not within the control of an individual. Furthermore, current therapies including pain management, improved nutrition, and regular programs for exercise do not lead to the resolution of osteoarthritis. As a result, new avenues for targeting the treatment of osteoarthritis are desperately needed. Wnt1 inducible signaling pathway protein 1 (WISP1), a matricellular protein and a downstream target of the wingless pathway Wnt1, is one such target to consider that governs cellular protection, stem cell proliferation, and tissue regeneration in a number of disorders including bone degeneration. However, increased WISP1 expression also has been associated with the progression of osteoarthritis. WISP1 has an intricate relationship with a number of proliferative and protective pathways that include phosphoinositide 3-kinase (PI 3-K), protein kinase B (Akt), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), interleukin -6 (IL-6), transforming growth factor-β, matrix metalloproteinase, small non-coding ribonucleic acids (RNAs), sirtuin silent mating type information regulation 2 homolog 1 (Saccharomyces cerevisiae) (SIRT1), and the mechanistic target of rapamycin (mTOR). Taken together, this complex association WISP1 holds with these signaling pathways necessitates a fine biological regulation of WISP1 activity that can offset the progression of degenerative joint disease, but not limit the cellular protective capabilities of the WISP1 pathway. PMID:26893943

  16. Evaluation of the first metacarpal proximal facet inclination as a prognostic predictor following arthroplasty for osteoarthritis of the thumb carpometacarpal joint.

    PubMed

    Tonogai, Ichiro; Hamada, Yoshitaka; Hibino, Naohito

    2013-01-01

    We have retrospectively reviewed 17 thumbs in 16 patients with osteoarthritis of the thumb carpometacarpal joints, for which arthroplasty was performed using Kaarela's method. Postoperatively, three thumbs in two patients had poor outcomes; both patients had a sharp slope of the base of the first metacarpal. Serial radiographic measurements suggested that this sharp slope affected the adducted position of the first metacarpal, and led to the appearance of a metacarpophalangeal joint hyperextension deformity of the thumb. This radiological finding could be a prognostic predictor after surgery for osteoarthritis of the thumb carpometacarpal joint. PMID:23413854

  17. Dietary fatty acid content regulates wound repair and the pathogenesis of osteoarthritis following joint injury

    PubMed Central

    Wu, Chia-Lung; Jain, Deeptee; McNeill, Jenna N.; Little, Dianne; Anderson, John A.; Huebner, Janet L.; Kraus, Virginia B.; Rodriguiz, Ramona M.; Wetsel, William C.; Guilak, Farshid

    2015-01-01

    Objective The mechanisms linking obesity and osteoarthritis (OA) are not fully understood and have been generally attributed to increased weight, rather than metabolic or inflammatory factors. Here, we examined the influence of dietary fatty acids, adipokines, and body weight following joint injury in mouse model of OA. Methods Mice were fed high-fat diets rich in various fatty acids (FAs) including saturated FAs (SFAs), ω-6 polyunsaturated FAs (PUFAs), and ω-3 PUFAs. OA was induced by destabilizing the medial meniscus. Wound healing was evaluated using an ear punch. OA, synovitis and wound healing were determined histologically, while bone changes were measured using microCT. Activity levels and serum cytokines were measured at various time-points. Multivariate models were performed to elucidate the associations of dietary, metabolic, and mechanical factors with OA and wound healing. Results Using weight-matched mice and multivariate models, we found that OA was significantly associated with dietary fatty acid content and serum adipokine levels, but not with body weight. Furthermore, spontaneous activity of the mice was independent of OA development. Small amounts of ω-3 PUFAs (8% by kcal) in a high-fat diet were sufficient to mitigate injury-induced OA, decreasing leptin and resistin levels. ω-3 PUFAs significantly enhanced wound repair, SFAs or ω-6 PUFAs independently increased OA severity, heterotopic ossification, and scar tissue formation. Conclusions Our results indicate that dietary FA content is a primary regulator of OA severity and wound regeneration with obesity, supporting the need for further studies of dietary FA supplements as a potential therapeutic approach for OA. PMID:25015373

  18. Detection of calcium phosphate crystals in the joint fluid of patients with osteoarthritis analytical approaches and challenges

    PubMed Central

    Yavorskyy, Alexander; Hernandez-Santana, Aaron; McCarthy, Geraldine

    2008-01-01

    Clinically, osteoarthritis (OA) is characterised by joint pain, stiffness after immobility, limitation of movement and, in many cases, the presence of basic calcium phosphate (BCP) crystals in the joint fluid. The detection of BCP crystals in the synovial fluid of patients with OA is fraught with challenges due to the submicroscopic size of BCP, the complex nature of the matrix in which they are found and the fact that other crystals can co-exist with them in cases of mixed pathology. Routine analysis of joint crystals still relies almost exclusively on the use of optical microscopy, which has limited applicability for BCP crystal identification due to limited resolution and the inherent subjectivity of the technique. The purpose of this Critical Review is to present an overview of some of the main analytical tools employed in the detection of BCP to date and the potential of emerging technologies such as atomic force microscopy (AFM) and Raman microspectroscopy for this purpose. PMID:18299743

  19. LOCATION-SPECIFIC HIP JOINT SPACE WIDTH FOR PROGRESSION OF HIP OSTEOARTHRITIS - DATA FROM THE OSTEOARTHRITIS INITIATIVE

    PubMed Central

    Ratzlaff, C.; Van Wyngaarden, C.; Duryea, J.

    2014-01-01

    Objective To establish the performance of a location-specific computer-assisted quantitative measure of hip JSW, by measuring responsiveness at fixed locations in those with hip OA and pain and those without. Secondary purposes included investigating the most responsive location, comparison to mJSW and evaluating reading time. Methods Design: nested case-control Data: drawn from the Osteoarthritis Initiative (OAI), a longitudinal cohort study of knee OA. All OAI participants had standardized standing AP pelvis radiographs at baseline and 48 months. Case definition (1): subjects with a total hip replacement (THR) after the 48 month visit with adequate baseline and 48 month radiographs (n=27) were selected and matched (1:1) on sex and age to subjects without a THR and no hip pain. Case definition (2): subjects with a THR at any point after baseline (n=79) were selected and the contralateral (CL) hip was designated the case hip, and subjects were matched (1:1) as above. Pain: the CL hip group were examined for the presence/absence of pain Measurements of superior hip JSW were made at three fixed locations relative to a landmark-based line, facilitated by software that delineated the femoral head and found the acetabular margin at the three points. The standardized response mean (SRM) was used to examine sensitivity to change from baseline to 48 months. Paired t-tests were used to compare cases and controls. Results Significant differences were observed between cases and controls and those with and without pain. The location-specific measure outperformed mJSW in all analyses, with SRM ranging from 0.53 (contralateral hip) to 1.06 (THR hip). The superior-medial location was the most responsive. Conclusion A new computer-assisted location-specific method of hip JSW is feasible and may provide a superior method to mJSW for radiographic OA progression. The superior-medial location was the most responsive. PMID:25278059

  20. Characterization of 3D Joint Space Morphology Using an Electrostatic Model (with Application to Osteoarthritis)

    PubMed Central

    Cao, Qian; Thawait, Gaurav; Gang, Grace J.; Zbijewski, Wojciech; Reigel, Thomas; Brown, Tyler; Corner, Brian; Demehri, Shadpour; Siewerdsen, Jeffrey H.

    2015-01-01

    Joint space morphology can be indicative of the risk, presence, progression, and/or treatment response of disease or trauma. We describe a novel methodology of characterizing joint space morphology in high-resolution 3D images [e.g., cone-beam CT (CBCT)] using a model based on elementary electrostatics that overcomes a variety of basic limitations of existing 2D and 3D methods. The method models each surface of a joint as a conductor at fixed electrostatic potential and characterizes the intra-articular space in terms of the electric field lines resulting from the solution of Gauss’ Law and the Laplace equation. As a test case, the method was applied to discrimination of healthy and osteoarthritic subjects (N = 39) in 3D images of the knee acquired on an extremity CBCT system. The method demonstrated improved diagnostic performance (area under the receiver operating characteristic curve, AUC > 0.98) compared to simpler methods of quantitative measurement and qualitative image-based assessment by three expert musculoskeletal radiologists (AUC = 0.87, p-value = 0.007). The method is applicable to simple (e.g., the knee or elbow) or multi-axial joints (e.g., the wrist or ankle) and may provide a useful means of quantitatively assessing a variety of joint pathologies. PMID:25575100

  1. Characterization of 3D joint space morphology using an electrostatic model (with application to osteoarthritis)

    NASA Astrophysics Data System (ADS)

    Cao, Qian; Thawait, Gaurav; Gang, Grace J.; Zbijewski, Wojciech; Reigel, Thomas; Brown, Tyler; Corner, Brian; Demehri, Shadpour; Siewerdsen, Jeffrey H.

    2015-02-01

    Joint space morphology can be indicative of the risk, presence, progression, and/or treatment response of disease or trauma. We describe a novel methodology of characterizing joint space morphology in high-resolution 3D images (e.g. cone-beam CT (CBCT)) using a model based on elementary electrostatics that overcomes a variety of basic limitations of existing 2D and 3D methods. The method models each surface of a joint as a conductor at fixed electrostatic potential and characterizes the intra-articular space in terms of the electric field lines resulting from the solution of Gauss’ Law and the Laplace equation. As a test case, the method was applied to discrimination of healthy and osteoarthritic subjects (N = 39) in 3D images of the knee acquired on an extremity CBCT system. The method demonstrated improved diagnostic performance (area under the receiver operating characteristic curve, AUC > 0.98) compared to simpler methods of quantitative measurement and qualitative image-based assessment by three expert musculoskeletal radiologists (AUC = 0.87, p-value = 0.007). The method is applicable to simple (e.g. the knee or elbow) or multi-axial joints (e.g. the wrist or ankle) and may provide a useful means of quantitatively assessing a variety of joint pathologies.

  2. Mechanisms of Osteoarthritis in the Knee: MR Imaging Appearance

    PubMed Central

    Shapiro, Lauren M.; McWalter, Emily J.; Son, Min-Sun; Levenston, Marc; Hargreaves, Brian A.; Gold, Garry E.

    2014-01-01

    Osteoarthritis has grown to become a widely prevalent disease that has major implications in both individual and public health. Although originally considered to be a degenerative disease driven by wear and tear of the articular cartilage, recent evidence has led to a consensus that osteoarthritis pathophysiology should be perceived in the context of the entire joint and multiple tissues. MRI is becoming an increasingly more important modality for imaging osteoarthritis, due to its excellent soft tissue contrast and ability to acquire morphological and biochemical data. This review will describe the pathophysiology of osteoarthritis as it is associated with various tissue types, highlight several promising MR imaging techniques for osteoarthritis and illustrate the expected appearance of osteoarthritis with each technique. PMID:24677706

  3. Altered swelling and ion fluxes in articular cartilage as a biomarker in osteoarthritis and joint immobilization: a computational analysis

    PubMed Central

    Manzano, Sara; Manzano, Raquel; Doblaré, Manuel; Doweidar, Mohamed Hamdy

    2015-01-01

    In healthy cartilage, mechano-electrochemical phenomena act together to maintain tissue homeostasis. Osteoarthritis (OA) and degenerative diseases disrupt this biological equilibrium by causing structural deterioration and subsequent dysfunction of the tissue. Swelling and ion flux alteration as well as abnormal ion distribution are proposed as primary indicators of tissue degradation. In this paper, we present an extension of a previous three-dimensional computational model of the cartilage behaviour developed by the authors to simulate the contribution of the main tissue components in its behaviour. The model considers the mechano-electrochemical events as concurrent phenomena in a three-dimensional environment. This model has been extended here to include the effect of repulsion of negative charges attached to proteoglycans. Moreover, we have studied the fluctuation of these charges owning to proteoglycan variations in healthy and pathological articular cartilage. In this sense, standard patterns of healthy and degraded tissue behaviour can be obtained which could be a helpful diagnostic tool. By introducing measured properties of unhealthy cartilage into the computational model, the severity of tissue degeneration can be predicted avoiding complex tissue extraction and subsequent in vitro analysis. In this work, the model has been applied to monitor and analyse cartilage behaviour at different stages of OA and in both short (four, six and eight weeks) and long-term (11 weeks) fully immobilized joints. Simulation results showed marked differences in the corresponding swelling phenomena, in outgoing cation fluxes and in cation distributions. Furthermore, long-term immobilized patients display similar swelling as well as fluxes and distribution of cations to patients in the early stages of OA, thus, preventive treatments are highly recommended to avoid tissue deterioration. PMID:25392400

  4. Morphological and biomechanical analyses of the subchondral mineralized zone in human sacral facet joints: Application to improved diagnosis of osteoarthritis.

    PubMed

    Berteau, Jean-Philippe; Mielke, Gabriela; Morlock, Michael M; Huber, Gerd

    2015-05-01

    The anatomy of the facet joint subchondral mineralized zone (SMZ) is the main parameter used in diagnosing osteoarthritis. Usually, a single CT scan slice is used to measure the thickness, but the measurement is highly location-dependent. Bone mineral density (BMD) and porosity could be more reliable than thickness for detecting SMZ sclerosis, and linking them to stiffness can provide insights into the mechanism of osteoarthritis progression. The goal of this study was two-fold: (1) to assess spatial heterogeneity in thickness, BMD, and porosity within the non-pathological human facet joint SMZ; (2) to correlate these measurements with the static modulus of elasticity (MOEsta ). Four non-pathological facet joints were excised and imaged using micro-computed tomography (µCT) to measure SMZ thickness, BMD, and porosity. A total of eight parallelepiped SMZ samples were similarly analyzed and then mechanically tested. The mean SMZ BMD, porosity, and thickness (± Standard Deviation) of the whole facet joints were 611 ± 35 mgHA/cc, 9.8 ± 1.3%, and 1.39 ± 0.41 mm, respectively. The mean BMD, porosity, and MOEsta of the eight SMZ samples were 479 ± 23 mgHA/cc, 12 ± 0.01%, and 387 ± 138 MPa, respectively, with a positive rank correlation between BMD and porosity. BMD and porosity were more homogeneous within the facet joint than thickness and they could be more reliable parameters than thickness for detecting SMZ sclerosis. The values for the physiological SMZ and MOEsta of human facets joints obtained here were independent of BMD. SMZ BMD and porosity were related to each other. PMID:25716678

  5. Targets, models and challenges in osteoarthritis research

    PubMed Central

    Thysen, Sarah; Luyten, Frank P.; Lories, Rik J. U.

    2015-01-01

    Osteoarthritis is a chronic degenerative disorder of the joint and represents one of the most common diseases worldwide. Its prevalence and severity are increasing owing to aging of the population, but treatment options remain largely limited to painkillers and anti-inflammatory drugs, which only provide symptomatic relief. In the late stages of the disease, surgical interventions are often necessary to partially restore joint function. Although the focus of osteoarthritis research has been originally on the articular cartilage, novel findings are now pointing to osteoarthritis as a disease of the whole joint, in which failure of different joint components can occur. In this Review, we summarize recent progress in the field, including data from novel ‘omics’ technologies and from a number of preclinical and clinical trials. We describe different in vitro and in vivo systems that can be used to study molecules, pathways and cells that are involved in osteoarthritis. We illustrate that a comprehensive and multisystem approach is necessary to understand the complexity and heterogeneity of the disease and to better guide the development of novel therapeutic strategies for osteoarthritis. PMID:25561745

  6. Status of hyaluronan supplementation therapy in osteoarthritis.

    PubMed

    Altman, Roy D

    2003-02-01

    Hyaluronans are polysaccharide molecules that occur naturally in synovial fluid; they help to create a viscous environment, cushion joints, and maintain normal function. The American College of Rheumatology recommends intra-articular injection of hyaluronans, which are available as several distinct therapeutic products, as an alternative to oral analgesics or nonsteroidal anti-inflammatory drugs for the symptomatic treatment of pain associated with osteoarthritis of the knee. A large body of literature supports the clinical efficacy and safety of this therapeutic class for this indication, although there are differences between the marketed products and they should be evaluated independently. Preliminary work investigating the use of hyaluronans for osteoarthritis in joints other than the knee has also produced promising results. There is growing evidence that hyaluronans, the biology of which is complex, may also have structure-modifying activity. Thus, compared with currently approved nonoperative therapies for osteoarthritis, hyaluronans may also have beneficial effects on the disease process in osteoarthritis. PMID:12590879

  7. Emerging drugs for osteoarthritis

    PubMed Central

    Matthews, Gloria

    2013-01-01

    Introduction Osteoarthritis (OA), the most prevalent form of joint disease, affecting as much as 13% of the world’s population. In the United States, it is the leading cause of disability in people over age 65 and is characterized by progressive cartilage loss, bone remodeling, osteophyte formation and synovial inflammation with resultant joint pain and disability. There are no treatments marketed for structural disease modification; current treatments mainly target symptoms, with >75% of patients reporting need for additional symptomatic treatment. Areas covered Drugs in later development (Phase II-III) for osteoarthritis pain and joint structural degeneration are reviewed. Not covered are procedural (e.g. arthrocentesis, physical therapy), behavioral (e.g. weight loss, pain coping techniques) or device (e.g. knee braces, surgical implants) based treatments. Expert opinion More in depth understanding of the pathophysiology of the disease, as well as elucidation of the link between clinical symptomatology and structural changes in the joint will likely lead to development of novel target classes with promising efficacy in the future. Efficacy notwithstanding, there remain significant hurdles to overcome in clinical development of these therapeutics, inherent in the progression pattern of the disease as well as challenges with readouts for both pain and structure modification trials. PMID:21542666

  8. Mesenchymal stem cells from development to postnatal joint homeostasis, aging, and disease.

    PubMed

    De Bari, Cosimo; Kurth, Tobias B; Augello, Andrea

    2010-12-01

    Joint morphogenesis involves signaling pathways and growth factors that recur in the adult life with less redundancy to safeguard joint homeostasis. Loss of such homeostasis due to abnormal signaling networks as in aging could lead to diseases such as osteoarthritis. Stem cells are the cellular counterpart and targets of the morphogenetic signals, and they function to maintain the tissues by ensuring replacement of cells lost to physiological turnover, injury, aging, and disease. Mesenchymal stem cells (MSCs) are key players in regenerative medicine for their ability to differentiate toward multiple lineages such as cartilage and bone, but they age along the host body and senesce when serially passaged in culture. Understanding correlations between aging and its effects on MSCs is of the utmost importance to explain how aging happens and unravel the underlying mechanisms. The investigation of the MSC senescence in culture will help in developing more efficient and standardized cell culture methods for cellular therapies in skeletal regenerative medicine. An important area to explore in biomedical sciences is the role of endogenous stem cell niches in joint homeostasis, remodeling, and disease. It is anticipated that an understanding of the stem cell niches and related remodeling signals will allow the development of pharmacological interventions to support effective joint tissue regeneration, to restore joint homeostasis, and to prevent osteoarthritis. PMID:21181887

  9. Indian Hedgehog signaling pathway members are associated with magnetic resonance imaging manifestations and pathological scores in lumbar facet joint osteoarthritis.

    PubMed

    Shuang, Feng; Zhou, Ying; Hou, Shu-Xun; Zhu, Jia-Liang; Liu, Yan; Zhang, Chun-Li; Tang, Jia-Guang

    2015-01-01

    Indian Hedgehog (HH) has been shown to be involved in osteoarthritis (OA) in articular joints, where there is evidence that Indian HH blockade could ameliorate OA. It seems to play a prominent role in development of the intervertebral disc (IVD) and in postnatal maintenance. There is little work on IHH in the IVD. Hence the aim of the current study was to investigate the role of Indian Hedgehog in the pathology of facet joint (FJ) OA. 24 patients diagnosed with lumbar intervertebral disk herniation or degenerative spinal stenosis were included. Preoperative magnetic resonance imaging (MRI) and Osteoarthritis Research Society International (OARSI) histopathology grading system was correlated to the mRNA levels of GLI1, PTCH1, and HHIP in the FJs. The Weishaupt grading and OARSI scores showed high positive correlation (r = 0.894) (P < 0.01). MRI Weishaupt grades showed positive correlation with GLI1 (r = 0.491), PTCH1 (r = 0.444), and HHIP (r = 0.654) mRNA levels (P < 0.05 in each case). OARSI scores were also positively correlated with GLI1 (r = 0. 646), PTCH1 (r = 0. 518), and HHIP (r = 0.762) mRNA levels (P < 0.01 in each case). Cumulatively our findings indicate that Indian HH signaling is increased in OA and is perhaps a key component in OA pathogenesis and progression. PMID:25992955

  10. Indian Hedgehog signaling pathway members are associated with magnetic resonance imaging manifestations and pathological scores in lumbar facet joint osteoarthritis

    NASA Astrophysics Data System (ADS)

    Shuang, Feng; Zhou, Ying; Hou, Shu-Xun; Zhu, Jia-Liang; Liu, Yan; Zhang, Chun-Li; Tang, Jia-Guang

    2015-05-01

    Indian Hedgehog (HH) has been shown to be involved in osteoarthritis (OA) in articular joints, where there is evidence that Indian HH blockade could ameliorate OA. It seems to play a prominent role in development of the intervertebral disc (IVD) and in postnatal maintenance. There is little work on IHH in the IVD. Hence the aim of the current study was to investigate the role of Indian Hedgehog in the pathology of facet joint (FJ) OA. 24 patients diagnosed with lumbar intervertebral disk herniation or degenerative spinal stenosis were included. Preoperative magnetic resonance imaging (MRI) and Osteoarthritis Research Society International (OARSI) histopathology grading system was correlated to the mRNA levels of GLI1, PTCH1, and HHIP in the FJs. The Weishaupt grading and OARSI scores showed high positive correlation (r = 0.894) (P < 0.01). MRI Weishaupt grades showed positive correlation with GLI1 (r = 0.491), PTCH1 (r = 0.444), and HHIP (r = 0.654) mRNA levels (P < 0.05 in each case). OARSI scores were also positively correlated with GLI1 (r = 0. 646), PTCH1 (r = 0. 518), and HHIP (r = 0.762) mRNA levels (P < 0.01 in each case). Cumulatively our findings indicate that Indian HH signaling is increased in OA and is perhaps a key component in OA pathogenesis and progression.

  11. Early diagnosis to enable early treatment of pre-osteoarthritis

    PubMed Central

    2012-01-01

    Osteoarthritis is a prevalent and disabling disease affecting an increasingly large swathe of the world population. While clinical osteoarthritis is a late-stage condition for which disease-modifying opportunities are limited, osteoarthritis typically develops over decades, offering a long window of time to potentially alter its course. The etiology of osteoarthritis is multifactorial, showing strong associations with highly modifiable risk factors of mechanical overload, obesity and joint injury. As such, characterization of pre-osteoarthritic disease states will be critical to support a paradigm shift from palliation of late disease towards prevention, through early diagnosis and early treatment of joint injury and degeneration to reduce osteoarthritis risk. Joint trauma accelerates development of osteoarthritis from a known point in time. Human joint injury cohorts therefore provide a unique opportunity for evaluation of pre-osteoarthritic conditions and potential interventions from the earliest stages of degeneration. This review focuses on recent advances in imaging and biochemical biomarkers suitable for characterization of the pre-osteoarthritic joint as well as implications for development of effective early treatment strategies. PMID:22682469

  12. X-ray guided three-dimensional diffuse optical tomography: in vivo study of osteoarthritis in the finger joints

    NASA Astrophysics Data System (ADS)

    Zhang, Qizhi; Yuan, Zhen; Sobel, Eric; Jiang, Huabei

    2007-02-01

    Osteoarthritis (OA), characterized by the damage of the articular cartilage, is the most common joint problem worldwide. In the effort of developing new clinical tools with the potential to alter the natural history of OA, near-infrared diffuse optical tomography (DOT) has received much attention due to its unique advantages. For optical imaging in highly heterogeneous media such as the finger joints, prior information could improve the quality of optical imaging. We report a hybrid imaging system for early detection of OA in the finger joints by imposing the geometry information obtained by X-ray on three-dimensional near-infrared DOT. X-ray tomosynthesis was employed to recover the three-dimensional structure of the two bones based on 16 X-ray projections generated with a mini C-arm system at different directions within a range of 180 degrees. The interface was carefully designed to guarantee an accurate co-registration of the optical and x-ray modalities. The prior structural information of bones was incorporated into our multi-modality imaging reconstruction algorithm to enhance the recovery of the optical properties of joint tissues. Several healthy and OA finger joints were examined. The initial clinical results showed that this hybrid imaging system had the ability to provide much enhanced image resolution and contrast than DOT alone for OA detection.

  13. Mobilization with movement and elastic tape application for the conservative management of carpometacarpal joint osteoarthritis.

    PubMed

    Villafañe, Jorge Hugo; Valdes, Kristin

    2015-01-01

    Carpometacarpal osteoarthritis can limit a person's ability to engage in desired activities. Many therapists utilize conservative approaches to assist these patients. These authors describe utilizing a combination of mobilization with movement and the use of elastic tape for patients with this arthritis. - Victoria Priganc, PhD, OTR, CHT, CLT, Practice Forum Editor. PMID:25287671

  14. Immediate effect of Masai Barefoot Technology shoes on knee joint moments in women with knee osteoarthritis.

    PubMed

    Tateuchi, Hiroshige; Taniguchi, Masashi; Takagi, Yui; Goto, Yusuke; Otsuka, Naoki; Koyama, Yumiko; Kobayashi, Masashi; Ichihashi, Noriaki

    2014-01-01

    Footwear modification can beneficially alter knee loading in patients with knee osteoarthritis. This study evaluated the effect of Masai Barefoot Technology shoes on reductions in external knee moments in patients with knee osteoarthritis. Three-dimensional motion analysis was used to examine the effect of Masai Barefoot Technology versus control shoes on the knee adduction and flexion moments in 17 women (mean age, 63.6 years) with radiographically confirmed knee osteoarthritis. The lateral and anterior trunk lean values, knee flexion and adduction angles, and ground reaction force were also evaluated. The influence of the original walking pattern on the changes in knee moments with Masai Barefoot Technology shoes was evaluated. The knee flexion moment in early stance was significantly reduced while walking with the Masai Barefoot Technology shoes (0.25±0.14Nm/kgm) as compared with walking with control shoes (0.30±0.19 Nm/kgm); whereas the knee adduction moment showed no changes. Masai Barefoot Technology shoes did not increase compensatory lateral and anterior trunk lean. The degree of knee flexion moment in the original walking pattern with control shoes was correlated directly with its reduction when wearing Masai Barefoot Technology shoes by multiple linear regression analysis (adjusted R2=0.44, P<0.01). Masai Barefoot Technology shoes reduced the knee flexion moment during walking without increasing the compensatory trunk lean and may therefore reduce external knee loading in women with knee osteoarthritis. PMID:24768084

  15. Diagnosis and Treatment of Degenerative Joint Disease in a Captive Male Chimpanzee (Pan troglodytes)

    PubMed Central

    Videan, Elaine N; Lammey, Michael L; Lee, D Rick

    2011-01-01

    Degenerative joint disease (DJD), also known as osteoarthritis, has been well documented in aging populations of captive and free-ranging macaques; however, successful treatments for DJD in nonhuman primates have not been published. Published data on chimpanzees show little to no DJD present in the wild, and there are no published reports of DJD in captive chimpanzees. We report here the first documented case of DJD of both the right and left femorotibial joints in a captive male chimpanzee. Progression from minimal to moderate to severe osteoarthritis occurred in this animal over the course of 1 y. Treatment with chondroprotective supplements (that is, glucosamine chondroitin, polysulfated glycosaminoglycan) and intraarticular corticosteroid injections (that is, methylprednisolone, ketorolac), together with pain management (that is, celecoxib, tramadol, carprofen), resulted in increased activity levels and decreased clinical signs of disease. DJD has a considerable negative effect on quality of life among the human geriatric population and therefore is likely to be one of the most significant diseases that will affect the increasingly aged captive chimpanzee population. As this case study demonstrates, appropriate treatment can improve and extend quality of life dramatically in these animals. However, in cases of severe osteoarthritis cases, medication alone may be insufficient to increase stability, and surgical options should be explored. PMID:21439223

  16. Enteral sesame oil therapeutically relieves disease severity in rat experimental osteoarthritis

    PubMed Central

    Hsu, Dur-Zong; Chu, Pei-Yi; Jou, I-Ming

    2016-01-01

    Background Osteoarthritis (OA) is the most common cause of joint pain, affecting approximately 15% of the population. Recent studies indicate that quadriceps muscle weakness is directly involved in the pathogenesis of OA-associated joint pain. Oxidative stress plays an important role in skeletal muscle dysfunction. Sesame oil is a natural product with excellent antioxidative property. However, whether sesame oil can decrease OA-induced joint pain has never been investigated. Objective The aim of the present study was to examine the effect of sesame oil on OA-induced joint pain in rats. Design OA-associated joint pain in rats was induced by medial meniscal transection in rats. Sesame oil (0, 1, 2, or 4 ml/kg/day, orally) was given to rats 7 days after OA induction, while the parameters were determined 7 days after sesame oil administration. Results Daily sesame oil treatment for 7 days significantly decreased OA-associated joint pain. Sesame oil decreased muscular interleukin-6 and increased citrate synthase activity and myosin heavy chain IIa mRNA expression. Furthermore, sesame oil decreased muscular lipid peroxidation, nuclear Nrf2 protein expression, and reactive oxygen species generations as well as increased glutathione production and glutathione peroxidase activity in OA rats. Conclusions Sesame oil may relieve OA-associated joint pain by inhibiting quadriceps muscular oxidative stress, at least partially, in rats. PMID:27032670

  17. Development of an Experimental Animal Model for Lower Back Pain by Percutaneous Injury-Induced Lumbar Facet Joint Osteoarthritis.

    PubMed

    Kim, Jae-Sung; Ahmadinia, Kasra; Li, Xin; Hamilton, John L; Andrews, Steven; Haralampus, Chris A; Xiao, Guozhi; Sohn, Hong-Moon; You, Jae-Won; Seo, Yo-Seob; Stein, Gary S; Van Wijnen, Andre J; Kim, Su-Gwan; Im, Hee-Jeong

    2015-11-01

    We report generation and characterization of pain-related behavior in a minimally invasive facet joint degeneration (FJD) animal model in rats. FJD was produced by a non-open percutaneous puncture-induced injury on the right lumbar FJs at three consecutive levels. Pressure hyperalgesia in the lower back was assessed by measuring the vocalization response to pressure from a force transducer. After hyperalgesia was established, pathological changes in lumbar FJs and alterations of intervertebral foramen size were assessed by histological and imaging analyses. To investigate treatment options for lumber FJ osteoarthritis-induced pain, animals with established hyperalgesia were administered with analgesic drugs, such as morphine, a selective COX-2 inhibitor, a non-steroidal anti-inflammatory drug (NSAID) (ketorolac), or pregabalin. Effects were assessed by behavioral pain responses. One week after percutaneous puncture-induced injury of the lumbar FJs, ipsilateral primary pressure hyperalgesia developed and was maintained for at least 12 weeks without foraminal stenosis. Animals showed decreased spontaneous activity, but no secondary hyperalgesia in the hind paws. Histopathological and microfocus X-ray computed tomography analyses demonstrated that the percutaneous puncture injury resulted in osteoarthritis-like structural changes in the FJs cartilage and subchondral bone. Pressure hyperalgesia was completely reversed by morphine. The administration of celecoxib produced moderate pain reduction with no statistical significance while the administration of ketorolac and pregabalin produced no analgesic effect on FJ osteoarthritis-induced back pain. Our animal model of non-open percutanous puncture-induced injury of the lumbar FJs in rats shows similar characteristics of low back pain produced by human facet arthropathy. PMID:25858171

  18. A Systems Biology Approach to Synovial Joint Lubrication in Health, Injury, and Disease

    PubMed Central

    Hui, Alexander Y.; McCarty, William J.; Masuda, Koichi; Firestein, Gary S.; Sah, Robert L.

    2013-01-01

    The synovial joint contains synovial fluid (SF) within a cavity bounded by articular cartilage and synovium. SF is a viscous fluid that has lubrication, metabolic, and regulatory functions within synovial joints. SF contains lubricant molecules, including proteoglycan-4 and hyaluronan. SF is an ultrafiltrate of plasma with secreted contributions from cell populations lining and within the synovial joint space, including chondrocytes and synoviocytes. Maintenance of normal SF lubricant composition and function are important for joint homeostasis. In osteoarthritis, rheumatoid arthritis, and joint injury, changes in lubricant composition and function accompany alterations in the cytokine and growth factor environment and increased fluid and molecular transport through joint tissues. Thus, understanding the synovial joint lubrication system requires a multi-faceted study of the various parts of the synovial joint and their interactions. Systems biology approaches at multiple scales are being used to describe the molecular, cellular, and tissue components and their interactions that comprise the functioning synovial joint. Analyses of the transcriptome and proteome of SF, cartilage, and synovium suggest that particular molecules and pathways play important roles in joint homeostasis and disease. Such information may be integrated with physicochemical tissue descriptions to construct integrative models of the synovial joint that ultimately may explain maintenance of health, recovery from injury, or development and progression of arthritis. PMID:21826801

  19. Cathepsin K inhibition reduces CTXII levels and joint pain in the guinea pig model of spontaneous osteoarthritis.

    PubMed

    McDougall, J J; Schuelert, N; Bowyer, J

    2010-10-01

    Cathepsin K is a cysteine proteinase which is believed to contribute to osteoarthritis (OA) pathogenesis. This brief report evaluates the effect of the novel selective cathepsin K inhibitor AZ12606133 on cartilage metabolism in the Dunkin-Hartley guinea pig model of spontaneous OA. In parallel, electrophysiological studies were performed to determine whether acute and chronic treatment with the cathepsin K inhibitor could alter joint nociception. Acute treatment of OA knees with AZ12606133 had no effect on joint afferent nerve activity; however, prolonged (1 month) administration of the cathepsin K inhibitor delivered via a chronically implanted osmotic pump significantly reduced mechanosensitivity in response to both non-noxious and noxious joint movements. Urinal concentrations of the cartilage breakdown products cross-linked C-telopeptides of type II collagen (CTXII) were also reduced by chronic cathepsin K inhibition. These data suggest that prolonged AZ12606133 administration can reduce cartilage turnover and joint nociception in the Dunkin-Hartley guinea pig model of spontaneous OA. PMID:20692355

  20. Paget's Disease of Bone and Osteoarthritis: Different Yet Related

    MedlinePlus

    ... about Paget’s disease , contact: NIH Osteoporosis and Related Bone Diseases ~ National Resource Center Website: http://www.bones.nih. ... Pub. No. 15-7919 NIH Osteoporosis and Related Bone Diseases ~ National Resource Center 2 AMS Circle Bethesda, MD ...

  1. Osteoarthritis of the knee

    PubMed Central

    2007-01-01

    Introduction Osteoarthritis of the knee affects about 10% of adults aged over 60 years, with risk increased in those with obesity, and joint damage or abnormalities. Progression of disease on x rays is commonplace, but x ray changes don’t correlate well with clinical symptoms. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-surgical treatments for osteoarthritis of the knee? What are the effects of surgical treatments for osteoarthritis of the knee? We searched: Medline, Embase, The Cochrane Library and other important databases up to October 2006 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 74 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: acupuncture, capsaicin, chondroitin, education to aid self-management, exercise and physiotherapy, glucosamine, insoles, intra-articular corticosteroids, intra-articular hyaluronan, joint bracing, knee replacement, non-steroidal anti-inflammatory drugs (including topical non-steroidal anti-inflammatory drugs), opioid analgesics, osteotomy, simple analgesics, and taping. PMID:19450299

  2. Osteoarthritis. A continuing challenge.

    PubMed Central

    Sack, K E

    1995-01-01

    Osteoarthritis is a disorder of cartilage that affects almost 85% of the population by age 75. A lack of rigorous clinical and radiographic criteria for defining the disorder makes precise determination of its prevalence impossible. The process of wear and tear explains many manifestations of osteoarthritis, but it does not account for some of the clinical findings or the biochemical changes in osteoarthritic cartilage. Thus, other factors such as heredity, hormones, and diet may play a role. Treatment consists of teaching patients about their disease, alleviating pain, and preserving joint function. Nonsteroidal anti-inflammatory drugs may be no more effective than simple analgesics in relieving the pain of this disorder. Moreover, some nonsteroidal anti-inflammatory drugs can adversely affect cartilage metabolism, and most are possibly dangerous in elderly patients. Drugs that inhibit the production or activity of chondrolytic enzymes can slow the degeneration of cartilage in some animals, but their effects on humans with osteoarthritis are unproved. The surgical repair of severely damaged joints can have gratifying results. Images Figure 2. PMID:8553653

  3. Severity of Coexisting Patellofemoral Disease is Associated with Increased Impairments and Functional Limitations in Patients with Knee Osteoarthritis

    PubMed Central

    Farrokhi, Shawn; Piva, Sara R.; Gil, Alexandra B.; Oddis, Chester V.; Brooks, Maria M.; Fitzgerald, G. Kelley

    2012-01-01

    Objective To evaluate the association between severity of coexisting patellofemoral (PF) disease with lower limb impairments and functional limitations in patients with tibiofemoral (TF) osteoarthritis (OA). Methods Radiographic views of the TF and PF compartments, knee extension strength and knee range of motion were obtained for 167 patients with knee OA. Additionally, knee-specific symptoms and functional limitations were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Activities of Daily Living Scale (ADLS). Results “Moderate/Severe PFOA” was associated with lower knee extension strength (1.4±0.5 Nm/BW) compared to “No PFOA” (1.8±0.5 Nm/BW). Additionally, total knee range of motion was significantly lower for patients with “Moderate/Severe PFOA” (120.8°±14.4°) compared to “No PFOA” (133.5°±10.7°) and “Mild PFOA” (125.8°±13.0°). “Moderate/Severe PFOA” and “Mild PFOA” were also associated with less pain while standing (OR= 0.2; 95% CI: 0.1,0.7 and OR= 0.2; 95% CI: 0.1,0.6, respectively) on the WOMAC and “Moderate/Severe PFOA” was associated with greater difficulty with going downstairs (OR=2.9; 95% CI: 1.0,8.1) on the ADLS. Conclusion It appears that knees with more severe coexisting PF disease demonstrate features distinct from those observed in TFOA in isolation or in combination with mild PF disease. Treatment strategies targeting the PF joint may be warranted to mitigate the specific lower limb impairments and functional problems present in this patient population. PMID:23045243

  4. Osteoarthritis-like pathologic changes in the knee joint induced by environmental disruption of circadian rhythms is potentiated by a high-fat diet

    PubMed Central

    Kc, Ranjan; Li, Xin; Forsyth, Christopher B.; Voigt, Robin M.; Summa, Keith C.; Vitaterna, Martha Hotz; Tryniszewska, Beata; Keshavarzian, Ali; Turek, Fred W.; Meng, Qing-Jun; Im, Hee-Jeong

    2015-01-01

    A variety of environmental factors contribute to progressive development of osteoarthritis (OA). Environmental factors that upset circadian rhythms have been linked to various diseases. Our recent work establishes chronic environmental circadian disruption - analogous to rotating shiftwork-associated disruption of circadian rhythms in humans - as a novel risk factor for the development of OA. Evidence suggests shift workers are prone to obesity and also show altered eating habits (i.e., increased preference for high-fat containing food). In the present study, we investigated the impact of chronic circadian rhythm disruption in combination with a high-fat diet (HFD) on progression of OA in a mouse model. Our study demonstrates that when mice with chronically circadian rhythms were fed a HFD, there was a significant proteoglycan (PG) loss and fibrillation in knee joint as well as increased activation of the expression of the catabolic mediators involved in cartilage homeostasis. Our results, for the first time, provide the evidence that environmental disruption of circadian rhythms plus HFD potentiate OA-like pathological changes in the mouse joints. Thus, our findings may open new perspectives on the interactions of chronic circadian rhythms disruption with diet in the development of OA and may have potential clinical implications. PMID:26584570

  5. Osteoarthritis-like pathologic changes in the knee joint induced by environmental disruption of circadian rhythms is potentiated by a high-fat diet.

    PubMed

    Kc, Ranjan; Li, Xin; Forsyth, Christopher B; Voigt, Robin M; Summa, Keith C; Vitaterna, Martha Hotz; Tryniszewska, Beata; Keshavarzian, Ali; Turek, Fred W; Meng, Qing-Jun; Im, Hee-Jeong

    2015-01-01

    A variety of environmental factors contribute to progressive development of osteoarthritis (OA). Environmental factors that upset circadian rhythms have been linked to various diseases. Our recent work establishes chronic environmental circadian disruption - analogous to rotating shiftwork-associated disruption of circadian rhythms in humans - as a novel risk factor for the development of OA. Evidence suggests shift workers are prone to obesity and also show altered eating habits (i.e., increased preference for high-fat containing food). In the present study, we investigated the impact of chronic circadian rhythm disruption in combination with a high-fat diet (HFD) on progression of OA in a mouse model. Our study demonstrates that when mice with chronically circadian rhythms were fed a HFD, there was a significant proteoglycan (PG) loss and fibrillation in knee joint as well as increased activation of the expression of the catabolic mediators involved in cartilage homeostasis. Our results, for the first time, provide the evidence that environmental disruption of circadian rhythms plus HFD potentiate OA-like pathological changes in the mouse joints. Thus, our findings may open new perspectives on the interactions of chronic circadian rhythms disruption with diet in the development of OA and may have potential clinical implications. PMID:26584570

  6. Establishment of a rat model of lumbar facet joint osteoarthritis using intraarticular injection of urinary plasminogen activator.

    PubMed

    Shuang, Feng; Hou, Shu-Xun; Zhu, Jia-Liang; Liu, Yan; Zhou, Ying; Zhang, Chun-Li; Tang, Jia-Guang

    2015-01-01

    Lumbar facet joint (LFJ) osteoarthritis (OA) is an important etiology of low back pain. Several animal models of LFJ OA have been established using intraarticular injection of various chemicals. This study aimed to establish a rat model of LFJ OA using urinary plasminogen activator (uPA). Sprague-Dawley rats were treated with intraarticular injection in the L5-L6 facet joints with uPA (OA group, n = 40) or normal saline (vehicle group, n = 40). Mechanical and thermal hyperalgesia in the ipsilateral hind paws were evaluated using von Frey hairs and a thermoalgesia instrument, respectively. Toluidine blue staining, hematoxylin-eosin staining, and immunohistochemical examination of the LFJ was performed. Treatment with uPA induced cartilage damage, synovitis, and proliferation of synovial cells in the fact joints. The OA group showed significantly higher hyperalgesia in the hind paws in comparison with the vehicle group and normal controls (P < 0.05). Expression of IL-1β, TNF-α, and iNOS in the LFJ cartilage in the OA group was significantly increased (P < 0.05). A rat model of LFJ OA was successfully established using intraarticular injection of uPA. This animal model is convenient and shows good resemblance to human OA pathology. PMID:25892493

  7. The role of imaging modalities in the diagnosis, differential diagnosis and clinical assessment of peripheral joint osteoarthritis.

    PubMed

    Wenham, C Y J; Grainger, A J; Conaghan, P G

    2014-10-01

    Peripheral joint osteoarthritis (OA) is predominantly a clinical diagnosis, though imaging may provide confirmation and aid with differential diagnosis where there is clinical doubt. Whilst radiographs (X-rays (XR)) are usually the first-line imaging modality selected, magnetic resonance imaging (MRI), ultrasound and computed tomography (CT) may all have a valuable role in assessing a person with OA, although each has its particular advantages and disadvantages. MRI is of particular use for diagnosing bone conditions that may cause a rapid increase in symptoms, such as avascular necrosis (AVN) or a subchondral insufficiency fracture (SIF), while providing concomitant soft tissue assessment. Ultrasound offers rapid assessment of peripheral joints and can easily assess for features of inflammatory arthritis. CT is faster to perform than MRI and can also image the subchondral bone, but does involve ionising radiation. Selecting the correct imaging modality, in the context of its advantages when visualising a specific joint (e.g., hand vs knee) and with clinical context in mind, will enhance the added value of imaging in clinical practice. PMID:25278078

  8. Establishment of a rat model of lumbar facet joint osteoarthritis using intraarticular injection of urinary plasminogen activator

    PubMed Central

    Shuang, Feng; Hou, Shu-Xun; Zhu, Jia-Liang; Liu, Yan; Zhou, Ying; Zhang, Chun-Li; Tang, Jia-Guang

    2015-01-01

    Lumbar facet joint (LFJ) osteoarthritis (OA) is an important etiology of low back pain. Several animal models of LFJ OA have been established using intraarticular injection of various chemicals. This study aimed to establish a rat model of LFJ OA using urinary plasminogen activator (uPA). Sprague-Dawley rats were treated with intraarticular injection in the L5-L6 facet joints with uPA (OA group, n = 40) or normal saline (vehicle group, n = 40). Mechanical and thermal hyperalgesia in the ipsilateral hind paws were evaluated using von Frey hairs and a thermoalgesia instrument, respectively. Toluidine blue staining, hematoxylin-eosin staining, and immunohistochemical examination of the LFJ was performed. Treatment with uPA induced cartilage damage, synovitis, and proliferation of synovial cells in the fact joints. The OA group showed significantly higher hyperalgesia in the hind paws in comparison with the vehicle group and normal controls (P < 0.05). Expression of IL-1?, TNF-?, and iNOS in the LFJ cartilage in the OA group was significantly increased (P < 0.05). A rat model of LFJ OA was successfully established using intraarticular injection of uPA. This animal model is convenient and shows good resemblance to human OA pathology. PMID:25892493

  9. Current concepts in osteoarthritis

    PubMed Central

    de Rezende, Márcia Uchôa; de Campos, Gustavo Constantino; Pailo, Alexandre Felício

    2013-01-01

    Osteoarthritis (OA), the most common form of joint disease, affects mainly the hips, knees, hands and feet, leading to severe disability and loss of quality of life, particularly in the elderly population. Its importance grows every year with the aging of the population, with a large increase in the elderly population compared to younger patients. The progressive understanding of the pathophysiology of OA, the perception that the process is not purely mechanical and / or aging, and clarification of the inflammatory pathways involved led recently to the clinical application of various drugs and other measures. This update aims to expose the current concepts on the pathophysiology and treatment of OA. PMID:24453655

  10. Self management, joint protection and exercises in hand osteoarthritis: a randomised controlled trial with cost effectiveness analyses

    PubMed Central

    2011-01-01

    Background There is limited evidence for the clinical and cost effectiveness of occupational therapy (OT) approaches in the management of hand osteoarthritis (OA). Joint protection and hand exercises have been proposed by European guidelines, however the clinical and cost effectiveness of each intervention is unknown. This multicentre two-by-two factorial randomised controlled trial aims to address the following questions: • Is joint protection delivered by an OT more effective in reducing hand pain and disability than no joint protection in people with hand OA in primary care? • Are hand exercises delivered by an OT more effective in reducing hand pain and disability than no hand exercises in people with hand OA in primary care? • Which of the four management approaches explored within the study (leaflet and advice, joint protection, hand exercise, or joint protection and hand exercise combined) provides the most cost-effective use of health care resources Methods/Design Participants aged 50 years and over registered at three general practices in North Staffordshire and Cheshire will be mailed a health survey questionnaire (estimated mailing sample n = 9,500). Those fulfilling the eligibility criteria on the health survey questionnaire will be invited to attend a clinical assessment to assess for the presence of hand or thumb base OA using the ACR criteria. Eligible participants will be randomised to one of four groups: leaflet and advice; joint protection (looking after your joints); hand exercises; or joint protection and hand exercises combined (estimated n = 252). The primary outcome measure will be the OARSI/OMERACT responder criteria combining hand pain and disability (measured using the AUSCAN) and global improvement, 6 months post-randomisation. Secondary outcomes will also be collected for example pain, functional limitation and quality of life. Outcomes will be collected at baseline and 3, 6 and 12 months post-randomisation. The main analysis will be on an intention to treat basis and will assess the clinical and cost effectiveness of joint protection and hand exercises for managing hand OA. Discussion The findings will improve the cost-effective evidence based management of hand OA. Trial registration identifier: ISRCTN33870549 PMID:21745357

  11. Equine rehabilitation therapy for joint disease.

    PubMed

    Porter, Mimi

    2005-12-01

    The principles of physical rehabilitation therapy can be applied to the horse to provide a reduction in discomfort and dysfunction associated with the various forms of joint disease. Physical agents,such as ice, heat, electricity, sound, light, magnetic fields, compression, and movement, can be used by the rehabilitation therapist to attempt to control pain, reduce swelling, and restore optimal movement and function in the affected joint. The equine therapist's attention is focused not only on the affected joint but on the body as a whole to manage secondary or compensatory problems. PMID:16297723

  12. Obesity & osteoarthritis

    PubMed Central

    King, Lauren K.; March, Lyn; Anandacoomarasamy, Ananthila

    2013-01-01

    The most significant impact of obesity on the musculoskeletal system is associated with osteoarthritis (OA), a disabling degenerative joint disorder characterized by pain, decreased mobility and negative impact on quality of life. OA pathogenesis relates to both excessive joint loading and altered biomechanical patterns together with hormonal and cytokine dysregulation. Obesity is associated with the incidence and progression of OA of both weight-bearing and non weight-bearing joints, to rate of joint replacements as well as operative complications. Weight loss in OA can impart clinically significant improvements in pain and delay progression of joint structural damage. Further work is required to determine the relative contributions of mechanical and metabolic factors in the pathogenesis of OA. PMID:24056594

  13. ROS/oxidative stress signaling in osteoarthritis.

    PubMed

    Lepetsos, Panagiotis; Papavassiliou, Athanasios G

    2016-04-01

    Osteoarthritis is the most common joint disorder with increasing prevalence due to aging of the population. Its multi-factorial etiology includes oxidative stress and the overproduction of reactive oxygen species, which regulate intracellular signaling processes, chondrocyte senescence and apoptosis, extracellular matrix synthesis and degradation along with synovial inflammation and dysfunction of the subchondral bone. As disease-modifying drugs for osteoarthritis are rare, targeting the complex oxidative stress signaling pathways would offer a valuable perspective for exploration of potential therapeutic strategies in the treatment of this devastating disease. PMID:26769361

  14. The relation between total joint arthroplasty and risk for serious cardiovascular events in patients with moderate-severe osteoarthritis: propensity score matched landmark analysis

    PubMed Central

    2013-01-01

    Objective To examine whether total joint arthroplasty of the hip and knee reduces the risk for serious cardiovascular events in patients with moderate-severe osteoarthritis. Design Propensity score matched landmark analysis. Setting Ontario, Canada. Participants 2200 adults with hip or knee osteoarthritis aged 55 or more at recruitment (1996-98) and followed prospectively until death or 2011. Main outcome measure Rates of serious cardiovascular events for those who received a primary total joint arthroplasty compared with those did not within an exposure period of three years after baseline assessment. Results The propensity score matched cohort consisted of 153 matched pairs of participants with moderate-severe arthritis. Over a median follow-up period of seven years after the landmark date (start of the study), matched participants who underwent a total joint arthroplasty during the exposure period were significantly less likely than those who did not to experience a cardiovascular event (hazards ratio 0.56, 95% confidence interval 0.43 to 0.74, P<0.001). Within seven years of the exposure period the absolute risk reduction was 12.4% (95% confidence interval 1.7% to 23.1%) and number needed to treat was 8 (95% confidence interval 4 to 57 patients). Conclusions Using a propensity matched landmark analysis in a population cohort with advanced hip or knee osteoarthritis, this study found a cardioprotective benefit of primary elective total joint arthroplasty. PMID:24174640

  15. Hip and knee joint rotations differ between patients with medial and lateral knee osteoarthritis: gait analysis of 30 patients and 15 controls.

    PubMed

    Weidow, Jonas; Tranberg, Roy; Saari, Tuuli; Kärrholm, Johan

    2006-09-01

    The motions and moments in the hip and knee in female patients on the waiting list for knee prosthesis surgery with medial (n = 15) or lateral (n = 15) osteoarthritis (OA) were compared with a control group (n = 15). We hypothesized that not only the kinematics and kinetics of the knee but also of the hip would differ between patients the medial and lateral groups. At midstance, patients with lateral OA showed slightly (2 degrees) more maximal (peak) adduction (p = 0.015) of the hip joint and patients with medial OA had 7 degrees more abduction (p < 0.001) than did controls. In patients with lateral OA, the femur was positioned in about 7 degrees more maximum external rotation (p = 0.001), but femur position did not differ between medial OA and controls (p > or = 0.8). There was a tendency to higher internal hip rotation moment in lateral OA compared to controls (p = 0.021). The maximum values of the internal knee abduction moments were 52% higher in medial OA (p = 0.005) and 63% lower in lateral OA (p < 0.001) compared to controls. Cases with medial OA had 9 degrees more, whereas those with lateral OA had 6 degrees less external tibial rotation than controls (medial vs. lateral OA, p = 0.001). We found an association between presence of lateral OA of the knee and the biomechanics of the hip joint. It remains to be evaluated if the changed biomechanics of the hip joint is a reason for development of lateral OA or an observation that is a result of this disease. PMID:16838360

  16. Effects of AR7 Joint Complex on arthralgia for patients with osteoarthritis: Results of a three-month study in Shanghai, China

    PubMed Central

    Xie, Qingwen; Shi, Rong; Xu, Gang; Cheng, Lifu; Shao, Liyun; Rao, Jianyu

    2008-01-01

    Background Osteoarthritis-induced arthralgia is a common cause of morbidity in both men and women worldwide. AR7 Joint Complex is a nutritional supplement containing various ingredients including sternum collagen II and methylsulfonylmethane. The product has been marketed in United States for over a decade, but clinical data measuring the effectiveness of this supplement in relieving arthralgia is lacking. The goal of this study was to determine the effect of AR7 Joint Complex on osteoarthritis. Methods A total of 100 patients over the age of 50 who had osteoarthritis were recruited to the double-blind study and randomly assigned into either treatment or placebo control groups. The patients in the treatment group were given AR7 Joint Complex orally, 1 capsule daily for 12 weeks, while the patients in the control group were given a placebo for the same period of time. Prior to and at the end of the study, data including Quality of Life questionnaires (SF-36), visual analog scales (1 to 100 mm), and X-rays of affected joints were collected. Results A total of 89 patients completed the study: 44 from the treatment group and 45 from the control group. No significant change in X-ray results was found in either group after the study. However, there was a significant decrease in patients complaining of arthralgia and tenderness (P < 0.01) in the treatment group and there was also a significant difference between the treatment and control groups at the end of the study. In addition, for Quality of Life data, the body pain index (BP) in the treatment group was significantly improved (P < 0.05) compared to the control group. No significant toxicity was noted in either group. Conclusion AR7 Joint Complex appears to have short-term effects in relieving pain in patients with osteoarthritis. Whether such an effect is long-lasting remains to be seen. PMID:18954461

  17. Characterization of a New Animal Model for Evaluation and Treatment of Back Pain Due to Lumbar Facet Joint Osteoarthritis

    PubMed Central

    Kim, Jae-Sung; Kroin, Jeffrey S.; Buvanendran, Asokumar; Li, Xin; van Wijnen, Andre J.; Tuman, Kenneth J.; Im, Hee-Jeong

    2011-01-01

    Degeneration of lumbar facet joints (FJs) has been implicated in lower back pain. To verify the biological links between cellular and structural alterations within FJ components and development of symptomatic chronic back pain, we generated an animal model for FJ degeneration by intra-articular injection of monosodium iodoacetate (MIA) in FJs (L3/L4, L4/L5, L5/L6) of Sprague Dawley rats followed by behavioral pain tests. The degree of primary hyperalgesia was assessed by measuring pain sensation due to pressure using an algometer, which mimics a mechanical stimulus for FJ injury. Biochemical assessments and µCT imaging revealed severely damaged FJ cartilage, proteoglycan loss and alterations of subchondral bone structure by MIA injection. The µCT analyses further suggested that the behavioral hyperalgesia from FJ degeneration is not associated with foramina stenosis. These biological and structural changes in FJs are closely related to sustained and robust chronic pain. Therapeutic modulation of chronic pain using pharmaceutical drugs was investigated in the facet joint osteoarthritis animal model. Morphine and pregabalin markedly alleviate pressure hyperalgesia while celecoxib (selective inhibitor of COX-2) and ketorolac (inhibitor of COX-1 and -2) demonstrate moderate to negligible anti-hyperalgesic effects, respectively. PMID:21953085

  18. Effects of Nordic walking on pelvis motion and muscle activities around the hip joints of adults with hip osteoarthritis

    PubMed Central

    Homma, Daisuke; Jigami, Hirofumi; Sato, Naritoshi

    2016-01-01

    [Purpose] Increased compensatory pelvic movement is remarkable in limping patients with hip osteoarthritis (OA). However, a method of improving limping has not been established. The purpose of this study was to identify the effects of two types of Nordic walking by analyzing the pelvic movement and muscle activities of adults with hip OA. [Subjects and Methods] Ten patients with OA of the hip performed Japanese-style Nordic walking (JS NW), European-style Nordic walking (ES NW), and Ordinary walking (OW), and the muscle activities around the hip joint and pelvic movements were analyzed. [Results] The pelvic rotation angle was significantly larger in ES NW than in JS NW. In the stance phase, hip abductor muscle activity was significantly decreased in JS NW compared to both OW and ES NW. In the swing phase, rectus abdominis muscle activity was significantly increased in both JS NW and ES NW compared to OW and lumbar erector spinae activity was significantly lower in JS NW than in OW. [Conclusion] JS NW style may reduce the compensatory pelvic rotation in patients with hip OA. JS NW might be better for joint protection and prevention of secondary disorders of the hip in OA patients. PMID:27190455

  19. Low-level laser therapy of myofascial pain syndromes of patients with osteoarthritis of knee and hip joints

    NASA Astrophysics Data System (ADS)

    Gasparyan, Levon V.

    2001-04-01

    The purpose of the given research is the comparison of efficiency of conventional treatment of myofascial pain syndromes of patients with osteoarthritis (OA) of hip and knee joints and therapy with additional application of low level laser therapy (LLLT) under dynamic control of clinical picture, rheovasographic, electromyographic examinations, and parameters of peroxide lipid oxidation. The investigation was made on 143 patients with OA of hip and knee joints. Patients were randomized in 2 groups: basic group included 91 patients, receiving conventional therapy with a course of LLLT, control group included 52 patients, receiving conventional treatment only. Transcutaneous ((lambda) equals 890 nm, output peak power 5 W, frequency 80 - 3000 Hz) and intravenous ((lambda) equals 633 nm, output 2 mW in the vein) laser irradiation were used for LLLT. Studied showed, that clinical efficiency of LLLT in the complex with conventional treatment of myofascial pain syndromes at the patients with OA is connected with attenuation of pain syndrome, normalization of parameters of myofascial syndrome, normalization of the vascular tension and parameters of rheographic curves, as well as with activation of antioxidant protection system.

