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Balogun S, Scott D, Aitken D. Association between sarcopenic obesity and knee osteoarthritis: A narrative review. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100489. [PMID: 38832052 PMCID: PMC11145545 DOI: 10.1016/j.ocarto.2024.100489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 05/09/2024] [Indexed: 06/05/2024] Open
Abstract
Sarcopenia and obesity have been studied independently as risk factors for knee osteoarthritis. However, there is now research interest in investigating whether the co-existence of sarcopenia and obesity (sarcopenic obesity) within the same individual significantly increases the risk of knee osteoarthritis, compared to sarcopenia or obesity alone. This review synthesises current literature to explore the association between sarcopenic obesity and knee osteoarthritis, emphasising both the clinical evidence and existing gaps. We highlight the challenges and progress in defining sarcopenic obesity and discuss the impact that the lack of a consensus definition of sarcopenic obesity has on comparing outcomes of studies investigating the relationship between sarcopenic obesity and knee OA. We offer methodological insights to guide future studies investigating whether sarcopenic obesity increases the risk of knee osteoarthritis above and beyond the risk associated with each condition on its own. The implications for clinical practice are discussed, including the need to incorporate effective resistance exercise into weight loss programs for individuals with sarcopenic obesity. This is critical as a general weight loss program alone among individuals with sarcopenic obesity can include substantial loss of muscle mass, potentially predisposing patients to further functional decline.
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Affiliation(s)
- Saliu Balogun
- Menzies Institute for Medical Research, University of Tasmania, Australia
| | - David Scott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Victoria, Australia
- School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia
| | - Dawn Aitken
- Menzies Institute for Medical Research, University of Tasmania, Australia
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Ferreira RM, Martins PN, Gonçalves RS. Non-pharmacological and non-surgical interventions to manage patients with knee osteoarthritis: An umbrella review 5-year update. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100497. [PMID: 39040626 PMCID: PMC11261791 DOI: 10.1016/j.ocarto.2024.100497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/17/2024] [Indexed: 07/24/2024] Open
Abstract
Objective This umbrella review aimed to summarize (and update) the effectiveness of non-pharmacological and non-surgical interventions for patients with knee osteoarthritis. Methods The study followed the PRISMA guidelines. Manual and electronic databases were searched, to identify systematic reviews, following the P (knee osteoarthritis) I (non-pharmacological and non-surgical treatments) C (pharmacological, surgical, placebo, no intervention, or other non-pharmacological/non-surgical conservative treatments) O (pain, function, quality of life, and other knee-specific measures) model. The quality of evidence was assessed using the R-AMSTAR checklist and GRADE principles. Results The search yielded 4086 records, of which 61 met the eligibility criteria. After evaluation with R-AMSTAR, four systematic reviews were excluded, resulting in 57 included systematic reviews, with an overall score of 29.6. The systematic reviews were published between 2018 and 2022 (29.8% in 2022), conducted in 19 countries (52.6% in China), and explored 24 distinct interventions. The systematic reviews encompassed 714 trials (mean of 13 ± 7.7 studies per systematic review), and 59,343 participants (mean 1041 ± 1002 per systematic review, and 82 ± 59.2 per study). The majority of participants were older obese women (61.6 ± 4.2 years, 30.2 ± 3.6 kg/m2, 70%, respectively). Conclusions Based on the systematic reviews findings, Diet Therapy, Patient Education, and Resistance Training are strongly supported as core interventions for managing patients with knee osteoarthritis. Aquatic Therapy, Balance Training, Balneology, Dietary Supplements, Extracorporeal Shockwave Therapy, and Tai Ji show moderate support. For other interventions, the evidence quality was low, results were mixed or inconclusive, or there was not sufficient efficacy to support their use.
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Affiliation(s)
- Ricardo Maia Ferreira
- Polytechnic Institute of Maia, N2i, Social Sciences, Education and Sport School, Avenida Carlos de Oliveira Campos, 4475-690 Maia, Portugal
- Polytechnic Institute of Coimbra, Coimbra Health School, Scientific-Pedagogical Unit of Physioterapy, Rua 5 de Outubro, São Martinho do Bispo, 3045-043 Coimbra, Portugal
- Sport Physical Activity and Health Research & Innovation Center (SPRINT), 4960-320 Melgaço, Portugal
| | - Pedro Nunes Martins
- Polytechnic Institute of Maia, N2i, Social Sciences, Education and Sport School, Avenida Carlos de Oliveira Campos, 4475-690 Maia, Portugal
| | - Rui Soles Gonçalves
- Polytechnic Institute of Coimbra, Coimbra Health School, Scientific-Pedagogical Unit of Physioterapy, Rua 5 de Outubro, São Martinho do Bispo, 3045-043 Coimbra, Portugal
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Baser O, Rodchenko K, Vivier E, Baser I, Lu Y, Mohamed M. The Impact of Approved Anti-obesity Medications on Osteoarthritis. Expert Opin Pharmacother 2024. [PMID: 39129529 DOI: 10.1080/14656566.2024.2391524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/07/2024] [Accepted: 08/08/2024] [Indexed: 08/13/2024]
Abstract
BACKGROUND Obesity has been established as a significant risk factor for osteoarthritis. Anti-obesity medications (AOMs) have demonstrated efficacy in weight management. However, potential impact on osteoarthritis risk remains uncertain. METHODS This retrospective cohort study used Kythera data from NOV2022 to JULY2024. Patients with obesity using AOMs were identified through diagnosis and prescription claims for tirzepatide, semaglutide, or liraglutide between 1NOV2023 and 31JAN2024, with a 6-month follow-up to assess OA risk. OA risk, analyzed using Cox regression and propensity score matching, controlled for comorbidities and sociodemographic factors. RESULTS There were 39,394 patients living with obesity using AOM (23,933 semaglutide 12,854 tirzepatide, 2,607 liraglutide) and 72,405 without AOM use. The adjusted osteoarthritis risk was 27% % lower in AOM users than in non-users (hazard ratio (HR) = 073, 95% CI (0.67-0.79), p < 0.01). Among AOMs, tirzepatide was associated with a significantly lower osteoarthritis (OA) risk compared to semaglutide (HR = 0.57, 95% CI: 0.50-0.65, p < 0.0001). Liraglutide was linked to a significantly higher OA risk vs tirzepatide (HR = 1.63, 95% CI: 1.23-2.15, p = 0.0007). CONCLUSIONS AOM use was associated with a significantly lower risk of OA and may be an effective obesity management intervention.
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Affiliation(s)
- Onur Baser
- Graduate School of Public Health, City University of New York, New York, NY, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
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Walsh MA, Latham AS, Zhang Q, Jacobs RA, Musci RV, LaRocca TJ, Moreno JA, Santangelo KS, Hamilton KL. Non-transgenic guinea pig strains exhibit divergent age-related changes in hippocampal mitochondrial respiration. Acta Physiol (Oxf) 2024; 240:e14185. [PMID: 38860650 PMCID: PMC11250940 DOI: 10.1111/apha.14185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 05/15/2024] [Accepted: 05/18/2024] [Indexed: 06/12/2024]
Abstract
AIM Alzheimer's disease (AD) is the most common form of dementia. However, while 150+ animal models of AD exist, drug translation from preclinical models to humans for treatment usually fails. One factor contributing to low translation is likely the absence of neurodegenerative models that also encompass the multi-morbidities of human aging. We previously demonstrated that, in comparison to the PigmEnTed (PET) guinea pig strain which models "typical" brain aging, the Hartley strain develops hallmarks of AD like aging humans. Hartleys also exhibit age-related impairments in cartilage and skeletal muscle. Impaired mitochondrial respiration is one driver of both cellular aging and AD. In humans with cognitive decline, diminished skeletal muscle and brain respiratory control occurs in parallel. We previously reported age-related declines in skeletal muscle mitochondrial respiration in Hartleys. It is unknown if there is concomitant mitochondrial dysfunction in the brain. METHODS Therefore, we assessed hippocampal mitochondrial respiration in 5- and 12-month Hartley and PET guinea pigs using high-resolution respirometry. RESULTS At 12 months, PETs had higher complex I supported mitochondrial respiration paralleling their increase in body mass compared to 5 months PETs. Hartleys were also heavier at 12 months compared to 5 months but did not have higher complex I respiration. Compared to 5 months Hartleys, 12 months Hartleys had lower complex I mitochondrial efficiency and compensatory increases in mitochondrial proteins collectively suggesting mitochondrial dysfunction with age. CONCLUSIONS Therefore, Hartleys might be a relevant model to test promising therapies targeting mitochondria to slow brain aging and AD progression.
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Affiliation(s)
- Maureen A Walsh
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado, USA
| | - Amanda S Latham
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Qian Zhang
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado, USA
| | - Robert A Jacobs
- Department of Human Physiology and Nutrition, University of Colorado Colorado Springs (UCCS), Colorado Springs, Colorado, USA
- William J. Hybl Sports Medicine and Performance Center, Colorado Springs, Colorado, USA
| | - Robert V Musci
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado, USA
| | - Thomas J LaRocca
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado, USA
- Columbine Health Systems Center for Healthy Aging, Colorado State University, Fort Collins, Colorado, USA
| | - Julie A Moreno
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
- Columbine Health Systems Center for Healthy Aging, Colorado State University, Fort Collins, Colorado, USA
| | - Kelly S Santangelo
- Columbine Health Systems Center for Healthy Aging, Colorado State University, Fort Collins, Colorado, USA
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, USA
| | - Karyn L Hamilton
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado, USA
- Columbine Health Systems Center for Healthy Aging, Colorado State University, Fort Collins, Colorado, USA
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Cha M, Bak H, Bai SJ, Lee BH, Jang JH. Quadriceps recovery and pain relief in knee osteoarthritis rats by cog polydioxanone filament insertion. Regen Biomater 2024; 11:rbae077. [PMID: 38974667 PMCID: PMC11226885 DOI: 10.1093/rb/rbae077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 06/03/2024] [Accepted: 06/15/2024] [Indexed: 07/09/2024] Open
Abstract
Quadriceps muscles play a pivotal role in knee osteoarthritis (OA) progression and symptom manifestation, particularly pain. This research investigates the therapeutic effectiveness of muscle enhancement and support therapy (MEST), a recently developed device intended for intramuscular insertion of cog polydioxanone filaments, in quadriceps restoration to alleviate OA pain. Knee OA was induced in Sprague Dawley rats via monoiodoacetate injections. MEST or sham treatment was performed in OA or Naive rat quadriceps. Pain was assessed using paw withdrawal threshold and weight bearing. Quadriceps injury and recovery via MEST were evaluated using biomarkers, tissue morphology, muscle mass, contractile force and hindlimb torque. Satellite cell and macrophage activation, along with their activators, were also assessed. Data were compared at 1- and 3-weeks post-MEST treatment (M-W1 and M-W3). MEST treatment in OA rats caused muscle injury, indicated by elevated serum aspartate transferase and creatinine kinase levels, and local β-actin changes at M-W1. This injury triggered pro-inflammatory macrophage and satellite cell activation, accompanied by heightened interleukin-6 and insulin-like growth factor-1 levels. However, by M-W3, these processes gradually shifted toward inflammation resolution and muscle restoration. This was seen in anti-inflammatory macrophage phenotypes, sustained satellite cell activation and injury markers regressing to baseline. Quadriceps recovery in mass and strength from atrophy correlated with substantial OA pain reduction at M-W3. This study suggests that MEST-induced minor muscle injury triggers macrophage and satellite cell activation, leading to recovery of atrophied quadriceps and pain relief in OA rats.
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Affiliation(s)
- Myeounghoon Cha
- Department of Physiology, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Heyji Bak
- Department of Physiology, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Sun Joon Bai
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Bae Hwan Lee
- Department of Physiology, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Brain Research Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Jun Ho Jang
- R&D Center, OV MEDI Co., Ltd, Gunpo 15847, Republic of Korea
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Liu X, Chen R, Song Z, Sun Z. Exercise following joint distraction inhibits muscle wasting and delays the progression of post-traumatic osteoarthritis in rabbits by activating PGC-1α in skeletal muscle. J Orthop Surg Res 2024; 19:325. [PMID: 38822418 PMCID: PMC11141044 DOI: 10.1186/s13018-024-04803-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 05/21/2024] [Indexed: 06/03/2024] Open
Abstract
OBJECTIVE Muscle wasting frequently occurs following joint trauma. Previous research has demonstrated that joint distraction in combination with treadmill exercise (TRE) can mitigate intra-articular inflammation and cartilage damage, consequently delaying the advancement of post-traumatic osteoarthritis (PTOA). However, the precise mechanism underlying this phenomenon remains unclear. Hence, the purpose of this study was to examine whether the mechanism by which TRE following joint distraction delays the progression of PTOA involves the activation of peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), as well as its impact on muscle wasting. METHODS Quadriceps samples were collected from patients with osteoarthritis (OA) and normal patients with distal femoral fractures, and the expression of PGC-1α was measured. The hinged external fixator was implanted in the rabbit PTOA model. One week after surgery, a PGC-1α agonist or inhibitor was administered for 4 weeks prior to TRE. Western blot analysis was performed to detect the expression of PGC-1α and Muscle atrophy gene 1 (Atrogin-1). We employed the enzyme-linked immunosorbent assay (ELISA) technique to examine pro-inflammatory factors. Additionally, we utilized quantitative real-time polymerase chain reaction (qRT-PCR) to analyze genes associated with cartilage regeneration. Synovial inflammation and cartilage damage were evaluated through hematoxylin-eosin staining. Furthermore, we employed Masson's trichrome staining and Alcian blue staining to analyze cartilage damage. RESULTS The decreased expression of PGC-1α in skeletal muscle in patients with OA is correlated with the severity of OA. In the rabbit PTOA model, TRE following joint distraction inhibited the expressions of muscle wasting genes, including Atrogin-1 and muscle ring finger 1 (MuRF1), as well as inflammatory factors such as interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in skeletal muscle, potentially through the activation of PGC-1α. Concurrently, the production of IL-1β, IL-6, TNF-α, nitric oxide (NO), and malondialdehyde (MDA) in the synovial fluid was down-regulated, while the expression of type II collagen (Col2a1), Aggrecan (AGN), SRY-box 9 (SOX9) in the cartilage, and superoxide dismutase (SOD) in the synovial fluid was up-regulated. Additionally, histological staining results demonstrated that TRE after joint distraction reduced cartilage degeneration, leading to a significant decrease in OARSI scores.TRE following joint distraction could activate PGC-1α, inhibit Atrogin-1 expression in skeletal muscle, and reduce C-telopeptides of type II collagen (CTX-II) in the blood compared to joint distraction alone. CONCLUSION Following joint distraction, TRE might promote the activation of PGC-1α in skeletal muscle during PTOA progression to exert anti-inflammatory effects in skeletal muscle and joint cavity, thereby inhibiting muscle wasting and promoting cartilage regeneration, making it a potential therapeutic intervention for treating PTOA.
