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1

Abstract--Osteoarthritis is a degenerative joint disease, which causes the degradation of articular cartilage and  

E-print Network

Abstract--Osteoarthritis is a degenerative joint disease, which causes the degradation of articular cartilage and subchondral bone. The disease may result in mechanical abnormalities of the joints, including STEOARTHRITIS (OA) is a debilitating disease with a high prevalence in elderly individuals. OA affects nearly 27

Zhao, Xiaopeng

2

Joint Instability and Osteoarthritis  

PubMed Central

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

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

2015-01-01

3

Mouse models of osteoarthritis and joint injury  

E-print Network

Nearly 21 million Americans are affected by osteoarthritis, a complex disease characterized by degenerative lesions to the articular cartilage and subchondral bone in the joints. The complexity of the disease makes the use ...

Avedillo, Jose Enrique

2012-01-01

4

Osteoarthritis (OA), a degenerative joint disease associ-ated with the degradation of articular cartilage, is a leading  

E-print Network

Osteoarthritis (OA), a degenerative joint disease associ- ated with the degradation of articular and progres- sion processes are poorly understood. Cartilage mechanics are highly sensitive to the poroelastic one cylindrical bo- vine cartilage plug ( 10mm x 10mm, 1mm cartilage 9mm subchondral bone). One sample

Firestone, Jeremy

5

Role of viscosupplementation in osteo-arthritis of knee joint.  

PubMed

Osteo-arthritis is the chronic degenerative disease associated with joint pain and loss of joint function. It is caused by 'wear and tear' on a joint. Knee is the most commonly Involved joint. Disease is so crippling that patient is unable to walk independently from bed to bathroom. The major causes of osteo-arthritis are age, gender, obesity, medical condition and hereditary. The signs and symptoms of osteo-arthritis are pain, joint stiffness, joint swelling, and loss of function. No blood tests are helpful in diagnosing osteo-arthritis. Management of osteo-arthritis includes non-pharmacological, pharmacological and surgical. A relatively new procedure is viscosupplementation, in which a preparation of hyaluronic acid is injected into the knee joint. Hyaluronic acid is a naturally occurring substance found in the synovial fluid. It acts as a lubricant to enable bones to move smoothly over each other and a shock absorber for joint loads. The decrease in the elastic and viscous properties of synovial fluid in osteo-arthritis results from both a reduced molecular size and a reduced concentration of hyaluronic acid in the synovial fluid. Viscosupplementation may be a therapeutic option for individuals with osteo-arthritis of the knee. Viscosupplementation has been shown to relieve pain in many patients who cannot get relief from non-medicinal measures or analgesic drugs. This article is to know the mechanism of action, patients' selection criteria, rationale and efficacy of viscosupplimentation in the management of osteo-arthritis of knee. PMID:24765695

Chandra, Rajesh; Mahajan, Sumit

2013-05-01

6

Suppression of pain and joint destruction by inhibition of the proteasome system in experimental osteoarthritis  

Microsoft Academic Search

Osteoarthritis is a degenerative joint disease with pain and loss of joint function as major pathological features. Recent studies show that proteasome inhibitors reduce pain in various pathological conditions. We evaluated the effects of MG132, a reversible proteasome inhibitor on pain and joint destruction in a rat model of osteoarthritis. Osteoarthritis was induced by intraarticular injection of monosodium iodoacetate into

Aisha Siddiqah Ahmed; Jian Li; Helena Erlandsson-Harris; André Stark; Georgy Bakalkin; Mahmood Ahmed

7

Surgical treatment of trapeziometacarpal joint osteoarthritis  

PubMed Central

Trapeziometacarpal joint osteoarthritis is a common cause of radial-sided wrist pain that prevalently affects women. It is diagnosed on the basis of a thorough history, physical examination, and radiographic evaluation. While radiographs are used to determine the stage of disease, treatment is dependent on the severity of the symptoms. Non-surgical treatment frequently consists of activity modification, non-steroidal anti-inflammatory drugs, splinting and corticosteroid injections. After failure of conservative treatment, various surgical options exist depending on the stage of the disease. These options range from ligament reconstruction or osteotomy, for early painful laxity, to trapeziectomy, arthrodesis and arthroplasty for more severe osteoarthritis. This article reviews the literature supporting the various surgical treatment options and analyzes the surgical techniques most frequently used in the different disease stages. PMID:25606524

TACCARDO, GIUSEPPE; DE VITIS, ROCCO; PARRONE, GIUSEPPE; MILANO, GIUSEPPE; FANFANI, FRANCESCO

2013-01-01

8

Targeted mutation of NOV/CCN3 in mice disrupts joint homeostasis and causes osteoarthritis-like disease  

PubMed Central

Summary Objective The matricellular protein NOV/CCN3, is implicated in osteoarthritis (OA) and targeted mutation of NOV in mice (Novdel3) leads to joint abnormalities. This investigation tested whether NOV is required for joint homeostasis and if its disruption causes joint degeneration. Method NOV expression in the adult mouse joint was characterized by immunohistochemistry. A detailed comparison of the joints of Novdel3?/? and Novdel3+/+ (wild-type) males and females at 2, 6 and 12 months of age was determined by X-ray, histology and immunohistochemistry. Results NOV protein was found in specific cells in articular cartilage, meniscus, synovium and ligament attachment sites in adult knees. Novdel3?/? males exhibited severe OA-like pathology at 12 months (OARSI score 5.0 ± 0.5, P < 0.001), affecting all tissues of the joint: erosion of the articular cartilage, meniscal enlargement, osteophytic outgrowths, ligament degeneration and expansion of fibrocartilage. Subchondral sclerosis and changes in extracellular matrix composition consistent with OA, were also seen. The density of articular cartilage cells in Novdel3+/+ knee joints is maintained at a constant level from 2 to 12 months of age whereas this is not the case in Novdel3?/? mice. Compared with age and sex-matched Novdel3+/+ mice, a significant increase in articular cartilage density was seen in Novdel3?/? males at 2 months, whereas a significant decrease was seen at 6 and 12 months in both Novdel3?/? males and females. Conclusion NOV is required for the maintenance of articular cartilage and for joint homeostasis, with disruption of NOV in ageing Novdel3?/? male mice causing OA-like disease. PMID:25541297

Roddy, K.A.; Boulter, C.A.

2015-01-01

9

Acupuncture for peripheral joint osteoarthritis  

PubMed Central

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

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

10

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

PubMed

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

Dreier, Rita

2010-01-01

11

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

Microsoft Academic Search

ABSTRACT: 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

Rita Dreier

2010-01-01

12

Early Knee Osteoarthritis Management Should First Address Mechanical Joint Overload  

PubMed Central

Early knee osteoarthritis poses a therapeutic dilemma to the musculoskeletal clinician. Despite the recent interest in arthroscopic and injectable regenerative therapies intended to repair or restore a focal target such as cartilage, meniscus, or subchondral bone, none have been shown to slow disease progression. A likely cause of these disappointing treatment outcomes is the failure to address chronic and excessive loading of the knee joint. A growing body of evidence suggests that first-line therapies for early knee osteoarthritis should emphasize unloading the knee joint since any potential therapeutic benefit of regenerative therapies will likely be attenuated by excessive mechanical demand at the knee joint. Minimally invasive medical devices such as patient-specific interpositional implants and extracapsular joint unloading implants are currently in development to address this clinical need. PMID:24744839

Arendt, Elizabeth A.; Miller, Larry E.; Block, Jon E.

2014-01-01

13

Clinical features of symptomatic patellofemoral joint osteoarthritis  

PubMed Central

Introduction Patellofemoral joint osteoarthritis (OA) is common and leads to pain and disability. However, current classification criteria do not distinguish between patellofemoral and tibiofemoral joint OA. The objective of this study was to provide empirical evidence of the clinical features of patellofemoral joint OA (PFJOA) and to explore the potential for making a confident clinical diagnosis in the community setting. Methods This was a population-based cross-sectional study of 745 adults aged ?50 years with knee pain. Information on risk factors and clinical signs and symptoms was gathered by a self-complete questionnaire, and standardised clinical interview and examination. Three radiographic views of the knee were obtained (weight-bearing semi-flexed posteroanterior, supine skyline and lateral) and individuals were classified into four subsets (no radiographic OA, isolated PFJOA, isolated tibiofemoral joint OA, combined patellofemoral/tibiofemoral joint OA) according to two different cut-offs: 'any OA' and 'moderate to severe OA'. A series of binary logistic and multinomial regression functions were performed to compare the clinical features of each subset and their ability in combination to discriminate PFJOA from other subsets. Results Distinctive clinical features of moderate to severe isolated PFJOA included a history of dramatic swelling, valgus deformity, markedly reduced quadriceps strength, and pain on patellofemoral joint compression. Mild isolated PFJOA was barely distinguished from no radiographic OA (AUC 0.71, 95% CI 0.66, 0.76) with only difficulty descending stairs and coarse crepitus marginally informative over age, sex and body mass index. Other cardinal signs of knee OA - the presence of effusion, bony enlargement, reduced flexion range of movement, mediolateral instability and varus deformity - were indicators of tibiofemoral joint OA. Conclusions Early isolated PFJOA is clinically manifest in symptoms and self-reported functional limitation but has fewer clear clinical signs. More advanced disease is indicated by a small number of simple-to-assess signs and the relative absence of classic signs of knee OA, which are predominantly manifestations of tibiofemoral joint OA. Confident diagnosis of even more advanced PFJOA may be limited in the community setting. PMID:22417687

2012-01-01

14

Osteoarthritis of the First Carpometacarpal Joint  

PubMed Central

The first carpometacarpal (trapeziometacarpal) joints are a frequent site of osteoarthritis in postmenopausal women. This osteoarthritis, which is typically bilateral both clinically and roentgenographically, may be mistaken for tenosynovitis unless its characteristic features are recognized. These features include tenderness, stiffness, crepitus, swelling, and pain on wringing movements or other motions that cause abduction of the thumb. The swelling, radial subluxation of the metacarpal and atrophy of the thenar muscles give the hand a squared appearance. In severe cases, conservative medical therapy is generally unsatisfactory. Intra-articular corticosteroids and local anesthetic give only transient relief. Results of surgical therapy, including excision of the trapezium or arthrodesis of the trapeziometacarpal joint, were in general good. Distinct indications exist for each type of operation. ImagesFigure 1.Figure 2.Figure 3.Figure 4.Figure 5.Figure 6.Figure 7.Figure 9.Figure 10. PMID:5673986

Peter, J. B.; Marmor, Leonard

1968-01-01

15

Morbid anatomy of ‘erosive osteoarthritis’ of the interphalangeal finger joints: an optimised scoring system to monitor disease progression in affected joints  

PubMed Central

Objectives To develop and validate a quantitative radiographic scoring system, the Ghent University Scoring System (GUSS), with better ability to detect progression over a shorter period of time in erosive osteoarthritis (OA) of the interphalangeal (IP) finger joints compared with the existing anatomic phase scoring system. Methods Thirty IP finger joints showing erosive features at baseline or follow-up were selected from 18 patients with erosive hand OA. Posteroanterior radiographs of these joints obtained at baseline, 6 and 12 months—totalling 90 images—were used for the study. All joints were first scored according to the original anatomic phase scoring system. Erosive progression and signs of repair or remodelling were then scored by indicating the proportion of normal subchondral bone, subchondral plate and joint space on an 11-point rating scale (range 0–100 with 10 unit increases). Inter- and intrareader reproducibility was studied using intraclass correlation coefficients (ICCs). Based on the within-variance of two readers, the smallest detectable change (SDC) was calculated and allowed identification of joints with changes above the SDC as ‘progressors’. Results Longitudinal inter-reader ICC scores rated well for all variables and the total score (ICC 0.86–0.93). To identify ‘real’ change over background noise, a change of at least 40 units on the total score (range 0–300) over 12 months (SDC 0–12:36.0), and 50 units over 6 months (SDC 0–6:47.6) had to be present. 60% of the 30 joints were identified as ‘progressors’ over 6 months compared with 33.3% with the classical anatomical scoring system, and 70% versus 56.6%, respectively, over 12 months. Conclusion GUSS, is a reliable method to score radiographic change over time in erosive IP OA and detects more progression over a shorter period of time than the classical scoring system. PMID:19948521

Verbruggen, Gust; Wittoek, Ruth; Cruyssen, Bert Vander; Elewaut, Dirk

2010-01-01

16

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 ...

17

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

PubMed Central

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

Cushnaghan, J; Dieppe, P

1991-01-01

18

Distinguishing erosive osteoarthritis and calcium pyrophosphate deposition disease.  

PubMed

Erosive osteoarthritis is a term utilized to describe a specific inflammatory condition of the interphalangeal and first carpal metacarpal joints of the hands. The term has become a part of medical philosophical semantics and paradigms, but the issue is actually more complicated. Even the term osteoarthritis (non-erosive) has been controversial, with some suggesting osteoarthrosis to be more appropriate in view of the perspective that it is a non-inflammatory process undeserving of the "itis" suffix. The term "erosion" has also been a source of confusion in osteoarthritis, as it has been used to describe cartilage, not bone lesions. Inflammation in individuals with osteoarthritis actually appears to be related to complicating phenomena, such as calcium pyrophosphate and hydroxyapatite crystal deposition producing arthritis. Erosive osteoarthritis is the contentious term. It is used to describe a specific form of joint damage to specific joints. The damage has been termed erosions and the distribution of the damage is to the interphalangeal joints of the hand and first carpal metacarpal joint. Inflammation is recognized by joint redness and warmth, while X-rays reveal alteration of the articular surfaces, producing a smudged appearance. This ill-defined, joint damage has a crumbling appearance and is quite distinct from the sharply defined erosions of rheumatoid arthritis and spondyloarthropathy. The appearance is identical to those found with calcium pyrophosphate deposition disease, both in character and their unique responsiveness to hydroxychloroquine treatment. Low doses of the latter often resolve symptoms within weeks, in contrast to higher doses and the months required for response in other forms of inflammatory arthritis. Reconsidering erosive osteoarthritis as a form of calcium pyrophosphate deposition disease guides physicians to more effective therapeutic intervention. PMID:23610748

Rothschild, Bruce M

2013-04-18

19

Osteoarthritis  

PubMed Central

Osteoarthritis is a chronic degenerative disorder characterised by cartilage loss. It is extremely prevalent in society and is a major cause of disability. It is important to treat osteoarthritis effectively using a multidisciplinary approach tailored to the patient's needs. This paper reviews current thinking on the aetiology, pathogenesis, investigations, and management of osteoarthritis. The paper also discusses the challenges for developing good quality outcome measures for use in large scale multicentre clinical trials for new osteoarthritis treatments, especially disease modifying osteoarthritis drugs. PMID:12897215

Haq, I; Murphy, E; Dacre, J

2003-01-01

20

Obesity and osteoarthritis: disease genesis and nonpharmacologic weight management  

PubMed Central

Synopsis The mechanisms by which obesity affects osteoarthritis are of great concern to osteoarthritis researchers and clinicians who manage this disease. Inflammation and joint loads are pathways commonly thought to cause or to exacerbate the disease process. This paper reviews the physiologic and mechanical consequences of obesity on older adults with knee OA; the effects of long-term exercise and weight-loss interventions, the most effective non-pharmacological treatments for obesity; and the utility and feasibility of translating these results to clinical practice. PMID:18687279

Messier, Stephen P.

2008-01-01

21

Determinants of willingness to pay for hip and knee joint replacement surgery for osteoarthritis  

Microsoft Academic Search

Objectives. To determine whether patients with osteoarthritis (OA) would be willing to pay for joint replacement and whether patient characteristics or health outcomes, including pain, physical function and health-related quality of life, were related to willingness to pay (WTP). Methods. Patients who had undergone primary total hip replacement (THR) or total knee replacement (TKR) for OA completed a disease-specific questionnaire

M. J. Cross; L. M. March; H. M. Lapsley; K. L. Tribe; A. J. M. Brnabic

2000-01-01

22

Disease-modifying therapies for osteoarthritis : current status.  

PubMed

Osteoarthritis, the most common form of arthritis, is a debilitating progressive disease principally affecting the elderly. Osteoarthritis therapy has evolved in the past few decades from symptomatic treatment to possible disease-modifying solutions. In this paper, the pathophysiology of osteoarthritis is first reviewed, including an examination of the mechanisms underlying osteoarthritis and discussions of the roles of cartilage, synovial fluid and subchondral bone. The remainder of the paper discusses therapeutic approaches in current use and those in development, with special attention given to pharmacological treatments. Current approaches to treating osteoarthritis--i.e. medications; nonpharmacological modalities, such as physical therapy, exercise, weight management and orthotics; and (as a last resort) surgery--focus on reducing pain and improving (or at least maintaining) mobility. Drugs currently used to treat osteoarthritis fall into several categories: analgesics, NSAIDs, cyclo-oxygenase-2 (COX-2) inhibitors, corticosteroids, viscosupplementation, and symptomatic slow-acting drugs ('nutraceuticals'). The analgesics (paracetamol [acetaminophen] and opiates) have demonstrated less symptomatic efficacy than NSAIDs, while the latter have displayed mixed results in terms of joint space narrowing. COX-2 inhibitors have been demonstrated to be equal to or superior to NSAIDs in effectiveness. However, once considered a safer alternative, COX-2 inhibitors have become the subject of intense scrutiny since recent clinical evidence has cast suspicion on their cardiovascular safety profile. Injectable therapies, such as corticosteroids and viscosupplementation have elicited favorable short-term response but no long-term structural modification. On the other hand, the slow-acting drugs, especially chondroitin and glucosamine sulfate, have shown promising results. Also reviewed are other established and experimental therapies that seek to modify and/or even reverse the course of osteoarthritis. These include such medications as colchicine, bisphosphonates and hormones; dietary therapeutics, such as ginger extract and green tea; and such truly experimental treatments as matrix metalloproteinase inhibitors, cytokines, nitric oxide, growth factors and gene therapy. Osteoarthritis continues to be a difficult disorder to treat, as there is no cure as such and current treatments focus mainly on relieving pain and maintaining joint function. The search nevertheless continues for management regimens that can slow, alter or reverse the degenerative processes of osteoarthritis. PMID:15733021

Fajardo, Marc; Di Cesare, Paul E

2005-01-01

23

Measurement of structure (disease) modification in osteoarthritis.  

PubMed

Osteoarthritis (OA) research is beginning to focus on developing structure (disease) modifying treatments that will stabilize or reverse morphological changes, thereby altering the underlying pathologic process. The ability of anti-arthritic agents to modify the course of disease has been investigated in a limited number of clinical trials. Agents studied in published clinical trials include glycosaminoglycan-peptide complex (GP-C), glycosaminoglycan polysulfate (GAGPS), diacerein, and glucosamine sulphate. These clinical trials have been difficult to interpret and compare because the patients studied are often inadequately characterized or are not comparable across studies. Studies also vary with respect to the outcome measures analyzed and the methodology applied to measurement and data analysis. Further, in general, the rate of radiographic progression of OA is slow and is not consistent across populations and patients with varying disease severity. In man, the radiograph has been the gold standard for evaluating treatments. Further longitudinal validation of the radiograph is needed. As techniques improve, variation in the system and the number of patients needed in studies are decreasing. It may be that the radiograph will not achieve the needed degree of validation and will be supplanted by magnetic resonance imaging as the surrogate marker of joint status. PMID:14698647

Altman, R D

2004-01-01

24

Osteoarthritis and body weight  

Microsoft Academic Search

Osteoarthritis (degenerative joint disease) is the most common type of arthritis, and is a significant source of pain and disability. Osteoarthritis has multiple risk factors, including some that are potentially modifiable, such as body weight. Increased body weight is associated with an increased risk of developing osteoarthritis. Relatively minor weight loss can effectively decrease the risk of the onset of

Patrick M. Foye; Todd P. Stitik; Boqing Chen; Scott F. Nadler

2000-01-01

25

Short-term results of the Ascension™ pyrolytic carbon metacarpophalangeal Joint replacement arthroplasty for osteoarthritis  

Microsoft Academic Search

Introduction. – Osteoarthritis of the metacarpophalangeal joints is difficult to manage due to the high demands placed on any prosthesis. We report the preliminary results of our experience using the Ascension™ pyrolytic carbon implant.Method. – A pyrocarbon metacarpophalangeal joint replacement was implanted into seven patients (10 metacarpophalangeal joints) with osteoarthritis. Patients were reviewed both clinically and radiologically.Results. – At a

V. A. Nuñez; N. D. Citron

2005-01-01

26

Concomitant treatment of mandibular ameloblastoma and bilateral temporomandibular joint osteoarthritis with bone graft and total joint prostheses.  

PubMed

Temporomandibular joint (TMJ) osteoarthritis is a degenerative disease that can create clinical problems in the masticatory musculature, jaws, occlusion, and other associated structures and is commonly accompanied by inflammatory changes and pain. Many cases of TMJ dysfunction can be managed with nonsurgical therapies, but patients with irreversible TMJ damage may require surgical intervention for repair or reconstruction. Despite various methods of TMJ reconstruction, the patient-fitted total joint prostheses may be the best option to achieve good outcomes. Multicystic ameloblastoma is a benign odontogenic neoplasm of the jaws that is found most often in the mandible, in the region of the molars, and the ramus. Ameloblastomas usually progress slowly, but are locally invasive and may cause significant morbidity and sometimes death. This report describes a case of concomitant treatment of recurrent mandibular ameloblastoma and severe bilateral TMJ osteoarthritis treated by resection of the tumor, reconstruction with bone grafting, and bilateral TMJ reconstruction in a 63-year-old woman. PMID:25511957

Rodrigues, Daniel B; Wolford, Larry M; Malaquias, Pietry; Campos, Paulo S F

2015-01-01

27

Is early osteoarthritis associated with differences in joint congruence?  

PubMed

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

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

2014-12-18

28

[Osteoarthritis].  

PubMed

Osteoarthritis (OA) is the most common cause of arthritis, and is associated with significant pain and disability. Epidemiological study showed a large number of the eldery in Japan suffered OA, especially OA of the knee. Rapid diagnosis and conservative treatments those includes patient education, weight loss, exercise, physical and occupational therapy are effective at early stage. Pharmacologic treatment are acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) including cyclooxygenase-2 (COX-2) selective agents. Surgery of the joint arthroplasty significantly reduces knee and hip pain, and restores the functions of the patient at the end stage. PMID:25509795

Yamamoto, Seizo

2014-10-01

29

Osteoarthritis  

NSDL National Science Digital Library

This patient education program explains osteoarthritis and how it affects the joints. Causes, symptoms, risk factors, diagnosis, and treatment options are also reviewed. This resource is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: This tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.

Patient Education Institute

30

Role of interleukin-7 in degenerative and inflammatory joint diseases  

Microsoft Academic Search

IL-7 is known foremost for its immunostimulatory capacities, including potent T cell-dependent catabolic effects on bone. In joint diseases like rheumatoid arthritis and osteoarthritis, IL-7, via immune activation, can induce joint destruction. Now it has been demonstrated that increased IL-7 levels are produced by human articular chondrocytes of older individuals and osteoarthritis patients. IL-7 stimulates production of proteases by IL-7

Joel AG van Roon; Floris PJG Lafeber

2008-01-01

31

Rapidly destructive osteoarthritis of the hip joint: a case series  

PubMed Central

Background Rapidly destructive arthrosis of the hip is a rare and incompletely understood disorder with scarce literature about variations in natural history within a population. Methods A series of cases from North Wales with rapid progressive joint destruction and extensive subchondral bone loss in the femoral head and acetabulum are presented. Radiographic findings mimicked those of other disorders such as septic arthritis, rheumatoid and seronegative arthritis, primary osteonecrosis with secondary osteoarthritis, or neuropathic osteoarthropathy, but none of the patients had clinical, pathologic, or laboratory evidence of these entities. Results Rapid progression of hip pain and disability was a consistent clinical feature. The average duration of symptoms was 1.4 years. Radiographs obtained at various intervals before surgery (average 14 months) in 18 patients documented rapid hip destruction, involvement being unilateral in 13 cases. All patients underwent total hip arthroplasty, and osteoarthritis was confirmed at pathologic examination. Conclusion The authors postulate that these cases represent an uncommon subset of osteoarthritis and regular review, both clinically and radiologically, are required to assess speed of progression and prevent rapid loss of bone stock without the surgeon being aware. These cases are unsuitable for being placed on long waiting list due to technical difficulties in delayed surgery and compromised outcome following surgery. PMID:18190689

Batra, Sameer; Batra, Meenakshi; McMurtrie, A; Sinha, AK

2008-01-01

32

Intra-articular pressures and joint mechanics: should we pay attention to effusion in knee osteoarthritis?  

PubMed

What factors play a role to ensure a knee joint does what it should given the demands of moving through the physical environment? This paper aims to probe the hypothesis that intra-articular joint pressures, once a topic of interest, have been left aside in contemporary frameworks in which we now view knee joint function. The focus on ligamentous deficiencies and the chondrocentric view of osteoarthritis, while important, have left little attention to the consideration of other factors that can impair joint function across the lifespan. Dynamic knee stability is required during every step we take. While there is much known about the role that passive structures and muscular activation play in maintaining a healthy knee joint, this framework does not account for the role that intra-articular joint pressures may have in providing joint stability during motion and how these factors interact. Joint injuries invariably result in some form of intra-articular fluid accumulation. Ultimately, it may be how the knee mechanically responds to this fluid, of which pressure plays a significant role that provides the mechanisms for continued function. Do joint pressures provide an important foundation for maintaining knee function? This hypothesis is unique and argues that we are missing an important piece of the puzzle when attempting to understand implications that joint injury and disease have for joint function. PMID:24947194

Rutherford, Derek James

2014-09-01

33

Clinical benefit of joint distraction in the treatment of severe osteoarthritis of the ankle: Proof of concept in an open prospective study and in a randomized controlled study  

Microsoft Academic Search

Objective. Osteoarthritis (OA) is a degenerative, disabling joint disease that affects >10% of the adult population. No effective disease-modifying treatment is available. In the present study, we used joint distrac- tion, a relatively new treatment in which mechanical contact between the articular surfaces is avoided while intraarticular intermittent fluid pressure is maintained, to treat patients with severe OA of the

Anne C. A. Marijnissen; Peter M. Van Roermund; Jan Van Melkebeek; Willem Schenk; Abraham J. Verbout; Johannes W. J. Bijlsma; Floris P. J. G. Lafeber

2002-01-01

34

Targeted disruption of Mig6 in the mouse genome leads to early onset degenerative joint disease  

Microsoft Academic Search

Degenerative joint disease, also known as osteoarthritis, is the most common joint disorder in human beings. The molecular mechanism underlying this disease is not fully understood. Here, we report that disruption of mitogen-inducible gene 6 (Mig-6) in mice by homologous recombination leads to early onset degenerative joint disease, which is revealed by simultaneous enlargement and deformity of multiple joints, degradation

Yu-Wen Zhang; Yanli Su; Nathan Lanning; Pamela J. Swiatek; Roderick T. Bronson; Robert Sigler; Richard W. Martin; George F. Vande Woude

2005-01-01

35

Estrogen aggravates iodoacetate-induced temporomandibular joint osteoarthritis.  

PubMed

Temporomandibular joint osteoarthritis (TMJOA) is clinically characterized by female preponderance, with a female-to-male ratio of more than 2:1; however, the underlying mechanism remains obscure. We examined the effects of estrogen on TMJOA induced by monosodium iodoacetate. Female rats were randomly and equally divided into 5 groups: control, sham-ovariectomized, and ovariectomized rats treated, respectively, with 17?-estradiol (E2) at doses of 0 µg, 20 µg, and 80 µg/day until the end of the experiment. After induction of TMJOA, TMJs were evaluated by histopathology and microCT, and the expression of Fas, FasL, caspase 3, and caspase 8 was evaluated by real-time polymerase chain-reaction or immunohistochemistry. Another 5 groups of female rats were used to evaluate the effect of estrogen receptor antagonist ICI 182780 on E2 effects on TMJOA, when injected intraperitoneally into the control, sham-ovariectomized, and 80-µg-E2-treated groups. We found that E2 potentiated cartilage degradation and subchondral bone erosion in iodoacetate-induced TMJOA. E2 also potentiated mRNA expression of Fas, FasL, caspase 3, and caspase 8 in the condylar cartilage. Moreover, the estrogen receptor antagonist partially blocked E2 effects on TMJOA. These findings suggest that E2 could aggravate TMJOA, which may be an important mechanism underlying the sexual dimorphism of TMJOA. PMID:23934157

Wang, X D; Kou, X X; Meng, Z; Bi, R Y; Liu, Y; Zhang, J N; Zhou, Y H; Gan, Y H

2013-10-01

36

Radiographic patterns of osteoarthritis of the knee joint in the community: the importance of the patellofemoral joint  

Microsoft Academic Search

The intimate relation which the patella has with the knee joint and quadriceps muscle suggests that patellofemoral joint osteoarthritis is likely to be an important cause of knee pain and disability. Two hundred and seventy three subjects who reported knee pain in a postal questionnaire survey and 240 control subjects consented to have anteroposterior weightbearing and lateral knee radiographs. Each

T E McAlindon; S Snow; C Cooper; P A Dieppe

1992-01-01

37

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

PubMed Central

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

Cammarata, Martha L; Dhaher, Yasin Y

2012-01-01

38

Range of joint motion and disability in patients with osteoarthritis of the knee or hip  

Microsoft Academic Search

OBJECTIVE: To establish the relationships between the range of joint motion (ROM) and disability in patients with osteoarthritis (OA) of the knee or hip. Two related issues were addressed: (1) the inter-relationships between ROMs of joint actions, and (2) the relationship between ROM and disability. METHODS: Data on 198 patients with OA of the knee or hip were used. The

M. P. M. Steultjens; J. Dekker; M. E. van Baar; R. A. B. Oostendorp; J. W. J. Bijlsma

2000-01-01

39

Osteoarthritis and telomere shortening.  

PubMed

Osteoarthritis is the most common disease of joints caused by degradation of articular cartilage and subchondral bone. It is classified as primary form with unknown cause and as secondary form with known etiology. Genetic and epigenetic factors interact with environmental factors and contribute to the development of primary osteoarthritis. Thus far, many polymorphisms associated with osteoarthritis have been identified and recent studies also indicate the involvement of epigenetic factors (e.g., telomere shortening) in the initiation of this disorder. Accelerated shortening of telomeres was detected in osteoarthritis and other age-related diseases. Studies revealed that telomere length is severely reduced in blood leukocytes and chondrocytes of patients with osteoarthritis, and this may contribute to the initiation and development of osteoarthritis, whose major cause is still unknown. PMID:25366419

Kuszel, Lukasz; Trzeciak, Tomasz; Richter, Magdalena; Czarny-Ratajczak, Malwina

2015-05-01

40

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

NASA Astrophysics Data System (ADS)

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.

Maezaki, Nobutaka; Ezumi, Tsutomu; Hachiya, Masashi

41

Association between facet joint osteoarthritis and the Oswestry Disability Index  

PubMed Central

AIM: To investigate the correlation of facet joint osteoarthritis (FJOA) at lumbar levels L4/L5 and L5/S1 and the Oswestry Disability Index (ODI). METHODS: The study involved lumbar MRIs of 591 patients with a mean age of 47.3 years. The MRIs of the lumbar spine were performed on a 1.5 Tesla scanner (Magnetom® Avanto, Siemens AG, Erlangen, Germany) using a dedicated receive only spine coil. After initial blinding, each dataset was evaluated by 2 board certified radiologist with more than 5 years experience in musculoskeletal imaging. In total 2364 facet joints were graded. Degenerative changes of the facet joints were evaluated according to the 4-point scale as proposed by Weishaupt et al Functional status was assessed using the ODI. The index is scored from 0 to 100 and interpreted as follows: 0%-20%, minimal disability; 20%-40%, moderate disability; 40%-60%, severe disability; 60%-80%, crippled; 80%-100%, patients are bedbound. Spearman’s coefficient of rank correlation was used for statistical analysis, with significance set at P < 0.05. RESULTS: In total 2364 facet joints at lumbar levels L4/5 and L5/S1 were analysed in 591 individuals. FJOA was present in 97% (L4/L5) and 98% (L5/S1). At level L4/5 (left/right) 17/15 (2.9%/2.5%) were described as grade 0, 146/147 (24.7%/24.9%) as grade 1, 290/302 (49.1%/51.1%) as grade 2 and 138/127 (23.4%/21.5%) as grade 3. At level L5/S1 (left/right) 10/11 (1.7%/1.9%) were described as grade 0, 136/136 (23.0%/23.0%) as grade 1, 318/325 (53.8%/55.0%) as grade 2 and 127/119 (21.5%/20.1%) as grade 3. Regarding the ODI scores, patients’ disability had a minimum of 0% and a maximum of 91.11% with an arithmetic mean of 32.77% ± 17.02%. The majority of patients (48.39%) had moderate functional disability (21%-40%). There was no significant correlation between FJOA and ODI on both sides of lumbar level L4/5 and on the left side of lumbar level L5/S1. A weak positive correlation was evaluated between ODI and FJOA on the right side of lumbar level L5/S1. CONCLUSION: The missing correlation of FJOA and ODI confirms our clinical experience that imaging alone is an insufficient approach explaining low back pain. Clinical correlation is imperative for an adequate diagnostic advance in patients with low back pain. PMID:25431643

Maataoui, Adel; Vogl, Thomas J; Middendorp, Marcus; Kafchitsas, Konstantinos; Khan, M Fawad

2014-01-01

42

Dental disease and periprosthetic joint infection.  

PubMed

? The number of patients with end-stage osteoarthritis is increasing, and treatment with hip and knee arthroplasty is expected to increase over the next several decades. ? Dental disease has long been anecdotally associated with increased periprosthetic joint infections, although case-control studies do not support this relationship. ? While most recent guidelines for the prevention of endocarditis have favored treatment of fewer patients, the most recent recommendations for prevention of periprosthetic joint infection have increased the number of patients who would receive antibiotics before a dental procedure. ? Antibiotics given before a dental procedure decrease the risk of bacteremia from the oral cavity, but this is of uncertain clinical importance. ? The number of patients who would require antibiotics before dental procedures to prevent one periprosthetic joint infection greatly outnumbers the number of patients who would experience an adverse event associated with antibiotics given before a dental procedure. PMID:24430417

Young, Heather; Hirsh, Joel; Hammerberg, E Mark; Price, Connie S

2014-01-15

43

Grading of monosodium iodoacetate-induced osteoarthritis reveals a concentration-dependent sensitization of nociceptors in the knee joint of the rat  

Microsoft Academic Search

Osteoarthritis (OA) is a degenerative joint disease characterized by joint pain for which there is currently no effective treatment. Previous studies have found that intra-articular injection of monosodium iodoacetate (MIA) caused a dose-dependent destruction of rat knees with concomitant increased pain. In this study, varying degrees of OA were induced by intra-articular injection of 0.1mg, 0.3mg and 3mg MIA. Electrophysiological

Niklas Schuelert; Jason J. McDougall

2009-01-01

44

Is running associated with degenerative joint disease  

SciTech Connect

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.

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

45

Effects of joint capsule tissue on cartilage degradation in an in vitro joint injury model  

E-print Network

Osteoarthritis is a degenerative disease of the whole joint that affects an estimated 20.7 million Americans. Traumatic joint injury causes an increase in risk for the development of osteoarthritis. A previously developed ...

Lin, Stephanie Norris, 1980-

2004-01-01

46

Prediction of the progression of joint space narrowing in osteoarthritis of the knee by bone scintigraphy  

Microsoft Academic Search

OBJECTIVES--To test the hypothesis that bone scintigraphy will predict the outcome of osteoarthritis (OA) of the knee joint. METHODS--Ninety four patients (65 women, 29 men; mean age 64.2 years) with established OA of one or both knee joints were examined in 1986, when radiographs and bone scan images (early and late phase) were also obtained. The patients were recalled, re-examined,

P Dieppe; J Cushnaghan; P Young; J Kirwan

1993-01-01

47

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

NASA Astrophysics Data System (ADS)

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.

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

2009-02-01

48

Is patellofemoral joint osteoarthritis an under-recognised outcome of anterior cruciate ligament reconstruction? A narrative literature review.  

PubMed

Patellofemoral joint (PFJ) osteoarthritis (OA) is a prevalent disease capable of being a potent source of knee symptoms. Although anterior cruciate ligament (ACL) injury and reconstruction (ACLR) are well-established risk factors for the development of tibiofemoral joint OA, PFJ OA after ACL reconstruction has gone largely unrecognised. This is despite the high prevalence of anterior knee pain after ACLR, which can reduce the capacity for physical activity and quality of life. The susceptibility of the PFJ to degenerative change after ACLR may have implications for current rehabilitation strategies. This review summarises the evidence describing the prevalence of PFJ OA after ACLR and examines why this compartment may be at increased risk of early onset OA after ACLR. Strategies that address the modifiable factors for risk of PFJ OA may aid in alleviating joint loads and symptoms for people after ACLR. PMID:23038783

Culvenor, Adam G; Cook, Jill L; Collins, Natalie J; Crossley, Kay M

2013-01-01

49

Failed joint unloading implant system in the treatment of medial knee osteoarthritis.  

PubMed

In the setting of end-stage osteoarthritis of the knee, total knee arthroplasty is the gold-standard treatment. Recently, a minimally invasive, joint preserving treatment option in the treatment of medial osteoarthritis of the knee has been developed. It is called the KineSpring(®) (Moximed(®) International GmbH, Zurich, Switzerland). The goal of this novel device is to reduce medial compartment loading without significantly affecting the loading of the lateral compartment. In this context, the current authors present a case of device failure using these new implants, which at 7 months post-op necessitated revision surgery with complete removal of the device. PMID:23912420

Citak, Mustafa; Kendoff, Daniel; O Loughlin, Padhraig F; Klatte, Till O; Gebauer, Matthias; Gehrke, Thorsten; Haasper, Carl

2013-11-01

50

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

PubMed Central

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

Kircher, Jörn; Kuerner, Konstanze; Morhard, Markus; Krauspe, Rüdiger; Habermeyer, Peter

2014-01-01

51

TRPV4 as a therapeutic target for joint diseases.  

PubMed

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

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

2015-04-01

52

Post-Injury Response Could Be Key Step in Osteoarthritis Development  

MedlinePLUS

... Injury Response Could be Key Step in Osteoarthritis Development Scientists long considered osteoarthritis (OA) a disease of ... the innate immune system, is critical to the development of OA. Through analyses of joint tissue and ...

53

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

PubMed

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

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

54

The prevalence of erosive osteoarthritis in carpometacarpal joints and its clinical burden in symptomatic community-dwelling adults  

PubMed Central

Summary Objective To estimate the prevalence of erosive disease in first carpometacarpal joints (CMCJs) and investigate its clinical impact compared with radiographic thumb base (TB) osteoarthritis (OA). Patient and methods Standardized assessments with hand radiographs were performed in participants of two population-based cohort studies in North Staffordshire with hand symptoms lasting ?1 day in the past month. Erosive disease was defined as the presence of eroded or remodeled phase in ?1 interphalangeal joint (IPJ) or first CMCJ following the Verbruggen–Veys classification. Hand pain and function were assessed with Australian/Canadian Hand Osteoarthritis Index (AUSCAN). Prevalence was estimated by dividing the number of persons with erosive lesions by population size. Linear and logistic regression analyses were used to contrast clinical determinants between persons with erosions and with radiographic TB OA. Results were presented as mean differences and odds ratios (ORs) with 95% confidence intervals (95% CI), adjusted for age, sex and radiographic severity. Results 1,076 participants were studied (60% women, mean age 64.7 years (SD 8.3); 24 persons had erosive disease in the TB. The prevalence of erosive disease in first CMCJs was 2.2% (95% CI 1.4, 3.3). Only 0.5% (95% CI 0.2, 1.2) had erosive disease affecting IPJs and first CMCJs combined. More persons with erosive disease of first CMCJs reported pain in their TB than persons with radiographic TB OA, AUSCAN pain and function scores were similar. Conclusion Erosive disease of first CMCJs was present in 2.2% of subjects with hand pain and was often not accompanied by erosions in IPJs. Erosive disease was associated with TB pain, but not with the level of pain, when compared with radiographic TB OA. PMID:24680934

Kwok, W.Y.; Kloppenburg, M.; Marshall, M.; Nicholls, E.; Rosendaal, F.R.; Peat, G.

2014-01-01

55

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

NASA Astrophysics Data System (ADS)

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.

