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Wang R, Wang ZM, Xiang SC, Jin ZK, Zhang JJ, Zeng JC, Tong PJ, Lv SJ. Relationship between 25-hydroxy vitamin D and knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Front Med (Lausanne) 2023; 10:1200592. [PMID: 37601800 PMCID: PMC10433223 DOI: 10.3389/fmed.2023.1200592] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/12/2023] [Indexed: 08/22/2023] Open
Abstract
Objective In order to examine the relationship between 25-hydroxyl vitamin D and knee osteoarthritis (KOA), a meta-analysis of 8 randomized controlled trials (RCTs) publications was hereby performed. Methods For the purpose of finding pertinent research, the databases of PubMed, Embase and the Cochrane Library were searched. Factors including tibial cartilage volume, joint space width (JSW), synovial fluid volume, and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were correspondingly evaluated, and the results were expressed using SMD and 95% confidence intervals (CI). Results The present meta-analysis evaluated the effects of vitamin D supplementation in patients with knee osteoarthritis, with 3,077 patients included. The results showed that vitamin D administration had a statistically significant impact on the amount of synovial fluid, Visual Analog Scale (VAS) and tibial cartilage. The pain and function scales of the WOMAC scale presented a statistically significant difference, and there was no discernible difference between the vitamin D and placebo groups in the stiffness scale. Additionally, bone marrow lesions and alterations in the diameter of the joint space were not influenced by the administration of vitamin D, and according to a subgroup study, a daily vitamin D supplement containing more than 2,000 IU significantly slowed the development of synovial tissue. Conclusion Vitamin D supplementation did benefit those suffering from knee discomfort and knee dysfunction. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022332033, identifier: CRD42022332033.
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Affiliation(s)
- Rui Wang
- Guanghua Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Orthopedic Surgery, Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
| | - Zheng-ming Wang
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Si-cheng Xiang
- The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Zhao-kai Jin
- The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Jing-jing Zhang
- The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Ji-cheng Zeng
- The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Pei-jian Tong
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
| | - Shuai-jie Lv
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
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Naoum S. The Role of Vitamin D in the Development and Progression of Osteoarthritis. ROMANIAN JOURNAL OF MILITARY MEDICINE 2023. [DOI: 10.55453/rjmm.2023.126.3.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
"Low levels of vitamin D in patients with osteoarthritis (ΟΑ) rather adversely affect the structure and function of articular cartilage. Low levels of vitamin D are also associated with joint pain, limited physical activity, quality of life, as well as decreased muscle strength, primarily in the lower extremities with adverse OA progression. A high percentage of low vitamin D levels was found in patients with OA and joint arthroplasty as well as a less satisfactory postoperative follow-up in patients with low vitamin D levels. The administration of vitamin D supplementation in patients with knee osteoarthritis has been associated with improved articular cartilage architecture, and reduced joint pain, combined with improved functionality and quality of life in patients with OA. "
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Amirkhizi F, Asoudeh F, Hamedi-Shahraki S, Asghari S. Vitamin D status is associated with inflammatory biomarkers and clinical symptoms in patients with knee osteoarthritis. Knee 2022; 36:44-52. [PMID: 35500429 DOI: 10.1016/j.knee.2021.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/27/2021] [Accepted: 12/14/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND AIM The association between vitamin D status and osteoarthritis (OA) and bone remodeling has been shown previously. The present study was conducted to determine the association between vitamin D status and inflammatory biomarkers and clinical symptoms in patients with knee OA. METHODS This case-control study was performed on 124 subjects with mild to moderate knee OA and 65 healthy controls. Demographic data was collected from all participants at baseline. We used Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC Index) for evaluating the severity of clinical symptoms in these patients. Serum levels of vitamin D as well as markers of inflammation including interleukin 1-β (IL-1β), interleukin 6 (IL-6), interleukin 10 (IL-10), tumor necrosis factor-alpha (TNF-α), high-sensitivity C-reactive protein (hs-CRP), and nuclear factor k-B (NF-κB) p65 were evaluated for each participant. RESULTS The results of the present study showed that patients with knee OA had lower levels of vitamin D and higher levels of IL-1β, TNF-α, hs-CRP, and NF-кB p65 compared with healthy controls (P < 0.0001). The levels of IL-1β, TNF-α, and NF-кB p65 in knee OA patients with vitamin D insufficiency were significantly higher compared with the knee OA patients with sufficient vitamin D (P < 0.05). Based on the linear regression analysis, serum vitamin D levels were inversely correlated with IL-1β, TNF-α, hs-CRP, and NF-кB p65 levels (P < 0.0001). Patients with sufficient vitamin D levels had lower total and physical function WOMAC scores compared with patients with vitamin D insufficiency (P = 0.011 and P = 0.010, respectively). CONCLUSION The results suggest a strong link between vitamin D deficiency and increased inflammatory biomarkers as well as increased severity of clinical symptoms in knee OA patients.