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Affiliation(s)
- Xinghui Liu
- School of Basic Medical Sciences, Hubei University of Arts and Science, Xiangyang, Hubei, 441000, China
| | - Rong Chen
- Department of Traumatic Orthopedics, Xiangyang Hospital of Traditional Chinese Medicine (Xiangyang Institute of Traditional Chinese Medicine), No. 24 Changzheng Road, Xiangyang, Hubei, 441001, China
| | - Zhenfei Song
- Department of Traumatic Orthopedics, Xiangyang Hospital of Traditional Chinese Medicine (Xiangyang Institute of Traditional Chinese Medicine), No. 24 Changzheng Road, Xiangyang, Hubei, 441001, China
| | - Zhibo Sun
- Department of Traumatic Orthopedics, Xiangyang Hospital of Traditional Chinese Medicine (Xiangyang Institute of Traditional Chinese Medicine), No. 24 Changzheng Road, Xiangyang, Hubei, 441001, China.
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Farinelli L, Riccio M, Gigante A, De Francesco F. Pain Management Strategies in Osteoarthritis. Biomedicines 2024; 12:805. [PMID: 38672160 PMCID: PMC11048725 DOI: 10.3390/biomedicines12040805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/27/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
Pain is the major symptom of osteoarthritis (OA) and is an important factor in strategies to manage this disease. However, the current standard of care does not provide satisfactory pain relief for many patients. The pathophysiology of OA is complex, and its presentation as a clinical syndrome is associated with the pathologies of multiple joint tissues. Treatment options are generally classified as pharmacologic, nonpharmacologic, surgical, and complementary and/or alternative, typically used in combination to achieve optimal results. The goals of treatment are the alleviation of symptoms and improvement in functional status. Several studies are exploring various directions for OA pain management, including tissue regeneration techniques, personalized medicine, and targeted drug therapies. The aim of the present narrative review is to extensively describe all the treatments available in the current practice, further describing the most important innovative therapies. Advancements in understanding the molecular and genetic aspects of osteoarthritis may lead to more effective and tailored treatment approaches in the future.
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Affiliation(s)
- Luca Farinelli
- Clinical Orthopaedics, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, 60121 Ancona, Italy; (L.F.); (A.G.)
| | - Michele Riccio
- Department of Reconstructive Surgery and Hand Surgery, Azienda Ospedaliera Universitaria delle Marche, 60126 Ancona, Italy;
| | - Antonio Gigante
- Clinical Orthopaedics, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, 60121 Ancona, Italy; (L.F.); (A.G.)
| | - Francesco De Francesco
- Department of Reconstructive Surgery and Hand Surgery, Azienda Ospedaliera Universitaria delle Marche, 60126 Ancona, Italy;
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Liao CD, Huang SW, Chen HC, Huang MH, Liou TH, Lin CL. Comparative Efficacy of Different Protein Supplements on Muscle Mass, Strength, and Physical Indices of Sarcopenia among Community-Dwelling, Hospitalized or Institutionalized Older Adults Undergoing Resistance Training: A Network Meta-Analysis of Randomized Controlled Trials. Nutrients 2024; 16:941. [PMID: 38612975 PMCID: PMC11013298 DOI: 10.3390/nu16070941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/20/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
Aging-related sarcopenia exerts harmful impacts on muscle mass, strength, and physical mobility. Protein supplementation has been demonstrated to augment efficacy of resistance training (RT) in elderly. This study compared the relative effects of different protein supplements on muscle mass, strength, and mobility outcomes in middle-aged and older individuals undergoing RT. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) examining the efficacy of protein supplement plus RT in untrained community-dwelling adults, hospitalized, or institutionalized residents who suffered acute or chronic health conditions. Network meta-analysis (NMA) was performed using a frequentist method for all analyses. Treatment effects for main outcomes were expressed as standard mean difference (SMD) with 95% confidence interval (CI). We used the surface-under-the cumulative-ranking (SUCRA) scores to rank probabilities of effect estimation among all identified treatments. Meta-regression analyses were performed to identify any relevant moderator of the treatment efficacy and results were expressed as β with 95% credible interval (CrI). We finally included 78 RCTs (5272 participants) for analyses. Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut, whey supplement yielded the most effective treatments augmenting efficacy of RT on muscle mass (SMD = 1.29, 95% CI: 0.96, 1.62; SUCRA = 0.86), handgrip strength (SMD = 1.46, 95% CI: 0.92, 2.00; SUCRA = 0.85), and walking speed (SMD = 0.73, 95% CI: 0.39, 1.07; SUCRA = 0.84). Participant's health condition, sex, and supplementation dose were significant factors moderating the treatment efficacy on muscle mass (β = 0.74; 95% CrI: 0.22, 1.25), handgrip strength (β = -1.72; 95% CrI: -2.68, -0.77), and leg strength (β = 0.76; 95% CrI: 0.06, 1.47), respectively. Our findings suggest whey protein yields the optimal supplements to counter sarcopenia in older individuals undergoing RT.
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Affiliation(s)
- Chun-De Liao
- International Ph.D. Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, New Taipei City 110301, Taiwan;
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan; (S.-W.H.); (H.-C.C.); (T.-H.L.)
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan; (S.-W.H.); (H.-C.C.); (T.-H.L.)
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City 110301, Taiwan
| | - Hung-Chou Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan; (S.-W.H.); (H.-C.C.); (T.-H.L.)
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City 110301, Taiwan
| | - Mao-Hua Huang
- Department of Biochemistry, University of Washington, Seattle, WA 98015, USA;
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan; (S.-W.H.); (H.-C.C.); (T.-H.L.)
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City 110301, Taiwan
| | - Che-Li Lin
- Department of Orthopedic Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City 11031, Taiwan
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Alkhamis BA, Reddy RS, Alahmari KA, Alshahrani MS, Koura GM, Ali OI, Mukherjee D, Elrefaey BH. Balancing act: Unraveling the link between muscle strength, proprioception, and stability in unilateral hip osteoarthritis. PLoS One 2024; 19:e0298625. [PMID: 38363786 PMCID: PMC10871501 DOI: 10.1371/journal.pone.0298625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/27/2024] [Indexed: 02/18/2024] Open
Abstract
The objectives of this study are to compare hip muscle strength, hip joint proprioception, and functional balance between individuals with unilateral hip OA and asymptomatic individuals and to examine the relationships among these variables in the hip OA population. In a prospective cross-sectional study, 122 participants (unilateral Hip OA: n = 56, asymptomatic: n = 56) were assessed at the CAMS/KKU musculoskeletal Physical Therapy laboratory. Ethical standards were upheld throughout the research, with informed consent obtained. Hip muscle strength was measured using a hand-held dynamometer, hip joint proprioception with a digital inclinometer, and functional balance using the Berg Balance Scale (BBS) and Timed Up and Go (TUG) test. Hip OA individuals exhibited significantly lower muscle strength and proprioceptive accuracy, and poorer functional balance than controls (p < 0.003). Correlation analyses revealed a positive correlation between muscle strength and BBS scores (r = 0.38 to 0.42) and a negative correlation with TUG test times (r = -0.36 to -0.41). Hip joint reposition sense (JRS) in flexion showed a negative correlation with balance (r = -0.46), while JRS in abduction was positively correlated (r = 0.46). The study highlights the clinical importance of muscle strength and proprioception in functional balance among individuals with unilateral hip OA. The results support the incorporation of muscle strengthening and proprioceptive training in interventions to improve balance and mobility in this population.
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Affiliation(s)
- Batool Abdulelah Alkhamis
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Khalid A. Alahmari
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Mastour Saeed Alshahrani
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Ghada Mohammed Koura
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Olfat Ibrahim Ali
- Physical Therapy Program, Batterjee Medical College, Jeddah, Saudi Arabia
| | - Debjani Mukherjee
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Basant Hamdy Elrefaey
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
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Lippi L, Ferrillo M, Turco A, Folli A, Moalli S, Refati F, Perrero L, Ammendolia A, de Sire A, Invernizzi M. Multidisciplinary Rehabilitation after Hyaluronic Acid Injections for Elderly with Knee, Hip, Shoulder, and Temporomandibular Joint Osteoarthritis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2047. [PMID: 38004096 PMCID: PMC10672933 DOI: 10.3390/medicina59112047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/12/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023]
Abstract
Osteoarthritis (OA) is a prevalent degenerative joint condition characterized by cartilage deterioration, joint inflammation, and functional limitations, particularly impacting the elderly population. Rehabilitation and hyaluronic acid (HA) injections are common therapeutic approaches routinely used in clinical practice, but their synergistic potential is far from being fully characterized. Thus, the aim of this narrative review was to elucidate the multilevel benefits and synergies of integrating these two approaches in multidisciplinary OA rehabilitation. This narrative review follows the scale for the assessment of narrative review articles (SANRA) criteria and involves a comprehensive literature search from July to August 2023. Two independent reviewers screened studies, including those involving human subjects with OA, rehabilitation strategies, and outcomes following HA injection, published in English. Results: HA injections might improve joint biomechanics, reducing friction, absorbing shocks, and potentially regulating inflammation. Rehabilitation plays a pivotal role in strengthening muscles, increasing the range of motion, and enhancing overall function. Optimizing rehabilitation following HA injection might provide additional benefits in joint health. OA management requires a multidisciplinary approach integrating HA injections, rehabilitation, and personalized care. Challenges in patient adherence and healthcare resources currently exist, but emerging technologies offer opportunities to enhance patient engagement and monitoring optimizing sustainability and outcomes of patients with knee, hip, shoulder, and temporomandibular joint OA.
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Affiliation(s)
- Lorenzo Lippi
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (A.F.); (S.M.); (F.R.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Martina Ferrillo
- Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Alessio Turco
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (A.F.); (S.M.); (F.R.); (M.I.)
| | - Arianna Folli
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (A.F.); (S.M.); (F.R.); (M.I.)
| | - Stefano Moalli
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (A.F.); (S.M.); (F.R.); (M.I.)
| | - Fjorelo Refati
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (A.F.); (S.M.); (F.R.); (M.I.)
| | - Luca Perrero
- Neurorehabilitation Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Antonio Ammendolia
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (A.A.); (A.d.S.)
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (A.A.); (A.d.S.)
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (A.F.); (S.M.); (F.R.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
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11
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Bunæs-Næss H, Kvæl LAH, Nilsson BB, Heywood S, Heiberg KE. Aquatic high-intensity interval training (HIIT) may be similarly effective to land-based HIIT in improving exercise capacity in people with chronic conditions: a systematic review and meta-analysis. BMJ Open Sport Exerc Med 2023; 9:e001639. [PMID: 38022764 PMCID: PMC10649609 DOI: 10.1136/bmjsem-2023-001639] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2023] [Indexed: 11/19/2023] Open
Abstract
Objective To investigate the effect of aquatic high-intensity interval training (AHIIT) on exercise capacity in people with chronic conditions. Design Systematic review and meta-analysis. Participants Adults (age ≥18 years) with any chronic conditions (long duration, continuing health problems). Data sources The databases Medline, EMBASE, CINAHL, SPORTSDiscus, PEDro and The Cochrane Library were searched from inception to 11 August 2023. Eligibility criteria Randomised or non-randomised controlled trials of adults reporting one or more chronic conditions were included, comparing the effect of AHIIT with a non-exercising control group, land-based high-intensity interval training (LBHIIT) or aquatic moderate-intensity continuous training (AMICT). Results Eighteen trials with 868 participants with chronic musculoskeletal, respiratory, cardiovascular, metabolic or neurological conditions were included. Adherence to AHIIT was high, ranging from 84% to 100%. There was moderate certainty in evidence according to the Grading of Recommendations Assessment, Development and Evaluation system for a moderate beneficial effect on exercise capacity standardised mean differences (SMD) 0.78 (95% CI 0.48 to 1.08), p<0.00001) of AHIIT compared with a non-exercising control group. There was moderate certainty in evidence for no difference of effects on exercise capacity (SMD 0.28 (95% CI -0.04 to 0.60), p=0.08) of AHIIT compared with LBHIIT. There was moderate certainty in evidence for small effect on exercise capacity (SMD 0.45 (95% CI 0.10 to 0.80), p=0.01) of AHIIT compared with AMICT. Conclusion There are beneficial effects of AHIIT on exercise capacity in people with a range of chronic conditions. AHIIT has similar effects on exercise capacity as LBHIIT and may represent an alternative for people unable to perform LBHIIT. PROSPERO registration number CRD42022289001.
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Affiliation(s)
- Heidi Bunæs-Næss
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Linda Aimée Hartford Kvæl
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
- Centre for Welfare and Labour Research, Norwegian Social Research, Oslo Metropolitan University, Oslo, Norway
| | - Birgitta Blakstad Nilsson
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
- Division of Medicine, Department of Clinical Services, Oslo University Hospital, Oslo, Norway
| | - Sophie Heywood
- Department of Physiotherapy, St Vincent's Hospital, St Vincent's Health Australia Ltd Fitzroy, Fitzroy, Victoria, Australia
- Department of Physiotherapy, University of Melbourne VCCC, Parkville, Victoria, Australia
| | - Kristi Elisabeth Heiberg
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
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12
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Alshahrani MS, Reddy RS. Quadriceps Strength, Postural Stability, and Pain Mediation in Bilateral Knee Osteoarthritis: A Comparative Analysis with Healthy Controls. Diagnostics (Basel) 2023; 13:3110. [PMID: 37835853 PMCID: PMC10573007 DOI: 10.3390/diagnostics13193110] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
Bilateral knee osteoarthritis (OA) poses significant challenges to individuals' functional abilities, including quadriceps strength, postural stability, and pain perception. Understanding the complex relationships among these factors is crucial for enhancing knee OA management strategies. The primary objective of this research is to evaluate and draw comparisons between the strength of the quadriceps and the level of postural stability in two distinct groups: individuals afflicted with bilateral knee OA and those who are healthy. Furthermore, the study seeks to examine the potential correlation between the strength of the quadriceps and the level of postural stability in individuals with knee OA. In addition to this, an investigation into the potential mediating effect of pain on the relationship between these physiological factors will also be conducted. A total of 95 participants with bilateral knee OA and 95 healthy controls were recruited. Quadriceps strength was assessed using dynamometry and postural stability was evaluated through anterior-posterior and medial-lateral sway measurements along with the ellipse area using a force plate. Pain levels were measured using the Visual Analog Scale (VAS). Mediation analysis was employed to explore the role of pain in mediating the relationship between quadriceps strength and postural stability. Statistical analyses included t-tests, Pearson correlation coefficients, and mediation analysis. Knee OA participants exhibited significantly lower quadriceps strength (1.08 Nm/kg ± 0.54) compared to controls (1.54 Nm/kg ± 0.57, p < 0.001). They also demonstrated compromised postural stability with increased anterior-posterior sway (9.86 mm ± 3.017 vs. 2.98 mm ± 1.12, p < 0.001), medial-lateral sway (7.87 mm ± 2.23 vs. 3.12 mm ± 1.34, p < 0.001), and larger ellipse area (935.75 mm2 ± 172.56 vs. 436.19 mm2 ± 135.48, p < 0.001). Negative correlations were observed between quadriceps strength and postural stability variables (r = from -0.43 to -0.51, p < 0.001). Pain significantly mediated the relationship between quadriceps strength and postural stability variables (p < 0.05). This study highlights the associations between quadriceps strength, postural stability, and pain mediation in individuals with bilateral knee OA. Our findings emphasize the need for targeted interventions addressing quadriceps weakness and compromised postural stability. Additionally, the mediation effect of pain underscores the complexity of these relationships, offering insights for more effective management strategies.