  20. β2-adrenergic signal transduction plays a detrimental role in subchondral bone loss of temporomandibular joint in osteoarthritis

    PubMed Central

    Jiao, Kai; Niu, Li-Na; Li, Qi-hong; Ren, Gao-tong; Zhao, Chang-ming; Liu, Yun-dong; Tay, Franklin R.; Wang, Mei-qing

    2015-01-01

    The present study tested whether activation of the sympathetic tone by aberrant joint loading elicits abnormal subchondral bone remodeling in temporomandibular joint (TMJ) osteoarthritis. Abnormal dental occlusion was created in experimental rats, which were then intraperitoneally injected by saline, propranolol or isoproterenol. The norepinephrine contents, distribution of sympathetic nerve fibers, expression of β-adrenergic receptors (β-ARs) and remodeling parameters in the condylar subchondral bone were investigated. Mesenchymal stem cells (MSCs) from condylar subchondral bones were harvested for comparison of their β-ARs, pro-osteoclastic gene expressions and pro-osteoclastic function. Increases in norepinephrine level, sympathetic nerve fiber distribution and β2-AR expression were observed in the condylar subchondral bone of experimental rats, together with subchondral bone loss and increased osteoclast activity. β-antagonist (propranolol) suppressed subchondral bone loss and osteoclast hyperfunction while β-agonist (isoproterenol) exacerbated those responses. MSCs from experimental condylar subchondral bone expressed higher levels of β2-AR and RANKL; norepinephrine stimulation further increased their RANKL expression and pro-osteoclastic function. These effects were blocked by inhibition of β2-AR or the PKA pathway. RANKL expression by MSCs decreased after propranolol administration and increased after isoproterenol administration. It is concluded that β2-AR signal-mediated subchondral bone loss in TMJ osteoarthritisis associated with increased RANKL secretion by MSCs. PMID:26219508

  1. The effect of osteoarthritis of the knee on the biomechanics of other joints in the lower limbs.

    PubMed

    Metcalfe, A J; Stewart, C; Postans, N; Dodds, A L; Holt, C A; Roberts, A P

    2013-03-01

    The aim of this study was to examine the loading of the other joints of the lower limb in patients with unilateral osteoarthritis (OA) of the knee. We recruited 20 patients with no other symptoms or deformity in the lower limbs from a consecutive cohort of patients awaiting knee replacement. Gait analysis and electromyographic recordings were performed to determine moments at both knees and hips, and contraction patterns in the medial and lateral quadriceps and hamstrings bilaterally. The speed of gait was reduced in the group with OA compared with the controls, but there were only minor differences in stance times between the limbs. Patients with OA of the knee had significant increases in adduction moment impulse at both knees and the contralateral hip (adjusted p-values: affected knee: p < 0.01, unaffected knee p = 0.048, contralateral hip p = 0.03), and significantly increased muscular co-contraction bilaterally compared with controls (all comparisons for co-contraction, p < 0.01). The other major weight-bearing joints are at risk from abnormal biomechanics in patients with unilateral OA of the knee. PMID:23450019

  2. Effects of exercise on knee joints with osteoarthritis: a pilot study of biologic markers

    NASA Technical Reports Server (NTRS)

    Bautch, J. C.; Malone, D. G.; Vailas, A. C.

    1997-01-01

    OBJECTIVE: To determine the effects of low intensity weight-bearing exercise on osteoarthritis (OA) of the knee. METHODS: Synovial fluid keratan sulfate (KS) and hydroxyproline were measured as markers of cartilage degradation. The Arthritis Impact Measurement Scales (AIMS) were used to measure health status, and a visual analog scale for pain assessment was used before and after intervention. An exercise (EX) group (n = 15) received a thrice-weekly 12-week low intensity exercise program and a weekly educational program, and a minimal treatment (Min RX) group (n = 15) received only the education program. RESULTS: Pain levels declined in the EX group, and the Min RX group showed improvement on the AIMS. Synovial fluid was obtained in 11 subjects before and after the intervention. Levels of KS and hydroxyproline did not change. CONCLUSION: Further study of exercise effects should include both clinical and biologic parameters to examine the outcome of exercise as a therapeutic intervention in OA of the knee.

  3. High-resolution x-ray guided three-dimensional diffuse optical tomography of joint tissues in hand osteoarthritis: Morphological and functional assessments

    SciTech Connect

    Yuan Zhen; Zhang Qizhi; Sobel, Eric S.; Jiang Huabei

    2010-08-15

    Purpose: The aim of this study was to investigate the potential use of multimodality functional imaging techniques to identify the quantitative optical findings that can be used to distinguish between osteoarthritic and normal finger joints. Methods: Between 2006 and 2009, the distal interphalangeal finger joints from 40 female subjects including 22 patients and 18 healthy controls were examined clinically and scanned by a hybrid imaging system. This system integrated x-ray tomosynthetic setup with a diffuse optical imaging system. Optical absorption and scattering images were recovered based on a regularization-based hybrid reconstruction algorithm. A receiver operating characteristic curve was used to calculate the statistical significance of specific optical features obtained from osteoarthritic and healthy joints groups. Results: The three-dimensional optical and x-ray images captured made it possible to quantify optical properties and joint space width of finger joints. Based on the recovered optical absorption and scattering parameters, the authors observed statistically significant differences between healthy and osteoarthritis finger joints. Conclusions: The statistical results revealed that sensitivity and specificity values up to 92% and 100%, respectively, can be achieved when optical properties of joint tissues were used as classifiers. This suggests that these optical imaging parameters are possible indicators for diagnosing osteoarthritis and monitoring its progression.

  4. Lessons from a non-domestic canid: joint disease in captive raccoon dogs (Nyctereutes procyonoides).

    PubMed

    Lawler, Dennis F; Evans, Richard H; Nieminen, Petteri; Mustonen, Anne-Mari; Smith, Gail K

    2012-01-01

    The purpose of this study was to describe pathological changes of the shoulder, elbow, hip and stifle joints of 16 museum skeletons of the raccoon dog (Nyctereutes procyonoides). The subjects had been held in long-term captivity and were probably used for fur farming or research, thus allowing sufficient longevity for joint disease to become recognisable. The prevalence of disorders that include osteochondrosis, osteoarthritis and changes compatible with hip dysplasia, was surprisingly high. Other changes that reflect near-normal or mild pathological conditions, including prominent articular margins and mild bony periarticular rim, were also prevalent. Our data form a basis for comparing joint pathology of captive raccoon dogs with other mammals and also suggest that contributing roles of captivity and genetic predisposition should be explored further in non-domestic canids. PMID:23277118

  5. Identifying compositional and structural changes in spongy and subchondral bone from the hip joints of patients with osteoarthritis using Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Buchwald, Tomasz; Niciejewski, Krzysztof; Kozielski, Marek; Szybowicz, Mirosław; Siatkowski, Marcin; Krauss, Hanna

    2012-01-01

    Raman microspectroscopy was used to examine the biochemical composition and molecular structure of extracellular matrix in spongy and subchondral bone collected from patients with clinical and radiological evidence of idiopathic osteoarthritis of the hip and from patients who underwent a femoral neck fracture, as a result of trauma, without previous clinical and radiological evidence of osteoarthritis. The objectives of the study were to determine the levels of mineralization, carbonate accumulation and collagen quality in bone tissue. The subchondral bone from osteoarthritis patients in comparison with control subject is less mineralized due to a decrease in the hydroxyapatite concentration. However, the extent of carbonate accumulation in the apatite crystal lattice increases, most likely due to deficient mineralization. The alpha helix to random coil band area ratio reveals that collagen matrix in subchondral bone is more ordered in osteoarthritis disease. The hydroxyapatite to collagen, carbonate apatite to hydroxyapatite and alpha helix to random coil band area ratios are not significantly changed in the differently loaded sites of femoral head. The significant differences also are not visible in mineral and organic constituents' content in spongy bone beneath the subchondral bone in osteoarthritis disease.

  6. Proteomic characterization of human normal articular chondrocytes: a novel tool for the study of osteoarthritis and other rheumatic diseases.

    PubMed

    Ruiz-Romero, Cristina; López-Armada, María J; Blanco, Francisco J

    2005-08-01

    Articular cartilage is composed of cells and an extracellular matrix. The chondrocyte is the only cell type present in mature cartilage, and it is important in the control of cartilage integrity. There is currently a great lack of knowledge about the chondrocyte proteome. To solve this deficiency, we have obtained the first reference map of the human normal articular chondrocyte. Cells were isolated from cartilages obtained from autopsies without history of joint disease. Cultured cells were used to obtain protein extracts which were resolved by 2-DE and visualized by silver nitrate or CBB staining. Almost 200 spots were excised from the gels and analyzed using MALDI-TOF or MALDI-TOF/TOF MS. The analysis leads to the identification of 136 spots that represent 93 different proteins. A significant proportion of proteins are involved in cell organization (26%), energy (16%), protein fate (14%), metabolism (12%), and cell stress (12%). From all the identified proteins, annexins, vimentin, transgelin, destrin, cathepsin D, heat shock protein 47, and mitochondrial superoxide dismutase were more abundant in chondrocytes than in other types of mesenchymal cells such as Jurkat-T cells. As metabolic program of chondrocytes is altered in osteoarthritis and other rheumatic diseases, this proteomic map is an important tool for future studies on these pathologies. PMID:16035116

  7. Arthritis and Rheumatic Diseases

    MedlinePlus

    ... bone. Osteoarthritis can cause joint pain and stiffness. Disability results most often when the disease affects the ... disease may affect the whole body and cause disability. Scleroderma (also known as systemic sclerosis). A condition ...

  8. New developments in osteoarthritis and cartilage biology.

    PubMed

    Poulet, Blandine; Staines, Katherine A

    2016-06-01

    Osteoarthritis (OA) is a degenerative joint disease and the most common form of arthritis. Characterised by articular cartilage loss, subchondral bone thickening and osteophyte formation, the OA joint afflicts much pain and disability. Whilst OA has been associated with many contributing factors, its underpinning molecular mechanisms are, nevertheless, not fully understood. Clinical management of OA is largely palliative and there is an ever growing need for an effective disease modifying treatment. This review discusses some of the recent progress in OA therapies in the different joint tissues affected by OA pathology. PMID:26921602

  9. Burden of Restraint, Disablement and Ethnic Identity: A Case Study of Total Joint Replacement for Osteoarthritis

    PubMed Central

    Harrison, Tracie

    2010-01-01

    Health disparities in total joint replacement have been documented based on gender and ethnicity in multiple countries. Absent are studies exploring the meaning of the procedures among diverse women, which is necessary to fully understand the impact of the disparity. Drawing on ethnographic data from a life course exploration of disablement among Mexican American women with mobility impairments, one woman’s reasons for forgoing a joint replacement are considered. It is suggested that inequalities in disablement cannot be understood without considering the mulitple cultural conflicts and loyalties that push and pull women in multiple directions. PMID:21767094

  10. Osteoarthritis of the Distal Interphalangeal and First Carpometacarpal Joints is Associated with High Bone Mass in Women and Small Bone Size and Low Lean Mass in Men

    PubMed Central

    von Schewelov, Thord; Magnusson, Håkan; Cöster, Maria; Karlsson, Caroline; Rosengren, Björn E

    2015-01-01

    Objective: To determine if primary hand osteoarthritis (OA) is associated with abnormal bone and anthropometric traits. Methods: We used DXA to measure total body bone mineral density (BMD), femoral neck width (bone size) and total body lean and fat mass in 39 subjects with hand OA (primary DIP and/or CMC I) and 164 controls. Data are presented as mean Z-scores or Odds Ratios (OR) with 95% confidence intervals. Results: Women with hand OA had (compared to controls) higher BMD (0.5(0.1,0.9)) but similar bone size (-0.3(-0.8,0.2)), lean mass (0.3(-0.3,0.9)), fat mass (-0.1(-0.6,0.5)) and BMI (0.0(-0.6,0.6)). Men with hand OA had (compared to controls) similar BMD (-0.1(-0.7,0.6)), smaller bone size (-0.5(-1.1,-0.01)), lower lean mass (-0.6(-1.1,-0.04)), and similar fat mass (-0.2(-0.7,0.4)) and BMI -0.1(-0.6,0.6). In women, each SD higher BMD was associated with an OR of 1.8 (1.03, 3.3) for having hand OA. In men each SD smaller bone size was associated with an OR of 1.8 (1.02, 3.1) and each SD lower proportion of lean body mass with an OR of 1.9 (1.1, 3.3) for having hand OA. Conclusion: Women with primary DIP finger joint and/or CMC I joint OA have a phenotype with higher BMD while men with the disease have a smaller bone size and lower lean body mass. PMID:26401163

  11. Management of open bite that developed during treatment for internal derangement and osteoarthritis of the temporomandibular joint

    PubMed Central

    Choi, Jae Won; Nakaoka, Kazutoshi; Hamada, Yoshiki; Nakamura, Yoshiki

    2015-01-01

    This case report describes the orthodontic treatment performed for open bite caused by internal derangement (ID) and osteoarthritis (OA) of the temporomandibular joint (TMJ). A Japanese woman, aged 31 years and 11 months, referred to our department by an oral surgeon had an open bite with clockwise rotation of the mandible and degeneration of the condyle. The overbite was corrected through intrusion of the maxillary and mandibular molars using mini-screw implants to induce counterclockwise rotation of the mandible. Then, the mandibular second premolars were extracted and comprehensive orthodontic treatment was performed to establish a Class I molar relationship with distalization of the maxillary arch and to eliminate anterior crowding. Following treatment, her facial profile improved and a functional and stable occlusion was achieved without recurrence of the TMJ symptoms. These results suggest that orthodontic intrusion of the molars is one of the safer and less stressful alternatives for the management of open bite due to degeneration of the condyles caused by ID and OA of TMJ. PMID:26023542

  12. Efficacy of Direct Injection of Etanercept into Knee Joints for Pain in Moderate and Severe Knee Osteoarthritis

    PubMed Central

    Orita, Sumihisa; Yamauchi, Kazuyo; Eguchi, Yawara; Ochiai, Nobuyasu; Kishida, Shunji; Kuniyoshi, Kazuki; Aoki, Yasuchika; Nakamura, Junichi; Ishikawa, Tetsuhiro; Miyagi, Masayuki; Kamoda, Hiroto; Suzuki, Miyako; Kubota, Gou; Sakuma, Yoshihiro; Oikawa, Yasuhiro; Inage, Kazuhide; Sainoh, Takeshi; Sato, Jun; Shiga, Yasuhiro; Abe, Koki; Fujimoto, Kazuki; Kanamoto, Hiroto; Toyone, Tomoaki; Inoue, Gen; Takahashi, Kazuhisa

    2015-01-01

    Purpose Osteoarthritic (OA) pain is largely considered to be inflammatory pain. However, during the last stage of knee OA, sensory nerve fibers in the knee are shown to be significantly damaged when the subchondral bone junction is destroyed, and this can induce neuropathic pain. Several authors have reported that tumor necrosis factor-α (TNFα) in a knee joint plays a crucial role in pain modulation. The purpose of the current study was to evaluate the efficacy of etanercept, a TNFα inhibitor, for pain in knee OA. Materials and Methods Thirty-nine patients with knee OA and a 2-4 Kellgren-Lawrence grading were evaluated in this prospective study. Patients were divided into two groups; hyaluronic acid (HA) and etanercept injection. All patients received a single injection into the knee. Pain scores were evaluated before and 4 weeks after injection using a visual analogue scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and they were compared between the groups. Results Before injection, VAS and WOMAC scores were not significantly different between the groups (p>0.05). Significant pain relief was found in the etanercept group at 1 and 2 weeks by VAS, and at 4 weeks by WOMAC score, compared with the HA group (p<0.05). No adverse events were observed in either group. Conclusion Direct injection of etanercept into OA knee joints was an effective treatment for pain in moderate and severe OA patients. Furthermore, this finding suggests that TNFα is one factor that induces OA pain. PMID:26256983

  13. Exercise and osteoarthritis

    PubMed Central

    Hunter, David J; Eckstein, Felix

    2009-01-01

    Exercise remains an extremely popular leisure time activity in many countries throughout the western world. It is widely promoted in the lay press as having salutory benefits for weight control, disease management advantages for cardiovascular disease and diabetes, in addition to improving psychological well-being amongst an array of other benefits. In contrast, however, the lay press and community perception is also that exercise is potentially deleterious to one's joints. The purpose of this review is to consider what osteoarthritis (OA) is and provide an overview of the epidemiology of OA focusing on validated risk factors for its development. In particular the role of both exercise and occupational activity in OA will be described as well as the role of exercise to the joints’ tissues (particularly cartilage) and the role of exercise in disease management. Despite the common misconception that exercise is deleterious to one's joints, in the absence of joint injury there is no evidence to support this notion. Rather it would appear that exercise has positive salutory benefits for joint tissues in addition to its other health benefits. PMID:19207981

  14. Obesity versus osteoarthritis: beyond the mechanical overload.

    PubMed

    Sartori-Cintra, Angélica Rossi; Aikawa, Priscila; Cintra, Dennys Esper Correa

    2014-09-01

    Obesity is currently considered a major public health problem in the world, already reaching epidemic characteristics, according to the World Health Organization. Excess weight is the major risk factor associated with various diseases, such as type 2 diabetes mellitus, hypertension, dyslipidemia and osteometabolic diseases, including osteoporosis and osteoarthritis. Osteoarthritis is the most prevalent rheumatic disease and the leading cause of physical disability and reduced quality of life of the population over 65 years. It mainly involves the joints that bear weight - knees and hips. However, along with the cases of obesity, its prevalence is increasing, and even in other joints, such as hands. Thus, it is assumed that the influence of obesity on the development of OA is beyond mechanical overload. The purpose of this review was to correlate the possible mechanisms underlying the genesis and development of these two diseases. Increased fat mass is directly proportional to excessive consumption of saturated fatty acids, responsible for systemic low-grade inflammation condition and insulin and leptin resistance. At high levels, leptin assumes inflammatory characteristics and acts in the articular cartilage, triggering the inflammatory process and changing homeostasis this tissue with consequent degeneration. We conclude that obesity is a risk factor for osteoarthritis and that physical activity and changes in diet composition can reverse the inflammatory and leptin resistance, reducing progression or preventing the onset of osteoarthritis. PMID:25184806

  15. Plain radiography or magnetic resonance imaging (MRI): Which is better in assessing outcome in clinical trials of disease-modifying osteoarthritis drugs? Summary of a debate held at the World Congress of Osteoarthritis 2014.

    PubMed

    Eckstein, Felix; Le Graverand, Marie-Pierre Hellio

    2015-12-01

    Osteoarthritis (OA) is the most common disease of synovial joints and currently lacks treatment options that modify structural pathology. Imaging is ideally suited for directly evaluating efficacy of disease-modifying OA drugs (DMOADs) in clinical trials, with plain radiography and MRI being most often applied. The current article is based on a debate held on April 26, 2014, at the World Congress of Osteoarthritis: The authors were invited to contrast strengths and limitations of both methods, highlighting scientific evidence on reliability, construct-validity, and correlations with clinical outcome, and comparing their sensitivity to change in knee OA and sensitivity to DMOAD treatment. The authors concluded that MRI provides more comprehensive information on articular tissues pathology, and that implementation of radiography in clinical trials remains a challenge. However, neither technique has thus far been demonstrated to be strongly superior over the other; for the time being it therefore appears advisable to use both in parallel in clinical trials, to provide more evidence on their relative performance. Radiographic JSW strongly depends on adequate positioning; it is not specific to cartilage loss but also to the meniscus. MRI provides somewhat superior sensitivity to change compared with the commonly used non-fluoroscopic radiographic acquisition protocols, and has recently provided non-location-dependent measures of cartilage thickness loss and gain, which are potentially more sensitive in detecting DMOAD effects than radiographic JSW or region-specific MRI. Non-location-dependent measures of cartilage thickness change should thus be explored further in context of anabolic and anti-catabolic DMOADs. PMID:26142321

  16. Increased osteoarthritis in moose from Isle Royale.

    PubMed

    Peterson, R O

    1988-07-01

    Over the past 30 yr, moose (Alces alces) in Isle Royale National Park (Michigan, USA) exhibited a several-fold increase in the prevalence of osteoarthritis, or degenerative joint disease (DJD). Available evidence points to an environmental explanation for this change. Greater physical activity among afflicted moose is not a likely contributing factor, nor is genetic change in the population. The possible introduction of an unspecified disease agent cannot be dismissed at this time. Moose exhibiting the highest prevalence of DJD were those born during a period of severe undernutrition, and it is hypothesized that nutritional stress early in life was responsible for increased joint disease during senescence. Such an etiology for osteoarthritis has not been suggested previously for any species. PMID:3411702

  17. Sleep Disturbances and Osteoarthritis.

    PubMed

    Pickering, Marie-Eva; Chapurlat, Roland; Kocher, Laurence; Peter-Derex, Laure

    2016-02-01

    Sleep disturbances are particularly troublesome in patients with painful rheumatic disease. This article reviews the literature specifically published on sleep disturbances in osteoarthritis, a prevalent pathology and leading cause of disability. Several aspects of the relationship between sleep and osteoarthritis are discussed, including epidemiology, pathophysiological hypotheses, and treatment outcomes. Sleep is of central importance in the well-being of patients and should systematically be assessed in patients with osteoarthritis. When needed, a specific treatment of sleep disorders should be associated with an optimal management of pain to achieve synergistic improvements in quality of life. More large-scale studies are needed to identify predictive factors of sleep impairment in osteoarthritis. PMID:25639339

  18. Regenerative Injection Therapy with Whole Bone Marrow Aspirate for Degenerative Joint Disease: A Case Series

    PubMed Central

    Hauser, Ross A.; Orlofsky, Amos

    2013-01-01

    Regenerative therapeutic strategies for joint diseases usually employ either enriched concentrates of bone marrow-derived stem cells, chondrogenic preparations such as platelet-rich plasma, or irritant solutions such as hyperosmotic dextrose. In this case series, we describe our experience with a simple, cost-effective regenerative treatment using direct injection of unfractionated whole bone marrow (WBM) into osteoarthritic joints in combination with hyperosmotic dextrose. Seven patients with hip, knee or ankle osteoarthritis (OA) received two to seven treatments over a period of two to twelve months. Patient-reported assessments were collected in interviews and by questionnaire. All patients reported improvements with respect to pain, as well as gains in functionality and quality of life. Three patients, including two whose progress under other therapy had plateaued or reversed, achieved complete or near-complete symptomatic relief, and two additional patients achieved resumption of vigorous exercise. These preliminary findings suggest that OA treatment with WBM injection merits further investigation. PMID:24046512

  19. Imaging biomarkers of spine osteoarthritis.

    PubMed

    Popham, Maria; M K Williams, Frances

    2010-01-01

    While there is an acknowledged need for biomarkers to progress arthritis research, imaging biomarkers for the spine have lagged behind those for peripheral joint osteoarthritis. Progress has been slow for a number of reasons. First and perhaps most importantly, there is currently no international agreement on definition of spine osteoarthritis (OA), either histologically or on imaging. Secondly, spine OA comprises two main pathologies, and debate continues as to whether they are separate entities or linked: degenerative disc disease and facet joint arthritis. Imaging those neighbouring joints is not straightforward and usually requires separate imaging investigations. Thirdly, it is only just becoming clear to what extent changes on imaging are associated with the main clinical problem - back pain. To compound the problem, the organisation of clinical services usually means that different specialties tend to focus on different anatomical areas, so a combined approach is not commonly adopted. Systematic evaluation of facet joints in epidemiological study is still in its infancy. Regardless of these hurdles, we have attempted in this review to summarise the state of play of imaging biomarkers in the spine with the emphasis on degenerative disc disease. MR imaging clearly leads the way and there exists a variety of specialist techniques such as T1rho and which may offer spine research imaging biomarkers in the future. PMID:25693040

  20. Interest of second harmonic generation imaging to study collageneous matrix modification in osteoarthritis disease

    NASA Astrophysics Data System (ADS)

    Werkmeister, Elisabeth; de Isla, Natalia; Marchal, Luc; Mainard, Didier; Stoltz, Jean-Franois; Dumas, Dominique

    2008-04-01

    Cartilage degenerative diseases like osteoarthritis affect the organization of the biological extracellular matrix (ECM) surrounding chondrocytes. This ECM is mainly composed by collagen giving rise to a strong Second Harmonic Generation (SHG) Signal, due to its high non linear susceptibility. Mechanical stress leads to perturbation of the collagen network comparable to modification occurring in disease. To be sure that SHG signal comes specifically from the collagen network, the enzymatical action of Collagenase was followed. We clearly noted the decrease of the collagen specific signal according to incubation time due to enzymatic degradation. To characterize structural modification on the arrangement of collagen fibers in the ECM, we used image analysis based on co-occurrence matrix (Haralick). Textural features give information like homogeneity ('Angular Second Moment') or size of textural elements ('Inverse Difference Moment', 'Correlation'). Samples submitted to compression are characterized by higher 'Correlation', associated with a decrease of 'IDM' and 'ASM'. Those evolutions suggest the presence of long linear structures, an effect of packing of collagen fibrils and the apparition of nodes where the density of collagen is important versus areas showing a lack of molecules. Collagen I, II and VI are biomarkers characterising disease states since its presence is increased in pathological cartilage (osteoarthritis). Fluorescence Lifetime Imaging Microscopy (FLIM) associated to Spectral and SHG analysis confirmed the presence of Collagen I and II in the extracellular and Collagen VI in the pericellular matrix of chondrocytes. SHG, FLIM and Spectral Imaging combined with multiphoton excitation enable tissue imaging at deep penetration. We pointed out a local modification of the ECM of cartilage without any labelling (SHG) under mechanical stress. Thus the association of all these techniques represents a potential diagnosis tool for disorganization of collagen.

  1. On the role of knee joint in balance control and postural strategies: effects of total knee replacement in elderly subjects with knee osteoarthritis.

    PubMed

    Gauchard, Gérome C; Vançon, Guy; Meyer, Philippe; Mainard, Didier; Perrin, Philippe P

    2010-06-01

    This study aimed to evaluate the role of the knee joint in the neurosensory organization of balance control and the generation of postural sensorimotor strategies. Ten patients, aged over 60 years and having undergone unilateral total knee replacement (TKR) for osteoarthritis, and 20 controls were submitted to static and dynamic posturographic tests and to a sensory organization test (SOT) aiming at evaluating postural control in quiet stance and during movement. The patients were submitted to these evaluations after the disappearance of pain (TKR(1)) and at the end of a 6-week rehabilitation program (TKR(2)). Balance control being greatly improved at TKR2 compared to TKR1, the patients attain a quality of postural regulation similar to that of the controls; some postural abnormalities did however persist for the static test. Moreover, SOT values at TKR(2) close to those of the controls highlighted an improvement in motor response, better management in altered proprioceptive information situations, and greater use of the ankle to control balance. This model of intervention on the knee joint, namely knee replacement due to osteoarthritis, has shown that gradual functional sensorimotor restoration after TKR, due to intrasensory proprioceptive compensation either at knee, or at other joint levels (hip/ankle), improves dynamic balance control. This reacquisition allows the knee joint to recover its corrective compensatory role in postural regulation allowing, through neuroplasticity, the modification of muscular activation sequences and, thus, the implementation of anticipatory sensorimotor strategies. PMID:20451390

  2. PA01.70. A clinical study on the efficacy of Jalaukawacharana in the management of janu sandhigata vata w.s.r. To osteoarthritis of knee joint

    PubMed Central

    Vardhan, S Ashok; Balakrishnan, T. V.; Rao, S Dattatreya; Rao, M Bhaskar; Kumar, K Srinivasa; Bhaskara Reddy, K. V. V. Vijaya

    2012-01-01

    Purpose: The sandhigata vata described in Ayurveda causes the symptomatology such as shula, sotha, stambhana, sparsha asahyata, sputana, akunchana prasarana vedana etc. whereas the osteoarthritis described in modern science can be correlated with sandhigata vata because it also produces the features such as inflammation, pain, stiffness, limited movements and deformity in severe cases. Osteoarthritis is the 2nd most common illness with 22 29% of prevalence in global population. Presently available modern medication is causing many side and toxic effects which sometimes may need hospitalization also. Hence it requires the need to find such a therapy which gives better relief without any side or toxic effects and also natural, cost effective and easily available. Hence the non surgical biological therapeutic means such jalaukawacharana was selected. Method: Total of 20 patients were selected on the basis of selection criteria (inclusion and exclusion criteria) and then they are grouped into two i.e. 10 each in Jalukawacharana and Yogaraja guggulu group. The jalukawacharana was done with 7 day interval for about 6 sittings in 1st group where as in 2nd group yogaraja guggulu 125mg thrice a day was given for 6 weeks. For assessment, the Koos was taken as subjective and range of motion was taken as objective parameter for proper assessment and they are subjected for statistical validity. Result: After analyzing, the jalukawacharana shown significant and remarkable result in comparison with Yogaraja guguulu. The symptomatology was reduced to great extent and range of motion is also improved a lot by jalukawacharana than with yogaraja guggulu. Conclusion: The janu sandhi gata vata can correlate or compared with osteoarthritis of knee joint. The non surgical, biological therapeutic means i.e. jalukawacharana shown good result in treating with janu sandhigata vata i.e. osteoarthritis of knee joint in comparison with standard group i.e. yogaraja guggulu.

  3. [Bone and Joint Involvement in Celiac Disease].

    PubMed

    Hoffmanová, I; Sánchez, D; Džupa, V

    2015-01-01

    Celiac disease (gluten-sensitive enteropathy) is currently regarded as a multisystem autoimmune disorder; its clinical signs and symptoms do not involve merely the gastrointestinal tract but are associated with several other medical specialties, including orthopaedics and traumatology. In orthopaedic and trauma patients, celiac disease should be suspected in the following diagnoses: osteomalacia, premenopausal osteoporosis, post-menopausal osteoporosis more severe than expected and refractory to medication, osteoporosis in men under 55 years of age, recurrent bone fractures in the limbs, large joint arthralgia or arthritis of unclear aetiology, erosive spondyloarthropathy particularly in patients with the history of chronic diarrhoea, anaemia or associated autoimmune disorders (type 1 diabetes mellitus or autoimmune thyreopathy), and in women with secondary amenorrhea or early menopause. The orthopaedist or trauma surgeon should be aware of suspected celiac disease in patients who do not respond adequately to the standard treatment of pain related to the musculoskeletal system, in patients with recurrent fractures of the limb bones and in young patients with suspected secondary osteoporosis. With the use of appropriate screening methods, celiac disease as-yet undiagnosed can be revealed. A long-life gluten-free diet in these patients results in the alleviation of metabolic osteopathy and joint and muscle problems, in reduced requirements of analgesic and antiphlogistic drugs as well as in reduced risks of fracture. PMID:26516737

  4. [Treatment of patients with osteoarthritis].

    PubMed

    Vargas Negrín, Francisco; Medina Abellán, María D; Hermosa Hernán, Juan Carlos; de Felipe Medina, Ricardo

    2014-01-01

    The therapeutic management of patients with osteoarthritis aims to decrease pain and inflammation, improve physical function, and to apply safe and effective treatments. A patient-centered approach implies the active participation of the patient in the design of the treatment plan and in timely and informed decision-making at all stages of the disease. The nucleus of treatment is patient education, physical activity and therapeutic exercise, together with weight control in overweight or obese patients. Self-care by the individual and by the family is fundamental in day-to-day patient management. The use of physical therapies, technical aids (walking sticks, etc.) and simple analgesics, opium alkaloids, and antiinflammatory drugs have demonstrated effectiveness in controlling pain, improving physical function and quality of life and their use is clearly indicated in the treatment of osteoarthritis. Conservative surgery and joint replacement is indicated when treatment goals are not achieved in specific patients. PMID:24467960

  5. Rocker-sole footwear versus prefabricated foot orthoses for the treatment of pain associated with first metatarsophalangeal joint osteoarthritis: study protocol for a randomised trial

    PubMed Central

    2014-01-01

    Background Osteoarthritis affecting the first metatarsophalangeal joint of the foot is a common condition which results in pain, stiffness and impaired ambulation. Footwear modifications and foot orthoses are widely used in clinical practice to treat this condition, but their effectiveness has not been rigorously evaluated. This article describes the design of a randomised trial comparing the effectiveness of rocker-sole footwear and individualised prefabricated foot orthoses in reducing pain associated with first metatarsophalangeal joint osteoarthritis. Methods Eighty people with first metatarsophalangeal joint osteoarthritis will be randomly allocated to receive either a pair of rocker-sole shoes (MBT® Matwa, Masai Barefoot Technology, Switzerland) or a pair of individualised, prefabricated foot orthoses (Vasyli Customs, Vasyli Medical™, Queensland, Australia). At baseline, the biomechanical effects of the interventions will be examined using a wireless wearable sensor motion analysis system (LEGSys™, BioSensics, Boston, MA, USA) and an in-shoe plantar pressure system (Pedar®, Novel GmbH, Munich, Germany). The primary outcome measure will be the pain subscale of the Foot Health Status Questionnaire (FHSQ), measured at baseline and 4, 8 and 12 weeks. Secondary outcome measures will include the function, footwear and general foot health subscales of the FHSQ, severity of pain and stiffness at the first metatarsophalangeal joint (measured using 100 mm visual analog scales), global change in symptoms (using a 15-point Likert scale), health status (using the Short-Form-12® Version 2.0 questionnaire), use of rescue medication and co-interventions to relieve pain, the frequency and type of self-reported adverse events and physical activity levels (using the Incidental and Planned Activity Questionnaire). Data will be analysed using the intention to treat principle. Discussion This study is the first randomised trial to compare the effectiveness of rocker-sole footwear and individualised prefabricated foot orthoses in reducing pain associated with osteoarthritis of the first metatarsophalangeal joint, and only the third randomised trial ever conducted for this condition. The study has been pragmatically designed to ensure that the findings can be implemented into clinical practice if the interventions are found to be effective, and the baseline biomechanical analysis will provide useful insights into their mechanism of action. Trial registration Australian New Zealand Clinical Trials Registry: ACTRN12613001245785 PMID:24629181

  6. Different thresholds for detecting osteophytes and joint space narrowing exist between the site investigators and the centralized reader in a multicenter knee osteoarthritis study—data from the Osteoarthritis Initiative

    PubMed Central

    Guermazi, Ali; Hunter, David J.; Li, Ling; Benichou, Olivier; Eckstein, Felix; Kwoh, C. Kent; Nevitt, Michael

    2011-01-01

    Objective To evaluate how the reading of knee radiographs by site investigators differs from that by an expert musculoskeletal radiologist who trained and validated them in a multicenter knee osteoarthritis (OA) study. Materials and methods A subset of participants from the Osteoarthritis Initiative progression cohort was studied. Osteophytes and joint space narrowing (JSN) were evaluated using Kellgren-Lawrence (KL) and Osteoarthritis Research Society International (OARSI) grading. Radiographs were read by site investigators, who received training and validation of their competence by an expert musculoskeletal radiologist. Radiographs were re-read by this radiologist, who acted as a central reader. For KL and OARSI grading of osteophytes, discrepancies between two readings were adjudicated by another expert reader. Results Radiographs from 96 subjects (49 women) and 192 knees (138 KL grade≥2) were included. The site reading showed moderate agreement for KL grading overall (kappa=0.52) and for KL≥2 (i.e., radiographic diagnosis of “definite OA”; kappa=0.41). For OARSI grading, the site reading showed substantial agreement for lateral and medial JSN (kappa=0.65 and 0.71), but only fair agreement for osteophytes (kappa=0.37). For KL grading, the adjudicator’s reading showed substantial agreement with the centralized reading (kappa=0.62), but only slight agreement with the site reading (kappa=0.10). Conclusion Site investigators over-graded osteophytes compared to the central reader and the adjudicator. Different thresholds for scoring of JSN exist even between experts. Our results suggest that research studies using radiographic grading of OA should use a centralized reader for all grading. PMID:21479521

  7. A prospective case-control study to compare the sensitivity and specificity of the grind and traction-shift (subluxation-relocation) clinical tests in osteoarthritis of the thumb carpometacarpal joint.

    PubMed

    Choa, R M; Parvizi, N; Giele, H P

    2014-03-01

    The diagnosis of osteoarthritis of the thumb carpometacarpal joint is made predominantly by correlating examination findings with patients' symptoms and radiographs. The importance of clinical examination is enhanced due to the poor correlation between radiological severity of osteoarthritis of this joint and symptoms. Despite the importance of clinical examination findings, no previous studies have analyzed the traction-shift test nor compared clinical tests for this diagnosis. In this prospective case-control study the relative performance of the commonly used grind and traction-shift (subluxation-relocation) tests were compared in 30 patients and 30 unaffected controls. The traction-shift test had greater sensitivity (66.7%) and specificity (100%) than the grind test (30% and 96.7%, respectively), whilst also demonstrating superior positive (100%) and negative (75%) predictive value than the grind test (90% and 58%, respectively). Therefore, we believe this to be the superior clinical test for osteoarthritis of the carpometacarpal joint of the thumb. PMID:24127463

  8. Genetic diseases of bones and joints.

    PubMed

    McCarthy, Edward F

    2011-02-01

    Genetic factors play roles in many diseases. Often these factors are ill defined and unpredictable. Other diseases are caused by specific single gene mutations and are passed to offspring in Mendelian inheritance patterns. There are over 5000 documented Mendelian disorders; over 500 of these affect bones and joints. Some of these single gene disorders affect many tissues, and the skeletal system is one of many organ systems involved. The surgical pathologist must often diagnose these disorders. Important examples are neurofibromatosis, Gaucher's disease, and alkaptonuria. Other single gene disorders almost exclusively affect the skeleton. These disorders are the skeletal dysplasias and 372 have been documented. These disorders are classified using radiographic, clinical, and molecular data. The most common dysplasias are osteogenesis imperfecta, achondroplasia, and osteopetrosis. The surgical pathologist usually does not play a role in the diagnosis of skeletal dysplasias. However, histologic studies often elucidate the pathophysiologic basis of these diseases and proper collection of tissues is important for the evolving understanding of the molecular basis of these disorders. PMID:21675375

  9. Effectiveness and utility of hyaluronic acid in osteoarthritis

    PubMed Central

    Migliore, Alberto; Procopio, Simone

    2015-01-01

    Summary Osteoarthritis (OA) is a chronic degenerative joint disease characterized by pain and progressive functional limitation. Viscosupplementation with intra-articular hyaluronic acid is a treatment option in knee OA that is included in the professional guidelines for treatment of this joint disease, but potentially should apply to all synovial joints in order to reduce pain and improve joint lubrication. Exogenous HA can enhance chondrocyte HA synthesis, prevent the degradation of cartilage and promote its regeneration. Moreover it can reduce the production of proinflammatory mediators and matrix metalloproteinases involved in OA pathogenesis. This mini review highlights the evidence of hyaluronic acid in reducing osteoarthritis symptoms and structural damage, as well as its ability to delay prosthetic surgery. Viscosupplementation should be considered as a long-term therapy. PMID:26136793

  10. Genetics in Osteoarthritis

    PubMed Central

    Fernández-Moreno, Mercedes; Rego, Ignacio; Carreira-Garcia, Vanessa; Blanco, Francisco J

    2008-01-01

    Osteoarthritis is a degenerative articular disease with complex pathogeny because diverse factors interact causing a process of deterioration of the cartilage. Despite the multifactorial nature of this pathology, from the 50’s it´s known that certain forms of osteoarthritis are related to a strong genetic component. The genetic bases of this disease do not follow the typical patterns of mendelian inheritance and probably they are related to alterations in multiple genes. The identification of a high number of candidate genes to confer susceptibility to the development of the osteoarthritis shows the complex nature of this disease. At the moment, the genetic mechanisms of this disease are not known, however, which seems clear is that expression levels of several genes are altered, and that the inheritance will become a substantial factor in future considerations of diagnosis and treatment of the osteoarthritis. PMID:19516961

  11. The role of imaging in osteoarthritis.

    PubMed

    Roemer, Frank W; Eckstein, Felix; Hayashi, Daichi; Guermazi, Ali

    2014-02-01

    Osteoarthritis (OA) is the most prevalent joint disorder with no approved disease-modifying treatment available. The importance of imaging in assessing all joint structures involved in the disease process, including articular cartilage, meniscus, subarticular bone marrow, and synovium for diagnosis, prognostication, and follow-up, has been well recognized. In daily clinical practice, conventional radiography is still the most commonly used imaging technique for the evaluation of a patient with known or suspected OA and radiographic outcome measures are still the only approved end point by regulatory authorities in clinical trials. The ability of magnetic resonance imaging (MRI) to visualize all joint structures in three-dimensional fashion including tissue ultrastructure has markedly deepened our understanding of the natural history of the disease. This article describes the roles and limitations of different imaging modalities for clinical practice and research in OA, with a focus on radiography and MRI and an emphasis on the knee joint. PMID:24792944

  12. Knee osteoarthritis image registration: data from the Osteoarthritis Initiative

    NASA Astrophysics Data System (ADS)

    Galván-Tejada, Jorge I.; Celaya-Padilla, José M.; Treviño, Victor; Tamez-Peña, José G.

    2015-03-01

    Knee osteoarthritis is a very common disease, in early stages, changes in joint structures are shown, some of the most common symptoms are; formation of osteophytes, cartilage degradation and joint space reduction, among others. Based on a joint space reduction measurement, Kellgren-Lawrence grading scale, is a very extensive used tool to asses radiological OA knee x-ray images, based on information obtained from these assessments, the objective of this work is to correlate the Kellgren-Lawrence score to the bilateral asymmetry between knees. Using public data from the Osteoarthritis initiative (OAI), a set of images with different Kellgren-Lawrencescores were used to determine a relationship of Kellgren-Lawrence score and the bilateral asymmetry, in order to measure the asymmetry between the knees, the right knee was registered to match the left knee, then a series of similarity metrics, mutual information, correlation, and mean squared error where computed to correlate the deformation (mismatch) of the knees to the Kellgren-Lawrence score. Radiological information was evaluated and scored by OAI radiologist groups. The results of the study suggest an association between Radiological Kellgren-Lawrence score and image registration metrics, mutual information and correlation is higher in the early stages, and mean squared error is higher in advanced stages. This association can be helpful to develop a computer aided grading tool.

  13. Intraarticular treatments for osteoarthritis: new perspectives.

    PubMed

    Chevalier, Xavier

    2010-05-01

    To date, no targeted treatments for osteoarthritis have been developed. Therefore the challenge for the next years is to find a treatment that may slow down the progression of the disease. Osteoarthritis of the weight-bearing joints, such as knee OA, is more a local mechanical driven disease than a generalized one. To reach a non-vascularised tissue such as the cartilage, local intra-articular administration of drugs should be considered. The purpose of this review is to evaluate the advantages of local intra-articular drug administration compared with a systemic one in patients with osteoarthritis of weight-bearing joints. New perspectives of such strategy are reviewed, including anti-cytokine therapy, gene therapy, delivery of growth factors, stem cells therapy and new lubricant agents such as lubricin. The main goal in the future will be to increase the residence time of the drug in the joint while improving its diffusion within the target tissues. One key question will be how to better define the patients likely to benefit by such an approach and when the treatment is most likely to work. Most importantly, the treatment strategy must be selected according to the pattern in an individual patient. Finally, with all intra-articular treatments, the risk/benefit ratio must be carefully evaluated. PMID:20199394

  14. Joint aging and chondrocyte cell death

    PubMed Central

    Grogan, Shawn P; D’Lima, Darryl D

    2010-01-01

    Articular cartilage extracellular matrix and cell function change with age and are considered to be the most important factors in the development and progression of osteoarthritis. The multifaceted nature of joint disease indicates that the contribution of cell death can be an important factor at early and late stages of osteoarthritis. Therefore, the pharmacologic inhibition of cell death is likely to be clinically valuable at any stage of the disease. In this article, we will discuss the close association between diverse changes in cartilage aging, how altered conditions influence chondrocyte death, and the implications of preventing cell loss to retard osteoarthritis progression and preserve tissue homeostasis. PMID:20671988

  15. What's new in osteoarthritis pathogenesis?

    PubMed

    Jones, G

    2016-02-01

    Osteoarthritis is the leading musculoskeletal cause of disability in the Western society. Despite this, it is still difficult to gain a precise definition of what osteoarthritis actually is. The methods used for the study are narrative review and viewpoint focussing on the knee. It is well known that there is a modest correlation between X-ray changes and pain. Improvements in imaging have shown that osteoarthritis should be regarded as an umbrella term for a number of pathophysiological processes leading to pain and/or cartilage loss. If these are inside the joint (such as bone marrow lesions, cartilage defects or meniscal tear) then they can be considered osteoarthritis, while those outside the joint (such as obesity, weak muscles and vitamin D deficiency) could be considered the osteoarthritis syndrome. These improvements in basic science are leading to lesion-specific therapies indicating the importance of trying to pinpoint causes of pain in the individual. PMID:26899891

  16. Altered frontal and transverse plane tibiofemoral kinematics and patellofemoral malalignments during downhill gait in patients with mixed knee osteoarthritis.

    PubMed

    Farrokhi, Shawn; Meholic, Brad; Chuang, Wei-Neng; Gustafson, Jonathan A; Fitzgerald, G Kelley; Tashman, Scott

    2015-07-16

    Patients with knee osteoarthritis often present with signs of mixed tibiofemoral and patellofemoral joint disease. It has been suggested that altered frontal and transverse plane knee joint mechanics play a key role in compartment-specific patterns of knee osteoarthritis, but in-vivo evidence in support of this premise remains limited. Using Dynamic Stereo X-ray techniques, the aim of this study was to compare the frontal and transverse plane tibiofemoral kinematics and patellofemoral malalignments during the loading response phase of downhill gait in three groups of older adults: patients with medial tibiofemoral compartment and coexisting patellofemoral osteoarthritis (n=11); patients with lateral tibiofemoral compartment and coexisting patellofemoral osteoarthritis (n=10); and an osteoarthritis-free control group (n=22). Patients with lateral compartment osteoarthritis walked with greater and increasing degrees of tibiofemoral abduction compared to the medial compartment osteoarthritis and the control groups who walked with increasing degrees of tibiofemoral adduction. Additionally, the medial and lateral compartment osteoarthritis groups demonstrated reduced degrees of tibiofemoral internal rotation compared to the control group. Both medial and lateral compartment osteoarthritis groups also walked with increasing degrees of lateral patella tilt and medial patella translation during the loading response phase of downhill gait. Our findings suggest that despite the differences in frontal and transverse plane tibiofemoral kinematics between patients with medial and lateral compartment osteoarthritis, the malalignments of their arthritic patellofemoral joint appears to be similar. Further research is needed to determine if these kinematic variations are relevant targets for interventions to reduce pain and disease progression in patients with mixed disease. PMID:26087880

  17. Measurement of the cross linking compound, pyridinoline, in urine as an index of collagen degradation in joint disease.

    PubMed Central

    Robins, S P; Stewart, P; Astbury, C; Bird, H A

    1986-01-01

    An enzyme linked immunoassay (ELISA) for the collagen cross link, pyridinoline, has been developed using affinity purified antibodies, with a sensitivity down to about 0.1 ng of cross link. Measurements of urinary pyridinoline were made in patients with rheumatoid arthritis (RA), osteoarthritis (OA), and a control group showing no signs of joint disease. Expressed relative to creatinine values, pyridinoline was significantly increased in both RA and OA groups compared with controls: these differences were much larger than could be attributed to any age related effects or to changes in urinary creatinine concentrations. These findings were confirmed by analysis of a series of 24 h urine collections which showed that the total pyridinoline excretions were significantly higher in both RA and OA groups than in the controls. As pyridinoline is much more prevalent in cartilage than in bone collagen, measurement of this compound in urine may provide an index for monitoring the increased joint destruction that occurs in arthritic disease. PMID:3813668

  18. Biomarkers of (osteo)arthritis

    PubMed Central

    Mobasheri, Ali; Henrotin, Yves

    2015-01-01

    Abstract Arthritic diseases are a major cause of disability and morbidity, and cause an enormous burden for health and social care systems globally. Osteoarthritis (OA) is the most common form of arthritis. The key risk factors for the development of OA are age, obesity, joint trauma or instability. Metabolic and endocrine diseases can also contribute to the pathogenesis of OA. There is accumulating evidence to suggest that OA is a whole-organ disease that is influenced by systemic mediators, inflammaging, innate immunity and the low-grade inflammation induced by metabolic syndrome. Although all joint tissues are implicated in disease progression in OA, articular cartilage has received the most attention in the context of aging, injury and disease. There is increasing emphasis on the early detection of OA as it has the capacity to target and treat the disease more effectively. Indeed it has been suggested that this is the era of “personalized prevention” for OA. However, the development of strategies for the prevention of OA require new and sensitive biomarker tools that can detect the disease in its molecular and pre-radiographic stage, before structural and functional alterations in cartilage integrity have occurred. There is also evidence to support a role for biomarkers in OA drug discovery, specifically the development of disease modifying osteoarthritis drugs. This Special Issue of Biomarkers is dedicated to recent progress in the field of OA biomarkers. The papers in this Special Issue review the current state-of-the-art and discuss the utility of OA biomarkers as diagnostic and prognostic tools. PMID:26954784

  19. Biomarkers of (osteo)arthritis.

    PubMed

    Mobasheri, Ali; Henrotin, Yves

    2015-12-01

    Arthritic diseases are a major cause of disability and morbidity, and cause an enormous burden for health and social care systems globally. Osteoarthritis (OA) is the most common form of arthritis. The key risk factors for the development of OA are age, obesity, joint trauma or instability. Metabolic and endocrine diseases can also contribute to the pathogenesis of OA. There is accumulating evidence to suggest that OA is a whole-organ disease that is influenced by systemic mediators, inflammaging, innate immunity and the low-grade inflammation induced by metabolic syndrome. Although all joint tissues are implicated in disease progression in OA, articular cartilage has received the most attention in the context of aging, injury and disease. There is increasing emphasis on the early detection of OA as it has the capacity to target and treat the disease more effectively. Indeed it has been suggested that this is the era of "personalized prevention" for OA. However, the development of strategies for the prevention of OA require new and sensitive biomarker tools that can detect the disease in its molecular and pre-radiographic stage, before structural and functional alterations in cartilage integrity have occurred. There is also evidence to support a role for biomarkers in OA drug discovery, specifically the development of disease modifying osteoarthritis drugs. This Special Issue of Biomarkers is dedicated to recent progress in the field of OA biomarkers. The papers in this Special Issue review the current state-of-the-art and discuss the utility of OA biomarkers as diagnostic and prognostic tools. PMID:26954784

  20. HIP osteoarthritis and work.

    PubMed

    Harris, E Clare; Coggon, David

    2015-06-01

    Epidemiological evidence points strongly to a hazard of hip osteoarthritis from heavy manual work. Harmful exposures may be reduced by the elimination or redesign of processes and the use of mechanical aids. Reducing obesity might help to protect workers whose need to perform heavy lifting cannot be eliminated. Particularly high relative risks have been reported in farmers, and hip osteoarthritis is a prescribed occupational disease in the UK for long-term employees in agriculture. Even where it is not attributable to employment, hip osteoarthritis impacts importantly on the capacity to work. Factors that may influence work participation include the severity of disease, the physical demands of the job, age and the size of the employer. Published research does not provide a strong guide to the timing of return to work following hip arthroplasty for osteoarthritis, and it is unclear whether patients should avoid heavy manual tasks in their future employment. PMID:26612242

  1. HIP OSTEOARTHRITIS AND WORK

    PubMed Central

    Harris, E Clare; Coggon, David

    2016-01-01

    Epidemiological evidence points strongly to a hazard of hip osteoarthritis from heavy manual work. Harmful exposures may be reduced by elimination or redesign of processes and use of mechanical aids. Reducing obesity might help to protect workers whose need to perform heavy lifting cannot be eliminated. Particularly high relative risks have been reported in farmers, and hip osteoarthritis is a prescribed occupational disease in the UK for long-term employees in agriculture. Even where it is not attributable to employment, hip osteoarthritis impacts importantly on capacity to work. Factors that may influence work participation include the severity of disease, the physical demands of the job, age, and the size of the employer. Published research does not provide a strong guide to the timing of return to work following hip arthroplasty for osteoarthritis, and it is unclear whether patients should avoid heavy manual tasks in their future employment. PMID:26612242

  2. Disordered glycometabolism involved in pathogenesis of Kashin–Beck disease, an endemic osteoarthritis in China

    SciTech Connect

    Wu, Cuiyan; Lei, Ronghui; Tiainen, Mika; Wu, Shixun; Zhang, Qiang; Pei, Fuxing; Guo, Xiong

    2014-08-15

    Kashin–Beck disease (KBD) is a chronic endemic osteoarthritis in China. Previous studies have suggested a role of metabolic dysfunction in causation of this disease. In this investigation, the metabolomics approach and cell experiments were used to discover the metabolic changes and their effects on KBD chondrocytes. Nuclear magnetic resonance ({sup 1}H NMR) spectroscopy was used to examine serum samples from both the KBD patients and normal controls. The pattern recognition multivariate analysis (OSC–PLS) and quantitative analysis (QMTLS iterator) revealed altered glycometabolism in KBD, with increased glucose and decreased lactate and citrate levels. IPA biological analysis showed the centric location of glucose in the metabolic network. Massive glycogen deposits in chondrocytes and increased uptake of glucose by chondrocytes further confirmed disordered glycometabolism in KBD. An in vitro study showed the effects of disordered glycometabolism in chondrocytes. When chondrocytes were treated with high glucose, expression of type II collagen and aggrecan were decreased, while TNF-α expression, the level of cellular reactive oxygen species and cell apoptosis rates all were increased. Therefore, our results demonstrated that disordered glycometabolism in patients with KBD was linked to the damage of chondrocytes. This may provide a new basis for understanding the pathogenesis of KBD. - Highlights: • Disordered glycometabolism in KBD was demonstrated by combining serum metabolomics and chondrocyte studies. • Glucose and TNF-α were key molecules linked to altered metabolism and inflammation in the pathophysiology of KBD. • The glycometabolism disorder was linked to expression of type II collagen and aggrecan, ROS and apoptosis of KBD chondrocytes.

  3. Antioxidant to treat osteoarthritis: dream or reality?

    PubMed

    Henrotin, Y; Kurz, B

    2007-02-01

    Osteoarthritis is one of the most common chronic diseases that causes pain and physical disability in patient. Although OA is considered as a global disease affecting all joint tissues, cartilage degradation is the end point. The degradation of cartilage results of the combination of mechanical stress and biochemical factors, mainly metalloproteinases and reactive oxygen species (ROS). The activity of reactive oxygen species is balanced by enzymatic and non-enzymatic antioxidants, that act by inhibiting oxidative enzymes, scavenging free radicals or chelating ion metals. Until now, few information is available on the antioxidative status of chondrocytes. Further, the modification of the antioxidative system in osteoarthritis remains unknown. Some antioxidant supplements or drugs with antioxidant properties have been developed to reinforce the cellular antioxidant status. However, until now, there is no consistent evidence that additional antioxidant supply is efficient to relieve OA symptoms or to prevent structural changes in OA cartilage. PMID:17305512

  4. [Bilateral knee osteoarthritis associated with supracondylar chondromas and popliteal osteochondromas].

    PubMed

    Van Linthoudt, D; Malterre, L; Pazera, A

    2003-03-19

    The knee is a complicated joint where various diseases can coexist. We present a case of a woman with bilateral knee osteoarthritis who's radiographic follow up allowed a 15 year watch of a bilateral medial supracondylar chondroma and of a popliteal osteochondroma of the both knees. This observation emphasizes the usefulness of repeated radiographs, not only in order to survey the evolution of the knee osteoarthritis but also to disclose the appearance and/or disappearance of other lesions in the neighborhood. PMID:12693145

  5. Knee Joint Distraction Compared to Total Knee Arthroplasty for Treatment of End Stage Osteoarthritis: Simulating Long-Term Outcomes and Cost-Effectiveness

    PubMed Central

    van der Woude, J. A. D.; Nair, S. C.; Custers, R. J. H.; van Laar, J. M.; Kuchuck, N. O.; Lafeber, F. P. J. G.; Welsing, P. M. J.

    2016-01-01

    Objective In end-stage knee osteoarthritis the treatment of choice is total knee arthroplasty (TKA). An alternative treatment is knee joint distraction (KJD), suggested to postpone TKA. Several studies reported significant and prolonged clinical improvement of KJD. To make an appropriate decision regarding the position of this treatment, a cost-effectiveness and cost-utility analysis from healthcare perspective for different age and gender categories was performed. Methods A treatment strategy starting with TKA and a strategy starting with KJD for patients of different age and gender was simulated. To extrapolate outcomes to long-term health and economic outcomes a Markov (Health state) model was used. The number of surgeries, QALYs, and treatment costs per strategy were calculated. Costs-effectiveness is expressed using the cost-effectiveness plane and cost-effectiveness acceptability curves. Results Starting with KJD the number of knee replacing procedures could be reduced, most clearly in the younger age categories; especially revision surgery. This resulted in the KJD strategy being dominant (more effective with cost-savings) in about 80% of simulations (with only inferiority in about 1%) in these age categories when compared to TKA. At a willingness to pay of 20.000 Euro per QALY gained, the probability of starting with KJD to be cost-effective compared to starting with a TKA was already found to be over 75% for all age categories and over 90–95% for the younger age categories. Conclusion A treatment strategy starting with knee joint distraction for knee osteoarthritis has a large potential for being a cost-effective intervention, especially for the relatively young patient. PMID:27171268

  6. Night-time immobilization of the distal interphalangeal joint reduces pain and extension deformity in hand osteoarthritis

    PubMed Central

    Kennedy, Donna L.; Carlisle, Katharine E.; Freidin, Andrew J.; Szydlo, Richard M.; Honeyfield, Lesley; Satchithananda, Keshthra; Vincent, Tonia L.

    2014-01-01

    Objective. DIP joint OA is common but has few cost-effective, evidence-based interventions. Pain and deformity [radial or ulnar deviation of the joint or loss of full extension (extension lag)] frequently lead to functional and cosmetic issues. We investigated whether splinting the DIP joint would improve pain, function and deformity. Methods. A prospective, radiologist-blinded, non-randomized, internally controlled trial of custom splinting of the DIP joint was carried out. Twenty-six subjects with painful, deforming DIP joint hand OA gave written, informed consent. One intervention joint and one control joint were nominated. A custom gutter splint was worn nightly for 3 months on the intervention joint, with clinical and radiological assessment at baseline, 3 and 6 months. Differences in the change were compared by the Wilcoxon signed rank test. Results. The median average pain at baseline was similar in the intervention (6/10) and control joints (5/10). Average pain (primary outcome measure) and worst pain in the intervention joint were significantly lower at 3 months compared with baseline (P = 0.002, P = 0.02). Differences between intervention and control joint average pain reached significance at 6 months (P = 0.049). Extension lag deformity was significantly improved in intervention joints at 3 months and in splinted joints compared with matched contralateral joints (P = 0.016). Conclusion. Short-term night-time DIP joint splinting is a safe, simple treatment modality that reduces DIP joint pain and improves extension of the digit, and does not appear to give rise to non-compliance, increased stiffness or joint restriction. Trial registration: clinical trials.gov, http://clinicaltrials.gov, NCT01249391. PMID:24509405

  7. Articular chondrocyte metabolism and osteoarthritis

    SciTech Connect

    Leipold, H.R.

    1989-01-01

    The three main objectives of this study were: (1) to determine if depletion of proteoglycans from the cartilage matrix that occurs during osteoarthritis causes a measurable increase of cartilage proteoglycan components in the synovial fluid and sera, (2) to observe what effect intracellular cAMP has on the expression of matrix components by chondrocytes, and (3) to determine if freshly isolated chondrocytes contain detectable levels of mRNA for fibronectin. Canine serum keratan sulfate and hyaluronate were measured to determine if there was an elevation of these serum glycosaminoglycans in a canine model of osteoarthritis. A single intra-articular injection of chymopapain into a shoulder joint increased serum keratan sulfate 10 fold and hyaluronate less than 2 fold in 24 hours. Keratan sulfate concentrations in synovial fluids of dogs about one year old were unrelated to the presence of spontaneous cartilage degeneration in the joints. High keratan sulfate in synovial fluids correlated with higher keratan sulfate in serum. The mean keratan sulfate concentration in sera of older dogs with osteoarthritis was 37% higher than disease-free controls, but the difference between the groups was not statistically significant. Treatment of chondrocytes with 0.5 millimolar (mM) dibutyryl cAMP (DBcAMP) caused the cells to adopt a more rounded morphology. There was no difference between the amount of proteins synthesized by cultures treated with DBcAMP and controls. The amount of fibronectin (FN) in the media of DBcAMP treated cultures detected by an ELISA was specifically reduced, and the amount of {sup 35}S-FN purified by gelatin affinity chromatography decreased. Moreover, the percentage of FN containing the extra domain. A sequence was reduced. Concomitant with the decrease in FN there was an increase in the concentration of keratan sulfate.