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Affiliation(s)
- Farshad Amirkhizi
- Department of Nutrition, Faculty of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Farzaneh Asoudeh
- Department of Clinical Nutrition, Faculty of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Soudabeh Hamedi-Shahraki
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Somayyeh Asghari
- Department of Clinical Nutrition, Faculty of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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Sakr BR, Al-Ashmory NM, Hassan SZ, Al-Akwa AA, Shaker OG. Vitamin D deficiency in Egyptian and Yemeni primary knee osteoarthritis patients: Relation to physical function and radiographic severity. THE EGYPTIAN RHEUMATOLOGIST 2021. [DOI: 10.1016/j.ejr.2020.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Tripathy SK, Gantaguru A, Nanda SN, Velagada S, Srinivasan A, Mangaraj M. Association of vitamin D and knee osteoarthritis in younger individuals. World J Orthop 2020; 11:418-425. [PMID: 33134104 PMCID: PMC7582112 DOI: 10.5312/wjo.v11.i10.418] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/13/2020] [Accepted: 08/25/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The incidence of primary osteoarthritis knee is gradually increasing among young individuals. The increasing prevalence of obesity, sedentary lifestyle, sporting activity, and vitamin D deficiency (VDD) has been hypothesized for this shifting disease trend. This study was designed to look for the association of serum vitamin D among these young arthritic patients.
AIM To look for the association of serum vitamin D in younger knee osteoarthritis (KOA) patients.
METHODS In a 2-year observational study, 146 non-obese KOA patients of 35-60 years were evaluated clinically (Knee injury and Osteoarthritis Outcome Score, KOOS) and radiologically (Kellegren-Lawrence stage, KL). The serum 25(OH)D level of these patients and 146 normal healthy individuals of same age group were estimated.
RESULTS Both the groups were comparable in terms of age and sex. The average serum 25(OH)D level in healthy individuals and KOA patients was 45.83 ng/mL and 34.58 ng/mL, respectively (P < 0.001). Inadequate serum 25(OH)D level (< 30 ng/mL) was found in 46.57% of KOA patients and 24% of normal healthy participants indicating a significant positive association (odds ratio 2.77, 95%CI: 1.67-4.54, P < 0.001). The 25(OH)D level in KL grade I, II, III and IV was 43.40, 30.59, 31.56 and 33.93 ng/mL respectively (no difference, P = 0.47). Similarly, the KOOS score in sufficient, insufficient and deficient groups were 65.31, 60.36 and 65.31, respectively (no difference, P = 0.051).
CONCLUSION The serum 25(OH)D level is significantly low in younger KOA patients. However, the clinical and radiological severities have no association with serum vitamin D level.
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Affiliation(s)
- Sujit Kumar Tripathy
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar 751019, Odisha, India
| | - Amrit Gantaguru
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar 751019, Odisha, India
| | - Saurav Narayan Nanda
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar 751019, Odisha, India
| | - Sandeep Velagada
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar 751019, Odisha, India
| | - Anand Srinivasan
- Department of Pharmacology, AIIMS Bhubaneswar, Bhubaneswar 751019, Odisha, India
| | - Manaswini Mangaraj
- Department of Biochemistry, AIIMS Bhubaneswar, Bhubaneswar 751019, Odisha, India
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Joseph GB, McCulloch CE, Nevitt MC, Neumann J, Lynch JA, Lane NE, Link TM. Associations Between Vitamins C and D Intake and Cartilage Composition and Knee Joint Morphology Over 4 Years: Data From the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2020; 72:1239-1247. [PMID: 31282125 DOI: 10.1002/acr.24021] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 07/02/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To determine the cross-sectional and longitudinal associations of vitamin C and D intake with magnetic resonance imaging (MRI) measures of cartilage composition (T2) and joint structure (cartilage, meniscus, and bone marrow) using data from the Osteoarthritis Initiative (OAI) cohort. METHODS A total of 1,785 subjects with radiographic Kellgren/Lawrence knee grades 0-3 in the right knee were selected from the OAI database. Vitamins C and vitamin D intake (diet, supplements, and total) were assessed using the Block Brief 2000 Food Frequency Questionnaire at baseline. The MRI analysis protocol included 3T cartilage T2 quantification and semiquantitative joint morphology gradings (Whole-Organ Magnetic Resonance Imaging Score [WORMS]) at baseline and 4 years. Linear regression was used to assess the association between standardized baseline vitamin intake and both baseline WORMS scores and standardized cartilage T2 values. RESULTS Higher vitamin C intake was associated with lower average cartilage T2 values, medial tibia T2 values, and medial tibia WORMS scores (standardized coefficient range -0.07 to -0.05, P < 0.05). Higher vitamin D intake was associated with a lower cartilage WORMS sum score and medial femur WORMS score (standardized coefficient range -0.24 to -0.09, P < 0.05). Consistent use of vitamin D supplements of 400 IU at least once a week over 4 years was associated with significantly less worsening of cartilage, meniscus, and bone marrow abnormalities (odds ratio range 0.40-0.56, P < 0.05). CONCLUSION Supplementation with vitamin D over 4 years was associated with significantly less progression of knee joint abnormalities. Given the observational nature of this study, future longitudinal randomized controlled trials of vitamin D supplementation are warranted.