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Affiliation(s)
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia;
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13
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Zhang L, Zhang C, Zhang J, Liu A, Wang P, Xu J. A Bidirectional Mendelian Randomization Study of Sarcopenia-Related Traits and Knee Osteoarthritis. Clin Interv Aging 2023; 18:1577-1586. [PMID: 37731961 PMCID: PMC10508245 DOI: 10.2147/cia.s424633] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/03/2023] [Indexed: 09/22/2023] Open
Abstract
Background With the development of population aging worldwide, sarcopenia and knee osteoarthritis (KOA), two age-related diseases, will continue to impose increasing medical and economic burdens on the society. Previous studies have discovered an association between the two, but the causality remains controversial, and it is difficult to eliminate confounding factors. Therefore, a Mendelian randomization (MR) study was conducted to overcome these confounding factors and investigate the causal relationship between sarcopenia and KOA. Objective The present work focused on assessing the causality between KOA and sarcopenia, so as to provide new strategies to prevent and treat these two conditions in clinic. Methods We registered the title with PROSPERO (ID: CRD42023421096). The two-sample bidirectional MR analysis was conducted in two steps, with sarcopenia being the exposure whereas KOA being the outcome in the first step, and vice versa in the second step. Genome-wide association studies (GWAS) data on low hand-grip strength (n=256,523), walking pace (n=459,915), appendicular lean mass (ALM, n=450,243), and KOA (n=403,124) were obtained from the UK Biobank. Methods such as the inverse variance weighted (IVW) and weighted median were utilized for assessing the causality of KOA with sarcopenia, and sensitivity analyses were also conducted. Results In the main MR analysis using the IVW method, evidence suggested that low hand-grip strength, walking pace, and ALM had adverse effects on KOA (p-value 0.0001, odds ratio (OR) 1.4569, 95% confidence interval (CI) 1.2007-1.7677 for low hand-grip strength; p-value 0.0003, OR 1.1500, 95% CI 1.050-1.183 for ALM; p-value 5.29E-19, OR 0.0932, 95% CI 0.0553-0.1572 for walking pace). However, there was no causality of KOA with sarcopenia in the opposite direction. Conclusion Our study suggests an obvious unidirectional causality of KOA with sarcopenia, and supports the notion that patients with sarcopenia are more susceptible to the development of KOA.
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Affiliation(s)
- Longyao Zhang
- Orthopedics Department, the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, People’s Republic of China
| | - Chao Zhang
- Orthopedics Department, the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, People’s Republic of China
| | - Juntao Zhang
- Orthopedics Department, the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, People’s Republic of China
| | - Aifeng Liu
- Orthopedics Department, the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, People’s Republic of China
| | - Ping Wang
- Orthopedics Department, the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, People’s Republic of China
| | - Jiankang Xu
- Orthopedics Department, the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, People’s Republic of China
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14
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Gim JA, Lee SY, Kim SC, Baek KW, Seo SH, Yoo JI. Relationship between DNA methylation changes and skeletal muscle mass. BMC Genom Data 2023; 24:48. [PMID: 37653517 PMCID: PMC10472633 DOI: 10.1186/s12863-023-01152-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 08/16/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Sarcopenia is a disease diagnosed in the elderly. In patients with sarcopenia, the muscle mass decreases every year. The occurrence of sarcopenia is greatly affected by extrinsic factors such as eating habits, exercise, and lifestyle. The present study aimed to determine the relationship between muscle mass traits and genes affected by epigenetic factors with three different adjustment methods using Korean Genome and Epidemiology Study (KOGES) data. RESULTS We conducted a demographic study and DNA methylation profiling by three studies according to the muscle mass index (MMI) adjustment methods: appendicular skeletal muscle mass divided by body weight (MMI1); appendicular skeletal muscle mass divided by square of height (MMI2); appendicular skeletal muscle mass divided by BMI (MMI3). We analyzed differentially methylated regions (DMRs) for each group. We then restricted our subjects to be top 30% (T30) and bottom 30% (B30) based on each MMI adjustment method. Additionally, we performed enrichment analysis using PathfindR to evaluate the relationship between identified DMRs and sarcopenia. A total of 895 subjects were included in the demographic study. The values of BMI, waist, and hip showed a significant difference in all three groups. Among 446 participants, 44 subjects whose DNA methylation profiles were investigated were included for DNA methylation analysis. The results of enrichment analysis showed differences between groups. In the women group through MMI1 method, only the glutamatergic synapse pathway showed a significant result. In the men group through MMI2 method, the adherens junction pathway was the most significant. Women group through MMI2 method showed similar results, having an enriched Rap1 signaling pathway. In men group through MMI3 method, the Fc epsilon RI signaling pathway was the most enriched. Particularly, the notch signaling pathway was significantly enriched in women group through MMI3 method. CONCLUSION This study presents results about which factor should be concerned first in muscle mass index (MMI) adjustment. The present study suggested that GAB2 and JPH3 in MMI1 method, HLA-DQB1 and TBCD in MMI2 method, GAB2, NDUFB4 and ISPD in MMI3 method are potential genes that can have an impact on muscle mass. It could enable future epigenetic studies of genes based on annotation results. The present study is a nationwide study in Korea with the largest size up to date that compares adjustment indices for MMI in epigenetic research.
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Affiliation(s)
- Jeong-An Gim
- Department of Medical Science Research Center, College of Medicine, Korea University, Seoul, South Korea
| | - Sang-Yeob Lee
- Department of Biomedical Research Institute, Gyeongsang National University Hospital, Jinju, South Korea
- Department of Theriogenology and Biotechnology, College of Veterinary Medicine, Gyeongsang National University, Jinju, South Korea
| | - Seung Chan Kim
- Department of Biostatistics Cooperation Center, Gyeongsang National University Hospital, Jinju, South Korea
| | - Kyung-Wan Baek
- Department of Physical Education, Gyeongsang National University, Jinju, South Korea
- Department of Research Institute of Pharmaceutical Sciences, Gyeongsang National University, Jinju, South Korea
| | - Sung Hyo Seo
- Department of Biomedical Research Institute, Gyeongsang National University Hospital, Jinju, South Korea
| | - Jun-Il Yoo
- Department of Orthopaedic Surgery, Inha University Hospital, 27 Inhang-ro, Jung-gu, Incheon, 22332, Republic of Korea.
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15
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Ehmig J, Engel G, Lotz J, Lehmann W, Taheri S, Schilling AF, Seif Amir Hosseini A, Panahi B. MR-Imaging in Osteoarthritis: Current Standard of Practice and Future Outlook. Diagnostics (Basel) 2023; 13:2586. [PMID: 37568949 PMCID: PMC10417111 DOI: 10.3390/diagnostics13152586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/30/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
Osteoarthritis (OA) is a common degenerative joint disease that affects millions of people worldwide. Magnetic resonance imaging (MRI) has emerged as a powerful tool for the evaluation and monitoring of OA due to its ability to visualize soft tissues and bone with high resolution. This review aims to provide an overview of the current state of MRI in OA, with a special focus on the knee, including protocol recommendations for clinical and research settings. Furthermore, new developments in the field of musculoskeletal MRI are highlighted in this review. These include compositional MRI techniques, such as T2 mapping and T1rho imaging, which can provide additional important information about the biochemical composition of cartilage and other joint tissues. In addition, this review discusses semiquantitative joint assessment based on MRI findings, which is a widely used method for evaluating OA severity and progression in the knee. We analyze the most common scoring methods and discuss potential benefits. Techniques to reduce acquisition times and the potential impact of deep learning in MR imaging for OA are also discussed, as these technological advances may impact clinical routine in the future.
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Affiliation(s)
- Jonathan Ehmig
- Institute of Diagnostic and Interventional Radiology, University Medical Center Göttingen, 37075 Göttingen, Germany; (J.E.); (G.E.)
| | - Günther Engel
- Institute of Diagnostic and Interventional Radiology, University Medical Center Göttingen, 37075 Göttingen, Germany; (J.E.); (G.E.)
| | - Joachim Lotz
- Institute of Diagnostic and Interventional Radiology, University Medical Center Göttingen, 37075 Göttingen, Germany; (J.E.); (G.E.)
| | - Wolfgang Lehmann
- Clinic of Trauma, Orthopedics and Reconstructive Surgery, Georg-August-University of Göttingen, 37075 Göttingen, Germany
| | - Shahed Taheri
- Clinic of Trauma, Orthopedics and Reconstructive Surgery, Georg-August-University of Göttingen, 37075 Göttingen, Germany
| | - Arndt F. Schilling
- Clinic of Trauma, Orthopedics and Reconstructive Surgery, Georg-August-University of Göttingen, 37075 Göttingen, Germany
| | - Ali Seif Amir Hosseini
- Institute of Diagnostic and Interventional Radiology, University Medical Center Göttingen, 37075 Göttingen, Germany; (J.E.); (G.E.)
| | - Babak Panahi
- Institute of Diagnostic and Interventional Radiology, University Medical Center Göttingen, 37075 Göttingen, Germany; (J.E.); (G.E.)
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16
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Di Martino A, Davico G, Castafaro V, Geraci G, Stefanini N, Tassinari L, Viceconti M, Faldini C. Magnetic resonance-based hip muscles retrospective analysis shows deconditioning and recovery after total hip arthroplasty surgery. INTERNATIONAL ORTHOPAEDICS 2023; 47:1441-1447. [PMID: 36914844 DOI: 10.1007/s00264-023-05762-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/01/2023] [Indexed: 03/16/2023]
Abstract
PURPOSE The purpose of this study is to estimate the effect of unilateral hip osteoarthritis (OA) on hip muscle volume and fatty infiltration and to evaluate changes of muscles after total hip arthroplasty (THA) surgery. METHODS A retrospective analysis was conducted on patients with unilateral hip OA subjected to THA with perioperative pelvic girdle 1.5 T magnetic resonance imaging (MRI). Thirty-five patients were included. Ten of these have also postoperative MRIs. Medius gluteus (MG) and iliopsoas (IP) muscles were manually segmented on the MRI scans, the corresponding 3D muscle geometries were reconstructed, and the volumes extracted. Muscle quality was assessed using the Goutallier classification on coronal MRI images. Volume and muscle quality differences were calculated between healthy and affected side. RESULTS Pre-operatively, MG and IP on the affected side presented a mean muscle volume 17.5 ± 18% (p < 0.001) and 14.4 ± 15.8% (p < 0.001) smaller than the healthy counterpart, respectively. Muscles on the affected side showed a significant higher grade of fatty infiltration compared to the healthy side (p < 0.05 for MG; p < 0.001 for IP). At an average follow-up of 13 ± 5.3 months after THA, MG, and IP muscles of the affected hip showed an average 22.8% (p < 0.001) and 28.2% (p < 0.001) volume increase after THA. Also, the healthy side showed a significant increase of muscle volume for IP (17.1% p < 0.001). No significant change for MG muscle was observed. CONCLUSIONS The study demonstrated preoperative reduced muscle volume and higher fatty infiltration at the muscles of the OA hip compared to the contralateral healthy one. A significant positive effect of THA on hip muscle volume was observed. These findings give an interesting insight on muscle deconditioning and recovery in patients undergoing THA.
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Affiliation(s)
- Alberto Di Martino
- Department of Biomedical and Neurimotor Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy.
- Ist Orthopedic Department, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Giorgio Davico
- Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Bologna, Italy
- Medical Technology Lab, IRCCS - Istituto Ortopedico Rizzoli di Bologna, Bologna, Italy
| | - Vanita Castafaro
- Department of Biomedical and Neurimotor Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
- Ist Orthopedic Department, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Giuseppe Geraci
- Department of Biomedical and Neurimotor Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
- Ist Orthopedic Department, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Niccolò Stefanini
- Department of Biomedical and Neurimotor Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
- Ist Orthopedic Department, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Leonardo Tassinari
- Department of Biomedical and Neurimotor Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
- Ist Orthopedic Department, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Marco Viceconti
- Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Bologna, Italy
- Medical Technology Lab, IRCCS - Istituto Ortopedico Rizzoli di Bologna, Bologna, Italy
| | - Cesare Faldini
- Department of Biomedical and Neurimotor Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
- Ist Orthopedic Department, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy
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Brito R, Costa D, Dias C, Cruz P, Barros P. Chondroitin Sulfate Supplements for Osteoarthritis: A Critical Review. Cureus 2023; 15:e40192. [PMID: 37431333 PMCID: PMC10329866 DOI: 10.7759/cureus.40192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2023] [Indexed: 07/12/2023] Open
Abstract
Over the years, chondroitin sulfate (CS) has been used as a slow-acting drug for the treatment of osteoarthritis, for the reduction of pain and improvement of function, and for its disease-modifying properties by limiting cartilage volume loss and joint space narrowing progression. However, there have been inconsistencies in published trials regarding clinical efficacy, with reports of a lack of significant effects compared to placebo. The therapeutic effects of chondroitin sulfate may depend on many variables, such as the source of origin, purity, and contamination with by-products. Another source of confusion may be related to the fact that CS is commonly combined with glucosamine, which makes it challenging to isolate the specific contribution of chondroitin to the therapeutic outcome. This is aggravated by the fact that CS supplements, used in many countries, are not regulated, and labels wrongly claim high levels of purity. Many of these inferior CS products may have been used in clinical trials, which may have had limited but significant results. This has led to recent recommendations to opt for higher-purity pharmacologic-grade CS for the treatment of OA. This article aims to provide an up-to-date view of the current literature regarding the biological effects and efficacy of CS and discusses the quality of available chondroitin sulfate supplements and the current direction in CS investigation. This review concludes that pharmacologic-grade CS supplements may have clinically significant benefits when properly standardized; however, high-quality evidence from properly designed clinical trials is still needed to draw definitive conclusions about clinical efficacy in osteoarthritis.
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Affiliation(s)
- Rui Brito
- Physical Medicine and Rehabilitation, Centro Hospitalar e Universitário de Santo António, Porto, PRT
| | - Diogo Costa
- Physical Medicine and Rehabilitation, Centro Hospitalar e Universitário de Santo António, Porto, PRT
| | - Carina Dias
- Physical Medicine and Rehabilitation, Centro Hospitalar e Universitário de Santo António, Porto, PRT
| | - Patrícia Cruz
- Physical Medicine and Rehabilitation, Centro Hospitalar e Universitário de Santo António, Porto, PRT
| | - Paula Barros
- Physical Medicine and Rehabilitation, Centro Hospitalar e Universitário de Santo António, Porto, PRT
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Spanoudaki M, Giaginis C, Mentzelou M, Bisbinas A, Solovos E, Papadopoulos K, Paliokas I, Zidrou C, Cheimaras A, Hassapidou M, Papadopoulos AN, Papadopoulou SK. Sarcopenia and Sarcopenic Obesity and Osteoarthritis: A Discussion among Muscles, Fat, Bones, and Aging. Life (Basel) 2023; 13:1242. [PMID: 37374023 DOI: 10.3390/life13061242] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/27/2023] [Accepted: 05/10/2023] [Indexed: 06/29/2023] Open
Abstract
Aging is a physical procedure for people and nature. Our aging world is expanding because of the life span extension. Aging has a crucial relationship with our body composition (muscles, bones, and adipose tissue), which is characterized by an increase in fat mass and a gradual decrease in muscle mass and strength and bone density. These alterations affect physical performance and impact quality of life enhancing the risk for non-communicable diseases, immobilization, and disability. As far we know, osteoarthritis of lower limbs, sarcopenic obesity, and muscle mass and/or strength loss are treated separately. However, bones, muscles, adipose tissue, and aging appear to have an interconnection through a dialogue as they talk to each other. Health disorders are coming into the surface when this relationship is disrupted. The aim of our study is to search deeper into this interconnection, so that when adipose tissue increases, we have to take a look into the condition of muscle mass, bone, and connective tissue and vice versa, through the assessment of physical performance. Consequently, the triad muscle-bone-adipose tissue disorders by aging should be treated as a single entity.