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

2010-02-01

56

Osteoarthritis in Temporomandibular Joint of Col2a1 Mutant Mice  

PubMed Central

Objective Col2a1 gene mutations cause premature degeneration of knee articular cartilage in disproportionate micromelia (Dmm) and spondyloepiphesial dysplasia congenita (sedc) mice. The present study analyzes the temporomandibular joint (TMJ) in Col2a1 mutant mice in order to provide an animal model of TMJ osteoarthritis (OA) that may offer better understanding of the progression of this disease in humans. Design Dmm/+ mice and controls were compared at two, six, nine and 12 months. Craniums were fixed, processed to paraffin sections, stained with Safranin-O/Fast Green, and analyzed with light microscopy. OA was quantified using a Mankin scoring procedure. Unfolded protein response (UPR) assay was performed and immunohistochemistry (IHC) was used to assay for known OA biomarkers. Results Dmm/+ TMJs showed fissuring of condylar cartilage as early as 6 months of age. Chondrocytes were clustered, leaving acellular regions in the matrix. Significant staining of HtrA1, Ddr2 and Mmp-13 was observed in Dmm/+ mice (p< 0.01). We detected upregulation of the UPR in knee but not TMJ. Conclusions Dmm/+ mice are subject to early-onset OA in the TMJ. We observed upregulation of biomarkers and condylar cartilage degradation concomitant with OA. An upregulated UPR may exacerbate the onset of OA. The Dmm/+ mouse TMJ is a viable model for the study of the progression of OA in humans. PMID:23518238

Ricks, M. L.; Farrell, J.T.; Falk, D. J.; Holt, D W.; Rees, M.; Carr, J.; Williams, T.; Nichols, B.A.; Bridgewater, L. C.; Reynolds, P. R.; Kooyman, D L; Seegmiller, R. E.

2013-01-01

57

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

PubMed

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

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

2013-11-01

58

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

NASA Astrophysics Data System (ADS)

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.

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

2011-03-01

59

Regulation and Role of TGF? Signaling Pathway in Aging and Osteoarthritis Joints  

PubMed Central

Transforming growth factor beta (TGF?) is a major signalling pathway in joints. This superfamilly is involved in numerous cellular processes in cartilage. Usually, they are considered to favor chondrocyte differentiation and cartilage repair. However, other studies show also deleterious effects of TGF? which may induce hypertrophy. This may be explained at least in part by alteration of TGF? signaling pathways in aging chondrocytes. This review focuses on the functions of TGF? in joints and the regulation of its signaling mediators (receptors, Smads) during aging and osteoarthritis. PMID:25489490

Baugé, Catherine; Girard, Nicolas; Lhuissier, Eva; Bazille, Celine; Boumediene, Karim

2014-01-01

60

All cause and disease specific mortality in patients with knee or hip osteoarthritis: population based cohort study  

PubMed Central

Objective To examine all cause and disease specific mortality in patients with osteoarthritis of the knee or hip. Design Population based cohort study. Setting General practices in the southwest of England. Participants 1163 patients aged 35 years or over with symptoms and radiological confirmation of osteoarthritis of the knee or hip. Main outcome measures Age and sex standardised mortality ratios and multivariable hazard ratios of death after a median of 14 years’ follow-up. Results Patients with osteoarthritis had excess all cause mortality compared with the general population (standardised mortality ratio 1.55, 95% confidence interval 1.41 to 1.70). Excess mortality was observed for all disease specific causes of death but was particularly pronounced for cardiovascular (standardised mortality ratio 1.71, 1.49 to 1.98) and dementia associated mortality (1.99, 1.22 to 3.25). Mortality increased with increasing age (P for trend <0.001), male sex (adjusted hazard ratio 1.59, 1.30 to 1.96), self reported history of diabetes (1.95, 1.31 to 2.90), cancer (2.28, 1.50 to 3.47), cardiovascular disease (1.38, 1.12 to 1.71), and walking disability (1.48, 1.17 to 1.86). However, little evidence existed for increased mortality associated with previous joint replacement, obesity, depression, chronic inflammatory disease, eye disease, or presence of pain at baseline. The more severe the walking disability, the higher was the risk of death (P for trend <0.001). Conclusion Patients with osteoarthritis are at higher risk of death compared with the general population. History of diabetes, cancer, or cardiovascular disease and the presence of walking disability are major risk factors. Management of patients with osteoarthritis and walking disability should focus on effective treatment of cardiovascular risk factors and comorbidities, as well as on increasing physical activity. PMID:21385807

2011-01-01

61

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

Microsoft Academic Search

ABSTRACT: 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

Mehrnaz Maleki-Fischbach; Joanne M Jordan

2010-01-01

62

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)

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.

Sun, Yao; Sobel, Eric; Jiang, Huabei

2013-05-01

63

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

PubMed Central

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

Uth, Kristin; Trifonov, Dimitar

2014-01-01

64

Excision of Femoral Head and Neck for Treatment of Coxofemoral Degenerative Joint Disease in a Rhesus Macaque (Macaca mulatta)  

PubMed Central

Nonhuman primates are a valuable model for osteoarthritis. Osteoarthritis has been extensively studied in nonhuman primates in both naturally occurring and induced disease states. However, little published information describes naturally occurring osteoarthritis of the coxofemoral joints of nonhuman primates. We report a case of naturally occurring coxofemoral joint osteoarthritis in a rhesus macaque. This case radiographically resembled hip dysplasia reported in other species and demonstrated a rapid progression in severity of lameness, with accompanying loss of muscle mass in the affected limb. We excised the femoral head and neck to alleviate the pain that accompanied the osteoarthritis. Physical therapy was initiated, and dual-energy X-ray absorptiometry and video recordings were performed to evaluate the macaque's response to surgical intervention. By 3 mo postoperatively, the macaque had regained full use of the affected limb. PMID:23561889

Dufour, Jason P; Phillippi-Falkenstein, Kathrine; Bohm, Rudolf P; Veazey, Ronald S; Carnal, Jean

2012-01-01

65

The Effects of Various Kinds of Lateral Wedge Insoles on Performance of Individuals with Knee Joint Osteoarthritis  

PubMed Central

Background: Knee joint osteoarthritis (OA) is one of the most incapacitating diseases affecting older population, which is associated with pain and functional limitation. Various kinds of conservative treatment have been used to decrease knee pain and to improve the quality of life of the subjects suffering from this disease. There are discrepancies in the clinical effects reported for the use of lateral wedge insole in spite of being used as one of the first conservative mechanical treatments for patients with medial compartments of knee OA. Methods: A total of 36 subjects with medial knee compartment OA were recruited in this research project. Subjects were randomized into two groups to receive 3- and 7-mm lateral wedge insoles based on the date of birth of the participants. Some parameters such as severity of knee pain, Tibiofemoral angle (TFA), severity of OA, and quality of life were selected in this research project. Results: The use of both 3-mm and 7-mm lateral wedge insole improves the quality of life and decreases knee joint pain. However, the effect of 7 mm lateral wedge insole was more than that of 3 mm. Conclusion: Using lateral wedge insole is a simple, inexpensive therapy for decreasing pain and improving quality of life; however, most research must be carried out to find the effects of lateral wedge on severity of knee joint OA and aligning TFA. PMID:23112895

Rafiaee, Masoud; Karimi, Mohammad T

2012-01-01

66

The Effects of Common Footwear on Joint Loading in Osteoarthritis of the Knee  

PubMed Central

Objective Elevated joint loads during walking have been associated with the severity and progression of osteoarthritis (OA) of the knee. Footwear may have the potential to alter these loads. This study compared the effects of several common shoe types on knee loading in subjects with OA of the knee. Methods 31 subjects (10 men, 21 women) with radiographic and symptomatic knee OA underwent gait analyses using an optoelectronic camera system and multi-component force plate. In each case, gait was evaluated barefoot and while wearing 4 different shoes: 1) clogs (Dansko®), 2) stability shoes (Brooks Addiction®), 3) flat walking shoes (Puma H Street®), and 4) flip-flops. Peak knee loads were compared between the different footwear conditions. Results Overall, the clogs and stability shoes, resulted in a significantly higher peak knee adduction moment (3.1±0.7 and 3.0±0.7 %BW*ht, respectively, ~15% higher, p<0.05)) compared with that of flat walking shoes (2.8±0.7%BW*ht), flip-flops (2.7±0.8%BW*ht) and barefoot walking (2.7±0.7%BW*ht). There were no statistically significant differences in knee loads with the flat walking shoes and flip-flops compared to barefoot walking. Conclusions These data confirm that footwear may have significant effects on knee loads during walking in subjects with OA of the knee. Flexibility and heel height may be important differentiating characteristics of shoes which affect knee loads. In light of the strong relationship between knee loading and OA, the design and biomechanical effects of modern footwear should be more closely evaluated in terms of their effects on the disease. PMID:20191571

Shakoor, Najia; Sengupta, Mondira; Foucher, Kharma C.; Wimmer, Markus A.; Fogg, Louis F.; Block, Joel A.

2010-01-01

67

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  

Microsoft Academic Search

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

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

2005-01-01

68

Compensatory load redistribution in naturally occurring osteoarthritis of the elbow joint and induced weight-bearing lameness of the forelimbs compared with clinically sound dogs  

Microsoft Academic Search

The current study investigated the compensatory load redistribution due to osteoarthritis of the elbow joint using ground reaction forces of all four legs, simultaneously measured on a treadmill with integrated force plates. Three groups of dogs were used: the first group was clinically sound; the second group suffered from a naturally occurring osteoarthritis of the elbow joint, and a reversible

Barbara A. Bockstahler; A. Vobornik; Marion Müller; Christian Peham

2009-01-01

69

Effect of the Japanese herbal medicine, Boiogito, on the osteoarthritis of the knee with joint effusion  

PubMed Central

Background Boiogito (Japanese herbal medicine, Tsumura Co. Tokyo, Japan) contains sinomenin which inhibits inflammatory reactions. Since sinomenine is a principle component of the Boiogito, there is a possibility of it being effective on osteoarthritis (OA) of the knee with joint effusion. However, there is no report concerning the effectiveness of Boiogito on knee OA. The objective of the present study is to investigate the therapeutic effect of Boiogito on OA of the knee associated with joint effusion in a comparative study among randomly assigned groups. Methods Study was performed using 50 patients who were diagnosed with primary osteoarthritis of the knee with joint effusion. The patients were randomly assigned to two groups: one group (25 patients) using both loxoprofen (2-{4-[(2-oxocyclopentyl) methyl]} propanoic acid) and Boiogito and the other group (25 patients) using loxoprofen, and were evaluated during a 12 week observation period. The assessment parameters including knee scores in the Knee Society Rating System including Knee score and Functional scores, amount of joint effusion by joint puncture in clinically detected cases, the 36-items short form of the Medical Outcome Study Questionnaire (SF-36) as a measurement of health related quality of life were used. Results The knee scores based on the Knee Society Rating System were improved in both groups. The staircase climbing up and down ability in the Knee society rating system functional score was significantly improved in the group using Boiogito and loxoprofen compared to the loxoprofen group. In the evaluation using SF-36, significant improvements were found in the scores in both groups in physical functioning after 12 weeks. The amount of joint fluid was significantly decreased at 4, 8 and 12 weeks compared to pre-administration baseline in the group using Boiogito and loxoprofen. A side effect of Boiogito, dry mouth, was found in one case. The symptom was mild and improved immediately after discontinuation of administration. Conclusion The results indicated that Boiogito have a possibility for a treatment modality for joint effusion with osteoarthritis of the knee. PMID:22230247

2012-01-01

70

Change of prostaglandin E level in joint fluids after treatment with flurbiprofen in patients with rheumatoid arthritis and osteoarthritis  

Microsoft Academic Search

The prostaglandin E (PGE) level in the knee joint fluid was determined by radioimmunoassay before and after anti-inflammatory therapy with flurbiprofen in 8 patients with rheumatoid arthritis (RA) and 4 patients with osteoarthritis (OA). The level of PGE in RA joint fluids before the anti-inflammatory treatment was 9.5-1.2 ng\\/ml and in proportion with the leucocyte count in the joint fluid.

M Tokunaga; K Ohuchi; S Yoshizawa; S Tsurufuji; A Rikimaru; E Wakamatsu

1981-01-01

71

Grading of monosodium iodoacetate-induced osteoarthritis reveals a concentration-dependent sensitization of nociceptors in the knee joint of the rat.  

PubMed

Osteoarthritis (OA) is a degenerative joint disease characterized by joint pain for which there is currently no effective treatment. Previous studies have found that intra-articular injection of monosodium iodoacetate (MIA) caused a dose-dependent destruction of rat knees with concomitant increased pain. In this study, varying degrees of OA were induced by intra-articular injection of 0.1 mg, 0.3 mg and 3 mg MIA. Electrophysiological recordings were made from knee joint primary afferents in response to rotation of the joint and firing frequencies were determined and compared to saline-injected control joints. The analgesic effect of local application of the classic non-steroidal anti-inflammatory drug (NSAID) diclofenac (0.1 mg/0.1 ml bolus) was also determined in each group. Joint afferent firing frequency was significantly enhanced in OA knees compared to saline injected control joints and the magnitude of this sensitization showed a direct relationship with increasing dose of MIA. Diclofenac reduced nociception significantly in the 3 mg MIA treated joint, but had no effect on nerve mechanosensitivity in rats with milder OA. This study shows for the first time that MIA produces a graded sensitization of joint nociceptors making this a useful model for the study of pain mechanisms in joints with progressive OA severity. The anti-nociceptive effect of diclofenac further indicates that the MIA model offers an attractive means of objectively testing potential therapeutic agents. PMID:19716399

Schuelert, Niklas; McDougall, Jason J

2009-11-13

72

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

PubMed Central

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

Mobasheri, Ali

2011-01-01

73

Applications of proteomics to osteoarthritis, a musculoskeletal disease characterized by aging.  

PubMed

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

Mobasheri, Ali

2011-01-01

74

Arthroscopy vs. MRI for a detailed assessment of cartilage disease in osteoarthritis: diagnostic value of MRI in clinical practice  

PubMed Central

Background In patients with osteoarthritis, a detailed assessment of degenerative cartilage disease is important to recommend adequate treatment. Using a representative sample of patients, this study investigated whether MRI is reliable for a detailed cartilage assessment in patients with osteoarthritis of the knee. Methods In a cross sectional-study as a part of a retrospective case-control study, 36 patients (mean age 53.1 years) with clinically relevant osteoarthritis received standardized MRI (sag. T1-TSE, cor. STIR-TSE, trans. fat-suppressed PD-TSE, sag. fat-suppressed PD-TSE, Siemens Magnetom Avanto syngo MR B 15) on a 1.5 Tesla unit. Within a maximum of three months later, arthroscopic grading of the articular surfaces was performed. MRI grading by two blinded observers was compared to arthroscopic findings. Diagnostic values as well as intra- and inter-observer values were assessed. Results Inter-observer agreement between readers 1 and 2 was good (kappa = 0.65) within all compartments. Intra-observer agreement comparing MRI grading to arthroscopic grading showed moderate to good values for readers 1 and 2 (kappa = 0.50 and 0.62, respectively), the poorest being within the patellofemoral joint (kappa = 0.32 and 0.52). Sensitivities were relatively low at all grades, particularly for grade 3 cartilage lesions. A tendency to underestimate cartilage disorders on MR images was not noticed. Conclusions According to our results, the use of MRI for precise grading of the cartilage in osteoarthritis is limited. Even if the practical benefit of MRI in pretreatment diagnostics is unequivocal, a diagnostic arthroscopy is of outstanding value when a grading of the cartilage is crucial for a definitive decision regarding therapeutic options in patients with osteoarthritis. PMID:20406481

2010-01-01

75

Wrist osteoarthritis.  

PubMed

Painful wrist osteoarthritis can result in major functional impairment. Most cases are related to posttraumatic sequel, metabolic arthropathies, or inflammatory joint disease, although wrist osteoarthritis occurs as an idiopathic condition in a small minority of cases. Surgery is indicated only when conservative treatment fails. The main objective is to ensure pain relief while restoring strength. Motion-preserving procedures are usually preferred, although residual wrist mobility is not crucial to good function. The vast array of available surgical techniques includes excisional arthroplasty, limited and total fusion, total wrist denervation, partial and total arthroplasty, and rib-cartilage graft implantation. Surgical decisions rest on the cause and extent of the degenerative wrist lesions, degree of residual mobility, and patient's wishes and functional demand. Proximal row carpectomy and four-corner fusion with scaphoid bone excision are the most widely used surgical procedures for stage II wrist osteoarthritis secondary to scapho-lunate advanced collapse (SLAC) or scaphoid non-union advanced collapse (SNAC) wrist. Proximal row carpectomy is not indicated in patients with stage III disease. Total wrist denervation is a satisfactory treatment option in patients of any age who have good range of motion and low functional demands; furthermore, the low morbidity associated with this procedure makes it a good option for elderly patients regardless of their range of motion. Total wrist fusion can be used not only as a revision procedure, but also as the primary surgical treatment in heavy manual labourers with wrist stiffness or generalised wrist-joint involvement. The role for pyrocarbon implants, rib-cartilage graft implantation, and total wrist arthroplasty remains to be determined, given the short follow-ups in available studies. PMID:25596986

Laulan, J; Marteau, E; Bacle, G

2015-02-01

76

Effect of Low-Level Laser on Healing of Temporomandibular Joint Osteoarthritis in Rats  

PubMed Central

Objective: Temporomandibular disorders (TMD) are clinical conditions characterized by pain and sounds of the temporomandibular joint (TMJ). This study was designed to assess the effect of low-level laser therapy (LLLT) on healing of osteoarthritis in rats with TMD. Materials and Methods: Thirty-two male Wistar rats (250–200 g) were housed in standard plastic cages. After injection of Complete Freund’s adjuvant into the TMJ, rats were randomly divided into two groups of 16 (case and control) and anesthetized; then osteoarthritis was induced via intraarticular injection of 50 µl of Complete Freund’s adjuvant; into the bilateral TMJs. In the case group, LLLT was done transcutaneously for 10 minutes daily, starting the day after the confirmation of osteoarthritis. Exposure was performed for 10 minutes at the right side of the TMJ with 880 nm low-level laser with 100 mW power and a probe diameter of 0.8 mm. Control rats were not treated with laser. Results: After three days of treatment the grade of cartilage defects, number of inflammatory cells, angiogenesis, number of cell layers and arthritis in rats in the case group were not significantly different compared with controls (P>0.05). After seven days, the grade of cartilage defects, number of inflammatory cells, number of cell layers, and arthritis in the case group improved compared to controls (P<0.05); angiogenesis in both groups was similar. Conclusion: Treatment of TMD with LLLT after 7 days of irradiation with a wavelength of 880 nm was associated with a greater improvement compared to the control group. PMID:25628667

Peimani, Ali; Sardary, Farimah

2014-01-01

77

Managing osteoarthritis.  

PubMed

Osteoarthritis (OA) is a degenerative disease that affects 27 million American women. All body joints can be affected. OA is more prevalent in women than men. Most women, with a diagnosis of OA report discomfort in the knee, hip, back and wrist joints. The discomforts of OA can be managed with life style changes before over the counter medications are introduced. Surgical interventions should be considered as the last treatment choice. Once a medication choice has been introduced, nurses can review methods to women that will improve their ability to continue activities of daily living and decrease the impact of the discomforts of OA. Nurses can be instrumental in the management of OA by providing education about different intervention choices for the management of OA symptoms. PMID:25690818

Kodadek, Marie

2015-02-01

78

Radiographic joint space narrowing in osteoarthritis of the knee: relationship to meniscal tears and duration of pain  

Microsoft Academic Search

Objective  The objective of this study was to assess, with knee radiography, joint space narrowing (JSN) and its relationship to meniscal\\u000a tears, anterior cruciate ligament (ACL) ruptures, articular cartilage erosion, and duration of pain in patients with knee\\u000a osteoarthritis.\\u000a \\u000a \\u000a \\u000a Materials and methods  A total of 140 patients who had knee osteoarthritis and underwent primary total knee replacement (TKR) surgery, with unicompartmental\\u000a medial

Wing P. Chan; Guo-Shu Huang; Shu-Mei Hsu; Yue-Cune Chang; Wei-Pin Ho

2008-01-01

79

Joint unloading implant modifies subchondral bone trabecular structure in medial knee osteoarthritis: 2-year outcomes of a pilot study using fractal signature analysis  

PubMed Central

Background Knee osteoarthritis (OA) is largely attributable to chronic excessive and aberrant joint loading. The purpose of this pilot study was to quantify radiographic changes in subchondral bone after treatment with a minimally invasive joint unloading implant (KineSpring® Knee Implant System). Methods Nine patients with unilateral medial knee OA resistant to nonsurgical therapy were treated with the KineSpring System and followed for 2 years. Main outcomes included Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, function, and stiffness subscores and independent core laboratory determinations of joint space width and fractal signature of the tibial cortex. Results WOMAC scores, on average, improved by 92% for pain, 91% for function, and 79% for stiffness over the 2-year follow-up period. Joint space width in the medial compartment of the treated knee significantly increased from 0.9 mm at baseline to 3.1 mm at 2 years; joint space width in the medial compartment of the untreated knee was unchanged. Fractal signatures of the vertically oriented trabeculae in the medial compartment decreased by 2.8% in the treated knee and increased by 2.1% in the untreated knee over 2 years. No statistically significant fractal signature changes were observed in the horizontally oriented trabeculae in the medial compartment or in the horizontal or vertical trabeculae of the lateral compartment in the treated knee. Conclusion Preliminary evidence suggests that the KineSpring System may modify knee OA disease progression by increasing joint space width and improving subchondral bone trabecular integrity, thereby reducing pain and improving joint function. PMID:25670891

Miller, Larry E; Sode, Miki; Fuerst, Thomas; Block, Jon E

2015-01-01

80

Reactive oxygen species and superoxide dismutases: role in joint diseases.  

PubMed

Reactive oxygen species (ROS) are produced in many normal and abnormal processes in humans, including atheroma, asthma, joint diseases, aging, and cancer. The superoxide anion O(2)(-) is the main ROS. Increased ROS production leads to tissue damage associated with inflammation. Superoxide dismutases (SODs) convert superoxide to hydrogen peroxide, which is then removed by glutathione peroxidase or catalase. Thus, SODs prevent the formation of highly aggressive ROS, such as peroxynitrite or the hydroxyl radical. Experimental models involving SOD knockout or overexpression are beginning to shed light on the pathophysiological role of SOD in humans. Although the antiinflammatory effects of exogenous native SOD (orgotein) are modest, synthetic SOD mimetics hold considerable promise for modulating the inflammatory response. In this review, we discuss new knowledge about the role of the superoxide anion and its derivates as mediators of inflammation and the role of SODs and SOD mimetics as antioxidant treatments in joint diseases such as rheumatoid arthritis, osteoarthritis, and crystal-induced arthropathies. PMID:17590367

Afonso, Valéry; Champy, Romuald; Mitrovic, Dragoslav; Collin, Pascal; Lomri, Abderrahim

2007-07-01

81

Hydroxyapatite deposition disease of the joint  

Microsoft Academic Search

Basic calcium phosphate (BCP) crystals include partially carbonate-substituted hydroxyapatite, octacalcium phosphate, and\\u000a tricalcium phosphate. They may form deposits, which are frequently asymptomatic but may give rise to a number of clinical\\u000a syndromes including calcific periarthritis, Milwaukee shoulder syndrome, and osteoarthritis, in and around joints. Recent\\u000a data suggest that magnesium whitlockite, another form of BCP, may play a pathologic role in

Eamonn S. Molloy; Geraldine M. McCarthy

2003-01-01

82

Effects of Diacerein at the Molecular Level in the Osteoarthritis Disease Process  

PubMed Central

In osteoarthritis (OA), the alterations in joint tissues are numerous and involve morphological, biochemical and metabolic changes and an upregulation of the inflammatory pathways. The focus of this article is a brief narrative review of the effects of diacerein, an antirheumatic drug from the anthraquinone chemical class, and its active metabolite, rhein, on the factors that participate in the complex interaction between OA tissues and cells leading to the progression of joint structural changes. PMID:22870441

Martel-Pelletier, Johanne; Pelletier, Jean-Pierre

2010-01-01

83

Tibial coverage, meniscus position, size and damage in knees discordant for joint space narrowing – data from the Osteoarthritis Initiative  

PubMed Central

SUMMARY Introduction Meniscal extrusion is thought to be associated with less meniscus coverage of the tibial surface, but the association of radiographic disease stage with quantitative measures of tibial plateau coverage is unknown. We therefore compared quantitative and semi-quantitative measures of meniscus position and morphology in individuals with bilateral painful knees discordant on medial joint space narrowing (mJSN). Methods A sample of 60 participants from the first half (2,678 cases) of the Osteoarthritis Initiative cohort fulfilled the inclusion criteria: bilateral frequent pain, Osteoarthritis Research Society International (OARSI) mJSN grades 1–3 in one, no-JSN in the contra-lateral (CL), and no lateral JSN in either knee (43 unilateral mJSN1; 17 mJSN2/3; 22 men, 38 women, body mass index (BMI) 31.3 ± 3.9 kg/m2). Segmentation and three-dimensional quantitative analysis of the tibial plateau and meniscus, and semi-quantitative evaluation of meniscus damage (magnetic resonance imaging (MRI) osteoarthritis knee score – MOAKS) was performed using coronal 3T MR images (MPR DESSwe and intermediate-weighted turbo spin echo (IW-TSE) images). CL knees were compared using paired t-tests (between-knee, within-person design). Results Medial tibial plateau coverage was 36 ± 9% in mJSN1 vs 45 ± 8% in CL no-JSN knees, and was 31 ± 9% in mJSN2/3 vs 46 ± 6% in no-JSN knees (both P < 0.001). mJSN knees showed greater meniscus extrusion and damage (MOAKS), but no significant difference in meniscus volume. No significant differences in lateral tibial coverage, lateral meniscus morphology or position were observed. Conclusions Knees with medial JSN showed substantially less medial tibial plateau coverage by the meniscus. We suggest that the less meniscal coverage, i.e., less mechanical protection may be a reason for greater rates of cartilage loss observed in JSN knees. PMID:23220556

Bloecker, K.; Guermazi, A.; Wirth, W.; Benichou, O.; Kwoh, C.K.; Hunter, D.J.; Englund, M.; Resch, H.; Eckstein, F.

2013-01-01

84

Degenerative joint disease of the acromioclavicular joint: a review.  

PubMed

Osteoarthritis of the acromioclavicular (AC) joint is a common condition causing anterior or superior shoulder pain, especially with overhead and cross-body activities. This most commonly occurs in middle-aged individuals because of degeneration to the fibrocartilaginous disk that cushions the articulations. Diagnosis relies on history, physical examination, imaging, and diagnostic local anesthetic injection. Diagnosis can be challenging given the lack of specificity with positive physical examination findings and the variable nature of AC joint pain. Of note, symptomatic AC osteoarthritis must be differentiated from instability and subtle instability, which may have similar symptoms. Although plain radiographs can reveal degeneration, diagnosis cannot be based on this alone because similar radiographic findings can be seen in asymptomatic individuals. Nonoperative therapy can provide symptomatic relief, whereas patients with persistent symptoms can be considered for resection arthroplasty by open or arthroscopic technique. Both techniques have proven to provide predictable pain relief; however, each has its own unique set of potential complications that may be minimized with an improved understanding of the anatomical and biomechanical characteristics of the joint along with meticulous surgical technique. PMID:23649008

Mall, Nathan A; Foley, Emily; Chalmers, Peter N; Cole, Brian J; Romeo, Anthony A; Bach, Bernard R

2013-11-01

85

Osteoprotegerin reduces the development of pain behaviour and joint pathology in a model of osteoarthritis  

PubMed Central

Background Increased subchondral bone turnover may contribute to pain in osteoarthritis (OA). Objectives To investigate the analgesic potential of a modified version of osteoprotegerin (osteoprotegerin-Fc (OPG-Fc)) in the monosodium iodoacetate (MIA) model of OA pain. Methods Male Sprague Dawley rats (140–260?g) were treated with either OPG-Fc (3?mg/kg, subcutaneously) or vehicle (phosphate-buffered saline) between days 1 and 27 (pre-emptive treatment) or days 21 and 27 (therapeutic treatment) after an intra-articular injection of MIA (1?mg/50?µl) or saline. A separate cohort of rats received the bisphosphonate zoledronate (100?µg/kg, subcutaneously) between days 1 and 25 post-MIA injection. Incapacitance testing and von Frey (1–15?g) hind paw withdrawal thresholds were used to assess pain behaviour. At the end of the study, rats were killed and the knee joints and spinal cord removed for analysis. Immunohistochemical studies using Iba-1 and GFAP quantified levels of activation of spinal microglia and astrocytes, respectively. Joint sections were stained with haematoxylin and eosin or Safranin-O fast green and scored for matrix proteoglycan and overall joint morphology. The numbers of tartrate-resistant acid phosphatase-positive osteoclasts were quantified. N=10 rats/group. Results Pre-emptive treatment with OPG-Fc significantly attenuated the development of MIA-induced changes in weightbearing, but not allodynia. OPG-Fc decreased osteoclast number, inhibited the formation of osteophytes and improved structural pathology within the joint similarly to the decrease seen after pretreatment with the bisphosphonate, zoledronate. Therapeutic treatment with OPG-Fc decreased pain behaviour, but did not improve pathology in rats with established joint damage. Conclusions Our data suggest that early targeting of osteoclasts may reduce pain associated with OA. PMID:23723320

Sagar, Devi Rani; Ashraf, Sadaf; Xu, Luting; Burston, James J; Menhinick, Matthew R; Poulter, Caroline L; Bennett, Andrew J; Walsh, David A; Chapman, Victoria

2014-01-01

86

OARSI–OMERACT initiative: defining thresholds for symptomatic severity and structural changes in disease modifying osteoarthritis drug (DMOAD) clinical trials  

PubMed Central

SUMMARY Objective Total joint replacement has been proposed as an endpoint in disease modifying osteoarthritis drug (DMOAD) randomized clinical trials (RCTs); however, disparities have generated concerns regarding this outcome. A combined Osteoarthritis Research Society International (OARSI)/Outcome Measures in Rheumatology (OMERACT) initiative was launched in 2004 to develop a composite index [‘virtual total joint replacement’ (VJR)] as a surrogate outcome for osteoarthritis (OA) progression in DMOAD RCTs. Our objective was to evaluate the prevalence of patients fulfilling different thresholds of sustained pain, reduced function, and X-ray change in existing DMOAD RCTs. Design Post hoc analysis of summary data from the placebo arm of eight DMOAD RCTs. Results Eight OA RCTs representing 1379 patients were included. Pain was assessed by WOMAC and/or VAS and function by WOMAC and/or Lequesne. Among six knee and two hip studies, 248 (22%) and 132 (51%) patients respectively had X-ray progression [decrease joint space width (JSW) ?0.5 mm]. The prevalence of patients fulfilling clinical and radiographic criteria was highest (n = 163, 12%) in the least stringent scenario (pain + function ?80 at ?2 visits); with few patients (n = 129, 2%) in the most stringent scenario (pain + function ?80 at ?4 visits). Using these prevalence data, a sample size of 352–2144 per group would be needed to demonstrate a 50% difference between groups. Conclusions The prevalence of patients with sustained symptomatic OA of at least a moderate degree with X-ray progression is low. Even using lenient criteria to define VJR, large patient numbers would be required to detect differences between groups in DMOAD RCTs. Investigation of the optimal cutoff threshold and combination of symptoms and radiographic change should be pursued. PMID:22178465

Manno, R.L.; Bingham, C.O.; Paternotte, S.; Gossec, L.; Halhol, H.; Giacovell, G.; Rovati, L.; Mazzuca, S.A.; Clegg, D.O.; Shi, H.; Tajana Messi, E.; Lanzarotti, A.; Dougados, M.

2015-01-01

87

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  

Microsoft Academic Search

Objective  To evaluate how the reading of knee radiographs by site investigators differs from that by an expert musculoskeletal radiologist\\u000a who trained and validated them in a multicenter knee osteoarthritis (OA) study.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  A subset of participants from the Osteoarthritis Initiative progression cohort was studied. Osteophytes and joint space narrowing\\u000a (JSN) were evaluated using Kellgren-Lawrence (KL) and Osteoarthritis Research Society

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

88

Crosslinking of fibrinogen and fibronectin by free radicals: A possible initial step in adhesion formation in osteoarthritis of the temporomandibular joint  

Microsoft Academic Search

Purpose: Adhesion formation in osteoarthritis (OA) of the temporomandibular joint (TMJ) typically results in a sustained limitation of joint movement. We propose the hypothesis that free-radical[ndash ]mediated crosslinking of proteins underlies this adhesion formation in affected joints. Free radicals may cause oxidative modification of proteins, creating an opportunity for the formation of intramolecular and intermolecular crosslinks via covalent bonds. This

Leonore C. Dijkgraaf; Gustavo Zardeneta; Fabian W. Cordewener; Robert S. B. Liem; John P. Schmitz; Lambert G. M. de Bont; Stephen B. Milam

2003-01-01

89

An Orthopedic Perspective. Does Running Cause Osteoarthritis?  

ERIC Educational Resources Information Center

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.…

Pascale, Mark; Grana, William A.

1989-01-01

90

Grading and quantification of hip osteoarthritis severity by analyzing the spectral energy distribution of radiographic hip joint space  

NASA Astrophysics Data System (ADS)

An image analysis system is proposed for the assessment of hip osteoarthritis (OA) severity. Sixty four hips (18 normal, 46 osteoarthritic), corresponding to 32 patients of unilateral or bilateral hip OA were studied. Employing custom developed software, 64 Region Of Interest (ROI) images of Hip Joint Spaces (HJSs) were delineated on patients' digitized radiographs. The Fourier spectrum of each HJS-ROI was computed and expressed in polar coordinates. Spectral signatures, quantifying the radial and angular distribution of HJS spectral energy were formed. Signature descriptors were generated and utilized in the design of a two-level hierarchical decision tree, used for the grading of the severity of the disease. Accordingly, at Level 1, implemented by a multiple classifier system, the discrimination between normal and osteoarthritic hips was performed. At Level 2, the hips that had been successfully characterized as osteoarthritic at Level 1, were further characterized as of ``Mild / Moderate'' or ``Severe'' OA, by the Bayes classifier. A signature descriptors based regression model was designed, so as to quantify OA-severity. The system graded OA reliably, given that the accomplished classification accuracies for Level 1 and Level 2 were 98.4% and 100%, respectively. OA-severity values, expressed by HJS-narrowing, correlated highly (r = 0.9, p < 0.001) with values predicted by the model. The system may contribute to OA-patient management.

Boniatis, I.; Costaridou, L.; Panagiotopoulos, E.; Panayiotakis, G.

2009-08-01

91

Degenerative joint disease: cartilage or vascular disease?  

Microsoft Academic Search

The aetiology of degenerative joint diseases is multifactorial, but one main cause is overloading (mechanical stress). While\\u000a until recently it was well accepted that this represented primarily a disorder of cartilage with reactive subchondral changes,\\u000a there is now some evidence that it might be primarily a subchondral problem with secondary changes in the articular cartilage.\\u000a Early subchondral changes include redistribution

H. Imhof; M. Breitenseher; F. Kainberger; S. Trattnig

1997-01-01

92

Pathogenesis of Degenerative Joint Disease in the Human Temporomandibular Joint  

Microsoft Academic Search

The wide range of disease prevalences reported in epidemiological studies of temporomandibular degenerative joint disease reflects the fact that diagnoses are frequently guided by the presence or absence of non-specific signs and symptoms. Treatment is aimed at alleviating the disease symptoms rather than being guided by an understanding of the underlying disease processes. Much of our current understanding of disease

Christine L. Haskin; Stephen B. Milam; Ivan L. Cameron

1995-01-01

93

Similar Properties of Chondrocytes from Osteoarthritis Joints and Mesenchymal Stem Cells from Healthy Donors for Tissue Engineering of Articular Cartilage  

PubMed Central

Lesions of hyaline cartilage do not heal spontaneously, and represent a therapeutic challenge. In vitro engineering of articular cartilage using cells and biomaterials may prove to be the best solution. Patients with osteoarthritis (OA) may require tissue engineered cartilage therapy. Chondrocytes obtained from OA joints are thought to be involved in the disease process, and thus to be of insufficient quality to be used for repair strategies. Bone marrow (BM) derived mesenchymal stem cells (MSCs) from healthy donors may represent an alternative cell source. We have isolated chondrocytes from OA joints, performed cell culture expansion and tissue engineering of cartilage using a disc-shaped alginate scaffold and chondrogenic differentiation medium. We performed real-time reverse transcriptase quantitative PCR and fluorescence immunohistochemistry to evaluate mRNA and protein expression for a range of molecules involved in chondrogenesis and OA pathogenesis. Results were compared with those obtained by using BM-MSCs in an identical tissue engineering strategy. Finally the two populations were compared using genome-wide mRNA arrays. At three weeks of chondrogenic differentiation we found high and similar levels of hyaline cartilage-specific type II collagen and fibrocartilage-specific type I collagen mRNA and protein in discs containing OA and BM-MSC derived chondrocytes. Aggrecan, the dominant proteoglycan in hyaline cartilage, was more abundantly distributed in the OA chondrocyte extracellular matrix. OA chondrocytes expressed higher mRNA levels also of other hyaline extracellular matrix components. Surprisingly BM-MSC derived chondrocytes expressed higher mRNA levels of OA markers such as COL10A1, SSP1 (osteopontin), ALPL, BMP2, VEGFA, PTGES, IHH, and WNT genes, but lower levels of MMP3 and S100A4. Based on the results presented here, OA chondrocytes may be suitable for tissue engineering of articular cartilage. PMID:23671648

Fernandes, Amilton M.; Herlofsen, Sarah R.; Karlsen, Tommy A.; Küchler, Axel M.; Fløisand, Yngvar; Brinchmann, Jan E.

2013-01-01

94

Neural network analysis of gait biomechanical data for classification of knee osteoarthritis  

Microsoft Academic Search

Osteoarthritis is a degenerative joint disease, which causes the degradation of articular cartilage and subchondral bone. The disease may result in mechanical abnormalities of the joints, including weight bearing joints such as the knees and hips. In this work, we analyze gait biomechanical data using neural network models to predict the level of joint deterioration and the level of pain

J. McBride; S. Zhang; M. Wortley; M. Paquette; G. Klipple; E. Byrd; L. Baumgartner; X. Zhao

2011-01-01

95

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

PubMed Central

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.

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

2015-01-01

96

Mechanisms of osteoarthritis in the knee: MR imaging appearance.  

PubMed

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

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

2014-06-01

97

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

PubMed Central

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

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

2012-01-01

98

Early-onset osteoarthritis of mouse temporomandibular joint induced by partial discectomy  

PubMed Central

Summary Objective The objective of this study is to characterize mouse temporomandibular joint (TMJ) following partial discectomy, since there is no documentation of whether or not partial discectomy can induce early-onset osteoarthritis (OA) in mouse TMJ. Methods Partial discs of TMJ in mice were removed by microsurgery. Histology was performed to characterize articular cartilages from the TMJ of mice. The morphology of the articular cartilages was evaluated using a modified Mankin scoring system. Immunohistostaining was carried out to examine the expression of discoidin domain receptor 2 (Ddr2), a type II collagen receptor, matrix metalloproteinase 13 (Mmp-13), and Mmp-derived type II collagen fragments in the articular cartilage of condyles from the mouse TMJ. Results Articular cartilage degeneration was seen in the mouse TMJ post discectomy, including increased proteoglycan staining in the extracellular matrix at 4 weeks, the appearance of chondrocyte clusters at 8 weeks, reduced proteoglycan staining and fibrillation at 12 weeks and the loss of articular cartilage at 16 weeks. Increased immunostaining for Ddr2, Mmp-13, and Mmp-derived type II collagen fragments was detected. Conclusion Results indicate that partial discectomy induces early-onset OA in mouse TMJ and that increased expression of Mmp-13, likely due to the elevated expression of Ddr2, may be one of the factors responsible for the early-onset OA in mouse TMJ. PMID:19230720

Xu, L.; Polur, I.; Lim, C.; Servais, J. M.; Dobeck, J.; Li, Y.; Olsen, B. R.