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Effects of exercise mode in knee cartilage thickness. J Bodyw Mov Ther 2020; 24:490-495. [PMID: 33218552 DOI: 10.1016/j.jbmt.2020.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 01/07/2020] [Accepted: 05/01/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND It is unclear how cycling and running would differ in terms of changes in cartilage thickness. Also, given squats are a popular type of exercise used to strengthen lower limbs, it is critical to assess if loads used during resisted training could lead to changes in cartilage cushioning properties. Therefore, the purpose of this study was to compare the effects of exercise mode in knee cartilage thickness. METHODS This study utilized a randomized cross-over design with repeated measures. All sessions were completed between 48hrs and seven days, at the same time of the day. Fourteen (seven males and seven females) apparently healthy participants without musculoskeletal or neurological diseases volunteered for the study. Participants were assessed after squats and functional exercises (n = 18 knees) or after running and cycling (n = 10 knees). All ultrasound images were collected at participants' arrival in the laboratory (Baseline), after warm-up (Pre-exercise), after the completion of each exercise protocol (Post-exercise), and at five (5-min) and 10 minutes (10-min) after exercise. RESULTS Cartilage thickness did not change after squats performed with 60% of 1-RM or after a set of three functional exercises (i.e. sit-to-stand, lunges, and step-ups; p = 0.68). However, longer duration exercises (i.e. cycling and running) led to increases in cartilage thickness after 5-min from the completion of the exercise (p = 0.02). CONCLUSION Knee cartilage may have capacity to sustain short-term cyclical loads applied during exercise (i.e. squats and functional exercises) but not to moderate duration exercises (i.e. cycling and running).
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Pleiotropic actions of Vitamin D in composite musculoskeletal trauma. Injury 2020; 51:2099-2109. [PMID: 32624209 DOI: 10.1016/j.injury.2020.06.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 05/21/2020] [Accepted: 06/13/2020] [Indexed: 02/02/2023]
Abstract
Composite tissue injuries are the result of high energy impacts caused by motor vehicle accidents, gunshot wounds or blasts. These are highly traumatic injuries characterized by wide-spread, penetrating wounds affecting the entire musculoskeletal system, and are generally defined by frank volumetric muscle loss with concomitant segmental bone defects. At the tissue level, the breadth of damage to multiple tissue systems, and potential for infection from penetration, have been shown to lead to an exaggerated, often chronic inflammatory response with subsequent dysregulation of normal musculoskeletal healing mechanisms. Aside from the direct effects of inflammation on myogenesis and osteogenesis, frank muscle loss has been shown to directly impair fracture union and ultimately contribute to failed wound regeneration. Care for these injuries requires extensive surgical intervention and acute care strategies. However, often these interventions do not adequately mitigate inflammation or promote proper musculoskeletal injury repair and force amputation of the limb. Therefore, identification of factors that can promote tissue regeneration and mitigate inflammation could be key to restoring wound healing after composite tissue injury. One such factor that may directly affect both inflammation and tissue regeneration in response to these multi-tissue injuries may be Vitamin D. Beyond traditional roles, the pleiotropic and localized actions of Vitamin D are increasingly being recognized in most aspects of wound healing in complex tissue injuries - e.g., regulation of inflammation, myogenesis, fracture callus mineralization and remodeling. Conversely, pre-existing Vitamin D deficiency leads to musculoskeletal dysfunction, increased fracture risk or fracture non-unions, decreased strength/function and reduced capacity to heal wounds through increased inflammation. This Vitamin D deficient state requires acute supplementation in order to quickly restore circulating levels to an optimal level, thereby facilitating a robust wound healing response. Herein, the purpose of this review is to address the roles and critical functions of Vitamin D throughout the wound healing process. Findings from this review suggest that careful monitoring and/or supplementation of Vitamin D may be critical for wound regeneration in composite tissue injuries.