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Affiliation(s)
- Maria Spanoudaki
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
- Clinical Dietetics & Nutrition Department, 424 General Military Hospital, New Efkarpia Ring Road, 56429 Thessaloniki, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece
| | - Maria Mentzelou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece
| | | | - Evangelos Solovos
- A Orthopaedic Clinic, 424 General Military Hospital, 56429 Thessaloniki, Greece
| | | | - Ioannis Paliokas
- School of Economics and Business Administration, International Hellenic University, 57001 Thessaloniki, Greece
| | | | - Antonis Cheimaras
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Maria Hassapidou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Athanasios N Papadopoulos
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Sousana K Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
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Budhiparama NC, Lumban-Gaol I, Sudoyo H, Magetsari R, Wibawa T. The role of genetic polymorphisms of interleukin-1 (IL-1R1 and IL-1RN) in primary knee osteoarthritis in Indonesia. Sci Rep 2023; 13:7967. [PMID: 37198429 DOI: 10.1038/s41598-023-34824-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 05/09/2023] [Indexed: 05/19/2023] Open
Abstract
This study aimed to evaluate the association of SNPs of the IL-1 family with the clinical severity of knee OA. This case‒control study was performed among 100 healthy knees and 130 osteoarthritis (OA) knees of people aged ≥ 50 years with a BMI ≥ 25 kg/m2. The possible correlations among clinical findings, radiographic evaluations, serum levels of IL-1R1 and IL-1Ra, and genotype analyses were evaluated. Three SNPs of IL-1R1, rs871659, rs3771202, and rs3917238, were associated with primary knee OA. Females with IL-1R1 SNP rs871659 allele A had a higher prevalence of primary knee OA. No correlation was found between SNPs of IL-1R1 and IL-1RN and clinical or radiologic severity or serum concentrations of IL-1R1 and IL-1Ra (p > 0.05). BMI and IL-1R1 rs3917238 genotype C/C were correlated with moderate-severe VAS scores. A correlation was also found between the EQ-5D-3L self-care dimension and obesity and between the EQ-5D-3L pain and usual activity dimensions and age ≥ 60 and obesity (p < 0.05). Radiologic severity was only associated with age ≥ 60 years (p < 0.05). We found the IL-1R1 SNPs rs871659, rs3771202, and rs3917238 to be predisposing factors for primary knee osteoarthritis. The clinical findings, radiographic severity, and serum concentrations of IL-1R1 and IL-1Ra were not correlated with these gene polymorphisms.
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Affiliation(s)
- Nicolaas C Budhiparama
- Department of Orthopaedic and Traumatology, Faculty of Medicine, Unversitas Airlangga, Surabaya, Indonesia.
- Nicolaas Institute of Constructive Orthopaedics Research and Education Foundation for Arthroplaty and Sports Medicine, Jakarta, Indonesia.
- Department of Orthopaedic and Traumatology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
- Department of Orthopaedics, Leiden University Medical Centre, Leiden, The Netherlands.
| | - Imelda Lumban-Gaol
- Nicolaas Institute of Constructive Orthopaedics Research and Education Foundation for Arthroplaty and Sports Medicine, Jakarta, Indonesia
| | | | - Rahadyan Magetsari
- Department of Orthopaedic and Traumatology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Tri Wibawa
- Department of Microbiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Knell SC, Longo F, Wolfer N, Schmierer PA, Hermann A, Pozzi A. Outcome and Complications following Stabilization of Coxofemoral Luxations in Cats Using a Modified Hip Toggle Stabilization-A Retrospective Multicentre Study. Vet Comp Orthop Traumatol 2023. [PMID: 37116537 DOI: 10.1055/s-0043-1768230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
OBJECTIVES The main aim of this study was to report the surgical technique, the complications and the clinical outcomes of the mini-Tight Rope system (mini-TR) for a modified hip toggle stabilization of coxofemoral luxation in cats. STUDY DESIGN A multicentre retrospective study. ANIMALS Thirty-two client-owned cats. METHODS Medical records (2009-2017) of cats, which underwent stabilization of a coxofemoral luxation with the mini-TR and had at least a 3-month follow-up, were reviewed. The femoral tunnel diameter, the use of one or two FiberWire loops, perioperative complications and clinical outcomes were recorded. Follow-up information was obtained through clinical and radiographic examinations and an owner questionnaire. RESULTS Thirty-two cats met the inclusion criteria. Concurrent injuries were present in 16 cats. A single or double loop mini-TR was used in 21 and 12 cats respectively. One double loop (1/12 cats) and four single loop (4/16 cats) sutures failed. Moderate-to-severe coxofemoral osteoarthritis developed in 14/27 cats. Owner questionnaires revealed excellent clinical outcomes. CLINICAL SIGNIFICANCE Mini-TR with a double-stranded implant is recommended to decrease the risk of suture failure. Osteoarthritis is common after open reduction of hip luxations.
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Affiliation(s)
- Sebastian Christoph Knell
- Department for Small Animals, Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - Federico Longo
- Department for Small Animals, Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - Nadja Wolfer
- Department for Clinical Diagnostics and Services, Clinic for Diagnostic Imaging, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - Philipp A Schmierer
- Department for Small Animals, Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
- Tierärztliche Klinik Posthausen, Posthausen, Germany
| | - Andreas Hermann
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Berne, Berne, Switzerland
| | - Antonio Pozzi
- Department for Small Animals, Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
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21
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Liao CD, Huang SW, Chen HC, Huang YY, Liou TH, Lin CL. Effects of Protein Supplementation Combined with Resistance Exercise Training on Walking Speed Recovery in Older Adults with Knee Osteoarthritis and Sarcopenia. Nutrients 2023; 15:nu15071552. [PMID: 37049391 PMCID: PMC10096553 DOI: 10.3390/nu15071552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/19/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023] Open
Abstract
Knee osteoarthritis (KOA) is closely associated with sarcopenia, sharing the common characteristics of muscle weakness and low physical performance. Resistance exercise training (RET), protein supplementation (PS), and PS+RET have promise as treatments for both sarcopenia and KOA. However, whether PS+RET exerts any effect on time to recovery to normal walking speed (WS) in older adults with sarcopenia and KOA remains unclear. This study investigated the treatment efficiency of PS+RET on WS recovery among individuals with KOA and sarcopenia. A total of 108 older adults aged ≥ 60 years who had a diagnosis of radiographic KOA and sarcopenia were enrolled in this prospective cohort study. Sarcopenia was defined on the basis of the cutoff values of the appendicular skeletal muscle mass index for Asian people and a slow WS less than 1.0 m/s. The patients were equally distributed to three groups: PS+RET, RET alone, and usual care. The weekly assessment was performed during a 12-week intervention and a subsequent 36-week follow-up period. A cutoff of 1.0 m/s was used to identify successful recovery to normal WS. Kaplan-Meier analysis was performed to measure the survival time to normal WS among the study groups. Multivariate Cox proportional-hazards regression (CPHR) models were established to calculate the hazard ratios (HRs) of successful WS recovery and determine its potential moderators. After the 3-month intervention, PS+RET as well as RET obtained greater changes in WS by an adjusted mean difference of 0.18 m/s (p < 0.0001) and 0.08 (p < 0.05) m/s, respectively, compared to usual care. Kaplan-Meier analysis results showed both RET and PS+RET interventions yielded high probabilities of achieving normal WS over the 12-month follow-up period. Multivariate CPHR results revealed that PS+RET (adjusted HR = 5.48; p < 0.001), as well as RET (adjusted HR = 2.21; p < 0.05), independently exerted significant effects on WS recovery. PS+RET may accelerate normal WS recovery by approximately 3 months compared with RET. Sex and initial WS may influence the treatment efficiency. For patients with KOA who suffer sarcopenia, 12-week RET alone exerts significant effects on WS recovery, whereas additional PS further augments the treatment effects of RET by speeding up the recovery time of WS toward a level ≥ 1.0 m/s, which facilitates the patients to diminish the disease severity or even free from sarcopenia.
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Affiliation(s)
- Chun-De Liao
- International Ph.D. Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei 110301, Taiwan
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Hung-Chou Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Yu-Yun Huang
- Department of Pediatrics, New York University Langone Medical Center, New York City, NY 10016, USA
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Che-Li Lin
- Department of Orthopedic Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
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Ueyama H, Kanemoto N, Minoda Y, Taniguchi Y, Nakamura H. Perioperative Essential Amino Acid Supplementation Facilitates Quadriceps Muscle Strength and Volume Recovery After TKA: A Double-Blinded Randomized Controlled Trial. J Bone Joint Surg Am 2023; 105:345-353. [PMID: 36856692 DOI: 10.2106/jbjs.22.00675] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
BACKGROUND Perioperative essential amino acid (EAA) supplementation suppresses lower-limb muscle atrophy and promotes functional improvement in the first 4 weeks after total knee arthroplasty (TKA). However, its effect on the recovery of muscle volume and strength in the intermediate term is unclear. The aim of this study was to evaluate the effect of perioperative EAA supplementation on the recovery of lower-limb muscle volume and strength in the 2 years after TKA. METHODS Sixty patients who underwent unilateral TKA for primary knee osteoarthritis were included in this double-blinded randomized controlled trial. After excluding dropouts, 26 patients assigned to the EAA group (9 g/day) and 26 assigned to the placebo group (powdered lactose, 9 g/day) were available for analysis. Patients received EAA supplementation or a placebo from 1 week prior to surgery to 2 weeks after it. The rectus femoris muscle area was measured using ultrasonography and quadriceps muscle strength was measured isometrically with a handheld dynamometer, preoperatively and periodically up to 2 years postoperatively. Knee pain, knee range of motion, functional mobility, and Knee Society Score 2011 subjective scores were measured at each time point. Perioperative management, except for supplementation, was identical in the 2 groups. RESULTS Taking the baseline as 100%, the mean values in the EAA and placebo groups were 134% ± 31% and 114% ± 27%, respectively, for the rectus femoris muscle area and 159% ± 54% and 125% ± 40% for the quadriceps muscle strength, respectively, at 2 years after surgery. The differences were significant (p < 0.05). Clinical outcomes were not significantly different between the 2 groups. CONCLUSIONS Perioperative EAA supplementation contributes to the recovery of rectus femoris muscle volume and quadriceps muscle strength in the 2 years after TKA. The EAA supplementation did not impact clinical outcomes. LEVEL OF EVIDENCE Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Hideki Ueyama
- Department of Orthopedic Surgery, Osaka Rosai Hospital, Sakai, Osaka, Japan.,Department of Orthopedic Surgery, Tanabe Central Hospital, Tanabe City, Wakayama, Japan.,Department of Orthopedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka City, Japan
| | - Narihiro Kanemoto
- Department of Orthopedic Surgery, Tanabe Central Hospital, Tanabe City, Wakayama, Japan
| | - Yukihide Minoda
- Department of Orthopedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka City, Japan
| | - Yoshiki Taniguchi
- Department of Orthopedic Surgery, Tanabe Central Hospital, Tanabe City, Wakayama, Japan
| | - Hiroaki Nakamura
- Department of Orthopedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka City, Japan
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23
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Karademir F, Ayhan Kuru C, Arın G, Soylu R. Morphometry of thenar muscles by water bath ultrasonography in trapeziometacarpal osteoarthritis: intra- and inter-rater reliability. J Hand Surg Eur Vol 2023; 48:115-122. [PMID: 36281061 DOI: 10.1177/17531934221130669] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We studied the intra- and inter-rater reliability of muscle thickness and cross-sectional area measurements of thenar muscles with a water bath ultrasonography technique in eight healthy volunteers and 16 patients with trapeziometacarpal osteoarthritis. Thickness and cross-sectional area of the opponens pollicis, abductor pollicis brevis, flexor pollicis brevis, first dorsal interosseous and adductor pollicis muscle were measured. The results showed changes in the morphometric properties of the thenar muscles in patients with trapeziometacarpal osteoarthritis (TMC OA) compared with the healthy volunteers. In the dominant-sided patients (n = 14), there were lower cross-sectional area values for the abductor pollicis brevis and opponens pollicis muscles. In the non-dominant-sided patients (n = 10), there were lower cross-sectional area values for the abductor pollicis brevis and flexor pollicis brevis and lower muscle thickness of the abductor pollicis brevis. The water bath ultrasonography technique could be used to diagnose and treat diseases where changes in thenar muscle thickness and cross-sectional area can be expected.Level of evidence: III.
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Affiliation(s)
- Feray Karademir
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Cigdem Ayhan Kuru
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Gamze Arın
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ruhi Soylu
- Department of Biophysics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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24
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The course of knee extensor strength after total knee arthroplasty: a systematic review with meta-analysis and -regression. Arch Orthop Trauma Surg 2023:10.1007/s00402-022-04750-5. [PMID: 36637491 PMCID: PMC10374784 DOI: 10.1007/s00402-022-04750-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/28/2022] [Indexed: 01/14/2023]
Abstract
PURPOSE Muscular strength loss and atrophy are postoperative complications. This systematic review with meta-analysis investigated the course of on knee extensor mass and strength from pre-surgery over total knee arthroplasty to rehabilitation and recovery. METHODS A systematic literature search was conducted in PubMed (Medline), Cochrane Library (CINAHL, Embase) and Web of Science (until 29th of June 2022). Main inclusion criteria were ≥ 1 preoperative and ≥ 1 measurement ≥ 3-months post-operation and ≥ 1 objective assessment of quadriceps strength, muscle mass or neuromuscular activity, measured at both legs. Studies were excluded if they met the following criteria: further impairment of treated extremity or of the contralateral extremity; further muscle affecting disease, or muscle- or rehabilitation-specific intervention. The Robins-I tool for non-randomized studies, and the Cochrane Rob 2 tool for randomized controlled studies were used for risk of bias rating. Pre-surgery, 3 months, 6 months and 1 year after surgery data were pooled using random effects meta-analyses (standardized mean differences, SMD, Hedge's g) in contrast to the pre-injury values. RESULTS 1417 studies were screened, 21 studies on 647 participants were included. Thereof, 13 were non-randomized controlled trails (moderate overall risk of bias in most studies) and 7 were randomized controlled trials (high risk of bias in at least one domain in most studies). Three (k = 12 studies; SMD = - 0.21 [95% confidence interval = - 0.36 to - 0.05], I2 = 4.75%) and six (k = 9; SMD = - 0.10 [- 0.28 to - 0.08]; I2 = 0%) months after total knee arthroplasty, a deterioration in the strength of the operated leg compared with the strength of the non-operated leg was observed. One year after surgery, the operated leg was stronger in all studies compared to the preoperative values. However, this increase in strength was not significant compared to the non-operated leg (k = 6, SMD = 0.18 [- 0.18 to 0.54], I2 = 77.56%). CONCLUSION We found moderate certainty evidence that deficits in muscle strength of the knee extensors persist and progress until 3 months post-total knee arthroplasty in patients with end-stage knee osteoarthritis. Very low certainty evidence exists that preoperatively existing imbalance of muscle strength and mass in favor of the leg not undergoing surgery is not recovered within 1 year after surgery.