  8. Republished: Value of biomarkers in osteoarthritis: current status and perspectives

    PubMed Central

    Lotz, M; Martel-Pelletier, J; Christiansen, C; Brandi, M-L; Bruyère, O; Chapurlat, R; Collette, J; Cooper, C; Giacovelli, G; Kanis, J A; Karsdal, M A; Kraus, V; Lems, W F; Meulenbelt, I; Pelletier, J-P; Raynauld, J-P; Reiter-Niesert, S; Rizzoli, R; Sandell, L J; Van Spil, W E; Reginster, J-Y

    2014-01-01

    Osteoarthritis affects the whole joint structure with progressive changes in cartilage, menisci, ligaments and subchondral bone, and synovial inflammation. Biomarkers are being developed to quantify joint remodelling and disease progression. This article was prepared following a working meeting of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis convened to discuss the value of biochemical markers of matrix metabolism in drug development in osteoarthritis. The best candidates are generally molecules or molecular fragments present in cartilage, bone or synovium and may be specific to one type of joint tissue or common to them all. Many currently investigated biomarkers are associated with collagen metabolism in cartilage or bone, or aggrecan metabolism in cartilage. Other biomarkers are related to non-collagenous proteins, inflammation and/or fibrosis. Biomarkers in osteoarthritis can be categorised using the burden of disease, investigative, prognostic, efficacy of intervention, diagnostic and safety classification. There are a number of promising candidates, notably urinary C-terminal telopeptide of collagen type II and serum cartilage oligomeric protein, although none is sufficiently discriminating to differentiate between individual patients and controls (diagnostic) or between patients with different disease severities (burden of disease), predict prognosis in individuals with or without osteoarthritis (prognostic) or perform so consistently that it could function as a surrogate outcome in clinical trials (efficacy of intervention). Future avenues for research include exploration of underlying mechanisms of disease and development of new biomarkers; technological development; the ‘omics’ (genomics, metabolomics, proteomics and lipidomics); design of aggregate scores combining a panel of biomarkers and/or imaging markers into single diagnostic algorithms; and investigation into the relationship between biomarkers and prognosis. PMID:24534711

  9. Three-dimensional osteogenic and chondrogenic systems to model osteochondral physiology and degenerative joint diseases.

    PubMed

    Alexander, Peter G; Gottardi, Riccardo; Lin, Hang; Lozito, Thomas P; Tuan, Rocky S

    2014-09-01

    Tissue engineered constructs have the potential to function as in vitro pre-clinical models of normal tissue function and disease pathogenesis for drug screening and toxicity assessment. Effective high throughput assays demand minimal systems with clearly defined performance parameters. These systems must accurately model the structure and function of the human organs and their physiological response to different stimuli. Musculoskeletal tissues present unique challenges in this respect, as they are load-bearing, matrix-rich tissues whose functionality is intimately connected to the extracellular matrix and its organization. Of particular clinical importance is the osteochondral junction, the target tissue affected in degenerative joint diseases, such as osteoarthritis (OA), which consists of hyaline articular cartilage in close interaction with subchondral bone. In this review, we present an overview of currently available in vitro three-dimensional systems for bone and cartilage tissue engineering that mimic native physiology, and the utility and limitations of these systems. Specifically, we address the need to combine bone, cartilage and other tissues to form an interactive microphysiological system (MPS) to fully capture the biological complexity and mechanical functions of the osteochondral junction of the articular joint. The potential applications of three-dimensional MPSs for musculoskeletal biology and medicine are highlighted. PMID:24994814

  10. Role of Vitamin D in Osteoarthritis: Molecular, Cellular, and Clinical Perspectives

    PubMed Central

    Mabey, Thomas; Honsawek, Sittisak

    2015-01-01

    Osteoarthritis is a debilitating and degenerative disease which affects millions of people worldwide. The causes and mechanisms of osteoarthritis remain to be fully understood. Vitamin D has been hypothesised to play essential roles in a number of diseases including osteoarthritis. Many cell types within osteoarthritic joints appear to experience negative effects often at increased sensitivity to vitamin D. These findings contrast clinical research which has identified vitamin D deficiency to have a worryingly high prevalence among osteoarthritis patients. Randomised-controlled trial is considered to be the most rigorous way of determining the effects of vitamin D supplementation on the development of osteoarthritis. Studies into the effects of low vitamin D levels on pain and joint function have to date yielded controversial results. Due to the apparent conflicting effects of vitamin D in knee osteoarthritis, further research is required to fully elucidate its role in the development and progression of the disease as well as assess the efficacy and safety of vitamin D supplementation as a therapeutic strategy. PMID:26229532

  11. Tribological and material properties for cartilage of and throughout the bovine stifle: support for the altered joint kinematics hypothesis of osteoarthritis

    PubMed Central

    Moore, A.; Burris, D.L.

    2014-01-01

    OBJECTIVE Prior studies suggest that ligament and meniscus tears cause osteoarthritis (OA) when changes in joint kinematics bring underused and underprepared regions of cartilage into contact. This study aims to test the hypothesis that material and tribological properties vary throughout the joint according to the local mechanical environment. METHOD The local tribological and material properties of bovine stifle cartilage (N=10 joints with 20 samples per joint) were characterized under physiologically consistent contact stress and fluid pressure conditions. RESULTS Overall, cartilage from the bovine stifle had an equilibrium contact modulus of Ec0=0.620.10MPa, a tensile modulus of Et=4.30.7MPa, and a permeability of k=2.80.910?3 mm4/Ns. During sliding, the cartilage had an effective friction coefficient of ?eff =0.0240.004, an effective contact modulus of Ec=3.90.7MPa and a fluid load fraction of F?=0.810.03. Tibial cartilage exhibited significantly poorer material and tribological properties than femoral cartilage. Statistically significant differences were also detected across the femoral condyle and tibial plateau. The central femoral condyle exhibited the most favorable properties while the uncovered tibial plateau exhibited the least favorable properties. CONCLUSIONS Our findings support a previous hypothesis that altered loading patterns can cause OA by overloading underprepared regions. They also help explain why damage to the tibial plateau often precedes damage to the mating femoral condyle following joint injury in animal models. Because the variations are driven by fundamental biological processes, we anticipate similar variations in the human knee, which could explain the OA risk associated with ligament and meniscus tears. PMID:25281916

  12. Efficacy and Safety of Zhuanggu Joint Capsules in Combination with Celecoxib in Knee Osteoarthritis: A Multi-center, Randomized, Double-blind, Double-dummy, and Parallel Controlled Trial

    PubMed Central

    Zhang, Xian-Long; Yang, Jing; Yang, Liu; Liu, Jian-Guo; Cai, Xin-Yu; Fan, Wei-Ming; Yun, Xue-Qing; Ma, Jin-Zhong; Weng, Xi-Sheng

    2016-01-01

    Background: Knee osteoarthritis (KOA) is a chronic joint disease that manifests as knee pain as well as different degrees of lower limb swelling, stiffness, and movement disorders. The therapeutic goal is to alleviate or eliminate pain, correct deformities, improve or restore joint functions, and improve the quality of life. This study aimed to evaluate the efficacy and safety of Zhuanggu joint capsules combined with celecoxib and the benefit of treatment with Zhuanggu alone for KOA. Methods: This multi-center, randomized, double-blind, double-dummy, parallel controlled trial, started from December 2011 to May 2014, was carried out in 6 cities, including Beijing, Shanghai, Chongqing, Changchun, Chengdu, and Nanjing. A total of 432 patients with KOA were divided into three groups (144 cases in each group). The groups were treated, respectively, with Zhuanggu joint capsules combined with celecoxib capsule simulants, Zhuanggu joint capsules combined with celecoxib capsules, and celecoxib capsules combined with Zhuanggu joint capsule simulants for 4 weeks consecutively. The improvement of Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index and the decreased rates in each dimension of WOMAC were evaluated before and after the treatment. Intergroup and intragroup comparisons of quantitative indices were performed. Statistically significant differences were evaluated with pairwise comparisons using Chi-square test (or Fisher's exact test) and an inspection level of α = 0.0167. Results: Four weeks after treatment, the total efficacies of Zhuanggu group, combination group, and celecoxib group were 65%, 80%, and 64%, respectively, with statistically significant differences among the three groups (P = 0.005). Intergroup pairwise comparisons showed that the total efficacy of the combination group was significantly higher than that of the Zhuanggu (P = 0.005) and celecoxib (P = 0.003) groups. The difference between the latter two groups was not statistically significant (P > 0.0167). Four weeks after discontinuation, the efficacies of the three groups were 78%, 95%, and 65%, respectively, with statistically significant differences (P < 0.0001). Intergroup pairwise comparisons revealed that the efficacy of the combination group was significantly better than that of the Zhuanggu and the celecoxib groups (P < 0.0001). The difference between the latter two groups was not statistically significant (P > 0.0167). The incidences of adverse events in Zhuanggu group, combination group, and celecoxib group were 8.5%, 8.5%, and 11.1%, respectively, with insignificant differences (P > 0.05). Conclusions: Zhuanggu joint capsules alone or combined with celecoxib showed clinical efficacy in the treatment of KOA. The safety of Zhuanggu joint capsules alone or combined with celecoxib was acceptable. Trial Registration: Chinese Clinical Trial Registry, ChiCTR-IPR-15007267; http://www.medresman.org/uc/project/projectedit.aspx?proj=1364. PMID:27064031

  13. Correlation of Bone Morphogenetic Protein-2 Levels in Serum and Synovial Fluid with Disease Severity of Knee Osteoarthritis

    PubMed Central

    Liu, Yan; Hou, Ruizhi; Yin, Ruofeng; Yin, Weitian

    2015-01-01

    Background This study aimed to investigate the bone morphogenetic protein-2 (BMP-2) levels in serum and synovial fluid (SF) of patients with primary knee osteoarthritis (OA) and to exam its correlation with radiographic and symptomatic severity of the disease. Material/Methods A total of 37 knee OA patients and 20 healthy controls were enrolled in this study. Knee OA radiographic grading was performed according to the Kellgren-Lawrence (KL) grading system by evaluating X-ray changes observed in anteroposterior knee radiography. Symptomatic severity of the disease was evaluated according to the Western Ontario McMaster University Osteoarthritis Index (WOMAC) scores. BMP-2 levels in serum and SF were determined using enzyme-linked immunosorbent assay. Results Serum BMP-2 level in patients with knee OA was higher than that in healthy controls. Knee OA patients with KL grade 4 showed significantly elevated BMP-2 levels in the serum and SF compared with those with KL grade 2 and 3. Knee OA patients with KL grade 3 had significant higher SF levels of BMP-2 than those with KL grade 2. BMP-2 levels in the serum and SF of knee OA patients were both positively correlated with KL grades and WOMAC scores. Conclusions BMP2 levels in serum and SF were closely related to the radiographic and symptomatic severity of knee OA and may serve as an alternative biochemical parameter to determine disease severity of primary knee OA. PMID:25644704

  14. The Content of the 14 Metals in Cancellous and Cortical Bone of the Hip Joint Affected by Osteoarthritis

    PubMed Central

    Zioła-Frankowska, Anetta; Kubaszewski, Łukasz; Dąbrowski, Mikołaj; Kowalski, Artur; Rogala, Piotr; Strzyżewski, Wojciech; Łabędź, Wojciech; Uklejewski, Ryszard; Novotny, Karel; Kanicky, Viktor; Frankowski, Marcin

    2015-01-01

    The aim of the study was to determine the content of particular elements Ca, Mg, P, Na, K, Zn, Cu, Fe, Mo, Cr, Ni, Ba, Sr, and Pb in the proximal femur bone tissue (cancellous and cortical bone) of 96 patients undergoing total hip replacement for osteoarthritis using ICP-AES and FAAS analytical techniques. The interdependencies among these elements and their correlations depended on factors including age, gender, place of residence, tobacco consumption, alcohol consumption, exposure to environmental pollution, physical activity, and type of degenerative change which were examined by statistical and chemometric methods. The factors that exerted the greatest influence on the elements in the femoral head and neck were tobacco smoking (higher Cr and Ni content in smokers), alcohol consumption (higher concentrations of Ni, Cu in people who consume alcohol), and gender (higher Cu, Zn, and Ni concentrations in men). The factors influencing Pb accumulation in bone tissue were tobacco, alcohol, gender, and age. In primary and secondary osteoarthritis of the hip, the content and interactions of elements are different (mainly those of Fe and Pb). There were no significant differences in the concentrations of elements in the femoral head and neck that could be attributed to residence or physical activity. PMID:26357659

  15. The Content of the 14 Metals in Cancellous and Cortical Bone of the Hip Joint Affected by Osteoarthritis.

    PubMed

    Zioła-Frankowska, Anetta; Kubaszewski, Łukasz; Dąbrowski, Mikołaj; Kowalski, Artur; Rogala, Piotr; Strzyżewski, Wojciech; Łabędź, Wojciech; Uklejewski, Ryszard; Novotny, Karel; Kanicky, Viktor; Frankowski, Marcin

    2015-01-01

    The aim of the study was to determine the content of particular elements Ca, Mg, P, Na, K, Zn, Cu, Fe, Mo, Cr, Ni, Ba, Sr, and Pb in the proximal femur bone tissue (cancellous and cortical bone) of 96 patients undergoing total hip replacement for osteoarthritis using ICP-AES and FAAS analytical techniques. The interdependencies among these elements and their correlations depended on factors including age, gender, place of residence, tobacco consumption, alcohol consumption, exposure to environmental pollution, physical activity, and type of degenerative change which were examined by statistical and chemometric methods. The factors that exerted the greatest influence on the elements in the femoral head and neck were tobacco smoking (higher Cr and Ni content in smokers), alcohol consumption (higher concentrations of Ni, Cu in people who consume alcohol), and gender (higher Cu, Zn, and Ni concentrations in men). The factors influencing Pb accumulation in bone tissue were tobacco, alcohol, gender, and age. In primary and secondary osteoarthritis of the hip, the content and interactions of elements are different (mainly those of Fe and Pb). There were no significant differences in the concentrations of elements in the femoral head and neck that could be attributed to residence or physical activity. PMID:26357659

  16. Effects of prescription non-steroidal anti-inflammatory agents on symptoms and disease progression among patients with knee osteoarthritis

    PubMed Central

    Lapane, Kate L.; Yang, Shibing; Driban, Jeffrey B.; Liu, Shao-Hsien; Dub, Catherine E.; McAlindon, Timothy E.; Eaton, Charles B.

    2014-01-01

    Objective The effect of short and long term non-steroidal anti-inflammatory agents (NSAIDs) use on structural change is equivocal. We estimate the extent to which recent and long-term use of prescription NSAIDs relieve symptoms and delay structural progression among patients with radiographically confirmed osteoarthritis (OA) of the knee. Methods We applied a new-user design among participants with confirmed OA not reporting NSAID use at enrollment in the Osteoarthritis Initiative. Participants were evaluated for changes in the Western Ontario and McMaster Universities Arthritis Index, WOMAC (n=1,846) and joint space width measured using serial x-rays and a customized software tool (n=1,116) over 4 years. We used marginal structural modeling to estimate the effect of NSAIDs. Results Compared to participants who never reported prescription NSAID use, those reporting use at 1 or 2 assessments had no clinically important changes, but those reporting prescription NSAID use on all 3 assessments had on average 0.88 point improvement over the follow-up period (95% Confidence Interval (CI): -0.46 to 2.22) in Pain, 0.72 point improvement (95% CI: -0.12 to 1.56) in Stiffness, 4.27 points improvement (95% CI: -0.31 to 8.84) in Function, and decreased by 0.28mm in joint space width (95% CI: -0.06 to 0.62) less than no use. Recent NSAID use findings were not clinically or statistically significant. Conclusions Long term but not recent NSAID use was associated with a priori defined minimally important clinical change in stiffness, function and structural change but not in pain. While showing modest clinical importance, estimates did not reach statistical significance. PMID:25369996

  17. Recognition of Immune Response for the Early Diagnosis and Treatment of Osteoarthritis

    PubMed Central

    Kandahari, Adrese M.; Yang, Xinlin; Dighe, Abhijit S.; Pan, Dongfeng; Cui, Quanjun

    2015-01-01

    Osteoarthritis is a common and debilitating joint disease that affects up to 30 million Americans, leading to significant disability, reduction in quality of life, and costing the United States tens of billions of dollars annually. Classically, osteoarthritis has been characterized as a degenerative, wear-and-tear disease, but recent research has identified it as an immunopathological disease on a spectrum between healthy condition and rheumatoid arthritis. A systematic literature review demonstrates that the disease pathogenesis is driven by an early innate immune response which progressively catalyzes degenerative changes that ultimately lead to an altered joint microenvironment. It is feasible to detect this infiltration of cells in the early, and presumably asymptomatic, phase of the disease through noninvasive imaging techniques. This screening can serve to aid clinicians in potentially identifying high-risk patients, hopefully leading to early effective management, vast improvements in quality of life, and significant reductions in disability, morbidity, and cost related to osteoarthritis. Although the diagnosis and treatment of osteoarthritis routinely utilize both invasive and non-invasive strategies, imaging techniques specific to inflammatory cells are not commonly employed for these purposes. This review discusses this paradigm and aims to shift the focus of future osteoarthritis-related research towards early diagnosis of the disease process. PMID:26064995

  18. Biomarkers for osteoarthritis: current position and steps towards further validation.

    PubMed

    Hunter, David J; Nevitt, Michael; Losina, Elena; Kraus, Virginia

    2014-02-01

    Historically disease knowledge development and treatment innovation in osteoarthritis (OA) has been considered to be slow. One of the many reasons purported as responsible for this slow pace has been the alleged lack of valid and responsive biomarkers to ascertain efficacy, which itself has been dependent upon the slow evolution of the understanding of the complex nature of joint tissue biology. This narrative review outlines the rationale for why we need OA biomarkers with regard to biomarker validation and qualification. The main biomarkers in current development for OA are biochemical and imaging markers. We describe an approach to biomarker validation and qualification for OA clinical trials that has recently commenced with the Foundation of NIH OA Biomarkers Consortium study cosponsored by the Osteoarthritis Research Society International (OARSI). With this approach we endeavor to identify, develop, and qualify biological markers (biomarkers) to support new drug development, preventive medicine, and medical diagnostics for osteoarthritis. PMID:24792945

  19. Association between Wnt inhibitory factor-1 expression levels in articular cartilage and the disease severity of patients with osteoarthritis of the knee

    PubMed Central

    GAO, SHU-GUANG; ZENG, CHAO; LIU, JUN-JIE; TIAN, JIAN; CHENG, CHAO; ZHANG, FANG-JIE; XIONG, YI-LIN; PAN, DING; XIAO, YONG-BING; LEI, GUANG-HUA

    2016-01-01

    Wnt inhibitory factor (WIF)-1 is a potent extracellular Wnt antagonist which may be used as a potential molecular therapy for the treatment of inflammatory and autoimmune diseases. Although previous studies have demonstrated that WIF-1 has a protective role in experimental studies of arthritis, its role in the various disease grades of osteoarthritis (OA) remains unclear. A total of 40 patients with various stages of primary OA of the knee and 10 control subjects were enrolled in the present study. Articular cartilage specimens were harvested from subjects following total knee arthroplasty or knee above amputation. Disease severity was determined according to Modified Mankin score and cartilage tissues were ascribed to four groups: Normal, mild, moderate and severe lesions. WIF-1 expression levels in articular cartilage were measured using immunohistochemical techniques. WIF-1 expression levels were detected in all cartilage tissues. As compared with the controls, patients with OA exhibited significantly decreased WIF-1 expression levels in the articular cartilage (0.19±0.05 vs. 0.26±0.04; P<0.01). Furthermore, articular cartilage WIF-1 expression levels in the moderate and severe lesion groups were significantly reduced, as compared with the controls (P<0.01) and mild lesion group (P<0.05). Subsequent analysis demonstrated that articular cartilage WIF-1 expression levels were negatively correlated with the severity of disease (r=−0.896, P<0.001). In conclusion, the results of the present study suggested that WIF-1 expression levels in articular cartilage may be negatively associated with progressive joint damage in patients with OA of the knee; therefore, WIF-1 expression may be a potential indictor for monitoring OA disease severity. PMID:27073457

  20. A combination of Scutellaria baicalensis and Acacia catechu extracts for short-term symptomatic relief of joint discomfort associated with osteoarthritis of the knee.

    PubMed

    Arjmandi, Bahram H; Ormsbee, Lauren T; Elam, Marcus L; Campbell, Sara C; Rahnama, Nader; Payton, Mark E; Brummel-Smith, Ken; Daggy, Bruce P

    2014-06-01

    The extracts of Scutellaria baicalensis and Acacia catechu have been shown in previous studies to alleviate joint discomfort, reduce stiffness, and improve mobility by reducing the production of proinflammatory molecules over long periods of supplementation. The acute effects of intake of these extracts have not yet been investigated. Thus, we carried out a 1 week clinical trial to examine the extent to which UP446-a natural proprietary blend of S. baicalensis and A. catechu (UP446)-decreases knee joint pain, mobility, and biomarkers of inflammation in comparison to naproxen. Seventy-nine men and women (40-90 years old) diagnosed as having mild to moderate osteoarthritis (OA) consumed either 500 mg/day of the UP446 supplement or 440 mg/day of naproxen for 1 week in a double-blind randomized control trial. Pain, knee range of motion (ROM), and overall physical activity were evaluated at the start and at the end of treatment. Fasting blood was collected to determine serum interleukins 1β and 6, tumor necrosis factor-α, C-reactive protein, and hyaluronic acid. The UP446 group experienced a significant decrease in perceived pain (P=.009) time dependently. Stiffness was significantly reduced by both treatments (P=.002 UP446, P=.008 naproxen). Significant increases in mean ROM over time (P=.04) were found in the UP446 group. These findings suggest that UP446 is effective in reducing the physical symptoms associated with knee OA. PMID:24611484

  1. What Is Osteoarthritis?

    MedlinePlus

    ... their doctor or other health care providers Solve problems. People with osteoarthritis find that self-management programs help them: Understand the disease Reduce pain while staying active Cope with their body, mind, and emotions Have more control over the disease ...

  2. Early and stable upregulation of collagen type II, collagen type I and YKL40 expression levels in cartilage during early experimental osteoarthritis occurs independent of joint location and histological grading.

    PubMed

    Lorenz, Helga; Wenz, Wolfram; Ivancic, Mate; Steck, Eric; Richter, Wiltrud

    2005-01-01

    While morphologic and biochemical aspects of degenerative joint disease (osteoarthritis [OA]) have been elucidated by numerous studies, the molecular mechanisms underlying the progressive loss of articular cartilage during OA development remain largely unknown. The main focus of the present study was to gain more insight into molecular changes during the very early stages of mechanically induced cartilage degeneration and to relate molecular alterations to histological changes at distinct localizations of the joint. Studies on human articular cartilage are hampered by the difficulty of obtaining normal tissue and early-stage OA tissue, and they allow no progressive follow-up. An experimental OA model in dogs with a slow natural history of OA (Pond-Nuki model) was therefore chosen. Anterior cruciate ligament transection (ACLT) was performed on 24 skeletally mature dogs to induce joint instability resulting in OA. Samples were taken from different joint areas after 6, 12, 24 and 48 weeks, and gene expression levels of common cartilage molecules were quantified in relation to the histological grading (modified Mankin score) of adjacent tissue. Histological changes reflected early progressive degenerative OA. Soon after ACLT, chondrocytes responded to the altered mechanical conditions by significant and stable elevation of collagen type II, collagen type I and YKL40 expression, which persisted throughout the study. In contrast to the mild to moderate histological alterations, these molecular changes were not progressive and were independent of the joint localization (tibia, femur, lateral, medial) and the extent of matrix degeneration. MMP13 remained unaltered until 24 weeks, and aggrecan and tenascinC remained unaltered until 48 weeks after ACLT. These findings indicate that elevated collagen type II, collagen type I and YKL40 mRNA expression levels are early and sensitive measures of ACLT-induced joint instability independent of a certain grade of morphological cartilage degeneration. A second phase of molecular changes in OA may begin around 48 weeks after ACLT with altered expression of further genes, such as MMP13, aggrecan and tenascin. Molecular changes observed in the present study suggest that dog cartilage responds to degenerative conditions by regulating the same genes in a similar direction as that observed for chondrocytes in late human OA. PMID:15642136

  3. Naturally-occurring osteoarthritis in the domestic rabbit: possible implications for bioengineering research

    PubMed Central

    Arzi, Boaz; Wisner, Erik R.; Huey, Daniel J.; Kass, Philip H.; Hu, Jerry; Athanasiou, Kyriacos A.

    2015-01-01

    Objective Osteoarthritis affects 1 in 8 American adults over the age of 25 and in the US is a leading cause of chronic disability. Therefore, researchers are pursuing investigations on treating this naturally occurring joint disease. Finding the appropriate animal model for translational purposes is of utmost importance. The aim of the present study is to report the occurrence of naturally-occurring osteoarthritis in the domestic rabbit in the context of an appropriate animal model system. Methods A six-year radiographic retrospective study of domestic rabbits was conducted to assess the presence and severity of naturally occurring osteoarthritis in four major joints: the hip, knee, shoulder, and elbow. Results The rabbit experiences radiographic signs of naturally-occurring osteoarthritis. There was a significant influence of age on the development of the disease. Rabbits begin to have radiographic signs of the disease as early as 1 year of age with older rabbits experiencing over 70% occurrence. The most commonly effected joints were the knee and the hip. In addition, there was certain correlation of weight with the occurrence of osteoarthritis. Conclusion Discovery of new osteoarthritis treatment modalities relies on documenting efficacy in a relevant animal model prior to clinical translation. Despite previous claims on the ability of the rabbit’s cartilage to heal spontaneously and readily repair, we demonstrate that radiographically rabbits demonstrate progressive osteoarthritis. We have found that the rabbit is an excellent spontaneously arising model that may allow a predictable translation of results obtained in bioengineering experiments pertaining to the naturally occurring human disease. PMID:22184086

  4. Innate Immunity Sensors Participating in Pathophysiology of Joint Diseases: A Brief Overview

    PubMed Central

    Gallo, Jiri; Raska, Milan; Konttinen, Yrjö T.; Nich, Christophe; Goodman, Stuart B.

    2015-01-01

    The innate immune system consists of functionally specialized “modules” that are activated in response to a particular set of stimuli via sensors located on the surface or inside the tissue cells. These cells screen tissues for a wide range of exogenous and endogenous danger/damage-induced signals with the aim to reject or tolerate them and maintain tissue integrity. In this line of thinking, inflammation evolved as an adaptive tool for restoring tissue homeostasis. A number of diseases are mediated by a maladaptation of the innate immune response, perpetuating chronic inflammation and tissue damage. Here, we review recent evidence on the cross talk between innate immune sensors and development of rheumatoid arthritis, osteoarthritis, and aseptic loosening of total joint replacements. In relation to the latter topic, there is a growing body of evidence that aseptic loosening and periprosthetic osteolysis results from long-term maladaptation of periprosthetic tissues to the presence of by-products continuously released from an artificial joint. PMID:25747032

  5. Treatment of Nongout Joint Deposition Diseases: An Update

    PubMed Central

    Richette, Pascal; Flipo, René-Marc

    2014-01-01

    This update develops the actual therapeutic options in the management of the joint involvement of calcium pyrophosphate deposition disease (CPPD), basic calcium phosphate (BCP) deposition disease, hemochromatosis (HH), ochronosis, oxalosis, and Wilson's disease. Conventional pharmaceutical treatment provides benefits for most diseases. Anti-interleukine-1 (IL-1) treatment could provide similar results in CPPD than in gout flares. There is only limited evidence about the efficacy of preventive long-term colchicine intake, methotrexate, and hydroxychloroquine in chronic CPPD. Needle aspiration and lavage have satisfactory short and midterm results in BCP. Extracorporeal shockwave therapy has also proved its efficacy for high-doses regimes. Phlebotomy does not seem to have shown real efficacy on joint involvement in HH so far. Iron chelators' effects have not been assessed on joint involvement either, while IL-1 blockade may prove useful. NSAIDs have limited efficacy on joint involvement of oxalosis, while colchicine and steroids have not been assessed either. The use of nitisinone for ochronotic arthropathy is still much debated, but it could provide beneficial effects on joint involvement. The effects of copper chelators have not been assessed either in the joint involvement of Wilson's disease. NSAIDs should be avoided because of the liver affection they may worsen. PMID:24895535

  6. What is the predictive value of MRI for the occurrence of knee replacement surgery in knee osteoarthritis?

    PubMed

    Pelletier, J-P; Cooper, C; Peterfy, C; Reginster, J-Y; Brandi, M-L; Bruyère, O; Chapurlat, R; Cicuttini, F; Conaghan, P G; Doherty, M; Genant, H; Giacovelli, G; Hochberg, M C; Hunter, D J; Kanis, J A; Kloppenburg, M; Laredo, J-D; McAlindon, T; Nevitt, M; Raynauld, J-P; Rizzoli, R; Zilkens, C; Roemer, F W; Martel-Pelletier, J; Guermazi, A

    2013-10-01

    Knee osteoarthritis is associated with structural changes in the joint. Despite its many drawbacks, radiography is the current standard for evaluating joint structure in trials of potential disease-modifying osteoarthritis drugs. MRI is a non-invasive alternative that provides comprehensive imaging of the whole joint. Frequently used MRI measurements in knee osteoarthritis are cartilage volume and thickness; others include synovitis, synovial fluid effusions, bone marrow lesions (BML) and meniscal damage. Joint replacement is considered a clinically relevant outcome in knee osteoarthritis; however, its utility in clinical trials is limited. An alternative is virtual knee replacement on the basis of symptoms and structural damage. MRI may prove to be a good alternative to radiography in definitions of knee replacement. One of the MRI parameters that predicts knee replacement is medial compartment cartilage volume/thickness, which correlates with radiographic joint space width, is sensitive to change, and predicts outcomes in a continuous manner. Other MRI parameters include BML and meniscal lesions. MRI appears to be a viable alternative to radiography for the evaluation of structural changes in knee osteoarthritis and prediction of joint replacement. PMID:23887285

  7. Characterization of joint disease in mucopolysaccharidosis type I mice

    PubMed Central

    de Oliveira, Patricia G; Baldo, Guilherme; Mayer, Fabiana Q; Martinelli, Barbara; Meurer, Luise; Giugliani, Roberto; Matte, Ursula; Xavier, Ricardo M

    2013-01-01

    Mucopolysaccharidoses (MPS) are lysosomal storage disorders characterized by mutations in enzymes that degrade glycosaminoglycans (GAGs). Joint disease is present in most forms of MPS, including MPS I. This work aimed to describe the joint disease progression in the murine model of MPS I. Normal (wild-type) and MPS I mice were sacrificed at different time points (from 2 to 12 months). The knee joints were collected, and haematoxylin–eosin staining was used to evaluate the articular architecture. Safranin-O and Sirius Red staining was used to analyse the proteoglycan and collagen content. Additionally, we analysed the expression of the matrix-degrading metalloproteinases (MMPs), MMP-2 and MMP-9, using immunohistochemistry. We observed progressive joint alterations from 6 months, including the presence of synovial inflammatory infiltrate, the destruction and thickening of the cartilage extracellular matrix, as well as proteoglycan and collagen depletion. Furthermore, we observed an increase in the expression of MMP-2 and MMP-9, which could conceivably explain the degenerative changes. Our results suggest that the joint disease in MPS I mice may be caused by a degenerative process due to increase in proteases expression, leading to loss of collagen and proteoglycans. These results may guide the development of ancillary therapies for joint disease in MPS I. PMID:23786352

  8. Premature development of erosive osteoarthritis of hands in patients with chronic renal failure.

    PubMed

    Duncan, I J; Hurst, N P; Sebben, R; Milazzo, S C; Disney, A

    1990-06-01

    The prevalence of grade III or IV osteoarthritis was determined in 210 patients with chronic renal failure, of whom 94 were receiving chronic haemodialysis and 116 had functioning renal transplants. The prevalence of grade III or IV osteoarthritis was three times greater in patients under 65 than in a control population, and all but two affected patients also had erosion of subchondral bone in at least one affected joint. The excess of osteoarthritis was apparent in both the transplant recipients and those receiving haemodialysis. Over the age of 65 there was no significant difference in prevalence. Metabolic bone disease, including osteopenia, might contribute to the development of erosive osteoarthritis in chronic renal failure. PMID:2383060

  9. Mesenchymal stem cell therapy in the treatment of osteoarthritis: reparative pathways, safety and efficacy - a review.

    PubMed

    Freitag, Julien; Bates, Dan; Boyd, Richard; Shah, Kiran; Barnard, Adele; Huguenin, Leesa; Tenen, Abi

    2016-01-01

    Osteoarthritis is a leading cause of pain and disability across the world. With an aging population its prevalence is likely to further increase. Current accepted medical treatment strategies are aimed at symptom control rather than disease modification. Surgical options including joint replacement are not without possible significant complications. A growing interest in the area of regenerative medicine, led by an improved understanding of the role of mesenchymal stem cells in tissue homeostasis and repair, has seen recent focused efforts to explore the potential of stem cell therapies in the active management of symptomatic osteoarthritis. Encouragingly, results of pre-clinical and clinical trials have provided initial evidence of efficacy and indicated safety in the therapeutic use of mesenchymal stem cell therapies for the treatment of knee osteoarthritis. This paper explores the pathogenesis of osteoarthritis and how mesenchymal stem cells may play a role in future management strategies of this disabling condition. PMID:27229856

  10. Synovial fluid hyaluronan mediates MSC attachment to cartilage, a potential novel mechanism contributing to cartilage repair in osteoarthritis using knee joint distraction

    PubMed Central

    Mastbergen, Simon C; Jones, Elena; Calder, Stuart J; Lafeber, Floris P J G; McGonagle, Dennis

    2016-01-01

    Objectives Knee joint distraction (KJD) is a novel, but poorly understood, treatment for osteoarthritis (OA) associated with remarkable ‘spontaneous’ cartilage repair in which resident synovial fluid (SF) multipotential mesenchymal stromal cells (MSCs) may play a role. We hypothesised that SF hyaluronic acid (HA) inhibited the initial interaction between MSCs and cartilage, a key first step to integration, and postulate that KJD environment favoured MSC/cartilage interactions. Methods Attachment of dual-labelled SF-MSCs were assessed in a novel in vitro human cartilage model using OA and rheumatoid arthritic (RA) SF. SF was digested with hyaluronidase (hyase) and its effect on adhesion was observed using confocal microscopy. MRI and microscopy were used to image autologous dual-labelled MSCs in an in vivo canine model of KJD. SF-HA was investigated using gel electrophoresis and densitometry. Results Osteoarthritic-synovial fluid (OA-SF) and purified high molecular weight (MW) HA inhibited SF-MSC adhesion to plastic, while hyase treatment of OA-SF but not RA-SF significantly increased MSC adhesion to cartilage (3.7-fold, p<0.05) These differences were linked to the SF mediated HA-coat which was larger in OA-SF than in RA-SF. OA-SF contained >9 MDa HA and this correlated with increases in adhesion (r=0.880). In the canine KJD model, MSC adhesion to cartilage was evident and also dependent on HA MW. Conclusions These findings highlight an unappreciated role of SF-HA on MSC interactions and provide proof of concept that endogenous SF-MSCs are capable of adhering to cartilage in a favourable biochemical and biomechanical environment in OA distracted joints, offering novel one-stage strategies towards joint repair. PMID:25948596

  11. [Genetics in osteoarthritis].

    PubMed

    Fernández-Moreno, Mercedes; Rego, Ignacio; Blanco, Francisco J

    2007-10-01

    Osteoarthritis is a degenerative articular pathology with complex pathogeny because diverse factors interact causing a process of deterioration of the cartilage. In spite of the multifactorial nature of this pathology, from years 50 one knows that certain forms of osteoarthritis are related to a strong genetic component. The genetic bases of this disease do not follow the typical patterns of mendelian inheritance and probably they are related to alterations in multiple genes. The identification of a high number of candidates genes to confer susceptibility to the development of the osteoarthritis shows the complex nature of this disease. At the moment, the genetic mechanisms of this pathology are not known, however, which seems clear is that levels of expression of several genes are altered, and that the inheritance will become a substantial factor in future considerations of diagnosis and treatment of the osteoarthitis. PMID:21794474

  12. Femoral neck erosions: sign of hip joint synovial disease

    SciTech Connect

    Goldberg, R.P.; Weissman, B.N.; Naimark, A.

    1983-07-01

    Pathologic synovial processes in the hip joint can cause characteristic extrinsic erosions of the femoral neck, which in extreme cases produce an ''apple core'' appearance. Nine such cases of synovial diseases, including synovial osteochondromatosis, pigmented villonodular synovitis, rheumatoid arthritis, and amyloidosis, that demonstrate this radiographic finding are presented. The anatomic relations of the hip joint that result in theis appearance, differential diagnosis, and radiographic techniques useful in diagnosis are discussed.

  13. Post-Injury Response Could Be Key Step in Osteoarthritis Development

    MedlinePlus

    ... Post-Injury Response Could be Key Step in Osteoarthritis Development Scientists long considered osteoarthritis (OA) a disease of wear and tear. Use ... play an important role in the initiation of osteoarthritis and its early progression, says V. Michael Holers, ...

  14. Nutritional management of osteoarthritis.

    PubMed

    Perea, Sally

    2012-05-01

    There is growing evidence of the role that nutrition can play in the management of veterinary patients with osteoarthritis. Current evidence supports nutritional management of body weight and dietary fortification with the long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid. Additional studies suggest that supplements and diet additives such as glucosamine, chondroitin sulfate, antioxidants, and green-lipped mussel may also have some benefit in managing osteoarthritis. Additional research evaluating pets with naturally occurring disease, using validated owner questionnaires and objective measurements, is needed. PMID:22581724

  15. Benefits of antioxidant supplements for knee osteoarthritis: rationale and reality.

    PubMed

    Grover, Ashok Kumar; Samson, Sue E

    2016-01-01

    Arthritis causes disability due to pain and inflammation in joints. There are many forms of arthritis, one of which is osteoarthritis whose prevalence increases with age. It occurs in various joints including hip, knee and hand with knee osteoarthritis being more prevalent. There is no cure for it. The management strategies include exercise, glucosamine plus chondroitin sulfate and NSAIDs. In vitro and animal studies provide a rationale for the use of antioxidant supplements for its management. This review assesses the reality of the benefits of antioxidant supplements in the management of knee osteoarthritis. Several difficulties were encountered in examining this issue: poorly conducted studies, a lack of uniformity in disease definition and diagnosis, and muddling of conclusions from attempts to isolate the efficacious molecules. The antioxidant supplements with most evidence for benefit for pain relief and function in knee osteoarthritis were based on curcumin and avocado-soya bean unsaponifiables. Boswellia and some herbs used in Ayurvedic and Chinese medicine may also be useful. The benefits of cuisines with the appropriate antioxidants should be assessed because they may be more economical and easier to incorporate into the lifestyle. PMID:26728196

  16. [Conservative Therapy of Osteoarthritis].

    PubMed

    Krasselt, Marco; Baerwald, Christoph

    2015-12-01

    The therapy of osteoarthritis is based on conservative therapeutic approaches, depending on the disease's severity. In this context, physical therapy and the use of sufficient analgesic regimes are of decisive importance. This article will discuss the current evidence based therapeutic concepts as well as promising new therapeutic approaches. PMID:26625235

  17. Presence of MRI-detected joint effusion and synovitis increases the risk of cartilage loss in knees without osteoarthritis at 30-month follow-up: the MOST study

    PubMed Central

    Roemer, Frank W.; Guermazi, Ali; Felson, David T.; Niu, Jingbo; Nevitt, Michael C.; Crema, Michel D.; Lynch, John A.; Lewis, Cora E.; Torner, James; Zhang, Yuqing

    2012-01-01

    Objective To evaluate if two different measures of synovial activation, baseline Hoffa-synovitis and effusion-synovitis, assessed by MRI, predict cartilage loss in the tibiofemoral joint at 30 months follow-up in subjects with neither cartilage damage nor tibiofemoral radiographic osteoarthritis (OA) of the knee. Methods Non-contrast enhanced MRI was performed using proton density-weighted fat-suppressed sequences in the axial and sagittal planes and a STIR sequence in the coronal plane. Hoffa-synovitis, effusion-synovitis and cartilage status were assessed semiquantitatively according to the WORMS scoring system. Included were knees that had neither radiographic OA nor MRI-detected tibio-femoral cartilage damage at the baseline visit. Presence of Hoffa-synovitis was defined as any grade ≥2 (range from 0–3) and effusion-synovitis as any grade ≥2 (range from 0–3). We performed logistic regression to examine the relation of presence of either measure to the risk of cartilage loss at 30 months adjusting for other potential confounders of cartilage loss. Results Of 514 knees included in the analysis, prevalence of Hoffa-synovitis and effusion-synovitis at the baseline visit was 8.4% and 10.3%, respectively. In the multivariable analysis, baseline effusion-synovitis was associated with an increased risk for cartilage loss (odds ratio (OR) = 2.7, 95% confidence intervals 1.4–5.1, p=0.002); however, no such an association was observed for baseline Hoffa-synovitis (OR =1.0, 95% confidence intervals 0.5–2.0). Conclusions Baseline effusion-synovitis, but not Hoffa-synovitis, predicted cartilage loss. Our findings suggest that effusion-synovitis, a reflection of inflammatory activity including joint effusion and synovitic thickening, may play a role in future development of cartilage lesions in knees without OA. PMID:21791448

  18. The Articular Morphology of the First Carpometacarpal Joint Does Not Differ between Men and Women, but Changes with Aging and Early Stage Osteoarthritis

    PubMed Central

    Halilaj, Eni; Moore, Douglas C.; Laidlaw, David H.; Got, Christopher J.; Weiss, Arnold-Peter C.; Ladd, Amy L.; Crisco, Joseph J.

    2014-01-01

    The increased prevalence of thumb carpometacarpal (CMC) joint osteoarthritis (OA) in women has been previously linked to the articular morphology of the trapezium. However, studies report conflicting results on how the articular shapes of male and female trapezia compare to one another, mainly because their findings are based on data from older cadaver specimens. The purpose of this in vivo study was to dissociate the effect of sex from that of aging and early OA by using cohorts of healthy young and healthy older subjects, as well as patients with early stage OA. Computed tomography scans from 68 healthy subjects and 87 arthritic subjects were used to obtain 3-D bone models. The trapezial and metacarpal articular surfaces were manually delineated on scaled bone models, to remove the effect of size, and then were compared between sex, age, and health groups by using polar histograms of curvature and average curvature values. We found no sex differences, but significant age-group and health-group differences, in the articular surfaces of both bones. The older healthy subjects had higher curvature in the concave and lower curvature in the convex directions of both the trapezial and metacarpal saddles than the healthy young subjects. Subjects with early OA had significantly different metacarpal and trapezial articular shapes from healthy subjects. These findings suggest that aging and OA affect the articular shape of the CMC joint, but that, in contrast to previously held beliefs, inherent sex differences are not responsible for the higher incidence of CMC OA in women. PMID:24909332

  19. Rapid, automated imaging of mouse articular cartilage by microCT for early detection of osteoarthritis and finite element modelling of joint mechanics

    PubMed Central

    Das Neves Borges, P.; Forte, A.E.; Vincent, T.L.; Dini, D.; Marenzana, M.

    2014-01-01

    Summary Objective Mouse articular cartilage (AC) is mostly assessed by histopathology and its mechanics is poorly characterised. In this study: (1) we developed non-destructive imaging for quantitative assessment of AC morphology and (2) evaluated the mechanical implications of AC structural changes. Methods Knee joints obtained from nave mice and from mice with osteoarthritis (OA) induced by destabilization of medial meniscus (DMM) for 4 and 12 weeks, were imaged by phosphotungstic acid (PTA) contrast enhanced micro-computed tomography (PTA-CT) and scored by conventional histopathology. Our software (Matlab) automatically segmented tibial AC, drew two regions centred on each tibial condyle and evaluated the volumes included. A finite element (FE) model of the whole mouse joint was implemented to evaluate AC mechanics. Results Our method achieved rapid, automated analysis of mouse AC (structural parameters in <10hfrom knee dissection) and was able to localise AC loss in the central region of the medial tibial condyle. AC thickness decreased by 15% at 4 weeks and 25% at 12 weeks post DMM surgery, whereas histopathology scores were significantly increased only at 12 weeks. FE simulations estimated that AC thinning at early-stages in the DMM model (4 weeks) increases contact pressures (+39%) and Tresca stresses (+43%) in AC. Conclusion PTA-CT imaging is a fast and simple method to assess OA in murine models. Once applied more extensively to confirm its robustness, our approach will be useful for rapidly phenotyping genetically modified mice used for OA research and to improve the current understanding of mouse cartilage mechanics. PMID:25278053

  20. Single Molecule Microscopy Reveals an Increased Hyaluronan Diffusion Rate in Synovial Fluid from Knees Affected by Osteoarthritis

    PubMed Central

    Kohlhof, Hendrik; Gravius, Sascha; Kohl, Sandro; Ahmad, Sufian S.; Randau, Thomas; Schmolders, Jan; Rommelspacher, Yorck; Friedrich, Max; Kaminski, Tim P.

    2016-01-01

    Osteoarthritis is a common and progressive joint disorder. Despite its widespread, in clinical practice only late phases of osteoarthritis that are characterized by severe joint damage are routinely detected. Since osteoarthritis cannot be cured but relatively well managed, an early diagnosis and thereby early onset of disease management would lower the burden of osteoarthritis. Here we evaluated if biophysical parameters of small synovial fluid samples extracted by single molecule microscopy can be linked to joint damage. In healthy synovial fluid (ICRS-score < 1) hyaluronan showed a slower diffusion (2.2 μm2/s, N = 5) than in samples from patients with joint damage (ICRS-score > 2) (4.5 μm2/s, N = 16). More strikingly, the diffusion coefficient of hyaluronan in healthy synovial fluid was on average 30% slower than expected by sample viscosity. This effect was diminished or missing in samples from patients with joint damage. Since single molecule microscopy needs only microliters of synovial fluid to extract the viscosity and the specific diffusion coefficient of hyaluronan this method could be of use as diagnostic tool for osteoarthritis. PMID:26868769

  1. Mild Joint Symptoms Are Associated with Lower Risk of Falls than Asymptomatic Individuals with Radiological Evidence of Osteoarthritis

    PubMed Central

    Ng, Chin Teck; Fadzli, Farhana; Rozalli, Faizatul I.; Khoo, Ee Ming; Hill, Keith D.; Tan, Maw Pin

    2015-01-01

    Osteoarthritis (OA) exacerbates skeletal muscle functioning, leading to postural instability and increased falls risk. However, the link between impaired physical function, OA and falls have not been elucidated. We investigated the role of impaired physical function as a potential mediator in the association between OA and falls. This study included 389 participants [229 fallers (≥2 falls or one injurious fall in the past 12 months), 160 non-fallers (no history of falls)], age (≥65 years) from a randomized controlled trial, the Malaysian Falls Assessment and Intervention Trial (MyFAIT). Physical function was assessed using Timed Up and Go (TUG) and Functional Reach (FR) tests. Knee and hip OA were diagnosed using three methods: Clinical, Radiological and Self-report. OA symptom severity was assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). The total WOMAC score was categorized to asymptomatic, mild, moderate and severe symptoms. Individuals with radiological OA and ‘mild’ overall symptoms on the WOMAC score had reduced risk of falls compared to asymptomatic OA [OR: 0.402(0.172–0.940), p = 0.042]. Individuals with clinical OA and ‘severe’ overall symptoms had increased risk of falls compared to those with ‘mild’ OA [OR: 4.487(1.883–10.693), p = 0.005]. In individuals with radiological OA, mild symptoms appear protective of falls while those with clinical OA and severe symptoms have increased falls risk compared to those with mild symptoms. Both relationships between OA and falls were not mediated by physical limitations. Larger prospective studies are needed for further evaluation. PMID:26491868

  2. Erosive osteoarthritis: a more severe form of radiographic hand osteoarthritis rather than a distinct entity?

    PubMed Central

    Marshall, Michelle; Nicholls, Elaine; Kwok, Wing-Yee; Peat, George; Kloppenburg, Margreet; van der Windt, Danielle; Myers, Helen; Dziedzic, Krysia

    2015-01-01

    Objectives To determine whether erosive osteoarthritis shares the same pattern of joint involvement and risk profile as increasing grades of non-erosive hand osteoarthritis. Methods Participants were from two population-based cohorts, aged ≥50 years, reporting hand symptoms in the previous month. Interphalangeal joints were assessed for erosive osteoarthritis (Verbruggen–Veys erosive or remodelled phase) and radiographic osteoarthritis (sliding cut-offs of K&L≥2, K&L≥3 and K&L=4). At the joint level, similarities in the frequency and pattern of erosive and non-erosive osteoarthritis were assessed by Spearman's rank correlation coefficients and generalised estimating equations. At the person level, individuals with erosive osteoarthritis were compared to those with non-erosive osteoarthritis using logistic regression, adjusted for age and gender (aOR), for the following exposures: family history, previous injury, overuse and metabolic factors (BMI, dyslipidaemia, hypertension, diabetes). Results In 1076 symptomatic participants the ranked frequency of involvement for erosive joints was comparable to joints with K&L≥3 and K&L=4 (r>0.95). Patterns of joint involvement in erosive osteoarthritis were strongest for symmetry (aOR=6.5; 95% CI 3.0 to 14.1), followed by row (2.0; 0.8 to 5.0) and ray (0.3; 0.0 to 2.5), which was similar to joints with K&L≥3 and K&L=4. Individuals with erosive osteoarthritis (n=80) had an increased risk of metabolic syndrome (2.7; 1.0 to 7.1), notably dyslipidaemia (4.7; 2.1 to 10.6) compared with non-erosive osteoarthritis classed K&L≥3 (n=193). Conclusions The similar frequency of radiographic joint involvement and patterning in erosive osteoarthritis and more severe non-erosive osteoarthritis is consistent with prevalent erosive osteoarthritis being a severe form of hand osteoarthritis rather than a distinct entity. Metabolic exposures, dyslipidaemia in particular, may be implicated in erosive osteoarthritis. PMID:24095935

  3. A Current Review of Molecular Mechanisms Regarding Osteoarthritis and Pain

    PubMed Central

    Lee, Andrew; Ellman, Michael B; Yan, Dongyao; Kroin, Jeffrey S; Cole, Brian J; van Wijnen, Andre J.; Im, Hee-Jeong

    2013-01-01

    Osteoarthritis afflicts millions of individuals across the world resulting in impaired quality of life and increased health costs. To understand this disease, physicians have been studying risk factors, such as genetic predisposition, aging, obesity, and joint malalignment; however have been unable to conclusively determine the direct etiology. Current treatment options are short-term or ineffective and fail to address pathophysiological and biochemical mechanisms involved with cartilage degeneration and the induction of pain in arthritic joints. OA pain involves a complex integration of sensory, affective, and cognitive processes that integrate a variety of abnormal cellular mechanisms at both peripheral and central (spinal and supraspinal) levels of the nervous system Through studies examined by investigators, the role of growth factors and cytokines has increasingly become more relevant in examining their effects on articular cartilage homeostasis and the development of osteoarthritis and osteoarthritis-associated pain. Catabolic factors involved in both cartilage degradation in vitro and nociceptive stimulation include IL-1, IL-6, TNF-α, PGE2, FGF-2 and PKCδ, and pharmacologic inhibitors to these mediators, as well as compounds such as RSV and LfcinB, may potentially be used as biological treatments in the future. This review explores several biochemical mediators involved in OA and pain, and provides a framework for the understanding of potential biologic therapies in the treatment of degenerative joint disease in the future. PMID:23830938

  4. Individuals with Primary Osteoarthritis Have Different Phenotypes Depending on the Affected Joint - A Case Control Study from Southern Sweden Including 514 Participants

    PubMed Central

    Karlsson, Magnus K; Karlsson, Caroline; Magnusson, Håkan; Cöster, Maria; von Schewelov, Tord; Nilsson, Jan Åke; Brudin, Lars; Rosengren, Björn E

    2014-01-01

    Objective: The aim of this study was to evaluate whether primary osteoarthritis (OA), independent of affected joint, is associated with a phenotype that is different from the phenotype in a normative cohort. Material and Methods: We included 274 patients with primary OA, 30 women and 32 men (mean age 66 years, range 42-84) with primary hip OA, 38 women and 74 men (mean age 61 years; range 34-85) with primary knee OA, 42 women and 19 men (men age 64 years, range 42-87) with primary ankle or foot OA and 20 women and 19 men (mean age 66 years, range 47-88) with primary hand or finger OA. Of all patients included with OA, 23% had hip OA, 41% knee OA, 22% ankle or foot OA and 14% hand or finger OA. Serving as references were 122 women and 118 men of the same ages who were population-based, included as a control cohort. We measured total body BMD (g/cm2) and proportion of fat and lean mass (%) with dual energy X-ray absorptiometry. Height, weight and BMI (kg/m2) were also assessed. We then calculated Z-scores (number of standard deviations difference from the mean value of the control cohort) in the OA patients and compared these between the groups. Results: Individuals with hand OA and controls had similar phenotype. Individuals with lower extremity OA, irrespective of the affected joint, had similar weight, BMI and BMD, but higher than in individuals with hand OA and controls (all p<0.05). Individuals with lower extremity OA had higher fat and lower lean mass than individuals with hand OA and controls (all p<0.001). Conclusion: Individuals with primary OA in the lower extremity have a phenotype with higher BMD, higher BMI, proportionally higher fat content and lower lean body mass content. The different skeletal phenotypes in our patients with OA in the lower extremity and patients with hand OA indicate that separate pathophysiologic pathways may be responsible for primary OA in different joints PMID:25614774

  5. Development and validation of a computational model of the knee joint for the evaluation of surgical treatments for osteoarthritis

    PubMed Central

    Mootanah, R.; Imhauser, C.W.; Reisse, F.; Carpanen, D.; Walker, R.W.; Koff, M.F.; Lenhoff, M.W.; Rozbruch, S.R.; Fragomen, A.T.; Dewan, Z.; Kirane, Y.M.; Cheah, Pamela A.; Dowell, J.K.; Hillstrom, H.J.

    2014-01-01

    A three-dimensional (3D) knee joint computational model was developed and validated to predict knee joint contact forces and pressures for different degrees of malalignment. A 3D computational knee model was created from high-resolution radiological images to emulate passive sagittal rotation (full-extension to 65°-flexion) and weight acceptance. A cadaveric knee mounted on a six-degree-of-freedom robot was subjected to matching boundary and loading conditions. A ligament-tuning process minimised kinematic differences between the robotically loaded cadaver specimen and the finite element (FE) model. The model was validated by measured intra-articular force and pressure measurements. Percent full scale error between EE-predicted and in vitro-measured values in the medial and lateral compartments were 6.67% and 5.94%, respectively, for normalised peak pressure values, and 7.56% and 4.48%, respectively, for normalised force values. The knee model can accurately predict normalised intra-articular pressure and forces for different loading conditions and could be further developed for subject-specific surgical planning. PMID:24786914

  6. New horizons in osteoarthritis.

    PubMed

    Oliviero, F; Ramonda, R; Punzi, L

    2010-01-01

    Osteoarthritis (OA), also known as degenerative joint disease, is the most frequent chronic musculoskeletal disease and the leading cause of disability in elderly persons. There are currently at least 27 million persons afflicted with OA in the United States, and the annual cost to society in medical care and wage loss is expected to reach nearly $100 billion dollars by 2020, with consequent increased spending on its diagnosis and treatment, side effect prevention, and loss of productivity. Despite this enormous burden, many aspects of OA are still unknown, with implications not only in terms of diagnosis and assessment but also with regard to therapy. Awareness of this state of affairs has attracted many researchers to this field, making OA one of the most actively studied sectors of rheumatology. Although some clinicians are unaware of recent advances, there is a large body of publications indicating that much has been achieved. Major progress has been made in formulating better definitions of risk factors, in particular in indicating the responsibility of biomechanical and genetic factors, and, with regard to pathogenesis, underlining the role of subchondral bone, cytokines and proteinases. Assessment of OA activity and its progression has been improved with the advent of biomarkers and new imaging procedures, in particular sonography and magnetic resonance imaging (MRI), but also of better clinical instruments, including more reliable patient questionnaires. Information from ongoing studies may improve the to some extent incomplete definition of OA phenotypes. Finally, promising new horizons have been opened up even with regard to the treatment of OA, which is still for the most part unsatisfactory except for surgical replacement therapy. Numerous new substances have been formulated and the findings of trials studying their effects are encouraging, although much has yet to be done. PMID:20458653

  7. Human synovial mast cell involvement in rheumatoid arthritis and osteoarthritis. Relationship to disease type, clinical activity, and antirheumatic therapy.

    PubMed

    Bridges, A J; Malone, D G; Jicinsky, J; Chen, M; Ory, P; Engber, W; Graziano, F M

    1991-09-01

    Mast cells were isolated by enzymatic digestion of synovium obtained from 48 patients with rheumatoid arthritis (RA) and 42 patients with osteoarthritis (OA). A significantly lower percentage of stainable synovial mast cells was obtained by tissue digestion from patients with clinically active RA compared with those with less active disease. The 54 patients treated with nonsteroidal antiinflammatory drugs had a significantly lower percentage of stainable synovial mast cells in cell suspension than did the other 36 patients. When anti-IgE antibody was used as a secretagogue in vitro, significantly greater histamine release was observed from synovial mast cells of RA patients compared with OA patients. Greater histamine release in response to anti-IgE was observed in the RA patients with more clinically active disease and those who were treated with prednisone, compared with RA patients without these features. Synovial mast cells of RA patients treated with a disease-modifying antirheumatic drug had a significantly lower mean histamine content than did cells from patients not receiving such treatment. Our data suggest that there are differences between synovial mast cells from tissues of patients with RA and OA and suggest that synovial mast cells may be activated in clinically active RA. In addition, the data indicate an effect of systemic antirheumatic therapy on mast cells isolated from synovium of patients with arthritis. PMID:1930330

  8. Cutpoints for mild, moderate and severe pain in patients with osteoarthritis of the hip or knee ready for joint replacement surgery

    PubMed Central

    Kapstad, Heidi; Hanestad, Berit R; Langeland, Norvald; Rustøen, Tone; Stavem, Knut

    2008-01-01

    Background Cutpoints (CPs) for mild, moderate and severe pain are established and used primarily in cancer pain. In this study, we wanted to determine the optimal CPs for mild, moderate, and severe pain in joint replacement surgery candidates with osteoarthritis (OA) of the hip or knee, and to validate the different CPs. Methods Patients (n = 353) completed the Brief Pain Inventory (BPI), the WOMAC Arthritis Index, and the SF-36 health status measure. Optimal CPs for categorizing average pain with three severity levels were derived using multivariate analysis of variance, using different CP sets for average pain as the independent variable and seven interference items from the BPI as the dependent variable. To validate the CPs, we assessed if patients in the three pain severity groups differed in pain as assessed with WOMAC and SF-36, and if BPI average pain with the optimal CPs resulted in higher correlation with pain dimensions of the WOMAC and SF-36 than other CPs. Results The optimal CPs on the 0–10 point BPI scale were CP (4,6) among hip patients and CP (4,7) among knee patients. The resulting pain severity groups differed in pain, as assessed with other scales than those used to derive the CPs. The optimal CPs had the highest association of average pain with WOMAC pain scores. Conclusion CPs for pain severity differed somewhat for patients with OA of the hip and knee. The association of BPI average pain scores categorized according to the optimal CPs with WOMAC pain scores supports the validity of the derived optimal CPs. PMID:18426591

  9. Comparison of total hip and knee joint replacement in patients with rheumatoid arthritis and osteoarthritis: a nationwide, population-based study

    PubMed Central

    Liao, Chi-Yang; Chan, Hui-Ting; Chao, En; Yang, Che-Ming; Lu, Tzu-Chuan

    2015-01-01

    INTRODUCTION Patients with rheumatoid arthritis (RA) and osteoarthritis (OA) may require total hip replacement (THR) or total knee replacement (TKR). The present study aimed to compare the demographic characteristics and medical costs of RA and OA patients from Taiwan who underwent either THR or TKR. METHODS The medical records of patients who had undergone THR or TKR from 1 January 1996 to 31 December 2010 were obtained from the Taiwan National Health Insurance Research Database (NHIRD). In all, we found 49 and 146 RA patients who received THR and TKR, respectively, and 1,191 and 6,574 OA patients who received THR and TKR, respectively. The gender, age, Charlson comorbidity index (CCI), hospital grade, age at registration in the catastrophic illness dataset, and medical utilisation costs of the different groups were compared. RESULTS There were statistically significant differences in age, CCI score, drug costs and surgery costs between RA and OA patients. Joint replacement incidence was lower in RA patients than in OA patients, and among patients who underwent THR, total medical costs incurred were higher for RA patients than OA patients. RA patients who underwent THR incurred a significantly greater total medical utilisation cost in the outpatient department (3 months before surgery and 12 months after surgery) than OA patients who underwent THR. CONCLUSION Analysis of Taiwan NHIRD with regard to patients who had undergone either THR or TKR indicated that RA patients were younger than OA patients, and that significantly more medical resources were used for RA patients before, during and after hospitalisation for these procedures. PMID:25640101

  10. Biplanar Open Wedge High Tibial Osteotomy in the Medial Compartment Osteoarthritis of the Knee Joint: Comparison between the Aescula and TomoFix Plate

    PubMed Central

    Lee, Byoung-Joo; Kim, Joon-Woo; Yoon, Seong-Dae

    2015-01-01

    Background The purpose of this study was to compare the results of Aescula and TomoFix plates used for biplanar open wedge high tibial osteotomy in medial osteoarthritis of the knee joint with varus deformity. Methods A consecutive series of 50 cases of biplanar open wedge high tibial osteotomy were evaluated retrospectively. Group A contained 25 cases treated by using the Aescula plate, and group T contained 25 cases treated by using the TomoFix plate. Full weight-bearing was permitted at 6 weeks after surgery in group A and at 2 weeks in group T. Clinical evaluations were performed at the final follow-up by using postoperative knee scores and functional scores. Radiographic analysis included postoperative mechanical femur-tibia angle, change in posterior tibial slope angle, and complications related to implants. The mean follow-up periods were 30 months in group A and 26 months in group T. Results The knee and functional scores were improved at the final follow-up in both groups (p < 0.05), but no differences were observed between the two groups (p > 0.05). An acceptable correction angle was obtained in 52% of group A and in 84% of group T (p = 0.015). Change in posterior tibial slope angle was larger in group A than in group T (p < 0.001), showing better maintenance of posterior tibial slope in group T. In group A, there were 3 cases of screw loosening and 4 cases of delayed union. In addition, there were residual varus deformities in 7 cases (6 in group A and 1 in group T). Conclusions This study shows that firm fixation using a TomoFix plate for open wedge high tibial osteotomy produces better radiologic results and a low complication rate than those of the Aescula spacer plate. PMID:26217464

  11. Anti-inflammatory response of dietary vitamin E and its effects on pain and joint structures during early stages of surgically induced osteoarthritis in dogs.