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Choi W, Kim JH, Byun SE, Ryu HS, Rojas D. Effect of preoperative vitamin D deficiency on functional outcomes after high tibial osteotomy: a retrospective case control study. BMC Musculoskelet Disord 2020; 21:251. [PMID: 32303230 PMCID: PMC7165410 DOI: 10.1186/s12891-020-03295-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 04/15/2020] [Indexed: 11/17/2022] Open
Abstract
Background This study aimed to evaluate the effects of vitamin D deficiency on the functional outcomes following a high tibial osteotomy (HTO). Methods Clinical data of 209 patients (327 knees) who underwent HTO done by a single surgeon were retrospectively registered for the study. Ninety-four patients (94 knees) who underwent HTO were analyzed. Patients were assigned into two groups according to their preoperative serum vitamin D levels (D- Deficiency and S- Sufficient); < 20 ng/ml (group D, N = 48) and ≥ 20 ng/ml (group S, N = 46) respectively. A subjective form of International Knee Documentation Committee (IKDC) score, mechanical alignment, and cartilage status before and 1 year following HTO were studied between groups. Results The mean postoperative IKDC score was significantly higher in group S (p = 0.012). Moreover, the difference of IKDC score between pre- and post- HTO was also significantly higher in group S (p = 0.006). Preoperative vitamin D level and IKDC score did not show a significant correlation. Serum vitamin D level was found to be moderately correlated to postoperative IKDC score (r = 0.342 and, p = 0.001). A moderately positive correlation between serum vitamin D level and improvement of IKDC score following osteotomy was appreciated (r = 0.381 and, p < 0.001). Conclusion Patients with vitamin D deficiency had less satisfactory functional outcomes within 1 year from HTO surgery. Our results suggest that preoperative serum vitamin D level is one of the factors affecting the outcome after HTO. We recommended analyzing serum vitamin D levels as part of the routine workup in patients undergoing HTO.
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Affiliation(s)
- Wonchul Choi
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Jae Hwa Kim
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Seong-Eun Byun
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
| | - Han-Seung Ryu
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - David Rojas
- Department of Orthopaedic Surgery, Denver Health Medical Center, Denver, CO, USA
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Assessment of Vitamin D Supplementation on Articular Cartilage Morphology in a Young Healthy Sedentary Rat Model. Nutrients 2019; 11:nu11061260. [PMID: 31163658 PMCID: PMC6628271 DOI: 10.3390/nu11061260] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/29/2019] [Accepted: 05/31/2019] [Indexed: 12/14/2022] Open
Abstract
Deficiency in vitamin D (Vit D) has been widely associated with several musculoskeletal diseases. However, the effects of the exogenous Vit D supplementation are still unclear in the prevention of the latter, especially in the cartilage developmental period. The aim of this study was to compare the effects of Vit D supplementation and restriction on the articular cartilage development in healthy young sedentary rats. To this aim, twelve nine-week-old healthy Sprague-Dawley male rats were subjected to Vit D-based experimental diets: R, with a content in Vit D of 1400 IU/kg; R-DS, with a Vit D supplementation (4000 IU/kg); R-DR, with a Vit D restriction (0 IU/kg) for 10 weeks. The morphology, thickness and expression of cartilage-associated molecules such as collagen type II/X, lubricin and Vit D receptor (VDR), were assessed. Histological, histomorphometric and immunohistochemical evaluations were made on rat tibial cartilage samples. In the present experimental model, restriction of Vit D intake induced: The lower thickness of cartilage compared both to R (p = < 0.0001) and R-DS (p = < 0.0001); reduction of proteoglycans in the extracellular matrix (ECM) compared both to R (p = 0.0359) and R-DS (p = < 0.0001); decreased collagen II (Col II) with respect both to R (p = 0.0076) and R-DS (p = 0.0016); increased collagen X (Col X) immunoexpression when compared both to R (p = < 0.0001) and R-DS (p = < 0.0001), confirming data from the literature. Instead, supplementation of Vit D intake induced: Higher cartilage thickness with respect both to R (p = 0.0071) and R-DR (p = < 0.0001); increase of ECM proteoglycan deposition compared both to R (p = 0.0175) and R-DR (p = < 0.0001); higher immunoexpression of lubricin with respect both to R (p = 0.001) and R-DR (p = 0.0008). These results suggest that Vit D supplementation with diet, already after 10 weeks, has a favorable impact on the articular cartilage thickness development, joint lubrication and ECM fibers deposition in a young healthy rat model.