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25
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Nicholson TA, Sagmeister M, Wijesinghe SN, Farah H, Hardy RS, Jones SW. Oligonucleotide Therapeutics for Age-Related Musculoskeletal Disorders: Successes and Challenges. Pharmaceutics 2023; 15:237. [PMID: 36678864 PMCID: PMC9866666 DOI: 10.3390/pharmaceutics15010237] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/04/2023] [Accepted: 01/08/2023] [Indexed: 01/13/2023] Open
Abstract
Age-related disorders of the musculoskeletal system including sarcopenia, osteoporosis and arthritis represent some of the most common chronic conditions worldwide, for which there remains a great clinical need to develop safer and more efficacious pharmacological treatments. Collectively, these conditions involve multiple tissues, including skeletal muscle, bone, articular cartilage and the synovium within the joint lining. In this review, we discuss the potential for oligonucleotide therapies to combat the unmet clinical need in musculoskeletal disorders by evaluating the successes of oligonucleotides to modify candidate pathological gene targets and cellular processes in relevant tissues and cells of the musculoskeletal system. Further, we discuss the challenges that remain for the clinical development of oligonucleotides therapies for musculoskeletal disorders and evaluate some of the current approaches to overcome these.
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Affiliation(s)
- Thomas A. Nicholson
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
| | - Michael Sagmeister
- Institute for Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Susanne N. Wijesinghe
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
| | - Hussein Farah
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
| | - Rowan S. Hardy
- Institute for Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Simon W. Jones
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
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Jung M, Rospleszcz S, Löffler MT, Walter SS, Maurer E, Jungmann PM, Peters A, Nattenmüller J, Schlett CL, Bamberg F, Kiefer LS, Diallo TD. Association of lumbar vertebral bone marrow and paraspinal muscle fat composition with intervertebral disc degeneration: 3T quantitative MRI findings from the population-based KORA study. Eur Radiol 2023; 33:1501-1512. [PMID: 36241920 PMCID: PMC9935727 DOI: 10.1007/s00330-022-09140-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 08/11/2022] [Accepted: 09/05/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess the association of lumbar bone marrow adipose tissue fat fraction (BMAT-FF) and paraspinal muscle proton density fat fraction (PDFF) and their interplay with intervertebral disc degeneration (IVDD). METHODS In this retrospective cross-sectional study based on a prospective population-based cohort, BMAT-FF and PDFF of asymptomatic individuals were calculated based on 3T-MRI dual-echo and multi-echo Dixon VIBE sequences. IVDD was assessed at motion segments L1 to L5 and dichotomized based on Pfirrmann grade ≥ 4 and/or presence of other severe degenerative changes or spinal abnormalities at least at one segment. Pearson's correlation coefficients were calculated for BMAT-FF and PDFF. Univariable and multivariable logistic regression models for IVDD were calculated. RESULTS Among 335 participants (mean age: 56.2 ± 9.0 years, 43.3% female), the average BMI was 27.7 ± 4.5 kg/m2 and the prevalence of IVDD was high (69.9%). BMAT-FF and PDFF were significantly correlated (r = 0.31-0.34; p < 0.001). The risk for IVDD increased with higher PDFF (OR = 1.45; CI 1.03, 2.04) and BMAT-FF (OR = 1.56; CI 1.16, 2.11). Pairwise combinations of PDFF and BMAT-FF quartiles revealed a lower risk for IVDD in individuals in the lowest BMAT-FF and PDFF quartile (OR = 0.21; CI 0.1, 0.48). Individuals in the highest BMAT-FF and PDFF quartile showed an increased risk for IVDD (OR = 5.12; CI 1.17, 22.34) CONCLUSION: Lumbar BMAT-FF and paraspinal muscle PDFF are correlated and represent both independent and additive risk factors for IVDD. Quantitative MRI measurements of paraspinal myosteatosis and vertebral bone marrow fatty infiltration may serve as imaging biomarkers to assess the individual risk for IVDD. KEY POINTS • Fat composition of the lumbar vertebral bone marrow is positively correlated with paraspinal skeletal muscle fat. • Higher fat-fractions of lumbar vertebral bone marrow and paraspinal muscle are both independent as well as additive risk factors for intervertebral disc degeneration. • Quantitative magnetic resonance imaging measurements of bone marrow and paraspinal muscle may serve as imaging biomarkers for intervertebral disc degeneration.
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Affiliation(s)
- Matthias Jung
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
| | - Susanne Rospleszcz
- grid.4567.00000 0004 0483 2525Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Oberschleißheim, Germany ,grid.5252.00000 0004 1936 973XDepartment of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University München, Munich, Germany
| | - Maximilian T. Löffler
- grid.5963.9Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany ,grid.6936.a0000000123222966Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
| | - Sven S. Walter
- grid.10392.390000 0001 2190 1447Department of Diagnostic and Interventional Radiology, Eberhard Karls University of Tuebingen, Tuebingen, Germany ,grid.137628.90000 0004 1936 8753Division of Musculoskeletal Radiology, Department of Radiology, NYU Grossman School of Medicine, 660 1st Ave, New York, NY 10016 USA
| | - Elke Maurer
- grid.482867.70000 0001 0211 6259Department of Trauma and Reconstructive Surgery, BG Unfallklinik, Schnarrenbergstraße 95, 72070 Tuebingen, Germany
| | - Pia M. Jungmann
- grid.5963.9Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany
| | - Annette Peters
- grid.4567.00000 0004 0483 2525Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Oberschleißheim, Germany ,grid.5252.00000 0004 1936 973XDepartment of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University München, Munich, Germany
| | - Johanna Nattenmüller
- grid.5963.9Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany
| | - Christopher L. Schlett
- grid.5963.9Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany
| | - Fabian Bamberg
- grid.5963.9Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany
| | - Lena S. Kiefer
- grid.10392.390000 0001 2190 1447Department of Diagnostic and Interventional Radiology, Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | - Thierno D. Diallo
- grid.5963.9Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany
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Gim JA, Lee S, Kim SC, Baek KW, Yoo JI. Demographic and Genome Wide Association Analyses According to Muscle Mass Using Data of the Korean Genome and Epidemiology Study. J Korean Med Sci 2022; 37:e346. [PMID: 36573383 PMCID: PMC9792260 DOI: 10.3346/jkms.2022.37.e346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/26/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Sarcopenia is commonly found in the elderly due to a decline in muscle mass. Many researchers have performed genome-wide association studies (GWAS) to find genetic risk factors of sarcopenia. Although many studies have discovered sarcopenia associated single nucleotide polymorphisms (SNPs), most of them are studies targeting Caucasians. The purpose of this study was to evaluate genetic correlation according to muscle mass in middle aged Koreans using data of the Korean Genome and Epidemiology Study (KOGES), a large population-based genomic cohort study. METHODS Baseline participants were 10,030 subjects aged 40 to 69 years who were from Ansan or Anseong in Gyeonggi-do, South Korea. Among them, 9,351 subjects with laboratory data available were included in this study. To identify sarcopenia associated variants, those in the top 30% and bottom 30% of muscle mass index (MMI) were compared. A total of 7,452 people with an MMI of 30-70% were excluded. A total of 1,004 people were also excluded due to missing data. Finally, 895 people were selected for this study. The Korea Biobank Array generated 500,568 SNPs for this dataset. RESULTS When subjects were divided into top 30% and bottom 30% of MMI, the top 30% had 169 men and 308 women and the bottom 30% had 220 men and 198 women. In men, age, body mass index (BMI), waist and hip were significantly (P < 0.005) different between top 30% and bottom 30% MMI groups. In women, age, BMI, waist, hip, and hypertension history were significantly different between the two MMI groups. There were 13 significant SNPs in men and 14 significant SNPs in women. Genes associated with variants in men based on the single-nucleotide polymorphism database (dbSNP) were LRP1B containing rs11679458 and RGS6 containing rs11848300. A gene associated with variants in women was Pi4K2A, which contained rs1189312 as a variant. In addition, rs11189312 was associated with expression quantitative trait loci (eQTL) of ZFYVE27 in skeletal muscles and other SNPs of ZFYVE27 (rs10882883, rs17108378, rs35077384) known to be associated with spastic paraplegia. The eQTL analysis revealed that rs11189312 was a variant associated with SNPs of ZFYVE27. CONCLUSIONS In the demographic study, significant results were found in BMI, waist, hip, history of hyperlipidemia, and sedentary life status in male group, and significant results were found in BMI, waist, hip, and hypertension history in female group. Variant rs11189312 was found to be a novel variant affecting ZFYVE27 expressed in skeletal muscles, suggesting that rs11189312 might be related to sarcopenia as a novel discovery of this study. Further study is needed to determine the association between sarcopenia and ZFYVE27 known to be associated with spastic paraplegia.
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Affiliation(s)
- Jeong-An Gim
- Medical Science Research Center, College of Medicine, Korea University, Seoul, Korea
| | - Sangyeob Lee
- Department of Biomedical Research Institute, Gyeongsang National University Hospital, Jinju, Korea
- Department of Theriogenology and Biotechnology, College of Veterinary Medicine, Gyeongsang National University, Jinju, Korea
| | - Seung Chan Kim
- Department of Biostatistics Cooperation Center, Gyeongsang National University Hospital, Jinju, Korea
| | - Kyung-Wan Baek
- Department of Physical Education, Gyeongsang National University, Jinju, Korea
- Research Institute of Pharmaceutical Sciences, Gyeongsang National University, Jinju, Korea
| | - Jun-Il Yoo
- Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, Korea.
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Drummer DJ, Lavin KM, Graham ZA, O'Bryan SM, McAdam JS, Lixandrão ME, Seay R, Aban I, Siegel HJ, Ghanem E, Singh JA, Bonfitto A, Antone J, Reiman R, Hutchins E, Van Keuren-Jensen K, Schutzler SE, Barnes CL, Ferrando AA, Bridges SL, Bamman MM. Muscle transcriptomic circuits linked to periarticular physiology in end-stage osteoarthritis. Physiol Genomics 2022; 54:501-513. [PMID: 36278270 PMCID: PMC9762959 DOI: 10.1152/physiolgenomics.00092.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/08/2022] [Accepted: 10/20/2022] [Indexed: 02/01/2023] Open
Abstract
The ability of individuals with end-stage osteoarthritis (OA) to functionally recover from total joint arthroplasty is highly inconsistent. The molecular mechanisms driving this heterogeneity have yet to be elucidated. Furthermore, OA disproportionately impacts females, suggesting a need for identifying female-specific therapeutic targets. We profiled the skeletal muscle transcriptome in females with end-stage OA (n = 20) undergoing total knee or hip arthroplasty using RNA-Seq. Single-gene differential expression (DE) analyses tested for DE genes between skeletal muscle overlaying the surgical (SX) joint and muscle from the contralateral (CTRL) leg. Network analyses were performed using Pathway-Level Information ExtractoR (PLIER) to summarize genes into latent variables (LVs), i.e., gene circuits, and link them to biological pathways. LV differences in SX versus CTRL muscle and across sources of muscle tissue (vastus medialis, vastus lateralis, or tensor fascia latae) were determined with ANOVA. Linear models tested for associations between LVs and muscle phenotype on the SX side (inflammation, function, and integrity). DE analysis revealed 360 DE genes (|Log2 fold-difference| ≥ 1, FDR ≤ 0.05) between the SX and CTRL limbs, many associated with inflammation and lipid metabolism. PLIER analyses revealed circuits associated with protein degradation and fibro-adipogenic cell gene expression. Muscle inflammation and function were linked to an LV associated with endothelial cell gene expression highlighting a potential regulatory role of endothelial cells within skeletal muscle. These findings may provide insight into potential therapeutic targets to improve OA rehabilitation before and/or following total joint replacement.
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Affiliation(s)
- Devin J Drummer
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Kaleen M Lavin
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
- Florida Institute for Human and Machine Cognition, Pensacola, Florida
| | - Zachary A Graham
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
- Florida Institute for Human and Machine Cognition, Pensacola, Florida
- Birmingham VA Medical Center, Birmingham, Alabama
| | - Samia M O'Bryan
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jeremy S McAdam
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
- Florida Institute for Human and Machine Cognition, Pensacola, Florida
| | - Manoel E Lixandrão
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Regina Seay
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Inmaculada Aban
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Herrick J Siegel
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Elie Ghanem
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jasvinder A Singh
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Birmingham VA Medical Center, Birmingham, Alabama
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Comprehensive Arthritis, Musculoskeletal, Bone, and Autoimmunity Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Anna Bonfitto
- Division of Neurogenomics, The Translational Genomics Research Institute, Phoenix, Arizona
| | - Jerry Antone
- Division of Neurogenomics, The Translational Genomics Research Institute, Phoenix, Arizona
| | - Rebecca Reiman
- Division of Neurogenomics, The Translational Genomics Research Institute, Phoenix, Arizona
| | - Elizabeth Hutchins
- Division of Neurogenomics, The Translational Genomics Research Institute, Phoenix, Arizona
| | | | - Scott E Schutzler
- Department of Geriatrics and Center for Translational Research in Aging and Longevity, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - C Lowry Barnes
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Arny A Ferrando
- Department of Geriatrics and Center for Translational Research in Aging and Longevity, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - S Louis Bridges
- Department of Medicine, Hospital for Special Surgery, New York, New York
- Division of Rheumatology, Weill Cornell Medical Center, New York, New York
| | - Marcas M Bamman
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
- Florida Institute for Human and Machine Cognition, Pensacola, Florida
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29
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Kim HJ, Hong YH. Age-related low skeletal muscle mass correlates with joint space narrowing in knee osteoarthritis in a South Korean population: a cross-sectional, case-control study. JOURNAL OF YEUNGNAM MEDICAL SCIENCE 2022; 39:285-293. [PMID: 35108762 PMCID: PMC9580060 DOI: 10.12701/jyms.2021.01536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/24/2021] [Indexed: 11/22/2022]
Abstract
Background This study was conducted to analyze the effects of low skeletal muscle mass index (SMI) and obesity on aging-related osteoarthritis (OA) in the Korean population. Methods A total of 16,601 participants who underwent a dual-energy X-ray absorptiometry and 3,976 subjects with knee X-rays according to the modified Kellgren-Lawrence (KL) system were enrolled. Knees of ≥KL grade 2 were classified as radiologic OA. The severity of joint space narrowing (JSN) was classified by X-rays as normal, mild-to-moderate, and severe JSN in radiologic OA. The subjects were grouped as normal SMI (SMI of ≥–1 standard deviation [SD] of the mean), low SMI class I (SMI of ≥–2 SDs and <–1 SD), and low SMI class II (SMI of <–2 SDs). Obesity was defined as a body mass index (BMI) of ≥27.5 kg/m2. Results The modified KL grade and JSN severity were negatively correlated with the SMI and positively correlated with BMI and age. The SMI was negatively correlated with age. JSN severity was significantly associated with a low SMI class compared to a normal SMI, which was more prominent in low SMI class II than class I. Obesity was significantly associated with more severe JSN, only for obesity with a low SMI class. Furthermore, patients with a low SMI class, regardless of obesity, were prone to having more severe JSN. Conclusion This study suggested that a low SMI class was associated with aging and that an age-related low SMI was more critically related to the severity of JSN in OA.