    PubMed

    Rhouma, Mohamed; de Oliveira El Warrak, Alexander; Troncy, Eric; Beaudry, Francis; Chorfi, Younès

    2013-07-01

    There is evidence that vitamin E (VE) has anti-inflammatory and analgesic properties in human osteoarthritis (OA). This double-blinded and randomized pilot study used a broad spectrum of clinical and laboratory parameters to investigate whether such beneficial effects could be detected in a canine experimental OA model. Dogs were divided into 2 groups: control (n = 8), which received a placebo, and test group (n = 7), which received 400 IU/animal per day of VE for 55 d, starting the day after transection of the cranial cruciate ligament. Lameness and pain were assessed using a visual analogue scale (VAS), numerical rating scale (NRS), and electrodermal activity (EDA) at day 0, day 28, and day 55. Cartilage and synovial inflammation lesions were assessed. One-side comparison was conducted at an alpha-threshold of 10%. At day 56, dogs were euthanized and concentrations of prostaglandin E2 (PGE2), nitrogen oxides (NOx), and interleukin-1 beta (IL-1β) were measured in synovial fluid. Concentrations of NOx and PGE2 in synovial fluid were lower in the test group (P < 0.0001 and P = 0.03, respectively). Values of VAS, NRS, and EDA showed a consistent trend to be lower in the test group than in the control, while statistical significance was reached for VAS at day 55 and for EDA at day 28 (adjusted P = 0.07 in both cases). Histological analyses of cartilage showed a significant reduction in the scores of lesions in the test group. This is the first time that a study in dogs with OA using a supplement with a high dose of vitamin E showed a reduction in inflammation joint markers and histological expression, as well as a trend to improving signs of pain. PMID:24101795

  12. Epidemiology of osteoarthritis: Zoetermeer survey. Comparison of radiological osteoarthritis in a Dutch population with that in 10 other populations.

    PubMed Central

    van Saase, J L; van Romunde, L K; Cats, A; Vandenbroucke, J P; Valkenburg, H A

    1989-01-01

    The prevalence of mild and severe radiological osteoarthritis was investigated in a random sample of 6585 inhabitants of a Dutch village. Radiographs were graded 0-4 according to the criteria described by Kellgren and Lawrence. The prevalence of radiological osteoarthritis increased strongly with age and was highest for cervical spine (peak: men 84.8%, women 84.3%), lumbar spine (peak: 71.9%, women 67.3%), and distal interphalangeal joints of the hands (peak: men 64.4%, women 76%). Prevalence did not exceed 10% in sacroiliac joints, lateral carpometacarpal joints, and tarsometatarsal joints. Severe radiological osteoarthritis (grade 3 or grade 4) was uncommon under age 45; in elderly persons the prevalence of severe radiological osteoarthritis did not exceed 20% except for the cervical and lumbar spine, distal interphalangeal joints of the hands and, in women only, metacarpophalangeal joints, first carpometacarpal joints, first metatarsophalangeal joints, and knees. Overall, differences between men and women were small except for hips and knees; however, severe radiological osteoarthritis was found in a higher proportion in most of the joints in women. Our data were compared with data from similar population surveys. The slope between joint involvement and age was strikingly constant for most of the joints. Differences between populations were mainly differences in level. These differences of prevalence of radiological osteoarthritis may be attributed to interobserver differences--that is, different criteria used to establish radiological osteoarthritis, in addition to genetic or environmental factors, or both. PMID:2712610

  13. Osteoarthritis Pathogenesis: A Review of Molecular Mechanisms

    PubMed Central

    Xia, Bingjiang; Chen, Di; Zhang, Jushi; Hu, Songfeng; Jin, Hongting; Tong, Peijian

    2016-01-01

    Osteoarthritis (OA), the most prevalent chronic joint disease, increases in prevalence with age, and affects majority of individuals over the age of 65 and is a leading musculoskeletal cause of impaired mobility in the elderly. Because the precise molecular mechanisms which are involved in the degradation of cartilage matrix and development of OA are poorly understood and there are currently no effective interventions to decelerate the progression of OA or retard the irreversible degradation of cartilage except for total joint replacement surgery. In this paper, the important molecular mechanisms related to OA pathogenesis will be summarized and new insights into potential molecular targets for the prevention and treatment of OA will be provided. PMID:25311420

  14. Metabolic analysis of osteoarthritis subchondral bone based on UPLC/Q-TOF-MS.

    PubMed

    Yang, Gang; Zhang, Hua; Chen, Tingmei; Zhu, Weiwen; Ding, Shijia; Xu, Kaiming; Xu, Zhongwei; Guo, Yanlei; Zhang, Jian

    2016-06-01

    Osteoarthritis (OA), one of the most widespread musculoskeletal joint diseases among the aged, is characterized by the progressive loss of articular cartilage and continuous changes in subchondral bone. The exact pathogenesis of osteoarthritis is not completely clear. In this work, ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry (UPLC/Q-TOF-MS) in combination with multivariate statistical analysis was applied to analyze the metabolic profiling of subchondral bone from 42 primary osteoarthritis patients. This paper described a modified two-step method for extracting the metabolites of subchondral bone from primary osteoarthritis patients. Finally, 68 metabolites were identified to be significantly changed in the sclerotic subchondral bone compared with the non-sclerotic subchondral bone. Taurine and hypotaurine metabolism and beta-alanine metabolism were probably relevant to the sclerosis of subchondral bone. Taurine, L-carnitine, and glycerophospholipids played a vital regulation role in the pathological process of sclerotic subchondral bone. In the sclerotic process, beta-alanine and L-carnitine might be related to the increase of energy consumption. In addition, our findings suggested that the intra-cellular environment of sclerotic subchondral bone might be more acidotic and hypoxic compared with the non-sclerotic subchondral bone. In conclusion, this study provided a new insight into the pathogenesis of subchondral bone sclerosis. Our results indicated that metabolomics could serve as a promising approach for elucidating the pathogenesis of subchondral bone sclerosis in primary osteoarthritis. Graphical Abstract Metabolic analysis of osteoarthritis subchondral bone. PMID:27074781

  15. Effects of low-level laser therapy on joint pain, synovitis, anabolic, and catabolic factors in a progressive osteoarthritis rabbit model.

    PubMed

    Wang, Pu; Liu, Chuan; Yang, Xiaotian; Zhou, Yujing; Wei, Xiaofei; Ji, Qiaodan; Yang, Lin; He, Chengqi

    2014-11-01

    The aim of this study was to investigate the effect of low-level laser therapy (LLLT) on short-term and long-term joint pain, synovitis, anabolic, and catabolic factors in the cartilage of a rabbit model with progressive osteoarthritis (OA) induced by anterior cruciate ligament transection (ACLT). A total of 160 New Zealand white rabbits were randomly assigned into two groups (ACLT group and LLLT group). All rabbits received ACLT surgery, and 2-, 4-, 6-, and 8-week treatment after the surgery, with 20 rabbits being tested biweekly over every study period. The LLLT group received LLLT with a helium-neon (He-Ne) laser (830 nm) of 1.5 J/cm(2) three times per week, and the ACLT group received placebo LLLT with the equipment switched off. Long-term and short-term pain was tested via weight-bearing asymmetry; synovitis was assessed histologically; and knee joint cartilage was evaluated by gross morphology, histology, and gene expression analysis of anabolic and catabolic factors. The histological assessment of pain and synovitis showed that at least 6-week intermittent irradiation of LLLT could relief knee pain and control synovium inflammation. Gross morphologic inspection and histological evaluation showed that 6 weeks of LLLT could decrease cartilage damage of medical femoral condyle and 8 weeks of LLLT could decrease cartilage damage of medical and lateral femoral condyles and medical tibial plateau. Gene expression analysis revealed two results: At least 6 weeks of LLLT could decrease production of catabolic factors, for example, interleukin 1β (IL-1β), inducible nitric oxide synthase (iNOS), and MMP-3, and slow down the loss of anabolic factors, mainly TIMP-1. Eight weeks of LLLT treatment could slow down the loss of collagen II, aggrecan, and anabolic factors, mainly transforming growth factor beta (TGF-β). The study suggests that LLLT plays a protective role against cartilage degradation and synovitis in rabbits with progressive OA by virtue of the regulation of catabolic and anabolic factors in the cartilage. PMID:24890034

  16. Jellyfish mucin may have potential disease-modifying effects on osteoarthritis

    PubMed Central

    2009-01-01

    Background We aimed to study the effects of intra-articular injection of jellyfish mucin (qniumucin) on articular cartilage degeneration in a model of osteoarthritis (OA) created in rabbit knees by resection of the anterior cruciate ligament. Qniumucin was extracted from Aurelia aurita (moon jellyfish) and Stomolophus nomurai (Nomura's jellyfish) and purified by ion exchange chromatography. The OA model used 36 knees in 18 Japanese white rabbits. Purified qniumucin extracts from S. nomurai or A. aurita were used at 1 mg/ml. Rabbits were divided into four groups: a control (C) group injected with saline; a hyaluronic acid (HA)-only group (H group); two qniumucin-only groups (M groups); and two qniumucin + HA groups (MH groups). One milligram of each solution was injected intra-articularly once a week for 5 consecutive weeks, starting from 4 weeks after surgery. Ten weeks after surgery, the articular cartilage was evaluated macroscopically and histologically. Results In the C and M groups, macroscopic cartilage defects extended to the subchondral bone medially and laterally. When the H and both MH groups were compared, only minor cartilage degeneration was observed in groups treated with qniumucin in contrast to the group without qniumucin. Histologically, densely safranin-O-stained cartilage layers were observed in the H and two MH groups, but cartilage was strongly maintained in both MH groups. Conclusion At the concentrations of qniumucin used in this study, injection together with HA inhibited articular cartilage degeneration in this model of OA. PMID:19995451

  17. Factors Important for Work Participation Among Older Workers with Depression, Cardiovascular Disease, and Osteoarthritis: A Mixed Method Study.

    PubMed

    Boot, Cécile R L; de Kruif, Anja Th C M; Shaw, William S; van der Beek, Allard J; Deeg, Dorly J; Abma, Tineke

    2016-06-01

    Purpose The aim of this study was to gain insight into differences and similarities in factors important for work participation in older (58-65 years) workers among three different chronic diseases: depression (D), cardiovascular disease (C), and osteoarthritis (O). Methods A mixed method design was used, with a qualitative part (in-depth interviews) with 14 patients with D, C or O and a quantitative part based on the 2002-2003 cohort of the Longitudinal Aging Study Amsterdam. We analysed and compared 3-year (response 93 %) predictors of paid work in 239 participants with D, C, or O using regression analyses. The qualitative findings were integrated with the quantitative findings aiming at complementarity. Results Common factors important for work participation were: working at baseline; male gender; lower age; partner with paid work; better physical and mental health; and higher mastery scores. The qualitative analyses added autonomy in work and provided contextual information regarding the perceived importance of working as factors important for participation in paid work. For D and C, work gave purpose in life and enhanced social contacts. Participation in work was perceived as necessary to structure life only for D. Conclusion Most factors important for work participation were similar for D, C, and O. However, the interviews revealed that for D, the context and the meaning attributed to these factors differed. PMID:26210996

  18. Association of the IL-6 -174G/C gene polymorphism with knee osteoarthritis in a Thai population.

    PubMed

    Honsawek, S; Deepaisarnsakul, B; Tanavalee, A; Yuktanandana, P; Bumrungpanichthaworn, P; Malila, S; Saetan, N

    2011-01-01

    Osteoarthritis is a chronic progressive degenerative joint disease characterized by age-related regressive change in articular cartilage. A single nucleotide polymorphism has been described at position -174 of the interleukin-6 (IL-6) promoter region, leading to three possible genotypes, GG, GC, and CC. We investigated a possible association of the IL-6 -174G/C gene polymorphism with knee osteoarthritis in a Thai population. Genotype distributions and allelic frequencies of the IL-6 -174G/C polymorphism were investigated in 115 knee osteoarthritis patients and 100 healthy controls. Genotyping was performed using PCR-RFLP. The genotype distribution of IL-6 was 79 GG, 36 GC, 0 CC in knee osteoarthritis patients and 88 GG, 12 GC, 0 CC in controls. The frequency of the GC genotype in subjects with knee osteoarthritis was higher than in controls (P< 0.001). Logistic regression analysis showed that the GC genotype was independently associated with increased risk of knee osteoarthritis (odds ratio = 3.3, 95% confidence interval = 1.6-6.9, P = 0.001). These findings suggest that the -174G/C polymorphism of the IL-6 gene promoter plays a role in the pathogenesis of knee osteoarthritis. PMID:21863560

  19. Cost-effectiveness analysis for joint pain treatment in patients with osteoarthritis treated at the Instituto Mexicano del Seguro Social (IMSS): Comparison of nonsteroidal anti-inflammatory drugs (NSAIDs) vs. cyclooxygenase-2 selective inhibitors

    PubMed Central

    Contreras-Hernández, Iris; Mould-Quevedo, Joaquín F; Torres-González, Rubén; Goycochea-Robles, María Victoria; Pacheco-Domínguez, Reyna Lizette; Sánchez-García, Sergio; Mejía-Aranguré, Juan Manuel; Garduño-Espinosa, Juan

    2008-01-01

    Background Osteoarthritis (OA) is one of the main causes of disability worldwide, especially in persons >55 years of age. Currently, controversy remains about the best therapeutic alternative for this disease when evaluated from a cost-effectiveness viewpoint. For Social Security Institutions in developing countries, it is very important to assess what drugs may decrease the subsequent use of medical care resources, considering their adverse events that are known to have a significant increase in medical care costs of patients with OA. Three treatment alternatives were compared: celecoxib (200 mg twice daily), non-selective NSAIDs (naproxen, 500 mg twice daily; diclofenac, 100 mg twice daily; and piroxicam, 20 mg/day) and acetaminophen, 1000 mg twice daily. The aim of this study was to identify the most cost-effective first-choice pharmacological treatment for the control of joint pain secondary to OA in patients treated at the Instituto Mexicano del Seguro Social (IMSS). Methods A cost-effectiveness assessment was carried out. A systematic review of the literature was performed to obtain transition probabilities. In order to evaluate analysis robustness, one-way and probabilistic sensitivity analyses were conducted. Estimations were done for a 6-month period. Results Treatment demonstrating the best cost-effectiveness results [lowest cost-effectiveness ratio $17.5 pesos/patient ($1.75 USD)] was celecoxib. According to the one-way sensitivity analysis, celecoxib would need to markedly decrease its effectiveness in order for it to not be the optimal treatment option. In the probabilistic analysis, both in the construction of the acceptability curves and in the estimation of net economic benefits, the most cost-effective option was celecoxib. Conclusion From a Mexican institutional perspective and probably in other Social Security Institutions in similar developing countries, the most cost-effective option for treatment of knee and/or hip OA would be celecoxib. PMID:19014495

  20. Non-invasive investigation in patients with inflammatory joint disease.

    PubMed

    Dal Pont, Elisabetta; D'Inc, Renata; Caruso, Antonino; Sturniolo, Giacomo-Carlo

    2009-05-28

    Gut inflammation can occur in 30%-60% of patients with spondyloarthropathies. However, the presence of such gut inflammation is underestimated, only 27% of patients with histological evidence of gut inflammation have intestinal symptoms, but subclinical gut inflammation is documented in two-thirds of patients with inflammatory joint disease. There are common genetic and immunological mechanisms behind concomitant inflammation in the joints and intestinal tract. A number of blood tests, e.g. erythrocyte sedimentation rate, orosomucoid, C-reactive protein, and white cell and platelet counts, are probably the most commonly used laboratory markers of inflammatory disease, however, these tests are difficult to interpret in arthropathies associated with gut inflammation, since any increases in their blood levels might be attributable to either the joint disease or to gut inflammation. Consequently, it would be useful to have a marker capable of separately identifying gut inflammation. Fecal proteins, which are indirect markers of neutrophil migration in the gut wall, and intestinal permeability, seem to be ideal for monitoring intestinal inflammation: they are easy to measure non-invasively and are specific for intestinal disease in the absence of gastrointestinal infections. Alongside the traditional markers for characterizing intestinal inflammation, there are also antibodies, in all probability generated by the immune response to microbial antigens and auto-antigens, which have proved useful in establishing the diagnosis and assessing the severity of the condition, as well as the prognosis and the risk of complications. In short, non-invasive investigations on the gut in patients with rheumatic disease may be useful in clinical practice for a preliminary assessment of patients with suspected intestinal disease. PMID:19468995

  1. Non-invasive investigation in patients with inflammatory joint disease

    PubMed Central

    Dal Pont, Elisabetta; D’Incà, Renata; Caruso, Antonino; Sturniolo, Giacomo Carlo

    2009-01-01

    Gut inflammation can occur in 30%-60% of patients with spondyloarthropathies. However, the presence of such gut inflammation is underestimated, only 27% of patients with histological evidence of gut inflammation have intestinal symptoms, but subclinical gut inflammation is documented in two-thirds of patients with inflammatory joint disease. There are common genetic and immunological mechanisms behind concomitant inflammation in the joints and intestinal tract. A number of blood tests, e.g. erythrocyte sedimentation rate, orosomucoid, C-reactive protein, and white cell and platelet counts, are probably the most commonly used laboratory markers of inflammatory disease, however, these tests are difficult to interpret in arthropathies associated with gut inflammation, since any increases in their blood levels might be attributable to either the joint disease or to gut inflammation. Consequently, it would be useful to have a marker capable of separately identifying gut inflammation. Fecal proteins, which are indirect markers of neutrophil migration in the gut wall, and intestinal permeability, seem to be ideal for monitoring intestinal inflammation: they are easy to measure non-invasively and are specific for intestinal disease in the absence of gastrointestinal infections. Alongside the traditional markers for characterizing intestinal inflammation, there are also antibodies, in all probability generated by the immune response to microbial antigens and auto-antigens, which have proved useful in establishing the diagnosis and assessing the severity of the condition, as well as the prognosis and the risk of complications. In short, non-invasive investigations on the gut in patients with rheumatic disease may be useful in clinical practice for a preliminary assessment of patients with suspected intestinal disease. PMID:19468995

  2. Cytokines as biochemical markers for knee osteoarthritis.

    PubMed

    Mabey, Thomas; Honsawek, Sittisak

    2015-01-18

    Osteoarthritis (OA) is a debilitating degenerative joint disease particularly affecting weightbearing joints within the body, principally the hips and knees. Current radiographic techniques are insufficient to show biochemical changes within joint tissue which can occur many years before symptoms become apparent. The need for better diagnostic and prognostic tools is heightened with the prevalence of OA set to increase in aging and obese populations. As inflammation is increasingly being considered an important part of OAs pathophysiology, cytokines are being assessed as possible candidates for biochemical markers. Cytokines, both pro- and anti-inflammatory, as well as angiogenic and chemotactic, have in recent years been studied for relevant characteristics. Biochemical markers show promise in determination of the severity of disease in addition to monitoring of the efficacy and safety of disease-modifying OA drugs, with the potential to act as diagnostic and prognostic tools. Currently, the diagnostic power of interleukin (IL)-6 and the relationship to disease burden of IL-1?, IL-15, tumor necrosis factor-?, and vascular endothelial growth factor make these the best candidates for assessment. Grouping appropriate cytokine markers together and assessing them collectively alongside other bone and cartilage degradation products will yield a more statistically powerful tool in research and clinical applications, and additionally aid in distinguishing between OA and a number of other diseases in which cytokines are known to have an involvement. Further large scale studies are needed to assess the validity and efficacy of current biomarkers, and to discover other potential biomarker candidates. PMID:25621214

  3. Crystals, inflammation, and osteoarthritis.

    PubMed

    Schumacher, H R

    1987-11-20

    Calcium pyrophosphate and apatite crystals are common in osteoarthritic knee effusions. One or the other crystal was found in 60 percent or more of cases. These crystals offer the potential for mechanical effects in cartilage but are also often phagocytized by synovial cells. A low-grade inflammation with release of proteases and other mediators of inflammation may be an important factor in the pain and joint damage of osteoarthritis. Crystal-associated changes may merit specific attention in any future approach to therapy. PMID:2825522

  4. Particle-based technologies for osteoarthritis detection and therapy.

    PubMed

    Kavanaugh, Taylor E; Werfel, Thomas A; Cho, Hongsik; Hasty, Karen A; Duvall, Craig L

    2016-04-01

    Osteoarthritis (OA) is a disease characterized by degradation of joints with the development of painful osteophytes in the surrounding tissues. Currently, there are a limited number of treatments for this disease, and many of these only provide temporary, palliative relief. In this review, we discuss particle-based drug delivery systems that can provide targeted and sustained delivery of imaging and therapeutic agents to OA-affected sites. We focus on technologies such as polymeric micelles and nano-/microparticles, liposomes, and dendrimers for their potential treatment and/or diagnosis of OA. Several promising studies are highlighted, motivating the continued development of delivery technologies to improve treatments for OA. PMID:25990835

  5. Chondroprotective effect of N-acetylglucosamine and hyaluronate in early stages of osteoarthritis--an experimental study in rabbits.

    PubMed

    Ozkan, Feyza Unlu; Ozkan, Korhan; Ramadan, Saime; Guven, Zeynep

    2009-01-01

    Osteoarthritis, the most common joint disease in the world, is characterized by joint pain, stiffness, and limitation of range of motion. Osteoarthritis is a slowly progressive disease and its morbidity increases with age. The most commonly involved sites are the spine, knee, hip, and hand joints. Although the ideal treatment for osteoarthritis should be the one that acts on the underlying mechanism, thus preventing joint destruction and disease progression, such an effective treatment option does not exist. Therefore, contemporary treatment aims to relieve pain, increase range of motion, and optimize joint function. Analgesics and nonsteroidal antiinflammatory drugs are most commonly used for the symptomatic treatment, but mainly their gastrointestinal side effects, especially in elderly patients, limit their usage. In this study, the chondroprotective effects of an aminomonosaccharide glucosamine and a polysaccharide hyaluronic acid in a rabbit osteoarthritis model were investigated. Anterior cruciate ligament transection was performed in 32 New Zealand rabbits to establish a model of osteoarthritis. Rabbits were randomized into four groups, each consisting of eight rabbits. Two weeks after the operation, intraarticular injections were performed to the right knees once a week for 5 weeks; intraarticular glucosamine to the first group, intraarticular hyaluronate to the second group, intraarticular hyaluronate and intramuscular glucosamine to the third group, and intraarticular saline solution to the fourth group, which served as the control group. At the end of the eighth week, the rabbits were sacrificed and their right knees with proximal femur and distal tibia were harvested. Joint surfaces of their femur and tibia were examined macroscopically, and sections from the medial femoral condyles were examined microscopically. Macroscopic evaluation revealed that the cartilage surface was preserved in the glucosamine, hyaluronate, and hyaluronate plus glucosamine groups, when compared with the control group. Microscopic evaluation showed that glucosamine, hyaluronate, and glucosamine plus hyaluronate have chondroprotective effect, but no statistically significant difference was found between study groups. PMID:20001938

  6. Current knowledge and importance of dGEMRIC techniques in diagnosis of hip joint diseases.

    PubMed

    Zilkens, Christoph; Tiderius, Carl Johann; Krauspe, Rüdiger; Bittersohl, Bernd

    2015-08-01

    Accurate assessment of early hip joint cartilage alterations may help optimize patient selection and follow-up of hip joint preservation surgery. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is sensitive to the glycosaminoglycan content in cartilage that is lost early in the development of osteoarthritis (OA). Hence, the dGEMRIC technique holds promise for the development of new diagnostic and therapeutic procedures. However, because of the location of the hip joint deep within the body and due to the fairly thin cartilage layers that require high spatial resolution, the diagnosis of early hip joint cartilage alterations may be problematic. The purpose of this review is to outline the current status of dGEMRIC in the assessment of hip joint cartilage. A literature search was performed with PubMed, using the terms "cartilage, osteoarthritis, hip joint, MRI, and dGEMRIC", considering all levels of studies. This review revealed that dGEMRIC can be reliably used in the evaluation of early stage cartilage pathology in various hip joint disorders. Modifications in the technique, such as the operation of three-dimensional imaging and dGEMRIC after intra-articular contrast medium administration, have expanded the range of application. Notably, the studies differ considerably in patient selection and technical prerequisites. Furthermore, there is a need for multicenter prospective studies with the required technical conditions in place to establish outcome based dGEMRIC data to obtain, in conjunction with clinical data, reliable threshold values for normal and abnormal cartilage, and for hips that may benefit from conservative or surgical treatment. PMID:25913097

  7. Sustaining disease-specific performance improvement measures for joint replacement.

    PubMed

    Cress, Deborah; Hansen, Linda; Pelton, JoAnne

    2012-01-01

    To maintain standards of excellence and continuously improve their outcomes, specialized joint replacement centers must develop, implement, and sustain specific performance improvement activities. This article describes the activities at one. Midwestern healthcare system's joint replacement center related to three disease-specific performance improvement measures: fall prevention, preoperative education, and pain management. Specific steps in the process for each measure are described. These include current-state analyses, goals established, the use of Plan-Do-Study-Act (PDSA) methodology to identify and implement appropriate interventions, and the use of the Six Sources of Influence model to promote successful change. Outcomes, lessons learned, and suggestions for replication by other institutions are discussed. PMID:22622605

  8. Subchondral bone changes and chondrogenic capacity of progenitor cells from subchondral bone in the collagenase-induced temporomandibular joints osteoarthritis rabbit model

    PubMed Central

    Wu, Guomin; Zhu, Songsong; Sun, Xiumei; Hu, Jing

    2015-01-01

    Purpose: The goals of this study were to characterize subchondral bone changes, and to determine biological activity characteristics of progenitor cell populations from subchondral bone in the collagenase-induced temporomandibular joint osteoarthritis (TMJOA) rabbit model. Greater understanding of such pathological changes occurring in TMJOA samples is critical in the future treatment modalities regarding cartilage protection and repair. Furthermore, the use of progenitor cell populations in various cartilage regeneration strategies proves to be a fruitful avenue for research and clinical applications. Materials and methods: Bone remodeling and anabolic activity of subchondral bone was evaluated by hematoxylin-eosin (H&E), Alcian blue-periodic acid-Schiff (AB-PAS) staining and immuohistochemical staining. The biological activity characteristics of progenitor cells were assessed by expressions of collagen type II, CD44, SOX-9 and MMP-9 by immunohistochemistry and Western blot analysis. Results: In most of the specimens, cartilage of the digested area displayed a reaction characterized by thickening of the cartilage cellular structure with retraction structure formation in the subchondral bone. Most of the specimens focuses on chondroid metaplasia were observed in the subchondral bone, promoting its remodeling, which could develop to endochondral ossification and increasing subchondral bone size. Meanwhile, immunohistochemistry analysis revealed that CD44 expressions in subchondral bone were most significantly increased in TMJOA at 2 weeks group (P < 0.01). And, at 4, 6 and 8 weeks groups, the osteochondral junction had completely disappeared by active subchondral bone remodeling, and collagen type II, CD44, SOX-9 and MMP-9 expressions in active subchondral bone region were significantly increased in TMJOA (P < 0.05). In addition, western blot analysis revealed that CD44 expression significantly emerged in subchondral bone region at 2 weeks group (P < 0.01). Meanwhile, SOX-9 expression emerged in all group, and the intensity was increased in the experimental groups (P < 0.05). Conclusion: Our results suggest that the beneficial activation of progenitor cells and bone marrow stem cells in subchondral bone at early stage of TMJOA played an important role on renovation and remodeling of subchondral bone. PMID:26617688

  9. Impaired aortic elastic properties in primary osteoarthritis.

    PubMed

    Belen, Erdal; Karaman, Ozgur; Caliskan, Gurkan; Atamaner, Oya; Aslan, Omer

    2016-02-01

    Osteoarthritis is one of the most common chronic diseases and associated with increased cardiovascular comorbidity and deaths. Elastic properties of aorta are closely associated with cardiovascular mortality and morbidity. In our study, we aimed to evaluate aortic stiffness in primary osteoarthritis patients. A total of 160 patients including 80 patients with primary knee osteoarthritis and 80 controls without osteoarthritis were included in the study. Additionally, osteoarthritis patients were divided into four subgroups according to the severity of the disease. Aortic parameters were evaluated by using transthoracic echocardiography method. While measurements of aortic stiffness of osteoarthritis group were higher compared to the control group (p?osteoarthritis group are lower than the control group (p?osteoarthritis increased also aortic stiffness increased highly significantly (p?=?0.001). Presence and severity of osteoarthritis are closely associated with elastic properties of aorta, which are correlated with cardiovascular mortality and morbidity. PMID:25925906

  10. Nutraceuticals for the treatment of osteoarthritis.

    PubMed

    Olsen, N J

    2011-02-01

    Osteoarthritis (OA) is a highly prevalent human condition which is becoming an even greater health problem in an aging global population. Existing treatments for OA provide pain relief and some anti-inflammatory effects, but no truly disease-modifying treatments are available for this disease. Furthermore, the generally advanced age and frequent comorbid conditions present in OA patients limit safety of many available drugs. Treatments with enhanced safety margins and that offer chondroprotective effects are unmet needs. Nutraceuticals derived from foods and herbs have been long used in traditional medicine, and many have wide-ranging biologic effects suggesting novel mechanisms of action. Some of these have shown promise in controlled clinical trials in OA patients. Whether these approaches could offer safe symptom relief and possibly mediate beneficial joint remodeling in early OA are possibilities that merit further investigation. PMID:21317847

  11. Knee osteoarthritis related pain: a narrative review of diagnosis and treatment

    PubMed Central

    Alshami, Ali M.

    2014-01-01

    Background Osteoarthritis is a common progressive joint disease, involving not only the joint lining but also cartilage, ligaments, and bone. For the last ten years, majority of published review articles were not specific to osteoarthritis of the knee, and strength of evidence and clinical guidelines were not appropriately summarized. Objectives To appraise the literature by summarizing the findings of current evidence and clinical guidelines on the diagnosis and treatment of knee osteoarthritis pain. Methodology English journal articles that focused on knee osteoarthritis related pain were searched via PubMed (1 January 2002 – 26 August 2012) and Physiotherapy Evidence Database (PEDro) databases, using the terms ‘knee’, ‘osteoarthritis’ and ‘pain’. In addition, reference lists from identified articles and related book chapters were included as comprehensive overviews. Results For knee osteoarthritis, the highest diagnostic accuracy can be achieved by presence of pain and five or more clinical or laboratory criteria plus osteophytes. Some inconsistencies in the recommendations and findings were found between the clinical guidelines and systematic reviews. Generally, paracetamol, oral and topical non-steroidal anti-inflammatory drugs, opioids, corticosteroid injections and physical therapy techniques, such as therapeutic exercises, joint manual therapy and transcutaneous electrical nerve stimulation, can help reduce pain and improve function. Patient education programs and weight reduction for overweight patients are important to be considered. Conclusions Some inconsistencies in the recommendations and findings were found between the clinical guidelines and systematic reviews. However, it is likely that a combination of pharmacological and non-pharmacological treatments is most effective in treating patients with knee osteoarthritis. PMID:24899883

  12. Prognostic factors affecting survival of 507 horses with joint disease: (1983 to 1990).

    PubMed

    Fubini, S L; Erb, H N; Freeman, K P; Todhunter, R J

    1999-10-01

    Between July 1, 1983 and December 31, 1990, risk factors were determined for all horses with joint disease presented to a referral center, of being discharged, of ever becoming sound, or of being alive at 3 mo follow-up. Logistic multiple-regression models were done separately for foals (< or = 4 mo), yearlings (> 4-24 mo) and racing or nonracing adult horses (> 24 mo). The breakdown in this study was 53 foals, 87 yearlings, 141 nonracing adults, and 226 racing adults. Thirty-one foals (58%), 68 yearlings (78%), 119 non-racing adults (84%), and 213 racing adults (94%) were discharged. Foals with a less severe lameness, duration of illness of > 1 d, and infectious arthritis had increased odds of discharge. At follow-up, 12 of 18 (67%) were alive, 10 (56%) of which were sound. Yearlings with osteochondrosis had higher odds of discharge; at follow-up, 38 of 49 (78%) were alive, 32 (65%) of which were sound. For non-racing adults, horses with less severe lameness, without a miscellaneous diagnosis, or intended for pleasure use had increased odds of discharge. At follow-up, 55 of 78 (70%) were alive and 33 of 58 (57%) with soundness data became sound. Risk factors for higher odds of being alive at follow-up were carpal lameness, arthroscopic surgery, a prognosis other than poor, became sound, above-median hospitalization costs, and duration of follow-up. The 161 racing adults (76% of discharges), with follow-up, were more likely to have had osteoarthritis, higher hospital costs, hospitalization > 1 d, and arthroscopy. Sixty-four (60%) of these became sound; the odds increased if the horse was not severely lame at admission or was hospitalized for > 1 d. Risk factors and prognosis differed by age-use group among horses seen at our hospital. PMID:10534004

  13. The radiology of joint disease. 3rd Ed

    SciTech Connect

    Forrester, D.M.; Brown, J.C.

    1987-01-01

    The book is a systematic radiographic approach to the arthritides. Part one deals with hand abnormalities ''to facilitate the teaching of basic principles and to dramatize the differences between radiographic features of various arthritides,'' as stated in the forward of the first edition. Part two, ''Arthritis from Head to Foot,'' illustrates the same diseases as they affect other joints. The ABCs (alignment, bone mineralization, cartilage space, soft tissue) approach is followed throughout the book. For example, reflex sympathetic dystrophy syndrome is dealt with in six different locations, and metatarsal stress fractures are mentioned in a chapter on erosions in rheumatoid arthritis.

  14. Osteoarthritis: diagnosis and treatment.

    PubMed

    Sinusas, Keith

    2012-01-01

    Osteoarthritis is a common degenerative disorder of the articular cartilage associated with hypertrophic bone changes. Risk factors include genetics, female sex, past trauma, advancing age, and obesity. The diagnosis is based on a history of joint pain worsened by movement, which can lead to disability in activities of daily living. Plain radiography may help in the diagnosis, but laboratory testing usually does not. Pharmacologic treatment should begin with acetaminophen and step up to nonsteroidal anti-inflammatory drugs. Exercise is a useful adjunct to treatment and has been shown to reduce pain and disability. The supplements glucosamine and chondroitin can be used for moderate to severe osteoarthritis when taken in combination. Corticosteroid injections provide inexpensive, short-term (four to eight weeks) relief of osteoarthritic flare-ups of the knee, whereas hyaluronic acid injections are more expensive but can maintain symptom improvement for longer periods. Total joint replacement of the hip, knee, or shoulder is recommended for patients with chronic pain and disability despite maximal medical therapy. PMID:22230308

  15. Strategies for the prevention of knee osteoarthritis.

    PubMed

    Roos, Ewa M; Arden, Nigel K

    2016-02-01

    Osteoarthritis (OA) has been thought of as a disease of cartilage that can be effectively treated surgically at severe stages with joint arthroplasty. Today, OA is considered a whole-organ disease that is amenable to prevention and treatment at early stages. OA develops slowly over 10-15 years, interfering with activities of daily living and the ability to work. Many patients tolerate pain, and many health-care providers accept pain and disability as inevitable corollaries of OA and ageing. Too often, health-care providers passively await final 'joint death', necessitating knee and hip replacements. Instead, OA should be viewed as a chronic condition, where prevention and early comprehensive-care models are the accepted norm, as is the case with other chronic diseases. Joint injury, obesity and impaired muscle function are modifiable risk factors amenable to primary and secondary prevention strategies. The strategies that are most appropriate for each patient should be identified, by selecting interventions to correct-or at least attenuate-OA risk factors. We must also choose the interventions that are most likely to be acceptable to patients, to maximize adherence to-and persistence with-the regimes. Now is the time to begin the era of personalized prevention for knee OA. PMID:26439406

  16. Regenerative Therapies for Equine Degenerative Joint Disease: A Preliminary Study

    PubMed Central

    Broeckx, Sarah; Zimmerman, Marieke; Crocetti, Sara; Suls, Marc; Mariën, Tom; Ferguson, Stephen J.; Chiers, Koen; Duchateau, Luc; Franco-Obregón, Alfredo

    2014-01-01

    Degenerative joint disease (DJD) is a major cause of reduced athletic function and retirement in equine performers. For this reason, regenerative therapies for DJD have gained increasing interest. Platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) were isolated from a 6-year-old donor horse. MSCs were either used in their native state or after chondrogenic induction. In an initial study, 20 horses with naturally occurring DJD in the fetlock joint were divided in 4 groups and injected with the following: 1) PRP; 2) MSCs; 3) MSCs and PRP; or 4) chondrogenic induced MSCs and PRP. The horses were then evaluated by means of a clinical scoring system after 6 weeks (T1), 12 weeks (T2), 6 months (T3) and 12 months (T4) post injection. In a second study, 30 horses with the same medical background were randomly assigned to one of the two combination therapies and evaluated at T1. The protein expression profile of native MSCs was found to be negative for major histocompatibility (MHC) II and p63, low in MHC I and positive for Ki67, collagen type II (Col II) and Vimentin. Chondrogenic induction resulted in increased mRNA expression of aggrecan, Col II and cartilage oligomeric matrix protein (COMP) as well as in increased protein expression of p63 and glycosaminoglycan, but in decreased protein expression of Ki67. The combined use of PRP and MSCs significantly improved the functionality and sustainability of damaged joints from 6 weeks until 12 months after treatment, compared to PRP treatment alone. The highest short-term clinical evolution scores were obtained with chondrogenic induced MSCs and PRP. This study reports successful in vitro chondrogenic induction of equine MSCs. In vivo application of (induced) MSCs together with PRP in horses suffering from DJD in the fetlock joint resulted in a significant clinical improvement until 12 months after treatment. PMID:24465787

  17. Dance between biology, mechanics, and structure: A systems-based approach to developing osteoarthritis prevention strategies.

    PubMed

    Chu, Constance R; Andriacchi, Thomas P

    2015-07-01

    Osteoarthritis (OA) is a leading cause of human suffering and disability for which disease-modifying treatments are lacking. OA occurs through complex and dynamic interplays between diverse factors over long periods of time. The traditional research and clinical focus on OA, the end stage disease, obscured understanding pathogenesis prior to reaching a common pathway defined by pain and functional deficits, joint deformity, and radiographic changes. To emphasize disease modification and prevention, we describe a multi-disciplinary systems-based approach encompassing biology, mechanics, and structure to define pre-osteoarthritic disease processes. Central to application of this model is the concept of "pre-osteoarthritis," conditions where clinical OA has not yet developed. Rather, joint homeostasis has been compromised and there are potentially reversible markers for heightened OA risk. Key messages from this perspective are (i) to focus research onto defining pre-OA through identifying and validating biological, mechanical, and imaging markers of OA risk, (ii) to emphasize multi-disciplinary approaches, and (iii) to propose that developing personalized interventions to address reversible markers of OA risk in healthy joints may be the key to prevention. Ultimately, a systems-based analysis of OA pathogenesis shows potential to transform clinical practice by facilitating development and testing of new strategies to prevent or delay the onset of osteoarthritis. PMID:25639920

  18. Joint Modeling of Transitional Patterns of Alzheimer's Disease

    PubMed Central

    Liu, Wei; Zhang, Bo; Zhang, Zhiwei; Zhou, Xiao-Hua

    2013-01-01

    While the experimental Alzheimer's drugs recently developed by pharmaceutical companies failed to stop the progression of Alzheimer's disease, clinicians strive to seek clues on how the patients would be when they visit back next year, based upon the patients' current clinical and neuropathologic diagnosis results. This is related to how to precisely identify the transitional patterns of Alzheimer's disease. Due to the complexities of the diagnosis of Alzheimer's disease, the condition of the disease is usually characterized by multiple clinical and neuropathologic measurements, including Clinical Dementia Rating (CDRGLOB), Mini-Mental State Examination (MMSE), a score derived from the clinician judgement on neuropsychological tests (COGSTAT), and Functional Activities Questionnaire (FAQ). In this research article, we investigate a class of novel joint random-effects transition models that are used to simultaneously analyze the transitional patterns of multiple primary measurements of Alzheimer's disease and, at the same time, account for the association between the measurements. The proposed methodology can avoid the bias introduced by ignoring the correlation between primary measurements and can predict subject-specific transitional patterns. PMID:24073268

  19. Perceptions of coping with non-disease-related life stress for women with osteoarthritis: a qualitative analysis

    PubMed Central

    Harris, Melissa L; Byles, Julie E; Townsend, Natalie; Loxton, Deborah

    2016-01-01

    Objective Coping with arthritis-related stress has been extensively studied. However, limited evidence exists regarding coping with stress extraneous to the disease (life stress). This study explored life stress and coping in a subset of older women with osteoarthritis from a larger longitudinal study. Setting An Australian regional university. Design This qualitative study involved semistructured telephone interviews. Potential participants were mailed a letter of invitation/participant information statement by the Australian Longitudinal Study on Women's Health (ALSWH). Invitations were sent out in small batches (primarily 10). Interviews were conducted until data saturation was achieved using a systematic process (n=19). Digitally recorded interviews were transcribed verbatim and deidentified. Data were thematically analysed. Participants Women who indicated being diagnosed or treated for arthritis in the previous 3 years in the fifth survey of the ALSWH (conducted in 2007) provided the sampling frame. Potential participants were randomly sampled by a blinded data manager using a random number generator. Results Coping with life stress involved both attitudinal coping processes developed early in life (ie, stoicism) and transient cognitive and support-based responses. Women also described a dualistic process involving a reduction in the ability to cope with ongoing stress over time, coupled with personal growth. Conclusions This is the first study to examine how individuals cope with non-arthritis-related stress. The findings add to the current understanding of stress and coping, and have implications regarding the prevention of arthritis in women. Importantly, this study highlighted the potential detrimental impact of persistent coping patterns developed early in life. Public health campaigns aimed at stress mitigation and facilitation of adaptive coping mechanisms in childhood and adolescence may assist with arthritis prevention. PMID:27188808

  20. An increased rate of falling leads to a rise in fracture risk in postmenopausal women with self-reported osteoarthritis: a prospective multinational cohort study (GLOW)

    PubMed Central

    Prieto-Alhambra, Daniel; Nogues, Xavier; Javaid, M Kassim; Wyman, Allison; Arden, Nigel K; Azagra, Rafael; Cooper, Cyrus; Adachi, Jonathan D; Boonen, Steven; Chapurlat, Roland D; Compston, Juliet E; Gehlbach, Stephen H; Greenspan, Susan L; Hooven, Frederick H; Netelenbos, J Coen; Pfeilschifter, Johannes; Rossini, Maurizio; Sambrook, Philip N; Silverman, Stuart; Siris, Ethel S; Watts, Nelson B; Díez-Pérez, Adolfo

    2016-01-01

    Objective Patients with osteoarthritis have increased bone mass, but no decrease in fractures. We studied the association between self-reported osteoarthritis and incident falls and fractures in postmenopausal women. Methods GLOW is a prospective, multinational cohort of 60 393 non-institutionalised women aged ≥55 years who had visited primary care practices within the previous 2 years. Questionnaires were mailed at yearly intervals. Patients were classified as osteoarthritic if they answered yes to the question “Has a doctor or other health provider ever said that you had osteoarthritis or degenerative joint disease?”, and this was validated against primary care records. Information on incident falls, fractures, and covariates was self-reported. Cox and Poisson models were used for incident fractures and number of falls, respectively, to compute hazard ratios (HRs) and rate ratios (RRs) for baseline osteoarthritis status. Results Of 51 386 women followed for a median of 2.9 (interquartile range 2.1 to 3.0) years, 20 409 (40%) reported osteoarthritis. The adjusted HR for osteoarthritis predicting fracture was 1.21 (95% CI 1.13 to 1.30; p<0.0001) and the adjusted RR for falls was 1.24 (95% CI 1.22 to 1.26; p<0.0001). However, the association between osteoarthritis and fracture was not significant after adjustment for incident falls: HR 1.06 (95% CI 0.98 to 1.15; p=0.13). Conclusion Postmenopausal women with self-reported osteoarthritis have a 20% increased risk of fracture and experience 25% more falls than osteoarthritis-free peers. Our data suggest that increased falls are the causal pathway of the association between osteoarthritis and fractures. PMID:22730372

  1. Strontium ranelate in the treatment of knee osteoarthritis: new insights and emerging clinical evidence.

    PubMed

    Reginster, Jean-Yves; Beaudart, Charlotte; Neuprez, Audrey; Bruyère, Olivier

    2013-10-01

    Osteoarthritis is a primary cause of disability and functional incapacity. Pharmacological treatment is currently limited to symptomatic management, and in advanced stages, surgery remains the only solution. The therapeutic armamentarium for osteoarthritis remains poor in treatments with an effect on joint structure, that is, disease-modifying osteoarthritis drugs (DMOADs). Glucosamine sulfate and chondroitin sulfate are the only medications for which some conclusive evidence for a disease-modifying effect is available. Strontium ranelate is currently indicated for the prevention of fracture in severe osteoporosis. Its efficacy and safety as a DMOAD in knee osteoarthritis has recently been explored in the SEKOIA trial, a 3-year randomized, double-blind, placebo-controlled trial. Outpatients with knee osteoarthritis, Kellgren and Lawrence grade 2 or 3, and joint space width (JSW) of 2.5-5 mm received strontium ranelate 1 g/day (n = 558) or 2 g/day (n = 566), or placebo (n = 559). This sizable population was aged 62.9 years and had a JSW of 3.50 ± 0.84 mm. Treatment with strontium ranelate led to significantly less progression of knee osteoarthritis: estimates for annual difference in joint space narrowing versus placebo were 0.14 mm [95% confidence interval (CI) 0.05-0.23 mm; p < 0.001] for 1 g/day and 0.10 mm (95% CI 0.02-0.19 mm; p = 0.018) for 2 g/day, with no difference between strontium ranelate groups. Radiological progression was less frequent with strontium ranelate (22% with 1 g/day and 26% with 2 g/day versus 33% with placebo, both p < 0.05), as was radioclinical progression (8% and 7% versus 12%, both p < 0.05). Symptoms also improved with strontium ranelate 2 g/day only in terms of total WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) score (p = 0.045), and its components for pain (p = 0.028) and physical function (p = 0.099). Responder analyses using a range of criteria for symptoms indicated that the effect of strontium ranelate 2 g/day on pain and physical function was clinically meaningful. Strontium ranelate was well tolerated. The observation of both structure and symptom modification with strontium ranelate 2 g/day makes SEKOIA a milestone in osteoarthritis research and treatment. PMID:24101948

  2. Measurements of C-reactive protein in serum and lactate dehydrogenase in serum and synovial fluid of patients with osteoarthritis.

    PubMed

    Hurter, K; Spreng, D; Rytz, U; Schawalder, P; Ott-Knüsel, F; Schmökel, H

    2005-03-01

    Diagnosis of osteoarthritis (OA) is based upon the clinical orthopaedic examination and the radiographic assessment, both of which can be non-specific and insensitive in early joint disease. The aim of our study was to investigate if there is an increase in serum levels of C-reactive protein (CRP) in degenerative joint disease (DJD) and if CRP could be used to help diagnose OA. We also wished to investigate whether it was possible to distinguish a joint with clinically and radiographically confirmed OA from a healthy joint by comparing lactate dehydrogenase (LDH) levels within the synovial fluid and the serum. We have shown a difference in synovial LDH levels between diseased and healthy joints (P<0.0001). There was also a significant difference between LDH in arthritic synovial fluid and serum, with no correlation between the values. Despite the fact that the values of our clinical patients tended to be higher than the values of our control group (P=0.05) all measured values were within the normal limits of previous publications. From these data, we conclude that single measurements of serum CRP do not permit detection of OA in clinical patients and that serum LDH is not a reliable marker for osteoarthritis. LDH levels in the synovial fluid could be of diagnostic value for identifying osteoarthritis. PMID:15727922

  3. Effects of Intensive Diet and Exercise on Knee Joint Loads, Inflammation, and Clinical Outcomes Among Overweight and Obese Adults With Knee Osteoarthritis

    PubMed Central

    Messier, Stephen P.; Mihalko, Shannon L.; Legault, Claudine; Miller, Gary D.; Nicklas, Barbara J.; DeVita, Paul; Beavers, Daniel P.; Hunter, David J.; Lyles, Mary F.; Eckstein, Felix; Williamson, Jeff D.; Carr, J. Jeffery; Guermazi, Ali; Loeser, Richard F.

    2015-01-01

    IMPORTANCE Knee osteoarthritis (OA), a common cause of chronic pain and disability, has biomechanical and inflammatory origins and is exacerbated by obesity. OBJECTIVE To determine whether a ≥10% reduction in body weight induced by diet, with or without exercise, would improve mechanistic and clinical outcomes more than exercise alone. DESIGN, SETTING, AND PARTICIPANTS Single-blind, 18-month, randomized clinical trial at Wake Forest University between July 2006 and April 2011. The diet and exercise interventions were center-based with options for the exercise groups to transition to a home-based program. Participants were 454 overweight and obese older community-dwelling adults (age ≥55 years with body mass index of 27–41) with pain and radiographic knee OA. INTERVENTIONS Intensive diet-induced weight loss plus exercise, intensive diet-induced weight loss, or exercise. MAIN OUTCOMES AND MEASURES Mechanistic primary outcomes: knee joint compressive force and plasma IL-6 levels; secondary clinical outcomes: self-reported pain (range, 0–20), function (range, 0–68), mobility, and health-related quality of life (range, 0–100). RESULTS At 18 months, 399 participants (88%) completed the study. Compared with exercise participants, knee compressive forces were lower in diet participants and IL-6 levels were lower in diet and diet + exercise participants. 18-mo Outcomes, Mean (95% CI) Exercise(E) Diet (D) D + E Difference,E vs D Difference, Evs D+E Weight loss, kg −1.8(−5.7to1.8) −8.9(−12.4 to −5.3) −10.6(−14.1 to −7.1) Knee compressiveforces, N 2687(2590 to 2784) 2487(2393 to 2581) 2543(2448 to 2637) 200(55 to 345)a 144(1 to 287) IL-6, pg/mL 3.1(2.9 to 3.4) 2.7(2.4 to 3.0) 2.7(2.5 to 3.0) 0.43(0.01 to 0.85)a 0.39(−0.03 to 0.81)a Pain 4.7(4.2 to 5.1) 4.8(4.3 to 5.2) 3.6(3.2 to 4.1) −0.11(−0.81 to 0.59) 1.02(0.33 to 1.71)a Function 18.4(16.9 to 19.9) 17.4(15.9 to 18.9) 14.1(12.6 to 15.6) 0.98(−1.24 to 3.20) 4.29(2.07 to 6.50)a SF-36 physical 41.9(40.5 to 43.2) 42.4(41.1 to 43.7) 44.7(43.4 to 46.0) −0.55(−2.53 to 1.43) −2.81(−4.76 to −0.86)a a Differences were significant. CONCLUSIONS AND RELEVANCE Among overweight and obese adults with knee OA, after 18 months, participants in the diet + exercise and diet groups had more weight loss and greater reductions in IL-6 levels than those in the exercise group; those in the diet group had greater reductions in knee compressive force than those in the exercise group. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00381290 PMID:24065013

  4. Aerobic Activity in Prevention & Symptom Control of Osteoarthritis

    PubMed Central

    Semanik, Pamela; Chang, Rowland W.; Dunlop, Dorothy D.

    2014-01-01

    Almost 27 million US adults suffer from some form of osteoarthritis (OA). An epidemic of arthritis-associated disability is expected in the US over the next 2 decades, largely fueled by the aging population and the tremendous growth in the prevalence of knee osteoarthritis (OA). Regular physical activity (PA), particularly strengthening and aerobic activity, can reduce pain and improve function and health status among patients with knee and hip osteoarthritis. The focus of this review is to examine the impact of aerobic activity on OA progression and symptom control. In general, both strengthening and aerobic exercise are associated with improvements in pain, perceived physical function, and performance measures for those with lower limb OA; although comparisons of strengthening versus aerobic exercise on these outcomes is unusual. Structural disease progression in persons with established OA has been directly evaluated by a limited number of PA clinical trials in knee OA, but these protocols focused on strength training exclusively. In healthy subjects, it appears that overall PA is beneficial, rather than detrimental, to knee joint health. Possibly the most important reason for engaging in PA is to prevent obesity, which has independently been associated with many serious chronic diseases, including OA incidence and progression. More research is needed to determine the optimal types and dosing of aerobic conditioning. PMID:22632701

  5. Management of the Retired Athlete with Osteoarthritis of the Knee

    PubMed Central

    Garrett, William E.

    2012-01-01

    Purpose: Osteoarthritis of the knee is a complex interaction of biological, mechanical, and biochemical factors that are further complicated by injury, which accelerates pathological processes within the joint. As a result, athletes, particularly those with a history of knee injury, have an earlier onset and higher prevalence of osteoarthritis that would be expected based on their age. This can present a clinical dilemma to the physician managing the patient who, despite the presence of radiologically confirmed disease, has few symptoms and wishes to maintain an active lifestyle. Methods: We reviewed meta-analyses and systematic reviews of randomized controlled trials about clinical management of knee osteoarthritis with special interest on effect sizes. Results: Numerous management options have undergone the rigor of clinical trials and subsequently have been summarized in meta-analyses and systematic reviews, the results of which offer evidence regarding varying degrees of effect. Based on the available evidence, most summaries and clinical practice guidelines suggest a regimen of patient education, self-management, weight control, and exercise supported by individualized pain management strategies. Other noninvasive or less invasive strategies are available that have varying degrees of effect. Conclusions: Although the evidence supporting many of the clinical management options might be considered modest, those effects are sufficient to permit an active lifestyle and have, given the prevalence of the disease, a public health impact. PMID:26069611

  6. Effects of Diagnostic Label and Disease Information on Emotions, Beliefs, and Willingness to Help Older Parents with Osteoarthritis

    ERIC Educational Resources Information Center

    Thomas, Kali S.; McIlvane, Jessica M.; Haley, William E.

    2012-01-01

    We studied the impact of the diagnostic label of osteoarthritis and educational information on family members' attributions, perceptions, and willingness to help older parents with pain. Undergraduate students (N = 636) were randomly assigned to one of three conditions where they read vignettes about an older mother with chronic pain, which varied…

  7. Effects of Diagnostic Label and Disease Information on Emotions, Beliefs, and Willingness to Help Older Parents with Osteoarthritis

    ERIC Educational Resources Information Center

    Thomas, Kali S.; McIlvane, Jessica M.; Haley, William E.

    2012-01-01

    We studied the impact of the diagnostic label of osteoarthritis and educational information on family members' attributions, perceptions, and willingness to help older parents with pain. Undergraduate students (N = 636) were randomly assigned to one of three conditions where they read vignettes about an older mother with chronic pain, which varied

  8. Unraveling the role of Mg(++) in osteoarthritis.

    PubMed

    Li, Yaqiang; Yue, Jiaji; Yang, Chunxi

    2016-02-15

    Mg(++) is widely involved in human physiological processes that may play key roles in the generation and progression of diseases. Osteoarthritis (OA) is a complex joint disorder characterized by articular cartilage degradation, abnormal mineralization and inflammation. Magnesium deficiency is considered to be a major risk factor for OA development and progression. Magnesium deficiency is active in several pathways that have been implicated in OA, including increased inflammatory mediators, cartilage damage, defective chondrocyte biosynthesis, aberrant calcification and a weakened effect of analgesics. Abundant in vitro and in vivo evidence in animal models now suggests that the nutritional supplementation or local infiltration of Mg(++) represent effective therapies for OA. The goal of this review is to summarize the current understanding of the role of Mg(++) in OA with particular emphasis on the related molecular mechanisms involved in OA progression. PMID:26800786

  9. Complementary and alternative exercises for management of osteoarthritis.

    PubMed

    Chyu, Ming-Chien; von Bergen, Vera; Brismée, Jean-Michel; Zhang, Yan; Yeh, James K; Shen, Chwan-Li

    2011-01-01

    Osteoarthritis (OA) is a chronic condition characterized by degeneration of cartilage and its underlying bone within a joint. With no cure currently available, the goals of treating OA are to alleviate pain, maintain, or improve joint mobility, increase the muscle strength of the joints, and minimize the disabling effects of the disease. Recent research has suggested that complementary and alternative medicine (CAM) exercises may improve OA symptoms. This paper covers CAM mind-body exercises-Tai Chi, qigong, and yoga-for OA management and evaluates their benefits in pain reduction, muscle strength, physical function, stiffness, balance, fear of falling, self-efficacy, quality of life, and psychological outcomes in patients with OA, based on randomized controlled trials published. Findings from the literature suggest that CAM exercises demonstrate considerable promise in the management of OA. Future studies require rigorous randomized controlled trials with larger sample sizes. PMID:22046516

  10. Complementary and Alternative Exercises for Management of Osteoarthritis

    PubMed Central

    Chyu, Ming-Chien; von Bergen, Vera; Brismée, Jean-Michel; Zhang, Yan; Yeh, James K.; Shen, Chwan-Li

    2011-01-01

    Osteoarthritis (OA) is a chronic condition characterized by degeneration of cartilage and its underlying bone within a joint. With no cure currently available, the goals of treating OA are to alleviate pain, maintain, or improve joint mobility, increase the muscle strength of the joints, and minimize the disabling effects of the disease. Recent research has suggested that complementary and alternative medicine (CAM) exercises may improve OA symptoms. This paper covers CAM mind-body exercises—Tai Chi, qigong, and yoga—for OA management and evaluates their benefits in pain reduction, muscle strength, physical function, stiffness, balance, fear of falling, self-efficacy, quality of life, and psychological outcomes in patients with OA, based on randomized controlled trials published. Findings from the literature suggest that CAM exercises demonstrate considerable promise in the management of OA. Future studies require rigorous randomized controlled trials with larger sample sizes. PMID:22046516

  11. Adipokine Hormones and Hand Osteoarthritis: Radiographic Severity and Pain

    PubMed Central

    Massengale, Mei; Lu, Bing; Pan, John J.; Katz, Jeffrey N.; Solomon, Daniel H.