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Roberts HM, Moore JP, Thom JM. The Reliability of Suprapatellar Transverse Sonographic Assessment of Femoral Trochlear Cartilage Thickness in Healthy Adults. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:935-946. [PMID: 30208236 DOI: 10.1002/jum.14775] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 06/21/2018] [Accepted: 07/04/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To determine the intrasession reliability of femoral cartilage thickness measurements using sonography and extend the pool of normative data for cartilage thickness measurements assessed by sonography. METHODS A total of 77 healthy participants (55 men, 22 women), with an average age of 43 ± 18 (mean ± standard deviation) years, volunteered. Resting suprapatellar sonography was used to image trochlear cartilage thickness on 2 separate occasions a maximum of 7 days apart. Reliability was evaluated with intraclass correlation coefficients, Bland-Altman analysis, standard error of measurement, and the smallest real difference. Normative data was assessed using linear, multiple regression models and independent group t tests. RESULTS The test-retest level of agreement at all locations was high (intraclass correlation coefficient, 0.779-0.843), which increased to high-very high in young adults (intraclass correlation coefficient, 0.884-0.920). The standard error of measurement was 8.2% to 8.3% at all locations and reduced further to 5.4% to 6.3% in younger adults. The smallest real difference was between 22.8% and 23.1% for the full sample and 14.9% and 17.5% in young adults only. Multiple regression analyses demonstrated that age, weight, female sex, and a high physical activity frequency could significantly predict cartilage thickness at all locations (P < .05); however, female sex was the only significant independent predictor in all models (all P < .01). Females also had thinner cartilage at all locations (P < .01). CONCLUSION Suprapatellar sonography demonstrates high intratester reliability and measurement precision and is a promising method to assess trochlear cartilage thickness. Being female may impact femoral cartilage thickness more than other potential risk factors for knee osteoarthritis such as age, weight, and high physical activity frequency.
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Affiliation(s)
- Harry M Roberts
- the School of Sport, Health & Exercise Sciences, Bangor University, Bangor, Gwynedd, Wales
- School of Biosciences and Medicine, University of Surrey, Guildford, Surrey, England
| | - Jonathan P Moore
- the School of Sport, Health & Exercise Sciences, Bangor University, Bangor, Gwynedd, Wales
| | - Jeanette M Thom
- School of Medical Sciences, University of New South Wales, Australia
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Madani A, Shamsian SA, Layegh P, Abrisham SM, Ravaghi A, Tayarani Najjaran N. Are certain factors involved in calcium metabolism associated with temporomandibular disorders? Cranio 2019; 39:202-208. [PMID: 30931843 DOI: 10.1080/08869634.2019.1596054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective: The aim of the present study was to investigate whether there is an association between serum concentrations of calcium, phosphate, alkaline phosphatase, parathyroid hormone (PTH), and vitamin D and temporomandibular disorders (TMDs).Methods: In this case-control study, 51 patients with TMDs (28 patients with TMJ clicking, 5 patients with muscular disorders, and 18 osteoarthritis patients) and 29 healthy subjects within the age range of 20-50 years as the control group, were referred to the laboratory for calcium, phosphate, alkaline phosphatase, PTH, and vitamin D (25 OHD) analysis tests. The TMJ status of all participants was examined according to RDC-TMD criteria by a prosthodontist who is an expert in TMDs. The results were analyzed with Fisher's precise test.Results: No statistically significant difference was observed between TMD patients and healthy subjects.Conclusion: Serum concentrations of calcium, phosphate, alkaline phosphatase, PTH, and vitamin D are not associated with TMDs.
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Affiliation(s)
- Azamsadat Madani
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Aliakbar Shamsian
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parvin Layegh
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyyed Mohammad Abrisham
- Department of Prosthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Niloufar Tayarani Najjaran
- Department of Prosthodontics, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Vaishya R, Vijay V, Lama P, Agarwal A. Does vitamin D deficiency influence the incidence and progression of knee osteoarthritis? - A literature review. J Clin Orthop Trauma 2019; 10:9-15. [PMID: 30705525 PMCID: PMC6349580 DOI: 10.1016/j.jcot.2018.05.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 05/12/2018] [Accepted: 05/19/2018] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Vitamin D has been believed to have a bearing in the pathogenesis of knee osteoarthritis (OA). This study was done to search the literature and review the correlation between vitamin D levels in knee OA in the adult population and the outcome of vitamin D supplementation in knee OA. METHODS An exhaustive search of Pub Med and Cochrane library database was done with keywords vitamin D, knee and osteoarthritis for a period from Jan 2005 to December 2015. All Randomized Control Trials (RCT), Cohort, Case-control, cross-sectional studies were included in the present systematic review. RESULTS The search resulted in a total of 86 studies; out of which 11 studies were included in the current review. There were two Randomized Control Trial (RCT), one case-control, four cross-sectional and four cohort studies. These studies comprised of a total of 5137 participants (ranging from 46 to 1248) Our results suggested there was a moderate evidence of positive association in vitamin D deficiency (VDD) and progression of radiographic OA (ROA), as assessed by Kellgren and Lawrence (KL) grading. However, VDD was not associated with the incidence of ROA and MRI-detected change in focal cartilage defect. However, this study has a limited evidence for a positive correlation in VDD and the cartilage volume loss. There was also limited evidence showing no role of vitamin D therapy in reducing cartilage volume loss and knee pain in Knee OA. CONCLUSION The VDD is common and has been associated with knee OA, in an adult population. However, there is still inconsistent evidence regarding the prevention of incidence and progression of ROA after vitamin D therapy. There is a need for multicentric and well-conducted randomized studies with larger samples to conclude the positive effect of Vitamin D therapy.