2010-01-01

99

Use of dimensionality reduction for structural mapping of hip joint osteoarthritis data  

NASA Astrophysics Data System (ADS)

A visualization-based, computer-oriented, classification scheme is proposed for assessing the severity of hip osteoarthritis (OA) using dimensionality reduction techniques. The introduced methodology tries to cope with the confined ability of physicians to structurally organize the entire available set of medical data into semantically similar categories and provide the capability to make visual observations among the ensemble of data using low-dimensional biplots. In this work, 18 pelvic radiographs of patients with verified unilateral hip OA are evaluated by experienced physicians and assessed into Normal, Mild and Severe following the Kellgren and Lawrence scale. Two regions of interest corresponding to radiographic hip joint spaces are determined and representative features are extracted using a typical texture analysis technique. The structural organization of all hip OA data is accomplished using distance and topology preservation-based dimensionality reduction techniques. The resulting map is a low-dimensional biplot that reflects the intrinsic organization of the ensemble of available data and which can be directly accessed by the physician. The conceivable visualization scheme can potentially reveal critical data similarities and help the operator to visually estimate their initial diagnosis. In addition, it can be used to detect putative clustering tendencies, examine the presence of data similarities and indicate the existence of possible false alarms in the initial perceptual evaluation.

Theoharatos, C.; Boniatis, I.; Panagiotopoulos, E.; Panayiotakis, G.; Fotopoulos, S.

2009-10-01

100

Disease-specific pain measures for osteoarthritis of the knee or hip  

Microsoft Academic Search

Many elders suffer from chronic pain resulting from osteoarthritis (OA) of the knee or hip. This review identifies useful pain measures for assessing OA. Several disease-specific pain measures are discussed: Arthritis Impact Measurement Scales pain subscale, Western Ontario and McMaster University OA Index pain subscale, pain subscales of the Index of Severity for OA of the Hip or of the

Pao-Feng Tsai; Sunghee Tak

2003-01-01

101

Targets, models and challenges in osteoarthritis research  

PubMed Central

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

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

2015-01-01

102

Targets, models and challenges in osteoarthritis research.  

PubMed

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

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

2015-01-01

103

Molecular mechanisms of cartilage remodelling in osteoarthritis  

Microsoft Academic Search

Osteoarthritis (OA) is a degenerative joint disease that is characterized primarily by progressive breakdown of articular cartilage. The loss of proteoglycans, the mineralization of the extracellular matrix (ECM) and the hypertrophic differentiation of the chondrocytes constitute hallmarks of the disease. The pathogenesis of OA includes several pathways, which in single are very well investigated and partly understood, but in their

Jessica Bertrand; Christoph Cromme; Daniel Umlauf; Svetlana Frank; Thomas Pap

2010-01-01

104

How to define responders in osteoarthritis  

PubMed Central

Background Osteoarthritis is a clinical syndrome of failure of the joint accompanied by varying degrees of joint pain, functional limitation, and reduced quality of life due to deterioration of articular cartilage and involvement of other joint structures. Scope Regulatory agencies require relevant clinical benefit on symptoms and structure modification for registration of a new therapy as a disease-modifying osteoarthritis drug (DMOAD). An international Working Group of the European Society on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and International Osteoporosis Foundation was convened to explore the current burden of osteoarthritis, review current regulatory guidelines for the conduct of clinical trials, and examine the concept of responder analyses for improving drug evaluation in osteoarthritis. Findings The ESCEO considers that the major challenges in DMOAD development are the absence of a precise definition of the disease, particularly in the early stages, and the lack of consensus on how to detect structural changes and link them to clinically meaningful endpoints. Responder criteria should help identify progression of disease and be clinically meaningful. The ideal criterion should be sensitive to change over time and should predict disease progression and outcomes such as joint replacement. Conclusion The ESCEO considers that, for knee osteoarthritis, clinical trial data indicate that radiographic joint space narrowing >0.5 mm over 2 or 3 years might be a reliable surrogate measure for total joint replacement. On-going research using techniques such as magnetic resonance imaging and biochemical markers may allow the identification of these patients earlier in the disease process. PMID:23557069

Cooper, Cyrus; Adachi, Jonathan D.; Bardin, Thomas; Berenbaum, Francis; Flamion, Bruno; Jonsson, Helgi; Kanis, John A.; Pelousse, Franz; Lems, Willem F.; Pelletier, Jean-Pierre; Martel-Pelletier, Johanne; Reiter, Susanne; Reginster, Jean-Yves; Rizzoli, René; Bruyère, Olivier

2013-01-01

105

Early diagnosis to enable early treatment of pre-osteoarthritis  

PubMed Central

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

2012-01-01

106

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

PubMed Central

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

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

2008-01-01

107

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

PubMed

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. Clin. Anat. 28:538-544, 2015. © 2015 Wiley Periodicals, Inc. PMID:25716678

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

2015-05-01

108

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

NASA Astrophysics Data System (ADS)

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.

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

2015-02-01

109

Evaluation of cartilage damage by measuring collagen degradation products in joint extracts in a traumatic model of osteoarthritis.  

PubMed

The objective of this work was to investigate whether collagen degradation products in protein extract from joints could provide quantitative information on cartilage damage. Osteoarthritis (OA) was surgically induced in rat knee joints. Joints were isolated 7, 14 and 28 days after surgery for protein extraction and histology. C-terminal telopeptide of type III collagen (CTX-II), CTX-I and hydroxyproline were measured in protein extracts. Matrix metalloproteinase (MMP)-2 and -9 activity was evaluated by gelatinase zymography and joint pathology was visualized by histology and immunohistochemistry. The results showed that levels of CTX-II were significantly increased in anterior cruciate ligament transection (ACLT)-operated compared with sham-operated knee joints on days 7 and 28, whereas the levels of hydroxyproline and CTX-I epitopes showed no difference. MMP activity was slightly increased in ACLT-operated joints. The CTX-II epitope was highly expressed and co-localized to damaged articular cartilage in ACLT-operated joints. We have therefore demonstrated an increased type II collagen degradation in knees after surgical induction of OA, and propose assessment of collagen degradation epitopes as a quantitative measure of cartilage damage. PMID:17852072

Nielsen, Rasmus H; Stoop, Reinout; Leeming, Diana J; Stolina, Marina; Qvist, Per; Christiansen, Claus; Karsdal, Morten A

2008-02-01

110

An adult case of temporomandibular joint osteoarthritis treated with splint therapy and the subsequent orthodontic occlusal reconstruction  

PubMed Central

Herein we report treatment for a 19-year-old female patient with severe osteoarthritis of the temporomandibular joint. The patient had severe open bite with a Class II molar relationship. She had limited mouth opening and pain. Clinical examination and magnetic resonance imaging revealed that she had anterior disc displacement without reduction. By splint therapy, limited mouth opening and pain was eliminated, but an anterior open bite developed after the treatment. By orthodontic treatment, an acceptable occlusion was achieved with a Class I molar relationship. PMID:22346169

Kurt, Hanefi; Özta?, Evren; Gençel, Burç; Ta?an, Demet Ataman; Özta?, Derya

2011-01-01

111

Degenerative Joint Disease Activated Osteoarthrosis Deformans: Hip, Knee, Shoulder and Other Joints  

Microsoft Academic Search

Osteoarthritis is a chronic, degenerative disorder of unknown cause characterized by the gradual loss of articular cartilage.\\u000a It is the most prevalent disease in the western societies, with a worldwide distribution. As a cause of disability (such as\\u000a walking and stair climbing) in the elderly in the west, osteoarthritis is second only to vascular diseases. Altogether 10%-15%\\u000a of adults over

Guido Hildebrandt; Friedrich-Hugo Kamprad

112

Degenerative joint disease: An example of calcium paradox  

Microsoft Academic Search

:   Osteoporosis and degenerative arthropathy such as osteoarthritis and spondylosis deformans represent the two most common\\u000a diseases seen in later life, sharing some common clinical features such as pain, deformity, and restriction of motion. Augmented\\u000a bone resorption, possibly mediated by cytokines such as interleukin 1, and favorable therapeutic response to estrogen also\\u000a characterize both diseases. Both osteoarthritis of the knee

Takuo Fujita

1998-01-01

113

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

PubMed Central

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

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

2011-01-01

114

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

PubMed Central

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

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

2012-01-01

115

Osteoarthritis. A continuing challenge.  

PubMed Central

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

Sack, K E

1995-01-01

116

Osteoarthritis of the knee  

PubMed Central

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

2007-01-01

117

The epigenetic effect of glucosamine and a nuclear factor-kappa B (NF-kB) inhibitor on primary human chondrocytes – Implications for osteoarthritis  

Microsoft Academic Search

Objective: Idiopathic osteoarthritis is the most common form of osteoarthritis (OA) world-wide and remains the leading cause of disability and the associated socio-economic burden in an increasing aging population. Traditionally, OA has been viewed as a degenerative joint disease characterized by progressive destruction of the articular cartilage and changes in the subchondral bone culminating in joint failure. However, the etiology

Kei Imagawa; MC de Andrés; Ko Hashimoto; Dominic Pitt; Eiji Itoi; Mary B. Goldring; Helmtrud I. Roach; Richard O. C. Oreffo

2011-01-01

118

Nutraceutical Therapies for Degenerative Joint Diseases: A Critical Review  

Microsoft Academic Search

There is growing recognition of the importance of nutritional factors in the maintenance of bone and joint health, and that nutritional imbalance combined with endocrine abnormalities may be involved in the pathogenesis of osteoarthritis (OA) and osteochondritis dissecans (OCD). Despite this, dietary programs have played a secondary role in the management of these connective tissue disorders. Articular cartilage is critically

Robert Goggs; Anne Vaughan-Thomas; Peter D. Clegg; Stuart D. Carter; John F. Innes; Ali Mobasheri; Mehdi Shakibaei; Wolfgang Schwab; Carolyn A. Bondy

2005-01-01

119

Clinical predictors of elective total joint replacement in persons with end-stage knee osteoarthritis  

Microsoft Academic Search

BACKGROUND: Arthritis is a leading cause of disability in the United States. Total knee arthroplasty (TKA) has become the gold standard to manage the pain and disability associated with knee osteoarthritis (OA). Although more than 400 000 primary TKA surgeries are performed each year in the United States, not all individuals with knee OA elect to undergo the procedure. No

Joseph A Zeni Jr; Michael J Axe; Lynn Snyder-Mackler

2010-01-01

120

Joint Involvement Associated with Inflammatory Bowel Disease  

Microsoft Academic Search

Joint involvement associated with inflammatory bowel disease (IBD) belongs to the concept of spondyloarthritis (SpA) and includes two types of arthritis: a peripheral arthritis characterized by the presence of pauciarticular asymmetrical arthritis affecting preferentially joints of lower extremities and an axial arthropathy including inflammatory back pain, sacroiliitis and ankylosing spondylitis (AS). Treatment of arthritis includes a short-term use of NSAIDs

M. De Vos

2009-01-01

121

Localization of SP and CGRP-immunopositive nerve fibers in the hip joint of patients with painful osteoarthritis and of patients with painless failed total hip arthroplasties  

Microsoft Academic Search

Using immunohistochemical methods we determined the presence of SP- and CGRP-immunopositive nerve fibers in the hip joint of patients with femoral neck fracture (controls, group 1), painful osteoarthritis (group 2), and painless failed total hip arthroplasties (group 3). Immunoreactive nerve fibers were found in the soft tissue of the fossa acetabuli as well as in the subintimal part of the

Guido Saxler; Franz Löer; Marc Skumavc; Jörg Pförtner; Ulrike Hanesch

2007-01-01

122

Interpersonal stress, depression, and disease activity in rheumatoid arthritis and osteoarthritis patients.  

PubMed

The relationships among interpersonal stressors, depression, coping inefficiency, hormones (prolactin, cortisol, and estradiol), and disease activity were examined. The sample comprised 33 women with rheumatoid arthritis (RAs; age 37-78) and 37 women with osteoarthritis (OAs; age 47-91), who served as controls. In a regression analysis, interpersonal conflict events accounted for more than twice as much variance in depression in RAs than in OAs. In the RA patients, the immune-stimulating hormones prolactin and estradiol were significantly positively correlated with interpersonal conflicts, depression, coping inefficacy, and clinician ratings of disease activity, suggesting that RAs are more reactive to interpersonal stressors than are OAs, both psychologically and physiologically. PMID:8020457

Zautra, A J; Burleson, M H; Matt, K S; Roth, S; Burrows, L

1994-03-01

123

Peripheral Calcitonin Gene-Related Peptide Receptor Activation and Mechanical Sensitization of the Joint in Rat Models of Osteoarthritis Pain  

PubMed Central

Objective To investigate the role of the sensory neuropeptide calcitonin gene-related peptide (CGRP) in peripheral sensitization in experimental models of osteoarthritis (OA) pain. Methods Experimental knee OA was induced in rats by intraarticular injection of monosodium iodoacetate (MIA) or by transection of the medial meniscus (MMT). Single-unit recordings of joint-innervating nociceptors were obtained in MIA- and saline-treated rats following administration of CGRP or the CGRP receptor antagonist CGRP 8–37. Effects of CGRP 8–37 were also examined in rats that underwent MMT and sham operations. Protein and messenger RNA (mRNA) levels of CGRP receptor components in the L3–L4 dorsal root ganglion (DRG) were investigated following MIA treatment. Results In both the MIA and MMT groups, the mechanical sensitivity of joint nociceptors was enhanced compared to that in the control groups. Exogenous CGRP increased mechanical sensitivity in a greater proportion of joint nociceptors in the MIA-treated rats than in the saline-treated rats. Local blockade of endogenous CGRP by CGRP 8–37 reversed both the MIA- and MMT-induced enhancement of joint nociceptor responses. Joint afferent cell bodies coexpressed the receptor for CGRP, called the calcitonin-like receptor (CLR), and the intracellular accessory CGRP receptor component protein. MIA treatment increased the levels of mRNA for CLR in the L3–L4 DRG and the levels of CLR protein in medium and large joint afferent neurons. Conclusion Our findings provide new and compelling evidence implicating a role of CGRP in peripheral sensitization in experimental OA. Our novel finding of CGRP-mediated control of joint nociceptor mechanosensitivity suggests that the CGRP receptor system may be an important target for the modulation of pain during OA. CGRP receptor antagonists recently developed for migraine pain should be investigated for their efficacy against pain in OA. PMID:24719311

Bullock, Craig M; Wookey, Peter; Bennett, Andrew; Mobasheri, Ali; Dickerson, Ian; Kelly, Sara

2014-01-01

124

Ten-year long-term results of total joint arthroplasties with ARPE® implant in the treatment of trapeziometacarpal osteoarthritis.  

PubMed

Between May 1999 and April 2002 a total of 69 consecutive thumb carpometacarpal joint arthoplasties were performed in a total of 64 patients for carpometacarpal joint osteoarthritis using the cementless hydroxyapatite (HA)-coated unconstrained ARPE implant. Clinical, functional and radiological results at 10-year follow-up are presented. Survival analysis was performed using the Kaplan-Meier method. Of the 64 patients, four were lost to follow-up, 60 implants (92.3%) were functional and five (7.7%) were not (two dislocated, two were removed and one with aseptic loosening). Survival estimate for functional implants over 10 years was 93.9% (95% confidence interval 82.3-97.9). The radiographs were satisfactory in 82.4%. There was subsidence of the cup in 15.8%. Thumb carpometacarpal joint arthroplasty with the ARPE implant offers a reliable treatment alternative in patients with Eaton grade III or IV thumb carpometacarpal joint arthritis in the presence of good bone stock. PMID:24334554

Martin-Ferrero, M

2014-10-01

125

Involvement of the endocannabinoid system in osteoarthritis pain.  

PubMed

Osteoarthritis is a degenerative joint disease associated with articular cartilage degradation. The major clinical outcome of osteoarthritis is a complex pain state that includes both nociceptive and neuropathic mechanisms. Currently, the therapeutic approaches for osteoarthritis are limited as no drugs are available to control the disease progression and the analgesic treatment has restricted efficacy. Increasing evidence from preclinical studies supports the interest of the endocannabinoid system as an emerging therapeutic target for osteoarthritis pain. Indeed, pharmacological studies have shown the anti-nociceptive effects of cannabinoids in different rodent models of osteoarthritis, and compelling evidence suggests an active participation of the endocannabinoid system in the pathophysiology of this disease. The ubiquitous distribution of cannabinoid receptors, together with the physiological role of the endocannabinoid system in the regulation of pain, inflammation and even joint function further support the therapeutic interest of cannabinoids for osteoarthritis. However, limited clinical evidence has been provided to support this therapeutic use of cannabinoids, despite the promising preclinical data. This review summarizes the promising results that have been recently obtained in support of the therapeutic value of cannabinoids for osteoarthritis management. PMID:24494687

La Porta, Carmen; Bura, Simona A; Negrete, Roger; Maldonado, Rafael

2014-02-01

126

Pattern of osteoarthritis in a West African teaching hospital.  

PubMed Central

The study of the pattern of osteoarthritis in different populations may yield valuable aetiological clues and also allow subtypes to be defined. Over one year 252 osteoarthritic joints from 140 patients seen at a West African teaching hospital were prospectively reviewed. The knee was the joint most often affected. Hip and hand disease, as well as Heberden's nodes, were uncommon. Joint disease was predominantly monoarticular; no patient had three or more sites affected. PMID:1994862

Adebajo, A O

1991-01-01

127

Biological Basis for the Use of Botanicals in Osteoarthritis and Rheumatoid Arthritis: A Review  

Microsoft Academic Search

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

Salahuddin Ahmed; Jeremy Anuntiyo; Charles J. Malemud; Tariq M. Haqqi

2005-01-01

128

Diagnostic Importance of Deoxypyridinoline and Osteocalcine in Equine Osteoarthritis  

Microsoft Academic Search

Arican M., Ö. Köylü, A.Uyaroglu, M. Erol, K.N. Çalim: Diagnostic Importance of Deoxypyridinoline and Osteocalcine in Equine Osteoarthritis. Acta Vet. Brno, 2004. 73: 491-496. In this study, deoxypyridinoline (Dpd) and osteocalcine (OC), which has been considered as a diagnostic and prognostic marker for joint disease in man and dog, was measured in urine from horses with osteoarthritis (OA). Serum and

M. ARICAN; Ö. KÖYLÜ; A. UYAROGLU; M. EROL; K. N. ÇALIM

129

Effect of a natural extract of chicken combs with a high content of hyaluronic acid (Hyal-Joint®) on pain relief and quality of life in subjects with knee osteoarthritis: a pilot randomized double-blind placebo-controlled trial  

Microsoft Academic Search

BACKGROUND: Intra-articular hyaluronic acid represents a substantive addition to the therapeutic armamentarium in knee osteoarthritis. We examined the effect of dietary supplementation with a natural extract of chicken combs with a high content of hyaluronic acid (60%) (Hyal-Joint®) (active test product, AP) on pain and quality of life in subjects with osteoarthritis of the knee. METHODS: Twenty subjects aged ?40

Douglas S Kalman; Maria Heimer; Anita Valdeon; Howard Schwartz; Eric Sheldon

2008-01-01

130

Experimental osteoarthritis models in mice.  

PubMed

Osteoarthritis (OA) is a slowly progressing, degenerative disorder of synovial joints culminating in the irreversible destruction of articular cartilage and subchondral bone. It affects almost everyone over the age of 65 and influences life quality of affected individuals with enormous costs to the health care system. Current therapeutic strategies seek to ameliorate pain and increase mobility; however, to date none of them halts disease progression or regenerates damaged cartilage or bone. Thus, there is an ultimate need for the development of new, noninvasive treatments that could substitute joint replacement for late- or end-stage patients. Therefore, osteoarthritis animal models for mimicking of all OA features are important. Mice develop an OA pathology that is comparable to humans, rapidly develop OA due to the short lifetime and show reproducible OA symptoms. They provide a versatile and widely used animal model for analyzing molecular mechanisms of OA pathology. One major advantage over large animal models is the availability of knockout or transgenic mice strains to examine genetic predispositions/contributions to OA.In this chapter, we describe three widely used instability-inducing murine osteoarthritis models. The most common two methods for surgical induction are: (1) destabilization of the medial meniscus (DMM) and (2) anterior cruciate ligament transection (ACLT). In the DMM model, the medial meniscotibial ligament is transected while in the ACLT model the anterior cruciate ligament is destroyed. In the third, chemical induced instability method, intraarticular collagenase is injected into the knee joint. Intraarticular collagenase weakens articular ligaments which cause instability of the joint, and full-blown OA develops within 6 weeks. For morphological evaluation, we correspond mainly to the recommendations of OARSI for histological assessment of osteoarthritis in mouse. For statistical evaluation summed or mean scores of all four knee areas (medial tibial plateau (MTP), medial tibial condyle (MFC), lateral tibial plateau (LTP) or lateral femoral condyle (LFC)), medial and/or lateral regions are used.In future, not only large animal models like guinea pigs, sheep, goats, or horses will be important for a better understanding of osteoarthritis, but especially the mouse model with its rapid development of osteoarthritis and its numerous advantages by providing knockout or transgenic strains will become more and more relevant for drug development and determination of genetic predispositions of osteoarthritis pathology. PMID:25064117

Lorenz, Julia; Grässel, Susanne

2014-01-01

131

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

PubMed

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

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

2015-01-01

132

The KineSpring® Knee Implant System: an implantable joint-unloading prosthesis for treatment of medial knee osteoarthritis  

PubMed Central

Symptomatic medial compartment knee osteoarthritis (OA) is the leading cause of musculoskeletal pain and disability in adults. Therapies intended to unload the medial knee compartment have yielded unsatisfactory results due to low patient compliance with conservative treatments and high complication rates with surgical options. There is no widely available joint-unloading treatment for medial knee OA that offers clinically important symptom alleviation, low complication risk, and high patient acceptance. The KineSpring® Knee Implant System (Moximed, Inc, Hayward, CA, USA) is a first-of-its-kind, implantable, extra-articular, extra-capsular prosthesis intended to alleviate knee OA-related symptoms by reducing medial knee compartment loading while overcoming the limitations of traditional joint-unloading therapies. Preclinical and clinical studies have demonstrated excellent prosthesis durability, substantial reductions in medial compartment and total joint loads, and clinically important improvements in OA-related pain and function. The purpose of this report is to describe the KineSpring System, including implant characteristics, principles of operation, indications for use, patient selection criteria, surgical technique, postoperative care, preclinical testing, and clinical experience. The KineSpring System has potential to bridge the gap between ineffective conservative treatments and irreversible surgical interventions for medial compartment knee OA. PMID:23717052

Clifford, Anton G; Gabriel, Stefan M; O’Connell, Mary; Lowe, David; Miller, Larry E; Block, Jon E

2013-01-01

133

The KineSpring(®) Knee Implant System: an implantable joint-unloading prosthesis for treatment of medial knee osteoarthritis.  

PubMed

Symptomatic medial compartment knee osteoarthritis (OA) is the leading cause of musculoskeletal pain and disability in adults. Therapies intended to unload the medial knee compartment have yielded unsatisfactory results due to low patient compliance with conservative treatments and high complication rates with surgical options. There is no widely available joint-unloading treatment for medial knee OA that offers clinically important symptom alleviation, low complication risk, and high patient acceptance. The KineSpring(®) Knee Implant System (Moximed, Inc, Hayward, CA, USA) is a first-of-its-kind, implantable, extra-articular, extra-capsular prosthesis intended to alleviate knee OA-related symptoms by reducing medial knee compartment loading while overcoming the limitations of traditional joint-unloading therapies. Preclinical and clinical studies have demonstrated excellent prosthesis durability, substantial reductions in medial compartment and total joint loads, and clinically important improvements in OA-related pain and function. The purpose of this report is to describe the KineSpring System, including implant characteristics, principles of operation, indications for use, patient selection criteria, surgical technique, postoperative care, preclinical testing, and clinical experience. The KineSpring System has potential to bridge the gap between ineffective conservative treatments and irreversible surgical interventions for medial compartment knee OA. PMID:23717052

Clifford, Anton G; Gabriel, Stefan M; O'Connell, Mary; Lowe, David; Miller, Larry E; Block, Jon E

2013-01-01

134

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

PubMed Central

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

2011-01-01

135

Exercise and osteoarthritis  

PubMed Central

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

Hunter, David J; Eckstein, Felix

2009-01-01

136

Identification of an urinary metabolite profile associated with osteoarthritis  

Microsoft Academic Search

Summary Objective: Osteoarthritis (OA) is one of the most common diseases among the elderly. The main characteristic is the progressive destruction of articular cartilage. We lack quantitative and sensitive biomarkers for OA to detect changes in the joints in an early stage of the disease. In this study, we investigated whether a urinary metabolite profile could be found that could

R. J. A. N. Lamers; J. H. J. van Nesselrooij; V. B. Kraus; J. M. Jordan; J. B. Renner; A. D. Dragomir; G. Luta; J. van der Greef; J. DeGroot

2005-01-01

137

Pharmaceutical and nutraceutical management of canine osteoarthritis: Present and future perspectives  

Microsoft Academic Search

Osteoarthritis (OA) is one of the most common chronic musculoskeletal diseases and causes of lameness in the dogs. The osteoarthritic disease process involves the entire synovial joint, encompassing the synovium, cartilage and underlying bone. Joint failure results from an abnormal mechanical strain causing damage to normal tissue or failure of pathologically impaired articular cartilage and bone under the influence of

Yves Henrotin; Christelle Sanchez; Marc Balligand

2005-01-01

138

Application of Computational Lower Extremity Model to Investigate Different Muscle Activities and Joint Force Patterns in Knee Osteoarthritis Patients during Walking  

PubMed Central

Many experimental and computational studies have reported that osteoarthritis in the knee joint affects knee biomechanics, including joint kinematics, joint contact forces, and muscle activities, due to functional restriction and disability. In this study, differences in muscle activities and joint force patterns between knee osteoarthritis (OA) patients and normal subjects during walking were investigated using the inverse dynamic analysis with a lower extremity musculoskeletal model. Extensor/flexor muscle activations and torque ratios and the joint contact forces were compared between the OA and normal groups. The OA patients had higher extensor muscle forces and lateral component of the knee joint force than normal subjects as well as force and torque ratios of extensor and flexor muscles, while the other parameters had little differences. The results explained that OA patients increased the level of antagonistic cocontraction and the adduction moment on the knee joint. The presented findings and technologies provide insight into biomechanical changes in OA patients and can also be used to evaluate the postoperative functional outcomes of the OA treatments. PMID:24302973

Nha, Kyung Wook; Shin, Jun Ho; Kim, Jong In; Kwon, Jae Ho; Kim, Yoon Hyuk

2013-01-01

139

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

SciTech Connect

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.

Yuan Zhen; Zhang Qizhi; Sobel, Eric S.; Jiang Huabei [Department of Biomedical Engineering, University of Florida, Gainesville, Florida 32611 (United States); Division of Rheumatology, College of Medicine, University of Florida, Gainesville, Florida 32611 (United States); Department of Biomedical Engineering, University of Florida, Gainesville, Florida 32611 (United States)

2010-08-15

140

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)

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.

Buchwald, Tomasz; Niciejewski, Krzysztof; Kozielski, Marek; Szybowicz, Miros?aw; Siatkowski, Marcin; Krauss, Hanna

2012-01-01

141

Ligament Injury, Reconstruction and Osteoarthritis  

PubMed Central

Purpose of Review The recent literature on the factors that initiate and accelerate the progression of osteoarthritis following ligament injuries and their treatment is reviewed. Recent Findings The ligament-injured joint is at high risk for osteoarthritis. Current conservative (e.g. rehabilitation) and surgical (e.g. reconstruction) treatment options appear not to reduce osteoarthritis following ligament injury. The extent of osteoarthritis does not appear dependent on which joint is affected, or the presence of damage to other tissues within the joint. Mechanical instability is the likely initiator of osteoarthritis in the ligament-injured patient. Summary The mechanism osteoarthritis begins with the injury rendering the joint unstable. The instability increases the sliding between the joint surfaces and reduces the efficiency of the muscles, factors that alter joint contact mechanics. The load distribution in the cartilage and underlying bone is disrupted, causing wear and increasing shear, which eventually leads to the osteochondral degeneration. The catalyst to the mechanical process is the inflammation response induced by the injury and sustained during healing. In contrast, the inflammation could be responsible for onset, while the mechanical factors accelerate progression. The mechanisms leading to osteoarthritis following ligament injury have not been fully established. A better understanding of these mechanisms should lead to alternative surgical, drug, and tissue-engineering treatment options, which could eliminate osteoarthritis in these patients. Progress is being made on all fronts. Considering that osteoarthritis is likely to occur despite current treatment options, the best solution may be prevention. PMID:17710194

Fleming, Braden C.; Hulstyn, Michael J.; Oksendahl, Heidi L.; Fadale, Paul D.

2007-01-01

142

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

NASA Technical Reports Server (NTRS)

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.

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

1997-01-01

143

The Prevalence of Lumbar Spine Facet Joint Osteoarthritis and Its Association with Low Back Pain in Selected Korean Populations  

PubMed Central

Background This study was to evaluate the association of lumbar spine facet joint osteoarthritis (LSFJOA) identified by multi-detector computed tomography (MDCT) with age and low back pain (LBP) in an adult community-based population in Korea. Methods A sample of 472 participants (age range, 20 to 84 years) who underwent MDCT imaging for abdominal or urological lesions, not for chief complaints of LBP, were included in this study. LSFJOA based on MDCT findings was characterized using four grades of osteoarthritis of the facet joints. The prevalence of LSFJOA according to age group (below 40 years, 40-49 years, 50-59 years, 60-69 years, and above 70 years), gender, and spinal level was analyzed using chi-square tests and the association between LBP and LSFJOA adjusting for age, gender, and spine level was analyzed using multiple binary logistic regression test. Results Eighty-three study subjects (17.58%) had LSFJOA (grade ? 2). The prevalence of LSFJOA was not associated with gender (p = 0.092). The prevalence of LSFJOA increased with age (p = 0.015). The highest prevalence of LSFJOA was observed at L4-5 in men (p = 0.001) and at L5-S1 in women (p = 0.003), and at L5-S1 in the overall population (p = 0.000). LSFJOA was not associated with LBP in men (p = 0.093) but was associated with LBP in women (p = 0.003), especially at L3-4 (p = 0.018) and L5-S1 (p = 0.026). Conclusions The prevalence of LSFJOA based on the computed tomography imaging was 17.58% in the adult community Korean population. The prevalence of LSFJOA increased with age, and the highest prevalence was noted at L5-S1. LSFJOA was not associated with LBP at any spinal level and age except at L3-4 and L5-S1 in women. PMID:25436061

Vaccaro, Alexander R.; Lee, Sangwook; Lee, Jaekun; Chang, Hojin

2014-01-01

144

Can we identify patients with high risk of osteoarthritis progression who will respond to treatment? A focus on epidemiology and phenotype of osteoarthritis.  

PubMed

Osteoarthritis is a syndrome affecting a variety of patient profiles. A European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis and the European Union Geriatric Medicine Society working meeting explored the possibility of identifying different patient profiles in osteoarthritis. The risk factors for the development of osteoarthritis include systemic factors (e.g., age, sex, obesity, genetics, race, and bone density) and local biomechanical factors (e.g., obesity, sport, joint injury, and muscle weakness); most also predict disease progression, particularly joint injury, malalignment, and synovitis/effusion. The characterization of patient profiles should help to better orientate research, facilitate trial design, and define which patients are the most likely to benefit from treatment. There are a number of profile candidates. Generalized, polyarticular osteoarthritis and local, monoarticular osteoarthritis appear to be two different profiles; the former is a feature of osteoarthritis co-morbid with inflammation or the metabolic syndrome, while the latter is more typical of post-trauma osteoarthritis, especially in cases with severe malalignment. Other biomechanical factors may also define profiles, such as joint malalignment, loss of meniscal function, and ligament injury. Early- and late-stage osteoarthritis appear as separate profiles, notably in terms of treatment response. Finally, there is evidence that there are two separate profiles related to lesions in the subchondral bone, which may determine benefit from bone-active treatments. Decisions on appropriate therapy should be made considering clinical presentation, underlying pathophysiology, and stage of disease. Identification of patient profiles may lead to more personalized healthcare, with more targeted treatment for osteoarthritis. PMID:25701074

Bruyère, Olivier; Cooper, Cyrus; Arden, Nigel; Branco, Jaime; Brandi, Maria Luisa; Herrero-Beaumont, Gabriel; Berenbaum, Francis; Dennison, Elaine; Devogelaer, Jean-Pierre; Hochberg, Marc; Kanis, John; Laslop, Andrea; McAlindon, Tim; Reiter, Susanne; Richette, Pascal; Rizzoli, René; Reginster, Jean-Yves

2015-03-01

145

[Treatment of patients with osteoarthritis].  

PubMed

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

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

2014-01-01

146

Dickkopf-1 is a master regulator of joint remodeling  

Microsoft Academic Search

Degenerative and inflammatory joint diseases lead to a destruction of the joint architecture. Whereas degenerative osteoarthritis results in the formation of new bone, rheumatoid arthritis leads to bone resorption. The molecular basis of these different patterns of joint disease is unknown. By inhibiting Dickkopf-1 (DKK-1), a regulatory molecule of the Wnt pathway, we were able to reverse the bone-destructive pattern

Danielle Diarra; Marina Stolina; Karin Polzer; Jochen Zwerina; Michael S Ominsky; Denise Dwyer; Adelheid Korb; Josef Smolen; Markus Hoffmann; Clemens Scheinecker; Desiree van der Heide; Robert Landewe; Dave Lacey; William G Richards; Georg Schett

2007-01-01

147

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

PubMed Central

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

Hauser, Ross A.; Orlofsky, Amos

2013-01-01

148

Plantar pressure distribution in older people with osteoarthritis of the first metatarsophalangeal joint (hallux limitus/rigidus).  

PubMed

The purpose of this study was to evaluate differences in dynamic plantar pressure distribution between older people with and without radiographically confirmed osteoarthritis (OA) of the first metatarsophalangeal joint (first MPJ) of the foot. Dynamic plantar pressure recordings using the TekScan MatScan system were obtained during barefoot level walking in 40 older participants; 20 with radiographically confirmed OA of the first MPJ displaying less than 55 degrees of passive dorsiflexion, and 20 with no evidence of OA in the first MPJ displaying greater than 55 degrees of passive dorsiflexion. Group comparisons between the variables maximum force and peak pressure were made for seven different regions underneath the right foot (heel, midfoot, first MPJ, second MPJ, third to fifth MPJs, hallux, and lesser toes). Compared to the control group, participants with OA of the first MPJ exhibited 34% greater maximum force (7.9 +/- 2.5 vs. 5.9 +/- 1.7 kg, p = 0.005) and 23% higher peak pressure (1.6 +/- 0.3 vs. 1.3 +/- 0.3 kg/cm(2), p = 0.001) under the hallux. Similar results were also found under the lesser toes with 43% greater maximum force (5.0 +/- 1.9 vs. 3.5 +/- 1.4 kg; p = 0.006) and 29% higher peak pressure (0.9 +/- 0.2 vs. 0.7 +/- 0.2 kg/cm(2), p = 0.018). No significant differences were found to exist between groups for any other plantar region. These findings indicate that OA of the first MPJ is associated with significant changes in load-bearing function of the foot, which may contribute to the development of secondary pathological changes associated with the condition, such as plantar callus formation and hyperextension of the hallux interphalangeal joint. PMID:18634037

Zammit, Gerard V; Menz, Hylton B; Munteanu, Shannon E; Landorf, Karl B

2008-12-01

149

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

PubMed Central

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

Harrison, Tracie

2010-01-01

150

Lumbar degenerative disc disease and tibiotalar joint arthritis: a 710-specimen postmortem study.  

PubMed

Research has associated lumbar spinal disease with lower extremity arthrosis. These studies focused solely on the lumbar spine's connection with hip or knee pathology, failing to investigate potential ankle relationships. We specifically explored the interplay between lumbar disc degeneration and tibiotalar joint arthritis. Lumbar disc degeneration and tibiotalar joint arthritis was graded 0 to 4, according to osteophytosis of the vertebral rim and talar surface in 710 randomly selected cadaveric specimens. We corrected for confounding factors of age, sex, race, and height. A significant association was found between lumbar disc degeneration and tibiotalar joint arthritis (P < .01). Lumbar disc degeneration encompassing 3 intervetebral discs demonstrated the highest odds for development of severe tibiotalar joint arthritis. Severe lumbar degenerative disc disease was more prevalent than severe tibiotalar joint arthritis in individuals age 20 years and older. Furthermore, the presence of severe lumbar degeneration significantly predisposes individuals to the development of severe ankle arthritis (P < .05). Gait changes resulting from disc degeneration or neural compression in the lumbar spine may play a role in ankle osteoarthritis development. This association must be considered when treating patients with lumbar disc degeneration and leg pain. PMID:25844591

Boiwka, Alex V; Bajwa, Navkirat S; Toy, Jason O; Eubanks, Jason; Ahn, Nicholas U

2015-04-01

151

Is running associated with degenerative joint disease  

Microsoft Academic Search

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

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

1986-01-01

152

Evolution of semiquantitative whole joint assessment of knee OA: MOAKS (MRI Osteoarthritis Knee Score)  

PubMed Central

Objective In an effort to evolve semi-quantitative scoring methods based upon limitations identified in existing tools, integrating expert readers’ experience with all available scoring tools and the published data comparing the different scoring systems, we iteratively developed the MRI Osteoarthritis Knee Score (MOAKS). The purpose of this report is to describe the instrument and its reliability. Methods The MOAKS instrument refines the scoring of BMLs (providing regional delineation and scoring across regions), cartilage (sub-regional assessment), and refines the elements of meniscal morphology (adding meniscal hypertrophy, partial maceration and progressive partial maceration) scoring. After a training and calibration session two expert readers read MRIs of 20 knees separately. In addition, one reader re-read the same 20 MRIs 4 weeks later presented in random order to assess intra-rater reliability. The analyses presented here are for both intra- and inter-rater reliability (calculated using the linear weighted kappa and overall percent agreement). Results With the exception of inter-rater reliability for tibial cartilage area (kappa=0.36) and tibial osteophytes (kappa=0.49); and intra-rater reliability for tibial BML number of lesions (kappa=0.54), Hoffa-synovitis (kappa=0.42) all measures of reliability using kappa statistics were very good (0.61-0.8) or reached near perfect agreement (0.81-1.0). Only intra-rater reliability for Hoffa-synovitis, and inter-rater reliability for tibial and patellar osteophytes showed overall percent agreement < 75%. Conclusion MOAKS scoring shows very good to excellent reliability for the large majority of features assessed. Further iterative development and research will include assessment of its validation and responsiveness. PMID:21645627

Hunter, David J; Guermazi, Ali; Lo, Grace H; Grainger, Andrew J; Conaghan, Philip G; Boudreau, Robert M; Roemer, Frank W.

2014-01-01

153

Knee Joint Loading during Gait in Healthy Controls and Individuals with Knee Osteoarthritis  

PubMed Central

Objective People with knee osteoarthritis (OA) are thought to walk with high loads at the knee which are yet to be quantfied using modeling techniques that account for subject specific EMG patterns, kinematics and kinetics. The objective was to estimate medial and lateral loading for people with knee OA and controls using an approach that is sensitive to subject specific muscle activation patterns. Methods 16 OA and 12 control (C) subjects walked while kinematic, kinetic and EMG data were collected. Muscle forces were calculated using an EMG-Driven model and loading was calculated by balancing the external moments with internal muscle and contact forces Results OA subjects walked slower and had greater laxity, static and dynamic varus alignment, less flexion and greater knee adduction moment (KAM). Loading (normalized to body weight) was no different between the groups but OA subjects had greater absolute medial load than controls and maintained a greater %total load on the medial compartment. These patterns were associated with body mass, sagittal and frontal plane moments, static alignment and close to signficance for dynamic alignment. Lateral compartment unloading during mid-late stance was observed in 50% of OA subjects. Conclusions Loading for control subjects was similar to data from instrumented prostheses. Knee OA subjects had high medial contact loads in early stance and half of the OA cohort demonstared lateral compartment lift-off. Results suggest that interventions aimed at reducing body weight and dynamic malalignment might be effective in reducing medial compartment loading and establishing normal medio-lateral load sharing patterns. PMID:23182814

Kumar, Deepak; Manal, Kurt T.; Rudolph, Katherine S.