    2012-01-01

    Introduction Obesity's association with hand osteoarthritis cannot be fully explained by mechanical loading. We examined the relationship between adipokines and radiographic hand osteoarthritis severity and pain. Methods In a pilot study of 44 hand osteoarthritis patients (39 women and 5 men), serum adipokine concentrations and hand x-ray Kallman-scores were analyzed using linear regression models. Secondary analyses examined correlates of hand pain. Results The cohort had a mean age of 63.5 years for women and 72.6 for men; mean (standard deviation) Kallman-scores were 43.3(17.4) for women and 46.2(10.8) for men. Mean body-mass-index was 30 kg/m2 for women and men. Mean leptin concentration was 32.2 ng/ml (women) and 18.5 ng/ml (men); mean adiponectin-total was 7.9 ng/ml (women) and 5.3 ng/ml (men); mean resistin was 7.3 ng/ml (women) and 9.4 ng/ml (men). No association was found between Kallman-scores and adipokine concentrations (R2 = 0.00–0.04 unadjusted analysis, all p-values>0.22). Secondary analyses showed mean visual-analog-scale pain of 4.8(2.4) for women and 6.6(0.9) for men. Leptin, BMI, and history of coronary artery disease were found to be associated with visual-analog-scale scores for chronic hand pain (R2 = 0.36 unadjusted analysis, p-values≤0.04). Conclusion In this pilot study, we found that adipokine serum concentrations were not associated with hand osteoarthritis radiographic severity; the most important correlates of joint damage were age and disease duration. Leptin serum concentration, BMI, and coronary artery disease were associated with the intensity of chronic hand OA pain. PMID:23110114

  12. Osteoarthritis associated with estrogen deficiency

    PubMed Central

    2009-01-01

    Osteoarthritis (OA) affects all articular tissues and finally leads to joint failure. Although articular tissues have long been considered unresponsive to estrogens or their deficiency, there is now increasing evidence that estrogens influence the activity of joint tissues through complex molecular pathways that act at multiple levels. Indeed, we are only just beginning to understand the effects of estrogen deficiency on articular tissues during OA development and progression, as well as on the association between OA and osteoporosis. Estrogen replacement therapy and current selective estrogen receptor modulators have mixed effectiveness in preserving and/or restoring joint tissue in OA. Thus, a better understanding of how estrogen acts on joints and other tissues in OA will aid the development of specific and safe estrogen ligands as novel therapeutic agents targeting the OA joint as a whole organ. PMID:19804619

  13. Atherosclerotic cardiovascular disease in patients with chronic inflammatory joint disorders.

    PubMed

    Agca, R; Heslinga, S C; van Halm, V P; Nurmohamed, M T

    2016-05-15

    Inflammatory joint disorders (IJD), including rheumatoid arthritis (RA), ankylosing spondylitis (ASp) and psoriatic arthritis (PsA), are prevalent conditions worldwide with a considerable burden on healthcare systems. IJD are associated with increased cardiovascular (CV) disease-related morbidity and mortality. In this review, we present an overview of the literature. Standardised mortality ratios are increased in IJD compared with the general population, that is, RA 1.3-2.3, ASp 1.6-1.9 and PsA 0.8-1.6. This premature mortality is mainly caused by atherosclerotic events. In RA, this CV risk is comparable to that in type 2 diabetes. Traditional CV risk factors are more often present and partially a consequence of changes in physical function related to the underlying IJD. Also, chronic systemic inflammation itself is an independent CV risk factor. Optimal control of disease activity with conventional synthetic, targeted synthetic and biological disease-modifying antirheumatic drugs decreases this excess risk. High-grade inflammation as well as anti-inflammatory treatment alter traditional CV risk factors, such as lipids. In view of the above-mentioned CV burden in patients with IJD, CV risk management is necessary. Presently, this CV risk management is still lacking in usual care. Patients, general practitioners, cardiologists, internists and rheumatologists need to be aware of the substantially increased CV risk in IJD and should make a combined effort to timely initiate CV risk management in accordance with prevailing guidelines together with optimal control of rheumatic disease activity. CV screening and treatment strategies need to be implemented in usual care. PMID:26888573

  14. Evidence from Raman Spectroscopy of a Putative Link Between Inherent Bone Matrix Chemistry and Degenerative Joint Disease

    PubMed Central

    Kerns, Jemma G; Gikas, Panagiotis D; Buckley, Kevin; Shepperd, Adam; Birch, Helen L; McCarthy, Ian; Miles, Jonathan; Briggs, Timothy W R; Keen, Richard; Parker, Anthony W; Matousek, Pavel; Goodship, Allen E

    2014-01-01

    Objective Osteoarthritis (OA) is a common debilitating disease that results in degeneration of cartilage and bone in the synovial joints. Subtle changes in the molecular structure of the subchondral bone matrix occur and may be associated with cartilage changes. The aim of this study was to explore whether the abnormal molecular changes observed in the matrix of OA subchondral bone can be identified with Raman spectroscopy. Methods Tibial plateaus from patients undergoing total knee replacement for OA (n = 10) were compared with healthy joints from patients undergoing leg amputation (n = 5; sex- and laterality-matched) and with non-OA cadaveric knee specimens (n = 5; age-matched). The samples were analyzed with Raman spectroscopy, peripheral quantitative computed tomography, and chemical analysis to compare changes in defined load-bearing sites in both the medial and lateral compartments. Results OA subchondral bone matrix changes were detected by Raman spectroscopy. Within each cohort, there was no spectral difference in bone matrix chemistry between the medial and lateral compartments, whereas a significant spectral difference (P < 0.001) was observed between the non-OA and OA specimens. Type I collagen chain ratios were normal in the non-OA specimens but were significantly elevated in the OA specimens. Conclusion In comparing the results of Raman spectroscopy with those obtained by other standard techniques, these findings show, for the first time, that subchondral bone changes, or inherent differences, exist in both the medial and lateral (beneath intact cartilage) compartments of OA knees. The development of Raman spectroscopy as a screening tool, based on molecular-specific modifications in bone, would facilitate the identification of clinical disease, including early molecular changes. PMID:24470432

  15. Trapeziometacarpal osteoarthritis: pyrocarbon interposition implants

    PubMed Central

    ODELLA, SIMONA; QUERENGHI, AMOS M.; SARTORE, ROBERTA; DE FELICE, AGOSTINO; DACATRA, UGO

    2014-01-01

    Purpose the aim of this study was to evaluate the effectiveness of interposition arthroplasty of the trapeziometacarpal (TMC) joint with pyrolitic carbon implants for the treatment of TMC osteoarthritis. Methods we evaluated two groups of patients surgically treated for TMC osteoarthritis: group 1 (34 patients - 36 TMC joints) treated with PyroDisk implantation and group 2 (25 patients - 25 TMC joints) treated with the Pyrocardan implant. All these patients were clinically evaluated at follow-up using the DASH score, Mayo Wrist score and VAS pain score. Results the mean follow-up was 42 months in group 1 and 12 months in group 2. Both groups showed good clinical outcomes in terms of pain relief, range of motion, and pinch and grasp strength. Revision surgery was needed in only one case in group 1 (2.8%) and in three cases (12%) in group 2. Conclusions prosthetic replacement of the TMC joint was found to be a good solution for low-demand patients. However, the PyroDisk could be a good solution in selected patients (Eaton stage I–III, non-subluxated joint): it provides good pain relief, good range of motion, good pinch and grasp strength, and stable results at more than three-years of follow-up. Level of evidence Level IV, therapeutic case series. PMID:25750903

  16. Current understanding of pathogenesis and treatment of TMJ osteoarthritis.

    PubMed

    Wang, X D; Zhang, J N; Gan, Y H; Zhou, Y H

    2015-05-01

    Osteoarthritis is a common disease that can cause severe pain and dysfunction in any joint, including the temporomandibular joint (TMJ). TMJ osteoarthritis (TMJOA) is an important subtype in the classification of temporomandibular disorders. TMJOA pathology is characterized by progressive cartilage degradation, subchondral bone remodeling, and chronic inflammation in the synovial tissue. However, the exact pathogenesis and process of TMJOA remain to be understood. An increasing number of studies have recently focused on inflammation and remodeling of subchondral bone during the early stage of TMJOA, which may elucidate the possible mechanism of initiation and progression of TMJOA. The treatment strategy for TMJOA aims at relieving pain, preventing the progression of cartilage and subchondral bone destruction, and restoring joint function. Conservative therapy with nonsteroidal anti-inflammatory drugs, splint, and physical therapy, such as low-energy laser and arthrocentesis, are the most common treatments for TMJOA. These therapies are effective in most cases in relieving the signs and symptoms, but their long-term therapeutic effect on the pathologic articular structure is unsatisfactory. A treatment that can reverse the damage of TMJOA remains unavailable to date. Treatments that prevent the progression of cartilage degradation and subchondral bone damage should be explored, and regeneration for the TMJ may provide the ideal long-term solution. This review summarizes the current understanding of mechanisms underlying the pathogenesis and treatment of TMJOA. PMID:25744069

  17. Relationship between pelvic incidence and osteoarthritis of the hip

    PubMed Central

    Weinberg, D. S.; Bohl, M. S.; Liu, R. W.

    2016-01-01

    Objectives Sagittal alignment of the lumbosacral spine, and specifically pelvic incidence (PI), has been implicated in the development of spine pathology, but generally ignored with regards to diseases of the hip. We aimed to determine if increased PI is correlated with higher rates of hip osteoarthritis (HOA). The effect of PI on the development of knee osteoarthritis (KOA) was used as a negative control. Methods We studied 400 well-preserved cadaveric skeletons ranging from 50 to 79 years of age at death. Each specimen’s OA of the hip and knee were graded using a previously described method. PI was measured from standardised lateral photographs of reconstructed pelvises. Multiple regression analysis was performed to determine the relationship between age and PI with HOA and KOA. Results The mean age was 60.2 years (standard deviation (sd) 8.1), and the mean PI was 46.7° (sd 10.7°). Multiple regression analysis demonstrated a significant correlation between increased PI and HOA (standardised beta = 0.103, p = 0.017). There was no correlation between PI and KOA (standardised beta = 0.003, p = 0.912). Conclusion Higher PI in the younger individual may contribute to the development of HOA in later life. Cite this article: Dr J. J. Gebhart. Relationship between pelvic incidence and osteoarthritis of the hip. Bone Joint Res 2016;5:66–72. DOI: 10.1302/2046-3758.52.2000552. PMID:26912384

  18. Diagnosis and clinical presentation of osteoarthritis.

    PubMed

    Abhishek, A; Doherty, Michael

    2013-02-01

    Osteoarthritis (OA), the commonest arthropathy, targets the knees, hips, finger interphalangeal joints, thumb bases, first metatarsophalangeal joints, and spinal facet joints, and displays marked heterogeneity of clinical presentation. Signs of OA include coarse crepitus, bony enlargement, reduced range of movement, and joint-line tenderness. Muscle wasting and joint deformity occur with severe OA. Painful periarticular disorders often coexist with OA. Inflammation is absent or only modest, although mild-moderate effusions are common at the knee. The diagnosis of OA may be made without recourse to radiographic or laboratory investigations in the at-risk age group with typical symptoms and signs. PMID:23312410

  19. [ESC/EASD joint guidelines on diabetes and cardiovascular diseases].

    PubMed

    Motz, Wolfgang; Dörr, Rolf

    2009-02-01

    The ESC/EASD (European Society of Cardiology/European Association for the Study of Diabetes) joint Guidelines on diabetes, pre-diabetes, and cardiovascular diseases have, for the first time, addressed diabetes mellitus and cardiovascular diseases (CVD) as a pathophysiological entity in Europe. Based on these guidelines, diabetes mellitus is regarded from the outset to be a cardiovascular disease, whose life-threatening complications myocardial infarction and stroke can only be avoided by an interdisciplinary concerted action. The most important information of these guidelines for the interdisciplinary cooperation of primary-care physicians, diabetologists and cardiologists are the postulations that patients with the main diagnosis diabetes mellitus with or without known CVD should, at regular intervals, be referred to a cardiologist, and patients with the main diagnosis CVD with or without diabetes mellitus should, at regular intervals, be referred to a diabetologist. Of fundamental importance is the prevention of diabetes and CVD by a comprehensive lifestyle modification including smoking cessation, regular physical activity and weight control, flanked by an evidence-based drug therapy. Within the framework of a multimodal risk management, an optimal antihypertensive therapy of a concomitant elevated blood pressure; a statin therapy in case of elevated LDL cholesterol or regardless of an elevated LDL in proven CVD; ACE inhibitors, angiotensin II receptor blockers, or beta-blockers in case of heart failure; and an anticoagulant therapy for the prevention of cardioembolic stroke in patients with atrial fibrillation all have class I recommendations. Concerning the preferred coronary revascularization procedure in diabetics, today no rigid general recommendation can be given in favor of or against coronary bypass surgery, or in favor of or against percutaneous coronary intervention. The decision for a specific revascularization procedure should, in any case, be based on a detailed analysis of the individual coronary anatomy. PMID:19214406

  20. Non-invasive mouse models of post-traumatic osteoarthritis.

    PubMed

    Christiansen, B A; Guilak, F; Lockwood, K A; Olson, S A; Pitsillides, A A; Sandell, L J; Silva, M J; van der Meulen, M C H; Haudenschild, D R

    2015-10-01

    Animal models of osteoarthritis (OA) are essential tools for investigating the development of the disease on a more rapid timeline than human OA. Mice are particularly useful due to the plethora of genetically modified or inbred mouse strains available. The majority of available mouse models of OA use a joint injury or other acute insult to initiate joint degeneration, representing post-traumatic osteoarthritis (PTOA). However, no consensus exists on which injury methods are most translatable to human OA. Currently, surgical injury methods are most commonly used for studies of OA in mice; however, these methods may have confounding effects due to the surgical/invasive injury procedure itself, rather than the targeted joint injury. Non-invasive injury methods avoid this complication by mechanically inducing a joint injury externally, without breaking the skin or disrupting the joint. In this regard, non-invasive injury models may be crucial for investigating early adaptive processes initiated at the time of injury, and may be more representative of human OA in which injury is induced mechanically. A small number of non-invasive mouse models of PTOA have been described within the last few years, including intra-articular fracture of tibial subchondral bone, cyclic tibial compression loading of articular cartilage, and anterior cruciate ligament (ACL) rupture via tibial compression overload. This review describes the methods used to induce joint injury in each of these non-invasive models, and presents the findings of studies utilizing these models. Altogether, these non-invasive mouse models represent a unique and important spectrum of animal models for studying different aspects of PTOA. PMID:26003950

  1. The Complexity of Human Walking: A Knee Osteoarthritis Study

    PubMed Central

    Kotti, Margarita; Duffell, Lynsey D.; Faisal, Aldo A.; McGregor, Alison H.

    2014-01-01

    This study proposes a framework for deconstructing complex walking patterns to create a simple principal component space before checking whether the projection to this space is suitable for identifying changes from the normality. We focus on knee osteoarthritis, the most common knee joint disease and the second leading cause of disability. Knee osteoarthritis affects over 250 million people worldwide. The motivation for projecting the highly dimensional movements to a lower dimensional and simpler space is our belief that motor behaviour can be understood by identifying a simplicity via projection to a low principal component space, which may reflect upon the underlying mechanism. To study this, we recruited 180 subjects, 47 of which reported that they had knee osteoarthritis. They were asked to walk several times along a walkway equipped with two force plates that capture their ground reaction forces along 3 axes, namely vertical, anterior-posterior, and medio-lateral, at 1000 Hz. Data when the subject does not clearly strike the force plate were excluded, leaving 1–3 gait cycles per subject. To examine the complexity of human walking, we applied dimensionality reduction via Probabilistic Principal Component Analysis. The first principal component explains 34% of the variance in the data, whereas over 80% of the variance is explained by 8 principal components or more. This proves the complexity of the underlying structure of the ground reaction forces. To examine if our musculoskeletal system generates movements that are distinguishable between normal and pathological subjects in a low dimensional principal component space, we applied a Bayes classifier. For the tested cross-validated, subject-independent experimental protocol, the classification accuracy equals 82.62%. Also, a novel complexity measure is proposed, which can be used as an objective index to facilitate clinical decision making. This measure proves that knee osteoarthritis subjects exhibit more variability in the two-dimensional principal component space. PMID:25232949

  2. Nanomedicine: AFM tackles osteoarthritis

    NASA Astrophysics Data System (ADS)

    Aigner, Thomas; Schmitz, Nicole; Haag, Jochen

    2009-03-01

    Current diagnostic tools detect cartilage degeneration only at advanced stages, but the atomic force microscope can now detect structural changes earlier, paving the way for treatment of joint diseases.

  3. Diclofenac Topical (osteoarthritis pain)

    MedlinePlus

    ... certain joints such as those of the knees, ankles, feet, elbows, wrists, and hands. Diclofenac topical liquid ( ... of the nose); swelling of the hands, feet, ankles, or lower legs; or kidney or liver disease. ...

  4. Correlation of CD₄⁺ CD₂₅⁺ Foxp₃⁺ Treg with the recovery of joint function after total knee replacement in rats with osteoarthritis.

    PubMed

    Guo, S-Y; Ding, Y-J; Li, L; Zhang, T; Zhang, Z-Z; Zhang, E-S

    2015-01-01

    In this study, we observed changes in CD4(+) CD25(+) Foxp3(+) Treg expression in rats with osteoarthritis (OA) to explore the role that CD4(+) CD25(+) Foxp3(+) Treg plays in the decline in the condition of OA rats. Thirty rats were randomly divided into 2 groups equally and OA was induced in rats in the model group by injection of papain and l-cysteine into the right knee joint. Cartilage lesions were scored by the modified Mankin scale; pulmonary function was assessed by spirometry; interleukin (IL)-17 and IL-4 levels were evaluated by the enzyme-linked immunosorbent assay; and the levels of CD4(+) CD25(+) Foxp3(+) Treg in peripheral blood were measured by flow cytometry. The left knee joints of the model rats appeared palpable swelling and osteophytes, while the body weight, heart and lung function of these rats decreased. The serum IL-4 level was lower, whereas the serum IL-17 level was higher in the model group (P < 0.05). The peripheral blood CD4(+) CD25(+) Foxp3(+) Treg of CD4(+)T cells was significantly lower. Correlation of the changes in the levels of IL-4, IL-17, and Treg suggests that the underlying mechanism may be a reduction of the regulatory effect of Treg. The specific mechanism still requires further study. PMID:26214407

  5. Differential proteomic analysis of synovial fluid from rheumatoid arthritis and osteoarthritis patients

    PubMed Central

    2014-01-01

    Background Rheumatoid arthritis and osteoarthritis are two common musculoskeletal disorders that affect the joints. Despite high prevalence rates, etiological factors involved in these disorders remain largely unknown. Dissecting the molecular aspects of these disorders will significantly contribute to improving their diagnosis and clinical management. In order to identify proteins that are differentially expressed between these two conditions, a quantitative proteomic profiling of synovial fluid obtained from rheumatoid arthritis and osteoarthritis patients was carried out by using iTRAQ labeling followed by high resolution mass spectrometry analysis. Results We have identified 575 proteins out of which 135 proteins were found to be differentially expressed by ≥3-fold in the synovial fluid of rheumatoid arthritis and osteoarthritis patients. Proteins not previously reported to be associated with rheumatoid arthritis including, coronin-1A (CORO1A), fibrinogen like-2 (FGL2), and macrophage capping protein (CAPG) were found to be upregulated in rheumatoid arthritis. Proteins such as CD5 molecule-like protein (CD5L), soluble scavenger receptor cysteine-rich domain-containing protein (SSC5D), and TTK protein kinase (TTK) were found to be upregulated in the synovial fluid of osteoarthritis patients. We confirmed the upregulation of CAPG in rheumatoid arthritis synovial fluid by multiple reaction monitoring assay as well as by Western blot. Pathway analysis of differentially expressed proteins revealed a significant enrichment of genes involved in glycolytic pathway in rheumatoid arthritis. Conclusions We report here the largest identification of proteins from the synovial fluid of rheumatoid arthritis and osteoarthritis patients using a quantitative proteomics approach. The novel proteins identified from our study needs to be explored further for their role in the disease pathogenesis of rheumatoid arthritis and osteoarthritis. Sartaj Ahmad and Raja Sekhar Nirujogi contributed equally to this article. PMID:24393543

  6. Anesthesia for joint replacement surgery: Issues with coexisting diseases

    PubMed Central

    Kakar, P N; Roy, Preety Mittal; Pant, Vijaya; Das, Jyotirmoy

    2011-01-01

    The first joint replacement surgery was performed in 1919. Since then, joint replacement surgery has undergone tremendous development in terms of surgical technique and anesthetic management. In this era of nuclear family and independent survival, physical mobility is of paramount importance. In recent years, with an increase in life expectancy, advances in geriatric medicine and better insurance coverage, the scenario of joint replacement surgery has changed significantly. Increasing number of young patients are undergoing joint replacement for pathologies like rheumatoid arthritis and ankylosing spondylitis. The diverse pathologies and wide range of patient population brings unique challenges for the anesthesiologist. This article deals with anesthetic issues in joint replacement surgery in patients with comorbidities. PMID:21897499

  7. Obtain osteoarthritis related molecular signature genes through regulation network.

    PubMed

    Li, Yawei; Wang, Bing; Lv, Guohua; Xiong, Guangzhong; Liu, Wei Dong; Li, Lei

    2012-01-01

    Osteoarthritis (OA), also known as degenerative joint disease or osteoarthrosis, is the most common form of arthritis. OA occurs when cartilage in the joints wears down over time. We used the GSE1919 series to identify potential genes that correlated to OA. The aim of our study was to obtain a molecular signature of OA through the regulation network based on differentially expressed genes. From the result of regulation network construction in OA, a number of transcription factors (TFs) and pathways closely related to OA were linked by our method. Peroxisome proliferator-activated receptor γ also arises as hub nodes in our transcriptome network and certain TFs containing CEBPD, EGR2 and ETS2 were shown to be related to OA by a previous study. PMID:21946934

  8. Osteoarthritis year in review 2015: biology.

    PubMed

    Malfait, A M

    2016-01-01

    This review highlights a selection of recently published literature in the area of osteoarthritis biology. Major themes transpiring from a PubMed search covering the year between the 2014 and the 2015 Osteoarthritis Research Society International (OARSI) World Congress are explored. Inflammation emerged as a significant theme, revealing complex pathways that drive dramatic changes in cartilage homeostasis and in the synovium. Highlights include a homeostatic role for CXC chemokines in cartilage, identification of the zinc-ZIP8-MTF1 axis as an essential regulator of cartilage catabolism, and the discovery that a small aggrecan fragment can have catabolic and pro-inflammatory effects through Toll-like receptor 2. Synovitis can promote joint damage, partly through alarmins such as S100A8. Synovitis and synovial expression of the pro-algesic neurotrophin, Nerve Growth Factor, are associated with pain. Increasingly, researchers are considering specific pathogenic pathways that may operate in distinct subsets of osteoarthritis associated with distinct risk factors, including obesity, age, and joint injury. In obesity, the contribution of metabolic factors and diet is under intense investigation. The role of autophagy and oxidative stress in age-related osteoarthritis has been further explored. This approach may open avenues for targeted treatment of distinct phenotypes of osteoarthritis. Finally, a small selection of novel analgesic targets in the periphery is briefly discussed, including calcitonin gene-related peptide and the neuronal sodium voltage-gated channels, Nav1.7 and Nav1.8. PMID:26707989

  9. Efficacy of Platelet-Rich Plasma versus Hyaluronic Acid for treatment of Knee Osteoarthritis: A systematic review and meta-analysis

    PubMed Central

    Sadabad, Hassan Niroomand; Behzadifar, Masoud; Arasteh, Farzad; Behzadifar, Meysam; Dehghan, Hamid Reza

    2016-01-01

    Introduction Knee osteoarthritis is a very common chronic degenerative disease that could impose significant costs to the health system. Although osteoarthritis can affect all joints, knee osteoarthritis is the most common type among adolescents. Non-surgical treatments include corticosteroids injection, hyaluronic acid, and platelet-rich plasma. The aim of this study was to investigate the efficiency of platelet-rich plasma versus hyaluronic acid for the treatment of knee osteoarthritis. Methods Pubmed, Cochran library, Scopus and Ovid databases were investigated to identify related studies from 2000 through August 2015. To study the efficiency, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) outcome using the Standard Mean Difference (SMD) index was calculated using a random model and a confidence interval of 95%. In addition, sensitivity and cumulative analysis were conducted. The data were analyzed using RevMan 5.3.5 and Stata 12 software. Results Seven studies with 722 subjects (364 participants in PRP and 358 participants in the HA group) were analyzed. The WOMAC PRP compared to HA, SMD = −0.75 (95% CI: −1.33 to −0.18, I2 = 92.6%) in treatment of knee osteoarthritis was statistically significant and PRP was more effective. Conclusion The results of this meta-analysis two years after PRP injection showed the efficacy of PRP versus HA. However, further studies are required to determine the longer-term effects. PMID:27123220

  10. Synovial inflammation in patients with different stages of knee osteoarthritis.

    PubMed

    Ene, Răzvan; Sinescu, Ruxandra Diana; Ene, Patricia; Cîrstoiu, Monica Mihaela; Cîrstoiu, Florin Cătălin

    2015-01-01

    The synovium is an intra-articular mesenchymal tissue and essential for the normal joint function. It is involved in many pathological characteristic processes and sometimes specific for this distinctive tissue. In this study, we refer to synovial proliferative disorders according to the stage of osteoarthritis (OA) disease. Forty-three patients with knee OA were treated in the Department of Orthopedics and Traumatology, Emergency University Hospital of Bucharest, Romania, in the last two years. In all cases, we used at least five criteria for the knee OA: knee pain, knee joint tenderness, no palpable warmth over the knee, stiffness, erythrocyte sedimentation rate and C-reactive protein levels. In all the cases the synovial tissue was selected by the orthopedic surgeon. X-ray examination was taken in every case of the affected joint. Patients who were considered to have early OA underwent arthroscopic synovial biopsy of the symptomatic joint. Synovial tissue samples from patients with late OA were obtained at the time of knee joint arthroplasty. Microscopic examination in early osteoarthritis revealed for more than half of patients with synovial biopsy through arthroscopic technique having synovitis lesions with mononuclear infiltrates, diffuse fibrosis, thickening of the lining layer, macrophages appearance and neoformation vessels also. The synovitis seen in advanced OA knees tends to be diffuse and is not mandatory localized to areas of chondral defects, although an association has been reported between chondral defects and associated synovitis in the knee medial tibio-femoral compartment. The overexpression of mediators of inflammation and the increased mononuclear cell infiltration were seen in early OA, compared with late OA. PMID:25826502

  11. The evolving role of biomarkers for osteoarthritis.

    PubMed

    Ishijima, Muneaki; Kaneko, Haruka; Kaneko, Kazuo

    2014-08-01

    Osteoarthritis (OA) is an increasingly important public health concern as the prevalence of this disease becomes higher and higher due to the ageing population. However, in addition to the absence of disease-modifying treatments, there are no sensitive diagnostic techniques beyond classical radiography, and physicians cannot predict who will progress with the disease. As a result, disease progression cannot be prevented or halted. Therefore, there is an urgent need for more effective techniques than radiography. Reliable, quantitative and dynamic tests to detect early damage and measure the progress of treatments targeted against joint destruction are required. Biomarkers, in addition to magnetic resonance imaging, are tools that can address these therapeutic shortcomings. Structural molecules and fragments derived from bone, cartilage and the synovium, all of which are affected by OA, have been reported to be potential candidates for biomarkers of OA. As the identification of biomarkers that can be applied more broadly from the very early to the end stages of knee OA is required, advances in the OA biomarker field remain challenging, but steadily progressive. Such advances will come not only from basic, but also preclinical and clinical research. In this review, we highlight recent OA biomarker studies generally published between 2011 and 2012. We classified the studies in this review into the following three categories: unique characteristics of the urinary level of C-terminal telopeptide of type II collagen; insight into the pathophysiology of OA revealed by biochemical biomarkers; and candidates for novel biomarkers of OA revealed by proteomics. PMID:25342994

  12. The evolving role of biomarkers for osteoarthritis

    PubMed Central

    Kaneko, Haruka; Kaneko, Kazuo

    2014-01-01

    Osteoarthritis (OA) is an increasingly important public health concern as the prevalence of this disease becomes higher and higher due to the ageing population. However, in addition to the absence of disease-modifying treatments, there are no sensitive diagnostic techniques beyond classical radiography, and physicians cannot predict who will progress with the disease. As a result, disease progression cannot be prevented or halted. Therefore, there is an urgent need for more effective techniques than radiography. Reliable, quantitative and dynamic tests to detect early damage and measure the progress of treatments targeted against joint destruction are required. Biomarkers, in addition to magnetic resonance imaging, are tools that can address these therapeutic shortcomings. Structural molecules and fragments derived from bone, cartilage and the synovium, all of which are affected by OA, have been reported to be potential candidates for biomarkers of OA. As the identification of biomarkers that can be applied more broadly from the very early to the end stages of knee OA is required, advances in the OA biomarker field remain challenging, but steadily progressive. Such advances will come not only from basic, but also preclinical and clinical research. In this review, we highlight recent OA biomarker studies generally published between 2011 and 2012. We classified the studies in this review into the following three categories: unique characteristics of the urinary level of C-terminal telopeptide of type II collagen; insight into the pathophysiology of OA revealed by biochemical biomarkers; and candidates for novel biomarkers of OA revealed by proteomics. PMID:25342994

  13. Radiographic evaluation of feline appendicular degenerative joint disease vs. Macroscopic appearance of articular cartilage.

    PubMed

    Freire, Mila; Robertson, Ian; Bondell, Howard D; Brown, James; Hash, Jon; Pease, Anthony P; Lascelles, B Duncan X

    2011-01-01

    Degenerative joint disease (DJD) is common in domesticated cats. Our purpose was to describe how radiographic findings thought to indicate feline DJD relate to macroscopic cartilage degeneration in appendicular joints. Thirty adult cats euthanized for reasons unrelated to this study were evaluated. Orthogonal digital radiographs of the elbow, tarsus, stifle, and coxofemoral joints were evaluated for the presence of DJD. The same joints were dissected for visual inspection of changes indicative of DJD and macroscopic cartilage damage was graded using a Total Cartilage Damage Score. When considering all joints, there was statistically significant fair correlation between cartilage damage and the presence of osteophytes and joint-associated mineralizations, and the subjective radiographic DJD score. Most correlations were statistically significant when looking at the different joints individually, but only the correlation between the presence of osteophytes and the subjective radiographic DJD score with the presence of cartilage damage in the elbow and coxofemoral joints had a value above 0.4 (moderate correlation). The joints most likely to have cartilage damage without radiographic evidence of DJD are the stifle (71% of radiographically normal joints) followed by the coxofemoral joint (57%), elbow (57%), and tarsal joint (46%). Our data support radiographic findings not relating well to cartilage degeneration, and that other modalities should be evaluated to aid in making a diagnosis of feline DJD. PMID:21418370

  14. Calcium Pyrophosphate Dihydrate Crystal Deposition Disease of the Sternoclavicular Joint

    PubMed Central

    Borowski, Andreas; Heikaus, Sebastian; Kurt, Muhammed

    2014-01-01

    Deposition of calcium pyrophosphate dihydrate (CPPD) crystals in the articular structures affects predominantly temporomandibular, knee, hip, spine, and wrist joints, and is a rare condition, often mimicking malignancy. Sternoclavicular joint is extremely rarely involved. We present a patient with swelling of the right upper extremity, in whom on computed tomography a mass posterior to the sternoclavicular joint causing compression of the brachiocephalic vein was detected. A modified resection arthroplasty was performed, and the histopathological findings revealed massive deposits of CPPD in the articular cartilage. To our knowledge, there is only one similar case published in the literature. PMID:26693128

  15. Exercise and knee osteoarthritis: benefit or hazard?

    PubMed Central

    Bosomworth, Neil J.

    2009-01-01

    ABSTRACT OBJECTIVE To determine whether physical exercise constitutes a benefit or a risk in the development and progression of knee osteoarthritis. QUALITY OF EVIDENCE MEDLINE, EMBASE, DARE, ACP Journal Club, and Cochrane databases were searched from registry inception to January 2009 using MeSH headings or text words, including osteoarthritis, arthritis and knee and exercise, physical training, and run. Reference lists from retrieved articles, citation listings when available, and related articles suggested in PubMed were also evaluated. For individuals without osteoarthritis, strong level II evidence was found (limited by problems with blinding and randomization); for those with pre-existing knee osteoarthritis, robust level I evidence was available. MAIN MESSAGE Knee osteoarthritis is a major contributor to disability in seniors, and patients have expressed concern that continued exercise might lead to knee symptoms in later years. Studies done on subjects self-selected for exercise and followed for substantial periods of time show no evidence of accelerated development of osteoarthritis, provided injury is avoided. Further, there is good evidence for reduced pain and disability with exercise in this cohort compared with controls. Patients with established osteoarthritis are shown to derive uniform benefit to physical functioning, with reduction of pain and disability, using aerobic, muscle strengthening, aquatic, or physiotherapy-based exercise modalities. CONCLUSION Provided trauma is avoided, moderate exercise does not lead to acceleration of knee osteoarthritis, whether or not there is evidence of pre-existing disease. In either case there appears to be improved physical functioning and reduction of pain and disability in those who exercise. It is likely that exercise interventions are underused in the management of established knee osteoarthritis symptoms. PMID:19752252

  16. Novel cartilage oligomeric matrix protein (COMP) neoepitopes identified in synovial fluids from patients with joint diseases using affinity chromatography and mass spectrometry.

    PubMed

    hrman, Emma; Lorenzo, Pilar; Holmgren, Kristin; Grodzinsky, Alan J; Dahlberg, Leif E; Saxne, Tore; Heinegrd, Dick; nnerfjord, Patrik

    2014-07-25

    To identify patients at risk for progressive joint damage, there is a need for early diagnostic tools to detect molecular events leading to cartilage destruction. Isolation and characterization of distinct cartilage oligomeric matrix protein (COMP) fragments derived from cartilage and released into synovial fluid will allow discrimination between different pathological conditions and monitoring of disease progression. Early detection of disease and processes in the tissue as well as an understanding of the pathologic mechanisms will also open the way for novel treatment strategies. Disease-specific COMP fragments were isolated by affinity chromatography of synovial fluids from patients with rheumatoid arthritis, osteoarthritis, or acute trauma. Enriched COMP fragments were separated by SDSPAGE followed by in-gel digestion and mass spectrometric identification and characterization.Using the enzymes trypsin, chymotrypsin, and Asp-N for the digestions, an extensive analysis of the enriched fragments could be accomplished. Twelve different neoepitopes were identified and characterized within the enriched COMP fragments. For one of the neoepitopes, Ser77, an inhibition ELISA was developed. This ELISA quantifies COMP fragments clearly distinguishable from total COMP. Furthermore, fragments containing the neoepitope Ser77 were released into the culture medium of cytokine (TNF-? and IL-6/soluble IL-6 receptor)-stimulated human cartilage explants. The identified neoepitopes provide a complement to the currently available commercial assays for cartilage markers. Through neoepitope assays, tools to pinpoint disease progression, evaluation methods for therapy, and means to elucidate disease mechanisms will be provided. PMID:24917676

  17. Higher Knee Flexion Moment During the Second Half of the Stance Phase of Gait Is Associated With the Progression of Osteoarthritis of the Patellofemoral Joint on Magnetic Resonance Imaging

    PubMed Central

    Teng, Hsiang-Ling; Macleod, Toran D.; Link, Thomas M.; Majumdar, Sharmila; Souza, Richard B.

    2016-01-01

    STUDY DESIGN Controlled laboratory study, longitudinal design. OBJECTIVE To examine whether baseline knee flexion moment or impulse during walking is associated with the progression of osteoarthritis (OA) with magnetic resonance imaging of the patellofemoral joint (PFJ) at 1 year. BACKGROUND Patellofemoral joint OA is highly prevalent and a major source of pain and dysfunction. The biomechanical factors associated with the progression of PFJ OA remain unclear. METHODS Three-dimensional gait analyses were performed at baseline. Magnetic resonance imaging of the knee (high-resolution, 3-D, fast spin-echo sequence) was used to identify PFJ cartilage and bone marrow edema–like lesions at baseline and a 1-year follow-up. The severity of PFJ OA progression was defined using the modified Whole-Organ Magnetic Resonance Imaging Score when new or increased cartilage or bone marrow edema–like lesions were observed at 1 year. Peak external knee flexion moment and flexion moment impulse during the first and second halves of the stance phase of gait were compared between progressors and nonprogressors, and used to predict progression after adjusting for age, sex, body mass index, and presence of baseline PFJ OA. RESULTS Sixty-one participants with no knee OA or isolated PFJ OA were included. Patellofemoral joint OA progressors (n = 10) demonstrated significantly higher peak knee flexion moment (P = .01) and flexion moment impulse (P = .04) during the second half of stance at baseline compared to nonprogressors. Logistic regression showed that higher peak knee flexion moment during the second half of the stance phase was significantly associated with progression at 1 year (adjusted odds ratio = 3.3, P = .01). CONCLUSION Peak knee flexion moment and flexion moment impulse during the second half of stance are related to the progression of PFJ OA and may need to be considered when treating individuals who are at risk of or who have PFJ OA. PMID:26161626

  18. What of guidelines for osteoarthritis?

    PubMed

    Lim, Anita Y N; Doherty, Michael

    2011-05-01

    Osteoarthritis (OA) is by far the most common joint disease and a major cause of pain and disability. The prevalence and impact of OA will increase in the next decades in the Asia-Pacific region due to increased longevity, increasing urbanization and a parallel increase in obesity. The three main types of evidence to inform evidence-based practice are research evidence, expert experience and patient opinion--all three of these are equally weighted. Guideline development groups vary in terms of process and structure of guideline production and in how much integration there is between research, expert and patient evidence. Nevertheless, guidelines on OA concur in recommending: holistic assessment of the patient and individualizing the management plan; patient information access; weight loss if overweight or obese, and prescription of exercise. Additional adjunctive non-pharmacological and pharmacological interventions, including surgery, may be added to this core set as required. However, when audited, it appears that management of OA is often suboptimal, with a major focus on oral analgesics, especially non-steroidal anti-inflammatory drugs. A number of barriers to implementation are evident and appropriate audit of care is necessary to improve delivery of service and to plan healthcare resources. For OA, the effect size of placebo in clinical trials is usually far greater than the additional specific effect of individual treatments, emphasizing the importance of contextual ('meaning') response in this chronic painful condition. This has important implications for clinical care in that optimization of the contextual response can lead to improvements in patient outcomes even in the absence of very effective treatments. PMID:21518312

  19. Management of knee osteoarthritis by combined stromal vascular fraction cell therapy, platelet-rich plasma, and musculoskeletal exercises: a case series

    PubMed Central

    Gibbs, Nathan; Diamond, Rod; Sekyere, Eric O; Thomas, Wayne D

    2015-01-01

    Introduction Knee osteoarthritis is associated with persistent joint pain, stiffness, joint deformities, ligament damage, and surrounding muscle atrophy. The complexity of the disease makes treatment difficult. There are no therapeutic drugs available to halt the disease progression, leaving patients dependent on pain medication, anti-inflammatory drugs, or invasive joint replacement surgery. Case presentations Four patients with a history of unresolved symptomatic knee osteoarthritis were investigated for the therapeutic outcome of combining an exercise rehabilitation program with intra-articular injections of autologous StroMed (ie, stromal vascular fraction cells concentrated by ultrasonic cavitation from lipoaspirate) and platelet-rich plasma (PRP). The Knee Injury and Osteoarthritis Outcome Score questionnaire (KOOS) was administered along with physical function tests over a 12-month period. The first patient achieved a maximum therapeutic outcome of 100 in all five KOOS subscales (left knee), and 100 for four subscales (right knee). The second patient scored 100 in all five KOOS subscales (left knee), and greater than 84 in all subscales (right knee). Treatment of the third patient resulted in improved outcomes in both knees of >93 for four KOOS subscales, and 60 for the Function in Sport and Recreation subscale. The fourth patient improved to 100 in all five KOOS subscales. In all patients, the physical function “Get-up and Go” test and “Stair Climbing Test” returned to normal (a value of zero). Conclusion This case series indicates that improved outcomes may be obtained when autologous stromal vascular fraction (StroMed) cell therapy is combined with traditional exercise practices and PRP for osteoarthritis. Of the seven joints treated: all patients’ scores of pain improved to >96; and quality of life scores to >93. Functional performance measures of mobility returned to normal. This simple treatment appears to be extremely effective for osteoarthritis disorders that have no drug treatment to halt disease progression. PMID:26609244

  20. Early detection of aging cartilage and osteoarthritis in mice and patient samples using atomic force microscopy

    NASA Astrophysics Data System (ADS)

    Stolz, Martin; Gottardi, Riccardo; Raiteri, Roberto; Miot, Sylvie; Martin, Ivan; Imer, Raphaël; Staufer, Urs; Raducanu, Aurelia; Düggelin, Marcel; Baschong, Werner; Daniels, A. U.; Friederich, Niklaus F.; Aszodi, Attila; Aebi, Ueli

    2009-03-01

    The pathological changes in osteoarthritis-a degenerative joint disease prevalent among older people-start at the molecular scale and spread to the higher levels of the architecture of articular cartilage to cause progressive and irreversible structural and functional damage. At present, there are no treatments to cure or attenuate the degradation of cartilage. Early detection and the ability to monitor the progression of osteoarthritis are therefore important for developing effective therapies. Here, we show that indentation-type atomic force microscopy can monitor age-related morphological and biomechanical changes in the hips of normal and osteoarthritic mice. Early damage in the cartilage of osteoarthritic patients undergoing hip or knee replacements could similarly be detected using this method. Changes due to aging and osteoarthritis are clearly depicted at the nanometre scale well before morphological changes can be observed using current diagnostic methods. Indentation-type atomic force microscopy may potentially be developed into a minimally invasive arthroscopic tool to diagnose the early onset of osteoarthritis in situ.

  1. Genetics of osteoarthritis.

    PubMed

    Rodriguez-Fontenla, Cristina; Gonzalez, Antonio

    2015-01-01

    Osteoarthritis (OA) is a complex disease caused by the interaction of multiple genetic and environmental factors. This review focuses on the studies that have contributed to the discovery of genetic susceptibility factors in OA. The most relevant associations discovered until now are discussed in detail: GDF-5, 7q22 locus, MCF2L, DOT1L, NCOA3 and also some important findings from the arcOGEN study. Moreover, the different approaches that can be used to minimize the specific problems of the study of OA genetics are discussed. These include the study of microsatellites, phenotype standardization and other methods such as meta-analysis of GWAS and gene-based analysis. It is expected that these new approaches contribute to finding new susceptibility genetic factors for OA. PMID:24992825

  2. Easing Arthritis: Research offers new hope for people with common joint disease.

    MedlinePlus

    ... Current Issue Past Issues Easing Arthritis: Research offers new hope for people with common joint disease Past ... knees, pain plagued her every step. Living in New York City, Saisselin relied on walking and public ...

  3. Genetics of digital osteoarthritis.

    PubMed

    Michou, Laëtitia

    2011-07-01

    Genetic factors contribute to the development of digital osteoarthritis, whose heritability has been estimated at 48 to 65%. Among the manifestations of digital osteoarthritis, only Heberden's nodes are transmitted by Mendelian inheritance, as a dominant trait in women and a recessive trait in men. The other forms of digital osteoarthritis are multifactorial, with a major gene and a residual multifactorial component that probably interacts with environmental factors. Hindrances to molecular studies include the absence to date of a universally accepted definition of the phenotype and the late onset of the manifestations. Genetic association studies of selected class I and II HLA genes produced conflicting results. The T303M polymorphism of the MATN3 gene, which was initially described as associated with hand osteoarthritis, may be more closely linked to trapeziometacarpal osteoarthritis than to digital osteoarthritis. Genome-wide scans have identified numerous loci linked to digital osteoarthritis. Replication has been achieved for some of these loci, most notably those located at 2p, 2q, 3p, 4q, and 7p. A recently published genome-wide association study showed that an A2BP1 gene polymorphism was significantly associated with hand osteoarthritis. Many candidate-gene studies found associations with AGC1, ASPN, ENPP1, HFE, KL, VDR, IL-1 cluster, and IL-6, although the results were not consistently reproducible. In one study, women with hand osteoarthritis had significant telomere shortening. Telomere shortening has also been reported in other age-related conditions. PMID:20971668

  4. Post-operative rehabilitation and nutrition in osteoarthritis.

    PubMed

    Musumeci, Giuseppe; Mobasheri, Ali; Trovato, Francesca Maria; Szychlinska, Marta Anna; Imbesi, Rosa; Castrogiovanni, Paola

    2014-01-01

    Osteoarthritis (OA) is a degenerative process involving the progressive loss of articular cartilage, synovial inflammation and structural changes in subchondral bone that lead to loss of synovial joint structural features and functionality of articular cartilage. OA represents one of the most common causes of physical disability in the world. Different OA treatments are usually considered in relation to the stage of the disease. In the early stages, it is possible to recommend physical activity programs that can maintain joint health and keep the patient mobile, as recommended by OA Research Society International (OARSI) and European League Against Rheumatism (EULAR). In the most severe and advanced cases of OA, surgical intervention is necessary. After, in early postoperative stages, it is essential to include a rehabilitation exercise program in order to restore the full function of the involved joint. Physical therapy is crucial for the success of any surgical procedure and can promote recovery of muscle strength, range of motion, coordinated walking, proprioception and mitigate joint pain. Furthermore, after discharge from the hospital, patients should continue the rehabilitation exercise program at home associated to an appropriate diet. In this review, we analyze manuscripts from the most recent literature and provide a balanced and comprehensive overview of the latest developments on the effect of physical exercise on postoperative rehabilitation in OA. The literature search was conducted using PubMed, Scopus, Web of Science and Google Scholar, using the keywords 'osteoarthritis', 'rehabilitation', 'exercise' and 'nutrition'. The available data suggest that physical exercise is an effective, economical and accessible to everyone practice, and it is one of the most important components of postoperative rehabilitation for OA. PMID:26962431

  5. Epigenetic Regulation of Chondrocyte Catabolism and Anabolism in Osteoarthritis

    PubMed Central

    Kim, Hyeonkyeong; Kang, Donghyun; Cho, Yongsik; Kim, Jin-Hong

    2015-01-01

    Osteoarthritis (OA) is one of the most prevalent forms of joint disorder, associated with a tremendous socioeconomic burden worldwide. Various non-genetic and lifestyle-related factors such as aging and obesity have been recognized as major risk factors for OA, underscoring the potential role for epigenetic regulation in the pathogenesis of the disease. OA-associated epigenetic aberrations have been noted at the level of DNA methylation and histone modification in chondrocytes. These epigenetic regulations are implicated in driving an imbalance between the expression of catabolic and anabolic factors, leading eventually to osteoarthritic cartilage destruction. Cellular senescence and metabolic abnormalities driven by OA-associated risk factors appear to accompany epigenetic drifts in chondrocytes. Notably, molecular events associated with metabolic disorders influence epigenetic regulation in chondrocytes, supporting the notion that OA is a metabolic disease. Here, we review accumulating evidence supporting a role for epigenetics in the regulation of cartilage homeostasis and OA pathogenesis. PMID:26242192

  6. Prognosis of inflammatory joint diseases. A three-year follow-up study.

    PubMed

    Nissil, M; Isomki, H; Kaarela, K; Kiviniemi, P; Martio, J; Sarna, S

    1983-01-01

    The prognosis 3 years after the onset of the disease was studied in 107 patients with definite rheumatoid arthritis, 161 with probable RA or non-specific arthritis, 84 with either ankylosing spondylitis, Reiter's disease or reactive arthritis, 14 with psoriatic arthritis and 10 with a systemic connective tissue disease. Prognosis was measured by clinical involvement of joints, radiological erosions in joints, deterioration in joint function, ESR, and working ability. A total of 44% of all patients were symptomless after 3 years. The prognosis was best in patients with an "HLA B 27-associated" disease and non-specific arthritis, and worst in RA. Two patients died during the follow-up of systemic connective tissue disease and one committed suicide with an overdose of hydroxychloroquine. Two HLA B27-positive patients developed systemic amyloidosis. PMID:6836238

  7. Establishment of a rat model for osteoarthritis resulting from anterior cruciate ligament rupture and its significance

    PubMed Central

    OUYANG, XIAO; WANG, JIAN; HONG, SHI DONG; XIN, FENG; WANG, LIN; YANG, XIAO WEI; WANG, JING RONG; WANG, LI MING; WEI, BO; WANG, QING; CUI, WEI DING

    2015-01-01

    The purpose of this study was to examine the establishment of a model concerned with osteoarthritis resulting from the anterior cruciate ligament rupture of rats and investigate the associated mechanism, as well as provide a theoretical basis for clinical treatment of the disease. Forty Sprague-Dawley male rats were randomly divided into two groups of 20 rats each and the anterior cruciate ligament transaction model and knee joint brake model were successfully established. Two rats in the anterior cruciate ligament transection group (10%) and 3 rats in the knee joint brake group (15.0%) died. The survival rate of the two groups was not statistically significant (χ2<0.001, P=1.000). Swelling of the knee joint and synovium of rats in the two experimental groups was aggravated. The Mankin score was significantly higher in the anterior cruciate ligament transection group than that in the experimental group and the difference was statistically significant (P<0.05). By contrast, no significant difference was observed for osteoarthritis severity for the two experimental groups (P>0.05). Analysis of the subgroups showed that the proportion of the anterior cruciate ligament in the experimental group was significantly higher than that of the knee joint brake group, and the difference was statistically significant (P<0.05). By contrast, the difference was not statistically significant in the comparison of the medium and early proportion (P>0.05). The content of protein polysaccharide and II collagen fiber in the experimental group of the anterior cruciate ligament transection was lower than that of the knee joint brake group, and this difference was statistically significant (P<0.05). Thus the mechanism of osteoarthritis may be associated with the decrease in the content of protein and II collagen fibers. PMID:26668592

  8. Current interventions in the management of knee osteoarthritis

    PubMed Central

    Bhatia, Dinesh; Bejarano, Tatiana; Novo, Mario

    2013-01-01

    Osteoarthritis (OA) is progressive joint disease characterized by joint inflammation and a reparative bone response and is one of the top five most disabling conditions that affects more than one-third of persons > 65 years of age, with an average estimation of about 30 million Americans currently affected by this disease. Global estimates reveal more than 100 million people are affected by OA. The financial expenditures for the care of persons with OA are estimated at a total annual national cost estimate of $15.5-$28.6 billion per year. As the number of people >65 years increases, so does the prevalence of OA and the need for cost-effective treatment and care. Developing a treatment strategy which encompasses the underlying physiology of degenerative joint disease is crucial, but it should be considerate to the different age ranges and different population needs. This paper focuses on different exercise and treatment protocols (pharmacological and non-pharmacological), the outcomes of a rehabilitation center, clinician-directed program versus an at home directed individual program to view what parameters are best at reducing pain, increasing functional independence, and reducing cost for persons diagnosed with knee OA. PMID:23559821

  9. Indian Hedgehog, a critical modulator in osteoarthritis, could be a potential therapeutic target for attenuating cartilage degeneration disease.

    PubMed

    Zhou, Jingming; Wei, Xiaochun; Wei, Lei

    2014-08-01

    The Hedgehog (Hh) family of proteins consists of Indian hedgehog (Ihh), sonic hedgehog (Shh), and desert hedgehog (Dhh). These proteins serve as essential regulators in a variety of developmental events. Ihh is mainly produced and secreted by prehypertrophic chondrocytes and regulates chondrocyte hypertrophy and endochondral bone formation during growth plate development. Tissue-specific deletion of the Ihh gene (targeted by Col2a1-Cre) causes early lethality in mice. Transgenic mice with induced Ihh expression exhibit increased chondrocyte hypertrophy and cartilage damage resembling human osteoarthritis (OA). During OA development, chondrocytes recapitulate the differentiation process that happens during the fetal status and which does not occur to an appreciable degree in adult articular cartilage. Ihh expression is up-regulated in human OA cartilage, and this upregulation correlates with OA progression and changes in chondrocyte morphology. A genetic study in mice further showed that conditional deletion of Ihh in chondrocytes attenuates OA progression, suggesting the possibility that blocking Ihh signaling can be used as a therapeutic approach to prevent or delay cartilage degeneration. However, Ihh gene deletion is currently not a therapeutic option as it is lethal in animals. RNA interference (RNAi) provides a means to knockdown Ihh without the severe side effects caused by chemical inhibitors. The currently available delivery methods for RNAi are nanoparticles and liposomes. Both have problems that need to be addressed. In the future, it will be necessary to develop a safe and effective RNAi delivery system to target Ihh signaling for preventing and treating OA. PMID:24844414

  10. Chondroitin for osteoarthritis

    PubMed Central

    Singh, Jasvinder A.; Noorbaloochi, Shahrzad; MacDonald, Roderick; Maxwell, Lara J.

    2016-01-01

    Background Osteoarthritis, a common joint disorder, is one of the leading causes of disability. Chondroitin has emerged as a new treatment. Previous meta-analyses have shown contradictory results on the efficacy of chondroitin. This, in addition to the publication of more trials, necessitates a systematic review. Objectives To evaluate the benefit and harm of oral chondroitin for treating osteoarthritis compared with placebo or a comparator oral medication including, but not limited to, nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics, opioids, and glucosamine or other “herbal” medications. Search methods We searched seven databases up to November 2013, including the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, CINAHL, EMBASE, Science Citation Index (Web of Science) and Current Controlled Trials. We searched the US Food and Drug Administration (FDA) and European Medicines Agency (EMEA) websites for adverse effects. Trial registers were not searched. Selection criteria All randomized or quasi-randomized clinical trials lasting longer than two weeks, studying adults with osteoarthritis in any joint, and comparing chondroitin with placebo, an active control such as NSAIDs, or other “herbal” supplements such as glucosamine. Data collection and analysis Two review authors independently performed all title assessments, data extractions, and risk of bias assessments. Main results Forty-three randomized controlled trials including 4,962 participants treated with chondroitin and 4,148 participants given placebo or another control were included. The majority of trials were in knee OA, with few in hip and hand OA. Trial duration varied from 1 month to 3 years. Participants treated with chondroitin achieved statistically significantly and clinically meaningful better pain scores (0–100) in studies less than 6 months than those given placebo with an absolute risk difference of 10% lower (95% confidence interval (CI), 15% to 6% lower; number needed to treat (NNT) = 5 (95% CI, 3 to 8; n = 8 trials) (level of evidence, low; risk of bias, high); but there was high heterogeneity between the trials (T2 = 0.07; I2 = 70%, which was not easily explained by differences in risk of bias or study sample size). In studies longer than 6 months, the absolute risk difference for pain was 9% lower (95% CI 18% lower to 0%); n = 6 trials; T2 = 0.18; I2 = 83% ), again with low level of evidence. For the Western Ontario and McMaster Universities Osteoarthritis Index Minimal Clinically Important Improvement (WOMAC MCII Pain subscale) outcome, a reduction in knee pain by 20% was achieved by 53/100 in the chondroitin group versus 47/100 in the placebo group, an absolute risk difference of 6% (95% CI 1% to 11%), (RR 1.12, 95% CI 1.01 to 1.24; T2 = 0.00; I2 = 0%) (n = 2 trials, 1253 participants; level of evidence, high; risk of bias, low). Differences in Lequesne’s index (composite of pain, function and disability) statistically significantly favoured chondroitin as compared with placebo in studies under six months, with an absolute risk difference of 8% lower (95% CI 12% to 5% lower; T2= 0.78; n = 7 trials) (level of evidence, moderate; risk of bias, unclear), also clinically meaningful. Loss of minimum joint space width in the chondroitin group was statistically significantly less than in the placebo group, with a relative risk difference of 4.7% less (95% CI 1.6% to 7.8% less; n = 2 trials) (level of evidence, high; risk of bias, low). Chondroitin was associated with statistically significantly lower odds of serious adverse events compared with placebo with Peto odds ratio of 0.40 (95% CI 0.19 to 0.82; n = 6 trials) (level of evidence, moderate). Chondroitin did not result in statistically significant numbers of adverse events or withdrawals due to adverse events compared with placebo or another drug. Adverse events were reported in a limited fashion, with some studies providing data and others not. Comparisons of chondroitin taken alone or in combination with glucosamine or another supplement showed a statistically significant reduction in pain (0–100) when compared with placebo or an active control, with an absolute risk difference of 10% lower (95% CI 14% to 5% lower); NNT = 4 (95% CI 3 to 6); T2 = 0.33; I2 = 91%; n = 17 trials) (level of evidence, low). For physical function, chondroitin in combination with glucosamine or another supplement showed no statistically significant difference from placebo or an active control, with an absolute risk difference of 1% lower (95% CI 6% lower to 3% higher with T2 = 0.04; n = 5 trials) (level of evidence, moderate). Differences in Lequesne’s index statistically significantly favoured chondroitin as compared with placebo, with an absolute risk difference of 8% lower (95% CI, 12% to 4% lower; T2 = 0.12; n = 10 trials) (level of evidence, moderate). Chondroitin in combination with glucosamine did not result in statistically significant differences in the numbers of adverse events, withdrawals due to adverse events, or in the numbers of serious adverse events compared with placebo or with an active control. The beneficial effects of chondroitin in pain and Lequesne’s index persisted when evidence was limited to studies with adequate blinding or studies that used appropriate intention to treat (ITT) analyses. These beneficial effects were uncertain when we limited data to studies with appropriate allocation concealment or a large study sample (> 200) or to studies without pharmaceutical funding. Authors’ conclusions A review of randomized trials of mostly low quality reveals that chondroitin (alone or in combination with glucosamine) was better than placebo in improving pain in participants with osteoarthritis in short-term studies. The benefit was small to moderate with an 8 point greater improvement in pain (range 0 to 100) and a 2 point greater improvement in Lequesne’s index (range 0 to 24), both likely clinically meaningful. These differences persisted in some sensitivity analyses and not others. Chondroitin had a lower risk of serious adverse events compared with control. More high-quality studies are needed to explore the role of chondroitin in the treatment of osteoarthritis. The combination of some efficacy and low risk associated with chondroitin may explain its popularity among patients as an over-the-counter supplement. PMID:25629804

  11. Osteoarthritis year in review 2015: mechanics.

    PubMed

    Varady, N H; Grodzinsky, A J

    2016-01-01

    Motivated by the conceptual framework of multi-scale biomechanics, this narrative review highlights recent major advances with a focus on gait and joint kinematics, then tissue-level mechanics, cell mechanics and mechanotransduction, matrix mechanics, and finally the nanoscale mechanics of matrix macromolecules. A literature review was conducted from January 2014 to April 2015 using PubMed to identify major developments in mechanics related to osteoarthritis (OA). Studies of knee adduction, flexion, rotation, and contact mechanics have extended our understanding of medial compartment loading. In turn, advances in measurement methodologies have shown how injuries to both the meniscus and ligaments, together, can alter joint kinematics. At the tissue scale, novel findings have emerged regarding the mechanics of the meniscus as well as cartilage superficial zone. Moving to the cell level, poroelastic and poro-viscoelastic mechanisms underlying chondrocyte deformation have been reported, along with the response to osmotic stress. Further developments have emerged on the role of calcium signaling in chondrocyte mechanobiology, including exciting findings on the function of mechanically activated cation channels newly found to be expressed in chondrocytes. Finally, AFM-based nano-rheology systems have enabled studies of thin murine tissues and brush layers of matrix molecules over a wide range of loading rates including high rates corresponding to impact injury. With OA acknowledged to be a disease of the joint as an organ, understanding mechanical behavior at each length scale helps to elucidate the connections between cell biology, matrix biochemistry and tissue structure/function that may play a role in the pathomechanics of OA. PMID:26707990

  12. Current Evidence for Osteoarthritis Treatments

    PubMed Central

    Anandacoomarasamy, Ananthila; March, Lyn

    2010-01-01

    Osteoarthritis (OA) is the most common form of arthritis and the leading cause of chronic disability among older people. The burden of the disease is expected to rise with an aging population and the increasing prevalence of obesity. Despite this, there is as yet no cure for OA. However, in recent years, a number of potential therapeutic advances have been made, in part due to improved understanding of the underlying pathophysiology. This review provides the current evidence for symptomatic management of OA including nonpharmacological, pharmacological and surgical approaches. The current state of evidence for disease-modifying therapy in OA is also reviewed. PMID:22870434

  13. Blockade of 11β-hydroxysteroid dehydrogenase type 1 enzyme inhibits experimental collagenase-induced osteoarthritis.

    PubMed

    Li, Faxin; Qiao, Chuanwu; Li, Yi; Zhu, Jie; Chen, Jian; Guo, Shuya

    2015-03-01

    Osteoarthritis (OA) is a common cause of functional deterioration in the joints of elderly adults and is a significant burden on the health of the aging population. 11β‑hydroxysteroid dehydrogenase type 1 enzyme (11β‑HSD1), which converts cortisone to cortisol, is known to contribute to a number of inflammatory diseases. However, the role of 11β‑HSD1 in human OA remains unclear. The aim of this study was to identify the effects of the selective 11β‑HSD1 inhibitor, BVT‑2733, in murine collagenase‑induced osteoarthritis (CIOA). CIOA mice were treated with BVT‑2733 (100 mg/kg, orally) or control vehicle twice daily for five weeks. Cartilage and bone destruction were subsequently examined. The expression of bone markers and STAT3 phosphorylation in joint tissues were detected using western blot analysis. The concentrations of proinflammatory cytokines were determined by an enzyme‑linked immunosorbent assay. Treatment with BVT‑2733 attenuated cartilage and bone destruction, and reduced the expression of bone markers and p‑STAT3 in the joints of CIOA mice. BVT‑2733 also decreased the serum levels of interleukin (IL)‑1β, IL‑6, IL‑17 and vascular endothelial growth factor. In conclusion, the present study showed that BVT‑2733 inhibits multiple inflammatory signaling pathways in the joints of CIOA mice, suggesting that 11β‑HSD1 inhibition may have therapeutic potential in human OA. PMID:25412149

  14. Effectiveness of phototherapy incorporated into an exercise program for osteoarthritis of the knee: study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Osteoarthritis is a chronic disease with a multifactor etiology involving changes in bone alignment, cartilage, and other structures necessary to joint stability. There is a need to investigate therapeutic resources that combine different wavelengths as well as different light sources (low-level laser therapy and light-emitting diode therapy) in the same apparatus for the treatment of osteoarthritis. The aim of the proposed study is to analyze the effect of the incorporation of phototherapy into a therapeutic exercise program for individuals with osteoarthritis of the knee. Methods/Design A double-blind, controlled, randomized clinical trial will be conducted involving patients with osteoarthritis of the knee. Evaluations will be performed using functional questionnaires before and after the treatment protocols, in a reserved room with only the evaluator and participant present, and no time constraints placed on the answers or evaluations. The following functional tests will also be performed: stabilometry (balance assessment), dynamometry (muscle strength of gluteus medius and quadriceps), algometry (pain threshold), fleximeter (range of motion), timed up-and-go test (functional mobility), and the functional reach test. The participants will then be allocated to three groups through a randomization process using opaque envelopes: exercise program, exercise program + phototherapy, or exercise program + placebo phototherapy, all of which will last for eight weeks. Discussion The purpose of this randomized clinical trial is to analyze the effect of the incorporation of phototherapy into a therapeutic exercise program for osteoarthritis of the knee. The study will support the practice based on evidence to the use of phototherapy in individuals with a diagnosis of osteoarthritis of the knee. Data will be published after the study is completed. Trial registration The protocol for this study has been submitted to Clinical Trials, registration number NCT02102347, on 29 March 2014. PMID:24919587

  15. Detection of degenerative disease of the temporomandibular joint by bone scintigraphy: concise communication

    SciTech Connect

    Goldstein, H.A.; Bloom, C.Y.