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Affiliation(s)
| | - Vipul Vijay
- Corresponding author at: Room no 1210, Department of Orthopaedics, Joint Replacement & Arthroscopy, Indraprastha Apollo Hospital, New Delhi, 110076, India.
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Saadoon A, Ambalavanan N, Zinn K, Ashraf AP, MacEwen M, Nicola T, Fanucchi MV, Harris WT. Effect of Prenatal versus Postnatal Vitamin D Deficiency on Pulmonary Structure and Function in Mice. Am J Respir Cell Mol Biol 2017; 56:383-392. [PMID: 27870560 DOI: 10.1165/rcmb.2014-0482oc] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Epidemiologic studies have linked gestational vitamin D deficiency to respiratory diseases, although mechanisms have not been defined. We hypothesized that antenatal vitamin D deficiency would impair airway development and alveolarization in a mouse model. We studied the effect of antenatal vitamin D deficiency by inducing it in pregnant mice and then compared lung development and function in their offspring to littermate controls. Postnatal vitamin D deficiency and sufficiency models from each group were also studied. We developed a novel tracheal ultrasound imaging technique to measure tracheal diameter in vivo. Histological analysis estimated tracheal cartilage total area and thickness. We found that vitamin D-deficient pups had reduced tracheal diameter with decreased tracheal cartilage minimal width. Vitamin D deficiency increased airway resistance and reduced lung compliance, and led to alveolar simplification. Postnatal vitamin D supplementation improved lung function and radial alveolar count, a parameter of alveolar development, but did not correct tracheal narrowing. We conclude that antenatal vitamin D deficiency impairs airway and alveolar development and limits lung function. Reduced tracheal diameter, cartilage irregularity, and alveolar simplification in vitamin D-deficient mice may contribute to increased airways resistance and diminished lung compliance. Vitamin D supplementation after birth improved lung function and, potentially, alveolar simplification, but did not improve defective tracheal structure. This mouse model offers insight into the mechanisms of vitamin D deficiency-associated lung disease and provides an in vivo model for investigating preclinical preventive and therapeutic strategies.
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Affiliation(s)
| | | | | | | | | | | | - Michelle V Fanucchi
- 3 Environmental Health Sciences, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
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Garfinkel RJ, Dilisio MF, Agrawal DK. Vitamin D and Its Effects on Articular Cartilage and Osteoarthritis. Orthop J Sports Med 2017; 5:2325967117711376. [PMID: 28680892 PMCID: PMC5480771 DOI: 10.1177/2325967117711376] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background: Osteoarthritis (OA) currently affects 10% of the American population. There has been a recent push to determine exactly what causes OA and how it can be treated most effectively. Serum vitamin D levels have been associated with OA and may have an effect on articular cartilage remodeling. Purpose: To critically review the published research on the effect of vitamin D on articular cartilage and the development of OA as well as on the mechanism behind cartilage regeneration and degeneration. Study Design: Review. Methods: A systematic search of PubMed and the Web of Science was performed for relevant studies published in the English language through April 30, 2016, using the terms vitamin D, articular cartilage, and osteoarthritis. Results: On a molecular level, 1α,25(OH)2D3, the activated form of vitamin D, plays a role in articular cartilage degeneration. Vitamin D binds to vitamin D receptors, triggering a signaling cascade that leads to chondrocyte hypertrophy. In clinical trials, vitamin D deficiency poses a risk factor for OA, and those with decreased cartilage thickness are more likely to be vitamin D–insufficient. Conclusion: The role of vitamin D supplementation in the treatment or prevention of OA remains uncertain. More research is needed to reconcile these conflicting findings.
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Affiliation(s)
- Rachel J Garfinkel
- Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, Nebraska, USA
| | | | - Devendra K Agrawal
- Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, Nebraska, USA
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17
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Vaishya R, Vijay V, Hussaini SM, Agarwal AK. Association of vitamin D and knee osteoarthritis – A review. APOLLO MEDICINE 2017. [DOI: 10.1016/j.apme.2017.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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18
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Devrimsel G, Beyazal MS, Turkyilmaz AK, Sahin SB. Ultrasonographic evaluation of the femoral cartilage thickness in patients with hypothyroidism. J Phys Ther Sci 2016; 28:2249-52. [PMID: 27630407 PMCID: PMC5011571 DOI: 10.1589/jpts.28.2249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 05/07/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to investigate the effects of hypothyroidism on
femoral cartilage thickness by using ultrasound, which has been found to be useful in the
early diagnosis of knee osteoarthritis. [Subjects and Methods] Forty patients diagnosed
with hypothyroidism and 30 age-, gender-, smoking status, physical activity-, and body
mass index-matched healthy subjects were enrolled. The thickness of the femoral articular
cartilage was measured using a 7- to 12-MHz linear probe. Three mid-point measurements
were taken from each knee at the lateral condyle, intercondylar area, and medial condyle.