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Affiliation(s)
- Hyun-Je Kim
- Division of Rheumatology, Department of Internal Medicine, CHA University, CHA Gumi Medical Center, Gumi, Korea
| | - Young-Hoon Hong
- Division of Rheumatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
- Corresponding author: Young-Hoon Hong, MD, PhD Division of Rheumatology, Department of Internal Medicine, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, Korea Tel: +82-53-620-3841 Fax: +82-53-654-8386 E-mail:
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30
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Khodabukus A, Guyer T, Moore AC, Stevens MM, Guldberg RE, Bursac N. Translating musculoskeletal bioengineering into tissue regeneration therapies. Sci Transl Med 2022; 14:eabn9074. [PMID: 36223445 PMCID: PMC7614064 DOI: 10.1126/scitranslmed.abn9074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Musculoskeletal injuries and disorders are the leading cause of physical disability worldwide and a considerable socioeconomic burden. The lack of effective therapies has driven the development of novel bioengineering approaches that have recently started to gain clinical approvals. In this review, we first discuss the self-repair capacity of the musculoskeletal tissues and describe causes of musculoskeletal dysfunction. We then review the development of novel biomaterial, immunomodulatory, cellular, and gene therapies to treat musculoskeletal disorders. Last, we consider the recent regulatory changes and future areas of technological progress that can accelerate translation of these therapies to clinical practice.
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Affiliation(s)
- Alastair Khodabukus
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Tyler Guyer
- Knight Campus for Accelerating Scientific Impact, University of Oregon, Eugene, OR 97403, USA
| | - Axel C Moore
- Departments of Materials and Bioengineering and Institute of Biomedical Engineering, Imperial College London, London SW7 2AZ, UK.,Department of Biomedical Engineering, University of Delaware, Newark, DE 19716, USA
| | - Molly M Stevens
- Departments of Materials and Bioengineering and Institute of Biomedical Engineering, Imperial College London, London SW7 2AZ, UK.,Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm 17177, Sweden
| | - Robert E Guldberg
- Knight Campus for Accelerating Scientific Impact, University of Oregon, Eugene, OR 97403, USA
| | - Nenad Bursac
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
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31
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Evans LAE, Pitsillides AA. Structural clues to articular calcified cartilage function: A descriptive review of this crucial interface tissue. J Anat 2022; 241:875-895. [PMID: 35866709 PMCID: PMC9482704 DOI: 10.1111/joa.13728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 06/26/2022] [Accepted: 06/30/2022] [Indexed: 11/26/2022] Open
Abstract
Articular calcified cartilage (ACC) has been dismissed, by some, as a remnant of endochondral ossification without functional relevance to joint articulation or weight-bearing. Recent research indicates that morphologic and metabolic ACC features may be important, reflecting knee joint osteoarthritis (OA) predisposition. ACC is less investigated than neighbouring joint tissues, with its component chondrocytes and mineralised matrix often being either ignored or integrated into analyses of hyaline articular cartilage and subchondral bone tissue respectively. Anatomical variation in ACC is recognised between species, individuals and age groups, but the selective pressures underlying this variation are unknown. Consequently, optimal ACC biomechanical features are also unknown as are any potential locomotory roles. This review collates descriptions of ACC anatomy and biology in health and disease, with a view to revealing its structure/function relationship and highlighting potential future research avenues. Mouse models of healthy and OA joint ageing have shown disparities in ACC load-induced deformations at the knee joint. This raises the hypothesis that ACC response to locomotor forces over time may influence, or even underlie, the bony and hyaline cartilage symptoms characteristic of OA. To effectively investigate the ACC, greater resolution of joint imaging and merging of hierarchical scale data will be required. An appreciation of OA as a 'whole joint disease' is expanding, as is the possibility that the ACC may be a key player in healthy ageing and in the transition to OA joint pathology.
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Affiliation(s)
- Lucinda A. E. Evans
- Department of Comparative Biomedical SciencesRoyal Veterinary College, University of LondonLondonUK
| | - Andrew A. Pitsillides
- Department of Comparative Biomedical SciencesRoyal Veterinary College, University of LondonLondonUK
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32
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Prophylactic administration of miR-451 inhibitor decreases osteoarthritis severity in rats. Sci Rep 2022; 12:16068. [PMID: 36167718 PMCID: PMC9513290 DOI: 10.1038/s41598-022-20415-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 09/13/2022] [Indexed: 11/29/2022] Open
Abstract
Transfection of chondrocytes with microRNA-451(miR-451), present in growth zone cartilage of the growth plate, upregulates production of enzymes association with extracellular matrix degradation. miR-451 is also present in articular cartilage and exacerbates IL-1β effects in articular chondrocytes. Moreover, when osteoarthritis (OA) was induced in Sprague Dawley rats via bilateral anterior cruciate ligament transection (ACLT), miR-451 expression was increased in OA cartilage compared to control, suggesting its inhibition might be used to prevent or treat OA. To examine the prophylactic and therapeutic potential of inhibiting miR-451, we evaluated treatment with miR-451 power inhibitor (451-PI) at the onset of joint trauma and treatment after OA had developed. The prophylactic animal cohort received twice-weekly intra-articular injections of either 451-PI or a negative control (NC-PI) beginning on post-surgical day 3. OA was allowed to develop for 24 days in the therapeutic cohort before beginning injections. All rats were killed on day 45. Micro-CT, histomorphometrics, OARSI scoring, and muscle force testing were performed on samples. 451-PI mitigated OA progression compared to NC-PI limbs in the prophylactic cohort based on histomorphometric analysis and OARSI scoring, but no differences were detected by micro-CT. 451-PI treatment beginning 24 days post-surgery was not able to reduce OA severity. Prophylactic administration of 451-PI mitigates OA progression in a post-trauma ACLT rat model supporting its potential to prevent OA development following an ACLT injury clinically.
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Jurado-Castro JM, Muñoz-López M, Ledesma AST, Ranchal-Sanchez A. Effectiveness of Exercise in Patients with Overweight or Obesity Suffering from Knee Osteoarthritis: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10510. [PMID: 36078226 PMCID: PMC9518463 DOI: 10.3390/ijerph191710510] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/19/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES The main purpose of this study was to review the evidence about the effectiveness of exercise in patients with overweight or obesity suffering from knee osteoarthritis. METHODS Randomized clinical trials (RCTs) published between January 2002 and May 2022 were included. RESULTS A total of 64 articles were identified, of which six met the criteria for meta-analysis. The pain scale score was higher in the control group (mean difference 0.95; confidence interval 0.42-1.47; p < 0.001; I2 = 44%). The physical function scale (lower scores indicate lower levels of symptoms or physical disability) presented a higher score in the control group (mean difference 3.74; confidence interval 0.85-6.53; p < 0.05; I2 = 56%). Moreover, the intervention group achieved a greater distance (meters) walking in a 6 min interval (mean difference 38.18; confidence interval 20.01-56.35; p < 0.001; I2 = 0%). CONCLUSIONS Exercise interventions seem effective in improving quality of life in people with overweight or obesity suffering from knee osteoarthritis, reducing pain and improving physical function.
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Affiliation(s)
- Jose Manuel Jurado-Castro
- Metabolism and Investigation Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Cordoba, Spain
- Ciencias De La Actividad Física y El Deporte, Escuela Universitaria de Osuna (Centro Adscrito a la Universidad de Sevilla), 41640 Osuna, Spain
| | - Mariano Muñoz-López
- Ciencias De La Actividad Física y El Deporte, Escuela Universitaria de Osuna (Centro Adscrito a la Universidad de Sevilla), 41640 Osuna, Spain
| | - Agustín Sánchez-Toledo Ledesma
- Instituto de Seguridad y Bienestar Laboral, 14001 Cordoba, Spain
- Higher School of Engineering and Technology, International University of La Rioja (UNIR), 26004 Logroño, Spain
| | - Antonio Ranchal-Sanchez
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14071 Cordoba, Spain
- Grupo De Investigación Clínico Epidemiológica De Atención Primaria, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Cordoba, Spain
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34
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Osburn SC, Romero MA, Roberson PA, Mumford PW, Wiggins DA, McAdam JS, Drummer DJ, Bridges SL, Bamman MM, Roberts MD. Effects of end-stage osteoarthritis on markers of skeletal muscle Long INterspersed Element-1 activity. BMC Res Notes 2022; 15:245. [PMID: 35799274 PMCID: PMC9264706 DOI: 10.1186/s13104-022-06113-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 06/15/2022] [Indexed: 11/15/2022] Open
Abstract
Objective Long INterspersed Element-1 (L1) is an autonomous transposable element in the genome. L1 transcripts that are not reverse transcribed back into the genome can accumulate in the cytoplasm and activate an inflammatory response via the cyclic GMP-AMP (cGAS)-STING pathway. We examined skeletal muscle L1 markers as well as STING protein levels in 10 older individuals (63 ± 11 y, BMI = 30.2 ± 6.8 kg/m2) with end-stage osteoarthritis (OA) undergoing total hip (THA, n = 4) or knee (TKA, n = 6) arthroplasty versus 10 young, healthy comparators (Y, 22 ± 2 y, BMI = 23.2 ± 2.5 kg/m2). For OA, muscle was collected from surgical (SX) and contralateral (CTL) sides whereas single vastus lateralis samples were collected from Y. Results L1 mRNA was higher in CTL and SX compared to Y (p < 0.001 and p = 0.001, respectively). Protein expression was higher in SX versus Y for ORF1p (p = 0.002) and STING (p = 0.022). While these data are preliminary due to limited n-sizes and the lack of a BMI-matched younger control group, higher L1 mRNA expression, ORF1p and STING protein are evident in older versus younger adults. More research is needed to determine whether cGAS-STING signaling contributes to heightened muscle inflammation during aging and/or OA. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-022-06113-0.
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Affiliation(s)
- Shelby C Osburn
- School of Kinesiology, Auburn University, 301 Wire Road, Office 260, Auburn, AL, 36849, USA
| | - Matthew A Romero
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, CA, USA
| | - Paul A Roberson
- Department of Cellular and Molecular Physiology, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Petey W Mumford
- School of Health Sciences, Lindenwood University, Saint Charles, MO, USA
| | - Derek A Wiggins
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, USA.,UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeremy S McAdam
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, USA.,UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Devin J Drummer
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, USA.,UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - S Louis Bridges
- Department of Medicine, Hospital for Special Surgery, New York, NY, USA.,Division of Rheumatology, Weill Cornell Medical Center, New York, NY, USA
| | - Marcas M Bamman
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, USA.,UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.,Florida Institute for Human and Machine Cognition, Pensacola, FL, USA
| | - Michael D Roberts
- School of Kinesiology, Auburn University, 301 Wire Road, Office 260, Auburn, AL, 36849, USA.
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35
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Alvarez AM, Alvarez-Flores MP, DeOcesano-Pereira C, Goldfeder MB, Chudzinski-Tavassi AM, Moreira V, Teixeira C. Losac and Lopap Recombinant Proteins from Lonomia obliqua Bristles Positively Modulate the Myoblast Proliferation Process. Front Mol Biosci 2022; 9:904737. [PMID: 35847970 PMCID: PMC9280836 DOI: 10.3389/fmolb.2022.904737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 06/09/2022] [Indexed: 11/18/2022] Open
Abstract
The pursuit of better therapies for disorders creating deficiencies in skeletal muscle regeneration is in progress, and several biotoxins are used in skeletal muscle research. Since recombinant proteins derived from Lonomia obliqua bristles, recombinant Lonomia obliqua Stuart-factor activator (rLosac) and recombinant Lonomia obliqua prothrombin activator protease (rLopap) act as cytoprotective agents and promote cell survival, we hypothesize that both rLosac and rLopap favour the skeletal muscle regeneration process. In the present work, we investigate the ability of these recombinant proteins rLosac and rLopap to modulate the production of key mediators of the myogenic process. The expression of myogenic regulatory factors (MRFs), cell proliferation, the production of prostaglandin E2 (PGE2) and the protein expression of cyclooxygenases COX-1 and COX-2 were evaluated in C2C12 mouse myoblasts pre-treated with rLosac and rLopap. We found an increased proliferation of myoblasts, stimulated by both recombinant proteins. Moreover, these proteins modulated PGE2 release and MRFs activities. We also found an increased expression of the EP4 receptor in the proliferative phase of C2C12 cells, suggesting the involvement of this receptor in the effects of PGE2 in these cells. Moreover, the recombinant proteins inhibited the release of IL-6 and PGE2, which is induced by an inflammatory stimulus by IL-1β. This work reveals rLopap and rLosac as promising proteins to modulate processes involving tissue regeneration as occurs during skeletal muscle injury.
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Affiliation(s)
- Angela María Alvarez
- Centre of Excellence in New Target Discovery -CENTD-, Butantan Institute, São Paulo, Brazil
- Pharmacology Department, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | - Mauricio Barbugiani Goldfeder
- Centre of Excellence in New Target Discovery -CENTD-, Butantan Institute, São Paulo, Brazil
- Innovation and Development Labororatory, Butantan Institute, São Paulo, Brazil
| | - Ana Marisa Chudzinski-Tavassi
- Centre of Excellence in New Target Discovery -CENTD-, Butantan Institute, São Paulo, Brazil
- Innovation and Development Labororatory, Butantan Institute, São Paulo, Brazil
| | - Vanessa Moreira
- Centre of Excellence in New Target Discovery -CENTD-, Butantan Institute, São Paulo, Brazil
- Pharmacology Department, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
- *Correspondence: Vanessa Moreira, ; Catarina Teixeira,
| | - Catarina Teixeira
- Centre of Excellence in New Target Discovery -CENTD-, Butantan Institute, São Paulo, Brazil
- Pharmacology Laboratory, Butantan Institute, São Paulo, Brazil
- *Correspondence: Vanessa Moreira, ; Catarina Teixeira,
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36
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Chakravarthy K, Lee D, Tram J, Sheth S, Heros R, Manion S, Patel V, Kiesel K, Ghandour Y, Gilligan C. Restorative Neurostimulation: A Clinical Guide for Therapy Adoption. J Pain Res 2022; 15:1759-1774. [PMID: 35756364 PMCID: PMC9231548 DOI: 10.2147/jpr.s364081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/26/2022] [Indexed: 11/23/2022] Open
Abstract
In this review, we present a comprehensive clinical approach to restorative neurostimulation, a novel form of stimulation for refractory chronic mechanical low back pain, targeting impaired neuromuscular control and degeneration of the multifidus muscle. We focus on patient identification, technique guidance, and review of the scientific background and clinical evidence. As our understanding of back pain grows, there is clear evidence that impaired neuromuscular control and consequent degeneration of the multifidus muscle contribute to mechanical low back pain development and maintenance. We provide clinical guidance regarding an implantable restorative neurostimulation system that targets impaired neuromuscular control. Supported by results from a randomized, active-sham-controlled clinical trial with long-term follow-up, we provide clinicians with a comprehensive overview and practical clinical guidance for the adoption of this therapy modality.