2013-01-01

154

Molecular monitoring of equine joint homeostasis  

Microsoft Academic Search

Diseases affecting synovial joints are a major cause of chronic disability both in humans and in companion animal species, most notably dogs and horses. As progressive deterioration of the articular cartilage is the hallmark of degenerative joint disease or osteoarthritis, research efforts traditionally tended to focus primarily on cartilage pathology. However, in recent years it has become clear that synovial

Janny C. de Grauw

2011-01-01

155

Efficacy of leech therapy in the management of osteoarthritis (Sandhivata)  

PubMed Central

Osteoarthritis (degenerative joint disease) is the most common joint disorder. It mostly affects cartilage. The top layer of cartilage breaks down and wears away. Osteoarthritis is of two types, primary (idiopathic) and secondary. In idiopathic osteoarthritis, the most common form of the disease, no predisposing factor is apparent. Secondary OA is pathologically indistinguishable from idiopathic OA but is attributable to an underlying cause. In Ayurveda the disease Sandhivata resembles with osteoarthritis which is described under Vatavyadhi. The NSAIDs are the main drugs of choice in modern medicine which have lots of side effects and therefore are not safe for long-term therapy. Raktamokshan, i.e., blood letting is one of the ancient and important parasurgical procedures described in Ayurveda for treatment of various diseases. Of them, Jalaukavacharana or leech therapy has gained greater attention globally, because of its medicinal values. The saliva of leech contains numerous biologically active substances, which have antiinflammatory as well as anesthetic properties. Keeping this view in mind we have started leech therapy in the patients of osteoarthritis and found encouraging results. PMID:22408305

Rai, P. K.; Singh, A. K.; Singh, O. P.; Rai, N. P.; Dwivedi, A. K.

2011-01-01

156

Identification of Novel Adipokines in the Joint. Differential Expression in Healthy and Osteoarthritis Tissues  

PubMed Central

Objectives Emerging data suggest that several metabolic factors, released mainly by white adipose tissue (WAT) and joint tissues, and collectively named adipokines, might have a role in the pathophysiology of OA. Recently, novel adipokines such as SERPINE2, WISP2, GPNMB and ITIH5 have been identified in WAT. The main goal of this study was to analyse the expression of these novel adipokines in synovium, infrapatellar fat pad and chondrocytes and to compare the expression of these molecules in healthy and OA tissues. Methods Synovial tissues, infrapatellar fat pad and chondrocytes were obtained from 36 OA patients (age 52–85; mean BMI 28.9) who underwent total knee replacement surgery. Healthy synovial tissues and infrapatellar fat pad were obtained from 15 traumatic knee patients (age 23–53; mean BMI 23.5). mRNA and protein expression were determined by qRT-PCR and western blot analysis respectively. Results All the novel adipokines, matter of our study, are expressed in OA synovium, infrapatellar fat pad and chondrocytes. Moreover, we detected a differential expression of SERPINE2 and ITIH5 in OA synovial tissues as compared to healthy samples. Finally, we also observed an increased expression of WISP2 in OA infrapatellar fat pad in comparison to healthy controls. Conclusions In this study we demonstrated for the first time the expression of four novel adipokines in different joint tissues and how these molecules are differentially expressed in healthy and OA joint tissues. PMID:25853553

Conde, Javier; Scotece, Morena; Abella, Vanessa; Gómez, Rodolfo; López, Verónica; Villar, Rosa; Hermida, Miguel; Pino, Jesús; Gómez-Reino, Juan Jesús; Gualillo, Oreste

2015-01-01

157

[Osteoarthritis: etiology, risk factors, molecular mechanisms].  

PubMed

Osteoarthritis is an incurable joint disease manifesting itself with gradually progressing degenerative changes, leading to premature motor disability. These changes mainly occur owing to an imbalance between the processes of degeneration and regeneration of articular cartilage structures. Until now many risk factors favoring the development of degenerative joint disease have been identified. These include age, weight, previously sustained traumas to joints, sports, sex and genetic predisposition. The latest scientific reports confirm that the pathogenesis of changes in osteoarthritic joints is complex and occurs on many levels. Enzymes belonging to the metalloproteinases family are mainly responsible for the degeneration of articular cartilage. Their activity is regulated by numerous pro-inflammatory cytokines, transcription factors and miRNA. A thorough analysis of all processes occurring in the afflicted joints needs to be carried out before effective therapeutic strategies can be developed. PMID:24864114

Chojnacki, Micha?; Kwapisz, Adam; Synder, Marek; Szemraj, Janusz

2014-01-01

158

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

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

2014-01-01

159

Adipokines: Biomarkers for osteoarthritis?  

PubMed Central

Osteoarthritis (OA) is one of the most common degenerative joint diseases in aging population. Obesity is an important risk factor for initiation and progression of OA. It is accepted that excess body weight may lead to cartilage degeneration by increasing the mechanical forces across weight-bearing joints. However, emerging data suggest that additional metabolic factors released mainly by white adipose tissue may also be responsible for the high prevalence of OA among obese people. Adipocyte-derived molecules ‘‘adipokines’’ have prompt much interest in OA pathophysiological research over the past decade since they play an important role in cartilage and bone homeostasis. Therefore, the aim of this review is to summarize the current knowledge on the role of adipokines including leptin, adiponectin, visfatin and resistin in OA and their potential to be used as biomarkers for earlier diagnosis, classifying disease severity, monitoring disease progression, and testing pharmacological interventions for OA. In OA patients, leptin, visfatin and resistin showed increased production whereas adiponectin showed decreased production. Leptin and adiponectin are far more studied than visfatin and resistin. Importantly, altered adipokine levels also contribute to a wide range of diseases. Further experiments are still crucial for understanding the relationship between adipokines and OA. PMID:25035835

Poonpet, Thitiya; Honsawek, Sittisak

2014-01-01

160

Increased Chondrocyte Apoptosis Is Associated with Progression of Osteoarthritis in Spontaneous Guinea Pig Models of the Disease  

PubMed Central

Osteoarthritis (OA) is the most common joint disease characterised by degradation of articular cartilage and bone remodelling. For almost a decade chondrocyte apoptosis has been investigated as a possible mechanism of cartilage damage in OA, but its precise role in initiation and/or progression of OA remains to the determined. The aim of this study is to determine the role of chondrocyte apoptosis in spontaneous animal models of OA. Right tibias from six male Dunkin Hartley (DH) and Bristol Strain 2 (BS2) guinea pigs were collected at 10, 16, 24 and 30 weeks of age. Fresh-frozen sections of tibial epiphysis were microscopically scored for OA, and immunostained with caspase-3 and TUNEL for apoptotic chondrocytes. The DH strain had more pronounced cartilage damage than BS2, especially at 30 weeks. At this time point, the apoptotic chondrocytes were largely confined to the deep zone of articular cartilage (AC) with a greater percentage in the medial side of DH than BS2 (DH: 5.7%, 95% CI: 4.2–7.2), BS2: 4.8%, 95% CI: 3.8–5.8), p > 0.05). DH had a significant progression of chondrocyte death between 24 to 30 weeks during which time significant changes were observed in AC fibrillation, proteoglycan depletion and overall microscopic OA score. A strong correlation (p ? 0.01) was found between chondrocyte apoptosis and AC fibrillation (r = 0.3), cellularity (r = 0.4) and overall microscopic OA scores (r = 0.4). Overall, the rate of progression in OA and apoptosis over the study period was greater in the DH (versus BS2) and the medial AC (versus lateral). Chondrocyte apoptosis was higher at the later stage of OA development when the cartilage matrix was hypocellular and highly fibrillated, suggesting that chondrocyte apoptosis is a late event in OA. PMID:23994836

Zamli, Zaitunnatakhin; Adams, Michael A.; Tarlton, John F.; Sharif, Mohammed

2013-01-01

161

Intraarticular cortisone injection for osteoarthritis of the hip. Is it effective? Is it safe?  

Microsoft Academic Search

Osteoarthritis of the hip is a significant source of morbidity in the elderly. Treatment guidelines are available for the\\u000a management of hip osteoarthritis, but these do not address the application of intraarticular corticosteroid injection. The\\u000a intraarticular injection of corticosteroid is used in the management of other large joint osteoarthritic diseases and is well\\u000a studied in the knee, however, this data

David W. Kruse

2008-01-01

162

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

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

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

2011-01-01

163

Radiological aspects of osteoarthritis.  

PubMed

Osteoarthritis (OA) is one of the most frequent indications in musculoskeletal imaging because OA is the most prevalent musculoskeletal disease in developed countries. As the population becomes older and older, the need for adequate imaging techniques also increases. The various forms of osteoarthritis are associated with a high degree of illness-induced physical disability and reduced life quality. In some forms, the pathogenesis is complex and can require the discrimination of a variety of predisposing diseases. The specific forms of osteoarthritis will be highlighted in this article. In addition, the value of each imaging modality will be assessed, with special regard to the most common sites: hand, hip, and knee. PMID:23413010

Sautner, Judith; Schueller-Weidekamm, Claudia

2013-05-01

164

Long-term follow-up of trapeziectomy with abductor pollicis longus tendon interposition arthroplasty for osteoarthritis of the thumb carpometacarpal joint  

PubMed Central

Purpose To evaluate the long-term clinical and radiographic outcomes of trapeziectomy with abductor pollicis longus tendon interposition arthroplasty for moderate to severe osteoarthritis of the thumb carpometacarpal joint (Eaton stages III-IV). Methods We evaluated 13 patients (15 thumbs) who underwent trapeziectomy and abductor pollicis longus tendon interposition arthroplasty for end-stage osteoarthritis of the thumb carpometacarpal joint, at an average follow-up of 15 years. Subjective clinical outcomes evaluated included visual analogue scale scores and disability of arm shoulder and hand score questionnaires. Objective clinical evaluation included lateral pinch and grip tests, and a range of active and passive thumb movements. All patients underwent a radiological assessment by two independent senior radiologists. Wherever possible, results obtained from the operated thumbs were compared to the non-operated side. Results At a mean of 15 years post operation (range 15–17 years), there was no statistical difference between the operated and non-operated hands with regards to grip and pinch strength. In all cases CMC and MCPJ range of motion in the operative hand was either equal to or greater than non-operative counterparts. Mean visual analogue scale score was 2.13 and mean DASH score was 16.85. Mean carpal height was 0.52 and mean trapezial space ratio was 0.163. There were no early or late complications recorded and no revision surgery was required. Conclusion It is the opinion of these authors that abductor pollicis longus tendon interposition arthroplasty is able to provide high-quality long-term results for patients who suffer from moderate to severe osteoarthritis of the thumb carpometacarpal joint. Level of evidence Therapeutic Level IV. PMID:24403751

Avisar, Erez; Elvey, Michael; Wasrbrout, Ziv; Aghasi, Maurice

2013-01-01

165

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

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

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

2014-03-01

166

Computed Tomography of Subchondral Bone and Osteophytes in Hip Osteoarthritis: the Shape of Things to Come?  

PubMed Central

Bone is a fundamental component of the disordered joint homeostasis seen in osteoarthritis, a disease that has been primarily characterized by the breakdown of articular cartilage accompanied by local bone changes and a limited degree of joint inflammation. In this review we consider the role of computed tomography imaging and computational analysis in osteoarthritis research, focusing on subchondral bone and osteophytes in the hip. We relate what is already known in this area to what could be explored through this approach in the future in relation to both clinical research trials and the underlying cellular and molecular science of osteoarthritis. We also consider how this area of research could impact on our understanding of the genetics of osteoarthritis. PMID:22649393

Turmezei, Tom D.; Poole, Ken E. S.

2011-01-01

167

Magnetic isolation of particles suspended in synovial fluid for diagnostics of natural joint chondropathies  

Microsoft Academic Search

Millions of people are stricken with the degenerative joint disease known as osteoarthritis. Osteoarthritis is associated with biochemical and mechanical processes, and is characterized by loss of articular cartilage and hypertrophy of bone. As cartilage and bone particles are released into the synovial fluid, a variety of biomarkers have been suggested for the analysis of this fluid. Here we have

Kalia Mendel; Noam Eliaz; Itai Benhar; David Hendel; Nahum Halperin

2010-01-01

168

MicroRNA in osteoarthritis.  

PubMed

Osteoarthritis (OA) is the most prevalent degenerative joint disease and is accompanied by pain and joint dysfunction. Its clinical treatment tends to be unsatisfactory. Novel targets in OA include genes that are involved in OA pathophysiology and have been discovered using gene network, epigenetic and microRNA (miRNA) approaches. miRNA has been implicated in important cellular processes such as lipid metabolism, apoptosis, differentiation and organ development. The importance of miRNA regulation in cellular function is becoming increasingly clear as new miRNA targets are revealed. The present review summarizes the current evidence of the important role played by miRNA in determining the complex gene expression patterns of OA chondrocytes and their role in the regulation of transcription, and possible demethylation mechanisms that might be applicable in OA. In summary, miRNA may have important diagnostic and therapeutic potential, and might provide a novel means of treating OA. PMID:21672302

Yu, C; Chen, W-P; Wang, X-H

2011-01-01

169

Molecular biology of temporomandibular joint disorders: Proposed mechanisms of disease  

Microsoft Academic Search

Purpose: The biologic processes of temporomandibular joint adaptation and disease are poorly understood. However, recent technologic advances have provided methods that allow sophisticated studies of the molecular mechanisms that are relevant to the pathophysiology of degenerative temporomandibular joint diseases. This review examines current models of the molecular events that may underlie both adaptive and pathologic responses of the articular tissues

Stephen B Milam; John P Schmitz

1995-01-01

170

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

PubMed

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

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

2014-03-01

171

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

PubMed Central

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

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

172

Value of biomarkers in osteoarthritis: current status and perspectives  

PubMed Central

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:23897772

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

2013-01-01

173

Value of biomarkers in osteoarthritis: current status and perspectives.  

PubMed

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:23897772

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

2013-11-01

174

Poor results of drilling in early stages of juxta-articular osteonecrosis in 12 joints affected by Gaucher disease  

PubMed Central

Background and purpose Gaucher disease is heterogeneous. One of the most devastating complications is bone involvement, ranging from mild osteopenia to osteonecrosis, but no markers have been discovered to predict onset and/or progression. We describe our experience in a large referral center using drilling for juxta-articular osteonecrosis in young patients with Gaucher disease. Patients and methods We retrospectively reviewed medical data from all patients who were recommended to undergo drilling for osteonecrosis of juxta-articular bone of the femoral head, the humeral head, or upper tibia for acute osteonecrosis at a pre-collapse stage. Results 11 patients (mean age 34 years) underwent drilling of 12 joints with juxta-articular osteonecrosis; 3 (mean age 51 years) refused intervention. 9 joints that were drilled showed advancing joint degeneration within 0.5 to 4 years. 3 joints have undergone replacement. Of the 3 joints that did not undergo drilling, 2 have undergone replacement and 1 has collapsed with osteoarthritis. Interpretation We found equally poor outcome with and without drilling. Effective intervention can only be achieved by improving our understanding of bone physiology and pathophysiology in Gaucher disease. PMID:19404804

Lebel, Ehud; Phillips, Mici; Zimran, Ari; Itzchaki, Menachem

2009-01-01

175

Prognostic biomarkers in osteoarthritis  

PubMed Central

Purpose of review Identification of patients at risk for incident disease or disease progression in osteoarthritis remains challenging, as radiography is an insensitive reflection of molecular changes that presage cartilage and bone abnormalities. Thus there is a widely appreciated need for biochemical and imaging biomarkers. We describe recent developments with such biomarkers to identify osteoarthritis patients who are at risk for disease progression. Recent findings The biochemical markers currently under evaluation include anabolic, catabolic, and inflammatory molecules representing diverse biological pathways. A few promising cartilage and bone degradation and synthesis biomarkers are in various stages of development, awaiting further validation in larger populations. A number of studies have shown elevated expression levels of inflammatory biomarkers, both locally (synovial fluid) and systemically (serum and plasma). These chemical biomarkers are under evaluation in combination with imaging biomarkers to predict early onset and the burden of disease. Summary Prognostic biomarkers may be used in clinical knee osteoarthritis to identify subgroups in whom the disease progresses at different rates. This could facilitate our understanding of the pathogenesis and allow us to differentiate phenotypes within a heterogeneous knee osteoarthritis population. Ultimately, such findings may help facilitate the development of disease-modifying osteoarthritis drugs (DMOADs). PMID:23169101

Attur, Mukundan; Krasnokutsky-Samuels, Svetlana; Samuels, Jonathan; Abramson, Steven B.

2013-01-01

176

Coxofemoral joint kinematics using video fluoroscopic images of treadmill-walking cats: development of a technique to assess osteoarthritis-associated disability.  

PubMed

The objectives of this pilot study were to develop a video fluoroscopy kinematics method for the assessment of the coxofemoral joint in cats with and without osteoarthritis (OA)-associated disability. Two non-OA cats and four cats affected by coxofemoral OA were evaluated by video fluoroscopy. Video fluoroscopic images of the coxofemoral joints were captured at 120 frames/s using a customized C-arm X-ray system while cats walked freely on a treadmill at 0.4 m/s. The angle patterns over time of the coxofemoral joints were extracted using a graphic user interface following four steps: (i) correction for image distortion; (ii) image denoising and contrast enhancement; (iii) frame-to-frame anatomical marker identification; and (iv) statistical gait analysis. Reliability analysis was performed. The cats with OA presented greater intra-subject stride and gait cycle variability. Three cats with OA presented a left-right asymmetry in the range of movement of the coxofemoral joint angle in the sagittal plane (two with no overlap of the 95% confidence interval, and one with only a slight overlap) consistent with their painful OA joint, and a longer gait cycle duration. Reliability analysis revealed an absolute variation in the coxofemoral joint angle of 2º-6º, indicating that the two-dimensional video fluoroscopy technique provided reliable data. Improvement of this method is recommended: variability would likely be reduced if a larger field of view could be recorded, allowing the identification and tracking of each femoral axis, rather than the trochanter landmarks. The range of movement of the coxofemoral joint has the potential to be an objective marker of OA-associated disability. PMID:24907140

Guillot, Martin; Gravel, Pierre; Gauthier, Marie-Lou; Leblond, Hugues; Tremblay, Maurice; Rossignol, Serge; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; de Guise, Jacques A; Troncy, Eric

2015-02-01

177

Molecular mechanisms of cartilage remodelling in osteoarthritis.  

PubMed

Osteoarthritis (OA) is a degenerative joint disease that is characterized primarily by progressive breakdown of articular cartilage. The loss of proteoglycans, the mineralization of the extracellular matrix (ECM) and the hypertrophic differentiation of the chondrocytes constitute hallmarks of the disease. The pathogenesis of OA includes several pathways, which in single are very well investigated and partly understood, but in their complex interplay remain mainly unclear. This review summarises recent data on the underlying mechanisms, specifically with respect to cell-matrix interactions and cartilage mineralization. It points out why these findings are of importance for future OA research and for the development of novel therapeutic strategies to treat OA. PMID:20603225

Bertrand, Jessica; Cromme, Christoph; Umlauf, Daniel; Frank, Svetlana; Pap, Thomas

2010-10-01

178

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

PubMed Central

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

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

2015-01-01

179

Association of hand and knee osteoarthritis: evidence for a polyarticular disease subset  

Microsoft Academic Search

OBJECTIVE--To examine the association between hand and knee osteoarthritis (OA) in a community based population. METHODS--Radiographs of 695 participants aged > or = 40 years in the Baltimore Longitudinal Study of Aging were read for changes of OA, using Kellgren-Lawrence grade > or = 2 as the case definition. RESULTS--Logistic regression analyses, adjusting for age, gender and body mass index,

R Hirsch; M Lethbridge-Cejku; W W Scott; R Reichle; C C Plato; J Tobin; M C Hochberg

1996-01-01

180

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

PubMed

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

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

2014-09-01

181

The Effects of a Moderate Exercise Program on Knee Osteoarthritis in Male Wistar Rats  

PubMed Central

Objective(s): Osteoarthritis (OA) or degenerative joint disease is the commonest form of arthritis and can lead to joint pain, decrease in joint’s range of motion, loss of function, and ultimately disability. Exercise is considered as one of the non-pharmacological treatments of OA. But the effects of exercise on knee joint cartilage remain ambiguous. The aim of the present study was to investigate the effect of a four-week moderate treadmill exercise on rats’ knee osteoarthritis. Materials and Methods: Eighteen male Wistar rats (173 ± 1 g, 8 weeks old) were randomly divided into three groups (n = 6): Intact control, monosodium iodoacetate (MIA) only (OA), and training. The osteoarthritis model was induced by intra-articular injection of monosodium iodoacetate (MIA). Subjects followed a moderate-intensity exercise program for 28 days. Rats were killed after 28 days and histological assessment was done on their knee joints. One-way ANOVA (P<0.05) and post-hoc Tukey test was used for the statistical analysis. Results: Histological assessment on 3 measurements of, depth ratio of lesions (P=0.001), total cartilage degeneration width (P=0.001), and significant cartilage degeneration width (P=0.001), demonstrated that moderate exercise for 4 weeks could surprisingly almost treat OA symptoms of rats’ knee joints. Conclusion: The findings of the present study indicate that a moderate treadmill exercise program exert a beneficial influence on rats’ knee osteoarthritis. PMID:23826489

Fallah Mohammadi, Mohammad; Hajizadeh Moghaddam, Akbar; Mirkarimpur, Hosein

2013-01-01

182

Cyst-like lesions of the knee joint and their relation to incident knee pain and development of radiographic osteoarthritis: The MOST study  

PubMed Central

Objective To determine whether intra- and periarticular cyst-like lesions of the knee are associated with incident knee pain and incident radiographic knee osteoarthritis (OA). Design The Multicenter Osteoarthritis (MOST) Study is a cohort of individuals who have or are at high risk for knee OA. Using a nested case-control study design, we investigated the associations of cyst-like lesions (Baker’s, meniscal and proximal tibiofibular joint (PTFJ) cysts, and prepatellar and anserine bursitides) with (a) incident pain at 15- or 30-month follow-up and (b) incident radiographic OA at 30-month follow-up. Baseline cyst-like lesions were scored semiquantitatively using the Whole Organ Magnetic Resonance Imaging Score (WORMS). Conditional logistic regression models were used to assess the relation between these lesions and the outcomes, adjusting for potential confounding factors (i.e. cartilage loss, meniscal damage, bone marrow lesions, synovitis and joint effusion, which were also scored using WORMS). Results Incident knee pain study included 157 cases and 336 controls. Prevalence of meniscal and PTFJ cysts in the case group was twice that in the control group (9 (6%) vs. 9 (3%) and 9 (6%) vs. 10 (3%), respectively). Incident radiographic OA study included 149 cases and 298 controls. Prevalence of grade 2 Baker’s cysts and PTFJ cysts in the case group was approximately 4 times that in the control group (16 [11%] vs. 9 [3%] and 6 [4%] vs. 3 [1%], respectively). However, none of the cyst-like lesions was associated with incident pain or radiographic OA after fully adjusted logistic regression analyses and correction of p-values for multiple comparisons. Conclusion None of the analyzed lesions was an independent predictor of incident knee pain or radiographic OA. Intra- and periarticular cyst-like lesions are likely to be a secondary phenomenon seen in painful or OA-affected knees, rather than a primary trigger for incident knee pain or radiographic OA. PMID:20816978

Guermazi, Ali; Hayashi, Daichi; Roemer, Frank W; Niu, Jingbo; Yang, Mei; Lynch, John A; Torner, James C; Lewis, Cora E; Sack, Burton; Felson, David T; Nevitt, Michael C

2010-01-01

183

Generation of disease-specific induced pluripotent stem cells from patients with rheumatoid arthritis and osteoarthritis  

PubMed Central

Introduction Since the concept of reprogramming mature somatic cells to generate induced pluripotent stem cells (iPSCs) was demonstrated in 2006, iPSCs have become a potential substitute for embryonic stem cells (ESCs) given their pluripotency and “stemness” characteristics, which resemble those of ESCs. We investigated to reprogram fibroblast-like synoviocytes (FLSs) from patients with rheumatoid arthritis (RA) and osteoarthritis (OA) to generate iPSCs using a 4-in-1 lentiviral vector system. Methods A 4-in-1 lentiviral vector containing Oct4, Sox2, Klf4, and c-Myc was transduced into RA and OA FLSs isolated from the synovia of two RA patients and two OA patients. Immunohistochemical staining and real-time PCR studies were performed to demonstrate the pluripotency of iPSCs. Chromosomal abnormalities were determined based on the karyotype. SCID-beige mice were injected with iPSCs and sacrificed to test for teratoma formation. Results After 14 days of transduction using the 4-in-1 lentiviral vector, RA FLSs and OA FLSs were transformed into spherical shapes that resembled embryonic stem cell colonies. Colonies were picked and cultivated on matrigel plates to produce iPSC lines. Real-time PCR of RA and OA iPSCs detected positive markers of pluripotency. Immunohistochemical staining tests with Nanog, Oct4, Sox2, Tra-1-80, Tra-1-60, and SSEA-4 were also positive. Teratomas that comprised three compartments of ectoderm, mesoderm, and endoderm were formed at the injection sites of iPSCs. Established iPSCs were shown to be compatible by karyotyping. Finally, we confirmed that the patient-derived iPSCs were able to differentiate into osteoblast, which was shown by an osteoimage mineralization assay. Conclusion FLSs derived from RA and OA could be cell resources for iPSC reprogramming. Disease- and patient-specific iPSCs have the potential to be applied in clinical settings as source materials for molecular diagnosis and regenerative therapy. PMID:24490617

2014-01-01

184

High molecular weight hyaluronic acid relieved joint pain and prevented the progression of cartilage degeneration in a rabbit osteoarthritis model after onset of arthritis.  

PubMed

We examined the therapeutic effect of high molecular weight hyaluronic acid (HA) on the progression of joint pain and cartilage degeneration in a rabbit osteoarthritis (OA) model. The OA model was induced by partial meniscectomy. In the time course study, cartilage degeneration was assessed at 3, 7 and 14 days after operation. In the therapeutic study, HA or loxoprofen (LOX) was administered for 14 days beginning four days after operation (after the onset of knee pain and cartilage degeneration). Knee pain was assessed by weight distribution on the hind paw, and cartilage damage and MMP production in the joints were evaluated 18 days after surgery. In the time course study, severe cartilage damage was found three days after operation. In the treatment study, weight-bearing on the injured paw in the control group decreased with time from four days after the operation. However, HA or LOX treatment beginning four days after the operation normalized the reduced hind paw weight distribution, and PGE(2) production was inhibited by HA treatment and LOX treatment. HA significantly inhibited cartilage degeneration, whereas LOX did not. HA also suppressed the production of MMP in joints. Treatment of HA after the onset of cartilage destruction and pain showed a cartilage protective effect as well as an analgesic effect. PMID:20407800

Hashizume, Misato; Koike, Nobuo; Yoshida, Hiroto; Suzuki, Miho; Mihara, Masahiko

2010-10-01

185

Hemophilic joint disease - current perspective and potential future strategies.  

PubMed

Recurrent hemarthroses can lead to hemophilic joint disease (HJD), which is one of the most disabling complications of these X-linked recessive disorders characterized by a deficiency of clotting factors VIII/IX. The pathogenesis of HJD is not well understood and there is evidence to suggest that iron may play a central role in the pathogenetic process causing changes at the molecular level and through the release of cytokines and perpetuation of a chronic inflammatory state. Also, there may be a role for angiogenesis in accelerating the joint damage begun by recurrent hemarthroses. Hemophilic joint disease can be diagnosed by MRI which provides information about the pathology of the synovium, articular cartilage and bone. However, it is expensive, and maybe cumbersome in young children who require sedation. Newer, cost-effective imaging tools such as ultrasonography need to be explored to facilitate diagnosis and monitoring of joint disease. Repeated bleeds into the joint could be prevented by reducing the number of bleeds by the prophylactic infusion of factor concentrates on a bi-weekly to alternate day schedule depending on the activity level and bleeding phenotype. However, the dose, schedule and timing of prophylaxis still remain unresolved despite some multi-center clinical studies proving its benefit in preserving joint function. Prohibitive costs and the need for venous access devices in delivering factor concentrates in younger children continue to complicate universal recommendations of prophylaxis. In those patients who fail or refuse prophylaxis, procedures such as isotopic synovectomy can provide relief from repeated joint bleeds, again the timing of which is not well-defined. Newer strategies to identify early joint disease through the use of serological markers are needed. Also, cost-effective imaging modalities are needed so that treatment strategies such as prophylaxis and isotopic synovectomy can be appropriately timed to reap maximum benefits. A combination of serological and imaging evidence of early joint disease might ultimately impact on the optimal management of hemophilic joint disease. PMID:18304874

Acharya, Suchitra S

2008-02-01

186

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

Microsoft Academic Search

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

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

2009-01-01

187

Antioxidative effects of sulphurous water from macerata feltria thermal resort in patients with osteoarthritis  

Microsoft Academic Search

Summary It has been widely demonstrated that reactive oxygen species are implica- ted as the main causative factors of osteoarthritis (OA), a degenerative joint disease characterized by a progressive degradation of the articular cartilage. Sulphur thermal therapies are employed in the treatment of OA since ancient times; however, their mechanisms of action in the control of OA are only partially

2007-01-01

188

Osteoarthritis associated with estrogen deficiency  

Microsoft Academic Search

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

Jorge A Roman-Blas; Santos Castañeda; Raquel Largo; Gabriel Herrero-Beaumont

2009-01-01

189

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

PubMed

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

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

190

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

PubMed Central

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

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

2015-01-01

191

Resistance Exercise for Knee Osteoarthritis  

PubMed Central

The initiation, progression, and severity of knee osteoarthritis (OA) has been associated with decreased muscular strength and alterations in joint biomechanics. Chronic OA pain may lead to anxiety, depression, fear of movement, and poor psychological outlook. The fear of movement may prevent participation in exercise and social events which could lead to further physical and social isolation. Resistance exercise (RX) has been shown to be an effective intervention both for decreasing pain and for improving physical function and self-efficacy. RX may restore muscle strength and joint mechanics while improving physical function. RX may also normalize muscle firing patterns and joint biomechanics leading to reductions in joint pain and cartilage degradation. These physical adaptations could lead to improved self-efficacy and decreased anxiety and depression. RX can be prescribed and performed by patients across the OA severity spectrum. When designing and implementing an RX program for a patient with knee OA, it is important to consider both the degree of OA severity as well as the level of pain. RX, either in the home or at a fitness facility, is an important component of a comprehensive regimen designed to offset the physical and psychological limitations associated with knee OA. Unique considerations for this population include: 1) monitoring pain during and after exercise, 2) providing days of rest when disease flares occur, and 3) infusing variety into the exercise regimen to encourage adherence. PMID:22632702

Vincent, Kevin R.; Vincent, Heather K.

2013-01-01

192

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

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

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

2005-01-01

193

Does high weight loss in older adults with knee osteoarthritis affect bone-on-bone joint loads and muscle forces during walking?  

PubMed Central

Objective The aim of this study was to examine the effects of high weight loss on knee joint loads during walking in participants with knee OA. Design Data were obtained from a subset of participants enrolled in the Arthritis, Diet, and Activity Promotion Trial (ADAPT). Complete baseline and 18 month follow-up data were obtained on 76 sedentary, overweight or obese older adults with radiographic knee OA. Three-dimensional gait analysis was used to calculate knee joint forces and moments. The cohort was divided into high (> 5%), low (< 5%), and no (0% or gain) weight loss groups. Results From baseline body weight, the high weight loss group lost an average of 10.2%, the low weight loss group lost an average of 2.7%, and the no weight loss group gained 1.5%. Adjusted 18 month outcome data revealed lower maximum knee compressive forces with greater weight loss (p = 0.05). The difference in compressive forces between the high weight loss and no weight loss groups was due primarily to lower hamstring forces (p = 0.04). Quadriceps forces were similar between the groups at 18 month follow-up. There was no difference between the groups in 18-month joint space width or Kellgren-Lawrence scores. Conclusions These results suggest that a 10% weight loss in an overweight and obese osteoarthritic population elicits positive changes in the mechanical pathway to knee osteoarthritis by having lower knee joint compressive loads during walking compared to low and no weight loss groups. The difference in compressive forces was due, in large part, to reductions in hamstring co-contraction during the initial portion of the stance phase. PMID:21134477

Messier, Stephen P.; Legault, Claudine; Loeser, Richard F.; Van Arsdale, Stephanie J.; Davis, Cralen; Ettinger, Walter H.; DeVita, Paul

2012-01-01

194

Demographic and clinical factors associated with radiographic severity of first metatarsophalangeal joint osteoarthritis: cross-sectional findings from the Clinical Assessment Study of the Foot  

PubMed Central

Summary Objective To explore demographic and clinical factors associated with radiographic severity of first metatarsophalangeal joint osteoarthritis (OA) (First MTPJ OA). Design Adults aged ?50 years registered with four general practices were mailed a Health Survey. Responders reporting foot pain within the last 12 months were invited to undergo a clinical assessment and weight-bearing dorso-plantar and lateral radiographs of both feet. Radiographic first MTPJ OA in the most severely affected foot was graded into four categories using a validated atlas. Differences in selected demographic and clinical factors were explored across the four radiographic severity subgroups using analysis of variance (ANOVA) and ordinal regression. Results Clinical and radiographic data were available from 517 participants, categorised as having no (n = 105), mild (n = 228), moderate (n = 122) or severe (n = 62) first MTPJ OA. Increased radiographic severity was associated with older age and lower educational attainment. After adjusting for age, increased radiographic first MTPJ OA severity was significantly associated with an increased prevalence of dorsal hallux and first MTPJ pain, hallux valgus, first interphalangeal joint (IPJ) hyperextension, keratotic lesions on the dorsal aspect of the hallux and first MTPJ, decreased first MTPJ dorsiflexion, ankle/subtalar joint eversion and ankle joint dorsiflexion range of motion, and a trend towards a more pronated foot posture. Conclusions This cross-sectional study has identified several dose–response associations between radiographic severity of first MTPJ OA and a range of demographic and clinical factors. These findings highlight the progressive nature of first MTPJ OA and provide insights into the spectrum of presentation of the condition in clinical practice. PMID:25450852

Menz, H.B.; Roddy, E.; Marshall, M.; Thomas, M.J.; Rathod, T.; Myers, H.; Thomas, E.; Peat, G.M.

2015-01-01

195

Treatment of Nongout Joint Deposition Diseases: An Update  

PubMed Central

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

Richette, Pascal; Flipo, René-Marc

2014-01-01

196

Treatment of nongout joint deposition diseases: an update.  

PubMed

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

Pascart, Tristan; Richette, Pascal; Flipo, René-Marc

2014-01-01

197

A Combination of Scutellaria Baicalensis and Acacia Catechu Extracts for Short-Term Symptomatic Relief of Joint Discomfort Associated with Osteoarthritis of the Knee  

PubMed Central

Abstract 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 1? and 6, tumor necrosis factor-?, 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

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

2014-01-01

198

Cartilage tissue engineering for degenerative joint disease  

Microsoft Academic Search

Pain in the joint is often due to cartilage degeneration and represents a serious medical problem affecting people of all ages. Although many, mostly surgical techniques, are currently employed to treat cartilage lesions, none has given satisfactory results in the long term. Recent advances in biology and material science have brought tissue engineering to the forefront of new cartilage repair

Dobrila Nesic; Robert Whiteside; Mats Brittberg; David Wendt; Ivan Martin; Pierre Mainil-Varlet

2006-01-01

199

Self-management pivotal in osteoarthritis.  

PubMed

Osteoarthritis is not caused by ageing per se, although prevalence does increase with age, and does not necessarily deteriorate over time. However, with the ageing population the incidence and prevalence of osteoarthritis will continue to rise. Osteoarthritis remains a clinical diagnosis and importantly radiographic changes and joint symptoms may be poorly correlated. The most commonly affected peripheral joints are the knees, hips and small joints of the hand especially the distal interphalangeal joints. A diagnosis of osteoarthritis should be reached clinically, without the need for investigations, in those older than 45 years, with mechanical joint pain, and/or with morning joint-related stiffness lasting less than 30 minutes. However, in unclear situations, blood tests and imaging can be very helpful to exclude other conditions such as gout, pseudogout, post-traumatic pain, inflammatory or septic arthritis. All patients with clinical osteoarthritis should be advised about activity and exercise irrespective of age, comorbidity, pain severity or disability. An effective exercise routine may include local muscle strengthening and general aerobic fitness and referral to physiotherapy should be considered. A rheumatological opinion should be sought if there is doubt regarding the diagnosis or symptoms persist despite treatment. NICE recommends yearly follow-up forall osteoarthritis patients who suffer from troublesome joint pain, have more than one symptomatic joint, more than one comorbidity and/or those patients taking regular medication for the condition. PMID:24881169

Negoescu, Andra; Ostör, Andrew J K

2014-04-01

200

Ageing and osteoarthritis: a circadian rhythm connection.  

PubMed

Osteoarthritis (OA) is the most common joint disease, affecting articular cartilage of the joints, with currently no cure. Age is a major risk factor for OA, but despite significant advances made in the OA research field, how ageing contributes to OA is still not well understood. In this review, we will focus on one particular aspect of chondrocyte biology, i.e., circadian rhythms. Disruptions to circadian clocks have been linked to various diseases. Our recent work demonstrates autonomous clocks in chondrocytes which regulate key pathways implicated in OA. The cartilage rhythm dampens with age and clock gene expression changes during the initiation stage of OA development in an experimental mouse OA model. Research into the molecular links between ageing, circadian clocks and OA may identify novel therapeutic routes for the prevention and management of OA, such as chronotherapy, or direct targeting of clock components/circadian rhythm. PMID:25078075

Gossan, Nicole; Boot-Handford, Ray; Meng, Qing-Jun

2015-04-01

201

Effect of an integrated approach of yoga therapy on quality of life in osteoarthritis of the knee joint: A randomized control study  

PubMed Central

Aim: This study was designed to evaluate the efficacy of addition of integrated yoga therapy to therapeutic exercises in osteoarthritis (OA) of knee joints. Materials and Methods: This was a prospective randomized active control trial. A total of t participants with OA of knee joints between 35 and 80 years (yoga, 59.56 ± 9.54 and control, 59.42 ± 10.66) from the outpatient department of Dr. John's Orthopedic Center, Bengaluru, were randomly assigned to receive yoga or physiotherapy exercises after transcutaneous electrical stimulation and ultrasound treatment of the affected knee joints. Both groups practiced supervised intervention (40 min per day) for 2 weeks (6 days per week) with followup for 3 months. The module of integrated yoga consisted of shithilikaranavyayama (loosening and strengthening), asanas, relaxation techniques, pranayama, meditation and didactic lectures on yama, niyama, jnana yoga, bhakti yoga, and karma yoga for a healthy lifestyle change. The control group also had supervised physiotherapy exercises. A total of 118 (yoga) and 117 (control) were available for final analysis. Results: Significant differences were observed within (P < 0.001, Wilcoxon's) and between groups (P < 0.001, Mann–Whitney U-test) on all domains of the Short Form-36 (P < 0.004), with better results in the yoga group than in the control group, both at 15th day and 90th day. Conclusion: An integrated approach of yoga therapy is better than therapeutic exercises as an adjunct to transcutaneous electrical stimulation and ultrasound treatment in improving knee disability and quality of life in patients with OA knees. PMID:22022123

Ebnezar, John; Nagarathna, Raghuram; Bali, Yogitha; Nagendra, Hongasandra Ramarao

2011-01-01

202

A Current Review of Molecular Mechanisms Regarding Osteoarthritis and Pain  

PubMed Central

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-?, PGE2, FGF-2 and PKC?, 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

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

2013-01-01

203

A current review of molecular mechanisms regarding osteoarthritis and pain.  

PubMed

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-?, PGE2, FGF-2 and PKC?, 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

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

2013-09-25

204

Syndecan-4 regulates ADAMTS-5 activation and cartilage breakdown in osteoarthritis.  

PubMed

Aggrecan cleavage by a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 5 (ADAMTS-5) is crucial for the breakdown of cartilage matrix during osteoarthritis, a degenerative joint disease that leads to the progressive destruction of articular structures. The mechanisms of ADAMTS-5 activation and their links to the pathogenesis of osteoarthritis remain poorly understood, but syndecans have been shown to be involved in the activation of ADAMTS-4 (ref. 3). Here we show that syndecan-4 is specifically induced in type X collagen-producing chondrocytes both in human osteoarthritis and in murine models of the disease. The loss of syndecan-4 in genetically modified mice and intra-articular injections of syndecan-4-specific antibodies into wild-type mice protect from proteoglycan loss and thereby prevent osteoarthritic cartilage damage in a surgically induced model of osteoarthritis. The occurrence of less severe osteoarthritis-like cartilage destruction in both syndecan-4-deficient mice and syndecan-4-specific antibody-treated wild-type mice results from a marked decrease in ADAMTS-5 activity. Syndecan-4 controls the activation of ADAMTS-5 through direct interaction with the protease and through regulating mitogen-activated protein kinase (MAPK)-dependent synthesis of matrix metalloproteinase-3 (MMP-3). Our data suggest that strategies aimed at the inhibition of syndecan-4 will be of great value for the treatment of cartilage damage in osteoarthritis. PMID:19684582

Echtermeyer, Frank; Bertrand, Jessica; Dreier, Rita; Meinecke, Ingmar; Neugebauer, Katja; Fuerst, Martin; Lee, Yun Jong; Song, Yeong Wook; Herzog, Christine; Theilmeier, Gregor; Pap, Thomas

2009-09-01

205

Femoral neck erosions: sign of hip joint synovial disease  

SciTech Connect

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.