    1980-10-01

    Nine patients with facial pain were evaluated with limited bone scans. The scintigrams correlated with microscopy in all patients, although radiographs correlated with microscopy in only five patients. The degenerative disease process in the temporomandibular joint was more extensive in the patients with radiographic and scintigraphic abnormalities than in those with scintigraphic abnormalities alone. The limited bone scan appears useful in detecting early degenerative changes in the temporomandibular joint.

  16. Long-Term Follow-Up of the Cheilectomy for Degenerative Joint Disease of the First Metatarsophalangeal Joint.

    PubMed

    Nicolosi, Nicole; Hehemann, Chris; Connors, James; Boike, Allan

    2015-01-01

    Cheilectomy is the surgical resection of 20% to 30% of the dorsal metatarsal head and proximal phalanx. The present retrospective study evaluated the long-term efficacy of aggressive cheilectomy to address degenerative joint disease of the first metatarsophalangeal joint. To our knowledge, this is the second longest duration study to date to evaluate the long-term efficacy of the cheilectomy procedure, with a mean follow-up period of 7.14 years (range 39 weeks to 14.87 years). The mean patient age was 55.71 ± 9.51 years, and 37 (65%) of the patients were female. Age, sex, foot type, and preoperative radiographic parameters of hallux rigidus were also evaluated and correlated. The mean percentage of success with this operation was 87.69%. Of the 58 patients, 51 (87.93%) experienced no limitations in their daily activities. Only 2 patients (3.33%) subsequently required subsequent arthrodesis. The results of the present study suggest that cheilectomy offers long-term satisfaction for patients with hallux rigidus and is an acceptable alternative to the joint destructive procedure of first metatarsophalangeal arthrodesis. PMID:25981441

  17. Chondrocyte Apoptosis in the Pathogenesis of Osteoarthritis

    PubMed Central

    Hwang, Hyun Sook; Kim, Hyun Ah

    2015-01-01

    Apoptosis is a highly-regulated, active process of cell death involved in development, homeostasis and aging. Dysregulation of apoptosis leads to pathological states, such as cancer, developmental anomalies and degenerative diseases. Osteoarthritis (OA), the most common chronic joint disease in the elderly population, is characterized by progressive destruction of articular cartilage, resulting in significant disability. Because articular cartilage depends solely on its resident cells, the chondrocytes, for the maintenance of extracellular matrix, the compromising of chondrocyte function and survival would lead to the failure of the articular cartilage. The role of subchondral bone in the maintenance of proper cartilage matrix has been suggested as well, and it has been proposed that both articular cartilage and subchondral bone interact with each other in the maintenance of articular integrity and physiology. Some investigators include both articular cartilage and subchondral bone as targets for repairing joint degeneration. In late-stage OA, the cartilage becomes hypocellular, often accompanied by lacunar emptying, which has been considered as evidence that chondrocyte death is a central feature in OA progression. Apoptosis clearly occurs in osteoarthritic cartilage; however, the relative contribution of chondrocyte apoptosis in the pathogenesis of OA is difficult to evaluate, and contradictory reports exist on the rate of apoptotic chondrocytes in osteoarthritic cartilage. It is not clear whether chondrocyte apoptosis is the inducer of cartilage degeneration or a byproduct of cartilage destruction. Chondrocyte death and matrix loss may form a vicious cycle, with the progression of one aggravating the other, and the literature reveals that there is a definite correlation between the degree of cartilage damage and chondrocyte apoptosis. Because current treatments for OA act only on symptoms and do not prevent or cure OA, chondrocyte apoptosis would be a valid target to modulate cartilage degeneration. PMID:26528972

  18. Predicting Knee Osteoarthritis.

    PubMed

    Gardiner, Bruce S; Woodhouse, Francis G; Besier, Thor F; Grodzinsky, Alan J; Lloyd, David G; Zhang, Lihai; Smith, David W

    2016-01-01

    Treatment options for osteoarthritis (OA) beyond pain relief or total knee replacement are very limited. Because of this, attention has shifted to identifying which factors increase the risk of OA in vulnerable populations in order to be able to give recommendations to delay disease onset or to slow disease progression. The gold standard is then to use principles of risk management, first to provide subject-specific estimates of risk and then to find ways of reducing that risk. Population studies of OA risk based on statistical associations do not provide such individually tailored information. Here we argue that mechanistic models of cartilage tissue maintenance and damage coupled to statistical models incorporating model uncertainty, united within the framework of structural reliability analysis, provide an avenue for bridging the disciplines of epidemiology, cell biology, genetics and biomechanics. Such models promise subject-specific OA risk assessment and personalized strategies for mitigating or even avoiding OA. We illustrate the proposed approach with a simple model of cartilage extracellular matrix synthesis and loss regulated by daily physical activity. PMID:26206679

  19. Patient education, disease activity and physical function: can we be more targeted? A cross sectional study among people with rheumatoid arthritis, psoriatic arthritis and hand osteoarthritis

    PubMed Central

    2013-01-01

    Introduction In order to target educational needs of patients more effectively, an Austrian-German educational needs assessment tool (OENAT) was developed, the educational needs of patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and hand osteoarthritis (HOA) were described and the relationships between educational needs, gender, disease activity and function were explored. Methods The English ENAT was adapted into Austrian-German using Beaton's cross-cultural adaptation process. Internal construct validity was assessed by Rasch analysis. Educational needs across diagnostic groups and subgroups of patients were summarized descriptively and their relationship with disease activity and physical functioning explored. Results The sample comprised 130 RA, 125 PsA and 48 HOA patients. Their mean ages ± SD were 56 ± 14, 51 ± 11 and 64 ± 7 years for RA, PsA and HOA; disease duration was 11 ± 9, 11 ± 11 and 14 ± 9 years, respectively. More than 70% in each patient group expressed interest in receiving education about their disease. The educational needs differed significantly between women and men in all 3 groups. In RA and PsA, female patients expressed significantly higher educational needs than men in 'movements’ and 'feelings’ domains (p=0.04 and p=0.03 for RA and p<0.01 and p=0.01 for PsA). Female patients in the HOA group had significantly higher scores on all domains except for the 'movements’. Older patients with PsA scored significantly higher than their younger counterparts in the 'pain’ domain (p=0.05). RA patients with disease duration >5 years), expressed higher educational needs in 'movements’ (p<0.01). Educational background had effects in the PsA group only, patients with basic education had greater scores than those with higher education on 'movements’ and 'arthritis process’ (p=0.01). In the RA group, DAS28 correlated significantly with 'movements’ (r=0.24, p=0.01), 'feelings’ (r=0.22, p=0.02), and 'treatments’ (r=0.22, p=0.03). In the PsA group, all OENAT domains correlated with disease activity (DAPSA and CDAI). Conclusions This study showed that educational needs vary with personal characteristics. Patient education may be more targeted and effective, if gender, age, educational background and disease duration are taken into account. Correlations with disease activity and function suggest that the OENAT could enable identification of 'intervention points’, which can be ideal opportunities for effective patient education. PMID:24286444

  20. Lack of Detection of Human Retrovirus-5 Proviral DNA in Synovial Tissue and Blood Specimens From Individuals With Rheumatoid Arthritis or Osteoarthritis

    PubMed Central

    PIPER, KERRYL E.; HANSSEN, ARLEN D.; LEWALLEN, DAVID G.; MATTESON, ERIC L.; OSMON, DOUGLAS R.; DUFFY, MARY C.; HAGAN, ROCHELLE A.; STECKELBERG, JAMES M.; PATEL, ROBIN

    2006-01-01

    Objective Prior studies have suggested an association of human retrovirus 5 with rheumatoid arthritis. The purpose of this study was to determine if human retrovirus-5 proviral DNA is present in synovial tissue and blood specimens from patients with rheumatoid arthritis or osteoarthritis, or those without joint disease. Methods Synovial tissue and whole blood from 75 patients with rheumatoid arthritis, 75 patients with osteoarthritis, and 50 patients without a primary arthritis diagnosis were assayed by real-time quantitative polymerase chain reaction (PCR) using primers that amplify a 186-bp fragment of human retrovirus-5 proviral DNA. Results A total of 200 tissue specimens, 200 mononuclear cells, and 196 of 200 granulocyte specimens tested negative for human retrovirus-5 proviral DNA. No association between human retrovirus 5 and rheumatoid arthritis or osteoarthritis (P = 0.516) was identified. Granulocyte specimens from 4 patients, 2 with rheumatoid arthritis and 2 with osteoarthritis, yielded a low positive human retrovirus-5 proviral DNA signal (83–1,365 copies of human retrovirus-5 proviral DNA/ml blood). Conclusion Contrary to prior reports, we did not find an association between human retrovirus 5 and rheumatoid arthritis or osteoarthritis using a real-time PCR assay. Our findings are consistent with the recent finding that human retrovirus 5 is actually rabbit endogenous retrovirus H. PMID:16463423

  1. Immediate Effects of an Elastic Knee Sleeve on Frontal Plane Gait Biomechanics in Knee Osteoarthritis

    PubMed Central

    Schween, Raphael; Gehring, Dominic; Gollhofer, Albert

    2015-01-01

    Introduction Osteoarthritis of the knee affects millions of people. Elastic knee sleeves aim at relieving symptoms. While symptomatic improvements have been demonstrated as a consequence of elastic knee sleeves, evidence for biomechanical alterations only exists for the sagittal plane. We therefore asked what effect an elastic knee sleeve would have on frontal plane gait biomechanics. Methods 18 subjects (8 women, 10 men) with osteoarthritis of the medial tibiofemoral joint walked over ground with and without an elastic knee sleeve. Kinematics and forces were recorded and joint moments were calculated using an inverse dynamics approach. Conditions with sleeve and without sleeve were compared with paired t-Tests. Results With the sleeve, knee adduction angle at ground contact was reduced by 1.9±2.1° (P = 0.006). Peak knee adduction was reduced by 1.5±1.6° (P = 0.004). The first peak knee adduction moment and positive knee adduction impulse were decreased by 10.1% (0.74±0.9 Nm•kg-1; P = 0.002) and 12.9% (0.28±0.3 Nm•s•kg-1; P < 0.004), respectively. Conclusion Our study provides evidence that wearing an elastic knee sleeve during walking can reduce knee adduction angles, moments and impulse in subjects with knee osteoarthritis. As a higher knee adduction moment has previously been identified as a risk factor for disease progression in patients with medial knee osteoarthritis, we speculate that wearing a knee sleeve may be beneficial for this specific subgroup. PMID:25621488

  2. Milk Consumption and Progression of Medial Tibiofemoral Knee Osteoarthritis: Data from the Osteoarthritis Initiative

    PubMed Central

    Lu, Bing; Driban, Jeffrey B.; Duryea, Jeffrey; McAlindon, Timothy; Lapane, Kate L.; Eaton, Charles B.

    2014-01-01

    Objectives: Milk consumption has long been recognized for its important role in bone health, but its role in the progression of knee osteoarthritis (OA) is unclear. We examine the prospective association of milk consumption with radiographic progression of knee OA. Methods: In the Osteoarthritis Initiative, 2,148 participants (3,064 knees) with radiographic knee OA and having dietary data at baseline were followed up to 12, 24, 36 and 48 months. The milk consumption was assessed with a Block Brief Food Frequency Questionnaire completed at baseline. To evaluate progression of OA, we used quantitative joint space width (JSW) between the medial femur and tibia of the knee based on plain radiographs. The multivariate linear models for repeated measures were used to test the independent association between milk intake and the decrease in JSW over time, while adjusting for baseline disease severity, body mass index, dietary factors and other potential confounders. Results: We observed a significant dose-response relationship between baseline milk intake and adjusted mean decrease of JSW in women (p trend=0.014). With increasing levels of milk intake (none, ?3, 4-6, and ?7 glasses/week), the mean decreases of JSW were 0.38mm, 0.29mm, 0.29mm and 0.26mm respectively. In men, we observed no significant association between milk consumption and the decreases of JSW. Conclusion: Our results suggest that frequent milk consumption may be associated with reduced OA progression in women. Replication of these novel findings in other prospective studies demonstrating the increase in milk consumption leads to delay in knee OA progression are needed. PMID:24706620

  3. Bilateral synovial chondromatosis in the knee joint with both intra and extra-articular diseases

    PubMed Central

    Bassir, Rida-Allah; Ismael, Farid; Elbardouni, Ahmed; Mahfoud, Mustapha; Berrada, Mohamed Saleh; Elyaacoubi, Moradh

    2014-01-01

    Synovial chondromatosis is a rare disease of unknown etiology. It usually occurs unilaterally in the large joints like the knee, but may occur in the shoulder, elbow, hip, ankle and temporomandibular joints. The disease is usually intracapsular, but can also be extracapsular on rare occasions. The diagnosis of synovial chondromatosis is given after an anamnesis, physical examination and radiographic examination. However, the diagnosis is obtained after histological examination of the synovial tissue. We report an unusual presentation of bilateral synovial chondromatosis in the knee joint, with both intra and extracapsular localization. never described in the literature. Although synovial chondromatosis is described as a benign disease, it can be very destructive and debilitating. These lesions can mimic a malignant tumor and present a diagnostic problem. PMID:25667719

  4. Osteoarthritis: physical medicine and rehabilitation--nonpharmacological management.

    PubMed

    Stemberger, Regina; Kerschan-Schindl, Katharina

    2013-05-01

    Osteoarthritis (OA) is the most common joint disease, mainly affecting middle-aged and elderly persons. People with OA of the knee or hip experience pain and deconditioning that may lead to disability. Treatment goals include pain control, maximizing functional independence, and improving quality of life within the constraints imposed by both OA and comorbidities. Exercise is a core recommendation in all nonpharmacological guidelines for the management of patients with knee or hip OA; it is supposed to ameliorate pain and maybe function as well. Therapeutic ultrasound, neuromuscular as well as transcutaneous electrostimulation, pulsed magnetic field therapy, low-level laser therapy, thermal agents, acupuncture, and assistive devices such as insoles, canes, and braces can be used additionally in a multimodal therapeutic program. They may positively influence pain and function, mobility, and quality of life in patients suffering from OA of the lower limbs. PMID:23519486

  5. Using the medical food flavocoxid [corrected] in managing osteoarthritis.

    PubMed

    Gottlieb, Daniel; Kuritzky, Louis

    2011-01-01

    Osteoarthritis (OA) is the most common debilitating joint disease worldwide. Clinicians have many therapeutic modalities and prescription medications in their arsenals to treat chronic inflammatory pain. However, as patients age, and develop numerous comorbidities, the most common, and often most effective pharmacologic treatment for OA, nonsteroidal anti-inflammatory drugs (NSAIDs), becomes problematic in that it may exacerbate or even cause cardiovascular, renal, and/or gastrointestinal pathology. This paper reviews the metabolism of arachidonic acid as it relates to the clinical treatment of inflammation, and explores a novel botanical therapy, flavocoxid, that has shown equal efficacy to naproxen in treating pain associated with mild to moderate OA of the knee. Flavocoxid has demonstrated balanced inhibition of the three primary enzymes responsible for processing AA, cyclooxygenases 1 and 2, and 5-lipoxygenase. Researchers have proposed that balanced inhibition of AA metabolism offers the promise of analgesia similar to NSAIDs without the associated cardiovascular, renal, or gastrointestinal side effects. PMID:21426218

  6. Knee osteoarthritis prevalence, risk factors, pathogenesis and features: Part I

    PubMed Central

    Heidari, Behzad

    2011-01-01

    Osteoarthritis (OA) a common disease of aged population and one of the leading causes of disability. Incidence of knee OA is rising by increasing average age of general population. Age, weight, trauma to joint due to repetiting movements in particular squatting and kneeling are common risk factors of knee OA. Several factors including cytokines, leptin, and mechanical forces are pathogenic factors of knee OA. In patients with knee pain attribution of pain to knee OA should be considered with caution. Since a proportion of knee OA are asymptomatic and in a number of patients identification of knee OA is not possible due to low sensitivity of radiographic examination. In this review data presented in regard to prevalence, pathogenesis, risk factors. PMID:24024017

  7. Detecting early stage osteoarthritis by optical coherence tomography?

    PubMed Central

    Jahr, Holger; Brill, Nicolai; Nebelung, Sven

    2015-01-01

    Abstract Osteoarthritis (OA) is the most common chronic disease of our joints, manifested by a dynamically increasing degeneration of hyaline articular cartilage (AC). While currently no therapy can reverse this process, the few available treatment options are hampered by the inability of early diagnosis. Loss of cartilage surface, or extracellular matrix (ECM), integrity is considered the earliest sign of OA. Despite the increasing number of imaging modalities surprisingly few imaging biomarkers exist. In this narrative review, recent developments in optical coherence tomography are critically evaluated for their potential to assess different aspects of AC quality as biomarkers of OA. Special attention is paid to imaging surface irregularities, ECM organization and the evaluation of posttraumatic injuries by light-based modalities. PMID:26862954

  8. Genetic Determinism of Primary Early-Onset Osteoarthritis.

    PubMed

    Aury-Landas, Juliette; Marcelli, Christian; Leclercq, Sylvain; Boumédiene, Karim; Baugé, Catherine

    2016-01-01

    Osteoarthritis (OA) is the most common joint disease worldwide. A minority of cases correspond to familial presentation characterized by early-onset forms which are genetically heterogeneous. This review brings a new point of view on the molecular basis of OA by focusing on gene mutations causing early-onset OA (EO-OA). Recently, thanks to whole-exome sequencing, a gain-of-function mutation in the TNFRSF11B gene was identified in two distant family members with EO-OA, opening new therapeutic perspectives for OA. Indeed, unraveling the molecular basis of rare Mendelian OA forms will improve our understanding of molecular processes involved in OA pathogenesis and will contribute to better patient diagnosis, management, and therapy. PMID:26691295

  9. Gait Analysis Methods for Rodent Models of Osteoarthritis

    PubMed Central

    Jacobs, Brittany Y.; Kloefkorn, Heidi E.; Allen, Kyle D.

    2014-01-01

    Patients with osteoarthritis (OA) primarily seek treatment due to pain and disability, yet the primary endpoints for rodent OA models tend to be histological measures of joint destruction. The discrepancy between clinical and preclinical evaluations is problematic, given that radiographic evidence of OA in humans does not always correlate to the severity of patient-reported symptoms. Recent advances in behavioral analyses have provided new methods to evaluate disease sequelae in rodents. Of particular relevance to rodent OA models are methods to assess rodent gait. While obvious differences exist between quadrupedal and bipedal gait sequences, the gait abnormalities seen in humans and in rodent OA models reflect similar compensatory behaviors that protect an injured limb from loading. The purpose of this review is to describe these compensations and current methods used to assess rodent gait characteristics, while detailing important considerations for the selection of gait analysis methods in rodent OA models. PMID:25160712

  10. Oxaceprol is as effective as diclofenac in the therapy of osteoarthritis of the knee and hip.

    PubMed

    Bauer, H W; Klasser, M; von Hanstein, K L; Rolinger, H; Schladitz, G; Henke, H D; Gimbel, W; Steinbach, K

    1999-01-01

    In this multicentre (five centres in Germany), randomised, double-blind, comparative study, 150 patients with painful degenerative joint disease according to EULAR criteria received either oxaceprol (200 mg three times daily) or diclofenac (25 mg three times daily) for 20 days. Joint function, the primary variable, assessed according to Lequesne's indices, improved equally in both treatment groups to a clinically relevant degree. Joint mobility improved by approximately 60% in both groups. By the end of therapy in both groups, the period of pain-free walking time had more than doubled and subjectively evaluated pain perception (VAS) was reduced by almost 50% without any significant differences between the treatments. The incidence of adverse drug reactions was similar in both groups but oxaceprol induced milder symptoms. Oxaceprol is as effective and better tolerated than diclofenac in the treatment of osteoarthritis. PMID:10088941

  11. Homeostatic Mechanisms in Articular Cartilage and Role of Inflammation in Osteoarthritis

    PubMed Central

    Houard, Xavier; Goldring, Mary B.; Berenbaum, Francis

    2014-01-01

    Osteoarthritis (OA) is a whole joint disease, in which thinning and disappearance of cartilage is a critical determinant in OA progression. The rupture of cartilage homeostasis whatever its cause: aging, genetic predisposition, trauma or metabolic disorder, induces profound phenotypic modifications of chondrocytes, which then promote the synthesis of a subset of factors that induce cartilage damage and target other joint tissues. Interestingly, among these factors are numerous components of the inflammatory pathways. Chondrocytes produce cytokines, chemokines, alarmins, prostanoids and adipokines and express numerous cell surface receptors for cytokines and chemokines, as well as toll-like receptors. These receptors activate intracellular signaling pathways involved in inflammatory and stress responses of chondrocytes in OA joints. This review focuses on mechanisms responsible for the maintenance of cartilage homeostasis and highlights the role of inflammatory processes in OA progression. PMID:24072604

  12. Post-traumatic knee osteoarthritis in the young patient: therapeutic dilemmas and emerging technologies

    PubMed Central

    Stiebel, Matthew; Miller, Larry E; Block, Jon E

    2014-01-01

    Traumatic knee injury is common in young adults and strongly contributes to premature development of knee osteoarthritis (OA). Post-traumatic knee OA poses a therapeutic dilemma to the physician, since no known therapy has an acceptable safety profile, effectively relieves joint pain, and enjoys reasonable patient acceptance. Consequently, these young patients will ultimately be faced with the decision to either undergo surgical intervention, despite prosthesis durability concerns, or to continue with ineffective nonsurgical treatment. Emerging therapies, such as biologics, disease-modifying drugs, partial joint resurfacings, and minimally invasive joint-unloading implants are currently being studied to fill this therapeutic void in the young patient with post-traumatic knee OA. PMID:24744616

  13. Osteoarthritis of the Foot and Ankle

    MedlinePlus

    ... Size Print Bookmark Osteoarthritis of the Foot and Ankle What Is Osteoarthritis? Osteoarthritis is a condition characterized ... is also often found in the midfoot and ankle. Causes Osteoarthritis is considered a “wear and tear” ...

  14. Obesity and osteoarthritis.

    PubMed

    Kulkarni, Kunal; Karssiens, Timothy; Kumar, Vijay; Pandit, Hemant

    2016-07-01

    This paper provides an up-to-date review of obesity and lower limb osteoarthritis (OA). OA is a major global cause of disability, with the knee being the most frequently affected joint. There is a proven association between obesity and knee OA, and obesity is suggested to be the main modifiable risk factor. Obese patients (Body Mass Index, BMI, over 30kg/m(2)) are more likely to require total knee arthroplasty (TKA). The global prevalence of obesity has doubled since 1980; by 2025, 47% of UK men and 36% of women are forecast to be obese. This rising global burden is a key factor in the growing rise in the use of TKA. It is therefore important to appreciate the outcomes of surgery in patients with end-stage OA and a high BMI. This review found that while OA is felt to contribute to weight gain, it is unclear whether TKA facilitates weight reduction. Surgery in obese patients is more technically challenging. This is reflected in the evidence, which suggests higher rates of short- to medium-term complications following TKA, including wound infection and medical complications, resulting in longer hospital stay, and potentially higher rates of malalignment, dislocation, and early revision. However, despite slower initial recovery and possibly lower functional scores and implant survival in the longer term, obese patients can still benefit from TKA in terms of improved function, quality of life and satisfaction. In conclusion, despite higher risks and more uncertain outcomes of surgery, higher BMI in itself should not be a contraindication to TKA; instead, each patient's individual circumstances should be considered. PMID:27180156

  15. [SECOT consensus on medial femorotibial osteoarthritis].

    PubMed

    Moreno, A; Silvestre, A; Carpintero, P

    2013-01-01

    A consensus, prepared by SECOT, is presented on the management of medial knee compartment osteoarthritis, in order to establish clinical criteria and recommendations directed at unifying the criteria in its management, dealing with the factors involved in the pathogenesis of medial femorotibial knee osteoarthritis, the usefulness of diagnostic imaging techniques, and the usefulness of arthroscopy. Conservative and surgical treatments are also analysed. The experts consulted showed a consensus (agreed or disagreed) in 65.8% of the items considered, leaving 14items where no consensus was found, which included the aetiopathogenesis of the osteoarthritis, the value of NMR in degenerative disease, the usefulness of COX-2 and the chondroprotective drugs, as well as on the ideal valgus tibial osteotomy technique. PMID:24169227

  16. Radiological and Radionuclide Imaging of Degenerative Disease of the Facet Joints.

    PubMed

    Shur, Natalie; Corrigan, Alexis; Agrawal, Kanhaiyalal; Desai, Amidevi; Gnanasegaran, Gopinath

    2015-01-01

    The facet joint has been increasingly implicated as a potential source of lower back pain. Diagnosis can be challenging as there is not a direct correlation between facet joint disease and clinical or radiological features. The purpose of this article is to review the diagnosis, treatment, and current imaging modality options in the context of degenerative facet joint disease. We describe each modality in turn with a pictorial review using current evidence. Newer hybrid imaging techniques such as single photon emission computed tomography/computed tomography (SPECT/CT) provide additional information relative to the historic gold standard magnetic resonance imaging. The diagnostic benefits of SPECT/CT include precise localization and characterization of spinal lesions and improved diagnosis for lower back pain. It may have a role in selecting patients for local therapeutic injections, as well as guiding their location with increased precision. PMID:26170560

  17. Radiological and Radionuclide Imaging of Degenerative Disease of the Facet Joints

    PubMed Central

    Shur, Natalie; Corrigan, Alexis; Agrawal, Kanhaiyalal; Desai, Amidevi; Gnanasegaran, Gopinath

    2015-01-01

    The facet joint has been increasingly implicated as a potential source of lower back pain. Diagnosis can be challenging as there is not a direct correlation between facet joint disease and clinical or radiological features. The purpose of this article is to review the diagnosis, treatment, and current imaging modality options in the context of degenerative facet joint disease. We describe each modality in turn with a pictorial review using current evidence. Newer hybrid imaging techniques such as single photon emission computed tomography/computed tomography (SPECT/CT) provide additional information relative to the historic gold standard magnetic resonance imaging. The diagnostic benefits of SPECT/CT include precise localization and characterization of spinal lesions and improved diagnosis for lower back pain. It may have a role in selecting patients for local therapeutic injections, as well as guiding their location with increased precision. PMID:26170560

  18. Proteinases in the joint: clinical relevance of proteinases in joint destruction

    PubMed Central

    Rengel, Yvonne; Ospelt, Caroline; Gay, Steffen

    2007-01-01

    Proteinases are involved in essential steps in cartilage and bone homeostasis. Consequently, efforts have been made to establish their potential role in the pathology of rheumatic conditions such as rheumatoid arthritis, osteoarthritis and spondyloarthritis. Matrix metalloproteinases (MMPs) are sensitive markers of disease severity and response to treatment, and therefore they have potential in the assessment of rheumatic diseases. Despite disappointing early results with synthetic inhibitors of MMPs, there is still much scope for developing effective and safe MMPs inhibitors, and consequently to deliver new options to inhibit joint destruction. PMID:18001502

  19. Posturography in patients with rheumatoid arthritis and osteoarthritis.

    PubMed

    Sokołowska, B; Czerwosz, L; Hallay-Suszek, M; Sadura-Sieklucka, T; Księżopolska-Orłowska, K

    2015-01-01

    The purpose of the paper was to investigate the usefulness of posturographic analysis in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). RA is a chronic inflammatory disorder responsible for destruction of active and passive components of joints. It is the most common autoimmune disease, and the second most common form of arthritis after OA. OA is a chronic disorder characterized by irreversible changes in the joint structure developing with advancing age. Both diseases lead to the destruction of many parts of the motor system, cause pain, weakness, and damage of ligaments, muscles, bones, and articular cartilage. The etiology of the diseases remains unknown. In the present study, evaluation of body balance in the standing position was performed by means of Pro-Med force plate system. Three posturographic tests were applied: with eyes open, closed, and with the biofeedback--under conscious visual control of body movements. The following posturographic parameters were measured: the radius of sways, the developed area, and the total length of posturograms, and also two directional components of sways: the length of left-right (in frontal plane) and forward-backward (in sagittal plane) motions. The results demonstrate that the biofeedback test is most useful in the evaluation of instability in rheumatic patients; it is more powerful than the other posturographic tests evaluated. PMID:25298260

  20. Age Related Macular Degeneration and Total Hip Replacement Due to Osteoarthritis or Fracture: Melbourne Collaborative Cohort Study

    PubMed Central

    Chong, Elaine W.; Wang, Yuanyuan; Robman, Liubov D.; Aung, Khin Zaw; Makeyeva, Galina A.; Giles, Graham G.; Graves, Stephen; Cicuttini, Flavia M.; Guymer, Robyn H.

    2015-01-01

    Osteoarthritis is the leading cause of total hip replacement, accounting for more than 80% of all total hip replacements. Emerging evidence suggests that osteoarthritis has a chronic inflammatory component to its pathogenesis similar to age-related macular degeneration. We evaluated the association between age-related macular degeneration and total hip replacement as proxy for severe osteoarthritis or fractured neck of femur in the Melbourne Collaborative Cohort Study. 20,744 participants had complete data on both age-related macular degeneration assessed from colour fundus photographs taken during 2003–2007 and total hip replacement. Total hip replacements due to hip osteoarthritis and fractured neck of femur during 2001–2011 were identified by linking the cohort records to the Australian Orthopedic Association National Joint Replacement Registry. Logistic regression was used to examine the association between age-related macular degeneration and risk of total hip replacement due to osteoarthritis and fracture separately, adjusted for confounders. There were 791 cases of total hip replacement for osteoarthritis and 102 cases of total hip replacement due to fractured neck of femur. After adjustment for age, sex, body mass index, smoking, and grouped country of birth, intermediate age-related macular degeneration was directly associated with total hip replacement for osteoarthritis (odds ratio 1.22, 95% CI 1.00–1.49). Late age-related macular degeneration was directly associated with total hip replacement due to fractured neck of femur (odds ratio 5.21, 95% CI2.25–12.02). The association between intermediate age-related macular degeneration and an increased 10-year incidence of total hip replacement due to osteoarthritis suggests the possibility of similar inflammatory processes underlying both chronic diseases. The association of late age-related macular degeneration with an increased 10-year incidence of total hip replacement due to fractured neck of femur may be due to an increased prevalence of fractures in those with poor central vision associated with the late complications of age-related macular degeneration. PMID:26355683

  1. Clinical evaluation of Boswellia serrata (Shallaki) resin in the management of Sandhivata (osteoarthritis)

    PubMed Central

    Gupta, P. K.; Samarakoon, S. M. S.; Chandola, H. M.; Ravishankar, B.

    2011-01-01

    Sandhigata vata is described under Vatavyadhi in all Ayurvedic texts. Charaka was the first to describe separately “Sandhigata anila”, but it was not included under 80 types of nanatmaja vatavyadhi. Osteoarthritis is the most common degenerative joint disease that begins asymptomatically in middle age with progressive symptoms in advancing age. Majority of people by the age 40 years may develop osteoarthritis, especially in weight bearing joints. Females are prone with 25% prevalence, whereas males have a prevalence of 16%. In the present study, 56 patients fulfilling the diagnostic criteria of Sandhigata vata, divided into two groups. Patients of first group were administered with 500 mg capsule of Shallaki, 6 g per day (in three divided doses) with lukewarm water (n=29) and the second group) capsule Shallaki as above along with local application of Shallaki ointment on the affected joints (n=23). After a course of therapy for 2 months, symptomatic improvement was observed in both the groups at various levels with promising results in the patients of first group. PMID:22661840

  2. Clinical evaluation of Boswellia serrata (Shallaki) resin in the management of Sandhivata (osteoarthritis).

    PubMed

    Gupta, P K; Samarakoon, S M S; Chandola, H M; Ravishankar, B

    2011-10-01

    Sandhigata vata is described under Vatavyadhi in all Ayurvedic texts. Charaka was the first to describe separately "Sandhigata anila", but it was not included under 80 types of nanatmaja vatavyadhi. Osteoarthritis is the most common degenerative joint disease that begins asymptomatically in middle age with progressive symptoms in advancing age. Majority of people by the age 40 years may develop osteoarthritis, especially in weight bearing joints. Females are prone with 25% prevalence, whereas males have a prevalence of 16%. In the present study, 56 patients fulfilling the diagnostic criteria of Sandhigata vata, divided into two groups. Patients of first group were administered with 500 mg capsule of Shallaki, 6 g per day (in three divided doses) with lukewarm water (n=29) and the second group) capsule Shallaki as above along with local application of Shallaki ointment on the affected joints (n=23). After a course of therapy for 2 months, symptomatic improvement was observed in both the groups at various levels with promising results in the patients of first group. PMID:22661840

  3. Prevalence of knee osteoarthritis and analysis of pain, rigidity, and functional incapacity.

    PubMed

    Nuñez, Montserrat; Nuñez, Esther; Sastre, Sergi; Del-Val, Jose-Luis; Segur, Josep-Maria; Macule, Francisco

    2008-08-01

    Knee osteoarthritis is one of the most prevalent health problems in our society. It accounts for 10% of all primary care visits in general medicine and 30% of outpatient appointments. The objectives of this cross-sectional descriptive study of 100 patients suffering from gonarthritis were to assess pain, functional capacity, and joint damage in patients diagnosed with knee osteoarthritis, as well as the possible repercussions for subsequent surgical treatment. Sociodemographic, clinical, and radiological data were collected, and pain and functional capacity were evaluated by using the Western Ontario and McMaster Universities Osteoarthritis Index. The majority (71) of patients were women, mean age 71 years (SD=7.84), of low educational (66%) and financial (89%) status, with mean disease duration of 11.8 years. Of the total, 87% presented with comorbidity. Radiographs revealed a varus malalignment in 31% of patients and a valgus malalignment in 17%, with bone collapse in 39% of these. The factors that most affect surgery and subsequent rehabilitation are closely linked to social status, the general state of the patient, and the radiological severity of gonarthritis. Most of the patients were obese and suffered from comorbid conditions, and some presented with psychopathology. These factors may influence surgery, and thus improvements in primary care should be made as a way of offering a simpler and more effective treatment for gonarthritis. PMID:19292422

  4. Role of gold nanoparticles as drug delivery vehicles for chondroitin sulfate in the treatment of osteoarthritis.

    PubMed

    Dwivedi, Priyanka; Nayak, Vijayashree; Kowshik, Meenal

    2015-01-01

    Osteoarthritis is a disease which is characterized by joint pain, swelling and stiffness. Articular cartilage has limited self-repair capacity due to its avascular and aneural nature. In this work, we show the use of gold nanoparticles (AuNps) for enhancing the delivery of chondroitin sulfate (CS), a drug used in the treatment of osteoarthritis (OA). AuNps were synthesized and were characterized by transmission electron microscopy (TEM), ultraviolet-visible (UV-Vis) spectroscopy, Fourier transform infrared spectroscopy (FTIR), and X-Ray diffraction analysis. AuNps were combined with CS (AuNps-CS) and their effect on primary goat chondrocytes was studied using MTT assay, Hoechst staining, production of glycosaminoglycan and collagen. Cell viability studies by MTT revealed that AuNps-CS stimulate cell proliferation. A two-fold increase in GAG and collagen production was observed in presence of AuNps-CS combination as compared to native CS, indicating that this combination stimulates chondrocyte proliferation and enhances extracellular matrix production (ECM). Hence, this study exhibits the potential of AuNps as a carrier of CS for treatment of osteoarthritis. PMID:26193993

  5. Comparative study of hamstring and quadriceps strengthening treatments in the management of knee osteoarthritis.

    PubMed

    Al-Johani, Ahmed H; Kachanathu, Shaji John; Ramadan Hafez, Ashraf; Al-Ahaideb, Abdulaziz; Algarni, Abdulrahman D; Meshari Alroumi, Abdulmohesn; Alanezi, Aqeel M

    2014-06-01

    [Purpose] Osteoarthritis (OA) of the knee is the most common form of joint disease. It is one of the major causes of impaired function that reduces quality of life (QOL) worldwide. The purpose of this study was to compare exercise treatments for hamstring and quadriceps strength in the management of knee osteoarthritis. [Subjects and Methods] Forty patients with OA knee, aged 50-65 years were divided into 2 groups. The first group (57.65±4.78 years) received hot packs and performed strengthening exercises for the quadriceps and hamstring, and stretching exercises for the hamstring. The second group (58.15±5.11 years) received hot packs and performed strengthening exercises for only the quadriceps, and stretching exercise for the hamstring. Outcome measures were the WOMAC (Western Ontario and McMaster Universities OA index questionnaire), Visual Analogue Scale (VAS) assessment of pain, the Fifty-Foot Walk Test (FWS), and Handheld dynamometry. [Results] There was a significant difference between the groups. The first group showed a more significant result than the second group. [Conclusion] Strengthening of the hamstrings in addition to strengthening of the quadriceps was shown to be beneficial for improving subjective knee pain, range of motion and decreasing the limitation of functional performance of patients with knee osteoarthritis. PMID:25013274

  6. Comparative Study of Hamstring and Quadriceps Strengthening Treatments in the Management of Knee Osteoarthritis

    PubMed Central

    Al-Johani, Ahmed H; Kachanathu, Shaji John; Ramadan Hafez, Ashraf; Al-Ahaideb, Abdulaziz; Algarni, Abdulrahman D; Meshari Alroumi, Abdulmohsen; Alenazi, Aqeel M.

    2014-01-01

    [Purpose] Osteoarthritis (OA) of the knee is the most common form of joint disease. It is one of the major causes of impaired function that reduces quality of life (QOL) worldwide. The purpose of this study was to compare exercise treatments for hamstring and quadriceps strength in the management of knee osteoarthritis. [Subjects and Methods] Forty patients with OA knee, aged 50–65 years were divided into 2 groups. The first group (57.65±4.78 years) received hot packs and performed strengthening exercises for the quadriceps and hamstring, and stretching exercises for the hamstring. The second group (58.15±5.11 years) received hot packs and performed strengthening exercises for only the quadriceps, and stretching exercise for the hamstring. Outcome measures were the WOMAC (Western Ontario and McMaster Universities OA index questionnaire), Visual Analogue Scale (VAS) assessment of pain, the Fifty-Foot Walk Test (FWS), and Handheld dynamometry. [Results] There was a significant difference between the groups. The first group showed a more significant result than the second group. [Conclusion] Strengthening of the hamstrings in addition to strengthening of the quadriceps was shown to be beneficial for improving subjective knee pain, range of motion and decreasing the limitation of functional performance of patients with knee osteoarthritis. PMID:25013274

  7. Nutraceuticals in joint health: animal models as instrumental tools.

    PubMed

    Mvel, Elsa; Monfoulet, Laurent-Emmanuel; Merceron, Christophe; Coxam, Vronique; Wittrant, Yohann; Beck, Laurent; Guicheux, Jrme

    2014-10-01

    Osteoarthritis (OA) is a degenerative joint disease with no curative treatments. Many studies have begun to demonstrate the efficacy of nutraceuticals for slowing down OA. Animal models are utilized as a compulsory step in demonstrating the protective potential of these compounds on joint health. Nevertheless, there exist a wide variety of available OA models and selecting a suitable system for evaluating the effects of a specific compound remains difficult. Here, we discuss animal studies that have investigated nutraceutical effects on OA. In particular, we highlight the large spectrum of animal models that are currently accepted for examining the OA-related effects of nutraceuticals, giving recommendations for their use. PMID:24955836

  8. Association of hip pain with radiographic evidence of hip osteoarthritis: diagnostic test study

    PubMed Central

    Nevitt, Michael C; Niu, Jingbo; Clancy, Mary M; Lane, Nancy E; Link, Thomas M; Vlad, Steven; Tolstykh, Irina; Jungmann, Pia M.; Felson, David T; Guermazi, Ali

    2015-01-01

    Study question Is there concordance between hip pain and radiographic hip osteoarthritis? Methods In this diagnostic test study, pelvic radiographs were assessed for hip osteoarthritis in two cohorts: the Framingham Osteoarthritis Study (community of Framingham, Massachusetts) and the Osteoarthritis Initiative (a multicenter longitudinal cohort study of osteoarthritis in the United States). Using visual representation of the hip joint, participants reported whether they had hip pain on most days and the location of the pain: anterior, groin, lateral, buttocks, or low back. In the Framingham study, participants with hip pain were also examined for hip pain with internal rotation. The authors analysed the agreement between radiographic hip osteoarthritis and hip pain, and for those with hip pain suggestive of hip osteoarthritis they calculated the sensitivity, specificity, positive predictive value, and negative predictive value of radiographs as the diagnostic test. Study answer and limitations In the Framingham study (n=946), only 15.6% of hips in patients with frequent hip pain showed radiographic evidence of hip osteoarthritis, and 20.7% of hips with radiographic hip osteoarthritis were frequently painful. The sensitivity of radiographic hip osteoarthritis for hip pain localised to the groin was 36.7%, specificity 90.5%, positive predictive value 6.0%, and negative predictive value 98.9%. Results did not differ much for hip pain at other locations or for painful internal rotation. In the Osteoarthritis Initiative study (n=4366), only 9.1% of hips in patients with frequent pain showed radiographic hip osteoarthritis, and 23.8% of hips with radiographic hip osteoarthritis were frequently painful. The sensitivity of definite radiographic hip osteoarthritis for hip pain localised to the groin was 16.5%, specificity 94.0%, positive predictive value 7.1%, and negative predictive value 97.6%. Results also did not differ much for hip pain at other locations. What this study adds Hip pain was not present in many hips with radiographic osteoarthritis, and many hips with pain did not show radiographic hip osteoarthritis. Most older participants with a high suspicion for clinical hip osteoarthritis (groin or anterior pain and/or painful internal rotation) did not have radiographic hip osteoarthritis, suggesting that in many cases, hip osteoarthritis might be missed if diagnosticians relied solely on hip radiographs. Funding, competing interests, data sharing See the full paper on thebmj.com for funding. The authors have no competing interests. Additional data are available from bevochan@bu.edu. PMID:26631296

  9. [Is knee osteotomy still indicated in knee osteoarthritis?].

    PubMed

    Antonescu, D N

    2000-12-01

    This study was undertaken to investigate whether high tibial osteotomy (HTO) still had a role in the treatment of osteoarthritis of the knee joint. The author has performed photoelasticity studies which confirmed abnormal stress distribution over the joint, as soon as its mechanical axis was deviated and the joint line had an obliquity over 10 degrees. High tibial osteotomy to correct varus or valgus deformity restores a symmetrical stress distribution and represents the only etiological treatment of secondary osteoarthritis of the knee. Two hundred and fifty HTO's were performed between 1971 and 1985 for osteoarthritis of the knee. The short-term result was good or very good in 75%, fair in 20% and poor in 5%. Fair and poor results were related to insufficient correction, to infection or mostly to incorrect indications. In 152 cases with a good or very good short term result, a further evaluation was made between 8 years and 15 years after operation. It was noted that osteoarthritis had been arrested in 105 cases (69%) whereas it had deteriorated in 47 cases. The main factors associated with further deterioration were insufficient correction and persistence of joint line obliquity. Provided on optimal correction is achieved (3 degrees to 6 degrees hypercorrection in valgus osteotomy, 0 degree in varus osteotomy) and provided a horizontal joint line is restored, HTO performed in good indications (Ahlback grade I or II) may provide good results for at least 10 to 15 years. PMID:11196365

  10. Treating Osteoarthritis of the Shoulder

    MedlinePlus

    ... over-the-counter medicine, such as acetaminophen (one brand: Tylenol) or ibuprofen (one brand: Motrin). Do physical therapy or certain exercises to ... your osteoarthritis is. Source Shoulder Osteoarthritis: Diagnosis and Management by Peter J. Millett, MD, Reuben Gobezie, MD, ...

  11. Crystalline glucosamine sulfate in the management of knee osteoarthritis: efficacy, safety, and pharmacokinetic properties

    PubMed Central

    Girolami, Federica; Persiani, Stefano

    2012-01-01

    Glucosamine is an amino monosaccharide and a natural constituent of glycosaminoglycans in articular cartilage. When administered exogenously, it is used for the treatment of osteoarthritis as a prescription drug or a dietary supplement. The latter use is mainly supported by its perception as a cartilage building block, but it actually exerts specific pharmacologic effects, mainly decreasing interleukin 1-induced gene expression by inhibiting the cytokine intracellular signaling cascade in general and nuclear factor-kappa B (NF-kB) activation in particular. As a whole, the use of glucosamine in the management of osteoarthritis is supported by the clinical trials performed with the original prescription product, that is, crystalline glucosamine sulfate. This is the stabilized form of glucosamine sulfate, while other formulations or different glucosamine salts (e.g. hydrochloride) have never been shown to be effective. In particular, long-term pivotal trials of crystalline glucosamine sulfate 1500 mg once daily have shown significant and clinically relevant improvement of pain and function limitation (symptom-modifying effect) in knee osteoarthritis. Continuous administration for up to 3 years resulted in significant reduction in the progression of joint structure changes compared with placebo as assessed by measuring radiologic joint space narrowing (structure-modifying effect). The two effects combined may suggest a disease-modifying effect that was postulated based on an observed decrease in the risk of undergoing total joint replacement in the follow up of patients receiving the product for at least 12 months in the pivotal trials. The safety of the drug was good in clinical trials and in the postmarketing surveillance. Crystalline glucosamine sulfate 1500 mg once daily is therefore recommended in the majority of clinical practice guidelines and was found to be cost effective in pharmacoeconomic analyses. Compared with other glucosamine formulations, salts, or dosage forms, the prescription product achieves higher plasma and synovial fluid concentrations that are above the threshold for a pharmacologically relevant effect, and may therefore justify its distinct therapeutic characteristics. PMID:22850875

  12. Effect of alcoholic extract of Entada pursaetha DC on monosodium iodoacetate-induced osteoarthritis pain in rats

    PubMed Central

    Kumari, Rashmi R.; More, Amar S.; Gupta, Gaurav; Lingaraju, Madhu C.; Balaganur, Venkanna; Kumar, Pankaj; Kumar, Dinesh; Sharma, Anil K.; Mishra, Santosh K.; Tandan, Surendra Kumar

    2015-01-01

    Background & objectives: Osteoarthritis (OA) is a degenerative disease characterized by joint pain and progressive loss of articular cartilage. Entada pursaetha has been traditionally used in the treatment of inflammatory disease, liver ailment, etc. In this study we investigated suppressive effect of ethanolic extract of E. pursaetha (EPE) on monosodium iodoacetate (MIA)-induced osteoarthritis pain and disease progression by histopathological changes in joints in a rat model. Methods: OA was induced in right knee of rat by intra-articular injection of 3 mg of MIA and characterized by pathological progression of disease and pain of affected joint. Spontaneous movements, mechanical, thermal and cold sensitivity were monitored at days 0 (before drug and MIA injection), 7, 14 and 21 of MIA administration. EPE (30, 100 and 300 mg/kg), vehicle or etoricoxib (10 mg/kg; reference drug) were administered daily for 21 days by oral route. Results: EPE at various doses significantly reduced mechanical, heat, cold hyperalgesia and increased the horizontal and vertical movements in intra-articular MIA injected rats. EPE prevented the damage to cartilage structure and reduced the cellular abnormalities. Articular cartilage of rats treated with EPE at 300 mg/kg group was almost normal with well-developed smooth surface and chondrocytes were distributed individually or arranged in column. Interpretation & conclusions: The present findings showed that the EPE was not only able to mitigate pain and hyperalgesia but also inhibited MIA-induced cartilage degeneration in vivo. EPE may have the potential to become therapeutic modality in the treatment of osteoarthritis. However, further studies need to be done to confirm these findings in other models and clinical trials. PMID:26112847

  13. [Septic osteo-arthritis in hemodialyzed patients: an incident not to underestimate (author's transl)].

    PubMed

    Pavlica, P; Viglietta, G; Fabbri, L

    1981-10-01

    Three cases of septic osteo-arthritis were seen occuring in patients on dialysis treatment. The sites of involvement included lumbar spine, knee joint, ribs and wrist. The culture of the same microorganisms simultaneously from the arterovenous prothesis, blood and synovial fluid supports the hypothesis that the osteo-arthritis was the result of hematogenous spread of bacteria from the infected focus. Early diagnosis and treatment may prevent severe bone and joint damage. PMID:7323334

  14. A comparison of radiographic, arthroscopic and histological measures of articular pathology in the canine elbow joint.

    PubMed

    Goldhammer, Marc A; Smith, Sionagh H; Fitzpatrick, Noel; Clements, Dylan N

    2010-10-01

    Validation of radiographic and arthroscopic scoring of joint pathology requires their comparison with histological measures of disease from the same joint. Fragmentation of the medial coronoid process (FMCP) is a naturally occurring disease of the canine elbow joint that results in osteoarthritis, and the objectives of this study were to compare the severity of histopathological changes in the medial coronoid process (MCP) and medial articular synovial membrane with gross radiographic scoring of elbow joint osteophytosis and the arthroscopic assessment of the MCP articular cartilage surface. Radiographic scoring of osteophytosis and the arthroscopic scoring of visual cartilage pathology of the MCP correlated moderately well with the histopathological evaluation of cartilage damage on the MCP and synovial inflammation in the medial part of the joint, but not with bone pathology in the MCP. Marked cartilage pathology on the MCP was identified in joints with either no radiographic evidence of osteophytosis or with mild cartilage damage that was evident arthroscopically. PMID:19716324

  15. Surgical treatment of an aseptic fistulized acromioclavicular joint cyst: a case report and review of the literature

    PubMed Central

    Murena, Luigi; D’angelo, Fabio; Falvo, Daniele A

    2009-01-01

    An acromioclavicular joint cyst is an uncommonly reported condition, which seems to result from a massive rotator cuff tear and degenerative osteoarthritis of the acromioclavicular joint. We present the case of an 81-year-old man affected by an acromioclavicular joint cyst, associated to a massive rotator cuff tear, proximal migration of the humeral head and osteoarthritis of the gleno-humeral joint. The mass was 7 × 2.5 cm in size and the overlying skin presented a fistula that drained clear synovial-like fluid. Plain X-ray examination of the left shoulder showed proximal migration of the humeral head migration and osteoarthritis of the gleno-humeral joint, and further MRI evaluation confirmed the clinical diagnosis of a complete rotator cuff tear and observed a large subcutaneous cyst in communication with the degenerative acromioclavicular joint. The patient underwent surgical excision of the cyst and lateral resection of the clavicle to prevent disease recurrence. To the best of our knowledge, this is the first reported case of an acromioclavicular joint cyst complicated by an aseptic fistula resulting from multiple aspirations. PMID:19918423

  16. Comparative Effectiveness of B and E Vitamins with Diclofenac in Reducing Pain Due to Osteoarthritis of the Knee

    PubMed Central

    Dehghan, Morteza

    2015-01-01

    Background: Knee osteoarthritis is one of the most prevalent chronic disorders. Several pharmacological and non pharmacological approaches are used to treat this disease. Today, the effect of B and E vitamins on rheumatology diseases is being discussed. In this study, the efficacy of B and E vitamins accompanied with diclofenac on pain relief in patients with knee osteoarthritis was investigated and compared. Methods: In this double-blinded clinical trial, 120 patients with knee osteoarthritis referring training Rheumatology and Orthopedics Clinic of Shahrekord University of Medical sciences were investigated. Of these patients, 12 were excluded throughout the study. The patients underwent treatment in three groups (oral diclofenac + oral B vitamin, oral diclofenac + oral vitamin E, and oral diclofenac + placebo). Pain relief was assessed by visual analogue scale (VAS) questionnaire and morning stiffness and physical function were assessed by WOMAC standard questionnaire at three times; the first examination, two weeks, and three weeks after referring. Results: The mean score of WOMAC questionnaire at VASs of knee pain, total pain severity, knee joint stiffness, and function of the last 48 hours decreased significantly in all three groups (diclofenac, E and B vitamins) from the first to third examination (P<0.001). Decrease in VAS of knee pain and function of the last 48 hours was higher in B vitamin group than the diclofenac and E vitamin group (P=0.008) and decrease in total pain severity was reported higher in B vitamin group than E vitamin and diclofenac group (P=0.019). Decrease in knee joint stiffness underwent a similar trend in the three groups. Conclusion: In view similar analgesic and anti-inflammatory properties, as well as very few, non prevalent complications of B and E vitamins, use of two or more drugs with a different mechanism of effect seems necessary to enhance their effect on osteoarthritis treatment. PMID:26005259

  17. Long-distance running, bone density, and osteoarthritis

    SciTech Connect

    Lane, N.E.; Bloch, D.A.; Jones, H.H.; Marshall, W.H. Jr.; Wood, P.D.; Fries, J.F.

    1986-03-07

    Forty-one long-distance runners aged 50 to 72 years were compared with 41 matched community controls to examine associations of repetitive, long-term physical impact (running) with osteoarthritis and osteoporosis. Roentgenograms of hands, lateral lumbar spine, and knees were assessed without knowledge of running status. A computed tomographic scan of the first lumbar vertebra was performed to quantitate bone mineral content. Runners, both male and female, have approximately 40% more bone mineral than matched controls. Female runners, but not male runners, appear to have somewhat more sclerosis and spur formation in spine and weight-bearing knee x-ray films, but not in hand x-ray films. There were no differences between groups in joint space narrowing, crepitation, joint stability, or symptomatic osteoarthritis. Running is associated with increased bone mineral but not, in this cross-sectional study, with clinical osteoarthritis.

  18. Extraarticular Supramalleolar Osteotomy for Managing Varus Ankle Osteoarthritis, Alternatives for Osteotomy: How and Why?

    PubMed

    Lee, Woo-Chun

    2016-03-01

    The supramalleolar osteotomy has been reported to be a joint preserving surgery with good clinical outcome for asymmetric ankle osteoarthritis, especially varus ankle osteoarthritis. Conventional supramalleolar osteotomy of the tibia and fibula creates angulation and translation of the ankle joint without changing the width of the ankle mortise. Distal tibial oblique osteotomy improved the preoperative clinical and radiological parameters; however, mean talar tilt angle did not decrease. Assessment of the ankle arthritis in sagittal, axial, and coronal planes may be helpful to achieve a decrease of the talar tilt in ankle osteoarthritis. PMID:26915776

  19. Menisectomized miniature Vietnamese pigs develop articular cartilage pathology resembling osteoarthritis.

    PubMed

    Cruz, Raymundo; Ramírez, Carmen; Rojas, Oscar I; Casas-Mejía, Oscar; Kouri, Juan B; Vega-López, Marco A

    2015-11-01

    Animal models have been used to understand the basic biology of osteoarthritis (OA) and have helped to identify new candidate biomarkers for the early diagnosis and treatment of this condition. Small animals cannot sufficiently mimic human diseases; therefore, large animal models are needed. Pigs have been used as models for human diseases because they are similar to humans in terms of their anatomy, physiology and genome. Hence, we analyzed articular cartilage and synovial membrane pathology in miniature Vietnamese pigs after a unilateral partial menisectomy and 20-day exercise regimen to determine if the pigs developed pathological characteristics similar to human OA. Histological and protein expression analysis of articular cartilage from menisectomized pigs revealed the following pathologic changes resembling OA: fibrillation, fissures, chondrocyte cluster formation, decrease in proteoglycan content and upregulation of the OA-associated proteins MMP-3, MMP-13, procaspase-3 and IL-1β. Moreover, histological analysis of synovial membrane revealed mild synovitis, characterized by hyperplasia, cell infiltration and neoangiogenesis. Pathological changes were not observed in the contralateral joints or the joints of sham-operated pigs. Further studies are required to validate such an OA model; however, our results can encourage the use of pigs to study early stages of OA physiopathology. Based on their similarities to humans, pigs may be useful for preclinical studies to identify new candidate biomarkers and novel treatments for OA. PMID:26296921

  20. Knee stabilization in patients with medial compartment knee osteoarthritis

    PubMed Central

    Lewek, Michael D.; Ramsey, Dan K.; Snyder-Mackler, Lynn; Rudolph, Katherine S.