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Affiliation(s)
- Krishnan Chakravarthy
- Department of Anesthesiology and Pain Medicine, University of California San Diego Health Sciences, San Diego, CA, USA.,VA San Diego Healthcare System, San Diego, CA, USA
| | - David Lee
- Fullerton Orthopedic Surgery Medical Group, Fullerton, CA, USA
| | - Jennifer Tram
- Department of Anesthesiology and Pain Medicine, University of California San Diego Health Sciences, San Diego, CA, USA
| | | | | | - Smith Manion
- Advent Health Pain Specialists, Merriam, KS, USA
| | - Vikas Patel
- Department of Orthopedic Surgery, University of Colorado, Denver, CO, USA
| | - Kyle Kiesel
- Department of Physical Therapy, University of Evansville, Evansville, IN, USA
| | - Yousef Ghandour
- Physical Rehabilitation Network (PRN), University of St. Augustine, San Diego, CA, USA
| | - Christopher Gilligan
- Division of Pain Medicine, Brigham & Women's Hospital/Harvard Medical School, Boston, MA, USA
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37
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Moznuzzaman M, Khan TI, Neher B, Teramoto K, Ide S. Ageing effect of lower limb muscle activity for correlating healthy and osteoarthritic knees by surface electromyogram analysis. SENSING AND BIO-SENSING RESEARCH 2022. [DOI: 10.1016/j.sbsr.2022.100488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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38
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Identifying Novel Osteoarthritis-Associated Genes in Human Cartilage Using a Systematic Meta-Analysis and a Multi-Source Integrated Network. Int J Mol Sci 2022; 23:ijms23084395. [PMID: 35457215 PMCID: PMC9030814 DOI: 10.3390/ijms23084395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 11/16/2022] Open
Abstract
Osteoarthritis, the most common joint disorder, is characterised by deterioration of the articular cartilage. Many studies have identified potential therapeutic targets, yet no effective treatment has been determined. The aim of this study was to identify and rank osteoarthritis-associated genes and micro-RNAs to prioritise those most integral to the disease. A systematic meta-analysis of differentially expressed mRNA and micro-RNAs in human osteoarthritic cartilage was conducted. Ingenuity pathway analysis identified cellular senescence as an enriched pathway, confirmed by a significant overlap (p < 0.01) with cellular senescence drivers (CellAge Database). A co-expression network was built using genes from the meta-analysis as seed nodes and combined with micro-RNA targets and SNP datasets to construct a multi-source information network. This accumulated and connected 1689 genes which were ranked based on node and edge aggregated scores. These bioinformatic analyses were confirmed at the protein level by mass spectrometry of the different zones of human osteoarthritic cartilage (superficial, middle, and deep) compared to normal controls. This analysis, and subsequent experimental confirmation, revealed five novel osteoarthritis-associated proteins (PPIB, ASS1, LHDB, TPI1, and ARPC4-TTLL3). Focusing future studies on these novel targets may lead to new therapies for osteoarthritis.
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Drummer DJ, McAdam JS, Seay R, Aban I, Lavin KM, Wiggins D, Touliatos G, Yang S, Kelley C, Tuggle SC, Peoples B, Siegel H, Ghanem E, Singh JA, Schutzler S, Barnes CL, Ferrando AA, Bridges SL, Bamman MM. Perioperative assessment of muscle inflammation susceptibility in patients with end-stage osteoarthritis. J Appl Physiol (1985) 2022; 132:984-994. [PMID: 35238652 PMCID: PMC8993516 DOI: 10.1152/japplphysiol.00428.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 02/22/2022] [Accepted: 02/28/2022] [Indexed: 11/22/2022] Open
Abstract
Many individuals with end-stage osteoarthritis (OA) undergo elective total hip/knee arthroplasty (THA/TKA) to relieve pain, improve mobility and quality of life. However, ∼30% suffer long-term mobility impairment following surgery. This may be in part due to muscle inflammation susceptibility (MuIS+), an overt proinflammatory pathology localized to skeletal muscle surrounding the diseased joint, present in some patients with TKA/THA. We interrogated the hypothesis that MuIS+ status results in a perturbed perioperative gene expression profile and decreases skeletal muscle integrity in patients with end-stage OA. Samples were leveraged from the two-site, randomized, controlled trial R01HD084124, NCT02628795. Participants were dichotomized based on surgical (SX) muscle gene expression of TNFRSF1A (TNF-αR). MuIS+/- samples were probed for gene expression and fibrosis. Paired and independent two-tailed t tests were used to determine differences between contralateral (CTRL) and surgical (SX) limbs and between-subject comparisons, respectively. Significance was declared at P < 0.05. Seventy participants (26M/44F; mean age 62.41 ± 8.86 yr; mean body mass index 31.10 ± 4.91 kg/m2) undergoing THA/TKA were clustered as MuIS+ (n = 24) or MuIS- (n = 46). Lower skeletal muscle integrity (greater fibrosis) exists on the SX versus CTRL limb (P < 0.001). Furthermore, MuIS+ versus MuIS- muscle exhibited higher proinflammatory (IL-6R and TNF-α) and catabolic (TRIM63) gene expression (P < 0.001, P = 0.004, and 0.024 respectively), with a trend for greater fibrosis (P = 0.087). Patients with MuIS+ exhibit more inflammation and catabolic gene expression in skeletal muscle of the SX limb, accompanied by decreased skeletal muscle integrity (Trend). This highlights the impact of MuIS+ status emphasizing the potential value of perioperative MuIS assessment to inform optimal postsurgical care.NEW & NOTEWORTHY This study assessed the skeletal muscle molecular characteristics associated with end-stage osteoarthritis and refined an important phenotype, in some patients, termed muscle inflammation susceptibility (MuIS+) that may be an important consideration following surgery. Furthermore, we provide evidence of differential inflammatory and catabolic gene expression between the contralateral and surgical limbs along with differences between the skeletal muscle surrounding the diseased hip versus knee joints.
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Affiliation(s)
- Devin J Drummer
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jeremy S McAdam
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
- Florida Institute for Human and Machine Cognition, Pensacola, Florida
| | - Regina Seay
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Inmaculada Aban
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Kaleen M Lavin
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
- Florida Institute for Human and Machine Cognition, Pensacola, Florida
| | - Derek Wiggins
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Gabriel Touliatos
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Sufen Yang
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Christian Kelley
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
| | - S Craig Tuggle
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
- Florida Institute for Human and Machine Cognition, Pensacola, Florida
| | - Brandon Peoples
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Herrick Siegel
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Elie Ghanem
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jasvinder A Singh
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Birmingham Veterans Affairs Medical Center, Birmingham, Alabama
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Comprehensive Arthritis, Musculoskeletal, Bone, and Autoimmunity Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Scott Schutzler
- Department of Geriatrics and Center for Translational Research in Aging and Longevity, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - C Lowry Barnes
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Arny A Ferrando
- Department of Geriatrics and Center for Translational Research in Aging and Longevity, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - S Louis Bridges
- Department of Medicine, Hospital for Special Surgery, New York, New York
- Division of Rheumatology, Weill Cornell Medical Center, New York, New York
| | - Marcas M Bamman
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
- Florida Institute for Human and Machine Cognition, Pensacola, Florida
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Stătescu C, Stoica D, Georgescu CV, Gavrilă BI, Popescu MN, Trăistaru MR, Căluianu EI, Bălşeanu TA, Bălşeanu TA. Osteoarthritis induces gender-related changes in the knee range of motion. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2022; 63:449-457. [PMID: 36374150 PMCID: PMC9801674 DOI: 10.47162/rjme.63.2.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In time, osteoarthritis (OA) generates the misalignment of the affected joint structures. However, due to the nature of bipedal gait, OA in the lower limb can also cause pathological gait patterns, which can generate instability and falls, with great consequence, especially in the aged population. With goniometry used to evaluate the range of motion (ROM) of joints, we wanted to evaluate how gender impacts gait dynamics in OA patients. For this study, we have compared 106 OA patients (74 females and 32 males) to age matched controls. All participants had their right leg as dominant. Video recording of normal gait was analyzed with a digital goniometry tool phone application, and the knee's ROM was measured in midstance and midswing moment of the gait. During midstance, significant extension and flexion of the knee excursion have been observed in both males and females. During midswing, knee OA presents more differences, whereas subjects with hip and knee OA present changes on the dominant knee. Midstance changes suggest that the knee's joint degenerative changes, such as synovitis, can be linked to hip OA secondary changes. Midswing changes in lower limb OA suggest a connection to the activities of daily life. Gender differences generated by OA must furthermore be studied in both lower limbs so that the best therapeutic approach can be chosen.
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Affiliation(s)
- Carmen Stătescu
- Department of Theory and Methodology of Motor Activities, Faculty of Physical Education and Sport, University of Craiova, Romania; ; Department of Nursing Surgery, University of Medicine and Pharmacy of Craiova, Romania;
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The Validity and Reliability of Two Commercially Available Load Sensors for Clinical Strength Assessment. SENSORS 2021; 21:s21248399. [PMID: 34960492 PMCID: PMC8703969 DOI: 10.3390/s21248399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/24/2021] [Accepted: 12/14/2021] [Indexed: 12/03/2022]
Abstract
Objective: Handheld dynamometers are common tools for assessing/monitoring muscular strength and endurance. Health/fitness Bluetooth load sensors may provide a cost-effective alternative; however, research is needed to evaluate the validity and reliability of such devices. This study assessed the validity and reliability of two commercially available Bluetooth load sensors (Activ5 by Activbody and Progressor by Tindeq). Methods: Four tests were conducted on each device: stepped loading, stress relaxation, simulated exercise, and hysteresis. Each test type was repeated three times using the Instron ElectroPuls mechanical testing device (a gold-standard system). Test–retest reliability was assessed through intraclass correlations. Agreement with the gold standard was assessed with Pearson’s correlation, interclass correlation, and Lin’s concordance correlation. Results: The Activ5 and Progressor had excellent test–retest reliability across all four tests (ICC(3,1) ≥ 0.999, all p ≤ 0.001). Agreement with the gold standard was excellent for both the Activ5 (ρ ≥ 0.998, ICC(3,1) ≥ 0.971, ρc ≥ 0.971, all p’s ≤ 0.001) and Progressor (ρ ≥ 0.999, ICC(3,1) ≥ 0.999, ρc ≥ 0.999, all p’s ≤ 0.001). Measurement error increased for both devices as applied load increased. Conclusion: Excellent test–retest reliability was found, suggesting that both devices can be used in a clinical setting to measure patient progress over time; however, the Activ5 consistently had poorer agreement with the gold standard (particularly at higher loads).
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Veronese N, Stefanac S, Koyanagi A, Al-Daghri NM, Sabico S, Cooper C, Rizzoli R, Reginster JY, Barbagallo M, Dominguez LJ, Smith L, Maggi S. Lower Limb Muscle Strength and Muscle Mass Are Associated With Incident Symptomatic Knee Osteoarthritis: A Longitudinal Cohort Study. Front Endocrinol (Lausanne) 2021; 12:804560. [PMID: 34975772 PMCID: PMC8716541 DOI: 10.3389/fendo.2021.804560] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 11/26/2021] [Indexed: 11/25/2022] Open
Abstract
Recent literature suggests that sarcopenia, often represented by low lower limbs muscle mass and strength, can be considered a potential risk factor for knee osteoarthritis (OA), but the available literature is still limited. We therefore aimed to investigate whether sarcopenia is associated with a higher risk of radiographic (ROA) and symptomatic knee OA (SxOA) in a large cohort of North American people in the context of the OA initiative. Sarcopenia at baseline was diagnosed in case of low skeletal muscle mass (i.e., lower skeletal mass index) and poor performance in the chair stands test. The outcomes of interest for this study included ROA (radiographical osteoarthritis) if a knee developed a Kellgren and Lawrence (KL) grade ≥2 at follow-up, and SxOA (symptomatic osteoarthritis) defined as new onset of a combination of painful knee OA. Altogether, 2,492 older participants (mean age: 68.4 years, 61.4% females) were included. At baseline, sarcopenia was present in 6.1% of the population. No significant difference in ROA prevalence was observed between those with and without sarcopenia (p=0.76), whilst people with sarcopenia reported a significant higher prevalence of SxOA (p<0.0001). Using a logistic regression analysis, adjusting for potential confounders at baseline and the diagnosis of sarcopenia during follow-up, sarcopenia was associated with a higher incidence of knee SxOA (odds ratio, OR=2.29; 95%CI [confidence interval]: 1.42-3.71; p=0.001), but not knee ROA (OR=1.48; 95%CI: 0.53-4.10; p=0.45). In conclusion, sarcopenia could be associated with a higher risk of negative knee OA outcomes, in particular symptomatic forms.
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Affiliation(s)
- Nicola Veronese
- Department of Internal Medicine, Geriatric Section, University of Palermo, Palermo, Italy
- Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Sinisa Stefanac
- Institute of Outcomes Research, Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Nasser M. Al-Daghri
- Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Shaun Sabico
- Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Cyrus Cooper
- Oxford National Institute for Health Research (NIHR) Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Oxford, United Kingdom
- Medical Research Council (MRC) Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, United Kingdom
- National Institute for Health Research Nutrition Biomedical Research Centre, Southampton General Hospital, University of Southampton and University Hospital Southampton National Health System (NHS) Foundation Trust, Southampton, United Kingdom
| | - Renè Rizzoli
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Jean-Yves Reginster
- Department of Public Health, Epidemiology and Health Economics, CHU Sart Tilman B23, University of Liege, Liège, Belgium
| | - Mario Barbagallo
- Department of Internal Medicine, Geriatric Section, University of Palermo, Palermo, Italy
| | - Ligia J. Dominguez
- Department of Internal Medicine, Geriatric Section, University of Palermo, Palermo, Italy
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Department of Life Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Stefania Maggi
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
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Jones TL, Esa MS, Li KHC, Krishnan SRG, Elgallab GM, Pearce MS, Young DA, Birrell FN. Osteoporosis, fracture, osteoarthritis & sarcopenia: A systematic review of circulating microRNA association. Bone 2021; 152:116068. [PMID: 34166859 DOI: 10.1016/j.bone.2021.116068] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/16/2021] [Accepted: 06/15/2021] [Indexed: 12/18/2022]
Abstract
Circulating microRNAs (c-miRs) show promise as biomarkers. This systematic review explores their potential association with age-related fracture/osteoporosis (OP), osteoarthritis (OA) and sarcopenia (SP), as well as cross-disease association. Most overlap occurred between OA and OP, suggesting potentially shared microRNA activity. There was little agreement in results across studies. Few reported receiver operating characteristic analysis (ROC) and many identified significant dysregulation in disease, but direction of effect was commonly conflicting. c-miRs with most evidence for consistency in dysregulation included miR-146a, miR-155 and miR-98 for OA (upregulated). Area under the curve (AUC) for miR-146a biomarker performance was AUC 0.92, p = 0.028. miR-125b (AUC 0.76-0.89), miR-100, miR-148a and miR-24 were consistently upregulated in OP. Insufficient evidence exists for c-miRs in SP. Study quality was typically rated intermediate/high risk of bias. Wide study heterogeneity meant meta-analysis was not possible. We provide detailed critique and recommendations for future approaches in c-miR analyses based on this review.