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

1983-07-01

206

Isolated patellofemoral osteoarthritis  

PubMed Central

Background and purpose The optimal treatment for isolated patellofemoral osteoarthritis is unclear at present. We systematically reviewed the highest level of available evidence on the nonoperative and operative treatment of isolated patellofemoral osteoarthritis to develop an evidenced-based discussion of treatment options. Methods A systematic computerized database search (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, MEDLINE (PubMed), and EMBASE) was performed in March 2009. The quality of the studies was assessed independently by two authors using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results We extracted data from 44 articles. The best available evidence for treatment of isolated patellofemoral osteoarthritis is sparse and of generally low methodological quality. Nonoperative treatment using physiotherapy (GRADE: high quality, weak recommendation for use), taping (GRADE: moderate quality, weak recommendation for use), or injection therapy (GRADE: very low quality, weak recommendation for use) may result in short-term relief. Joint-preserving surgical treatment may result in insufficient, unpredictable, or only short-term improvement (GRADE: low quality, weak recommendation against use). Total knee replacement with patellar resurfacing results in predictable and good, durable results (GRADE: low quality, weak recommendation for use). Outcome after patellofemoral arthroplasty in selected patients is good to excellent (GRADE: low quality, weak recommendation for use). Interpretation Methodologically good quality comparative studies, preferably using a patient-relevant outcome instrument, are needed to establish the optimal treatment strategy for patients with isolated patellofemoral osteoarthritis. PMID:20175647

Poolman, Rudolf W; van Kampen, Albert

2010-01-01

207

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

PubMed Central

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

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

2015-01-01

208

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

PubMed Central

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

Alshami, Ali M.

2014-01-01

209

Proteases involved in cartilage matrix degradation in osteoarthritis  

PubMed Central

Osteoarthritis is a common joint disease for which there are currently no disease-modifying drugs available. Degradation of the cartilage extracellular matrix is a central feature of the disease and is widely though to be mediated by proteinases that degrade structural components of the matrix, primarily aggrecan and collagen. Studies on transgenic mice have confirmed the central role of Adamalysin with Thrombospondin Motifs 5 (ADAMTS-5) in aggrecan degradation, and the collagenolytic matrix metalloproteinase MMP-13 in collagen degradation. This review discusses recent advances in current understanding of the mechanisms regulating expression of these key enzymes, as well as reviewing the roles of other proteinases in cartilage destruction. PMID:21777704

Troeberg, Linda; Nagase, Hideaki

2011-01-01

210

Progressive Change in Joint Degeneration in Patients with Knee or Hip Osteoarthritis Treated with Fentanyl in a Randomized Trial  

PubMed Central

Purpose Opioids improve pain from knee and hip osteoarthritis (OA) and decrease the functional impairment of patients. However, there is a possibility that opioids induce analgesia and suppress the physiological pain of OA in patients, thereby inducing the progression of OA changes in these patients. The purpose of the current study was to investigate the possibility of progressive changes in OA among patients using opioids. Materials and Methods Two hundred knee or hip OA patients were evaluated in the current prospective, randomized, active-controlled study. Patients were randomized 1:1:1 into three parallel treatment groups: loxoprofen, tramadol/acetaminophen, and transdermal fentanyl groups. Medication was administered for 12 weeks. Pain scores and progressive OA changes on X-ray films were evaluated. Results Overall, pain relief was obtained by all three groups. Most patients did not show progressive OA changes; however, 3 patients in the transdermal fentanyl group showed progressive OA changes during the 12 weeks of treatment. These 3 patients used significantly higher doses than others in the transdermal fentanyl group. Additionally, the average pain score for these 3 patients was significantly lower than the average pain score for the other patients in the transdermal fentanyl group. Conclusion Fentanyl may induce progressive changes in knee or hip OA during a relatively short period, compared with oral Non-Steroidal Anti-Inflammatory Drugs or tramadol. PMID:25048500

Fujii, Tatsuya; Takana, Koshi; Orita, Sumihisa; Inoue, Gen; Ochiai, Nobuyasu; Kuniyoshi, Kazuki; Aoki, Yasuchika; Ishikawa, Tetsuhiro; Miyagi, Masayuki; Kamoda, Hiroto; Suzuki, Miyako; Sakuma, Yoshihiro; Kubota, Gou; Oikawa, Yasuhiro; Inage, Kazuhide; Sainoh, Takeshi; Sato, Jun; Yamauchi, Kazuyo; Toyone, Tomoaki; Nakamura, Junichi; Kishida, Shunji; Takahashi, Kazuhisa

2014-01-01

211

Cartilage tissue engineering for degenerative joint disease.  

PubMed

Pain in the joint is often due to cartilage degeneration and represents a serious medical problem affecting people of all ages. Although many, mostly surgical techniques, are currently employed to treat cartilage lesions, none has given satisfactory results in the long term. Recent advances in biology and material science have brought tissue engineering to the forefront of new cartilage repair techniques. The combination of autologous cells, specifically designed scaffolds, bioreactors, mechanical stimulations and growth factors together with the knowledge that underlies the principles of cell biology offers promising avenues for cartilage tissue regeneration. The present review explores basic biology mechanisms for cartilage reconstruction and summarizes the advances in the tissue engineering approaches. Furthermore, the limits of the new methods and their potential application in the osteoarthritic conditions are discussed. PMID:16574268

Nesic, Dobrila; Whiteside, Robert; Brittberg, Mats; Wendt, David; Martin, Ivan; Mainil-Varlet, Pierre

2006-05-20

212

No loss of cartilage volume over three years in patients with knee osteoarthritis as assessed by magnetic resonance imaging  

Microsoft Academic Search

Objective Magnetic resonance imaging (MRI) has the potential to provide accurate quantification of structural changes in joint disease, with sensitivity to change, as it can provide direct visualization of the cartilage and bone. In this study, we investigated whether knee cartilage volume, as assessed by MRI, is sensitive to change over time in patients with osteoarthritis (OA).Design Sixteen patient volunteers

S. J. Gandy; P. A. Dieppe; M. C. Keen; R. A. Maciewicz; I. Watt; J. C. Waterton

2002-01-01

213

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

PubMed Central

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 naïve 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 <10 h from 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

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

2014-01-01

214

Pilot Clinical Studies of Long Duration, Low Intensity Therapeutic Ultrasound for Osteoarthritis  

PubMed Central

Osteoarthritis is one of the leading causes of disability in the aging population. Long duration, low intensity therapeutic ultrasound has had promising impact in animal models to slow the progression of the disease and provide joint relief. Two pilot studies were conducted using a novel, wearable platform for delivering ultrasound to evaluate the potential clinical benefits of ultrasound therapy on knee osteoarthritis. There was a pain reduction effect from using ultrasound, as high as fifty two percent in one study. As well, initial data demonstrates that mobility may be increased for patients experiencing mild to moderate arthritis of the knee. PMID:25788823

Langer, Matthew D; Levine, Vanessa; Taggart, Rebecca; Lewis, George K; Hernandez, Lyndon; Ortiz, Ralph

2015-01-01

215

Bone and joint complications related to Gaucher disease  

Microsoft Academic Search

There is a broad spectrum of Gaucher disease-related skeletal complications, ranging from asymptomatic osteopenia to osteonecrosis\\u000a (of the shoulders and hips) with secondary degenerative joint disease. Characterization of the pattern and severity of bone\\u000a involvement in the individual patient requires the application of conventional and advanced radiographic techniques. The introduction\\u000a of enzyme replacement therapy (ERT) for this inborn error of

Gregory M. Pastores; Manan J. Patel; Hossien Firooznia

2000-01-01

216

Inhibition of TGF-? signaling in mesenchymal stem cells of subchondral bone attenuates osteoarthritis.  

PubMed

Osteoarthritis is a highly prevalent and debilitating joint disorder. There is no effective medical therapy for the condition because of limited understanding of its pathogenesis. We show that transforming growth factor ?1 (TGF-?1) is activated in subchondral bone in response to altered mechanical loading in an anterior cruciate ligament transection (ACLT) mouse model of osteoarthritis. TGF-?1 concentrations are also high in subchondral bone from humans with osteoarthritis. High concentrations of TGF-?1 induced formation of nestin-positive mesenchymal stem cell (MSC) clusters, leading to formation of marrow osteoid islets accompanied by high levels of angiogenesis. We found that transgenic expression of active TGF-?1 in osteoblastic cells induced osteoarthritis, whereas inhibition of TGF-? activity in subchondral bone attenuated the degeneration of articular cartilage. In particular, knockout of the TGF-? type II receptor (T?RII) in nestin-positive MSCs led to less development of osteoarthritis relative to wild-type mice after ACLT. Thus, high concentrations of active TGF-?1 in subchondral bone seem to initiate the pathological changes of osteoarthritis, and inhibition of this process could be a potential therapeutic approach to treating this disease. PMID:23685840

Zhen, Gehua; Wen, Chunyi; Jia, Xiaofeng; Li, Yu; Crane, Janet L; Mears, Simon C; Askin, Frederic B; Frassica, Frank J; Chang, Weizhong; Yao, Jie; Carrino, John A; Cosgarea, Andrew; Artemov, Dmitri; Chen, Qianming; Zhao, Zhihe; Zhou, Xuedong; Riley, Lee; Sponseller, Paul; Wan, Mei; Lu, William Weijia; Cao, Xu

2013-06-01

217

Reactive oxygen species and superoxide dismutases: Role in joint diseases  

Microsoft Academic Search

Reactive oxygen species (ROS) are produced in many normal and abnormal processes in humans, including atheroma, asthma, joint diseases, aging, and cancer. The superoxide anion O2? is the main ROS. Increased ROS production leads to tissue damage associated with inflammation. Superoxide dismutases (SODs) convert superoxide to hydrogen peroxide, which is then removed by glutathione peroxidase or catalase. Thus, SODs prevent

Valéry Afonso; Romuald Champy; Dragoslav Mitrovic; Pascal Collin; Abderrahim Lomri

2007-01-01

218

Oxidative stress and degenerative temporomandibular joint disease: A proposed hypothesis  

Microsoft Academic Search

The molecular events that underlie degenerative temporomandibular joint diseases are poorly understood. Recent studies have provided evidence that a variety of molecular species, including cytokines, matrix degrading enzymes, neuropeptides, and arachidonic acid catabolites may be involved. This paper advances the theory that mechanical stresses lead to the accumulation of damaging free radicals in affected articular tissues of susceptible individuals. This

Stephen B Milam; Gustavo Zardeneta; John P Schmitz

1998-01-01

219

Hemophilic joint disease – current perspective and potential future strategies  

Microsoft Academic Search

Recurrent hemarthroses can lead to hemophilic joint disease (HJD), which is one of the most disabling complications of these X-linked recessive disorders characterized by a deficiency of clotting factors VIII\\/IX. The pathogenesis of HJD is not well understood and there is evidence to suggest that iron may play a central role in the pathogenetic process causing changes at the molecular

Suchitra S. Acharya

2008-01-01

220

Cytokines as biochemical markers for knee osteoarthritis  

PubMed Central

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

Mabey, Thomas; Honsawek, Sittisak

2015-01-01

221

Cytokines as biochemical markers for knee osteoarthritis.  

PubMed

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

Mabey, Thomas; Honsawek, Sittisak

2015-01-18

222

Jellyfish mucin may have potential disease-modifying effects on osteoarthritis  

PubMed Central

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

2009-01-01

223

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

PubMed Central

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

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

2014-01-01

224

A review of temporomandibular joint disease (TMJD). Part II: Clinical and radiological semiology. Morbidity processes  

Microsoft Academic Search

Summary The clinical signs and symptoms of greatest semiologic value in temporomandibular joint disease (TMJD) are muscle pain, joint pain, limitations in mandibular movement, and joint sounds. Imaging studies of the joint are very useful for establishing the diagnosis and for discarding other disease processes, though in many cases diagnostic error results from the detection of a large proportion of

Rafael Poveda Roda; José María Díaz Fernández; Sergio Hernández Bazán; Yolanda Jiménez Soriano; María Margaix; Gracia Sarrión; Rafael Poveda-Roda

225

Role of Hyaluronic Acid in Early Diagnosis of Knee Osteoarthritis  

PubMed Central

Introduction: Osteoarthritis of knee is traditionally diagnosed on the basis of clinical and radiological findings. Usually joint tissue degeneration is already advanced by the time a clinical diagnosis is made, hence the research focus has now shifted to use of biomarkers to diagnose the condition at an early stage of the disease. Aims & Objectives: The aim of this study was to assess the efficacy of serum HA levels in early detection and grading of the severity of primary knee osteoarthritis and it’s co-relation with Western Ontario and McMaster university osteoarthritis index (WOMAC scores) and Kellgren -Lawrence grading (K-L grade). Materials and Methods: The study included 150 subjects (100 cases and 50 controls) and all were subjected to WOMAC scoring and K-L grading and estimation of serum HA levels. Results: Age and WOMAC scores have significant correlation with HA levels, but multivariate analysis shows only WOMAC score as an independent variable associated with HA levels. The results show statistically significant high HA levels in cases than in normal population. HA levels are also able to differentiate between various clinical severity grades. ROC Curve analysis suggests cut-off levels of HA between mild, moderate and severe cases. Conclusion: HA levels are able to differentiate between normal asymptomatic population and symptomatic cases and also between various severity grades of osteoarthritis. PMID:25653977

Kumar, Dharmendra; Sharma, Nishant Raj

2014-01-01

226

Symptoms and radiographic osteoarthritis: not as discordant as they are made out to be?  

PubMed Central

Objectives Joint pain and radiographic osteoarthritis are often discordant. Aim To investigate this issue more closely by studying the detailed nature of pain and disability, and how this relates to radiographic osteoarthritis. Methods Population?based study of 819 adults aged ?50?years with knee pain. The severity of knee pain, stiffness and disability was measured using a validated scale (the Western Ontario and McMaster Universities (WOMAC) Score) and pain persistence was recorded. Global severity was measured by the graded chronic pain scale. Three radiographic views of the knees were obtained—weight?bearing posteroanterior metatarsophalangeal, supine skyline and supine lateral. Results 745 participants with knee pain in the past 6?months were eligible (mean age 65?years, 338 men). Radiographic osteoarthritis was more common in those with a longer history and more persistent symptoms. A strong trend was found of radiographic osteoarthritis being more strongly associated with higher WOMAC scores for pain severity, stiffness and disability (adjusted odds ratio (95% confidence interval (CI)) for highest v lowest WOMAC category: 3.7 (2.0 to 6.7), 3.0 (2.0 to 4.6) and 2.8 (1.6 to 5.0), respectively). Those individual WOMAC items for pain and disability pertaining to weight?bearing mobility were the most strongly associated with radiographic osteoarthritis. Combining pain persistence and global severity, persistent severe pain was associated with a significant increase in the occurrence of radiographic osteoarthritis (2.6 (95% CI 1.5 to 4.7)). Conclusions A consistent association was found between severity of pain, stiffness and physical function and the presence of radiographic osteoarthritis. This study highlights the potential contribution of underlying joint disease to the degree of pain and disability. PMID:16877532

Duncan, R; Peat, G; Thomas, E; Hay, E; McCall, I; Croft, P

2007-01-01

227

Interpretation of Serum C-Reactive Protein (CRP) Levels for Cardiovascular Disease Risk is Complicated by Race, Pulmonary Disease, Body Mass Index, Gender, and Osteoarthritis  

PubMed Central

Objective High sensitivity serum C-reactive protein (hsCRP) is used as a marker of risk for cardiovascular disease (CVD); however CRP is a non-specific acute phase reactant. We evaluated the association between hsCRP concentrations and the most common form of arthritis, osteoarthritis (OA), and assessed the applicability of hsCRP for CVD risk prediction. Methods Participants (n=662) were selected from the population-based Johnston County Osteoarthritis Project, using stratified simple random sampling to achieve balance according to radiographic knee OA status, ethnic group, gender, and age group. The presence and severity of knee and hip OA were determined radiographically. CVD risk was estimated by hsCRP concentration and independently with the Framingham risk algorithm. Results Serum ln hsCRP was higher in African-Americans (p<0.0001) and women (p<0.0001), was higher in participants who had chronic pulmonary disease (p = 0.01), hypertension (p < 0.0001), or used pain medications (p = 0.004), and correlated with BMI (r=0.40, p<0.0001) and waist circumference (r=0.33, p<0.0001), but not with age, CVD, or current smoking. Ln hsCRP was strongly positively associated with all definitions of radiographic OA (p<0.0001), but this association was not independent of BMI. Although 183 participants reported no CVD and were classified as low risk by the Framingham CVD score, 61% of them were classified as moderate or high risk for CVD using hsCRP; this proportion designated high risk for CVD on the basis of hsCRP consisted primarily of women (p<0.05) and individuals with OA (p<0.01). Conclusions The pathogenic significance of hsCRP elevations in this subgroup is unclear. Serum hsCRP for predicting risk of CVD is confounded by obesity, ethnicity, gender and comorbidities. PMID:17395501

Kraus, Virginia B; Stabler, Thomas V; Luta, Gheorghe; Renner, Jordan B; Dragomir, Anca D; Jordan, Joanne M

2009-01-01

228

Superoxide dismutase down regulation in osteoarthritis progression and end-stage disease  

PubMed Central

Objective Oxidative stress is proposed as an important factor in osteoarthritis (OA). We therefore investigated the expression of the three superoxide dismutase (SOD) antioxidant enzymes in OA. Methods SOD expression was determined by real-time polymerase chain reaction and immunohistochemistry using human femoral head cartilage. SOD2 expression in Dunkin Hartley guinea pig knee articular cartilage was determined by immunohistochemistry. The DNA methylation status of the SOD2 promoter was determined using bisulfite sequencing. RNA interference was used to determine the consequence of SOD2 depletion on the levels of reactive oxygen species (ROS) using MitoSOX™ and collagenases, matrix metalloproteinase 1 (MMP-1) and MMP-13, gene expression. Results All three SOD were abundantly expressed in human cartilage but were markedly down-regulated in end-stage OA cartilage, especially SOD2. In the Dunkin Hartley guinea pig spontaneous OA model SOD2 expression was decreased in the medial tibial chondyle cartilage prior to, and following, the development of OA-like lesions. The SOD2 promoter had significant DNA methylation alterations in OA cartilage. Depletion of SOD2 in chondrocytes gave an increase in ROS but a decrease in collagenase expression. Conclusion This is the first comprehensive expression profile of all SOD genes in cartilage and importantly, using an animal model, we show that a reduction in SOD2 is associated with the earliest stages of OA. We found that a decrease in SOD2 associates with an increase in ROS and but a reduction of collagenase gene expression, demonstrating the complexities of ROS function. PMID:20511611

Scott, Jenny L.; Gabrielides, Christos; Davidson, Rose K.; Swingler, Tracey E.; Clark, Ian M.; Wallis, Gillian A.; Boot-Handford, Raymond P.; Kirkwood, Tom B.L.; Talyor, Robert W.; Young, David A.

2013-01-01

229

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

PubMed Central

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

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

230

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 Central

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-1?) 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

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

2013-01-01

231

Comorbid diseases as predictors of survival of primary total hip and knee replacements: a nationwide register-based study of 96?754 operations on patients with primary osteoarthritis  

PubMed Central

Objectives To examine how comorbid diseases (cardiovascular diseases, hypertension, diabetes, cancer, pulmonary diseases, depression, psychotic disorders and neurodegenerative diseases) affect survival of hip and knee replacements. Methods Data for this register-based study were collected by combining data from five nationwide health registers. 43?747 primary total hip and 53?007 primary total knee replacements performed for osteoarthritis were included. The independent effects of comorbid diseases on prosthesis survival were analysed using multivariate Cox regression analysis. Results Occurrence of one or more of the diseases analysed was associated with poorer survival of hip (HR for revision 1.16, 95% CI 1.08 to 1.23) and knee replacements (1.23, 1.16 to 1.30). Cardiovascular diseases and psychotic disorders were associated with increased risk of revision after both hip (1.19, 1.06 to 1.34 and 1.41, 1.04 to 1.91, respectively) and knee replacement (1.29, 1.14 to 1.45 and 1.41, 1.07 to 1.86, respectively). Hypertension and diabetes were associated with early revision (0–5?years after primary operation) after knee replacements (1.14, 1.01 to 1.29 and 1.27, 1.08 to 1.50, respectively). Cancer was associated with poorer survival of hip replacements (1.27, 1.05 to 1.54) and late revision (>5?years) of knee replacements (2.21, 1.31 to 3.74). Depression affected the risk of early revision after hip replacement (1.50, 1.02 to 2.21). Neurodegenerative and pulmonary diseases did not affect prosthesis survival. Conclusions Comorbid diseases may play an important role in predicting survival of primary hip and knee replacements. The mechanisms underlying these findings and their effect on cost-effectiveness of joint replacements, merit further research. PMID:23253916

Jämsen, Esa; Peltola, Mikko; Eskelinen, Antti; Lehto, Matti U K

2013-01-01

232

The Multicenter Osteoarthritis Study (MOST): Opportunities for Rehabilitation Research  

PubMed Central

The Multicenter Osteoarthritis Study (MOST) is a longitudinal observational study of the effects of biomechanical, bone and joint structural, and nutritional factors on the incidence and progression of knee symptoms and radiographic and symptomatic knee osteoarthritis (OA). It is the first large-scale epidemiologic study to focus on symptomatic knee OA in a community-based sample of adultswith or at high risk for knee OA, based on thepresence of knee symptoms, history of knee injury or surgery or being overweight. Beginning in 2003, 3026 individuals (60.1% women) age 50-79 years were enrolled. Examinations at baseline, and 15, 30, 60, 72 and 84 months later included assessment of risk factors, disease characteristics, body functions and structure, and measures of physical activity and participation. The wealth of data from this longitudinal cohort of community-dwelling older adults affords valuable opportunities for rehabilitation researchers. PMID:23953013

Segal, Neil A.; Nevitt, Michael C.; Gross, K. Douglas; Hietpas, Jean; Glass, Natalie A.; Lewis, Cora E.; Torner, James C.

2013-01-01

233

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

PubMed

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 1? (IL-1?), 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-?). 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

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

2014-11-01

234

Improved Flow Cytometric Assessment Reveals Distinct Microvesicle (Cell-Derived Microparticle) Signatures in Joint Diseases  

PubMed Central

Introduction Microvesicles (MVs), earlier referred to as microparticles, represent a major type of extracellular vesicles currently considered as novel biomarkers in various clinical settings such as autoimmune disorders. However, the analysis of MVs in body fluids has not been fully standardized yet, and there are numerous pitfalls that hinder the correct assessment of these structures. Methods In this study, we analyzed synovial fluid (SF) samples of patients with osteoarthritis (OA), rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA). To assess factors that may confound MV detection in joint diseases, we used electron microscopy (EM), Nanoparticle Tracking Analysis (NTA) and mass spectrometry (MS). For flow cytometry, a method commonly used for phenotyping and enumeration of MVs, we combined recent advances in the field, and used a novel approach of differential detergent lysis for the exclusion of MV-mimicking non-vesicular signals. Results EM and NTA showed that substantial amounts of particles other than MVs were present in SF samples. Beyond known MV-associated proteins, MS analysis also revealed abundant plasma- and immune complex-related proteins in MV preparations. Applying improved flow cytometric analysis, we demonstrate for the first time that CD3+ and CD8+ T-cell derived SF MVs are highly elevated in patients with RA compared to OA patients (p?=?0.027 and p?=?0.009, respectively, after Bonferroni corrections). In JIA, we identified reduced numbers of B cell-derived MVs (p?=?0.009, after Bonferroni correction). Conclusions Our results suggest that improved flow cytometric assessment of MVs facilitates the detection of previously unrecognized disease-associated vesicular signatures. PMID:23185418

György, Bence; Szabó, Tamás G.; Turiák, Lilla; Wright, Matthew; Herczeg, Petra; Lédeczi, Zsigmond; Kittel, Ágnes; Polgár, Anna; Tóth, Kálmán; Dérfalvi, Beáta; Zelenák, Gerg?; Böröcz, István; Carr, Bob; Nagy, György; Vékey, Károly; Gay, Steffen; Falus, András; Buzás, Edit I.

2012-01-01

235

Exercising with Osteoarthritis  

MedlinePLUS

... everyone. In fact, studies show that people with osteoarthritis benefit from regular exercise and physical activity. For people with osteoarthritis, regular exercise can help: l Maintain healthy and ...

236

Evidenzbasierte Therapie degenerativer Gelenkerkrankungen: Teil 1: Allgemeine und operative Therapieverfahren Evidence Based Therapy of Degenerative Joint Diseases - Surgical Treatment Options  

Microsoft Academic Search

Osteoarthritis is the most common joint affec- tion in humans. Women are twice as often af- fected as men. Incidence and prevalence are expected to notably rise further within the next years. In therapy, all common methods should be used fi rst. To those methods belong appropriate or modifi ed shoes, walking sticks as well as other orthopaedic-technical methods. The

T. Rosemann

237

Feline degenerative joint disease: a genomic and proteomic approach.  

PubMed

The underlying disease mechanisms for feline degenerative joint disease (DJD) are mostly unidentified. Today, most of what is published on mammalian arthritis is based on human clinical findings or on mammalian models of human arthritis. However, DJD is a common occurrence in the millions of domestic felines worldwide. To get a better understanding of the changes in biological pathways that are associated with feline DJD, this study employed a custom-designed feline GeneChip, and the institution's unique access to large sample populations to investigate genes and proteins from whole blood and serum that may be up- or down-regulated in DJD cats. The GeneChip results centered around three main pathways that were affected in DJD cats: immune function, apoptosis and oxidative phosphorylation. By identifying these key disease-associated pathways it will then be possible to better understand disease pathogenesis and diagnose it more easily, and to better target it with pharmaceutical and nutritional intervention. PMID:23295270

Gao, Xiangming; Lee, Junyu; Malladi, Sukhaswami; Melendez, Lynda; Lascelles, B Duncan X; Al-Murrani, Samer

2013-06-01

238

Unicompartmental and bicompartmental knee osteoarthritis show different patterns of mononuclear cell infiltration and cytokine release in the affected joints.  

PubMed

It is still controversial which cell types are responsible for synovial inflammation in osteoarthritic (OA) joints. The aim of this study was to quantify the mononuclear cell populations and their cytokines in patients with different knee OA subtypes. Synovial membrane (SM), synovial fluid (SF) and peripheral blood (PB) were harvested from patients with unicompartmental (UC) and bicompartmental (BC) knee OA. Frequencies of mononuclear cells were assessed by flow cytometry in PB and SM. Naive SF samples were analysed for a broad variety of cytokines by multiplex analysis. SM of both groups displayed a distinct mononuclear cell infiltration, with CD14(+) macrophages being the major cell population, followed by CD4(+) T cells and only small numbers of CD8(+) T, CD19(+) B and CD16(+) CD56(+) natural killer (NK) cells. Between the two groups, SM of BC OA showed significantly higher amounts of mononuclear cells (135·7?±?180 versus 805?±?675 cells/mg, P?=?0·0009) and higher CD4(+) T cell presence (3·4?±?4·6 versus 9·1?±?7·5%, P?=?0·0267). SF of BC OA displayed significantly higher concentrations for a number of proinflammatory cytokines [CXCL1, eotaxin, interferon (IFN)-?, interleukin (IL)-7, IL-8, IL-9, IL-12]. UC and BC OA show significant differences in their synovial inflammatory pattern. Whereas in UC OA CD14(+) macrophages are the predominant cell population, BC OA has a higher inflammatory profile and seems to be driven by CD14(+) macrophages and CD4(+) T cells. Inclusion of clinical information into the analysis of cellular and molecular results is pivotal in understanding the pathophysiology of OA. PMID:25393692

Moradi, B; Rosshirt, N; Tripel, E; Kirsch, J; Barié, A; Zeifang, F; Gotterbarm, T; Hagmann, S

2015-04-01

239

Bradykinin and its role in osteoarthritis.  

PubMed

Osteoarthritis (OA), the most common joint disorder, is a disease involving all the articular structures. It presents both degenerative and inflammatory aspects. Recently, the important role of Bradykinin (BK), a phlogistic mediator, has been proposed in the pathophysiology of OA. In our review, we summarized the currently available information on the mechanisms of action of BK in OA by linking its B2 receptors. Then, we analyzed the data about the effects of BK in synoviocytes and chondrocytes cultures. Furthermore, we described the action of B2 receptor antagonists (Icatibant and Fasitibant), presenting them as new promising symptom-anddisease- modifying agents in the treatment of OA. However, more in vitro, animal model and clinical studies, are needed to better understand the mechanisms of action as well as the efficacy and tolerability of the B2 receptor antagonists in OA. PMID:23884024

De Falco, L; Fioravanti, A; Galeazzi, M; Tenti, S

2013-01-01

240

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

ERIC Educational Resources Information Center

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…

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

2012-01-01

241

Regenerative Therapies for Equine Degenerative Joint Disease: A Preliminary Study  

PubMed Central

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

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

2014-01-01

242

2-Butoxyethanol model of haemolysis and disseminated thrombosis in female rats: a preliminary study of the vascular mechanism of osteoarthritis in the temporomandibular joint.  

PubMed

Female rats develop haemolytic anaemia and disseminated thrombosis and infarction in multiple organs, including bone, when exposed to 2-butoxyethanol (BE). There is growing evidence that vascular occlusion of the subchondral bone may play a part in some cases of osteoarthritis. The subchondral bone is the main weight bearer as well as the source of the blood supply to the mandibular articular cartilage. Vascular occlusion is thought to be linked to sclerosis of the subchondral bone associated with disintegration of the articular cartilage. The aim of this study was to find out whether this model of haemolysis and disseminated thrombosis supports the vascular hypothesis of osteoarthritis. Six female rats were given BE orally for 4 consecutive days and the two control rats were given tap water alone. The rats were killed 26 days after the final dose. The mandibular condyles showed histological and radiological features consistent with osteoarthritis in three of the four experimental rats and in neither of the control rats. These results may support the need to explore the vascular mechanism of osteoarthritis further. PMID:20034712

Amir, G; Goldfarb, A W; Nyska, M; Redlich, M; Nyska, A; Nitzan, D W

2011-01-01

243

Joint Modeling of Transitional Patterns of Alzheimer's Disease  

PubMed Central

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

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

2013-01-01

244

Animal models of osteoarthritis for the understanding of the bone contribution  

PubMed Central

Osteoarthritis characterizes the joint disease that results in cartilage damage accompanied by bone lesions and synovial inflammation. Joint integrity results from physiological interactions between all these tissues. Local factors such as cytokines and growth factors regulate cartilage remodeling and metabolism as well as chondrocyte differentiation and survival. Tremendous progress has been made through the use of animal models and provided insight for the mechanism of cartilage loss and chondrocyte functions. Surgical, chemical or genetic models have been developed to investigate the role of molecules in the pathogenesis or treatment of osteoarthritis. Indeed, the animal models are helpful to investigate the cartilage changes in relation to changes in bone remodeling. Increased bone resorption occurs at early stage of the development of osteoarthritis, the inhibition of which prevents cartilage damage, confirming the role of bone factors in the crosstalk between both tissues. Among these numerous molecules, some participate in the imbalance in cartilage homeostasis and in the pathophysiology of osteoarthritis. These local factors are potential candidates for new drug targets. PMID:24422124

Cohen-Solal, Martine; Funck-Brentano, Thomas; Hay, Eric

2013-01-01

245

Osteoarthritis associated with estrogen deficiency  

PubMed Central

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

2009-01-01

246

Locking of the Metacarpophalangeal Joints in Degenerative Disease  

Microsoft Academic Search

Nine cases of locking of the metacarpo-phalangeal joint are described. The previously asymptomatic middle finger joint in an elderly person was most likely to be affected. Radiology of the joint has shown degenerative changes in all cases. In two patients, spontaneous unlocking of the joint occurred and in a further six operative release was undertaken. The important anatomical features of

G. J. STEWART; E. A. WILLIAMS

1981-01-01

247

Joints  

NSDL National Science Digital Library

Hinge joints move only in one direction, ball-and-socket joints are free to rotate in all directions, and gliding joints are able to move forward, backward, and side to side, but do not rotate freely.

Olivia Worland (Purdue University; Biological Sciences)

2008-06-06

248

Trapeziometacarpal osteoarthritis: pyrocarbon interposition implants  

PubMed Central

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.

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

2014-01-01

249

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

PubMed Central

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

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

250

Abnormal cancellous bone collagen metabolism in osteoarthritis.  

PubMed Central

Biochemical investigations into the pathogenesis of osteoarthritis have, for the last two decades, concentrated on the mechanisms involved in the destruction of the articular cartilage. Although bone changes are known to occur, the biochemistry of the collagenous matrix within osteoarthritic bone has received scant attention. We report that bone collagen metabolism is increased within osteoarthritic femoral heads, with the greatest changes occurring within the subchondral zone. Collagen synthesis and its potential to mineralize were determined by the carboxy-terminal propeptide content and alkaline phosphatase activity, respectively. These data supported elevated new matrix formation. Our finding of a three- to fourfold increase in TGF-beta in osteoarthritic bone indicates that this might represent a stimulus for the increased collagen synthesis observed. Of additional significance is the hypomineralization of deposited collagen in the subchondral zone of osteoarthritic femoral heads, supporting a greater proportion of osteoid in the diseased tissue. The cross-linking of collagen was similar to that observed for controls. In addition, the degradative potential of osteoarthritic bone was considerably higher as demonstrated by increased matrix metalloproteinase 2 activity, and again the greater activity was associated with the subchondral bone tissue. The polarization exhibited in the metabolism of bone collagen from osteoarthritic hips might exacerbate the processes involved in joint deterioration by altering joint morphology. This in turn may alter the distribution of mechanical forces to the various tissues, to which bone is a sensitive responder. Bone collagen metabolism is clearly an important factor in the pathogenesis of osteoarthritis and certainly warrants further biochemical study. PMID:9541489

Mansell, J P; Bailey, A J

1998-01-01

251

Chondrosenescence: definition, hallmarks and potential role in the pathogenesis of osteoarthritis.  

PubMed

Aging and inflammation are major contributing factors to the development and progression of arthritic and musculoskeletal diseases. "Inflammaging" refers to low-grade inflammation that occurs during physiological aging. In this paper we review the published literature on cartilage aging and propose the term "chondrosenescence" to define the age-dependent deterioration of chondrocyte function and how it undermines cartilage function in osteoarthritis. We propose the concept that a small number of senescent chondrocytes may be able to take advantage of the inflammatory tissue microenvironment and the inflammaging and immunosenescence that is concurrently occurring in the arthritic joint, further contributing to the age-related degradation of articular cartilage, subchondral bone, synovium and other tissues. In this new framework "chondrosenescence" is intimately linked with inflammaging and the disturbed interplay between autophagy and inflammasomes, thus contributing to the age-related increase in the prevalence of osteoarthritis and a decrease in the efficacy of articular cartilage repair. A better understanding of the basic mechanisms underlying chondrosenescence and its modification by drugs, weight loss, improved nutrition and physical exercise could lead to the development of new therapeutic and preventive strategies for osteoarthritis and a range of other age-related inflammatory joint diseases. Aging is inevitable but age-related diseases may be modifiable. PMID:25637957

Mobasheri, Ali; Matta, Csaba; Zákány, Róza; Musumeci, Giuseppe

2015-03-01

252

Handout on Health: Osteoarthritis  

MedlinePLUS

... are more likely to have positive outcomes. Self-Management Programs Do Help People with osteoarthritis find that ... susceptibility to knee osteoarthritis. Patient Education and Self-Management When patients understand and feel that they have ...

253

The Complexity of Human Walking: A Knee Osteoarthritis Study  

PubMed Central

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

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

2014-01-01

254

Antibiotic prophylaxis for haematogenous bacterial arthritis in patients with joint disease: a cost effectiveness analysis  

Microsoft Academic Search

OBJECTIVETo assess the cost effectiveness of antibiotic prophylaxis for haematogenous bacterial arthritis in patients with joint disease.METHODSIn a decision analysis, data from a prospective study on bacterial arthritis in 4907 patients with joint disease were combined with literature data to assess risks and benefits of antibiotic prophylaxis. Effectiveness and cost effectiveness calculations were performed on antibiotic prophylaxis for various patient

P. Krijnen; C J E Kaandorp; E. W. Steyerberg; D van Schaardenburg; H J Bernelot Moens; J. D. F. Habbema

2001-01-01

255

Nanomedicine: AFM tackles osteoarthritis  

NASA Astrophysics Data System (ADS)

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.

Aigner, Thomas; Schmitz, Nicole; Haag, Jochen

2009-03-01

256

Acromioclavicular osteoarthritis: a common cause of shoulder pain.  

PubMed

Osteoarthritis of the acromioclavicular joint is a frequent cause of shoulder pain and can result in significant debilitation. It is the most common disorder of the acromioclavicular joint and may arise from a number of pathologic processes, including primary (degenerative), posttraumatic, inflammatory, and septic arthritis. Patients often present with nonspecific complaints of pain located in the neck, shoulder, and/or arm, further complicating the clinical picture. A thorough understanding of the pertinent anatomy, disease process, patient history, and physical examination is crucial to making the correct diagnosis and formulating a treatment plan. Initial nonoperative management is aimed at relieving pain and restoring function. Typical treatments include anti-inflammatory medications, physical therapy, and injections. Patients who continue to exhibit symptoms after appropriate nonsurgical treatment may be candidates for operative resection of the distal clavicle through either open or arthroscopic techniques. PMID:24937735

Menge, Travis J; Boykin, Robert E; Bushnell, Brandon D; Byram, Ian R

2014-05-01

257

Stress radiographs in the evaluation of degenerative femorotibial joint disease  

Microsoft Academic Search

Thirty-eight osteoarthrotic knees were examined to assess the widths of the femorotibial joint spaces. Radiographs were exposed with the patient lying, in a standing position, and with an adduction and abduction force. Forced compression of the osteoarthrotic joint compartment caused, on average, 18% greater narrowing than when loading it in the standing position. Compared to the joint space at rest,

Kai Tallroth; T. Sam Lindholm

1987-01-01

258

The evolving role of biomarkers for osteoarthritis  

PubMed Central

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

Kaneko, Haruka; Kaneko, Kazuo

2014-01-01

259

Modulation of the intramedullary pressure responses by calcium dobesilate in a rabbit knee model of osteoarthritis  

PubMed Central

Background and purpose The presence of bone marrow edema in patients with osteoarthritis is associated with pain and disease progression. Management of bone edema with the synthetic prostacyclin iloprost may be complicated by side effects. Calcium dobesilate, a treatment for chronic venous disease, shares some pharmacological actions with iloprost but appears to be better tolerated. Anecdotal reports have suggested that calcium dobesilate may be useful for medical management of osteoarthritis, possibly by reducing bone marrow edema, and this study was performed to investigate possible benefits of treatment. Methods The effects of a 6-week period of oral calcium dobesilate administration on tibial intramedullary pressure dynamics and physical joint characteristics were evaluated in 20 rabbits with unilaterally induced knee osteoarthritis that were randomly allocated to either a treatment group or a placebo control group. Treatment or placebo started 8 weeks after induction of osteoarthritis, and was followed by a 4-week washout period. Results Calcium dobesilate did not affect joint thickness or range of motion, nor individual pressure measurements, compared to placebo. Pressure ranges in the operated limb were greater than in the intact limb after 8 weeks, and approached those of the intact limb after 6 weeks of treatment with calcium dobesilate but not with placebo. Inter-limb differences were lower (p = 0.02) in the dobesilate group following the washout period. Interpretation Calcium dobesilate had a detectable effect on pressure dynamics in the subchondral bone of osteoarthritic joints in this model. The significance of these effects for pain and function should be established. PMID:21895501

2011-01-01

260

Electrokinetic methods for arthroscopic detection of cartilage degeneration in synovial joints  

Microsoft Academic Search

This study focuses on two approaches for the nondestructive measurement of certain electrokinetic properties of articular cartilage that provide a sensitive measure of tissue degradation in degenerative joint diseases such as osteoarthritis. The first method involves measurement of current generated stress (electrical to mechanical transduction) using a newly developed surface probe to apply a standing wave of electric current to

S. I. Berkenblit; E. H. Frank; L. J. Bonassar; D. L. Bombard; N. J. Duffin; A. J. Grodzinsky

1994-01-01

261

The role of pain and functional impairment in the decision to recommend total joint replacement in hip and knee osteoarthritis: an international cross-sectional study of 1909 patients. Report of the OARSI-OMERACT Task Force on total joint replacement  

PubMed Central

Objective To assess the pain and functional disability levels corresponding to an indication for total joint replacement (TJR) in hip and knee osteoarthritis (OA). Methods Design: international cross-sectional study in 10 countries. Patients: consecutive outpatients with definite hip or knee OA attending an orthopaedic outpatient clinic. Gold standard measure for recommendation for TJR: surgeon's decision that TJR is justified. Outcome measures: pain (ICOAP: intermittent and constant osteoarthritis pain, 0-100) and functional impairment (HOOS-PS/KOOS-PS: Hip/Knee injury and Osteoarthritis Outcome Score Physical function Short-form, 0-100). Analyses: Comparison of patients with versus without surgeons' indication for TJR. ROC curve analyses and logistic regression were applied to determine cut-points of pain and disability defining recommendation for TJR. Results In all, 1909 patients were included (1130 knee/779 hip OA). Mean age was 66.4 (SD 10.9) years, 58.1% were women; 628/1130 (55.6%) knee OA and 574/779 (73.7%) hip OA patients were recommended for TJR. Although patients recommended for TJR (yes versus no) had worse symptom levels (pain, 55.5 [95% confidence interval 54.2, 56.8] vs. 44.9 [43.2, 46.6], and functional impairment, 59.8 [58.7, 60.9] vs. 50.9 [49.3, 52.4], respectively, both p<0.0001), there was substantial overlap in symptom levels between groups, even when adjusting for radiographic joint status. Thus, it was not possible to determine cut points for pain and function defining ‘requirement for TJR’. Conclusion Although symptom levels were higher in patients recommended for TJR, pain and functional disability alone did not discriminate between those who were and were not considered to need TJR by the orthopaedic surgeon. PMID:21044689

Gossec, Laure; Paternotte, Simon; Maillefert, Jean Francis; Combescure, Christophe; Conaghan, Philip G; Davis, Aileen M.; Gunther, Klaus-Peter; Hawker, Gillian; Hochberg, Marc; Katz, Jeffrey N; Kloppenburg, Margreet; Lim, Keith; Lohmander, L. Stefan; Mahomed, Nizar N.; March, Lyn; Pavelka, Karel; Punzi, Leonardo; Roos, Ewa M.; Sanchez-Riera, Lydia; Singh, Jasvinder A.; Suarez-Almazor, Maria E.; Dougados, Maxime

2014-01-01

262

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

NASA Astrophysics Data System (ADS)

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.