[Results] Age, gender, body mass index, smoking status, and physical activity were similar
between the groups, but patients with hypothyroidism had thinner femoral cartilage than
the healthy controls at all measurement sites. Nonetheless, the differences were not
statistically significant (except in the case of the left medial condyle). [Conclusion]
Ultrasonographic measurement of femoral cartilage thickness may be useful in the early
diagnosis of knee osteoarthritis in patients with hypothyroidism.
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Affiliation(s)
- Gul Devrimsel
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Recep Tayyip Erdogan University, Turkey
| | - Munevver Serdaroglu Beyazal
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Recep Tayyip Erdogan University, Turkey
| | - Aysegul Kucukali Turkyilmaz
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Recep Tayyip Erdogan University, Turkey
| | - Serap Baydur Sahin
- Department of Endocrinology and Metabolism Disease, Recep Tayyip Erdogan University Medical School, Turkey
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Şahin Onat Ş, Malas FÜ, Öztürk GT, Akkaya N, Kara M, Özçakar L. Ultrasonographic assessment of the quadriceps muscle and femoral cartilage in transtibial amputees using different prostheses. Prosthet Orthot Int 2016; 40:484-9. [PMID: 26163535 DOI: 10.1177/0309364615592701] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 05/10/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND In patients with lower limb amputations, gait alteration, increased loading on the intact extremity, and use of prosthesis may lead to joint degeneration. OBJECTIVE To explore the effects of prosthesis type on quadriceps muscle and distal femoral cartilage thicknesses in transtibial amputees. STUDY DESIGN A cross-sectional study. METHODS A total of 38 below-knee amputees were enrolled in the study, of which 13 patients were using vacuum system type prosthesis and 25 patients were using silicon liner pin system prosthesis. Patients' femoral cartilage and quadriceps muscle thickness measurements were performed using musculoskeletal ultrasound. RESULTS When compared with the intact sides, cartilage and rectus femoris, vastus intermedius, and vastus medialis muscle thickness values were significantly decreased on the amputee sides (all p < 0.05). Clinical characteristics and ultrasound measurements were similar between the two groups except the lateral and medial femoral condyle thicknesses, thinner in the silicon liner pin system users (both p < 0.05). CONCLUSION The distal femoral cartilage and quadriceps muscle thicknesses were found to be decreased on the amputated sides, and the negative impact on the cartilage seemed to be worse in the silicon liner pin system users. CLINICAL RELEVANCE This study might provide another argument as regards the preference of vacuum system type prosthesis to prevent possible knee osteoarthritis due to cartilage thinning in adult transtibial amputees.
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Affiliation(s)
- Şule Şahin Onat
- Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Fevziye Ünsal Malas
- Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Gökhan Tuna Öztürk
- Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Nuray Akkaya
- Department of Physical Medicine and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Murat Kara
- Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, Turkey
| | - Levent Özçakar
- Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, Turkey
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Low Levels of Vitamin D have a Deleterious Effect on the Articular Cartilage in a Rat Model. HSS J 2016; 12:150-7. [PMID: 27385944 PMCID: PMC4916094 DOI: 10.1007/s11420-016-9492-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 01/14/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Vitamin D appears to play an important role in bone and cartilage metabolism since its receptors are widely found in human articular chondrocytes. Thus, effects of variation of vitamin D may directly impact cartilage and bone biology. QUESTIONS/PURPOSES The aims of this study are to compare (1) articular cartilage structure and composition and (2) trabecular and cortical bone microstructure in rats with normal versus insufficient vitamin D levels. METHODS Twenty-five mature, male Sprague-Dawley rats were allocated to two groups: (1) control arm (vitamin D replete-12 rats) and (2) an experimental arm (vitamin D deficient-13 rats). Vitamin D deficiency was induced using a vitamin D-deficient diet and UV light restriction. Rats were sacrificed after 4 weeks vitamin D deficiency was confirmed. The right knee was harvested for analysis of both the medial (MFC) and lateral femoral condyles (LFC). A region of interest was established on both condyles to correlate subchondral bone architecture and the overlying cartilage. Histological analysis was performed and graded using the modified Mankin score. Subchondral and cortical bony architecture was evaluated with micro-CT. RESULTS After 4 weeks, the vitamin D-deficient group had statistically significant changes in cartilage structure in both the MFC and LFC [1.55 ± 0.6 vs. 4.23 ± 4.1 (p = 0.035) and 1.55 ± 0.6 vs. 3.53 ± 2.4 (p = 0.009), respectively]. Micro-CT analysis revealed no correlation between subchondral bone values and the overlying cartilage Mankin score (p = 0.460). No significant difference was evident between the subchondral bone of the control and study group. CONCLUSIONS Low levels of vitamin D have a deleterious effect on the cartilage. Given the high prevalence of vitamin D deficiency in the general population, these findings raise important questions about the potential role of vitamin D in articular cartilage health.