    2005-01-01

    OBJECTIVE Individuals with medial knee osteoarthritis (MKOA) experience knee laxity and instability. Muscle stabilization strategies may influence the long term integrity of the joint. In this study we determined how individuals with medial knee OA respond to a rapid valgus knee movement to investigate the relationship between muscle stabilization strategies and knee instability. METHODS Twenty one subjects with MKOA and genu varum, and 19 control subjects were tested. Subjects stood with the test limb on a moveable platform that translated laterally to rapidly stress the knee’s medial periarticular structures and create a potentially destabilizing feeling at the knee joint. Knee motion and muscle responses were recorded. Subjects rated their knee instability with a self-report questionnaire about knee instability during daily activities. RESULTS Prior to plate movement the OA subjects demonstrated more medial muscle co-contraction (p=0.014). Following plate movement the OA subjects shifted less weight off the test limb (p = 0.013) and had more medial co-contraction (p=0.037). Those without instability had higher VMMH co-contraction than those who reported more instability (p=0.038). Knee stability correlated positively with VMMH co-contraction prior to plate movement (r = 0.459; p = 0.042). CONCLUSION This study demonstrates that individuals with MKOA attempt to stabilize the knee with greater medial muscle co-contraction in response to laxity that appears on only the medial side of the joint. This strategy presumably contributes to higher joint compression and could exacerbate joint destruction and needs to be altered to slow or stop the progression of the OA disease process. PMID:16142714

  1. Applying computation biology and "big data" to develop multiplex diagnostics for complex chronic diseases such as osteoarthritis.

    PubMed

    Ren, Guomin; Krawetz, Roman

    2015-12-01

    The data explosion in the last decade is revolutionizing diagnostics research and the healthcare industry, offering both opportunities and challenges. These high-throughput "omics" techniques have generated more scientific data in the last few years than in the entire history of mankind. Here we present a brief summary of how "big data" have influenced early diagnosis of complex diseases. We will also review some of the most commonly used "omics" techniques and their applications in diagnostics. Finally, we will discuss the issues brought by these new techniques when translating laboratory discoveries to clinical practice. PMID:26809774

  2. Applying computation biology and “big data” to develop multiplex diagnostics for complex chronic diseases such as osteoarthritis

    PubMed Central

    Ren, Guomin; Krawetz, Roman

    2015-01-01

    Abstract The data explosion in the last decade is revolutionizing diagnostics research and the healthcare industry, offering both opportunities and challenges. These high-throughput “omics” techniques have generated more scientific data in the last few years than in the entire history of mankind. Here we present a brief summary of how “big data” have influenced early diagnosis of complex diseases. We will also review some of the most commonly used “omics” techniques and their applications in diagnostics. Finally, we will discuss the issues brought by these new techniques when translating laboratory discoveries to clinical practice. PMID:26809774

  3. Simvastatin Effect on Calcium and Silicon Plasma Levels in Postmenopausal Women with Osteoarthritis.

    PubMed

    Horecka, Anna; Hordyjewska, Anna; Blicharski, Tomasz; Kocot, Joanna; Żelazowska, Renata; Lewandowska, Anna; Kurzepa, Jacek

    2016-05-01

    Postmenopausal women more often suffered from knee osteoarthritis and its pathogenesis still remains unclear. Calcium and silicon are significant elements involved in bone and joint metabolism, especially in older people. Cardiovascular diseases are common worldwide and simvastatin is the most prescribed drug in such population of patients. The purpose of this study was to evaluate the effect of simvastatin administration on calcium and silicon concentration in the plasma of postmenopausal women with osteoarthritis. Sixty postmenopausal mild hypercholesterolemic women (mean age 61.4 years, range 54-68) were enrolled. Thirty patients received simvastatin (20 or 40 mg/day) for at least 1 year before being enrolled (simvastatin "+" group). Control group consists of remaining 30 women (simvastatin "-"group). Silicon and calcium concentrations were measured spectrophotometrically. Plasma simvastatin level was determined 3 h after the drug administration using HPLC-UV-Vis. Calcium but not silicon level was significantly lower in patients receiving simvastatin in comparison with non-statin group (1.91 ± 0.32 vs. 2.33 ± 0.19 mmol/l, p < 0.05). A weak but significant positive correlation between plasma silicon and simvastatin levels (r = 0.3, p < 0.05) was observed; this may be due to the fact that simvastatin contains silicon dioxide as an inactive ingredient. The mean simvastatin concentration was 9.02 ng/ml. All hypotheses were verified at the significance level of p < 0.05. A statistically significant decrease in the plasma calcium concentration of postmenopausal women, treated with simvastatin suggests that simvastatin may play a role in calcium metabolism in postmenopausal women with osteoarthritis. Positive correlation of simvastatin concentration with silicon level in the plasma suggests that both might prompt the positive effect of osteoarthritis treatment. PMID:26858096

  4. Sacroiliac joint imaging.

    PubMed

    Tuite, Michael J

    2008-03-01

    The sacroiliac (SI) joint has several unique anatomical features that make it one of the more challenging joints to image. The joint is difficult to profile well on radiographic views, and therefore the radiographic findings of sacroiliitis are often equivocal. Computed tomography images can usually show the findings of sacroiliitis and osteoarthritis earlier than radiographs. Magnetic resonance imaging performed with proper sequences is excellent for diagnosing even very early sacroiliitis and for following treatment response. The SI joint is often involved in patients with osteoarthritis or one of the inflammatory spondyloarthritides, most notably ankylosing spondylitis. Ankylosing spondylitis often presents with sacroiliitis, which appears as erosions, sclerosis, and joint space narrowing, eventually leading to ankylosis. Several disorders can cause sacroiliitis-like changes of the joint, including hyperparathyroidism and repetitive shear-stress injuries in athletes. The joint can become painful during pregnancy as it widens and develops increased motion, and some postpartum women develop iliac sclerosis adjacent to the joint termed osteitis condensans ilii. Another cause of SI joint pain is a disorder called sacroiliac joint dysfunction, which typically has few abnormal imaging findings. Patients with SI joint dysfunction, as well as sacroiliitis, often get relief from image-guided SI joint therapeutic injections. PMID:18382946

  5. Critical-size defect induces unicompartmental osteoarthritis in a stable ovine knee.

    PubMed

    Schinhan, Martina; Gruber, Martin; Vavken, Patrick; Dorotka, Ronald; Samouh, Leila; Chiari, Catharina; Gruebl-Barabas, Ruth; Nehrer, Stefan

    2012-02-01

    Animal models simulating osteoarthritis are frequently associated with irreversible changes in biomechanics. Although these models successfully induce osteoarthritis, results of experimental repair procedures are impaired by biomechanical problems. The aim of this study was to define the critical size of a chondral lesion to induce unicompartmental osteoarthritis in a stable joint. Sixteen sheep were randomly divided into four treatment groups. A cartilage defect (7- or 14-mm diameter) was created in the weight-bearing zone of the medial femoral condyle. The sheep were mobilized for 6 or 12 weeks. Osteoarthritis was determined by gross assessment, India ink staining, histology (Mankin score), and analysis of COMP in the serum. In the 6-week group, only minor osteoarthritis was registered for either defect size. After 12 weeks, the 14-mm defect induced minor osteoarthritis at the femoral condyle and caused significant degenerative changes at the tibial articular cartilage and the meniscus. The 7-mm defect created focal unicompartmental osteoarthritis at the medial femoral condyle and minor degenerative changes at the corresponding tibia. A 7-mm full-thickness chondral defect with a weight-bearing regimen of 12 weeks induced local osteoarthritis at the medial compartment in an otherwise stable joint as aimed. PMID:21818770

  6. Medical treatment of osteoarthritis in the horse - a review.

    PubMed

    Goodrich, Laurie R; Nixon, Alan J

    2006-01-01

    The medical treatment of osteoarthritis (OA) in the horse is one of the most utilized therapeutic regimens in the equine practice. It is important to understand the anatomy of synovial joints and the pathophysiology of the disease process to treat OA adequately. Once a thorough understanding of the disease process is comprehended the proper combination of systemic nonsteroidal anti-inflammatory drugs (NSAIDs), intraarticular steroids, viscosupplementation and chondroprotectants can be used to treat the disease and inhibit further progression of degenerative changes to the cartilage surface. The equine practitioner is faced with many choices for controlling inflammation in OA. This review presents the background and appropriate uses of various NSAIDs such as phenylbutazone, flunixin meglumine, ketoprofen, naproxen, and carprofen as well as their associated toxicities. Various steroid formulations exist for intraarticular (IA) administration and much has been learned in the past decade regarding correct dosage, frequency of administrations, indications and toxicity. This review presents IA steroids and their indications in addition to various chondroprotective drugs that also exist to control inflammation and provide viscosupplementation. Data are also given on disease modifying OA drugs such as glucosamine and chondroitin sulphate that have more recently become available to the equine practitioner. PMID:16427582

  7. Animal Models of Osteoarthritis: Comparisons and Key Considerations.

    PubMed

    McCoy, A M

    2015-09-01

    Osteoarthritis (OA) is unquestionably one of the most important chronic health issues in humans, affecting millions of individuals and costing billions of dollars annually. Despite widespread awareness of this disease and its devastating impact, the pathogenesis of early OA is not completely understood, hampering the development of effective tools for early diagnosis and disease-modifying therapeutics. Most human tissue available for study is obtained at the time of joint replacement, when OA lesions are end stage and little can be concluded about the factors that played a role in disease development. To overcome this limitation, over the past 50 years, numerous induced and spontaneous animal models have been utilized to study disease onset and progression, as well as to test novel therapeutic interventions. Reflecting the heterogeneity of OA itself, no single "gold standard" animal model for OA exists; thus, a challenge for researchers lies in selecting the most appropriate model to answer a particular scientific question of interest. This review provides general considerations for model selection, as well as important features of species such as mouse, rat, guinea pig, sheep, goat, and horse, which researchers should be mindful of when choosing the "best" animal model for their intended purpose. Special consideration is given to key variations in pathology among species as well as recommended guidelines for reporting the histologic features of each model. PMID:26063173

  8. Nutraceuticals: Potential for Chondroprotection and Molecular Targeting of Osteoarthritis

    PubMed Central

    Leong, Daniel J.; Choudhury, Marwa; Hirsh, David M.; Hardin, John A.; Cobelli, Neil J.; Sun, Hui B.

    2013-01-01

    Osteoarthritis (OA) is a degenerative joint disease and a leading cause of adult disability. There is no cure for OA, and no effective treatments which arrest or slow its progression. Current pharmacologic treatments such as analgesics may improve pain relief but do not alter OA disease progression. Prolonged consumption of these drugs can result in severe adverse effects. Given the nature of OA, life-long treatment will likely be required to arrest or slow its progression. Consequently, there is an urgent need for OA disease-modifying therapies which also improve symptoms and are safe for clinical use over long periods of time. Nutraceuticals—food or food products that provide medical or health benefits, including the prevention and/or treatment of a disease—offer not only favorable safety profiles, but may exert disease- and symptom-modification effects in OA. Forty-seven percent of OA patients use alternative medications, including nutraceuticals. This review will overview the efficacy and mechanism of action of commonly used nutraceuticals, discuss recent experimental and clinical data on the effects of select nutraceuticals, such as phytoflavonoids, polyphenols, and bioflavonoids on OA, and highlight their known molecular actions and limitations of their current use. We will conclude with a proposed novel nutraceutical-based molecular targeting strategy for chondroprotection and OA treatment. PMID:24284399

  9. Gla-rich protein is involved in the cross-talk between calcification and inflammation in osteoarthritis.

    PubMed

    Cavaco, Sofia; Viegas, Carla S B; Rafael, Marta S; Ramos, Acácio; Magalhães, Joana; Blanco, Francisco J; Vermeer, Cees; Simes, Dina C

    2016-03-01

    Osteoarthritis (OA) is a whole-joint disease characterized by articular cartilage loss, tissue inflammation, abnormal bone formation and extracellular matrix (ECM) mineralization. Disease-modifying treatments are not yet available and a better understanding of osteoarthritis pathophysiology should lead to the discovery of more effective treatments. Gla-rich protein (GRP) has been proposed to act as a mineralization inhibitor and was recently shown to be associated with OA in vivo. Here, we further investigated the association of GRP with OA mineralization-inflammation processes. Using a synoviocyte and chondrocyte OA cell system, we showed that GRP expression was up-regulated following cell differentiation throughout ECM calcification, and that inflammatory stimulation with IL-1β results in an increased expression of COX2 and MMP13 and up-regulation of GRP. Importantly, while treatment of articular cells with γ-carboxylated GRP inhibited ECM calcification, treatment with either GRP or GRP-coated basic calcium phosphate (BCP) crystals resulted in the down-regulation of inflammatory cytokines and mediators of inflammation, independently of its γ-carboxylation status. Our results strengthen the calcification inhibitory function of GRP and strongly suggest GRP as a novel anti-inflammatory agent, with potential beneficial effects on the main processes responsible for osteoarthritis progression. In conclusion, GRP is a strong candidate target to develop new therapeutic approaches. PMID:26337479

  10. Sport practice and osteoarthritis of the limbs.

    PubMed

    Lequesne, M G; Dang, N; Lane, N E

    1997-03-01

    Participation in sports has evolved as a cause of osteoarthritis (OA), especially in hip and knee joints. OA often occurs at a relatively early age in adult life, in certain sports (soccer, rugby, racket sports and other track and field sports) and under certain conditions (high level of practice). We review preclinical considerations and published epidemiological studies. Joint overuse even without notable trauma is likely the main mechanism of OA both in these sports and in certain occupational activities (relative risk ranges from 1.5 to more than 5 depending chiefly on the category of sport and on the level and duration of practice). Irregular or sudden impacts, heavy load application on the dominant weight-bearing lower limb and the pre-existing state of the joint including dysplasia, dystrophy or previous trauma are risk factors for OA. However, recreational sport activities at a reasonable level are not likely to be harmful for most individuals, in most sport activities. PMID:9135819

  11. Host and parasite diversity jointly control disease risk in complex communities

    PubMed Central

    Johnson, Pieter T. J.; Preston, Daniel L.; Hoverman, Jason T.; LaFonte, Bryan E.

    2013-01-01

    Host–parasite interactions are embedded within complex communities composed of multiple host species and a cryptic assemblage of other parasites. To date, however, surprisingly few studies have explored the joint effects of host and parasite richness on disease risk, despite growing interest in the diversity–disease relationship. Here, we combined field surveys and mechanistic experiments to test how transmission of the virulent trematode Ribeiroia ondatrae was affected by the diversity of both amphibian hosts and coinfecting parasites. Within natural wetlands, host and parasite species richness correlated positively, consistent with theoretical predictions. Among sites that supported Ribeiroia, however, host and parasite richness interacted to negatively affect Ribeiroia transmission between its snail and amphibian hosts, particularly in species-poor assemblages. In laboratory and outdoor experiments designed to decouple the relative contributions of host and parasite diversity, increases in host richness decreased Ribeiroia infection by 11–65%. Host richness also tended to decrease total infections by other parasite species (four of six instances), such that more diverse host assemblages exhibited ∼40% fewer infections overall. Importantly, parasite richness further reduced both per capita and total Ribeiroia infection by 15–20%, possibly owing to intrahost competition among coinfecting species. These findings provide evidence that parasitic and free-living diversity jointly regulate disease risk, help to resolve apparent contradictions in the diversity–disease relationship, and emphasize the challenges of integrating research on coinfection and host heterogeneity to develop a community ecology-based approach to infectious diseases. PMID:24082092

  12. The Role of Inflammatory and Anti-Inflammatory Cytokines in the Pathogenesis of Osteoarthritis

    PubMed Central

    Poniatowski, Łukasz A.

    2014-01-01

    Osteoarthritis (OA) is the most common chronic disease of human joints. The basis of pathologic changes involves all the tissues forming the joint; already, at an early stage, it has the nature of inflammation with varying degrees of severity. An analysis of the complex relationships indicates that the processes taking place inside the joint are not merely a set that (seemingly) only includes catabolic effects. Apart from them, anti-inflammatory anabolic processes also occur continually. These phenomena are driven by various mediators, of which the key role is attributed to the interactions within the cytokine network. The most important group controlling the disease seems to be inflammatory cytokines, including IL-1β, TNFα, IL-6, IL-15, IL-17, and IL-18. The second group with antagonistic effect is formed by cytokines known as anti-inflammatory cytokines such as IL-4, IL-10, and IL-13. The role of inflammatory and anti-inflammatory cytokines in the pathogenesis of OA with respect to inter- and intracellular signaling pathways is still under investigation. This paper summarizes the current state of knowledge. The cytokine network in OA is put in the context of cells involved in this degenerative joint disease. The possibilities for further implementation of new therapeutic strategies in OA are also pointed. PMID:24876674

  13. Controlling joint pain in older people.

    PubMed

    Paisley, Peter; Serpell, Mick

    2016-01-01

    Jont pain in oldder people The prevalence of chronic pain in older people in the community ranges from 25 to 76% and for those in residential care, it is even higher at 83 to 93%. The most common sites affected are the back, hip, or knee, and other joints. There is increased reporting of pain in women (79%) compared with men (53%). Common conditions include osteoarthritis and, to a lesser extent, the inflammatory arthropathies such as rheumatoid arthritis. The differential diagnosis includes non-articular pain such as vascular limb pain and nocturnal cramp, some neuropathic pain conditions (such as compressive neuropathies and postherpetic neuralgia), soft tissue disorders such as fibromyalgia and myofascial pain syndromes. In addition to an assessment of pain intensity, a biopsychosocial model should be adopted to ascertain the effect of the pain on the patient's degree of background pain at rest. The disease is often localised to the large load-bearing joints, predominantly the hips and knees. In contrast to osteoarthritis, the inflammatory arthritides typically present with symmetrical swollen, stiff, and painful small joints of the hands and feet, usually worse in the morning. PMID:27180497

  14. The ABJS 2005 Nicolas Andry Award: osteoarthritis and injury at the base of the human thumb: survival of the fittest?

    PubMed

    Pellegrini, Vincent D

    2005-09-01

    The basal joint complex, consisting of four trapezial articulations providing a foundation for the thumb, defines our anatomic evolution from a Simian ancestry by providing an opposable member. Ironically, the trapeziometacarpal joint also is responsible for the most common malady leading to operative reconstruction in the upper limb for arthritic disease. The paradoxic relationship between these two facts has stimulated investigation that has defined the scientific basis for common surgical procedures and provided a foundation for the development of novel treatments for conditions at the base of the thumb. Patterns of articular surface degeneration are determined by areas of contact loading in the joint. Ligament reconstruction, metacarpophalangeal joint flexion splinting, and extension metacarpal osteotomy for early disease resulting from instability all have biomechanical justification for their clinical application. Likewise, percutaneous pinning of Bennett's fracture dislocation is predicated on reestablishing functional continuity of the beak ligament and unloading the palmar joint surfaces. For advanced disease, ligament reconstruction has become the cornerstone of arthroplasty. Perhaps most importantly, the trapeziometacarpal joint as an instability model can provide insight into the interplay of mechanical and biological factors in producing the primary lesion associated with osteoarthritis. PMID:16131901

  15. Biological Basis for the Use of Botanicals in Osteoarthritis and Rheumatoid Arthritis: A Review

    PubMed Central

    2005-01-01

    Osteoarthritis (OA) of the knee and hip is a debilitating disease affecting more women than men and the risk of developing OA increases precipitously with aging. Rheumatoid arthritis (RA), the most common form of inflammatory joint diseases, is a disease of unknown etiology and affects ∼1% of the population worldwide, and unlike OA, generally involves many joints because of the systemic nature of the disease. Non-steroidal anti-inflammatory drugs (NSAIDs) are the first drugs of choice for the symptomatic treatment of both OA and RA. Because of the risks associated with the use of NSAIDs and other limitations, the use of alternative therapies, such as acupuncture and medicinal herbs, is on the rise and according to reports ∼60–90% of dissatisfied arthritis patients are likely to seek the option of complementary and alternative medicine (CAM). This paper reviews the efficacy of some of the common herbs that have a history of human use and their anti-inflammatory or antiarthritic properties have been evaluated in animal models of inflammatory arthritis, in studies employing well defined and widely accepted in vitro models that use human chondrocytes/cartilage explants or in clinical trials. Available data suggests that the extracts of most of these herbs or compounds derived from them may provide a safe and effective adjunctive therapeutic approach for the treatment of OA and RA. This, in turn, argues for trials to establish efficacy and optimum dosage of these compounds for treating human inflammatory and degenerative joint diseases. PMID:16136208

  16. Association of interleukin-6 gene polymorphism (rs1800796) with severity and functional status of osteoarthritis in elderly individuals.

    PubMed

    Fernandes, Marcos T P; Fernandes, Karen B P; Marquez, Audrey S; Cólus, Ilce M S; Souza, Marilesia F; Santos, João Paulo M; Poli-Frederico, Regina C

    2015-10-01

    Osteoarthritis (OA) is the most prevalent disease of the musculoskeletal system and it has an important genetic component. Despite several reports have shown the involvement of pro-inflammatory cytokine such as interleukin-1β and TNF-α, the role of interleukin-6 (IL-6) in osteoarthritis is still unclear. Thus, this study aimed to analyze the relationship between the single nucleotide polymorphism in the portion -572 of the promoter region of the IL6 gene (SNP -572G/C) with hip and knee OA in the elderly. In this case-control study, 257 physically independent elderly were recruited (case group: 92 individuals with osteoarthritis and control group: 165 individuals with no osteoarthritis). Blood samples were collected from patients for the DNA fragments extraction and amplification by real-time polymerase chain reaction (PCR) by TaqMan system for subsequent genotyping of IL6 gene. The degree of joint damage was assessed by radiographic classification based on the criteria of Kellgren and Lawrence. The functional status was evaluated by Lequesne and WOMAC questionnaires. It was observed that individuals carrying the C allele have lower susceptibility to osteoarthritis (OR=0.51, 95% CI: 0.32-0.80, p=0.004) and less radiological impairment for both hip (Fisher-Freeman-Halton test=4.2 and p=0.04) and knee joints (Fisher-Freeman-Halton test=4.7 and p=0.03). Regarding functional status, individuals carrying the C allele has a lower degree of functional impairment assessed by WOMAC (Mann-Whitney test, p=0.04), although no difference was observed in the Lequesne questionnaire (p>0.05). Additionally, it was observed a marked reduction in IL-6 serum levels in individuals with GC and CC genotypes when compared to individuals harboring GG genotype. In conclusion, the polymorphism -572G/C IL6 is a protective factor for the presence and severity of hip and knee osteoarthritis in the elderly. Further prospective studies with large sample size and methods (e.g. effect of this polymorphism on gene expression, haplotype analysis for IL-6 promoter polymorphism) are needed to validate this study findings. PMID:26233477

  17. Complementary therapies for osteoarthritis: are they effective?

    PubMed

    Shengelia, Rouzi; Parker, Samantha J; Ballin, Mary; George, Teena; Reid, M Carrington

    2013-12-01

    Increasing interest has focused on complementary management modalities, including tai chi, acupuncture, yoga, and massage therapy, as treatments for osteoarthritis (OA). This review article synthesizes evidence from randomized controlled trials (RCTs) and systematic reviews (SRs) that examined one or more of the above as treatments for OA. Medline, Pubmed, and Cinahl databases were searched to identify English-language articles using an RCT design or that conducted a SR of published studies and presented data on symptom or functional outcomes. Two authors independently abstracted relevant information (e.g., study sample, intervention characteristics, treatment effects, safety data). Retained articles (n = 29) included those that evaluated tai chi (8 RCTs, 2 SRs), acupuncture (11 RCTs, 4 SRs), yoga (2 RCTs), and massage therapy (2 RCTs). Available evidence indicates that tai chi, acupuncture, yoga, and massage therapy are safe for use by individuals with OA. Positive short-term (≤6 months) effects in the form of reduced pain and improved self-reported physical functioning were found for all 4 treatments. Limited information exists regarding the relative effectiveness of the therapies (e.g., yoga vs. tai chi vs. acupuncture), as well as treatment effects in persons with joint involvement besides the knee and in distinct patient subgroups (e.g., older vs. younger adults, persons with mild vs. moderate vs. advanced disease). Complementary therapies can reduce pain and improve function in adults with OA. Research is needed to evaluate long-term benefits of the treatments, as well as their relative effects among diverse patient subgroups. PMID:24315281

  18. Development of an equine groove model to induce metacarpophalangeal osteoarthritis: a pilot study on 6 horses.

    PubMed

    Maninchedda, Ugo; Lepage, Olivier M; Gangl, Monika; Hilairet, Sandrine; Remandet, Bernard; Meot, Francoise; Penarier, Geraldine; Segard, Emilie; Cortez, Pierre; Jorgensen, Christian; Steinberg, Régis

    2015-01-01

    The aim of this work was to develop an equine metacarpophalangeal joint model that induces osteoarthritis that is not primarily mediated by instability or inflammation. The study involved six Standardbred horses. Standardized cartilage surface damage or "grooves" were created arthroscopically on the distal dorsal aspect of the lateral and medial metacarpal condyles of a randomly chosen limb. The contralateral limb was sham operated. After 2 weeks of stall rest, horses were trotted 30 minutes every other day for 8 weeks, then evaluated for lameness and radiographed. Synovial fluid was analyzed for cytology and biomarkers. At 10 weeks post-surgery, horses were euthanized for macroscopic and histologic joint evaluation. Arthroscopic grooving allowed precise and identical damage to the cartilage of all animals. Under the controlled exercise regime, this osteoarthritis groove model displayed significant radiographic, macroscopic, and microscopic degenerative and reactive changes. Histology demonstrated consistent surgically induced grooves limited to non-calcified cartilage and accompanied by secondary adjacent cartilage lesions, chondrocyte necrosis, chondrocyte clusters, cartilage matrix softening, fissuring, mild subchondral bone inflammation, edema, and osteoblastic margination. Synovial fluid biochemistry and cytology demonstrated significantly elevated total protein without an increase in prostaglandin E2, neutrophils, or chondrocytes. This equine metacarpophalangeal groove model demonstrated that standardized non-calcified cartilage damage accompanied by exercise triggered altered osteochondral morphology and cartilage degeneration with minimal or inefficient repair and little inflammatory response. This model, if validated, would allow for assessment of disease processes and the effects of therapy. PMID:25680102

  19. Development of an Equine Groove Model to Induce Metacarpophalangeal Osteoarthritis: A Pilot Study on 6 Horses

    PubMed Central

    Maninchedda, Ugo; Lepage, Olivier M.; Gangl, Monika; Hilairet, Sandrine; Remandet, Bernard; Meot, Francoise; Penarier, Geraldine; Segard, Emilie; Cortez, Pierre; Jorgensen, Christian; Steinberg, Régis

    2015-01-01

    The aim of this work was to develop an equine metacarpophalangeal joint model that induces osteoarthritis that is not primarily mediated by instability or inflammation. The study involved six Standardbred horses. Standardized cartilage surface damage or “grooves” were created arthroscopically on the distal dorsal aspect of the lateral and medial metacarpal condyles of a randomly chosen limb. The contralateral limb was sham operated. After 2 weeks of stall rest, horses were trotted 30 minutes every other day for 8 weeks, then evaluated for lameness and radiographed. Synovial fluid was analyzed for cytology and biomarkers. At 10 weeks post-surgery, horses were euthanized for macroscopic and histologic joint evaluation. Arthroscopic grooving allowed precise and identical damage to the cartilage of all animals. Under the controlled exercise regime, this osteoarthritis groove model displayed significant radiographic, macroscopic, and microscopic degenerative and reactive changes. Histology demonstrated consistent surgically induced grooves limited to non-calcified cartilage and accompanied by secondary adjacent cartilage lesions, chondrocyte necrosis, chondrocyte clusters, cartilage matrix softening, fissuring, mild subchondral bone inflammation, edema, and osteoblastic margination. Synovial fluid biochemistry and cytology demonstrated significantly elevated total protein without an increase in prostaglandin E2, neutrophils, or chondrocytes. This equine metacarpophalangeal groove model demonstrated that standardized non-calcified cartilage damage accompanied by exercise triggered altered osteochondral morphology and cartilage degeneration with minimal or inefficient repair and little inflammatory response. This model, if validated, would allow for assessment of disease processes and the effects of therapy. PMID:25680102

  20. Involvement of BDNF in knee osteoarthritis: the relationship with inflammation and clinical parameters.

    PubMed

    Simão, Adriano Prado; Mendonça, Vanessa Amaral; de Oliveira Almeida, Tássio Málber; Santos, Sérgio Antunes; Gomes, Wellington Fabiano; Coimbra, Candido Celso; Lacerda, Ana Cristina Rodrigues

    2014-08-01

    The aim of this study was to analyze the levels of brain-derived neurotrophic factor (BDNF) in both the plasma and synovial fluid of patients with primary knee osteoarthritis compared with control individuals and to investigate the relationship between BDNF levels and self-reported pain. Twenty-seven patients with knee osteoarthritis (OA) and 19 healthy subjects were enrolled in the study. Anteroposterior knee radiographs were taken to determine the disease severity of the affected knee. Radiographic grading of OA in the knee was performed using the Kellgren-Lawrence criteria. The BDNF levels in the plasma and synovial fluid were measured by enzyme-linked immunosorbent assay. The mean plasma BDNF levels of the knee OA patients were significantly higher than that of the healthy controls (2,378 ± 1,067.2 vs. 1,756 ± 804.3 pg/mL, p < 0.05). BDNF levels in the synovial fluid of OA patients (358.9 ± 178.4 pg/mL) were sixfold lower than in corresponding blood samples (p < 0.0001) and fourfold lower than in the plasma of healthy controls (p < 0.0001). Subsequent analyses showed that the plasma BDNF levels significantly correlated with self-reported pain (Western Ontario and McMaster Universities Osteoarthritis Index) (r s = 0.39, p = 0.04). Furthermore, no correlation was found between the plasma and synovial fluid BDNF concentrations and knee OA severity. The findings of this study suggest that systemic BDNF levels are most likely associated with the mechanism of joint pain in knee OA in the acute stage of joint inflammatory process. Further studies are necessary to address the functional role of BDNF in the modulation of pain to establish new therapeutic implications. PMID:24399456

  1. Osteoarthritis year in review 2015: clinical.

    PubMed

    Sharma, L

    2016-01-01

    The purpose of this review is to highlight clinical research in osteoarthritis (OA). A literature search was conducted using PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) with the search terms "osteoarthritis [All Fields] AND treatment [All Fields]" and the following limits activated: humans, English language, all adult 19+ years, published between April 1, 2014 and April 1, 2015. A second literature search was then conducted with the search terms "osteoarthritis [All Fields] AND epidemiology [All Fields]", with the same limits. Reports of surgical outcome, case series, surgical technique, tissue sample or culture studies, trial protocols, and pilot studies were excluded. Of 1523, 150 were considered relevant. Among epidemiologic and observational clinical studies, themes included physical activity, early knee OA, and confidence/instability/falls. Symptom outcomes of pharmacologic treatments were reported for methotrexate, adalimumab, anti-nerve growth factor monoclonal antibodies, strontium ranelate, bisphosphonates, glucosamine, and chondroitin sulfate, and structural outcomes of pharmacologic treatments for strontium ranelate, recombinant human fibroblast growth factor 18, and glucosamine and chondroitin sulfate. Symptom outcomes of non-pharmacologic interventions were reported for: neuromuscular exercise, quadriceps strengthening, weight reduction and maintenance, TENS, therapeutic ultrasound, stepped care strategies, cognitive behavior therapy for sleep disturbance, acupuncture, gait modification, booster physical therapy, a web-based therapeutic exercise resource center for knee OA; hip physical therapy for hip OA; and joint protection and hand exercises for hand OA. Structure outcomes of non-pharmacologic interventions were reported for patellofemoral bracing. PMID:26707991

  2. Mesenchymal stem cell therapy for osteoarthritis: current perspectives

    PubMed Central

    Wyles, Cody C; Houdek, Matthew T; Behfar, Atta; Sierra, Rafael J

    2015-01-01

    Osteoarthritis (OA) is a painful chronic condition with a significant impact on quality of life. The societal burden imposed by OA is increasing in parallel with the aging population; however, no therapies have demonstrated efficacy in preventing the progression of this degenerative joint disease. Current mainstays of therapy include activity modification, conservative pain management strategies, weight loss, and if necessary, replacement of the affected joint. Mesenchymal stem cells (MSCs) are a multipotent endogenous population of progenitors capable of differentiation to musculoskeletal tissues. MSCs have a well-documented immunomodulatory role, managing the inflammatory response primarily through paracrine signaling. Given these properties, MSCs have been proposed as a potential regenerative cell therapy source for patients with OA. Research efforts are focused on determining the ideal source for derivation, as MSCs are native to several tissues. Furthermore, optimizing the mode of delivery remains a challenge both for appropriate localization of MSCs and for directed guidance toward stemming the local inflammatory process and initiating a regenerative response. Scaffolds and matrices with growth factor adjuvants may prove critical in this effort. The purpose of this review is to summarize the current state of MSC-based therapeutics for OA and discuss potential barriers that must be overcome for successful implementation of cell-based therapy as a routine treatment strategy in orthopedics. PMID:26357483

  3. Current nutraceuticals in the management of osteoarthritis: a review

    PubMed Central

    Akhtar, Nahid

    2012-01-01

    Osteoarthritis (OA) is a progressive degenerative joint disease that has a major impact on joint function and quality of life. Nutraceuticals and dietary supplements derived from herbs have long been used in traditional medicine and there is considerable evidence that nutraceuticals may play an important role in inflammation and joint destruction in OA. We review the biological effects of some medicinal fruits and herbs – pomegranate, green tea, cat’s claw, devil’s claw, ginger, Indian olibaum, turmeric and ananas – in an attempt to understand the pivotal molecular targets involved in inflammation and the joint destruction process and to summarize their toxicities and efficacy for OA management. So far there is insufficient reliable evidence on the effectiveness of ginger, turmeric and ananas. Pomegranate and green tea only have preclinical evidence of efficacy due to the lack of clinical data. In vivo and clinical studies are required to understand their targets and efficacy in OA. Limited in vitro and in vivo evidence is available for cat’s claw and Indian olibaum. More extensive studies are required before long-term controlled trials of whole cat’s claw and Indian olibaum extracts, or isolated active compounds, are carried out in patients with OA to determine their long-term efficacy and safety. Devil’s claw has not been rigorously tested to determine its antiarthritic potential in in vitro and in vivo models. There is strong clinical evidence of the effectiveness of devil’s claw in pain reduction. However, high-quality clinical trials are needed to determine its effectiveness. No serious side effects have been reported for any fruits and herbs. Overall, these studies identify and support the use of nutraceuticals to provide symptomatic relief to patients with OA and to be used as adjunct therapy for OA management. More high-quality trials are needed to provide definitive answers to questions related to their efficacy and safety for OA prevention and/or treatment. PMID:22850529

  4. Post-operative rehabilitation and nutrition in osteoarthritis

    PubMed Central

    Musumeci, Giuseppe; Mobasheri, Ali; Trovato, Francesca Maria; Szychlinska, Marta Anna; Imbesi, Rosa; Castrogiovanni, Paola

    2016-01-01

    Osteoarthritis (OA) is a degenerative process involving the progressive loss of articular cartilage, synovial inflammation and structural changes in subchondral bone that lead to loss of synovial joint structural features and functionality of articular cartilage. OA represents one of the most common causes of physical disability in the world. Different OA treatments are usually considered in relation to the stage of the disease. In the early stages, it is possible to recommend physical activity programs that can maintain joint health and keep the patient mobile, as recommended by OA Research Society International (OARSI) and European League Against Rheumatism (EULAR). In the most severe and advanced cases of OA, surgical intervention is necessary. After, in early postoperative stages, it is essential to include a rehabilitation exercise program in order to restore the full function of the involved joint. Physical therapy is crucial for the success of any surgical procedure and can promote recovery of muscle strength, range of motion, coordinated walking, proprioception and mitigate joint pain. Furthermore, after discharge from the hospital, patients should continue the rehabilitation exercise program at home associated to an appropriate diet. In this review, we analyze manuscripts from the most recent literature and provide a balanced and comprehensive overview of the latest developments on the effect of physical exercise on postoperative rehabilitation in OA. The literature search was conducted using PubMed, Scopus, Web of Science and Google Scholar, using the keywords ‘osteoarthritis’, ‘rehabilitation’, ‘exercise’ and ‘nutrition’. The available data suggest that physical exercise is an effective, economical and accessible to everyone practice, and it is one of the most important components of postoperative rehabilitation for OA. PMID:26962431

  5. A Rare Case of Tumoral Calcium Pyrophosphate Dihydrate Crystal Deposition Disease of the Wrist Joint

    PubMed Central

    Nakamura, Osamu; Kaji, Yoshio; Yamagami, Yoshiki; Yamaguchi, Kounosuke; Nishimura, Hideki; Fukuoka, Natsuko; Yamamoto, Tetsuji

    2015-01-01

    Introduction. Tumoral calcium pyrophosphate dihydrate (CPPD) crystal deposition disease (CPPDCD), also known as tophaceous calcium pyrophosphate deposition disease (CPDD), is a tumorlike lesion, and it should be distinguished from usual CPDD that causes severe joint inflammation and arthralgia. A case of tumoral CPPDCD of the wrist joint that required differentiation from synovial osteochondromatosis is described. Case Presentation. The patient was a 78-year-old woman with a 5-year history of nodular lesions at the right wrist that had gradually increased in size. An excisional biopsy and a histological examination of the excised nodular lesions by hematoxylin and eosin (H&E) staining were performed, demonstrating numerous polarizable, rhabdoid, and rectangular crystals, surrounded by fibroblasts, macrophages, and foreign body-type giant cells, consistent with tumoral CPPDCD. Conclusion. Tumoral CPPDCD, especially at the wrist joint, is rare, and, to the best of our knowledge, only 2 articles have been published. This case seems to need further follow-up for recurrence, because tumoral CPPDCD may recur after complete or incomplete surgical excision. PMID:26783477

  6. Joint Effects of Smoking and Silicosis on Diseases to the Lungs

    PubMed Central

    Tse, Lap Ah; Yu, Ignatius T. S.; Qiu, Hong; Leung, Chi Chiu

    2014-01-01

    Smokers are subject to being more susceptible to the long-term effects of silica dust, whilst it remains unclear whether the joint effect of smoking and silicosis differs amongst diseases to the lungs; this study aims to address this knowledge gap. This was a historical cohort study comprised of 3202 silicotics in Hong Kong during 1981–2005 who were followed up till 31/12/2006. We estimated the standardized mortality ratio (SMR) in the smoking and never smoking silicotics using the mortality rates of male general population indiscriminately by smoking status, but these SMRs were regarded as biased. We adjusted these biased SMRs using “smoking adjustment factors (SAF)”. We assessed the multiplicative interaction between smoking and silicosis using ‘relative silicosis effect (RSE)’ that was the ratio of SAF-corrected SMR of smoking silicotics to the never smokers. A RSE differs significantly from one implies the presence of multiplicative interaction. A significant excess SMR was observed for respiratory diseases (lung cancer, chronic obstructive pulmonary diseases [COPD], silicosis) and other diseases to the lungs (pulmonary heart disease, tuberculosis). All the ‘biased-SMRs’ in smokers were higher than those in never smokers, but the SAF-corrected SMRs became higher in never smokers. The RSE was 0.95 (95%CI: 0.37–3.55), 0.94 (95%CI: 0.42–2.60), and 0.81 (95%CI: 0.60–1.19) for lung cancer, COPD, and silicosis; whilst it was 1.21 (95%CI: 0.32–10.26) for tuberculosis and 1.02 (95%CI: 0.16–42.90) for pulmonary heart disease. This study firstly demonstrated the joint effect of smoking and silicosis may differ amongst diseases to the lungs, but power is limited. PMID:25105409

  7. [The approach to bone and joint disease for extending the healthy life expectancy].

    PubMed

    Deie, Masataka; Asaeda, Makoto; Kono, Yoshifumi; Terai, Chiaki

    2014-10-01

    In Japan, the super-aged society, the difference between the healthy life expectancy and life expectancy is large, it has become a social problem. For the extension of healthy life expectancy, measures to bone and joint disease are important. Lower limb muscle strengthening is useful to decrease in pain and improvement of walking ability. Further, in order to maintain a balance function, improvement in range of motion is important. On the other hand, for patients who had joint destruction, decreased ability of exercise, muscle weakness, balance dysfunction has already occurred, it is necessary for extension of healthy life expectancy including surgical treatment. We believe that by performing the appropriate therapeutic intervention, extending healthy life expectancy would be possible. PMID:25509814

  8. Photoacoustic tomography of the human finger: towards the assessment of inflammatory joint diseases

    NASA Astrophysics Data System (ADS)

    van Es, P.; Biswas, S. K.; Bernelot Moens, H. J.; Steenbergen, W.; Manohar, S.

    2015-03-01

    Inflammatory arthritis is often manifested in finger joints. The growth of new or withdrawal of old blood vessels can be a sensitive marker for these diseases. Photoacoustic (PA) imaging has great potential in this respect since it allows the sensitive and highly resolved visualization of blood. We systematically investigated PA imaging of finger vasculature in healthy volunteers using a newly developed PA tomographic system. We present the PA results which show excellent detail of the vasculature. Vessels with diameters ranging between 100 μm and 1.5 mm are visible along with details of the skin, including the epidermis and the subpapillary plexus. The focus of all the studies is at the proximal and distal interphalangeal joints, and in the context of ultimately visualizing the inflamed synovial membrane in patients. This work is important in laying the foundation for detailed research into PA imaging of the phalangeal vasculature in patients suffering from rheumatoid arthritis.

  9. Joint Disease Mapping of Two Digestive Cancers in Golestan Province, Iran Using a Shared Component Model

    PubMed Central

    Chamanpara, Parisa; Moghimbeigi, Abbas; Faradmal, Javad; Poorolajal, Jalal

    2015-01-01

    Objectives Recent studies have suggested the occurrence patterns and related diet factor of esophagus cancer (EC) and gastric cancer (GC). Incidence of these cancers was mapped either in general and stratified by sex. The aim of this study was to model the geographical variation in incidence of these two related cancers jointly to explore the relative importance of an intended risk factor, diet low in fruit and vegetable intake, in Golestan, Iran. Methods Data on the incidence of EC and GC between 2004 and 2008 were extracted from Golestan Research Center of Gastroenterology and Hepatology, Hamadan, Iran. These data were registered as new observations in 11 counties of the province yearly. The Bayesian shared component model was used to analyze the spatial variation of incidence rates jointly and in this study we analyzed the data using this model. Joint modeling improved the precision of estimations of underlying diseases pattern, and thus strengthened the relevant results. Results From 2004 to 2008, the joint incidence rates of the two cancers studied were relatively high (0.8–1.2) in the Golestan area. The general map showed that the northern part of the province was at higher risk than the other parts. Thus the component representing diet low in fruit and vegetable intake had larger effect of EC and GC incidence rates in this part. This incidence risk pattern was retained for female but for male was a little different. Conclusion Using a shared component model for joint modeling of incidence rates leads to more precise estimates, so the common risk factor, a diet low in fruit and vegetables, is important in this area and needs more attention in the allocation and delivery of public health policies. PMID:26430618

  10. Pterosin B prevents chondrocyte hypertrophy and osteoarthritis in mice by inhibiting Sik3

    PubMed Central

    Yahara, Yasuhito; Takemori, Hiroshi; Okada, Minoru; Kosai, Azuma; Yamashita, Akihiro; Kobayashi, Tomohito; Fujita, Kaori; Itoh, Yumi; Nakamura, Masahiro; Fuchino, Hiroyuki; Kawahara, Nobuo; Fukui, Naoshi; Watanabe, Akira; Kimura, Tomoatsu; Tsumaki, Noriyuki

    2016-01-01

    Osteoarthritis is a common debilitating joint disorder. Risk factors for osteoarthritis include age, which is associated with thinning of articular cartilage. Here we generate chondrocyte-specific salt-inducible kinase 3 (Sik3) conditional knockout mice that are resistant to osteoarthritis with thickened articular cartilage owing to a larger chondrocyte population. We also identify an edible Pteridium aquilinum compound, pterosin B, as a Sik3 pathway inhibitor. We show that either Sik3 deletion or intraarticular injection of mice with pterosin B inhibits chondrocyte hypertrophy and protects cartilage from osteoarthritis. Collectively, our results suggest Sik3 regulates the homeostasis of articular cartilage and is a target for the treatment of osteoarthritis, with pterosin B as a candidate therapeutic. PMID:27009967

  11. Pterosin B prevents chondrocyte hypertrophy and osteoarthritis in mice by inhibiting Sik3.

    PubMed

    Yahara, Yasuhito; Takemori, Hiroshi; Okada, Minoru; Kosai, Azuma; Yamashita, Akihiro; Kobayashi, Tomohito; Fujita, Kaori; Itoh, Yumi; Nakamura, Masahiro; Fuchino, Hiroyuki; Kawahara, Nobuo; Fukui, Naoshi; Watanabe, Akira; Kimura, Tomoatsu; Tsumaki, Noriyuki

    2016-01-01

    Osteoarthritis is a common debilitating joint disorder. Risk factors for osteoarthritis include age, which is associated with thinning of articular cartilage. Here we generate chondrocyte-specific salt-inducible kinase 3 (Sik3) conditional knockout mice that are resistant to osteoarthritis with thickened articular cartilage owing to a larger chondrocyte population. We also identify an edible Pteridium aquilinum compound, pterosin B, as a Sik3 pathway inhibitor. We show that either Sik3 deletion or intraarticular injection of mice with pterosin B inhibits chondrocyte hypertrophy and protects cartilage from osteoarthritis. Collectively, our results suggest Sik3 regulates the homeostasis of articular cartilage and is a target for the treatment of osteoarthritis, with pterosin B as a candidate therapeutic. PMID:27009967

  12. Comparison of the outcomes of three surgical treatments for end-stage temporomandibular joint disease.

    PubMed

    Dimitroulis, G

    2014-08-01

    The aim of this study was to determine whether there are any differences between condylectomy, rib grafts, and prosthetic joints (Biomet TMJ stock prosthesis) with regard to outcomes for patients with end-stage temporomandibular joint (TMJ) disease. Fifty-six of a total 127 patients who presented with category 5 end-stage TMJ disease over 3 years (2010-2013) agreed to participate in this retrospective, comparative, cohort study. Patients were divided into four groups: preoperative (n=16), condylectomy (n=8), rib graft (n=16), and prosthetic joint (n=16). They were assessed for major postoperative complications (i.e., return to theatre) and maximum range of mandibular motion, and all completed a specific quality of life (QOL) questionnaire. Whilst the condylectomy group demonstrated the best mandibular range of motion (P<0.01), rib graft patients were more likely to experience complications (43.8%) necessitating a return to theatre. The prosthesis group recorded the best mean aggregate QOL score, but the difference compared to the rib graft and condylectomy groups was not statistically significant. The results of this study suggest that for dentate patients, prosthetic joints are highly dependable with no returns to theatre and favourable QOL outcomes. For edentulous patients, condylectomies alone also appear to work well. Future TMJ prosthetic designs should focus on improving mandibular range of motion, as the current stock prosthesis allows only a restricted range, no better than that achieved with rib graft (P>0.05) and far less than that achieved with condylectomy (P<0.01). PMID:24629849

  13. Targeting mechanotransduction pathways in osteoarthritis: a focus on the pericellular matrix.

    PubMed

    Vincent, Tonia L

    2013-06-01

    Mechanical joint loading is an essential factor in joint homeostasis but it is also the most important aetiological factor in the development of osteoarthritis (OA). Although OA has long been regarded a disease of 'wear and tear', data arising from studies over the past 10 years have put pay to a mechanical 'attrition' theory of OA and place the induction and activation of specific matrix degrading enzymes centrally in the disease process. The finding that these enzymes are induced in vivo in a mechanosensitive manner provides a clear and sensible unifying hypothesis for disease pathogenesis; namely that mechanical 'wear' actively drives the enzymes that produce 'tear'. This review focuses on recent advances in our knowledge of the molecular mechanisms by which chondrocytes (and most likely other cells of the joint) sense and respond to changes in their mechanical environment. As mechanical signals drive both beneficial responses as well as those that drive disease, modulation of specific pathways provides a choice of strategies for treating OA. PMID:23428386

  14. Linkage of early-onset osteoarthritis and chondrocalcinosis to human chromosome 8q

    SciTech Connect

    Baldwin, C.T.; Farrer, L.A.; Adair, R.; Dharmavaram, R.; Jimenez, S.; Anderson, L.

    1995-03-01

    Calcium pyrophosphate-deposition disease (CPDD), also called {open_quotes}chondrocalcinosis{close_quotes} or {open_quotes}pseudogout{close_quotes}, is a disorder characterized by the deposition of calcium-containing crystals in joint tissue, which leads to arthritis-like symptoms. The presence of these crystals in joint tissue is a common finding in the elderly, and, in this population, there is a poor correlation with joint pain. In contrast, early-onset CPDD has been described in several large families in which the disease progresses to severe degenerative osteoarthritis (OA). In these families, an autosomal dominant mode of inheritance is observed, with an age at onset between the 2nd and 5th decades of life. In this report, we describe a large New England family with early-onset CPDD and severe degenerative OA. We found genetic linkage between the disease in this family and chromosome 8q, with a multipoint lod score of 4.06. These results suggest that a defective gene at this location causes the disease in this family. 29 refs., 2 figs., 1 tab.

  15. Interplay between Cartilage and Subchondral Bone Contributing to Pathogenesis of Osteoarthritis

    PubMed Central

    Sharma, Ashish R.; Jagga, Supriya; Lee, Sang-Soo; Nam, Ju-Suk

    2013-01-01

    Osteoarthritis (OA) is a common debilitating joint disorder, affecting large sections of the population with significant disability and impaired quality of life. During OA, functional units of joints comprising cartilage and subchondral bone undergo uncontrolled catabolic and anabolic remodeling processes to adapt to local biochemical and biological signals. Changes in cartilage and subchondral bone are not merely secondary manifestations of OA but are active components of the disease, contributing to its severity. Increased vascularization and formation of microcracks in joints during OA have suggested the facilitation of molecules from cartilage to bone and vice versa. Observations from recent studies support the view that both cartilage and subchondral bone can communicate with each other through regulation of signaling pathways for joint homeostasis under pathological conditions. In this review we have tried to summarize the current knowledge on the major signaling pathways that could control the cartilage-bone biochemical unit in joints and participate in intercellular communication between cartilage and subchondral bone during the process of OA. An understanding of molecular communication that regulates the functional behavior of chondrocytes and osteoblasts in both physiological and pathological conditions may lead to development of more effective strategies for treating OA patients. PMID:24084727

  16. Non-surgical management of knee osteoarthritis: where are we now and where do we need to go?

    PubMed Central

    Buttgereit, Frank; Burmester, Gerd-Rüdiger; Bijlsma, Johannes W J

    2015-01-01

    After the successful treatment of inflammatory rheumatic diseases with targeted therapies, the greatest challenge in rheumatic diseases remains the treatment of the most common chronic joint disorder, osteoarthritis. Osteoarthritis (OA) commonly affects the knee, with an age-standardised and sex-standardised incidence of 240 per 100.000 person-years. With the aging of the population and rising obesity throughout the world, it is anticipated that the burden of OA will increase and become a major problem for health systems globally. Given this background, proper guidance on the management of OA is needed. This issue has been addressed over recent months in updated guidelines or recommendations detailing three treatment modalities: non-pharmacological, pharmacological and surgical. It should be noted, that OA is not a uniform disease entity. In some patients, progression of the disease seems to be driven by cartilage factors, in others by bone factors or by inflammatory factors. Ongoing research aims to identify potential biomarkers for these different forms of OA. Research is also underway into disease modifying OA drugs (DMOADs) that target different aspects of the disease, treatments for OA pain, and cell-based therapies. PMID:26509057

  17. Joint laxity in the parents of children with temporary brittle bone disease.

    PubMed

    Paterson, Colin R; Mole, Patricia A

    2012-09-01

    One controversial cause of unexplained fractures in young children is temporary brittle bone disease. Contributory factors for this disorder include the following: premature birth, twin pregnancy and diminished foetal movement. Heritable factors may also be important. Infants with findings consistent with temporary brittle bone disease were identified from clinical and medico-legal referrals. The routine evaluation of each family included examination of both parents where available for joint laxity using the nine-point Beighton scale. Of 81 children in whom both parents had been examined personally, 40 had at least one parent with a Beighton score of four or more, conventionally regarded as indicative of the hypermobility syndrome. We found no significant difference in laxity when we compared the whole group of mothers with the controls (P = 0.081). The fathers were significantly different from their control group (P = 0.013). When we compared the figures for the most flexible parent of each child, there were significant differences from control subjects both in the mothers and in the fathers (P = 0.042 and P = 0.0065, respectively). We draw attention to the likely autosomal dominant inheritance of this risk factor for temporary brittle bone disease as well as the potential value of assessing parental joint laxity in evaluating children with fractures. PMID:21881991

  18. “Incidence and risk factors for clinically diagnosed knee, hip and hand osteoarthritis: influences of age, gender and osteoarthritis affecting other joints”

    PubMed Central

    Prieto-Alhambra, Daniel; Judge, Andrew; Javaid, M Kassim; Cooper, Cyrus; Diez-Perez, Adolfo; Arden, Nigel K

    2013-01-01

    Objectives Data on the incidence of symptomatic osteoarthritis (OA) are scarce. We estimated incidence of clinical hip, knee and hand osteoarthritis, and studied the effect of prevalent OA on joint-specific incident OA. Methods SIDIAP contains primary care records for >5 million people from Catalonia (Spain). Participants aged ≥40 years with an incident diagnosis of knee, hip or hand OA between 2006 and 2010 were identified using ICD-10 codes. Incidence rates and female-to-male Rate Ratios (RR) for each joint site were calculated. Age, gender and body mass index-adjusted Hazard Ratios (HR) for future joint-specific OA according to prevalent OA at other sites were estimated using Cox regression. Results 3,266,826 participants were studied for a median of 4.45 years. Knee and hip OA rates increased continuously with age, and female-to-male RRs were highest at age 70-75 years. In contrast, female hand OA risk peaked at age 60-64 years, and corresponding female-to-male RR was highest at age 50-55. Adjusted HR for prevalent knee OA on risk of hip OA was 1.35 (99%CI 1.28-1.43); prevalent hip OA on incident knee OA 1.15 (1.08-1.23). Prevalent hand OA predicted both incident knee and hip OA: HR 1.20 (1.14-1.26) and 1.23 (1.13-1.34) respectively. Conclusions The effect of age is greatest in the elderly for knee and hip OA, but around the menopause for hand OA. OA clusters within individuals, with higher risk of incident knee and hip disease from prevalent lower limb and hand OA. PMID:23744977

  19. Poly (caprolactone) microparticles and chitosan thermogels based injectable formulation of etoricoxib for the potential treatment of osteoarthritis.

    PubMed

    Arunkumar, P; Indulekha, S; Vijayalakshmi, S; Srivastava, R

    2016-04-01

    This study aimed to evaluate Poly (caprolactone) microparticles (MPs) loaded composite injectable Chitosan gel (CICGs) as a dual purpose (visco-supplement and intra articular drug delivery depot) therapeutic agent for the treatment of Osteoarthritis. Etoricoxib (COX-2 inhibitor), a highly hydrophobic drug was chosen as a model drug for the study. When administered orally, Etoricoxib poses severe cardiovascular toxicity issues. So, we have attempted to deliver this drug intra-articularly, which could retain the drug longer in the joint region and thus could ameliorate these toxicity issues. CICGs were prepared by dispersing MPs in the chitosan-Ammonium hydrogen phosphate solution and incubated at 37°C. Rheology studies proved that gels were stable and had visco-elastic properties comparable to that of existing visco-supplements. The in vitro drug release profiles of CICGs were found to be more controlled when compared to MPs and bare chitosan gel (BCGs). In vitro and in vivo biocompatibility studies proved that the gels were biocompatible. In vivo synovial drug clearance studies proved that CICGs had a better drug retention capacity than BCGs and MPs. In vivo fluorescence imaging results confirmed that CICGs could stay longer in the joint region when compared to BCGs and MPs. Thus this novel CICGs could be a potential dual purpose gel for the treatment of diseased joint regions especially for Osteoarthritis. PMID:26838881

  20. The potential utility of high-intensity ultrasound to treat osteoarthritis.

    PubMed

    Nieminen, H J; Salmi, A; Karppinen, P; Hæggström, E; Hacking, S A

    2014-11-01

    Osteoarthritis (OA) is a widespread musculoskeletal disease that reduces quality of life and for which there is no cure. The treatment of OA is challenging since cartilage impedes the local and systemic delivery of therapeutic compounds (TCs). This review identifies high-intensity ultrasound (HIU) as a non-contact technique to modify articular cartilage and subchondral bone. HIU enables new approaches to overcome challenges associated with drug delivery to cartilage and new non-invasive approaches for the treatment of joint disease. Specifically, HIU has the potential to facilitate targeted drug delivery and release deep within cartilage, to repair soft tissue damage, and to physically alter tissue structures including cartilage and bone. The localized, non-invasive ultrasonic delivery of TCs to articular cartilage and subchondral bone appears to be a promising technique in the immediate future. PMID:25106678

  1. Changes in Membrane Receptors and Ion Channels as Potential Biomarkers for Osteoarthritis

    PubMed Central

    Lewis, Rebecca; Barrett-Jolley, Richard

    2015-01-01

    Osteoarthritis (OA), a degenerative joint condition, is currently difficult to detect early enough for any of the current treatment options to be completely successful. Early diagnosis of this disease could increase the numbers of patients who are able to slow its progression. There are now several diseases where membrane protein biomarkers are used for early diagnosis. The numbers of proteins in the membrane is vast and so it is a rich source of potential biomarkers for OA but we need more knowledge of these before they can be considered practical biomarkers. How are they best measured and are they selective to OA or even certain types of OA? The first step in this process is to identify membrane proteins that change in OA. Here, we summarize several ion channels and receptors that change in OA models and/or OA patients, and may thus be considered candidates as novel membrane biomarkers of OA. PMID:26648874

  2. Rheumatoid arthritis-celiac disease relationship: joints get that gut feeling.

    PubMed

    Lerner, Aaron; Matthias, Torsten

    2015-11-01

    Rheumatoid arthritis (RA) and celiac disease (CD) belong to the autoimmune disease family. Despite being separate entities they share multiple aspects. Epidemiologically they share comparable incidence environmental influences, associated antibodies and a recent incidental surge. They differ in their HLA pre-dispositions and specific predictive and diagnostic biomarkers. At the clinical level, celiac disease exhibits extra-intestinal rheumatic manifestations and RA gastrointestinal ones. Small bowel pathology exists in rheumatic patients. A trend towards responsiveness to a gluten free diet has been observed, ameliorating celiac rheumatic manifestations, whereas dietary interventions for rheumatoid arthritis remain controversial. Pathophysiologically, both diseases are mediated by endogenous enzymes in the target organs. The infectious, dysbiotic and increased intestinal permeability theories, as drivers of the autoimmune cascade, apply to both diseases. Contrary to their specific HLA pre-disposition, the diseases share multiple non-HLA loci. Those genes are crucial for activation and regulation of adaptive and innate immunity. Recently, light was shed on the interaction between host genetics and microbiota composition in relation to CD and RA susceptibility, connecting bugs and us and autoimmunity. A better understanding of the above mentioned similarities in the gut-joint inter-relationship, may elucidate additional facets in the mosaic of autoimmunity, relating CD to RA. PMID:26190704

  3. Nuclear medicine in diagnosis and therapy of bone and joint diseases.

    PubMed

    Riccabona, G

    1999-01-01

    Concerning bone and joint diseases therapy of rheumatic synovitis (= radiosynoviorthesis) was introduced in 1952 before clinically relevant diagnostic procedures were developed. Radionuclides of Sr and later on 99mTc phosphonates then started the wide use of bone scintigraphy since > 30 years. The diagnostic methods have an excellent sensitivity for detection of local abnormalities of bone metabolism, the specificity of such studies, however, is low. Modifications of the technique (3-phase-bone-scintigraphy, pinhole collimators, ROI-technique), increasing knowledge of pathological scan patterns and introduction of other radionuclide studies (67Ga, 201Tl, inflammation scans with 99mTc-leukocytes or 99mTc-HIG) as well as 18FDG-PET have increased the specificity significantly in recent years and improvements of imaging systems (SPECT) also increased the accuracy of diagnostic methods in diseases of bone and joints. Therapy of such diseases has made considerable progress: inflamed, swollen joints can effectively be treated with 90Y-, 186Re, 169Er-colloids or with 165Dy-particles by radiosynoviorthesis. Severe pain due to disseminated bone metastases of cancer or polyarthritis can be controlled by radionuclide therapy with 89Sr, 153Sm-EDTMP, 186Re- or 188Re-HEDP and possibly 117mSn-DTPA with an acceptable risk of myelodepression. Possibilities, technical details and limitations of radionuclide applications for diagnostic and therapeutic purposes must be considered if optimal benefit for individual patients should be achieved. Overall Nuclear Medicine can become an essential element in management of bone and joint diseases. The relationship of Nuclear Medicine to bone and joint pathology is peculiar: In 1952 treatment of rheumatic synovitis by radiosynoviorthesis with 198Au Colloid was started by Fellinger and Schmid before diagnostic approaches to bone pathology existed. Bone scintigraphy was introduced only in 1961 using 85Sr but obviously the unfavourable radiation characteristics of this radionuclide limited it's broad application and 87mSr did not improve this situation. Only when 99mTc phosphonates were developed by Subramanian the importance of bone scintigraphy became apparent: The excellent imaging properties of these radiotracers showed, that abnormal bone metabolism could be visualized even before morphological alterations in the skeleton become visible on radiographies or even CT-scans. Moreover, proposals made earlier to use 32P or 89Sr for palliation of pain in patients with disseminated skeletal metastases were picked up again and led also to other radiopharmaceuticals (186Re-HEDP, 153Sm-EDTMP, 117mSn-DTPA) which are applied today for the same purpose with very good success. Therefore Nuclear Medicine today has a broad program for diagnostic and therapeutic approaches to diseases of bone and joints. In bone scanning the high sensitivity led to inclusion of this method for routine staging and re-staging programs in a variety of cancer forms which have a trend to develop bone metastases (e.g. breast, lung, prostate, melanoma) but the low specificity of abnormal patterns on such scans can impair the diagnostic value of the technique. To increase specificity and to define inflammatory lesions, radiotracers used for "inflammation scanning" were introduced such as labeled granulocytes, 99mTc Human Immunoglobulin and others but also a simple modification of bone scanning--triple phase bone scintigraphy--was used. Recently the excellent properties of 18F for PET of the skeleton were rediscovered again and emission CT scanning--possibly with overlay with transmission CT or MRT pictures--can enhance the diagnostic impact of radionuclide bone studies. PMID:14601000

  4. Joint Disorders

    MedlinePlus

    A joint is where two or more bones come together, like the knee, hip, elbow, or shoulder. Joints can be damaged by many types of injuries or diseases, including Arthritis - inflammation of a joint. It causes pain, stiffness, and swelling. Over time, ...