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

263

Immunopathogenesis of Osteoarthritis  

PubMed Central

Even though osteoarthritis (OA) is mainly considered as a degradative condition of the articular cartilage, there is increasing body of data demonstrating the involvement of all branches of the immune system. Genetic, metabolic or mechanical factors cause an initial injury to the cartilage resulting in release of several cartilage specific auto-antigens, which trigger the activation of immune response. Immune cells including T cells, B cells and macrophages infiltrate the joint tissues, cytokines and chemokines are released from different kind of cells present in the joint, complement system is activated, cartilage degrading factors such as matrix metalloproteins (MMPs) and prostaglanding E2 (PGE2) are released, resulting in further damage to the articular cartilage. There is considerable success in the treatment of rheumatoid arthritis using anti-cytokine therapies. In OA, however, these therapies did not show much effect, highlighting more complex nature of pathogenesis of OA. This needs the development of more novel approaches to treat OA, which may include therapies that act on multiple targets. Plant natural products have this kind of properties and may be considered for future drug development efforts. Here we reviewed the studies implicating different components of the immune system in the pathogenesis of OA. PMID:23360836

Haseeb, Abdul; Haqqi, Tariq M.

2013-01-01

264

Preliminary histopathological study of intra-articular injection of a novel highly cross-linked hyaluronic acid in a rabbit model of knee osteoarthritis.  

PubMed

Osteoarthritis is a degenerative joint disease mostly occurring in the knee and commonly seen in middle-aged and elderly adults. Intra-articular injection of hyaluronic acid has been widely used for treatment of knee osteoarthritis. The aim of this study was to evaluate the efficacy of intra-articular injection of a novel highly cross-linked hyaluronic acid, alone or in combination with ropivacaine hydrochloride and triamcinolone acetonide, on knee articular cartilage in a rabbit model of collagenase-induced knee osteoarthritis. After induction of experimental osteoarthritis by intra-articular injection of collagenase, adult New Zealand white rabbits (n = 12) were divided into 3 groups. Group 1 (control group) received 0.3 ml phosphate buffered saline into the right knee joint. Group 2 received 0.3 ml cross-linked hyaluronic acid (33 mg/ml) into the right knee joint. Group 3 received a mixture of 0.15 ml cross-linked hyaluronic acid (33 mg/ml), 0.05 ml ropivacaine hydrochloride 1 % and 0.1 ml triamcinolone acetonide (10 mg/ml) into the right knee joint. Intra-articular injections were given 4 weeks after first collagenase injection and were administered once a week for 3 weeks. Gross pathology and histological evaluation of rabbits' knee joints were performed after 16 weeks following initial collagenase injection. Histological analysis of sections of right knee joints at lesion sites showed a significant decrease in Mankin's score in groups treated with hyaluronic acid alone or in combination with ropivacaine hydrochloride and triamcinolone acetonide versus control group (p < 0.05 and p < 0.01 respectively). This evidence was consistent with strong articular degenerative changes in control right knee joints (grade III osteoarthritis), while the treated groups revealed less severe articular degenerative changes (grade II osteoarthritis). The present results show that cross-linked hyaluronic acid, alone or in combination with ropivacaine hydrochloride and triamcinolone acetonide, produces a significant improvement in knee articular cartilage degeneration in a rabbit model of collagenase-induced osteoarthritis. PMID:23389746

Iannitti, Tommaso; Elhensheri, Mohamed; Bingöl, Ali O; Palmieri, Beniamino

2013-04-01

265

Association between disease-specific quality-of-life and magnetic resonance imaging outcomes in a clinical trial of prolotherapy for knee osteoarthritis  

PubMed Central

Objective To assess the relationship between knee osteoarthritis (KOA)-specific quality-of-life (QoL) and intra-articular cartilage volume (CV) in participants treated with prolotherapy. KOA is characterized by CV loss and multifactorial pain. Prolotherapy is an injection therapy reported to improve KOA-related QoL compared to blinded saline injections and at-home exercise but the mechanism of action is unknown. Design Two-arm (Prolotherapy, Control), partially blinded, controlled trial. Setting Outpatient. Participants 37 adults with ?3 months of symptomatic KOA. Intervention Prolotherapy: 5 monthly injection sessions; Control: blinded saline injections or at-home exercise. Outcome Measures Primary: KOA-specific QoL scores (baseline, 5, 9, 12, 26, 52 weeks; Western Ontario McMaster University Osteoarthritis Index, WOMAC). Secondary: KOA-specific pain, stiffness, function (WOMAC subscales), magnetic resonance imaging (MRI)-assessed CV (baseline, 52 weeks). Results Knee-specific QoL improvement among Prolotherapy participants exceeded that of Controls (17.6±3.2 versus 8.6±5.0 points, p=0.05) at 52 weeks. Both groups lost CV over time (p<0.05); no between-group differences were noted (p=0.98). While Prolotherapy participants lost CV at varying rates, those who lost the least CV (“Stable CV”) had the greatest improvement in pain scores. Among Prolotherapy, but not Control participants, the change in CV and the change in pain (but not stiffness or function) scores were correlated; each 1% CV loss was associated with 2.7% less improvement in pain score (p<0.05). Conclusions Prolotherapy resulted in safe, substantial improvement in KOA-specific QoL compared to Control over 52-weeks. Among prolotherapy participants, but not Controls, MRI-assessed CV change (CV stability) predicted pain severity score change, suggesting prolotherapy may have pain-specific disease-modifying effect. Further research is warranted. PMID:23850615

Rabago, David; Kijowski, Richard; Woods, Michael; Patterson, Jeffrey J.; Mundt, Marlon; Zgierska, Aleksandra; Grettie, Jessica; Lyftogt, John; Fortney, Luke

2013-01-01

266

Synovial chondromatosis of the temporomandibular joint with calcium pyrophosphate dihydrate crystal deposition disease (pseudogout)  

PubMed Central

This report describes a very rare case of synovial chondromatosis with deposition of calcium pyrophosphate dihydrate (CPPD) crystals (pseudogout) in the temporomandibular joint (TMJ) of a 46-year-old male patient. Synovial chondromatosis is a non-neoplastic disease characterized by metaplasia of the connective tissue leading to chondrogenesis in the synovial membrane. Pseudogout is an inflammatory disease of the joints caused by the deposition of CPPD, producing similar symptoms to those observed in gout but not hyperuricaemia. Both diseases commonly affect the knee, hip and elbow joints, but rarely affect the TMJ. PMID:23166363

Matsumura, Y; Nomura, J; Nakanishi, K; Yanase, S; Kato, H; Tagawa, T

2012-01-01

267

Molecular monitoring of equine joint homeostasis.  

PubMed

Diseases affecting synovial joints are a major cause of chronic disability both in humans and in companion animal species, most notably dogs and horses. As progressive deterioration of the articular cartilage is the hallmark of degenerative joint disease or osteoarthritis, research efforts traditionally tended to focus primarily on cartilage pathology. However, in recent years it has become clear that synovial joints should be considered intricate organs in their own right, with each of the constituent tissues (cartilage, bone, and synovial membrane) interacting with each other both in health and disease. Moreover, with the advent of modern molecular biology techniques, the importance of synovial inflammation in disease development and progression has become increasingly recognized. These realizations have spurred the need for tools that allow a more comprehensive, integral study of synovial joint homeostasis. This review provides a brief overview of synovial joint biology and the concept of joint homeostasis, followed by a discussion of methods that may be used to study joint homeostasis (varying from in vitro tissue culture to in vivo imaging) including specific advantages and limitations of each approach. It then zooms in on one such approach, synovial fluid biomarker analysis, as a promising avenue in synovial joint research, highlighting some results from equine studies performed in the author's own laboratory that illustrate how such studies may help shed light on in vivo joint homeostasis and therapeutic modulation thereof. The review concludes with some future perspectives and promising developments in the field. PMID:22029852

de Grauw, Janny C

2011-06-01

268

Identification of a central role for complement in osteoarthritis  

PubMed Central

Osteoarthritis, characterized by the breakdown of articular cartilage in synovial joints, has long been viewed as the result of “wear and tear”1. Although low-grade inflammation is detected in osteoarthritis, its role is unclear2–4. Here we identify a central role for the inflammatory complement system in the pathogenesis of osteoarthritis. Through proteomic and transcriptomic analyses of synovial fluids and membranes from individuals with osteoarthritis, we find that expression and activation of complement is abnormally high in human osteoarthritic joints. Using mice genetically deficient in C5, C6, or CD59a, we show that complement, and specifically the membrane attack complex (MAC)-mediated arm of complement, is critical to the development of arthritis in three different mouse models of osteoarthritis. Pharmacological modulation of complement in wild-type mice confirmed the results obtained with genetically deficient mice. Expression of inflammatory and degradative molecules was lower in chondrocytes from destabilized joints of C5-deficient mice than C5-sufficient mice, and MAC induced production of these molecules in cultured chondrocytes. Furthermore, MAC co-localized with matrix metalloprotease (MMP)-13 and with activated extracellular signal-regulated kinase (ERK) around chondrocytes in human osteoarthritic cartilage. Our findings indicate that dysregulation of complement in synovial joints plays a critical role in the pathogenesis of osteoarthritis. PMID:22057346

Wang, Qian; Rozelle, Andrew L.; Lepus, Christin M.; Scanzello, Carla R.; Song, Jason J.; Larsen, D. Meegan; Crish, James F.; Bebek, Gurkan; Ritter, Susan Y.; Lindstrom, Tamsin M.; Hwang, Inyong; Wong, Heidi H.; Punzi, Leonardo; Encarnacion, Angelo; Shamloo, Mehrdad; Goodman, Stuart B.; Wyss-Coray, Tony; Goldring, Steven R.; Banda, Nirmal K.; Thurman, Joshua M.; Gobezie, Reuben; Crow, Mary K.; Holers, V. Michael; Lee, David M.; Robinson, William H.

2011-01-01

269

Efficacy of intra-articular hyaluronan (Synvisc®) for the treatment of osteoarthritis affecting the first metatarsophalangeal joint of the foot (hallux limitus): study protocol for a randomised placebo controlled trial  

PubMed Central

Background Osteoarthritis of the first metatarsophalangeal joint (MPJ) of the foot, termed hallux limitus, is common and painful. Numerous non-surgical interventions have been proposed for this disorder, however there is limited evidence for their efficacy. Intra-articular injections of hyaluronan have shown beneficial effects in case-series and clinical trials for the treatment of osteoarthritis of the first metatarsophalangeal joint. However, no study has evaluated the efficacy of this form of treatment using a randomised placebo controlled trial. This article describes the design of a randomised placebo controlled trial to evaluate the efficacy of intra-articular hyaluronan (Synvisc®) to reduce pain and improve function in people with hallux limitus. Methods One hundred and fifty community-dwelling men and women aged 18 years and over with hallux limitus (who satisfy inclusion and exclusion criteria) will be recruited. Participants will be randomised, using a computer-generated random number sequence, to receive a single intra-articular injection of up to 1 ml hyaluronan (Synvisc®) or sterile saline (placebo) into the first MPJ. The injections will be performed by an interventional radiologist using fluoroscopy to ensure accurate deposition of the hyaluronan in the joint. Participants will be given the option of a second and final intra-articular injection (of Synvisc® or sterile saline according to the treatment group they are in) either 1 or 3 months post-treatment if there is no improvement in pain and the participant has not experienced severe adverse effects after the first injection. The primary outcome measures will be the pain and function subscales of the Foot Health Status Questionnaire. The secondary outcome measures will be pain at the first MPJ (during walking and at rest), stiffness at the first MPJ, passive non-weightbearing dorsiflexion of the first MPJ, plantar flexion strength of the toe-flexors of the hallux, global satisfaction with the treatment, health-related quality of life (assessed using the Short-Form-36 version two questionnaire), magnitude of symptom change, use of pain-relieving medication and changes in dynamic plantar pressure distribution (maximum force and peak pressure) during walking. Data will be collected at baseline, then 1, 3 and 6 months post-treatment. Data will be analysed using the intention to treat principle. Discussion This study is the first randomised placebo controlled trial to evaluate the efficacy of intra-articular hyaluronan (Synvisc®) for the treatment of osteoarthritis of the first MPJ (hallux limitus). The study has been pragmatically designed to ensure that the study findings can be implemented into clinical practice if this form of treatment is found to be an effective treatment strategy. Trial registration Australian New Zealand Clinical Trials Registry: ACTRN12607000654459 PMID:19146707

Munteanu, Shannon E; Menz, Hylton B; Zammit, Gerard V; Landorf, Karl B; Handley, Christopher J; ElZarka, Ayman; DeLuca, Jason

2009-01-01

270

Post-traumatic osteoarthritis: from mouse models to clinical trials.  

PubMed

Osteoarthritis (OA), the most common of all arthropathies, is a leading cause of disability and has a large (and growing) worldwide socioeconomic cost. Despite its burgeoning importance, translation of disease-modifying OA therapies from the laboratory into clinical practice has slowed. Differences between the OA models studied preclinically and the disease evaluated in human clinical trials contribute to this failure. Most animal models of OA induce disease through surgical or mechanical disruption of joint biomechanics in young individuals rather than the spontaneous development of age-associated disease. This instability-induced joint disease in animals best models the arthritis that develops in humans after an injurious event, known as post-traumatic OA (PTOA). Studies in genetically modified mice suggest that PTOA has a distinct molecular pathophysiology compared with that of spontaneous OA, which might explain the poor translation from preclinical to clinical OA therapeutic trials. This Review summarizes the latest data on potential molecular targets for PTOA prevention and modification derived from studies in genetically modified mice, and describes their validation in preclinical therapeutic trials. This article focuses on how these findings might best be translated to humans, and identifies the potential challenges to successful implementation of clinical trials of disease-modifying drugs for PTOA. PMID:23689231

Little, Christopher B; Hunter, David J

2013-08-01

271

Host and parasite diversity jointly control disease risk in complex communities  

E-print Network

Host and parasite diversity jointly control disease risk in complex communities Pieter T. J, Berkeley, CA, and approved September 10, 2013 (received for review June 3, 2013) Host­parasite interactions parasites. To date, however, surprisingly few studies have explored the joint effects of host and parasite

Johnson, Pieter

272

Correlation between knee roentgenogram changes and clinical symptoms in osteoarthritis.  

PubMed

The main purpose of this study was to analyze the relationship between clinical symptoms and roentgenographic changes in patients with incipient osteoarthritis of the knees (OA). One hundred and sixty-two patients (126 women, 36 men, mean age 59 years) with established osteoarthritis of the knee were examined. Patients performed subjective self-assessment using Lequesne's questionnaire (index of severity for OA of the knee) and had frontal and lateral roentgenograms of both knees. Validity of the indices as reflections of individual symptoms was documented. A statistically significant correlation was found between clinical and patient indices (r = 0.327, p < 0.0001) as well as a very weak correlation between the clinical and roentgenogram indices (r = 0.196, p = 0.286). However, there was no correlation between the patient index and roentgenogram index (r = 0.065, p = 0.47). For the assessment of severity and progression of the disease, items reflecting acute irritation (swelling, effusion, increased joint temperature, pain during passive motion) were more reliable than items reflecting chronicity (muscular atrophy, decreased range of motion, crepitus). This study confirmed that Lequesne's questionnaire is a suitable tool for assessing subjective symptoms as well as for generating a condensed measure of disease severity. In addition, sclerosis, narrowing and osteophytes were proved to be important features characterizing the OA process. PMID:1494737

Pavelka, K; Gatterová, J; Pavelka, K; Pelítskova, Z; Svarcová, Z; Janousek, J; Fencl, F; Urbanová, Z; Gollerová, V; Sedlacková, M

1992-10-01

273

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 ...

274

Automated Quantitative Histomorphometry in Osteoarthritis  

E-print Network

(degenerative joint disease), part of the research includes test on mice which spontaneously develop the disease In the development process of drugs for different diseases the pharmaceutical companies spend a lot of resources and the structure of the subchondral bone. The evaluation was focused on the medial tibia part of the knee joint

275

New molecular targets for the treatment of osteoarthritis.  

PubMed

Osteoarthritis (OA) is a chronic degenerative joint disorder characterized by destruction of the articular cartilage, subchondral bone alterations and synovitis. Current treatments are focused on symptomatic relief but they lack efficacy to control the progression of this disease which is a leading cause of disability. Therefore, the development of effective disease-modifying drugs is urgently needed. Different initiatives are in progress to define the molecular mechanisms involved in the initiation and progression of OA. These studies support the therapeutic potential of pathways relevant in joint metabolism such as Wnt/beta-catenin, discoidin domain receptor 2 or proteinase-activated receptor 2. The dysregulation in cartilage catabolism and subchondral bone remodeling could be improved by selective inhibitors of matrix metalloproteinases, aggrecanases and other proteases. Another approach would favor the activity of anabolic processes by using growth factors or regulatory molecules. Recent studies have also revealed the role of oxidative stress and synovitis in the progression of this disease, supporting the development of a number of inhibitory strategies. Novel targets in OA are represented by genes involved in OA pathophysiology discovered using gene network, epigenetic and microRNA approaches. Further insights into the molecular mechanisms involved in OA initiation and progression may lead to the development of new therapies able to control joint destruction and repair. PMID:20206140

Alcaraz, Maria José; Megías, Javier; García-Arnandis, Isabel; Clérigues, Victoria; Guillén, Maria Isabel

2010-07-01

276

Current interventions in the management of knee osteoarthritis  

PubMed Central

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

Bhatia, Dinesh; Bejarano, Tatiana; Novo, Mario

2013-01-01

277

Neuromuscular alterations during walking in persons with moderate knee osteoarthritis  

Microsoft Academic Search

This paper compared the neuromuscular responses during walking between those with early-stage knee osteoarthritis (OA) to asymptomatic controls. The rationale for studying those with mild to moderate knee OA was to determine the alterations in response to dynamic loading that might be expected before severe pain, joint space narrowing and joint surface changes occur. We used pattern recognition techniques to

C. L. Hubley-Kozey; K. J. Deluzio; S. C. Landry; J. S. McNutt; W. D. Stanish

2006-01-01

278

Patellofemoral Osteoarthritis  

PubMed Central

Patellofemoral arthritis is a fairly common disease, and it has been gaining interest with increasing number of studies due to its diverse treatment methods. Patellofemoral arthritis has a broad range of management options according to the characteristics of individual diseases. Identifying whether patellofemoral arthritis is the primary cause of knee pain and is compartment arthritis is necessary for establishing an adequate treatment method. Through investigation of the literature, the issues of recent knowledge of femoropatella arthritis and the diagnosis and treatment of which were studied. PMID:23269956

Joo, Yong-Bum

2012-01-01

279

Joint Genome-Wide Profiling of miRNA and mRNA Expression in Alzheimer's Disease Cortex Reveals Altered  

E-print Network

Joint Genome-Wide Profiling of miRNA and mRNA Expression in Alzheimer's Disease Cortex Reveals in Alzheimer's disease (AD). In this study, we used microarrays for the first joint profiling and analysis TE, Finch CE, Zhou XJ (2010) Joint Genome-Wide Profiling of miRNA and mRNA Expression in Alzheimer

Zhou, Xianghong Jasmine

280

Viscosupplementation for Osteoarthritis: a Primer for Primary Care Physicians  

PubMed Central

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

2015-01-01

281

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

PubMed Central

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

2014-01-01

282

Effect of S-methylisothiourea, an inducible nitric oxide synthase inhibitor, in joint pain and pathology in surgically induced model of osteoarthritis.  

PubMed

The aim of the present study was to evaluate in vivo modulatory effect of S-methylisothiourea (SMT), a preferential inhibitor of inducible nitric oxide synthase (iNOS) on pain and pathology in the surgical model of osteoarthritis (OA) in rats. The OA was produced by the anterior cruciate ligament transection (ACLT) and medial meniscectomy (MMx) of right knee. SMT was administered 1 day prior to the production of OA and continued up to day 42 postoperation. Mechanical hyperalgesia, thermal hyperalgesia, tail flick latency after repeated flexion and extension of OA knee and knee diameter of right knee were determined at weekly intervals. Serum levels of IL-1?, TNF-? and nitrite concentration were determined at the end of the experiment. Glycosaminoglycan (GAG) content, collagen content and histopathological evaluation of articular cartilage were also determined at the end of the experiment. SMT reduced mechanical hyperalgesia and the serum levels of IL-1?, TNF-? and nitrite. Further, SMT reduced the loss of GAG from articular cartilage. Microscopically, SMT reduced the severity of the cartilage lesion. The results indicate the effectiveness of SMT in attenuating the pain and pathology of experimental OA phase by reducing the production of nitric oxide and interleukin-1? and tumor necrosis factor-?, which are known to play a major role in the pathophysiology of OA. PMID:25111192

Balaganur, Venkanna; Pathak, Nitya Nand; Lingaraju, Madhu C; More, Amar Sunil; Latief, Najeeb; Kumari, Rashmi Rekha; Kumar, Dinesh; Tandan, Surendra K

2014-01-01

283

Pathology of the Calcified Zone of Articular Cartilage in Post-Traumatic Osteoarthritis in Rat Knees  

PubMed Central

Objectives This study aimed to investigate the pathology occurring at the calcified zone of articular cartilage (CZC) in the joints afflicted with post-traumatic osteoarthritis (PTOA). Methods Rats underwent bilateral anterior cruciate ligament (ACL) transection and medial meniscectomy to induce PTOA. Sham surgery was performed on another five rats to serve as controls. The rats were euthanized after four weeks of surgery and tibial plateaus were dissected for histology. The pathology of PTOA, CZC area and the tidemark roughness at six pre-defined locations on the tibial plateaus were quantified by histomorphometry. Results PTOA developed in the knees, generally more severe at the medial plateau than the lateral plateau, of rats in the experimental group. The CZC area was unchanged in the PTOA joints, but the topographic variations of CZC areas that presented in the control knees were reduced in the PTOA joints. The tidemark roughness decreased in areas of the medial plateau of PTOA joints and that was inversely correlated with the Mankin’s score of PTOA pathology. Conclusion Reduced tidemark roughness and unchanged CZC area differentiate PTOA from primary osteoarthritis, which is generally believed to have the opposite pathology at CZC, and may contribute to the distinct disease progression of the two entities of arthropathy. PMID:25807537

Schultz, Melissa; Molligan, Jeremy; Schon, Lew; Zhang, Zijun

2015-01-01

284

Susceptibility to large-joint osteoarthritis (hip and knee) is associated with BAG6 rs3117582 SNP and the VNTR polymorphism in the second exon of the FAM46A gene on chromosome 6.  

PubMed

Family with sequence similarity 46, member A (FAM46A) gene VNTR and BCL2-Associated Athanogene 6 (BAG6) gene rs3117582 polymorphisms were genotyped in a case-control study with 474 large-joint (hip and knee) osteoarthritis (OA) patients and 568 controls in Croatian population by candidate-gene approach for association with OA. We found that BAG6 rs3117582 SNP genotypes were associated with protection (major allele homozygote) and susceptibility (major-minor allele heterozygote) to OA. BAG6 rs3117582 major allele (A) was associated with reduced risk to OA while the minor allele (C) was associated with increased risk to OA. We identified 6 alleles harboring 2 to 7 repeats making 20 genotypes for FAM46A. A rare FAM46A VNTR genotype comprising VNTR alleles with four and seven repeats (c/f) was associated with increased OA risk in both genders. The genotype with four and six repeats (c/e) was also associated with increased risk to OA in males. A polymorphic FAM46A allele with six repeats (e) was associated with reduced risk to OA in females. Our results suggest association between the FAM46A gene, BAG6 gene and OA in Croatian population, respectively. This is the first study to show associations between these genetic loci and OA. PMID:25231575

Etokebe, Godfrey E; Jotanovic, Zdravko; Mihelic, Radovan; Mulac-Jericevic, Biserka; Nikolic, Tamara; Balen, Sanja; Sestan, Branko; Dembic, Zlatko

2015-01-01

285

Grape seed proanthocyanidin extract ameliorates monosodium iodoacetate-induced osteoarthritis.  

PubMed

Osteoarthritis (OA) is an age-related joint disease that is characterized by degeneration of articular cartilage and chronic pain. Oxidative stress is considered one of the pathophysiological factors in the progression of OA. We investigated the effects of grape seed proanthocyanidin extract (GSPE), which is an antioxidant, on monosodium iodoacetate (MIA)-induced arthritis of the knee joint of rat, which is an animal model of human OA. GSPE (100 mg/kg or 300 mg/kg) or saline was given orally three times per week for 4 weeks after the MIA injection. Pain was measured using the paw withdrawal latency (PWL), the paw withdrawal threshold (PWT) and the hind limb weight bearing ability. Joint damage was assessed using histological and microscopic analysis and microcomputerized tomography. Matrix metalloproteinase-13 (MMP13) and nitrotyrosine were detected using immunohistochemistry. Administration of GSPE to the MIA-treated rats significantly increased the PWL and PWT and this resulted in recovery of hind paw weight distribution (P < 0.05). GSPE reduced the loss of chondrocytes and proteoglycan, the production of MMP13, nitrotyrosine and IL-1? and the formation of osteophytes, and it reduced the number of subchondral bone fractures in the MIA-treated rats. These results indicate that GSPE is antinociceptive and it is protective against joint damage in the MIA-treated rat model of OA. GSPE could open up novel avenues for the treatment of OA. PMID:21795829

Woo, Yun Ju; Joo, Young Bin; Jung, Young Ok; Ju, Ji Hyeon; Cho, Mi La; Oh, Hye Jwa; Jhun, Joo Youn; Park, Mi Kyung; Park, Jin Sil; Kang, Chang Min; Sung, Mi Sook; Park, Sung Hwan; Kim, Ho Youn; Min, Jun Ki

2011-10-31

286

Testing a novel bioactive marine nutraceutical on osteoarthritis patients.  

PubMed

Osteoarthritis (OA) is a slow, chronic joint disease characterized by focal degeneration of articular cartilage and alterations of the chemical and mechanical articular function and also major cause of pain and physical disability. There is clinical evidence that increasing dietary n-3 relative to n-6 may be beneficial in terms of symptom management in humans but not all studies conclude that dietary n-3 PUFA supplementation is of benefit, in the treatment of OA. Our recent studies highlight the effect of a biomarine compound (LD-1227) on MMPs, collagen metabolism and on chondrocyte inflammatory markers. Thus, the aim of the present work was to test such bioactive compound versus a common nutraceutical intervention (glucosamine/chrondroitin sulfate) in knee osteoarthritis patients. The patients population consisted of 60 subjects with a recent diagnosis of knee osteoarthririts of mild-moderate severity. Patients were randomized in a double-blind study comparing LD-1227 (group A) versus a mixture of glucosamine (500 mg), chondroitin sulfate (400 mg) (group B). Patients were allowed their established painkillers on demand. At 4, 9 and 18 weeks patients were evaluated as for: VAS score assessing pain at rest, and during physical exercise, Lequesne index, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale and KOOS scale. Moreover, serum concentrations of IL-6, IL-?, CRP, TNF-sR1 and TNF-sR2 were assessed. As compared to GC treatment, LD-1227 yielded a quicker and higher degree of improvement of the whole clinical indexes and a lower NSAIDs use at the end of the study. LD-1227 brought about also a more significant downregulation of the tested cytokines cascade. Taken overall, these data suggest that LD-1227 has the potential to be included in the nutraceutical armamentarium in the management of OA. PMID:24189760

Catanzaro, Roberto; Lorenzetti, Aldo; Solimene, Umberto; Zerbinati, Nicola; Milazzo, Michele; Celep, Gulcip; Sapienza, Chiara; Italia, Angelo; Polimeni, Ascanio; Marotta, Francesco

2013-04-01

287

Prevention and management of knee osteoarthritis and knee cartilage injury in sports.  

PubMed

Articular cartilage defects in the knee of young or active individuals remain a problem in orthopaedic practice. These defects have limited ability to heal and may progress to osteoarthritis. The prevalence of knee osteoarthritis among athletes is higher than in the non-athletic population. The clinical symptoms of osteoarthritis are joint pain, limitation of range of motion and joint stiffness. The diagnosis of osteoarthritis is confirmed by the symptoms and the radiological findings (narrowing joint space, osteophyte formation and subchondral sclerosis). There is no strong correlation between symptoms and radiographic findings. The aetiology of knee osteoarthritis is multifactorial. Excessive musculoskeletal loading (at work or in sports), high body mass index, previous knee injury, female gender and muscle weakness are well-known risk factors. The high-level athlete with a major knee injury has a high incidence of knee osteoarthritis. Cartilage injuries are frequently observed in young and middle-aged active athletes. Often this injury precedes osteoarthritis. Reducing risk factors can decrease the prevalence of knee osteoarthritis. The prevention of knee injury, especially anterior cruciate ligament and meniscus injury in sports, is important to avoid progression of knee osteoarthritis. PMID:21357577

Takeda, Hideki; Nakagawa, Takumi; Nakamura, Kozo; Engebretsen, Lars

2011-04-01

288

Post-traumatic knee osteoarthritis in the young patient: therapeutic dilemmas and emerging technologies.  

PubMed

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

Stiebel, Matthew; Miller, Larry E; Block, Jon E

2014-01-01

289

Oxaceprol is as effective as diclofenac in the therapy of osteoarthritis of the knee and hip.  

PubMed

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

Bauer, H W; Klasser, M; von Hanstein, K L; Rolinger, H; Schladitz, G; Henke, H D; Gimbel, W; Steinbach, K

1999-01-01

290

Post-traumatic knee osteoarthritis in the young patient: therapeutic dilemmas and emerging technologies  

PubMed Central

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

Stiebel, Matthew; Miller, Larry E; Block, Jon E

2014-01-01

291

Serum Metabolites as Potential Biomarkers for Diagnosis of Knee Osteoarthritis  

PubMed Central

Knee osteoarthritis (OA) is a highly prevalent chronic degenerative joint disease that mainly affects the elderly population. The aim of this study was to investigate serum signature metabolites as potential biomarkers for early diagnosis of knee OA. Global serum metabolic profiles of 40 patients with knee OA and 20 healthy controls (HC) were analyzed by ultra-performance liquid chromatography coupled to mass spectrometry. An OA-specific metabolic profile was established that can clearly discriminate patients with OA from HCs. Fourteen metabolites that are involved in the metabolism of amino acids, purine, energy, glycolysis, fatty acids, and lipids were significantly altered in patients with OA compared to HCs. These metabolites could be potentially used as biomarkers for the diagnosis of knee OA.

Zhang, Qingmeng; Li, Heng; Zhang, Zhendong; Yang, Fan; Chen, Jiying

2015-01-01

292

mTOR: A Potential Therapeutic Target in Osteoarthritis?  

PubMed

Osteoarthritis (OA) is a chronic degenerative joint disease characterized by the progressive loss of articular cartilage, remodeling of the subchondral bone, and synovial inflammation. Mammalian target of rapamycin (mTOR) is a serine/threonine protein kinase that controls critical cellular processes such as growth, proliferation, and protein synthesis. Recent studies suggest that mTOR plays a vital role in cartilage growth and development and in altering the articular cartilage homeostasis as well as contributing to the process of cartilage degeneration associated with OA. Both pharmacological inhibition and genetic deletion of mTOR have been shown to reduce the severity of OA in preclinical mouse models. In this review article, we discuss the roles of mTOR in cartilage development, in maintaining articular cartilage homeostasis, and its potential as an OA therapeutic target. PMID:25688060

Pal, Bandna; Endisha, Helal; Zhang, Yue; Kapoor, Mohit

2015-03-01

293

EULAR report on the use of ultrasonography in painful knee osteoarthritis. Part 1: Prevalence of inflammation in osteoarthritis  

PubMed Central

Objectives: To assess the prevalence of inflammation in subjects with chronic painful knee osteoarthritis (OA), as determined by the presence of synovitis or joint effusion at ultrasonography (US); and to evaluate the correlation between synovitis, effusion, and clinical parameters. Methods: A cross sectional, multicentre, European study was conducted under the umbrella of EULAR-ESCISIT. Subjects had primary chronic knee OA (ACR criteria) with pain during physical activity ?30 mm for at least 48 hours. Clinical parameters were collected by a rheumatologist and an US examination of the painful knee was performed by a radiologist or rheumatologist within 72 hours of the clinical examination. Ultrasonographic synovitis was defined as synovial thickness ?4 mm and diffuse or nodular appearance, and a joint effusion was defined as effusion depth ?4 mm. Results: 600 patients with painful knee OA were analysed. At US 16 (2.7%) had synovitis alone, 85 (14.2%) had both synovitis and effusion, 177 (29.5%) had joint effusion alone, and 322 (53.7%) had no inflammation according to the definitions employed. Multivariate analysis showed that inflammation seen by US correlated statistically with advanced radiographic disease (Kellgren-Lawrence grade ?3; odds ratio (OR) = 2.20 and 1.91 for synovitis and joint effusion, respectively), and with clinical signs and symptoms suggestive of an inflammatory "flare", such as joint effusion on clinical examination (OR = 1.97 and 2.70 for synovitis and joint effusion, respectively) or sudden aggravation of knee pain (OR = 1.77 for joint effusion). Conclusion: US can detect synovial inflammation and effusion in painful knee OA, which correlate significantly with knee synovitis, effusion, and clinical parameters suggestive of an inflammatory "flare". PMID:15878903

D'Agostino, M; Conaghan, P; Le Bars, M; Baron, G; Grassi, W; Martin-Mola, E; Wakefield, R; Brasseur, J; So, A; Backhaus, M; Malaise, M; Burmester, G; Schmidely, N; Ravaud, P; Dougados, M; Emery, P

2005-01-01

294

Changes in A? non-nociceptive primary sensory neurons in a rat model of osteoarthritis pain  

Microsoft Academic Search

BACKGROUND: Pain is a major debilitating factor in osteoarthritis (OA), yet few mechanism-based therapies are available. To address the need to understand underlying mechanisms the aim of the present study was to determine changes in sensory neurons in an animal model of OA pain. RESULTS: The model displayed typical osteoarthritis pathology characterized by cartilage degeneration in the knee joint and

Qi Wu; James L Henry

2010-01-01

295

External validity is neglected in reports of randomized trials The example of hip and knee osteoarthritis  

E-print Network

1 External validity is neglected in reports of randomized trials The example of hip and knee treatment for hip and knee osteoarthritis. Methods: All RCTs assessing pharmacologic treatments (e.g., oral, rehabilitation, education, joint lavage, nonimplantable devices) for hip and knee osteoarthritis indexed between

Paris-Sud XI, Université de

296

Characterisation of a Peripheral Neuropathic Component of the Rat Monoiodoacetate Model of Osteoarthritis  

Microsoft Academic Search

Joint degeneration observed in the rat monoiodoacetate (MIA) model of osteoarthritis shares many histological features with the clinical condition. The accompanying pain phenotype has seen the model widely used to investigate the pathophysiology of osteoarthritis pain, and for preclinical screening of analgesic compounds. We have investigated the pathophysiological sequellae of MIA used at low (1 mg) or high (2 mg)

Matthew Thakur; Wahida Rahman; Carl Hobbs; Anthony H. Dickenson; David L. H. Bennett

2012-01-01

297

New developments in osteoarthritis. Posttraumatic osteoarthritis: pathogenesis and pharmacological treatment options  

PubMed Central

Joint trauma can lead to a spectrum of acute lesions, including osteochondral fractures, ligament or meniscus tears and damage to the articular cartilage. This is often associated with intraarticular bleeding and causes posttraumatic joint inflammation. Although the acute symptoms resolve and some of the lesions can be surgically repaired, joint injury triggers a chronic remodeling process in cartilage and other joint tissues that ultimately manifests as osteoarthritis in a majority of cases. The objective of the present review is to summarize information on pathogenetic mechanisms involved in the acute and chronic consequences of joint trauma and discuss potential pharmacological interventions. The focus of the review is on the early events that follow joint trauma since therapies for posttraumatic joint inflammation are not available and this represents a unique window of opportunity to limit chronic consequences. PMID:20602810

2010-01-01

298

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

SciTech Connect

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.

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

1980-10-01

299

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” ...

300

Effect of integrated yoga therapy on pain, morning stiffness and anxiety in osteoarthritis of the knee joint: A randomized control study  

PubMed Central

Aim: To study the effect of integrated yoga on pain, morning stiffness and anxiety in osteoarthritis of knees. Materials and Methods: Two hundred and fifty participants with OA knees (35–80 years) were randomly assigned to yoga or control group. Both groups had transcutaneous electrical stimulation and ultrasound treatment followed by intervention (40 min) for two weeks with follow up for three months. The integrated yoga consisted of yogic loosening and strengthening practices, asanas, relaxation, pranayama and meditation. The control group had physiotherapy exercises. Assessments were done on 15th (post 1) and 90th day (post 2). Results: Resting pain (numerical rating scale) reduced better (P<0.001, Mann–Whitney U test) in yoga group (post 1=33.6% and post 2=71.8%) than control group (post 1=13.4% and post 2=37.5%). Morning stiffness decreased more (P<0.001) in yoga (post 1=68.6% and post 2=98.1%) than control group (post 1=38.6% and post 2=71.6%). State anxiety (STAI-1) reduced (P<0.001) by 35.5% (post 1) and 58.4% (post 2) in the yoga group and 15.6% (post 1) and 38.8% (post 2) in the control group; trait anxiety (STAI 2) reduced (P<0.001) better (post 1=34.6% and post 2=57.10%) in yoga than control group (post 1=14.12% and post 2=34.73%). Systolic blood pressure reduced (P<0.001) better in yoga group (post 1=?7.93% and post 2=?15.7%) than the control group (post 1=?1.8% and post 2=?3.8%). Diastolic blood pressure reduced (P<0.001) better in yoga group (post 1=?7.6% and post 2=?16.4%) than the control group (post 1=?2.1% and post 2=?5.0%). Pulse rate reduced (P<0.001) better in yoga group (post 1=?8.41% and post 2=?12.4%) than the control group (post 1=?5.1% and post 2=?7.1%). Conclusion: Integrated approach of yoga therapy is better than physiotherapy exercises as an adjunct to transcutaneous electrical stimulation and ultrasound treatment in reducing pain, morning stiffness, state and trait anxiety, blood pressure and pulse rate in patients with OA knees. PMID:22346063

Ebnezar, John; Nagarathna, Raghuram; Yogitha, Bali; Nagendra, Hongasandra Ramarao

2012-01-01

301

Image-guided optical spectroscopy in diagnosis of osteoarthritis by combining spectral and spatial a-priori information  

NASA Astrophysics Data System (ADS)

A multi-modality imaging approach and instrument that integrate optical imaging system and near-infrared spectroscopy into an x-ray tomosynthesis setup have been employed to perform a clinical study of image-guided spectroscopy on osteoarthritis (OA) in the finger joints. The multiwavelength spectroscopy of the joints using x-ray-guided spatial constraints provides 3D images of oxygen saturation and water content with high resolution and improved quantitative capability. Based on the recovered quantitative results from 18 healthy volunteers and 22 patients, we observed that oxygen saturation and water content were significant discriminators for differentiation of healthy joints from diseased ones. The recovered images appear to show that the OA joints have high water values and decreased oxygen saturation.