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Jacob EA, Blum L, Bedair HS, Freiberg AA, Quraishi SA. The Association of Vitamin D Status and Pre-operative Physical Activity in Patients with Hip or Knee Osteoarthritis. JOURNAL OF RESTORATIVE MEDICINE 2015; 4:3-10. [PMID: 30505632 PMCID: PMC6261296 DOI: 10.14200/jrm.2015.4.0101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Vitamin D is important for musculoskeletal health and may have significant implications for maintaining physical activity in elderly patients. Our goal was to investigate whether serum 25-hydroxyvitamin D (25OHD) levels are associated with pre-operative physical activity in patients who are offered elective knee or hip joint replacement surgery. METHODS We performed a single-center, retrospective analysis of patients who had elective knee or hip replacement surgery from 2002 to 2012. To investigate the association of serum 25OHD levels with pre-operative physical activity, as assessed by the University of California, Los Angeles (UCLA) activity scale, we performed a multivariable logistic regression analysis while controlling for age, sex, race, body mass index, American Society of Anesthesiologists physical status score, and season. RESULTS We identified 182 patients who met inclusion criteria. Mean (± standard deviation) 25OHD level and UCLA activity scale score were 29±13 ng/mL and 4±2, respectively. Patients with 25OHD levels <20 ng/mL were almost three times more likely to have UCLA activity scale scores ≤3 [adjusted odds ratio 2.78; 95% confidence interval 1.72-9.17]. Further adjusting for "type of 25OHD assay" or "type of joint surgery" did not materially change this result. CONCLUSION In our cohort of knee or hip joint replacement surgery patients, 25OHD levels were associated with pre-operative physical activity scores. Prospective, randomized, clinical trials are needed to verify whether optimizing pre-operative vitamin D status may improve physical activity and influence clinical decision-making in knee or hip joint replacement surgery candidates.
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Affiliation(s)
| | - Livnat Blum
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Hany S. Bedair
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Andrew A. Freiberg
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sadeq A. Quraishi
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Yıldızgören MT, Karataş Toğral A, Baki AE, Ekiz T. Effects of isotretinoin treatment on cartilage and tendon thicknesses: an ultrasonographic study. Clin Rheumatol 2014; 34:1255-8. [PMID: 24985041 DOI: 10.1007/s10067-014-2733-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Revised: 06/15/2014] [Accepted: 06/18/2014] [Indexed: 10/25/2022]
Abstract
Effects of retinoic acid on collagen synthesis and cartilage have previously been shown. However, its effects on cartilage and tendons in humans have not been studied yet. Therefore, in order to provide a morphologic insight, the aim of this study was to measure femoral cartilage, Achilles and supraspinatus tendon thicknesses in patients under systemic isotretinoin treatment by using ultrasound. Fifteen patients (nine F, six M) who used isotretinoin for their acnes were included. All patients were treated with isotretinoin 0.5 mg/kg/day for the first month, and the dosage was escalated up to 1 mg/kg/day thereafter. Distal femoral cartilage, supraspinatus, and Achilles tendons thicknesses have been evaluated both before the treatment and at the end of the third month. Femoral cartilage thicknesses were assessed from three midpoints bilaterally; medial condyle, lateral condyle, and intercondylar area. Short/long-axis diameters and cross-sectional area of the Achilles tendons and axial tendon thicknesses of supraspinatus tendon were evaluated from the nondominant side. The mean age of the patients was 20.1 ± 4.9 years, and body mass index was 21.7 ± 2.5 kg/m(2). Although posttreatment cartilage measurements of 30 knees were lower for the three midpoints, it reached significance only for lateral condyle (p = 0.05). In addition, posttreatment tendon measurements were not statistically significant compared with pretreatment values (all p > 0.05). Systemic isotretinoin treatment seems to make cartilage thinner. Further studies considering histological and molecular evaluations with more sample sizes are awaited.
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Affiliation(s)
- Mustafa Turgut Yıldızgören
- Department of Physical Medicine and Rehabilitation, Ankara Occupational Diseases Hospital, Ankara, Turkey,
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