  5. Local Gene Transfer of OPG Prevents Joint Damage and Disease Progression in Collagen-Induced Arthritis

    PubMed Central

    Zhang, Qingguo; Gong, Weiming; Ning, Bin; Nie, Lin; Wooley, Paul H.

    2013-01-01

    This study examined the influence of osteoprotegerin (OPG) gene transfer on a murine collagen-induced arthritis model. A single periarticular injection of AAV-OPG or AAV-LacZ on the arthritic paw successfully incorporated the exogenous gene to the local tissue and resulted in marked transgene expression in the joint homogenate for at least three weeks. Clinical disease scores were significantly improved in OPG treated mice starting at 28-day post-treatment (P < 0.05). Histological assessment demonstrated that OPG gene transfer dramatically protected mice from erosive joint changes compared with LacZ controls (P < 0.05), although treatment appeared less effective on the local inflammatory progress. MicroCT data suggested significant protection against subchondral bone mineral density changes in OPG treated CIA mice. Interestingly, mRNA expressions of IFN-g and MMP3 were noticeably diminished following OPG gene transfer. Overall, gene transfer of OPG effectively inhibited the arthritis-associated periarticular bone erosion and preserved the architecture of arthritic joints, and the study provides evidence that the cartilage protection of the OPG gene therapy may be associated with the down-regulation of MMP3 expression. PMID:24222748

  6. Total hip replacement in osteoarthritis: the role of bone metabolism and its complications.

    PubMed

    Bottai, Vanna; Dell'Osso, Giacomo; Celli, Fabio; Bugelli, Giulia; Cazzella, Niki; Cei, Elena; Guido, Giulio; Giannotti, Stefano

    2015-01-01

    Osteoarthritis is one of the most common joint disorder. For treatment of hip symptomatic osteoarthritis, when conservative medical therapy has failed, total hip arthroplasty (THA) is a successful orthopaedic procedures that reduces pain and improves function and quality of life. Incidence of osteoarthritis is constantly increasing with raising life expectancy. This aging process also has led to an increasing number of patients with osteoporosis who need hip replacement for osteoarthritis. Osteoporosis have 3 major potential complications in total hip arthroplasty: perioperative fracture, an increased risk of periprosthetic fracture, and late aseptic loosening. The purpose of the present study was to examine the effects of osteoporosis on total hip replacement procedure outcome and highlight the importance of adequate study of calcium-phosphorus metabolism in patient candidate for hip surgery, and the need to start a suitable therapy to recover the bone mass before surgery. Bone quality of the hip joint has become an important risk factor limiting the durability of THA. PMID:26811704

  7. Hallux rigidus: Joint preserving alternatives to arthrodesis - a review of the literature

    PubMed Central

    Polzer, Hans; Polzer, Sigmund; Brumann, Mareen; Mutschler, Wolf; Regauer, Markus

    2014-01-01

    Hallux rigidus describes the osteoarthritis of the first metatarsophalangeal joint. It was first mentioned in 1887. Since then a multitude of terms have been introduced referring to the same disease. The main complaints are pain especially during movement and a limited range of motion. Radiographically the typical signs of osteoarthritis can be observed starting at the dorsal portion of the joint. Numerous classifications make the comparison of the different studies difficult. If non-operative treatment fails to resolve the symptoms operative treatment is indicated. The most studied procedure with reproducible results is the arthrodesis. Nevertheless, many patients refuse this treatment option, favouring a procedure preserving motion. Different motion preserving and joint sacrificing operations such as arthroplasty are available. In this review we focus on motion and joint preserving procedures. Numerous joint preserving osteotomies have been described. Most of them try to relocate the viable plantar cartilage more dorsally, to decompress the joint and to increase dorsiflexion of the first metatarsal bone. Multiple studies are available investigating these procedures. Most of them suffer from low quality, short follow up and small patient numbers. Consequently the grade of recommendation is low. Nonetheless, joint preserving procedures are appealing because if they fail to relief the symptoms an arthrodesis or arthroplasty can still be performed thereafter. PMID:24649409

  8. Quantitative Cartilage Imaging in Knee Osteoarthritis

    PubMed Central

    Eckstein, Felix; Wirth, Wolfgang

    2011-01-01

    Quantitative measures of cartilage morphology (i.e., thickness) represent potentially powerful surrogate endpoints in osteoarthritis (OA). These can be used to identify risk factors of structural disease progression and can facilitate the clinical efficacy testing of structure modifying drugs in OA. This paper focuses on quantitative imaging of articular cartilage morphology in the knee, and will specifically deal with different cartilage morphology outcome variables and regions of interest, the relative performance and relationship between cartilage morphology measures, reference values for MRI-based knee cartilage morphometry, imaging protocols for measurement of cartilage morphology (including those used in the Osteoarthritis Initiative), sensitivity to change observed in knee OA, spatial patterns of cartilage loss as derived by subregional analysis, comparison of MRI changes with radiographic changes, risk factors of MRI-based cartilage loss in knee OA, the correlation of MRI-based cartilage loss with clinical outcomes, treatment response in knee OA, and future directions of the field. PMID:22046518

  9. Proteoglycan synthesis and osteophyte formation in 'metabolically' and 'mechanically' induced murine degenerative joint disease: an in-vivo autoradiographic study.

    PubMed Central

    van der Kraan, P. M.; Vitters, E. L.; van Beuningen, H. M.; van den Berg, W. B.

    1992-01-01

    We investigated the in-vivo proteoglycan synthesis in specific areas of murine knee joint articular cartilage after the induction of degenerative joint disease by means of 35S-sulphate autoradiography. Degenerative joint disease was induced either by direct interference with cartilage metabolism (papain and iodoacetate), or by the induction of joint instability (collagenase). Injection of iodoacetate and papain led to inhibition of proteoglycan synthesis mainly in the central parts of the patellae, patellaris femoris and the central part of the medial tibial plateau. Articular cartilage adjacent to the strongly inhibited areas frequently showed a significantly enhanced synthesis of proteoglycans. A strong inhibition of proteoglycan synthesis was observed in the central part of the medial plateau after collagenase injection while other cartilage sites and joint structures such as the capsule and ligaments were stimulated in their proteoglycan synthesis. This study shows that the localization of changes in cartilage metabolism in degenerative joint disease of the knee might be related to differences in the pathogenetic mechanism in different variants of this common joint disorder. Images Fig. 5 p341-a Fig. 2 Fig. 3 Fig. 4 Fig. 6 Fig. 7 Fig. 8 Fig. 9 PMID:1320394

  10. Viscosupplementation for Osteoarthritis: a Primer for Primary Care Physicians

    PubMed Central

    2015-01-01

    Introduction Osteoarthritis (OA) constitutes a growing public health burden and the most common cause of disability in the United States. Non-pharmacologic modalities and conservative pharmacologic therapies are recommended for the initial treatment of OA, including acetaminophen, and topical and oral non-steroidal anti-inflammatory drugs. However, safety concerns continue to mount regarding the use of these treatments and none have been shown to impact disease progression. Viscosupplementation with injections of hyaluronans (HAs) are indicated when non-pharmacologic and simple analgesics have failed to relieve symptoms (e.g., pain, stiffness) associated with knee OA. This review evaluates literature focusing on the efficacy and/or safety of HA injections in treating OA of the knee and in other joints, including the hip, shoulder, and ankle. Methods Relevant literature on intra-articular (IA) HA injections as a treatment for OA pain in the knee and other joints was identified through PubMed database searches from inception until January 2013. Search terms included “hyaluronic acid” or “hylan”, and “osteoarthritis”. Discussion Current evidence indicates that HA injections are beneficial and safe for patients with OA of the knee. IA injections of HAs treat the symptoms of knee OA and may also have disease-modifying properties, potentially delaying progression of OA. Although traditionally reserved for second-line treatment, evidence suggests that HAs may have value as a first-line therapy in the treatment of knee OA as they have been shown to be more effective in earlier stages and grades of disease, more recently diagnosed OA, and in less severe radiographic OA. Conclusion For primary care physicians who treat and care for patients with OA of the knee, IA injection with HAs constitutes a safe and effective treatment that can be routinely administered in the office setting. PMID:24203348

  11. Hip Osteoarthritis and the Risk of All-Cause and Disease-Specific Mortality in Older Women: Population-Based Cohort Study

    PubMed Central

    Barbour, Kamil E.; Lui, Li-Yung; Nevitt, Michael C.; Murphy, Louise B.; Helmick, Charles G.; Theis, Kristina A.; Hochberg, Marc C.; Lane, Nancy E.; Hootman, Jennifer M.; Cauley, Jane A.

    2015-01-01

    Objectives Determine the risk of all-cause and disease-specific mortality among older women with hip OA and identify mediators in the causal pathway. Methods Data were from the Study of Osteoporotic Fractures, a US population-based cohort study of 9704 white women, aged ≥65 years. The analytic sample included women with hip radiographs at baseline (N=7,889) and year 8 (N=5,749). Mortality was confirmed through October 2013 by death certificates and hospital discharge summaries. Radiographic hip OA (RHOA) was defined as having Croft grade ≥2 in at least 1 hip (definite joint space narrowing or osteophytes plus 1 other radiographic feature). Results Mean follow-up time was 16.1 ±6.2 years. Baseline and year 8 prevalence of RHOA was 8.0% and 11.0%, respectively. Cumulative incidence (proportion of deaths during study period) was 67.7% for all-cause mortality, 26.3% for cardiovascular disease (CVD) mortality, 11.7% for cancer mortality, 1.9% for gastrointestinal disease mortality, and 27.8% for all other mortality causes. RHOA was associated with an increased risk of all-cause (hazard ratio [HR], 1.14; 95% confidence interval [CI], 1.05–1.24), and CVD (HR, 1.24; 95% CI, 1.09–1.41) mortality adjusted for age, body mass index, education, smoking, health status, diabetes, and stroke. These associations were partially explained by physical function (mediating variable). Conclusion RHOA was associated with an increased risk of all-cause and CVD mortality among older white women followed for 16 years. Dissemination of evidence-based physical activity and self-management interventions for hip OA in community and clinical settings can improve physical function and might also contribute to lower mortality. PMID:25778744

  12. Mitochondrial DNA (mtDNA) Haplogroups Influence the Progression of Knee Osteoarthritis. Data from the Osteoarthritis Initiative (OAI)

    PubMed Central

    Soto-Hermida, Angel; Fernández-Moreno, Mercedes; Oreiro, Natividad; Fernández-López, Carlos; Pértega, Sonia; Cortés-Pereira, Estefania; Rego-Pérez, Ignacio; Blanco, Francisco J.

    2014-01-01

    Objective To evaluate the influence of the mtDNA haplogroups on knee osteoarthritis progression in Osteoarthritis Initiative (OAI) participants through longitudinal data from radiographs and magnetic resonance imaging (MRI). Methods Four-year knee osteoarthritis progression was analyzed as increase in Kellgren and Lawrence (KL) grade, in addition to increase in OARSI atlas grade for joint space narrowing (JSN), osteophytes and subchondral sclerosis in the tibia medial compartment of 891 Caucasian individuals from the progression subcohort. The influence of the haplogroups on the rate of structural progression was also assessed as the four-year change in minimum joint space width (mJSW in millimetres) in both knees of (n = 216) patients with baseline unilateral medial-tibiofemoral JSN. Quantitative cartilage measures from longitudinal MRI data were those related to cartilage thickness and volume with a 24 month follow-up period (n = 381). Results During the four-year follow-up period, knee OA patients with the haplogroup T showed the lowest increase in KL grade (Hazard Risk [HR] = 0.499; 95% Confidence Interval [CI]: 0.261–0.819; p<0.05) as well as the lowest cumulative probability of progression for JSN (HR = 0.547; 95% CI: 0.280–0.900; p<0.05), osteophytes (HR = 0.573; 95% CI: 0.304–0.893; p<0.05) and subchondral sclerosis (HR = 0.549; 95% CI: 0.295–0.884; p<0.05). They also showed the lowest decline in mJSW (standardized response means (SRM) = −0.39; p = 0.037) in those knees without baseline medial JSN (no-JSN knees). Normalized cartilage volume loss was significantly lower in patients carrying the haplogroup T at medial tibia femoral (SRM = −0.33; p = 0.023) and central medial femoral (SRM = −0.27; p = 0.031) compartments. Cartilage thickness loss was significantly lower in carriers of haplogroup T at central medial tibia-femoral (SRM = −0.42; p = 0.011), medial tibia femoral (SRM = −0.32; p = 0.018), medial tibia anterior (SRM = +0.31; p = 0.013) and central medial femoral (SRM = −0.19; p = 0.013) compartments. Conclusions Mitochondrial genome seems to play a role in the progression of knee osteoarthritis. mtDNA variation could improve identification of patients predisposed to faster or severe progression of the disease. PMID:25390621

  13. Perspectives on the Use of Gene Therapy for Chronic Joint Diseases

    PubMed Central

    Ghivizzani, Steven C.; Gouze, Elvire; Gouze, Jean-Noel; Kay, Jesse D.; Bush, Marsha L.; Watson, Rachael S.; Levings, Padraic P.; Nickerson, David M.; Colahan, Patrick T.; Robbins, Paul D.; Evans, Christopher H.

    2015-01-01

    Advances in molecular and cellular biology have identified a wide variety of proteins including targeted cytokine inhibitors, immunomodulatory proteins, cytotoxic mediators, angiogenesis inhibitors, and intracellular signalling molecules that could be of great benefit in the treatment of chronic joint diseases, such as osteo- and rheumatoid arthritis. Unfortunately, protein-based drugs are difficult to administer effectively. They have a high rate of turnover, requiring frequent readministration, and exposure in non-diseased tissue can lead to serious side effects. Gene transfer technologies offer methods to enhance the efficacy of protein-based therapies, enabling the body to produce these molecules locally at elevated levels for extended periods. The proof of concept of gene therapies for arthritis has been exhaustively demonstrated in multiple laboratories and in numerous animal models. This review attempts to condense these studies and to discuss the relative benefits and limitations of the methods proposed and to discuss the challenges toward translating these technologies into clinical realities. PMID:18691023

  14. Preliminary results of automated removal of degenerative joint disease in bone scan lesion segmentation

    NASA Astrophysics Data System (ADS)

    Chu, Gregory H.; Lo, Pechin; Kim, Hyun J.; Auerbach, Martin; Goldin, Jonathan; Henkel, Keith; Banola, Ashley; Morris, Darren; Coy, Heidi; Brown, Matthew S.

    2013-03-01

    Whole-body bone scintigraphy (or bone scan) is a highly sensitive method for visualizing bone metastases and is the accepted standard imaging modality for detection of metastases and assessment of treatment outcomes. The development of a quantitative biomarker using computer-aided detection on bone scans for treatment response assessment may have a significant impact on the evaluation of novel oncologic drugs directed at bone metastases. One of the challenges to lesion segmentation on bone scans is the non-specificity of the radiotracer, manifesting as high activity related to non-malignant processes like degenerative joint disease, sinuses, kidneys, thyroid and bladder. In this paper, we developed an automated bone scan lesion segmentation method that implements intensity normalization, a two-threshold model, and automated detection and removal of areas consistent with non-malignant processes from the segmentation. The two-threshold model serves to account for outlier bone scans with elevated and diffuse intensity distributions. Parameters to remove degenerative joint disease were trained using a multi-start Nelder-Mead simplex optimization scheme. The segmentation reference standard was constructed manually by a panel of physicians. We compared the performance of the proposed method against a previously published method. The results of a two-fold cross validation show that the overlap ratio improved in 67.0% of scans, with an average improvement of 5.1% points.

  15. JOINT DISEASE MAPPING OF CERVICAL AND MALE OROPHARYNGEAL CANCER INCIDENCE IN BLACKS AND WHITES IN SOUTH CAROLINA

    PubMed Central

    Onicescu, Georgiana; Hill, Elizabeth G.; Lawson, Andrew B.; Korte, Jeffrey E.; Gillespie, M. Boyd

    2010-01-01

    Human papillomavirus (HPV) infection is an established causal agent for cervical cancer and a subset of oropharyngeal cancers. It is hypothesized that orogenital transmission results in oral cavity infection. In this paper we explore the geographical association between cervical and male oropharyngeal cancer incidence in blacks and whites in South Carolina using Bayesian joint disease mapping models fit to publicly available data. Our results suggest weak evidence for county-level association between the diseases, and different patterns of joint disease behavior for blacks and whites. PMID:20563237

  16. Severe destructive arthritis of the carpometacarpal joint: a diagnosis of exclusion case report.

    PubMed

    Vaghela, Kalpesh R; Patel, Nirav K; Sarraf, Khaled M; Owers, Kate

    2013-01-01

    We present a case of severe destruction of the thumb carpometacarpal joint (CMCJ) and surrounding structures on a background of osteoarthritis and Seronegative Rheumatoid arthritis. Imaging studies suggested a soft tissue lesion consistent with Pigmented Villonodular Synovitis (PVNS), Synovial Osteochondromatosis or Giant Cell Tumour (GCT). Due to the possibility of malignant transformation and deteriorating symptoms the mass was excised. Histological analysis of the lesion revealed severe degenerative disease with no evidence of malignancy or infection. This represents an atypical presentation of thumb carpometacarpal joint arthritis, which should be diagnosed once more sinister pathology has been excluded. PMID:24662912

  17. Quantitative three-dimensional photoacoustic tomography of the finger joints: an in vivo study

    NASA Astrophysics Data System (ADS)

    Sun, Yao; Sobel, Eric; Jiang, Huabei

    2009-11-01

    We present for the first time in vivo full three-dimensional (3-D) photoacoustic tomography (PAT) of the distal interphalangeal joint in a human subject. Both absorbed energy density and absorption coefficient images of the joint are quantitatively obtained using our finite-element-based photoacoustic image reconstruction algorithm coupled with the photon diffusion equation. The results show that major anatomical features in the joint along with the side arteries can be imaged with a 1-MHz transducer in a spherical scanning geometry. In addition, the cartilages associated with the joint can be quantitatively differentiated from the phalanx. This in vivo study suggests that the 3-D PAT method described has the potential to be used for early diagnosis of joint diseases such as osteoarthritis and rheumatoid arthritis.

  18. Leg length discrepancy and osteoarthritis in the knee, hip and lumbar spine

    PubMed Central

    Murray, Kelvin J.; Azari, Michael F.

    2015-01-01

    Osteoarthritis (OA) is an extremely common condition that creates substantial personal and health care costs. An important recognised risk factor for OA is excessive or abnormal mechanical joint loading. Leg length discrepancy (LLD) is a common condition that results in uneven and excessive loading of not only knee joints but also hip joints and lumbar motion segments. Accurate imaging methods of LLD have made it possible to study the biomechanical effects of mild LLD (LLD of 20mm or less). This review examines the accuracy of these methods compared to clinical LLD measurements. It then examines the association between LLD and OA of the joints of the lower extremity. More importantly, it addresses the largely neglected association between LLD and degeneration of lumbar motion segments and the patterns of biomechanical changes that accompany LLD. We propose that mild LLD may be an important instigator or contributor to OA of the hip and lumbar spine, and that it deserves to be rigorously studied in order to decrease OA’s burden of disease. PMID:26500356

  19. Temporomandibular joint diagnostics using CBCT

    PubMed Central

    Abrahamsson, A-K; Kristensen, M; Arvidsson, L Z

    2015-01-01

    The present review will give an update on temporomandibular joint (TMJ) imaging using CBCT. It will focus on diagnostic accuracy and the value of CBCT compared with other imaging modalities for the evaluation of TMJs in different categories of patients; osteoarthritis (OA), juvenile OA, rheumatoid arthritis and related joint diseases, juvenile idiopathic arthritis and other intra-articular conditions. Finally, sections on other aspects of CBCT research related to the TMJ, clinical decision-making and concluding remarks are added. CBCT has emerged as a cost- and dose-effective imaging modality for the diagnostic assessment of a variety of TMJ conditions. The imaging modality has been found to be superior to conventional radiographical examinations as well as MRI in assessment of the TMJ. However, it should be emphasized that the diagnostic information obtained is limited to the morphology of the osseous joint components, cortical bone integrity and subcortical bone destruction/production. For evaluation of soft-tissue abnormalities, MRI is mandatory. There is an obvious need for research on the impact of CBCT examinations on patient outcome. PMID:25369205

  20. Relationship between the shape of the central and third tarsal bones and the presence of tarsal osteoarthritis.

    PubMed

    Sprackman, Lucy; Dakin, Stephanie G; May, Stephen A; Weller, Renate

    2015-04-01

    Osteoarthritis (OA) of the low motion joints of the tarsus, commonly termed 'bone spavin', is common in horses. Whilst the aetiology of this condition is multifactorial, it has been suggested that dorsal wedging of the central tarsal bone (CTB) and third tarsal bone (TTB) may predispose to the development of this disease. The aim of this study was to investigate the relationship between tarsal bone conformation and osteoarthritis of the proximal intertarsal (PIT), distal intertarsal (DIT) and tarsometatarsal (TMT) joints. It was hypothesised that wedging of the CTB and TTB would be associated with OA in these joints. Multiplanar reconstructions based on computed tomographic (CT) images were used to measure the height of the central and third tarsal bones at their dorsal and plantar aspects in three parasagittal planes in cadaver specimens. A wedging index was calculated as the ratio between the dorsal and plantar measurements. All tarsal bones were graded for OA on CT images. There was a significant moderate negative correlation between the wedging index of the CTB and OA of the DIT (ρ = -0.45, P <0.01), TMT (ρ = -0.49, P <0.01) and PIT joints (ρ = -0.43, P <0.01). Dorsal wedging of the TTB was seen in mild and moderate grades of OA, but severe cases of OA were associated with plantar wedging. Our study suggests that wedging of the small tarsal bones is associated with OA in the associated joints and hence care should be taken in foals to prevent the development of wedging. PMID:25792180

  1. Vitamin D Deficiency Is Associated with Progression of Knee Osteoarthritis12

    PubMed Central

    Zhang, Fang Fang; Driban, Jeffrey B; Lo, Grace H; Price, Lori Lyn; Booth, Sarah; Eaton, Charles B; Lu, Bing; Nevitt, Michael; Jackson, Becky; Garganta, Cheryl; Hochberg, Marc C; Kwoh, Kent; McAlindon, Timothy E

    2014-01-01

    Background: Knee osteoarthritis causes functional limitation and disability in the elderly. Vitamin D has biological functions on multiple knee joint structures and can play important roles in the progression of knee osteoarthritis. The metabolism of vitamin D is regulated by parathyroid hormone (PTH). Objective: The objective was to investigate whether serum concentrations of 25-hydroxyvitamin D [25(OH)D] and PTH, individually and jointly, predict the progression of knee osteoarthritis. Methods: Serum 25(OH)D and PTH were measured at the 30- or 36-mo visit in 418 participants enrolled in the Osteoarthritis Initiative (OAI) who had ?1 knee with both symptomatic and radiographic osteoarthritis. Progression of knee osteoarthritis was defined as any increase in the radiographic joint space narrowing (JSN) score between the 24- and 48-mo OAI visits. Results: The mean concentrations of serum 25(OH)D and PTH were 26.2 ?g/L and 54.5 pg/mL, respectively. Approximately 16% of the population had serum 25(OH)D < 15 ?g/L. Between the baseline and follow-up visits, 14% progressed in JSN score. Participants with low vitamin D [25(OH)D < 15 ?g/L] had >2-fold elevated risk of knee osteoarthritis progression compared with those with greater vitamin D concentrations (?15 ?g/L; OR: 2.3; 95% CI: 1.1, 4.5). High serum PTH (?73 pg/mL) was not associated with a significant increase in JSN score. However, participants with both low vitamin D and high PTH had >3-fold increased risk of progression (OR: 3.2; 95%CI: 1.2, 8.4). Conclusion: Our results suggest that individuals deficient in vitamin D have an increased risk of knee osteoarthritis progression. PMID:25411034

  2. The treatment of osteoarthritis.

    PubMed Central

    Jones, A C; Doherty, M

    1992-01-01

    1. The treatment of osteoarthritis is currently purely symptomatic. To enable rational therapy, careful clinical assessment is necessary to identify the origin of symptoms. Often, effective therapy can result from a biomechanical approach such as surgery, orthotics, physiotherapy and dieting. If drugs are required, there is little evidence that the current over-reliance on non-steroidal anti-inflammatory drugs (NSAIDs) is justified. Full dose regular paracetamol should be the first line of analgesic therapy. In the majority of patients, simple analgesics are probably as effective as NSAIDs. If NSAIDs are used it is necessary to review regularly their use and to be aware of potential toxicity. 2. Many alternative strategies of pain management such as topical preparations, intra-articular steroid injections, acupuncture, radiosynovectomy, transcutaneous nerve stimulation and anti-depressants, may be effective but their precise place in the armamentarium is not yet fully established. 3. The realisation that osteoarthritis is not a passive 'wear and tear' phenomenon but an active process that may be potentially modified, has led to interest in 'chondroprotective' agents, which may beneficially affect the osteoarthritic process. To date there are no convincing data available that such agents are, in fact, chondroprotective in humans. PMID:1576063

  3. Influence of Adult Height on Rheumatoid Arthritis: Association with Disease Activity, Impairment of Joint Function and Overall Disability

    PubMed Central

    Chen, Ying; Yu, Zanzhe; Packham, Jonathan C.; Mattey, Derek L.

    2013-01-01

    Objectives To investigate whether normal variation of adult height is associated with clinical characteristics in rheumatoid arthritis (RA), including disease activity (DAS28), impairment of joint function (mechanical joint score, MJS) and overall disability (health assessment questionnaire, HAQ). Methods A cohort (134 males, 287 females) of consecutively recruited RA patients of Northern European origin was studied. Height, weight and demographic information were obtained. A core set of disease measurements, including DAS28, MJS and HAQ, were recorded at baseline, 12 and 24 months. Other clinical variables (e.g. disease duration, IgM rheumatoid factor, antibodies to cyclic citrullinated peptide, C-reactive protein, erythrocyte sedimentation rate) were recorded at baseline. Socioeconomic status, smoking status, comorbid condition, other autoimmune conditions and drug therapy were also recorded. Associations were analyzed using univariate statistics and multivariate linear regression models. Mediation tests were also carried out for evaluating the relationship between gender, height and disease measures. Results In males, height was inversely associated with DAS28, MJS and HAQ (at baseline and over 24 months) independent of other factors (e.g. weight, body mass index, age, disease duration, osteoporosis, autoantibodies, erosive disease, joint replacement, steroid use, smoking status, socioeconomic status and comorbid disease). In females, a similar trend was seen but the relationships were non significant. In the whole population, the association of female gender with more active disease and poor function disappeared after adjustment for height. Mediation analysis indicated that height served as a full mediator in the relationship of gender with disease activity and overall disability. Confirmation of these findings was demonstrated in a second RA population (n = 288). Conclusion Adult height is inversely associated with disease activity, impairment of joint function and overall disability in RA, particularly in males. The association of female sex with more severe disease activity and disability appears to be mediated by smaller stature. PMID:23705017

  4. Therapeutic Potential of Differentiated Mesenchymal Stem Cells for Treatment of Osteoarthritis

    PubMed Central

    Ham, Onju; Lee, Chang Youn; Kim, Ran; Lee, Jihyun; Oh, Sekyung; Lee, Min Young; Kim, Jongmin; Hwang, Ki-Chul; Maeng, Lee-So; Chang, Woochul

    2015-01-01

    Osteoarthritis (OA) is a chronic, progressive, and irreversible degenerative joint disease. Conventional OA treatments often result in complications such as pain and limited activity. However, transplantation of mesenchymal stem cells (MSCs) has several beneficial effects such as paracrine effects, anti-inflammatory activity, and immunomodulatory capacity. In addition, MSCs can be differentiated into several cell types, including chondrocytes, osteocytes, endothelia, and adipocytes. Thus, transplantation of MSCs is a suggested therapeutic tool for treatment of OA. However, transplanted naïve MSCs can cause problems such as heterogeneous populations including differentiated MSCs and undifferentiated cells. To overcome this problem, new strategies for inducing differentiation of MSCs are needed. One possibility is the application of microRNA (miRNA) and small molecules, which regulate multiple molecular pathways and cellular processes such as differentiation. Here, we provide insight into possible strategies for cartilage regeneration by transplantation of differentiated MSCs to treat OA patients. PMID:26147426

  5. Roles of microRNA and signaling pathway in osteoarthritis pathogenesis*

    PubMed Central

    Xu, Bin; Li, Yao-yao; Ma, Jun; Pei, Fu-xing

    2016-01-01

    Osteoarthritis (OA) is a common chronic degenerative joint disease, with complicated pathogenic factors and undefined pathogenesis. Various signaling pathways play important roles in OA pathogenesis, including genetic expression, matrix synthesis and degradation, cell proliferation, differentiation, apoptosis, and so on. MicroRNA (miRNA) is a class of non-coding RNA in Eukaryon, regulating genetic expression on the post-transcriptional level. A great number of miRNAs are involved in the development of OA, and are closely associated with different signaling pathways. This article reviews the roles of miRNAs and signaling pathways in OA, looking toward having a better understanding of its pathogenesis mechanisms and providing new therapeutic targets for its treatment. PMID:26984840

  6. Circulating T helper 9 cells and increased serum interleukin-9 levels in patients with knee osteoarthritis.

    PubMed

    Qi, Changlin; Shan, Yuxing; Wang, Jing; Ding, Fupeng; Zhao, Ding; Yang, Teng; Jiang, Yanfang

    2016-05-01

    The purpose of this study was to examine the roles of T helper 9 (Th9) cells and the serum interleukin (IL)-9 level in the pathogenesis of osteoarthritis (OA). The numbers of IL-9(+)  CD4(+)  CD8(-) T cells, interferon (IFN)-γ+ CD4(+)  CD8(-) T cells, IL-4(+) CD4(+)  CD8(-) T cells, and IL-17A(+ ) CD4(+ ) CD8(-) T cells in 25 OA patients and 13 healthy controls (HC) were examined by flow cytometry. The serum concentrations of IL-9, IL-4, IL-17A, and IFN-γ were also determined. The numbers of CD4(+) CD45RO(+) T cells, Th9 cells, Th1 cells, and Th17 cells in OA patients were significantly higher than those in HCs. Furthermore, serum IL-9, IL-17A, and IFN-γ levels in OA patients were higher than those in HCs. The number of Th9 cells was positively correlated with the number of Th17 cells in OA patients. Furthermore, greater numbers of Th9 cells were positively associated with elevated C-reactive protein, and both Th9 cells and IL-9 levels were positively correlated with the Western Ontario and McMaster Universities Osteoarthritis index in OA patients. Th9 cell numbers and IL-9 levels are correlated with OA patient symptoms and joint functionality and may be a marker of disease activity. PMID:26926842

  7. In vivo detection of osteoarthritis in the hand with three-dimensional photoacoustic tomography

    NASA Astrophysics Data System (ADS)

    Sun, Yao; Sobel, Eric; Jiang, Huabei

    2010-02-01

    This paper presents a pilot clinical study in detecting osteoarthritis (OA) in the hand using threedimensional (3-D) photoacoustic tomography (PAT). Distal interphalangeal (DIP) finger joints from OA patients and healthy volunteers were imaged with our 3-D PAT system in a spherical scanning configuration. Absorption coefficient images of the joint tissue were obtained using our finite element based photoacoustic image reconstruction algorithm coupled with the photon diffusion equation. The recovered quantitative photoacoustic images revealed significant differences in the absorption coefficient of the joint cavity (cartilage and synovial fluid) between the OA and healthy joints. Quantitative analysis of the joints also indicated an apparent difference in the recovered joint spacing between OA and healthy subjects, which is in agreement with the clinical observations. This study suggests that 3D PAT has the potential to become a useful tool for diagnosis of osteoarthritis.

  8. Expression and functions of very late antigen 1 in inflammatory joint diseases.

    PubMed

    Bank, I; Roth, D; Book, M; Guterman, A; Shnirrer, I; Block, R; Ehrenfeld, M; Langevitz, P; Brenner, H; Pras, M

    1991-01-01

    In the human immune system, very late antigen 1 (VLA-1), a putative collagen receptor, is expressed on the surface of T lymphocytes that have undergone mitogenic or antigenic stimulation. A new VLA-1-specific monoclonal antibody, 1B3.1, was used to probe the expression and function of VLA-1 on T lymphocytes in patients with arthritis. Synovial mononuclear cells from the joints of patients with rheumatoid arthritis or other joint diseases contained 32.9 +/- 13.8% 1B3.1-positive cells (42.8 +/- 10.4% in patients with rheumatoid arthritis and 28 +/- 12.6% in non rheumatoid patients). In the peripheral blood, patients with active rheumatoid arthritis expressed VLA-1 on 11.7 +/- 6.0% of their mononuclear cells, compared to 1.9 +/- 1.5% in controls (P less than 0.001). Using dual fluorescence analysis, virtually all the 1B3.1-positive synovial cells were CD3+ T lymphocytes and included both CD4+ and CD8+ T cells. When 1B3.1-expressing synovial mononuclear cells or in vitro activated T lymphocytes were triggered with anti-CD3 antibodies, marked augmentation of their proliferation occurred if they were simultaneously cross-linked with mab 1B3.1. Collagen type IV, a putative ligand of VLA-1, also augmented T-cell proliferation to anti-CD3. The data suggest that the VLA-1 molecule could play an important role in the pathophysiology of arthritis by modulating T-cell activation in these diseases. PMID:1827128

  9. Biomarkers of early stage osteoarthritis, rheumatoid arthritis and musculoskeletal health

    PubMed Central

    Ahmed, Usman; Anwar, Attia; Savage, Richard S.; Costa, Matthew L.; Mackay, Nicola; Filer, Andrew; Raza, Karim; Watts, Richard A.; Winyard, Paul G.; Tarr, Joanna; Haigh, Richard C.; Thornalley, Paul J.; Rabbani, Naila

    2015-01-01

    There is currently no biochemical test for detection of early-stage osteoarthritis (eOA). Tests for early-stage rheumatoid arthritis (eRA) such as rheumatoid factor (RF) and anti–cyclic citrullinated peptide (CCP) antibodies require refinement to improve clinical utility. We developed robust mass spectrometric methods to quantify citrullinated protein (CP) and free hydroxyproline in body fluids. We detected CP in the plasma of healthy subjects and surprisingly found that CP was increased in both patients with eOA and eRA whereas anti–CCP antibodies were predominantly present in eRA. A 4-class diagnostic algorithm combining plasma/serum CP, anti-CCP antibody and hydroxyproline applied to a cohort gave specific and sensitive detection and discrimination of eOA, eRA, other non-RA inflammatory joint diseases and good skeletal health. This provides a first-in-class plasma/serum-based biochemical assay for diagnosis and type discrimination of early-stage arthritis to facilitate improved treatment and patient outcomes, exploiting citrullinated protein and related differential autoimmunity. PMID:25788417

  10. Management of Osteoarthritis with Avocado/Soybean Unsaponifiables

    PubMed Central

    Christiansen, Blaine A.; Bhatti, Simrit; Goudarzi, Ramin

    2015-01-01

    Osteoarthritis (OA) is a painful and life-altering disease that severely limits the daily activities of millions of Americans, and it is one of the most common causes of disability in the world. With obesity on the rise and the world’s population living longer, the prevalence of OA is expected to increase dramatically in the coming decades, generating burdensome socioeconomic costs. This review summarizes current pharmaceutical, nonpharmaceutical, and prospective new treatments for OA, with primary focus on the dietary supplement avocado/soybean unsaponifiables (ASU). ASU modulates OA pathogenesis by inhibiting a number of molecules and pathways implicated in OA. Anticatabolic properties prevent cartilage degradation by inhibiting the release and activity of matrix metalloproteinases and increasing tissue inhibitors of these catabolic enzymes. ASU also inhibits fibrinolysis by stimulating the expression of plasminogen activator inhibitor. Anabolic properties promote cartilage repair by stimulating collagen and aggrecan synthesis via inhibition of inflammatory cytokines such as interleukin (IL)-1, IL-6, IL-8, tumor necrosis factor, ERK, and prostaglandin E2. Chondroprotective effects are mediated by correcting growth factor abnormalities, increasing TGF-β, and decreasing vascular endothelial growth factor (VEGF) in synovial fluid. ASU also inhibits cholesterol absorption and endogenous cholesterol biosynthesis, which mediate reactive oxygen species pathology in chondrocytes. At the clinical level, ASU reduces pain and stiffness while improving joint function, resulting in decreased dependence on analgesics. PMID:25621100

  11. Current research on pharmacologic and regenerative therapies for osteoarthritis

    PubMed Central

    Zhang, Wei; Ouyang, Hongwei; Dass, Crispin R; Xu, Jiake

    2016-01-01

    Osteoarthritis (OA) is a degenerative joint disorder commonly encountered in clinical practice, and is the leading cause of disability in elderly people. Due to the poor self-healing capacity of articular cartilage and lack of specific diagnostic biomarkers, OA is a challenging disease with limited treatment options. Traditional pharmacologic therapies such as acetaminophen, non-steroidal anti-inflammatory drugs, and opioids are effective in relieving pain but are incapable of reversing cartilage damage and are frequently associated with adverse events. Current research focuses on the development of new OA drugs (such as sprifermin/recombinant human fibroblast growth factor-18, tanezumab/monoclonal antibody against β-nerve growth factor), which aims for more effectiveness and less incidence of adverse effects than the traditional ones. Furthermore, regenerative therapies (such as autologous chondrocyte implantation (ACI), new generation of matrix-induced ACI, cell-free scaffolds, induced pluripotent stem cells (iPS cells or iPSCs), and endogenous cell homing) are also emerging as promising alternatives as they have potential to enhance cartilage repair, and ultimately restore healthy tissue. However, despite currently available therapies and research advances, there remain unmet medical needs in the treatment of OA. This review highlights current research progress on pharmacologic and regenerative therapies for OA including key advances and potential limitations. PMID:26962464

  12. Mutation analysis of the Smad3 gene in human osteoarthritis.

    PubMed

    Yao, Jun-Yan; Wang, Yan; An, Jing; Mao, Chun-Ming; Hou, Ning; Lv, Ya-Xin; Wang, You-Liang; Cui, Fang; Huang, Min; Yang, Xiao

    2003-09-01

    Osteoarthritis (OA) is the most common joint disease worldwide. Recent studies have shown that targeted disruption of Smad3 in mouse results in OA. To reveal the possible association between the Smad3 gene mutation and human OA, we employed polymerase chain reaction-single strand conformation polymorphism and sequencing to screen mutations in all nine exons of the Smad3 gene in 32 patients with knee OA and 50 patients with only bone fracture. A missense mutation of the Smad3 gene was found in one patient. The single base mutation located in the linker region of the SMAD3 protein was A --> T change in the position 2 of codon 197 and resulted in an asparagine to isoleucine amino-acid substitution. The expressions of matrix metalloproteinase 2 (MMP-2) and MMP-9 in sera of the patient carrying the mutation were higher than other OA patients and controls. This is the first report showing that the Smad3 gene mutations could be associated with the pathogenesis of human OA. PMID:12939660

  13. Minimal detectable change for mobility and patient-reported tools in people with osteoarthritis awaiting arthroplasty

    PubMed Central

    2014-01-01

    Background Thoughtful use of assessment tools to monitor disease requires an understanding of clinimetric properties. These properties are often under-reported and, thus, potentially overlooked in the clinic. This study aimed to determine the minimal detectable change (MDC) and coefficient of variation per cent (CV%) for tools commonly used to assess the symptomatic and functional severity of knee and hip osteoarthritis. Methods We performed a test-retest study on 136 people awaiting knee or hip arthroplasty at one of two hospitals. The MDC95 (the range over which the difference [change] for 95% of patients is expected to lie) and the coefficient of variation per cent (CV%) for the visual analogue scale (VAS) for joint pain, the six-minute walk test (6MWT), the timed up-and-go (TUG) test, the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Hip Disability and Osteoarthritis Outcome Score (HOOS) subscales were calculated. Results Knee cohort (n = 75) - The MDC95 and CV% values were as follows: VAS 2.8 cm, 15%; 6MWT 79 m, 8%; TUG +/-36.7%, 13%; KOOS pain 20.2, 19%; KOOS symptoms 24.1, 22%; KOOS activities of daily living 20.8, 17%; KOOS quality of life 26.6, 44. Hip cohort (n = 61) - The MDC95 and CV% values were as follows: VAS 3.3 cm, 17%; 6MWT 81.5 m, 9%; TUG +/-44.6%, 16%; HOOS pain 21.6, 22%; HOOS symptoms 22.7, 19%; HOOS activities of daily living 17.7, 17%; HOOS quality of life 24.4, 43%. Conclusions Distinguishing real change from error is difficult in people with severe osteoarthritis. The 6MWT demonstrates the smallest measurement error amongst a range of tools commonly used to assess disease severity, thus, has the capacity to detect the smallest real change above measurement error in everyday clinical practice. PMID:25015083

  14. Living Better With Osteoarthritis | NIH MedlinePlus the Magazine

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Osteoarthritis Living Better with Osteoarthritis Past Issues / Winter 2013 Table of Contents What Is Osteoarthritis? Osteoarthritis is the most common type of arthritis. ...

  15. Temporomandibular Joint, Open

    MedlinePlus

    ... Search Text size: Website Contents NIDCR Home Oral Health Diseases and Conditions Gum Disease TMJ Disorders Oral Cancer Dry Mouth Burning Mouth Tooth Decay See All Oral Complications of Systemic Diseases Cancer ... Joint, Open The Temporomandibular Joint, Open ...

  16. Clinical effect of Nirgundi Patra pinda sweda and Ashwagandhadi Guggulu Yoga in the management of Sandhigata Vata (Osteoarthritis)

    PubMed Central

    Joshi, Alpesh; Mehta, Charmi S.; Dave, Alankruta R.; Shukla, V. D.

    2011-01-01

    Sandhigata Vata is one among the 80 Nanatmaja Vata Vyadhies. Sandhigata Vata and Osteoarthritis have common symptoms, and hence, both are considered as similar entities by a majority of Ayurvedic scholars and same has been adopted here. Osteoarthritis is the most common joint disease among human beings today. In this study, a total of 116 patients were registered, out of them 101 patients had completed the full course of treatment, while 15 patients left against medical advice. The 101 patients of Sandhigata Vata were treated in two groups. Group A: In this group 50 patients of Sandhigata Vata were treated with Nirgundi Patra pinda sweda for 21 days and Ashwagandhadi Guggulu Yoga3 g/day for 45 days was given orally. Group B: In this group 51 patients of Sandhigata Vata were treated with only Ashwagandhadi Guggulu Yoga 3 g/day for 45 days. To assess the effect of the therapy objectively, all the signs and symptoms of Sandhigata Vata were given a score, depending upon their severity. Also functional tests like walking time, climbing stairs, and joint movement, were measured as a criteria for assessment. Both the groups showed good results, but Group B showed better results in comparison to group A PMID:22408304

  17. Clinical effect of Nirgundi Patra pinda sweda and Ashwagandhadi Guggulu Yoga in the management of Sandhigata Vata (Osteoarthritis).

    PubMed

    Joshi, Alpesh; Mehta, Charmi S; Dave, Alankruta R; Shukla, V D

    2011-04-01

    Sandhigata Vata is one among the 80 Nanatmaja Vata Vyadhies. Sandhigata Vata and Osteoarthritis have common symptoms, and hence, both are considered as similar entities by a majority of Ayurvedic scholars and same has been adopted here. Osteoarthritis is the most common joint disease among human beings today. In this study, a total of 116 patients were registered, out of them 101 patients had completed the full course of treatment, while 15 patients left against medical advice. The 101 patients of Sandhigata Vata were treated in two groups. Group A: In this group 50 patients of Sandhigata Vata were treated with Nirgundi Patra pinda sweda for 21 days and Ashwagandhadi Guggulu Yoga3 g/day for 45 days was given orally. Group B: In this group 51 patients of Sandhigata Vata were treated with only Ashwagandhadi Guggulu Yoga 3 g/day for 45 days. To assess the effect of the therapy objectively, all the signs and symptoms of Sandhigata Vata were given a score, depending upon their severity. Also functional tests like walking time, climbing stairs, and joint movement, were measured as a criteria for assessment. Both the groups showed good results, but Group B showed better results in comparison to group A. PMID:22408304

  18. In vivo x-ray phase contrast analyzer-based imaging for longitudinal osteoarthritis studies in guinea pigs

    NASA Astrophysics Data System (ADS)

    Coan, Paola; Wagner, Andreas; Bravin, Alberto; Diemoz, Paul C.; Keyriläinen, Jani; Mollenhauer, Juergen

    2010-12-01

    Over the last two decades phase contrast x-ray imaging techniques have been extensively studied for applications in the biomedical field. Published results demonstrate the high capability of these imaging modalities of improving the image contrast of biological samples with respect to standard absorption-based radiography and routinely used clinical imaging techniques. A clear depiction of the anatomic structures and a more accurate disease diagnosis may be provided by using radiation doses comparable to or lower than those used in current clinical methods. In the literature many works show images of phantoms and excised biological samples proving the high sensitivity of the phase contrast imaging methods for in vitro investigations. In this scenario, the applications of the so-called analyzer-based x-ray imaging (ABI) phase contrast technique are particularly noteworthy. The objective of this work is to demonstrate the feasibility of in vivo x-ray ABI phase contrast imaging for biomedical applications and in particular with respect to joint anatomic depiction and osteoarthritis detection. ABI in planar and tomographic modes was performed in vivo on articular joints of guinea pigs in order to investigate the animals with respect to osteoarthritis by using highly monochromatic x-rays of 52 keV and a low noise detector with a pixel size of 47 × 47 µm2. Images give strong evidence of the ability of ABI in depicting both anatomic structures in complex systems as living organisms and all known signs of osteoarthritis with high contrast, high spatial resolution and with an acceptable radiation dose. This paper presents the first proof of principle study of in vivo application of ABI. The technical challenges encountered when imaging an animal in vivo are discussed. This experimental study is an important step toward the study of clinical applications of phase contrast x-ray imaging techniques.

  19. The benefits and barriers to physical activity and lifestyle interventions for osteoarthritis affecting the adult knee

    PubMed Central

    2012-01-01

    Osteoarthritis prevalence is increasing, placing greater demands on healthcare and future socioeconomic costing models. Exercise and non-pharmacological methods should be employed to manage this common and disabling disease. Expectations at all stages of disease are increasing with a desire to remain active and independent. Three key areas have been reviewed; the evidence for physical activity, lifestyle changes and motivational techniques concerning knee osteoarthritis and the barriers to instituting such changes. Promotion of activity in primary care is discussed and evidence for compliance has been reviewed. This article reviews a subject that is integral to all professionals involved with osteoarthritis care. PMID:22462601

  20. Cartilage degeneration and excessive subchondral bone formation in spontaneous osteoarthritis involves altered TGF-β signaling.

    PubMed

    Zhao, Weiwei; Wang, Ting; Luo, Qiang; Chen, Yan; Leung, Victor Y L; Wen, Chunyi; Shah, Mohammed F; Pan, Haobo; Chiu, KwongYuen; Cao, Xu; Lu, William W

    2016-05-01

    Transforming growth factor-β (TGF-β) has been demonstrated as a potential therapeutic target in osteoarthritis. However, beneficial effects of TGF-β supplement and inhibition have both been reported, suggesting characterization of the spatiotemporal distribution of TGF-β during the whole time course of osteoarthritis is important. To investigate the activity of TGF-β in osteoarthritis progression, we collected knee joints from Dunkin-Hartley (DH) guinea pigs at 3, 6, 9, and 12-month old (n = 8), which develop spontaneous osteoarthritis in a manner extraordinarily similar to humans. Via histology and micro-computed tomography (CT) analysis, we found that the joints exhibited gradual cartilage degeneration, subchondral plate sclerosis, and elevated bone remodeling during aging. The degenerating cartilage showed a progressive switch of the expression of phosphorylated Smad2/3 to Smad1/5/8, suggesting dual roles of TGF-β/Smad signaling during chondrocyte terminal differentiation in osteoarthritis progression. In subchondral bone, we found that the locations and age-related changes of osterix(+) osteoprogenitors were in parallel with active TGF-β, which implied the excessive osteogenesis may link to the activity of TGF-β. Our study, therefore, suggests an association of cartilage degeneration and excessive bone remodeling with altered TGF-β signaling in osteoarthritis progression of DH guinea pigs. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:763-770, 2016. PMID:26496668

  1. The Etiology of Osteoarthritis of the Hip

    PubMed Central

    Ganz, Reinhold; Leunig-Ganz, Katharina; Harris, William H.

    2008-01-01

    The etiology of osteoarthritis of the hip has long been considered secondary (eg, to congenital or developmental deformities) or primary (presuming some underlying abnormality of articular cartilage). Recent information supports a hypothesis that so-called primary osteoarthritis is also secondary to subtle developmental abnormalities and the mechanism in these cases is femoroacetabular impingement rather than excessive contact stress. The most frequent location for femoroacetabular impingement is the anterosuperior rim area and the most critical motion is internal rotation of the hip in 90° flexion. Two types of femoroacetabular impingement have been identified. Cam-type femoroacetabular impingement, more prevalent in young male patients, is caused by an offset pathomorphology between head and neck and produces an outside-in delamination of the acetabulum. Pincer-type femoroacetabular impingement, more prevalent in middle-aged women, is produced by a more linear impact between a local (retroversion of the acetabulum) or general overcoverage (coxa profunda/protrusio) of the acetabulum. The damage pattern is more restricted to the rim and the process of joint degeneration is slower. Most hips, however, show a mixed femoroacetabular impingement pattern with cam predominance. Surgical attempts to restore normal anatomy to avoid femoroacetabular impingement should be performed in the early stage before major cartilage damage is present. Level of Evidence: Level V, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18196405

  2. Osteoarthritis Classification Scales: Interobserver Reliability and Arthroscopic Correlation

    PubMed Central

    Wright, Rick W.; Ross, James R.; Haas, Amanda K.; Huston, Laura J.; Garofoli, Elizabeth A.; Harris, David; Patel, Kushal; Pearson, David; Schutzman, Jake; Tarabichi, Majd; Ying, David; Albright, John P.; Allen, Christina R.; Amendola, Annunziato; Anderson, Allen F.; Andrish, Jack T.; Annunziata, Christopher C.; Arciero, Robert A.; Bach, Bernard R.; Baker, Champ L.; Bartolozzi, Arthur R.; Baumgarten, Keith M.; Bechler, Jeffery R.; Berg, Jeffrey H.; Bernas, Geoffrey A.; Brockmeier, Stephen F.; Brophy, Robert H.; Bush-Joseph, Charles A.; Butler V, J. Brad; Campbell, John D.; Carpenter, James E.; Cole, Brian J.; Cooper, Daniel E.; Cooper, Jonathan M.; Cox, Charles L.; Creighton, R. Alexander; Dahm, Diane L.; David, Tal S.; DeBerardino, Thomas M.; Dunn, Warren R.; Flanigan, David C.; Frederick, Robert W.; Ganley, Theodore J.; Gatt, Charles J.; Gecha, Steven R.; Giffin, James Robert; Hame, Sharon L.; Hannafin, Jo A.; Harner, Christopher D.; Harris, Norman Lindsay; Hechtman, Keith S.; Hershman, Elliott B.; Hoellrich, Rudolf G.; Hosea, Timothy M.; Johnson, David C.; Johnson, Timothy S.; Jones, Morgan H.; Kaeding, Christopher C.; Kamath, Ganesh V.; Klootwyk, Thomas E.; Lantz, Brett A.; Levy, Bruce A.; Ma, C. Benjamin; Maiers, G. Peter; Mann, Barton; Marx, Robert G.; Matava, Matthew J.; Mathien, Gregory M.; McAllister, David R.; McCarty, Eric C.; McCormack, Robert G.; Miller, Bruce S.; Nissen, Carl W.; O’Neill, Daniel F.; Owens, LTC Brett D.; Parker, Richard D.; Purnell, Mark L.; Ramappa, Arun J.; Rauh, Michael A.; Rettig, Arthur; Sekiya, Jon K.; Shea, Kevin G.; Sherman, Orrin H.; Slauterbeck, James R.; Smith, Matthew V.; Spang, Jeffrey T.; Spindler, Kurt P.; Stuart, Michael J.; Svoboda, LTC Steven J.; Taft, Timothy N.; Tenuta, COL Joachim J.; Tingstad, Edwin M.; Vidal, Armando F.; Viskontas, Darius G.; White, Richard A.; Williams, James S.; Wolcott, Michelle L.; Wolf, Brian R.; York, James J.; Carey, James L.

    2014-01-01

    Background: Osteoarthritis of the knee is commonly diagnosed and monitored with radiography. However, the reliability of radiographic classification systems for osteoarthritis and the correlation of these classifications with the actual degree of confirmed degeneration of the articular cartilage of the tibiofemoral joint have not been adequately studied. Methods: As the Multicenter ACL (anterior cruciate ligament) Revision Study (MARS) Group, we conducted a multicenter, prospective longitudinal cohort study of patients undergoing revision surgery after anterior cruciate ligament reconstruction. We followed 632 patients who underwent radiographic evaluation of the knee (an anteroposterior weight-bearing radiograph, a posteroanterior weight-bearing radiograph made with the knee in 45° of flexion [Rosenberg radiograph], or both) and arthroscopic evaluation of the articular surfaces. Three blinded examiners independently graded radiographic findings according to six commonly used systems—the Kellgren-Lawrence, International Knee Documentation Committee, Fairbank, Brandt et al., Ahlbäck, and Jäger-Wirth classifications. Interobserver reliability was assessed with use of the intraclass correlation coefficient. The association between radiographic classification and arthroscopic findings of tibiofemoral chondral disease was assessed with use of the Spearman correlation coefficient. Results: Overall, 45° posteroanterior flexion weight-bearing radiographs had higher interobserver reliability (intraclass correlation coefficient = 0.63; 95% confidence interval, 0.61 to 0.65) compared with anteroposterior radiographs (intraclass correlation coefficient = 0.55; 95% confidence interval, 0.53 to 0.56). Similarly, the 45° posteroanterior flexion weight-bearing radiographs had higher correlation with arthroscopic findings of chondral disease (Spearman rho = 0.36; 95% confidence interval, 0.32 to 0.39) compared with anteroposterior radiographs (Spearman rho = 0.29; 95% confidence interval, 0.26 to 0.32). With respect to standards for the magnitude of the reliability coefficient and correlation coefficient (Spearman rho), the International Knee Documentation Committee classification demonstrated the best combination of good interobserver reliability and medium correlation with arthroscopic findings. Conclusions: The overall estimates with the six radiographic classification systems demonstrated moderate (anteroposterior radiographs) to good (45° posteroanterior flexion weight-bearing radiographs) interobserver reliability and medium correlation with arthroscopic findings. The International Knee Documentation Committee classification assessed with use of 45° posteroanterior flexion weight-bearing radiographs had the most favorable combination of reliability and correlation. Level of Evidence: Diagnostic Level I. See Instructions for Authors for a complete description of levels of evidence. PMID:25031368

  3. Value of the nuclear medical scan in the diagnosis of temporomandibular joint disease

    SciTech Connect

    Craemer, T.D.; Ficara, A.J.

    1984-10-01

    A total of 125 patients with temporomandibular joint complaints underwent nuclear medical scans of their joints as part of their diagnostic work-ups. The scan results were compared with the radiographic and arthrogram findings of these patients. The results suggest that the nuclear medical scan is not a highly reliable diagnostic aid for the majority of temporomandibular joint patients.

  4. Radiographic patterns and associations of osteoarthritis of the knee in patients referred to hospital.

    PubMed Central

    Ledingham, J; Regan, M; Jones, A; Doherty, M

    1993-01-01

    OBJECTIVES--To investigate differing patterns and associations of osteoarthritis of the knee in patients referred to hospital. METHODS--Two hundred and fifty two consecutive patients (161 women, 91 men; mean age 70 years, range 34-91 years) referred to hospital with osteoarthritis of the knee underwent clinical, radiographic, and synovial fluid screening. RESULTS--Radiographic changes of osteoarthritis of the knee (definite narrowing with or without osteoarthritic features) were bilateral in 85% of patients. Of 470 knees affected, 277 (59%) were affected in two compartments and 28 (6%) in three compartments. Unilateral and isolated medial tibiofemoral osteoarthritis were more common in men. Calcium pyrophosphate crystal deposition was common (synovial fluid identification in 132 (28%) knees; knee chondrocalcinosis in 76 (30%) patients) and associated with disability, bilateral, multicompartmental and severe radiographic osteoarthritis, marked osteophytosis, attrition, and cysts. Multiple clinical nodes (58 (23%) patients) and radiographic polyarticular interphalangeal osteoarthritis (66 (26%) patients) were associated with a higher frequency of inactivity pain, disability, multicompartmental and severe radiographic change. Forestier's disease predominated in men but showed n