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

2009-02-01

302

Invited review: the mitochondrion in osteoarthritis  

Microsoft Academic Search

In a variety of tissues, cumulative oxidative stress, disrupted mitochondrial respiration, and mitochondrial damage promote aging, cell death, and ultimately, functional failure and degeneration. Because articular cartilage chondroyctes are highly glycolytic, mitochondrially mediated pathogenesis has not been previously applied in models for pathogenesis of osteoarthritis (OA), a cartilage degenerative disease that increases markedly in aging. However, chondrocyte mitochondria respire in

Robert Terkeltaub; Kristen Johnson; Anne Murphy; Soumitra Ghosh

2002-01-01

303

Bilateral synovial chondromatosis in the knee joint with both intra and extra-articular diseases  

PubMed Central

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

Bassir, Rida-Allah; Ismael, Farid; Elbardouni, Ahmed; Mahfoud, Mustapha; Berrada, Mohamed Saleh; Elyaacoubi, Moradh

2014-01-01

304

Serum Levels of Proinflammatory Cytokines in Painful Knee Osteoarthritis and Sensitization  

PubMed Central

Osteoarthritis (OA) is the most common joint disorder in the world. Among the mechanisms involved in osteoarthritis, biomarkers (cytokines profile) may be related to pain and pain intensity, functional capacity, and pressure pain thresholds (PPT). Thus, the study of these relationships may offer useful information about pathophysiology and associated mechanisms involved in osteoarthritis. Therefore, the objective of this study was to investigate the seric concentration of pro (IL-6, IL-8, and TNF-?) and anti-inflammatory (IL-10) cytokines in patients with painful knee osteoarthritis and to correlate the levels of these biomarkers with the patients' functional capacity and pressure pain threshold (PPT) values.

Imamura, Marta; Ezquerro, Fernando; Marcon Alfieri, Fábio; Vilas Boas, Lucy; Tozetto-Mendoza, Tania Regina; Chen, Janini; Özçakar, Levent; Arendt-Nielsen, Lars

2015-01-01

305

[SECOT consensus on medial femorotibial osteoarthritis].  

PubMed

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

Moreno, A; Silvestre, A; Carpintero, P

2013-01-01

306

Posturography in patients with rheumatoid arthritis and osteoarthritis.  

PubMed

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

Soko?owska, B; Czerwosz, L; Hallay-Suszek, M; Sadura-Sieklucka, T; Ksi??opolska-Or?owska, K

2015-01-01

307

Minimal detectable change for mobility and patient-reported tools in people with osteoarthritis awaiting arthroplasty  

PubMed Central

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

2014-01-01

308

Cyclic phosphatidic acid relieves osteoarthritis symptoms  

PubMed Central

Background Cyclic phosphatidic acid (cPA) is a naturally occurring phospholipid mediator with a unique cyclic phosphate ring at the sn-2 and sn-3 positions of its glycerol backbone. Natural cPA and its chemically stabilized cPA derivative, 2-carba-cPA (2ccPA), inhibit chronic and acute inflammation, and 2ccPA attenuates neuropathic pain. Osteoarthritis (OA) is a degenerative disease frequently associated with symptoms such as inflammation and joint pain. Because 2ccPA has obvious antinociceptive activity, we hypothesized that 2ccPA might relieve the pain caused by OA. We aimed to characterize the effects of 2ccPA on the pathogenesis of OA induced by total meniscectomy in the rabbit knee joint. Results Intra-articular injection of 2ccPA (twice a week for 42 days) significantly reduced pain and articular swelling. Histopathology showed that 2ccPA suppressed cartilage degeneration in OA. We also examined the effects of 2ccPA on the inflammatory and catabolic responses of human OA synoviocytes and chondrosarcoma SW1353 cells in vitro. 2ccPA stimulated synthesis of hyaluronic acid and suppressed production of the metalloproteinases MMP-1, -3, and -13. However, it had no effect on the production of interleukin (IL)-6, an inflammatory cytokine. The suppressive effect of 2ccPA on MMP-1 and -3 production in synoviocytes and on MMP-13 production in SW1353 cells was not mediated by the lysophosphatidic acid receptor, LPA1 receptor (LPA1R). Conclusions Our results suggest that 2ccPA significantly reduces the pain response to OA by inducing hyaluronic acid production and suppressing MMP-1, -3, and -13 production in synoviocytes and chondrocytes. PMID:25123228

2014-01-01

309

The role of stem cells in osteoarthritis  

PubMed Central

Introduction Osteoarthritis (OA) is a progressively debilitating disease that affects mostly cartilage, with associated changes in the bone. The increasing incidence of OA and an ageing population, coupled with insufficient therapeutic choices, has led to focus on the potential of stem cells as a novel strategy for cartilage repair. Methods In this study, we used scaffold-free mesenchymal stem cells (MSCs) obtained from bone marrow in an experimental animal model of OA by direct intra-articular injection. MSCs were isolated from 2.8 kg white New Zealand rabbits. There were ten in the study group and ten in the control group. OA was induced by unilateral transection of the anterior cruciate ligament of the knee joint. At 12 weeks post-operatively, a single dose of 1 million cells suspended in 1 ml of medium was delivered to the injured knee by direct intra-articular injection. The control group received 1 ml of medium without cells. The knees were examined at 16 and 20 weeks following surgery. Repair was investigated radiologically, grossly and histologically using haematoxylin and eosin, Safranin-O and toluidine blue staining. Results Radiological assessment confirmed development of OA changes after 12 weeks. Rabbits receiving MSCs showed a lower degree of cartilage degeneration, osteophyte formation, and subchondral sclerosis than the control group at 20 weeks post-operatively. The quality of cartilage was significantly better in the cell-treated group compared with the control group after 20 weeks. Conclusions Bone marrow-derived MSCs could be promising cell sources for the treatment of OA. Neither stem cell culture nor scaffolds are absolutely necessary for a favourable outcome. Cite this article: Bone Joint Res 2014;3:32–7. PMID:24526748

Singh, A.; Goel, S. C.; Gupta, K. K.; Kumar, M.; Arun, G. R.; Patil, H.; Kumaraswamy, V.; Jha, S.

2014-01-01

310

Diclofenac Topical (osteoarthritis pain)  

MedlinePLUS

... is also available as a 3% gel (Solaraze; generic) that is applied to the skin to treat ... osteoarthritis. If you are using diclofenac gel (Solaraze, generic) for actinic keratosis, read the monograph entitleddiclofenac topical ( ...

311

Viscosupplementation for Knee Osteoarthritis  

MedlinePLUS

... Osteoarthritis of the Knee. A Systematic Review and Meta-analysis.” It is in the 7 August 2012 issue ... intervention. The authors used a statistical method called meta-analysis to combine the results of the separate studies ...

312

A review on the mechanical quality of articular cartilage - implications for the diagnosis of osteoarthritis.  

PubMed

The functional behaviour of articular cartilage in diarthrodial joints is determined by its morphological and biomechanical properties. Whereas morphological changes are mainly detectable in the progressed stages of osteoarthritis, biomechanical properties seem to be more sensitive to early degenerative variations since they are determined by the biochemical composition and structural arrangement of the extracellular matrix. The objective of this paper is to review studies focussing on variations in the mechanical compressive properties during the early pre-osteoarthritic stage. The aim is to quantify the requirements to detect the early cartilage degeneration in pre-osteoarthritis based on the mechanical parameters and to create an updated basis for a better understanding of inherent relationships between characteristic parameters in articular cartilage. Correlations between mechanical and biochemical parameters as well as magnetic resonance, ultrasonic, histological and structural parameters were observed. In early osteoarthritis, static moduli decrease below 80% of healthy controls and dynamic moduli below 30% of controls. To identify osteoarthritic changes of articular cartilage based on static or dynamic mechanical parameters in an early stage of the disease progression the accuracy of a mechanical testing method has to be adequate to detect changes of 10% in cartilage stiffness. PMID:16979270

Knecht, Sven; Vanwanseele, Benedicte; Stüssi, Edgar

2006-12-01

313

Comparative Study of Hamstring and Quadriceps Strengthening Treatments in the Management of Knee Osteoarthritis  

PubMed Central

[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

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

314

Role of inflammation in the pathogenesis of osteoarthritis: latest findings and interpretations  

PubMed Central

Osteoarthritis (OA) has traditionally been classified as a noninflammatory arthritis; however, the dichotomy between inflammatory and degenerative arthritis is becoming less clear with the recognition of a plethora of ongoing immune processes within the OA joint and synovium. Synovitis is defined as inflammation of the synovial membrane and is characteristic of classical inflammatory arthritidies. Increasingly recognized is the presence of synovitis in a significant proportion of patients with primary OA, and based on this observation, further studies have gone on to implicate joint inflammation and synovitis in the pathogenesis of OA. However, clinical OA is not one disease but a final common pathway secondary to many predisposing factors, most notably age, joint trauma, altered biomechanics, and obesity. How such biochemical and mechanical processes contribute to the progressive joint failure characteristic of OA is tightly linked to the interplay of joint damage, the immune response to perceived damage, and the subsequent state of chronic inflammation resulting in propagation and progression toward the phenotype recognized as clinical OA. This review will discuss a wide range of evolving data leading to our current hypotheses regarding the role of immune activation and inflammation in OA onset and progression. Although OA can affect any joint, most commonly the knee, hip, spine, and hands, this review will focus primarily on OA of the knee as this is the joint most well characterized by epidemiologic, imaging, and translational studies investigating the association of inflammation with OA. PMID:23641259

Lepus, Christin M.

2013-01-01

315

Conservative management of symptomatic knee osteoarthritis: a flawed strategy?  

PubMed Central

Conservative management of medial compartment knee osteoarthritis (OA) is a misleading term used to describe the application of medical, orthotic, and/or rehabilitative therapies exclusive of surgical interventions. The implication of this nomenclature is that these therapies offer satisfactory symptom relief, alter disease progression, and have limited side effects. Unfortunately, conservative therapeutic options possesses few, if any, characteristics of an ideal treatment, namely one that significantly alleviates pain, improves knee function, and reduces medial compartmental loading without adverse side effects. As uncompensated mechanical loading is a primary culprit in the development and progression of knee OA, we propose that the therapeutic perspective of conservative treatment should shift from pharmacological treatments, which have no influence on joint loading, minimal potential to alter joint function, substantial associated risks, and significant financial costs, towards minimally invasive load absorbing therapeutic interventions. A safe and effective minimally invasive medical device specifically engineered for symptomatic relief of medial knee OA by limiting joint contact forces has the potential to reduce the clinical and economic knee OA burden. This review characterizes the current standard of care recommendations for conservative management of medial compartment knee OA with respect to treatment efficacy, risk profile, and economic burden. PMID:23705060

Crawford, Dennis C.; Miller, Larry E.; Block, Jon E.

2013-01-01

316

Summary and recommendations of the OARSI FDA osteoarthritis Assessment of Structural Change Working Group  

PubMed Central

summary Objective The Osteoarthritis Research Society International initiated a number of working groups to address a call from the US Food and Drug Administration (FDA) on updating draft guidance on conduct of osteoarthritis (OA) clinical trials. The development of disease-modifying osteoarthritis drugs (DMOADs) remains challenging. The Assessment of Structural Change (ASC) Working Group aimed to provide a state-of-the-art critical update on imaging tools for OA clinical trials. Methods The Group focussed on the performance metrics of conventional radiographs (CR) and magnetic resonance imaging (MRI), performing systematic literature reviews for these modalities. After acquiring these reviews, summary and research recommendations were developed through a consensus process. Results For CR, there is some evidence for construct and predictive validity, with good evidence for reliability and responsiveness of metric measurement of joint space width (JSW). Trials off at least 1 and probably 2 years duration will be required. Although there is much less evidence for hip JSW, it may provide greater responsiveness than knee JSW. For MRI cartilage morphometry in knee OA, there is some evidence for construct and predictive validity, with good evidence for reliability and responsiveness. The responsiveness of semi-quantitative MRI assessment of cartilage morphology, bone marrow lesions and synovitis was also good in knee OA. Conclusions Radiographic JSW is still a recommended option for trials of structure modification, with the understanding that the construct represents a number of pathologies and trial duration may be long. MRI is now recommended for clinical trials in terms of cartilage morphology assessment. It is important to study all the joint tissues of the OA joint and the literature is growing on MRI quantification (and its responsiveness) of non-cartilage features. The research recommendations provided will focus researchers on important issues such as determining how structural change within the relatively short duration of a trial reflects long-term change in patient-centred outcomes. PMID:21396466

Conaghan, P.G.; Hunter, D.J.; Maillefert, J.F.; Reichmann, W.M.; Losina, E.

2012-01-01

317

Intra-articular hyaluronans in knee osteoarthritis: rationale and practical considerations.  

PubMed

Intra-articular hyaluronans are used to treat pain associated with osteoarthritis of the knee. Many controlled clinical studies have demonstrated their efficacy for this indication. The rationale for the use of hyaluronans therapeutically is based on observations that hyaluronic acid is an important component of the synovial fluid acting as a cushion and lubricant for the joint and also serving as a major component of the extracellular matrix of the cartilage, helping to enhance the ability of cartilage to resist shear and maintain a resiliency to compression. While intra-articular hyaluronans are indicated at this time only for the treatment of pain in osteoarthritis of the knee, there are data to suggest that they may also be useful in treating degenerative disease of other articular joints, as well as have an impact on disease progression. The mechanisms by which hyaluronans mediate their clinical benefit seem to be multifactorial and biologically related, in contrast to the notion that they provide only viscous fluid replacement. The safety profile of intra-articular hyaluronans is very favorable and, because they are used as a local therapy, there are no known drug interactions-an advantage for patients receiving treatment for comorbid conditions. Some adverse effects, such as pseudosepsis, have been associated with cross-linked hyaluronan agents and do not appear to be class related. PMID:15005296

Kelly, Michael A; Kurzweil, Peter R; Moskowitz, Roland W

2004-02-01

318

Mesenchymal stem cells and osteoarthritis: remedy or accomplice?  

PubMed

Multipotent mesenchymal stromal or stem cells (MSCs) are likely to be agents of connective tissue homeostasis and repair. Because the hallmark of osteoarthritis (OA) is degeneration and failure to repair connective tissues it is compelling to think that these cells have a role to play in OA. Indeed, MSCs have been implicated in the pathogenesis of OA and, in turn, progression of the disease has been shown to be therapeutically modulated by MSCs. This review discusses current knowledge on the potential of both marrow- and local joint-derived MSCs in OA, the mode of action of the cells, and possible effects of the osteoarthritic niche on the function of MSCs. The use of stem cells for repair of isolated cartilage lesions and strategies for modulation of OA using local cell delivery are discussed as well as therapeutic options for the future to recruit and appropriately activate endogenous progenitors and/or locally systemically administered MSCs in the early stages of the disease. The use of gene therapy protocols, particularly as they pertain to modulation of inflammation associated with the osteoarthritic niche, offer an additional option in the treatment of this chronic disease. In summary, elucidation of the etiology of OA and development of technologies to detect early disease, allied to an increased understanding of the role MSCs in aging and OA, should lead to more targeted and efficacious treatments for this debilitating chronic disease in the future. PMID:20649459

Coleman, Cynthia M; Curtin, Caroline; Barry, Frank P; O'Flatharta, Cathal; Murphy, J Mary

2010-10-01

319

Nutraceuticals: Potential for Chondroprotection and Molecular Targeting of Osteoarthritis  

PubMed Central

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

Leong, Daniel J.; Choudhury, Marwa; Hirsh, David M.; Hardin, John A.; Cobelli, Neil J.; Sun, Hui B.

2013-01-01

320

A comparison of radiographic, arthroscopic and histological measures of articular pathology in the canine elbow joint.  

PubMed

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

Goldhammer, Marc A; Smith, Sionagh H; Fitzpatrick, Noel; Clements, Dylan N

2010-10-01

321

The acoustical characteristics of the normal and abnormal temporomandibular joint.  

PubMed

This paper describes the results of a clinical study that recorded and analyzed sounds emitted from the temporomandibular joint (TMJ) during simple function as a means for differentially diagnosing disorders of the joint. The technique is based on the principle that each different disorder of the TMJ produces a different effect on the mechanical relationship between the articulating surfaces of the joint, and that these mechanical effects can be determined by analyzing joint sounds in relation to joint movement. A total of 79 patients (101 joints) were studied; 32 (46 joints) were diagnosed as having extracapsular disorders, (primarily MPD), 27 (32 joints) were diagnosed as having a displaced disc with reduction, nine (10 joints) were diagnosed as having a displaced disc without reduction, and 11 (13 joints) were diagnosed as degenerative disease (osteoarthritis/arthrosis). In addition, 25 adults (50 joints) with normal TMJs were included as controls. The results of this study demonstrated that each specific disease of the TMJ is characterized by a unique relationship between the sounds propagated by the joint and the movement of the joint. Essentially, an extracapsular disease was characterized by acoustic quiescence during natural (as opposed to maximal) jaw movement, an internal derangement by a usually symmetrical short duration click/reciprocal click, or random click complex, depending on the subcategory of the disorder, and a degenerative disease by a long duration noise during either or both jaw opening and closing. The data further suggest that the technique serves to reflect the mechanical events (and abnormalities) that are involved in function of the diseased joint and has potential for use as a clinical diagnostic tool. PMID:3471925

Gay, T; Bertolami, C N; Donoff, R B; Keith, D A; Kelly, J P

1987-05-01

322

Intraarticular Application of Unsealed Beta-Emitting Radionuclides in the Treatment Course of Inflammatory Joint Diseases  

Microsoft Academic Search

Intraarticular injection of ?-emitting radionuclides, called radiation synovectomy or radiosynoviorthesis, is an effective treatment in patients suffering from inflammatory-rheumatoid and degenerative joint diseases. Since the first description of intraarticular radionuclide therapy in 1952, several gamma- and beta-emitting radionuclides have been used in both experimental and clinical studies. Today, mainly three substances are in clinical use, each of them for special

W. U. Kampen; W. Brenner; N. Czech; E. Henze

2002-01-01

323

Causes of pain in degenerative bone and joint disease: a lesson from vertebroplasty  

Microsoft Academic Search

Pain in degenerative bone and joint disease is usually attributed to sensitized nociceptors in inflamed periarticular soft tissues. Here we draw attention to the potential contribution of intrinsic bone innervation. The structure and innervation of articular bone ends is analogous to that of teeth. Although some dental pain derives from inflamed periodontal soft tissue, a more important source is the

David Niv; Michael Gofeld; Marshall Devor

2003-01-01

324

The tissue architecture of synovial membranes in inflammatory and non-inflammatory joint diseases  

Microsoft Academic Search

Utilizing monoclonal reagents directed towards antigens of the monocyte-macrophage lineage and Ia antigens, the tissue architecture of synovial membranes obtained from patients with non-inflammatory joint diseases and patients with rheumatoid arthritis was studied. Emphasis was placed on the localization of the type I, type II and type III synoviocytes that previously had been defined by their cell surface phenotype with

G. R. Burmester; P. Locher; B. Koch; R. J. Winchester; A. Dimitriu-Bona; J. R. Kalden; W. Mohr

1983-01-01

325

Therapy Insight: how the gut talks to the joints—inflammatory bowel disease and the spondyloarthropathies  

Microsoft Academic Search

Axial and peripheral arthritis can occur in up to 30% of patients with inflammatory bowel disease. Likewise, the presence of gut inflammation in primary spondyloarthropathies is underappreciated, with subclinical gut inflammation documented in up to two-thirds of patients with this group of inflammatory disorders. Common genetic and immunologic mechanisms underlie the coincidence of inflammation in the joints and the intestine.

Carmen Meier; Scott Plevy

2007-01-01

326

Long-distance running, bone density, and osteoarthritis  

SciTech Connect

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.

Lane, N.E.; Bloch, D.A.; Jones, H.H.; Marshall, W.H. Jr.; Wood, P.D.; Fries, J.F.

1986-03-07

327

Outcome measures in osteoarthritis: Randomized controlled trials  

Microsoft Academic Search

Accepted outcome measures in randomized controlled trials (RCTs) in osteoarthritis (OA) include patient-reported assessments\\u000a of physical function and health-related quality of life (HRQOL). Available data can inform treatment decisions when statistically\\u000a significant changes are viewed in terms of clinically important improvements. Patient-reported outcomes validated in OA include\\u000a global assessments of pain, disease activity, and disease-specific and generic measures of physical

Vibeke Strand; Ariella Kelman

2004-01-01

328

MicroRNAs are potential prognostic and therapeutic targets in diabetic osteoarthritis.  

PubMed

Osteoarthritis is an aging-related degenerative disease that severely influences the elders' life quality. However, there have been few clinical approaches available until now. Currently, more knowledge of the pathology of osteoarthritis has been illustrated. Especially, diabetes can be the only predictor of osteoarthritis. Due to its outstanding characteristics, MicroRNA has been considered as an efficient target in treating diseases. In this review, we will discuss a new insight focusing on the roles of microRNA in the progression of osteoarthritis-induced by diabetes, especially type II diabetes mellitus. PMID:25245120

Jingsheng, Shi; Yibing, Wei; Jun, Xia; Siqun, Wang; Jianguo, Wu; Feiyan, Chen; Gangyong, Huang; Jie, Chen

2015-01-01

329

Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial  

Microsoft Academic Search

Summary Background Treatment of osteoarthritis is usually limited to short-term symptom control. We assessed the effects of the specific drug glucosamine sulphate on the long-term progression of osteoarthritis joint structure changes and symptoms. Methods We did a randomised, double-blind placebo controlled trial, in which 212 patients with knee osteoarthritis were randomly assigned 1500 mg sulphate oral glucosamine or placebo once

Jean Yves Reginster; Rita Deroisy; Lucio C Rovati; Richard L Lee; Eric Lejeune; Olivier Bruyere; Giampaolo Giacovelli; Yves Henrotin; Jane E Dacre; Christiane Gossett

2001-01-01

330

Obesity has been associated with a shortened lifespan as well as a variety of diseases including insulin resistance\\/ diabetes mellitus, lameness, osteoarthritis, dermatopathy, lower urinary tract disease, cardiovascular and renal disease, and pancreatitis  

Microsoft Academic Search

1 In cats, the strongest correlations are with diabetes mellitus and osteoarthritis. It is estimated that 31% of diabetes mellitus and 34% of lameness could be eliminated if cats achieved ideal body condition. 2 In dogs one lifelong study demonstrated that overweight dogs live an average of 2 years less than their normal weight counterparts. Over their entire lifespan, the

Ralph Schickel

331

Anti-Tumor Necrosis Factor Ameliorates Joint Disease in Murine Collagen- Induced Arthritis  

NASA Astrophysics Data System (ADS)

There is considerable evidence implicating tumor necrosis factor ? (TNF-?) in the pathogenesis of rheumatoid arthritis. This evidence is based not only on the universal presence of TNF-? in arthritic joints accompanied by the upregulation of TNF-? receptors but also on the effects of neutralizing TNF-? in joint cell cultures. Thus, neutralization of TNF-? in vitro results in inhibition of the production of interleukin 1, which like TNF-?, is believed to contribute to joint inflammation and erosion. To determine the validity of this concept in vivo, the effect of administering TNF-neutralizing antibodies to mice with collagen-induced arthritis has been studied. This disease model was chosen because of its many immunological and pathological similarities to human rheumatoid arthritis. TN3-19.12, a hamster IgG1 monoclonal antibody to murine TNF-?/?, was injected i.p. into mice either before the onset of arthritis or after the establishment of clinical disease. Anti-TNF administered prior to disease onset significantly reduced paw swelling and histological severity of arthritis without reducing the incidence of arthritis or the level of circulating anti-type II collagen IgG. More relevant to human disease was the capacity of the antibody to reduce the clinical score, paw swelling, and the histological severity of disease even when injected after the onset of clinical arthritis. These results have implications for possible modes of therapy of human arthritis.

Williams, Richard O.; Feldmann, Marc; Maini, Ravinder N.

1992-10-01

332

MRI demonstration of hypertrophic articular cartilage repair in osteoarthritis  

Microsoft Academic Search

Transection of the anterior cruciate ligament in the dog produces changes in the unstable joint typical of osteoarthritis, although full-thickness cartilage ulceration is rare. Information concerning the late fate of the cartilage after transection is meager. In the present study magnetic resonance imaging (MRI) was used to evaluate cartilage abnormalities 3 years after transection. Plain radiographs of the osteoarthritic and

Ethan M. Braunstein; Kenneth D. Brandt; Marjorie Albrecht

1990-01-01

333

Extracellular superoxide dismutase and oxidant damage in osteoarthritis  

Microsoft Academic Search

Objective. To use human cartilage samples and a mouse model of osteoarthritis (OA) to determine whether extracellular superoxide dismutase (EC-SOD) is a constituent of cartilage and to evaluate whether there is a relationship between EC-SOD deficiency and OA. Methods. Samples of human cartilage were ob- tained from femoral heads at the time of joint replace- ment surgery for OA or

Elizabeth Regan; Joanne Flannelly; Russell Bowler; Karen Tran; Michael Nicks; Beth Duda Carbone; Deborah Glueck; Harry Heijnen; Roger Mason; James Crapo

2005-01-01

334

Social determinants and osteoarthritis outcomes  

PubMed Central

Osteoarthritis (OA) is one of the most frequently occurring musculoskeletal diseases, posing a significant public health problem due to its impact on pain and disability. Traditional risk factors fail to account for all of the risk observed for OA outcomes. In recent years, our view of disease causation has broadened to include health risks that are created by an individual’s socioeconomic circumstances. Early research into social determinants has focused on social position and explored factors related to the individual such as education, income and occupation. Results from these investigations suggest that low education attainment and nonprofessional occupation are associated with poorer arthritis outcomes. More recently, research has expanded to examine how one’s neighborhood socioeconomic environment may be relevant to OA outcomes. This narrative review proposes a framework to help guide our understanding of how social context may interact with pathophysiological processes and individual-level variables to influence health outcomes in those living with OA. PMID:23243459

Luong, My-Linh N; Cleveland, Rebecca J; Nyrop, Kirsten A; Callahan, Leigh F

2012-01-01

335

Health care utilisation in subjects with osteoarthritis, chronic back pain and osteoporosis aged 65 years and more: mediating effects of limitations in activities of daily living, pain intensity and mental diseases.  

PubMed

Musculoskeletal diseases (MDs) have major consequences for the individual, and also for society and may thus lead to increased use of health care. It was the aim of this study to explore health care utilisation in patients with self-reported osteoarthritis, chronic back pain or osteoporosis compared with people of the same age without those diseases, based on data of the Austrian health interview survey including 3,097 subjects aged ? 65 years. Patients with MDs in our study visited a general practitioner (GP) and were hospitalised significantly more often compared with persons without the respective diseases. Problems in the activities of daily living (ADLs), pain intensity and anxiety/depression influenced GP consultations. Complex factors explain the higher health care utilisation in subjects with MDs in our study. Our results indicate that integrated strategies are needed to manage those patients, which should focus on management of ADL problems, pain and mental health. PMID:24468829

Stamm, Tanja Alexandra; Pieber, Karin; Blasche, Gerhard; Dorner, Thomas Ernst

2014-04-01

336

Three-dimensional osteochondral microtissue to model pathogenesis of osteoarthritis.  

PubMed

Osteoarthritis (OA), the most prevalent form of arthritis, affects up to 15% of the adult population and is principally characterized by degeneration of the articular cartilage component of the joint, often with accompanying subchondral bone lesions. Understanding the mechanisms underlying the pathogenesis of OA is important for the rational development of disease-modifying OA drugs. While most studies on OA have focused on the investigation of either the cartilage or the bone component of the articular joint, the osteochondral complex represents a more physiologically relevant target because the disease ultimately is a disorder of osteochondral integrity and function. In our current investigation, we are constructing an in vitro three-dimensional microsystem that models the structure and biology of the osteochondral complex of the articular joint. Osteogenic and chondrogenic tissue components are produced using adult human mesenchymal stem cells derived from bone marrow and adipose seeded within biomaterial scaffolds photostereolithographically fabricated with defined internal architecture. A three-dimensional-printed, perfusion-ready container platform with dimensions to fit into a 96-well culture plate format is designed to house and maintain the osteochondral microsystem that has the following features: an anatomic cartilage/bone biphasic structure with a functional interface; all tissue components derived from a single adult mesenchymal stem cell source to eliminate possible age/tissue-type incompatibility; individual compartments to constitute separate microenvironment for the synovial and osseous components; accessible individual compartments that may be controlled and regulated via the introduction of bioactive agents or candidate effector cells, and tissue/medium sampling and compositional assays; and compatibility with the application of mechanical load and perturbation. The consequences of mechanical injury, exposure to inflammatory cytokines, and compromised bone quality on degenerative changes in the cartilage component are examined in the osteochondral microsystem as a first step towards its eventual application as an improved and high-throughput in vitro model for prediction of efficacy, safety, bioavailability, and toxicology outcomes for candidate disease-modifying OA drugs. PMID:24564995

Lozito, Thomas P; Alexander, Peter G; Lin, Hang; Gottardi, Riccardo; Cheng, Anthony Wai-Ming; Tuan, Rocky S

2013-01-01

337

Hip joint replacement  

MedlinePLUS

... made joint. The artificial joint is called a prosthesis . ... thromboembolic disease in patients undergoing elective hip and ... joint arthroplasties: current concepts of patient outcomes after ...

338

Development of an Equine Groove Model to Induce Metacarpophalangeal Osteoarthritis: A Pilot Study on 6 Horses  

PubMed Central

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

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

339

Development of an equine groove model to induce metacarpophalangeal osteoarthritis: a pilot study on 6 horses.  

PubMed

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

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

340

Short-term consolidation of articular cartilage in the long-term context of osteoarthritis.  

PubMed

Over ten percent of the population are afflicted by osteoarthritis, a chronic disease of diarthrodial joints such as the knees and hips, costing hundreds of billions of dollars every year. In this condition, the thin layers of articular cartilage on the bones degrade and weaken over years, causing pain, stiffness and eventual immobility. The biggest controllable risk factor is long-term mechanical overloading of the cartilage, but the disparity in time scales makes this process a challenge to model: loading events can take place every second, whereas degradation occurs over many months. Therefore, a suitable model must be sufficiently simple to permit evaluation over long periods of variable loading, yet must deliver results sufficiently accurate to be of clinical use, conditions unmet by existing models. To address this gap, we construct a two-component poroelastic model endowed with a new flow restricting boundary condition, which better represents the joint space environment compared to the typical free-flow condition. Under both static and cyclic loading, we explore the rate of gradual consolidation of the medium. In the static case, we analytically characterise the duration of consolidation, which governs the duration of effective fluid-assisted lubrication. In the oscillatory case, we identify a region of persistent strain oscillations in otherwise consolidated tissue, and derive estimates of its depth and magnitude. Finally, we link the two cases through the concept of an equivalent static stress, and discuss how our results help explain the inexorable cartilage degeneration of osteoarthritis. PMID:25591888

Woodhouse, Francis G; Gardiner, Bruce S; Smith, David W

2015-03-01

341

Meta-analysis of the Related Nutritional Supplements Dimethyl Sulfoxide and Methylsulfonylmethane in the Treatment of Osteoarthritis of the Knee  

Microsoft Academic Search

Dimethyl sulphoxide and methylsulfonylmethane are two related nutritional supplements used for symptomatic relief of osteoarthritis (OA). We conducted a meta-analysis to evaluate their efficacy in reducing pain associated with OA. Randomized or quasi-randomized controlled trials (RCTs), identified by systematic electronic searches, citation tracking and searches of clinical trial registries, assessing these supplements in osteoarthritis of any joint were considered for

Sarah Brien; Phil Prescott; George Lewith

2009-01-01

342

Current Perspectives in Mesenchymal Stem Cell Therapies for Osteoarthritis  

PubMed Central

Osteoarthritis (OA) is a degenerative joint disease most commonly occurring in the ageing population. It is a slow progressive condition resulting in the destruction of hyaline cartilage followed by pain and reduced activity. Conventional treatments have little effects on the progression of the condition often leaving surgery as the last option. In the last 10 years tissue engineering utilising mesenchymal stem cells has been emerging as an alternative method for treating OA. Mesenchymal stem cells (MSCs) are multipotent progenitor cells found in various tissues, most commonly bone marrow and adipose tissue. MSCs are capable of differentiating into osteocytes, adipocytes, and chondrocytes. Autologous MSCs can be easily harvested and applied in treatment, but allogenic cells can also be employed. The early uses of MSCs focused on the implantations of cell rich matrixes during open surgeries, resulting in the formation of hyaline-like durable cartilage. More recently, the focus has completely shifted towards direct intra-articular injections where a great number of cells are suspended and injected into affected joints. In this review the history and early uses of MSCs in cartilage regeneration are reviewed and different approaches in current trends are explained and evaluated. PMID:25548573

Honsawek, Sittisak

2014-01-01

343

What Is Osteoarthritis?  

MedlinePLUS

... publication. To order the Osteoarthritis: Handout on Health full-text version, please contact NIAMS using the contact information ... mailed to you? Visit our online order form. Full NIAMS Site NIH… Turning Discovery Into Health ® ... Comments Moderation Policy Site Map | Viewers and Players

344

Current nutraceuticals in the management of osteoarthritis: a review  

PubMed Central

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

Akhtar, Nahid

2012-01-01

345

Influence of degenerative joint disease on spinal bone mineral measurements in postmenopausal women  

Microsoft Academic Search

We assessed the impact of various forms of spinal degenerative joint disease (DJD) on bone mineral density (BMD) measured by quantitative computed tomography (QCT) and dual X-ray absorptiometry (DXA) in a group of postmenopausal women. Lateral (T4-L4) and AP (L1-L4) spinal radiographs were reviewed for fracture and DJD in 209 women (mean age 62.6±6.7). The severity of DJD findings was

W. Yu; C.-C. Glüer; T. Fuerst; S. Grampp; J. Li; Y. Lu; H. K. Genant

1995-01-01

346

Linkage of early-onset osteoarthritis and chondrocalcinosis to human chromosome 8q  

SciTech Connect

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.

Baldwin, C.T.; Farrer, L.A.; Adair, R. [Boston Univ. School of Medicine, MA (United States); Dharmavaram, R.; Jimenez, S. [Thomas Jefferson Univ., Philadelphia, PA (United States); Anderson, L. [Rheumatology Associates, Portland, ME (United States)

1995-03-01

347

Gait and neuromuscular pattern changes are associated with differences in knee osteoarthritis severity levels.  

PubMed

Knee osteoarthritis (OA) is a multifactoral, progressive disease process of the musculoskeletal system. Mechanical factors have been implicated in the progression of knee OA, but the role of altered joint mechanics and neuromuscular control strategies in progressive mechanisms of the disease have not been fully explored. Previous biomechanical studies of knee OA have characterized changes in joint kinematics and kinetics with the disease, but it has been difficult to determine if these biomechanical changes are involved in the development of disease, are in response to degenerative changes in the joint, or are compensatory mechanisms in response to these degenerative changes or other related factors as joint pain. The goal of this study was to explore the association between biomechanical changes and knee OA severity in an effort to understand the changing role of biomechanical factors in the progression of knee OA. A three-group cross-sectional model was used that included asymptomatic subjects, subjects clinically diagnosed with moderate knee OA and severe knee OA subjects just prior to total joint replacement surgery. Principal component analysis and discriminant analysis were used to determine the combinations of electromyography, kinematic and kinetic waveform pattern changes at the knee, hip and ankle joints during gait that optimally separated the three levels of severity. Different biomechanical mechanisms were important in discriminating between severity levels. Changes in knee and hip kinetic patterns and rectus femoris activation were important in separating the asymptomatic and moderate OA gait patterns. In contrast, changes in knee kinematics, hip and ankle kinetics and medial gastrocnemius activity were important in discriminating between the moderate and severe OA gait patterns. PMID:18078943

Astephen, Janie L; Deluzio, Kevin J; Caldwell, Graham E; Dunbar, Michael J; Hubley-Kozey, Cheryl L

2008-01-01

348

Host and parasite diversity jointly control disease risk in complex communities  

PubMed Central

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

Johnson, Pieter T. J.; Preston, Daniel L.; Hoverman, Jason T.; LaFonte, Bryan E.

2013-01-01

349

Host and parasite diversity jointly control disease risk in complex communities.  

PubMed

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

Johnson, Pieter T J; Preston, Daniel L; Hoverman, Jason T; LaFonte, Bryan E

2013-10-15

350

CAPSULAR TISSUES OF THE PROXIMAL INTERPHALANGEAL JOINT: NORMAL COMPOSITION AND EFFECTS OF DUPUYTREN'S DISEASE AND RHEUMATOID ARTHRITIS  

Microsoft Academic Search

Three fibrocartilages associated with the proximal interphalangeal joint are described—at the attachment of the central slip to bone, within the slip where it passes over the joint, and the volar plate. Material was obtained at surgery following trauma, Dupuytren's disease and rheumatoid arthritis. The fibrocartilages were structurally distinct and immunolabelled differently with monoclonal antibodies to extracellular matrix components. All fibrocartilages

M. BENJAMIN; J. R. RALPHS; M. SHIBU; M. IRWIN

1993-01-01

351

EFFECTIVENESS OF THE TREATMENT OF DEGENERATIVE JOINT DISEASE WITH PERIARTICULAR, INTRAARTICULAR, AND INTRAMUSCULAR INJECTIONS OF ZEEL T  

Microsoft Academic Search

Summary Effectiveness of the treatment of degenerative joint disease by Zeel injections was assessed on the basis of published work and our own experience, including the results of a study carried out in a group of 523 patients. The solution was injected into the affected joints, periarticularly and intramuscularly. We also assessed the product's tolerability. Women were predominant (71%) in

Andrzej Lesiak; Rainer Gottwald; Michael Weiser

352

Genomics of pain in osteoarthritis  

PubMed Central

Summary Osteoarthritis (OA) accounts for the majority of the disease burden for musculoskeletal disorders and is one of the leading causes of disability worldwide. This disability is the result not of the cartilage loss that defines OA radiographically, but of the chronic pain whose presence defines symptomatic OA. It is becoming clear that many genes, each with a small effect size, contribute to the risk of developing OA. However, the genetics of OA pain are only just starting to be explored. This review will describe the first genes to have been identified in genomic studies of OA pain, as well as the possible dual roles of genes previously identified in genomic studies of OA in the context of pain. Difficulties associated with attempting to characterise the genetics of OA pain will be discussed and promising future avenues of research into genetic and epigenetic factors affecting OA pain described. PMID:23973152

Thakur, M.; Dawes, J.M.; McMahon, S.B.

2013-01-01

353

The potential utility of high-intensity ultrasound to treat osteoarthritis.  

PubMed

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

Nieminen, H J; Salmi, A; Karppinen, P; Hæggström, E; Hacking, S A

2014-11-01

354

Clinical classification criteria for knee osteoarthritis: performance in the general population and primary care  

PubMed Central

Background Doubts have been expressed about the performance of the American College of Rheumatology (ACR) clinical classification criteria for osteoarthritis when applied in the general population. Objective To investigate whether the distribution of population subgroups and underlying disease severity might explain the performance of these criteria in the population setting. Methods Population?based cross?sectional study. 819 adults aged ?50?years reporting knee pain in the last 12?months were clinically assessed by research therapists using standardised protocols and blinded to radiographic status. All participants underwent plain radiography of the knees, scored by a single reader blinded to clinical status. The relationship between fulfilling the ACR clinical classification criteria for knee osteoarthritis and the presence of symptomatic radiographic knee osteoarthritis was summarised for the sample as a whole and within subgroups. Results Radiographic osteoarthritis was present in 539 participants (68%) and symptomatic radiographic knee osteoarthritis in 259 (33%). 238 participants (30%) fulfilled the ACR clinical criteria for knee osteoarthritis. Agreement between the ACR clinical criteria and symptomatic radiographic knee osteoarthritis was low (sensitivity 41%; specificity 75%; positive predictive value 44%; negative predictive value 72%). Sensitivity and specificity did not vary markedly between population subgroups, although they were influenced by the underlying severity of radiographic osteoarthritis. Conclusion The ACR clinical criteria seem to reflect later signs in advanced disease. Other approaches may be needed to identify early, mild osteoarthritis in the general population and primary care. PMID:16627539

Peat, G; Thomas, E; Duncan, R; Wood, L; Hay, E; Croft, P

2006-01-01

355

Inhibited osteoclastic bone resorption through alendronate treatment in rats reduces severe osteoarthritis progression.  

PubMed

Osteoarthritis (OA) is a non-rheumatoid joint disease characterized by progressive degeneration of extra-cellular cartilage matrix (ECM), enhanced subchondral bone remodeling, osteophyte formation and synovial thickening. Alendronate (ALN) is a potent inhibitor of osteoclastic bone resorption and results in reduced bone remodeling. This study investigated the effects of pre-emptive use of ALN on OA related osteoclastic subchondral bone resorption in an in vivo rat model for severe OA. Using multi-modality imaging we measured effects of ALN treatment within cartilage and synovium. Severe osteoarthritis was induced in left rat knees using papain injections in combination with a moderate running protocol. Twenty rats were treated with subcutaneous ALN injections and compared to twenty untreated controls. Animals were longitudinally monitored for 12weeks with in vivo ?CT to measure subchondral bone changes and SPECT/CT to determine synovial macrophage activation using a folate-based radiotracer. Articular cartilage was analyzed at 6 and 12weeks with ex vivo contrast enhanced ?CT and histology to measure sulfated-glycosaminoglycan (sGAG) content and cartilage thickness. ALN treatment successfully inhibited subchondral bone remodeling. As a result we found less subchondral plate porosity and reduced osteophytosis. ALN treatment did not reduce subchondral sclerosis. However, after the OA induction phase, ALN treatment protected cartilage ECM from degradation and reduced synovial macrophage activation. Surprisingly, ALN treatment also improved sGAG content of tibia cartilage in healthy joints. Our data was consistent with the hypothesis that osteoclastic bone resorption might play an important role in OA and may be a driving force for progression of the disease. However, our study suggest that this effect might not solely be effects on osteoclastic activity, since ALN treatment also influenced macrophage functioning. Additionally, ALN treatment and physical activity exercised a positive effect in healthy control joints, which increased cartilage sGAG content. More research on this topic might lead to novel insights as to improve cartilage quality. PMID:24933343

Siebelt, M; Waarsing, J H; Groen, H C; Müller, C; Koelewijn, S J; de Blois, E; Verhaar, J A N; de Jong, M; Weinans, H

2014-09-01

356

Treating Osteoarthritis of the Shoulder  

MedlinePLUS

... corticosteroid (a drug that helps relieve pain and inflammation) in your shoulder or prescribe a ... Shoulder Osteoarthritis: Diagnosis and Management by Peter J. Millett, MD, Reuben Gobezie, MD, ...

357

Joint Effects of Smoking and Silicosis on Diseases to the Lungs  

PubMed Central

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

Tse, Lap Ah; Yu, Ignatius T. S.; Qiu, Hong; Leung, Chi Chiu

2014-01-01

358

Human Endogenous Retrovirus W Activity in Cartilage of Osteoarthritis Patients  

PubMed Central

The etiology of viruses in osteoarthritis remains controversial because the prevalence of viral nucleic acid sequences in peripheral blood or synovial fluid from osteoarthritis patients and that in healthy control subjects are similar. Until now the presence of virus has not been analyzed in cartilage. We screened cartilage and chondrocytes from advanced and non-/early osteoarthritis patients for parvovirus B19, herpes simplex virus-1, Epstein Barr virus, cytomegalovirus, human herpes virus-6, hepatitis C virus, and human endogenous retroviruses transcripts. Endogenous retroviruses transcripts, but none of the other viruses, were detected in 15 out the 17 patients. Sequencing identified the virus as HERV-WE1 and E2. HERV-W activity was confirmed by high expression levels of syncytin, dsRNA, virus budding, and the presence of virus-like particles in all advanced osteoarthritis cartilages examined. Low levels of HERV-WE1, but not E2 envelope RNA, were observed in 3 out of 8 non-/early osteoarthritis patients, while only 3 out of 7 chondrocytes cultures displayed low levels of syncytin, and just one was positive for virus-like particles. This study demonstrates for the first time activation of HERV-W in cartilage of osteoarthritis patients; however, a causative role for HERV-W in development or deterioration of the disease remains to be proven. PMID:25136615

Bendiksen, Signy; Martinez-Zubiavrra, Inigo; Knutsen, Gunnar; Elvenes, Jan; Olsen, Elisabeth; Olsen, Randi

2014-01-01

359

Clinical effects of Garcinia kola in knee osteoarthritis  

PubMed Central

Objectives Over the past years, there has been a growing number of knee osteoarthritis (KOA) patients who are not willing to comply with long-term non-steroidal anti-inflammatory drugs (NSAID) treatment and wish to use herbal anti- rheumatic medicine. This study assessed the clinical effects of Garcinia kola (GK) in KOA patients. Patients and methods Prospective randomized, placebo controlled, double blind, clinical trial approved by the institutional medical ethics review board and written informed consent obtained from each patient. All KOA patients presenting at the Obafemi Awolowo University Teaching Hospital complex were recruited into the study. The patients were grouped into four (A = Placebo, B = Naproxen, C = Garcinia kola, D = Celebrex). The drugs and placebo were given twice a day per oral route. Each dose consisted of 200 mg of G. kola, Naproxen (500 mg), Celebrex (200 mg) and Ascorbic acid (100 mg). The primary outcome measure over six weeks study period was the change in mean WOMAC pain visual analogue scales (VAS). Secondary outcome measures included the mean change in joint stiffness and physical function (mobility/walking). Results 143 patients were recruited, 84 (58.7%, males – 24, females – 60) satisfied the selection criteria and completed the study. The effect of knee osteoarthritis bilateralism among the subjects was not significant on their outcome (p > 0.05). The change in the mean WOMAC pain VAS after six weeks of G. kola was significantly reduced compared to the placebo (p < 0.001). Multiple comparisons of the mean VAS pain change of G. kola group was not lowered significantly against the naproxen and celebrex groups (p > 0.05). The onset of G. kola symptomatic pain relief was faster than the placebo (p < 0.001). However, it was slower than the active comparators (p > 0.05). The duration of therapeutic effect of Garcinia kola was longer than the placebo (p > 0.001). G. kola period of effect was less than naproxen and celebrex (p < 0.001). G. kola subjects had improved mean change mobility/walking after six weeks better than the control group(p < 0.001). The mean change in mobility of the G. kola group when compared to the active comparators was not significantly better (p < 0.05). The mean change of knee joint stiffness (p < 0.001) and the change of mean WOMAC score (p < 0.001) were improved on Garcinia kola as compared to the placebo. The mid term outcome of eleven Garcinia kola subjects after cessation of use had a mean pain relief period of 17.27 +/- 5.15 days (range: 9–26 days). There was no significant cardiovascular, renal or drug induced adverse reaction to Garcinia kola. Conclusion Garcinia kola appeared to have clinically significant analgesic/anti-inflammatory effects in knee osteoarthritis patients. Garcinia kola is a potential osteoarthritis disease activity modifier with good mid term outcome. Further studies are required for standardization of dosages and to determine long-term effects. PMID:18667082

Adegbehingbe, Olayinka O; Adesanya, Saburi A; Idowu, Thomas O; Okimi, Oluwakemi C; Oyelami, Oyesiku A; Iwalewa, Ezekiel O

2008-01-01

360

Histological and molecular characterisation of feline humeral condylar osteoarthritis  

PubMed Central

Background Osteoarthritis (OA) is a clinically important and common disease of older cats. The pathological changes and molecular mechanisms which underpin the disease have yet to be described. In this study we evaluated selected histological and transcriptomic measures in the articular cartilage and subchondral bone (SCB) of the humeral condyle of cats with or without OA. Results The histomorphometric changes in humeral condyle were concentrated in the medial aspect of the condyle. Cats with OA had a reduction in articular chondrocyte density, an increase in the histopathological score of the articular cartilage and a decrease in the SCB porosity of the medial part of the humeral condyle. An increase in LUM gene expression was observed in OA cartilage from the medial part of the humeral condyle. Conclusions Histopathological changes identified in OA of the feline humeral condyle appear to primarily affect the medial aspect of the joint. Histological changes suggest that SCB is involved in the OA process in cats. Differentiating which changes represent OA rather than the aging process, or the effects of obesity and or bodyweight requires further investigation. PMID:23731511

2013-01-01

361

Etiology of Ankle Osteoarthritis  

Microsoft Academic Search

The purpose of this study was to evaluate the distribution rate of etiologies leading to ankle arthritis and to quantify and\\u000a compare the important clinical and radiologic variables among these etiologic groups. We evaluated data from 390 patients\\u000a (406 ankles) who consulted our center because of painful end-stage ankle osteoarthritis (OA) by using medical history, physical\\u000a examination, and radiography. Posttraumatic

Victor Valderrabano; Monika Horisberger; Iain Russell; Hugh Dougall; Beat Hintermann

2009-01-01

362

Innovative therapies in osteoarthritis  

Microsoft Academic Search

Until recently, osteoarthritis (OA) was classified as a mechanical wear-and-tear disorder of articular cartilage, for which\\u000a only pain-modifying therapies such as nonaddictive analgesics were prescribed. Little scientific attention had been focused\\u000a on the patient with OA, who typically was seen as a frail elderly person hobbling down the street with a cane. With the demographic\\u000a change that is facing medical

Richard Polisson

2001-01-01

363

Gene therapies for osteoarthritis  

Microsoft Academic Search

Osteoarthritis (OA) is a major health problem in urgent need of better treatment. Gene therapy offers to meet this need. Of\\u000a the different strategies for using gene therapy in OA, local gene transfer to synovium is in the most advanced stage of development.\\u000a Local gene transfer brings several advantages, including a focused, local therapy that promises greater efficacy with reduced

Christopher H. Evans

2004-01-01

364

Relative contribution of contact and complement activation to inflammatory reactions in arthritic joints.  

PubMed Central

Although both the complement and contact system are thought to contribute to the inflammatory reaction in arthritic joints, only activation of complement has so far been well established, whereas contact activation and its contribution to arthritis has not been systematically explored. Complement and contact activation were assessed in 71 patients with inflammatory arthropathies and 11 with osteoarthritis using sensitive assays for C3a, and C1-inhibitor (C1INH)-kallikrein and C1INH-factor XIIa complexes respectively. Increased plasma concentrations of kallikrein-and factor XIIa-C1INH complexes were found in two and seven of the 71 patients with inflammatory arthropathies, respectively, and in none of the patients with osteoarthritis. Increased synovial fluid concentrations of kallikrein and factor XIIa complexes occurred in 13 and 15 patients with inflammatory joint diseases respectively, and in two patients with osteoarthritis. Contact system parameters did not correlate with clinical symptoms, local activity, or neutrophil activation. In contrast, synovial fluid concentrations of C3a and C1INH-C1 complexes were increased in all patients and in 20 patients with inflammatory arthropathies respectively, and were higher in patients with a higher local activity score. Synovial fluid C3a correlated with parameters of neutrophil activation such as lactoferrin. Increased plasma concentrations of C3a and C1INH-C1 complexes occurred in 13 and 11 patients with inflammatory joint diseases, and in one and two patients with osteoarthritis respectively. Plasma concentrations of C3a correlated with the number of painful joints. Thus contact activation occurs only sporadically in patients with arthritis and contributes little if anything to the local inflammatory reaction and neutrophil activation. These latter events are significantly related to the extent of complement activation. PMID:1444625

Abbink, J J; Kamp, A M; Nuijens, J H; Erenberg, A J; Swaak, A J; Hack, C E

1992-01-01

365

Factors that may mediate the relationship between physical activity and the risk for developing knee osteoarthritis  

Microsoft Academic Search

Studies investigating the effect of physical activity on risk for developing osteoarthritis at weight-bearing joints have reported conflicting results. We examine evidence to suggest that this may be due to the existence of subgroups of individuals who differ in their response to physical activity, as well as methodological issues associated with the assessment of knee joint structure and physical activity.

Donna M Urquhart; Cathy Soufan; Andrew J Teichtahl; Anita E Wluka; Fahad Hanna; Flavia M Cicuttini

2008-01-01

366

Diet-induced obesity differentially regulates behavioral, biomechanical, and molecular risk factors for osteoarthritis in mice  

Microsoft Academic Search

INTRODUCTION: Obesity is a major risk factor for the development of osteoarthritis in both weight-bearing and nonweight-bearing joints. The mechanisms by which obesity influences the structural or symptomatic features of osteoarthritis are not well understood, but may include systemic inflammation associated with increased adiposity. In this study, we examined biomechanical, neurobehavioral, inflammatory, and osteoarthritic changes in C57BL\\/6J mice fed a

Timothy M Griffin; Beverley Fermor; Janet L Huebner; Virginia B Kraus; Ramona M Rodriguiz; William C Wetsel; Li Cao; Lori A Setton; Farshid Guilak

2010-01-01

367

Effectiveness of diclofenac versus acetaminophen in primary care patients with knee osteoarthritis: [NTR1485], DIPA-Trial: design of a randomized clinical trial  

PubMed Central

Background Osteoarthritis is the most frequent chronic joint disease which causes pain and disability of especially hip and knee. According to international guidelines and the Dutch general practitioners guidelines for non-traumatic knee symptoms, acetaminophen should be the pain medication of first choice for osteoarthritis. However, of all prescribed pain medication in general practice, 90% consists of non-steroidal anti-inflammatory drugs compared to 10% of acetaminophen. Because general practitioners may lack evidence showing a similar efficacy of acetaminophen and non-steroidal anti-inflammatory drugs, we present the design of a randomized open-label trial to investigate the efficacy of a non-steroidal anti-inflammatory drug (diclofenac) compared with acetaminophen in new consulters with knee osteoarthritis in general practice. Methods/Design Patients aged 45 years or older consulting their general practitioner with non-traumatic knee pain, meeting the clinical American College of Rheumatology criteria, and with a pain severity score of 2 or higher (on a 0-10 scale), will be randomly allocated to either diclofenac (maximum daily dose of 150 mg) or acetaminophen (maximum daily dose of 3000 mg) for 2 weeks and, if required, an additional 1-2 weeks, with a total follow-up period of 12 weeks. The primary outcomes are knee pain measured with a daily diary, and pain and function measured with the Knee Injury and Osteoarthritis Outcome Score (KOOS) at baseline, and at 3, 6, 9, and 12-weeks follow-up. Secondary outcomes are patients' perceived recovery, quality of life, medical, patient, and productivity costs, compliance to therapy, co-interventions, and adverse reactions. Discussion The successful completion of this trial would lead to a better understanding of which medication should be used in the treatment of primary care patients with mild knee osteoarthritis. Trial registration Dutch trial registry NTR1485. PMID:20067607

2010-01-01

368

Post-traumatic osteoarthritis after ACL injury.  

PubMed

Post-traumatic osteoarthritis (PTOA) occurs as a consequence of joint trauma or occupations or sports that subject joints to excessive loading stresses. Ligament injuries to the knee, particularly tears of the anterior cruciate ligament (ACL), often result in PTOA. Approximately half of the individuals with an ACL injury develop PTOA regardless of the reconstruction of the torn ligament. This observation has raised the possibility that other injuries occur to the knee in association with ACL tears that may involve ligamentous capsular structures, articular cartilage, or subchondral bone. Many ACL injuries occur in noncontact sports and are the result of biomechanical abnormalities. Female athletes are more likely than their male counterparts to suffer ACL injuries. This review outlines the epidemiology of ACL tears, its pathology in cartilage and bone, some of the demographic, biomechanical, and neuromuscular factors involved in ACL tears, and PTOA and important information gained from preclinical injury models. PMID:25365816

Racine, Jennifer; Aaron, Roy K

2014-11-01

369

The role of leukocyte-stromal interactions in chronic inflammatory joint disease  

PubMed Central

Rheumatoid arthritis (RA) is a debilitating, chronic, persistent inflammatory disease that is characterised by painful and swollen joints. The aetiology of RA is unknown, however whereas past research has concentrated on the role of immune or inflammatory infiltrating cells in inflammation, it is becoming clear that stromal cells play a critical part in regulating the quality and duration of an inflammatory response. In this review we assess the role of fibroblasts within the inflamed synovium in modulating immune responses; in particular we examine the role of stromal cells in the switch from resolving to persistent inflammation as is found in the rheumatoid synovium. PMID:15681242

Burman, Angela; Haworth, Oliver; Bradfield, Paul; Parsonage, Greg; Filer, Andrew; Thomas, Andrew M.C.; Amft, Nicole; Salmon, Mike; Buckley, Christopher D.

2011-01-01

370

Nuclear medicine in diagnosis and therapy of bone and joint diseases.  

PubMed

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

Riccabona, G

1999-01-01

371

Quantitative three-dimensional photoacoustic tomography of the finger joints: an in vivo study  

NASA Astrophysics Data System (ADS)

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.

Sun, Yao; Sobel, Eric; Jiang, Huabei

2009-11-01

372

Biomarkers of cartilage and surrounding joint tissue.  

PubMed

The identification and clinical demonstration of efficacy and safety of osteo- and chondro-protective drugs are met with certain difficulties. During the last few decades, the pharmaceutical industry has, in the field of rheumatology, experienced disappointments associated with the development of disease modification. Today, the vast amount of patients suffering from serious, chronic joint diseases can only be offered treatments aimed at improving symptoms, such as pain and acute inflammation, and are not aimed at protecting the joint tissue. This huge, unmet medical need has been the driver behind the development of improved analytical techniques allowing better and more efficient clinical trial design, implementation and analysis. With this review, we aim to provide a brief and general overview of biochemical markers of joint tissue, with special focus on neoepitopes. Furthermore, we highlight recent studies applying biochemical markers in joint degenerative diseases. These disorders, including osteoarthritis, rheumatoid arthritis and spondyloarthropathies, are the most predominant disorders in Europe and the USA, and have enormous socioeconomical impact. PMID:25123039

Siebuhr, Anne S; He, Yi; Gudmann, Natasja S; Gram, Aurelie; Kjelgaard-Petersen, Cecilie F; Qvist, Per; Karsdal, Morten A; Bay-Jensen, Anne C

2014-01-01

373

Relationship between the shape of the central and third tarsal bones and the presence of tarsal osteoarthritis.  

PubMed

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 (??=?-0.45, P?<0.01), TMT (??=?-0.49, P?<0.01) and PIT joints (??=?-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

Sprackman, Lucy; Dakin, Stephanie G; May, Stephen A; Weller, Renate

2015-04-01

374

Lower body positive pressure: an emerging technology in the battle against knee osteoarthritis?  

PubMed Central

Background Knee osteoarthritis (OA) is the most prevalent medical condition in individuals over the age of 65 years, and is a progressive joint degenerative condition with no known cure. Research suggests that there is a strong relationship between knee pain and loss of physical function. The resulting lifestyle modifications negatively impact not only disease onset and progression but also overall health, work productivity, and quality of life of the affected individual. Purpose The goal of this investigation was to examine the feasibility of using an emerging technology called lower body positive pressure (LBPP) to simulate weight loss and reduce acute knee pain during treadmill walking exercise in overweight individuals with radiographically confirmed symptomatic knee OA. Design Prospective case series. Methods Twenty-two overweight individuals with knee OA completed two 20-minute treadmill walking sessions (one full weight bearing and one LBPP supported) at a speed of 3.1 mph, 0% incline. Acute knee pain was assessed using a visual analog scale, and the percentage of LBPP support required to minimize knee pain was evaluated every 5 minutes. Knee Osteoarthritis Outcome Scores were used to quantify knee pain and functional status between walking sessions. The order of testing was randomized, with sessions occurring a minimum of 1 week apart. Results A mean LBPP of 12.4% of body weight provided participants with significant pain relief during walking, and prevented exacerbation of acute knee pain over the duration of the 20-minute exercise session. Patients felt safe and confident walking with LBPP support on the treadmill, and demonstrated no change in Knee Osteoarthritis Outcome Scores over the duration of the investigation. Conclusion Results suggest that LBPP technology can be used safely and effectively to simulate weight loss and reduce acute knee pain during weight-bearing exercise in an overweight knee OA patient population. These results could have important implications for the development of future treatment strategies used in the management of at-risk patients with progressive knee OA. PMID:23926425

Takacs, Judit; Anderson, Judy E; Leiter, Jeff RS; MacDonald, Peter B; Peeler, Jason D

2013-01-01

375

Perspectives on the Use of Gene Therapy for Chronic Joint Diseases  

PubMed Central

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

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

376

[Limb and joint pain in Lyme disease. An important differential neurologic diagnosis].  

PubMed

On the basis of 4 cases, attention is drawn to the problem of early detection of Lyme disease. The occurrence of joint pain with fluctuating spread and unresponsive to the usual antiinflammatory therapy should prompt the physician to consider lyme disease, which can be confirmed or excluded only by lumbar puncture. The CSF shows a cell count of between 300/3 and 2,000/3 cells (90% lymphocytes) and usually moderately elevated protein. A demonstration of elevated antibody titers confirms the diagnosis. The condition can be cured with antibiotics (penicillins or cephalosporins) and also cerebral nerve involvement (usual the facial nerve) with or without impairment of taste also clears up completely. PMID:2767602

von Albert, H H

1989-08-10

377

Expression of MIG-6, WNT-9A, and WNT-7B during osteoarthritis.  

PubMed

Although the molecular mechanisms for initiation of cartilage destruction in osteoarthritis (OA) are unknown, it has been demonstrated that disruption of mitogen-inducible gene 6 (Mig-6) in mice leads to the onset of a degenerative joint disease like OA. On this basis, we correlated gene expression of Mig-6 with Wnt-9a and Wnt-7b genes; we showed downregulation of Mig-6, Wnt-7b, and Wnt-9a during OA, while Wnt-7b was expressed also in osteoblast-like cells. Here we suggest that Aggrecan degradation occurs before the downregulation of Mig-6. It remains to be proven whether there is any relation between Wnt signaling and Aggrecan degradation. PMID:18056042

Velasquillo, Cristina; Garciadiego-Cázares, David; Almonte, Maylin; Bustamante, Marcia; Ibarra, Clemente; Kouri, Juan B; Chimal-Monroy, Jesús

2007-11-01

378

Risk Factors for Osteoarthritis and Contributing Factors to Current Arthritic Pain in South Korean Older Adults  

PubMed Central

Purpose Although previous studies have focused on risk factors for osteoarthritis, there is some debate on this issue. Furthermore, associated factors with arthritic symptom (arthralgia) have not been sufficiently investigated, despite its clinical importance in the management of osteoarthritis. This study was performed to examine the risk factors for osteoarthritis and the contributing factors to current arthritic pain in older adults. Materials and Methods The Fourth Korean National Health and Nutrition Examination Surveys was conducted in 2009. Therein, 720 males and 1008 females aged 65 years and older were included. Comprehensive data on habitual, socioeconomic, medical, nutritional, and psychological factors were collected along with the presence of osteoarthritis and arthritic pain. After univariate analysis, binary logistic regression analysis was performed to identify risk factors for osteoarthritis and contributing factors to current arthritic pain. Results Age (p=0.005), female gender (p<0.001), higher body mass index (BMI) (p<0.001), and osteoporosis (p<0.001) were significant risk factors for osteoarthritis, while higher education level (p=0.025) was a protective factor for osteoarthritis. Higher BMI (p=0.047), lack of weekly moderate intensity activity (p<0.001), and unfavorable subjective health status (p<0.001) were significant factors contributing to current arthritic pain among subjects with osteoarthritis. Both osteoarthritis and current arthritic pain adversely affected health related quality of life. Conclusion Higher BMI, lack of weekly moderate intensity activity, and unfavorable subjective health status were significant factors contributing to current arthritic pain. More attention needs to be paid to psychiatric effects on osteoarthritis and joint related pain. PMID:25510755

Lee, Kyoung Min; Sung, Ki Hyuk; Lee, Seung Yeol; Won, Sung Hun; Kim, Tae Gyun; Choi, Young; Kwon, Soon-Sun; Kim, Yeon Ho; Park, Moon Seok

2015-01-01

379

Bone marrow derived stem cells in joint and bone diseases: a concise review.  

PubMed

Stem cells have huge applications in the field of tissue engineering and regenerative medicine. Their use is currently not restricted to the life-threatening diseases but also extended to disorders involving the structural tissues, which may not jeopardize the patients' life, but certainly influence their quality of life. In fact, a particularly popular line of research is represented by the regeneration of bone and cartilage tissues to treat various orthopaedic disorders. Most of these pioneering research lines that aim to create new treatments for diseases that currently have limited therapies are still in the bench of the researchers. However, in recent years, several clinical trials have been started with satisfactory and encouraging results. This article aims to review the concept of stem cells and their characterization in terms of site of residence, differentiation potential and therapeutic prospective. In fact, while only the bone marrow was initially considered as a "reservoir" of this cell population, later, adipose tissue and muscle tissue have provided a considerable amount of cells available for multiple differentiation. In reality, recently, the so-called "stem cell niche" was identified as the perivascular space, recognizing these cells as almost ubiquitous. In the field of bone and joint diseases, their potential to differentiate into multiple cell lines makes their application ideally immediate through three main modalities: (1) cells selected by withdrawal from bone marrow, subsequent culture in the laboratory, and ultimately transplant at the site of injury; (2) bone marrow aspirate, concentrated and directly implanted into the injury site; (3) systemic mobilization of stem cells and other bone marrow precursors by the use of growth factors. The use of this cell population in joint and bone disease will be addressed and discussed, analysing both the clinical outcomes but also the basic research background, which has justified their use for the treatment of bone, cartilage and meniscus tissues. PMID:25005462

Marmotti, Antonio; de Girolamo, Laura; Bonasia, Davide Edoardo; Bruzzone, Matteo; Mattia, Silvia; Rossi, Roberto; Montaruli, Angela; Dettoni, Federico; Castoldi, Filippo; Peretti, Giuseppe

2014-09-01

380

Joint disease mapping using six cancers in the Yorkshire region of England  

PubMed Central

Objectives The aims of this study were to model jointly the incidence rates of six smoking related cancers in the Yorkshire region of England, to explore the patterns of spatial correlation amongst them, and to estimate the relative weight of smoking and other shared risk factors for the relevant disease sites, both before and after adjustment for socioeconomic background (SEB). Methods Data on the incidence of oesophagus, stomach, pancreas, lung, kidney, and bladder cancers between 1983 and 2003 were extracted from the Northern & Yorkshire Cancer Registry database for the 532 electoral wards in the Yorkshire region. Using postcode of residence, each case was assigned an area-based measure of SEB using the Townsend index. Standardised incidence ratios (SIRs) were calculated for each cancer site and their correlations investigated. The joint analysis of the spatial variation in incidence used a Bayesian shared-component model. Three components were included to represent differences in smoking (for all six sites), bodyweight/obesity (for oesophagus, pancreas and kidney cancers) and diet/alcohol consumption (for oesophagus and stomach cancers). Results The incidence of cancers of the oesophagus, pancreas, kidney, and bladder was relatively evenly distributed across the region. The incidence of stomach and lung cancers was more clustered around the urban areas in the south of the region, and these two cancers were significantly associated with higher levels of area deprivation. The incidence of lung cancer was most impacted by adjustment for SEB, with the rural/urban split becoming less apparent. The component representing smoking had a larger effect on cancer incidence in the eastern part of the region. The effects of the other two components were small and disappeared after adjustment for SEB. Conclusion This study demonstrates the feasibility of joint disease modelling using data from six cancer sites. Incidence estimates are more precise than those obtained without smoothing. This methodology may be an important tool to help authorities evaluate healthcare system performance and the impact of policies. PMID:18662387

Downing, Amy; Forman, David; Gilthorpe, Mark S; Edwards, Kimberley L; Manda, Samuel OM

2008-01-01

381

Preliminary results of automated removal of degenerative joint disease in bone scan lesion segmentation  

NASA Astrophysics Data System (ADS)

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.

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

382

Biomarkers of early stage osteoarthritis, rheumatoid arthritis and musculoskeletal health  

PubMed Central

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

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

383

Osteoarthritis pain mechanisms: Basic studies in animal models  

PubMed Central

Osteoarthritis (OA) is a complex and painful disease of the whole joint. At present there are no satisfying agents for treating OA. The current standard of care mainly involves managing and alleviating its symptoms. Mechanisms of OA pain have been studied in rodent knee OA models produced by intra-knee injection of the chondrocyte glycolytic inhibitor mono-iodoacetate, surgery, or spontaneous development in some species. These models are clinically relevant in terms of histological damage and functional changes, and are used to study mechanisms underlying mechanical, thermal, ambulatory, body weight supporting-evoked, and ongoing OA pain. Recent peripheral, spinal, and supraspinal biochemical and electrophysiological studies in these models suggest that peripheral pro-inflammatory mediators and neuropeptides sensitize knee nociceptors. Spinal cytokines and neuropeptides promote OA-associated pain, and peripheral and spinal cannabinoids inhibit OA pain respectively through cannabinoid-1 (CB1) and CB1/CB2 receptors. TRPV1 and metalloproteinases contribute and supraspinal descending facilitation of 5-HT/5-HT 3 receptors may also contribute to OA pain. Conditioned place preference tests demonstrate that OA pain induces aversive behaviors suggesting brain involvement in OA pain. During OA, brain functional connectivity is enhanced, but at present it is unclear how this change is related to OA pain. PMID:23973145

Zhang, Rui-Xin; Ren, Ke; Dubner, Ronald

2013-01-01

384

Management of Osteoarthritis with Avocado/Soybean Unsaponifiables  

PubMed Central

Osteoarthritis (OA) is a painful and life-altering disease that severely limits the daily activity of millions of Americans, and 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, non-pharmaceutical, 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 (MMP-2,3,13) and increasing tissue inhibitors of these catabolic enzymes (TIMP-1). ASU also inhibits fibrinolysis by stimulating the expression of plasminogen activator inhibitor (PAI-1). Anabolic properties promote cartilage repair by stimulating collagen and aggrecan synthesis via inhibition of inflammatory cytokines such as IL1, IL6, IL8, TNF, ERK, and PGE2. Chondroprotective effects are mediated by correcting growth factor abnormalities, increasing TGF? while 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

Christiansen, Blaine A.; Bhatti, Simi; Goudarzi, Ramin; Emami, Shahin

2015-01-01

385

Biomarkers of early stage osteoarthritis, rheumatoid arthritis and musculoskeletal health.  

PubMed

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

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

386

Retropatellar Chondromalacia Associated with Medial Osteoarthritis after Meniscus Injury  

Microsoft Academic Search

Background\\/Aims: In an ovine meniscal repair model, the patellofemoral (PF) osteoarthritis due to a non-sutured tear or failed repair was investigated. Methods: A radial meniscus tear was either sutured with polydioxanone (PDS), with a slow degrading polylactide long-term suture(LTS) or left without treatment. Knee joint cartilage in the PF and medial compartment was evaluated compared to normal knees (healthy controls).

C. Burger; K. Kabir; M. Mueller; C. Rangger; T. Minor; R. H. Tolba

2006-01-01

387

In vivo detection of osteoarthritis in the hand with three-dimensional photoacoustic tomography  

NASA Astrophysics Data System (ADS)

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.

Sun, Yao; Sobel, Eric; Jiang, Huabei

2010-02-01

388

Segment-specific association between cervical pillar hyperplasia (CPH) and degenerative joint disease (DJD)  

PubMed Central

Background Cervical pillar hyperplasia (CPH) is a recently described phenomenon of unknown etiology and clinical significance. Global assessment of pillar hyperplasia of the cervical spine as a unit has not shown a relationship with degenerative joint disease, but a more sensible explanation of the architectural influence of CPH on cervical spine biomechanics may be segment-specific. Objective The objective of this study was to determine the level of association between degenerative joint disease (DJD) and cervical pillar hyperplasia (CPH) in an age- and gender-matched sample on a [cervical spine] by-level basis. Research Methods Two-hundred and forty radiographs were collected from subjects ranging in age between 40 and 69 years. The two primary outcome measures used in the study were the segmental presence/absence of cervical pillar hyperplasia from C3 to C6, and segment-specific presence/absence of degenerative joint disease from C1 to C7. Contingency Coefficients, at the 5% level of significance, at each level, were used to determine the strength of the association between CPH and DJD. Odds Ratios (OR) with their 95% Confidence Intervals (95% CI) were also calculated at each level to assess the strength of the association. Results Our study suggests that an approximately two-to-one odds, or a weak-to-moderate correlation, exists at C4 and C5 CPH and adjacent level degenerative disc disease (DDD); with the strongest (overall) associations demonstrated between C4 CPH and C4–5 DDD and between C5 CPH and C5–6 DDD. Age-stratified results demonstrated a similar pattern of association, even reaching the initially hypothesized OR ? 5.0 (95% CI > 1.0) or "moderately-strong correlation of C ? .4 (p ? .05)" in some age categories, including the 40–44, 50–59, and 60–64 years of age subgroups; these ORs were as follows: OR = 5.5 (95% CI 1.39–21.59); OR = 6.7 (95% CI 1.65–27.34); and OR = 5.3 (95% CI 1.35–21.14), respectively. Conclusion Our results suggest that CPH has around two-to-one odds, that is, only a weak-to-moderate association with the presence of DJD (DDD component) at specific cervical spine levels; therefore, CPH may be but one of several factors that contributes (to a clinically important degree) to the development of DJD at specific levels in the cervical spine. PMID:16970812

Stupar, Maja; Peterson, Cynthia K

2006-01-01

389

Variations in the pre-operative status of patients coming to primary hip replacement for osteoarthritis in European orthopaedic centres  

PubMed Central

Background Total hip joint replacement (THR) is a high volume, effective intervention for hip osteoarthritis (OA). However, indications and determinants of outcome remain unclear. The 'EUROHIP consortium' has undertaken a cohort study to investigate these questions. This paper describes the variations in disease severity in this cohort and the relationships between clinical and radiographic severity, and explores some of the determinants of variation. Methods A minimum of 50 consecutive, consenting patients coming to primary THR for primary hip OA in each of the 20 participating orthopaedic centres entered the study. Pre-operative data included demographics, employment and educational attainment, drug utilisation, and involvement of other joints. Each subject completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC – Likert version 3.1). Other data collected at the time of surgery included the prosthesis used and American Society of Anaesthesiologists (ASA) status. Pre-operative radiographs were read by the same three readers for Kellgren and Lawrence (K&L) grading and Osteoarthritis Research Society International (OARSI) atlas features. Regression analyses were carried out. Results Data from 1327 subjects has been analysed. The mean age of the group was 65.7 years, and there were more women (53.4%) than men. Most (79%) were ASA status 1 or 2. Reported disease duration was 5 years or less in 69.2%. Disease in other joint sites was common. Radiographs were available in 1051 subjects and the K&L grade was 3 or 4 in 95.8%. There was much more variation in clinical severity (WOMAC score); the mean total WOMAC score was 59.2 (SD 16.1). The radiographic severity showed no correlation with WOMAC scores. Significantly higher WOMAC scores (worse disease) were seen in older people, women, those with obesity, those with worse general health, and those with lower educational attainment. Conclusion 1. Clinical disease severity varies widely at the time of THR for OA. 2. In advanced hip OA clinical severity shows no correlation with radiographic severity. 3. Simple scores of pain and disability do not reflect the complexity of decision-making about who should have a THR. PMID:19208230

Dieppe, Paul; Judge, Andrew; Williams, Susan; Ikwueke, Ifeoma; Guenther, Klaus-Peter; Floeren, Markus; Huber, Joerg; Ingvarsson, Thorvaldur; Learmonth, Ian; Lohmander, L Stefan; Nilsdotter, Anna; Puhl, Wofhart; Rowley, David; Thieler, Robert; Dreinhoefer, Karsten

2009-01-01

390

In vivo x-ray phase contrast analyzer-based imaging for longitudinal osteoarthritis studies in guinea pigs  

NASA Astrophysics Data System (ADS)

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.

Coan, Paola; Wagner, Andreas; Bravin, Alberto; Diemoz, Paul C.; Keyriläinen, Jani; Mollenhauer, Juergen

2010-12-01

391

Mitochondrial DNA haplogroups modulate the radiographic progression of Spanish patients with osteoarthritis.  

PubMed

Not all patients with osteoarthritis (OA) show the same disease progression, as some of them remain relatively stable over time, while others progress to severe structural deterioration of the joint. In this sense, the main goal of both genetic and protein biomarkers in OA is to predict not only the risk of OA at an earlier stage of the disease but also which OA patients are more likely to progress to severe disease. Taking into account the incidence of the mitochondria and the mtDNA haplogroups in the pathogenesis of OA, the main objective of this work was to evaluate the incidence of the mtDNA haplogroups in the radiographic progression of the OA disease in a well-characterized follow-up cohort of Spanish patients. DNA from 281 OA patients from Hospital Universitario A Coruña was isolated to determine the European mtDNA haplogroups. Knee or hip radiographs from all affected joints were obtained at two time points with at least 36 months apart. Radiographs were evaluated using the Kellgren/Lawrence (K/L) scale; radiographic OA progression was defined as any radiographic worsening of the K/L joint score. Statistical analyses included Kaplan-Meier survival curves and Cox regression models. Patients belonging to the cluster TJ showed a slower radiographic OA progression than patients in the cluster KU (p = 0.036). Moreover, patients carrying the most common mtDNA haplogroup H are more apt to require total joint replacement surgery than non-H patients (p = 0.049). The inherited mitochondrial variants influence the radiographic progression of OA and could be considered among the genetic variants taken into account when the radiographic progression of OA is analyzed. PMID:25086630

Soto-Hermida, Angel; Fernández-Moreno, Mercedes; Pértega-Díaz, Sonia; Oreiro, Natividad; Fernández-López, Carlos; Blanco, Francisco J; Rego-Pérez, Ignacio

2015-02-01

392

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. ...

393

Temporomandibular signs, symptoms, joint alterations and disease activity in juvenile idiopathic arthritis – an observational study  

PubMed Central

Background Juvenile idiopathic arthritis (JIA) is a heterogeneous disease that frequently affects also the temporomandibular joint (TMJ) and associated structures. The main aim of this observational study was to describe systematically orofacial clinical signs and subjective symptoms in JIA patients, classified according to the International League of Associations for Rheumatology (ILAR) criteria, and to relate the findings to disease activity and radiological TMJ condyle lesions. Methods The study was a retrospective evaluation of dental and medical records in consecutive JIA patients referred to one of three dental specialist clinics in Sweden during an eight-year period. Data concerning temporomandibular signs, symptoms and general disease activity were collected and condylar alterations were judged on panoramic radiographs. Results All ILAR categories of JIA were represented among the 266 referrals included in the study. The distribution of patients among categories resembled the pattern seen in epidemiological studies. Persistent oligoarthritis was the largest category with 36.5% of the patients. Temporomandibular clinical signs (mild, moderate or severe) occurred in 57.7% to 92.0%, and subjective symptoms (mild or severe) in 32.0% to 76.0% of the patients in all categories. Patients in the juvenile psoriatic arthritis category had the largest number of orofacial signs and symptoms, and patients in the persistent oligoarthritis category had the fewest signs and symptoms. There were significant associations between clinical signs as well as subjective symptoms and overall disease activity. Half of all the patients had undergone panoramic examinations and 37.9% of those were judged to have condylar alterations after a mean of 2.9 years after onset. No associations between radiological findings and variables, such as signs, symptoms or disease activity, were found. Conclusions Temporomandibular signs and symptoms can be expected to a varying degree, including severe cases, in all JIA categories. Clinical and subjective orofacial involvement appears to be related to disease activity but not to condylar lesions. PMID:24134193

2013-01-01

394

Influence of Adult Height on Rheumatoid Arthritis: Association with Disease Activity, Impairment of Joint Function and Overall Disability  

PubMed Central

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