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Affiliation(s)
- Tania L Jones
- Population Health Sciences Institute, Faculty of Medicine, Newcastle University, Sir James Spence Building, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, United Kingdom.
| | - Mohammed S Esa
- Population Health Sciences Institute, Faculty of Medicine, Newcastle University, Sir James Spence Building, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, United Kingdom.
| | - K H Christien Li
- Medical Research Council Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
| | - S R Gokul Krishnan
- Biosciences Institute, Newcastle University, Newcastle upon Tyne NE1 3BZ, United Kingdom.
| | - George M Elgallab
- Faculty of Health Sciences and Wellbeing, Sciences Complex, City Campus, Chester Road, University of Sunderland, Sunderland SR1 3SD, United Kingdom
| | - Mark S Pearce
- Population Health Sciences Institute, Faculty of Medicine, Newcastle University, Sir James Spence Building, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, United Kingdom.
| | - David A Young
- Biosciences Institute, Newcastle University, Newcastle upon Tyne NE1 3BZ, United Kingdom.
| | - Fraser N Birrell
- Population Health Sciences Institute, Faculty of Medicine, Newcastle University, Sir James Spence Building, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, United Kingdom; Medical Research Council Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom.
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Kikuchi N, Yoshioka T, Arai N, Sugaya H, Hyodo K, Taniguchi Y, Okuno K, Kanamori A, Yamazaki M. A Retrospective Analysis of Clinical Outcome and Predictive Factors for Responders with Knee Osteoarthritis to a Single Injection of Leukocyte-Poor Platelet-Rich Plasma. J Clin Med 2021; 10:jcm10215121. [PMID: 34768641 PMCID: PMC8584297 DOI: 10.3390/jcm10215121] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/22/2021] [Accepted: 10/26/2021] [Indexed: 12/21/2022] Open
Abstract
Although various platelet-rich plasma (PRP) kits are commercially available, the efficacy of these kits for knee osteoarthritis (KOA) has not been fully investigated. This study aimed to investigate the short-term results of leukocyte-poor PRP (LP-PRP) and the factors that contribute to its efficacy. We retrospectively reviewed 124 patients with KOA who were treated with LP-PRP. White blood cell (WBC) and platelet counts in the whole blood and the LP-PRP were measured. KOA severity was assessed using radiography. Clinical evaluation was performed both prior to injection and after an average of 3.3 weeks after the injection using the Japanese Knee Osteoarthritis Measure (JKOM). Responders were defined based on the JKOM. The contributing factors for responders were examined using a multivariate logistic analysis. The responder rate was 58.1% and the contributing factors for responders were a higher visual analog scale score before injection, WBC count in whole blood, and platelet concentration ratio of LP-PRP. The LP-PRP improved the clinical scores in the short term. Certain patient characteristics before injection and the concentration ratio of LP-PRP may be predictors of its efficacy; these may provide clues for elucidating which components of LP-PRP act on KOA pathologies.
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Affiliation(s)
- Naoya Kikuchi
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan; (N.K.); (N.A.); (K.H.); (K.O.); (A.K.); (M.Y.)
| | - Tomokazu Yoshioka
- Division of Regenerative Medicine for Musculoskeletal System, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan
- Correspondence:
| | - Norihito Arai
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan; (N.K.); (N.A.); (K.H.); (K.O.); (A.K.); (M.Y.)
| | - Hisashi Sugaya
- Department of Health, Faculty of Health Sciences, Tsukuba University of Technology, 4-3-15 Amakubo, Tsukuba 305-0005, Ibaraki, Japan;
| | - Kojiro Hyodo
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan; (N.K.); (N.A.); (K.H.); (K.O.); (A.K.); (M.Y.)
| | - Yu Taniguchi
- Department of Orthopaedic Surgery, Ichihara Hospital, 3681 Ozone, Tsukuba 300-3295, Ibaraki, Japan;
| | - Kosuke Okuno
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan; (N.K.); (N.A.); (K.H.); (K.O.); (A.K.); (M.Y.)
| | - Akihiro Kanamori
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan; (N.K.); (N.A.); (K.H.); (K.O.); (A.K.); (M.Y.)
| | - Masashi Yamazaki
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan; (N.K.); (N.A.); (K.H.); (K.O.); (A.K.); (M.Y.)
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Freo U, Ruocco C, Valerio A, Scagnol I, Nisoli E. Paracetamol: A Review of Guideline Recommendations. J Clin Med 2021; 10:jcm10153420. [PMID: 34362203 PMCID: PMC8347233 DOI: 10.3390/jcm10153420] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/11/2021] [Accepted: 07/28/2021] [Indexed: 02/06/2023] Open
Abstract
Musculoskeletal pain conditions are age-related, leading contributors to chronic pain and pain-related disability, which are expected to rise with the rapid global population aging. Current medical treatments provide only partial relief. Furthermore, non-steroidal anti-inflammatory drugs (NSAIDs) and opioids are effective in young and otherwise healthy individuals but are often contraindicated in elderly and frail patients. As a result of its favorable safety and tolerability record, paracetamol has long been the most common drug for treating pain. Strikingly, recent reports questioned its therapeutic value and safety. This review aims to present guideline recommendations. Paracetamol has been assessed in different conditions and demonstrated therapeutic efficacy on both acute and chronic pain. It is active as a single agent and is additive or synergistic with NSAIDs and opioids, improving their efficacy and safety. However, a lack of significant efficacy and hepatic toxicity have also been reported. Fast dissolving formulations of paracetamol provide superior and more extended pain relief that is similar to intravenous paracetamol. A dose reduction is recommended in patients with liver disease or malnourished. Genotyping may improve efficacy and safety. Within the current trend toward the minimization of opioid analgesia, it is consistently included in multimodal, non-opioid, or opioid-sparing therapies. Paracetamol is being recommended by guidelines as a first or second-line drug for acute pain and chronic pain, especially for patients with limited therapeutic options and for the elderly.
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Affiliation(s)
- Ulderico Freo
- Anesthesiology and Intensive Care, Department of Medicine—DIMED, University of Padua, 35122 Padua, Italy;
- Correspondence: ; Tel.: +39-049-821-3090
| | - Chiara Ruocco
- Center for the Study and Research on Obesity, Department of Biomedical Technology and Translational Medicine, University of Milan, 20129 Milan, Italy; (C.R.); (E.N.)
| | - Alessandra Valerio
- Department of Molecular and Translational Medicine, University of Brescia, 25100 Brescia, Italy;
| | - Irene Scagnol
- Anesthesiology and Intensive Care, Department of Medicine—DIMED, University of Padua, 35122 Padua, Italy;
| | - Enzo Nisoli
- Center for the Study and Research on Obesity, Department of Biomedical Technology and Translational Medicine, University of Milan, 20129 Milan, Italy; (C.R.); (E.N.)
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Systematic Review Shows Tele-Rehabilitation Might Achieve Comparable Results to Office-Based Rehabilitation for Decreasing Pain in Patients with Knee Osteoarthritis. ACTA ACUST UNITED AC 2021; 57:medicina57080764. [PMID: 34440970 PMCID: PMC8398992 DOI: 10.3390/medicina57080764] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/16/2021] [Accepted: 07/26/2021] [Indexed: 12/31/2022]
Abstract
Background and Objectives This systematic review aims to evaluate the efficacy of Tele-Rehabilitation for decreasing pain in patients with knee osteoarthritis (OA). Materials and Methods: Following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), three electronic databases (CINAHL, PubMed, PEDro), along with the addition of grey literature, were used to collect information. Randomized control trials (RCTs) comparing tele-rehabilitation (TR) to office-based-rehabilitation (OB) were critically appraised using the 2005 University of Oxford Standard. A total of 139 articles (PubMed = 132, CINAHL = 5, PEDro = 0, grey literature = 2) were acquired. Results: After the screening, three RCTs were included in our review. Their results show no statistically significant differences between TR and OB intervention. Furthermore, their results showed an overall reduction in pain in both groups from the baseline to the end of the study. However, each intervention's clinical efficiency was dependent on the exercise protocol itself and not on the method of delivery. There is a potential ceiling effect to the amount of therapy a patient can receive in which additional therapy would no longer lead to improved recovery. Conclusions: Our review suggests evidence that TR's efficacy is similar to that of OB for improvement of WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) score parameters in patients suffering from knee OA.
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Scott D, Blyth F, Naganathan V, Le Couteur DG, Handelsman DJ, Seibel MJ, Waite LM, Hirani V. Prospective associations of chronic and intrusive pain with sarcopenia and physical disability amongst older Australian men: The Concord Health and Ageing in Men Project. Exp Gerontol 2021; 153:111501. [PMID: 34314842 DOI: 10.1016/j.exger.2021.111501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/16/2021] [Accepted: 07/21/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Associations of chronic and intrusive pain with sarcopenia and disability in older men are unclear. METHODS 1452 community-dwelling men aged ≥70 years self-reported chronic pain (pain every day for ≥3 months) and intrusive pain (pain interfering with normal activities in the last 4 weeks) at baseline and five years later, and were classified as having no, prevalent (baseline only), incident (follow-up only) or persistent (both baseline and follow-up) pain. Appendicular lean mass (ALM), hand grip strength and gait speed were assessed. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People (EWGSOP2) and Sarcopenia Diagnosis and Outcomes Consortium (SDOC) definitions. Activity of daily living (ADL) and instrumental activity of daily living (IADL) impairment were assessed by questionnaires. RESULTS Approximately 11% of men reported both chronic and intrusive pain. Gait speed, but not ALM or hand grip strength, significantly mediated the relationship of chronic pain and intrusive pain with ADL and IADL disability by 12-57%. Over five years, incident (odds ratio: 1.84; 95% CI: 1.10-3.10) and persistent (3.02; 1.55-5.88) intrusive pain, and persistent chronic pain (2.29; 1.30-4.04), were associated with increased likelihood of incident sarcopenia (SDOC). Incident and persistent intrusive pain were associated with incident ADL (1.91; 1.04-3.52 and 3.78; 1.90-7.51, respectively) and IADL (2.98; 1.81-4.90 and 4.63; 2.22-9.65, respectively) impairment. CONCLUSIONS Older men with incident and persistent intrusive pain have increased risk for incident sarcopenia and disability over five years. The association of pain with disability appears to be mediated by gait speed.
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Affiliation(s)
- David Scott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia; School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
| | - Fiona Blyth
- School of Public Health, University of Sydney, New South Wales, Sydney, Australia; Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Sydney, Australia; The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Sydney, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Sydney, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Sydney, Australia; ANZAC Research Institute & Charles Perkins Centre, University of Sydney, New South Wales, Sydney, Australia
| | - David J Handelsman
- Department of Andrology, Concord Hospital & ANZAC Research Institute, University of Sydney, New South Wales, Sydney, Australia
| | - Markus J Seibel
- Bone Research Program, ANZAC Research Institute, Dept of Endocrinology & Metabolism, Concord Hospital, The University of Sydney, New South Wales, Sydney, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Sydney, Australia
| | - Vasant Hirani
- School of Public Health, University of Sydney, New South Wales, Sydney, Australia; The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Sydney, Australia
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48
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Effects of Protein-Rich Nutritional Composition Supplementation on Sarcopenia Indices and Physical Activity during Resistance Exercise Training in Older Women with Knee Osteoarthritis. Nutrients 2021; 13:nu13082487. [PMID: 34444645 PMCID: PMC8399515 DOI: 10.3390/nu13082487] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 12/31/2022] Open
Abstract
Older adults with knee osteoarthritis (KOA) are at high risk of sarcopenia. Protein-rich nutritional composition supplementation (PS) combined with resistance exercise training (RET) improves muscle gains and facilitates physical activity in older adults. However, whether PS augments the effects of RET on muscle mass and PA in patients with KOA remains unclear. Therefore, this study identified the effects of PS on sarcopenic indices and PA in older women with KOA subjected to an RET program. Eligible older women aged 60–85 years and diagnosed as having KOA were randomly assigned to either the experimental group (EG) or the control group (CG). Both groups performed RET twice a week for 12 weeks. The EG received additional PS during this period. Outcome measures included appendicular lean mass index, walking speed, physical activity, and scores on the Western Ontario and McMaster Universities Osteoarthritis Index—WOMAC). All measures were tested at baseline and after intervention. With participant characteristics and baseline scores as covariates, analysis of variance was performed to identify between-group differences in changes in all outcome measures after intervention. Statistical significance was defined as p < 0.05. Compared with the CG, the EG achieved greater changes in appendicular lean mass index (adjusted mean difference (aMD) = 0.19 kg/m2, p < 0.01), physical activity (aMD = 30.0 MET-hour/week, p < 0.001), walking speed (aMD = 0.09 m/s, p < 0.05), and WOMAC global function (aMD = −8.21, p < 0.001) after intervention. In conclusion, PS exerted augmentative effects on sarcopenic indices, physical activity, and perceived global WOMAC score in older women with KOA through 12 weeks of RET.
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Scarpelli MC, Bergamasco JGA, Arruda EADB, Cook SB, Libardi CA. Resistance Training With Partial Blood Flow Restriction in a 99-Year-Old Individual: A Case Report. Front Sports Act Living 2021; 3:671764. [PMID: 34240050 PMCID: PMC8257955 DOI: 10.3389/fspor.2021.671764] [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] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/27/2021] [Indexed: 12/25/2022] Open
Abstract
In aging populations for which the use of high loads is contraindicated, low load resistance training associated with blood flow restriction (RT-BFR) is an alternative strategy to induce muscle mass gains. This study investigates the effects of RT-BFR on muscle mass, muscle function, and quality of life of a 99-year-old patient with knee osteoarthritis and advanced muscle mass deterioration. Training protocol consisted of 24 sessions of a unilateral free-weight knee extension exercise associated with partial blood flow restriction through a manometer cuff set at 50% of complete vascular occlusion pressure. We evaluated: cross-sectional area (CSA) and thickness (MT) of the vastus lateralis muscle by ultrasound; function through the Timed Up and Go (TUG) test; and quality of life (QoL) by the WHOQOL-bref, WHOQOL-OLD and WOMAC questionnaires. All tests were performed prior to the training period (Pre) and after the 12th (Mid) and 24th (Post) sessions. Changes were considered significant if higher than 2 times the measurement's coefficient of variation (CV). After 24 sessions, there was an increase of 12% in CSA and 8% in MT. Questionnaires scores and TUG values worsened from Pre to Mid and returned in Post. We consider RT-BFR a viable and effective strategy to promote muscle mass gains in nonagenarians and delay the decline in functionality and QoL associated with aging.
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Affiliation(s)
- Maíra Camargo Scarpelli
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos, São Carlos, Brazil
| | - João Guilherme Almeida Bergamasco
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos, São Carlos, Brazil
| | - Estevan A de Barros Arruda
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos, São Carlos, Brazil
| | - Summer B Cook
- Department of Kinesiology, University of New Hampshire, Durham, NH, United States
| | - Cleiton Augusto Libardi
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos, São Carlos, Brazil
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50
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The Efficacy of Backward Walking on Static Stability, Proprioception, Pain, and Physical Function of Patients with Knee Osteoarthritis: A Randomized Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5574966. [PMID: 34221078 PMCID: PMC8213492 DOI: 10.1155/2021/5574966] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/27/2021] [Indexed: 12/17/2022]
Abstract
Objective Impaired static stability and proprioception have been observed in individuals with knee osteoarthritis (KOA), which serves as a major factor increasing risk of fall. This study aimed to investigate the effects of backward walking (BW) on static stability, proprioception, pain, and physical function in KOA patients. Methods Thirty-two subjects with knee osteoarthritis were randomly assigned to either an BW group (BG, n = 16) or a control group (CG, n = 16). The participants in the BG received combination treatment of a 4-week BW training and conventional treatments, while those in the CG was treated with conventional treatments alone. All the participants were tested for the assessment of static stability [center of pressure (COP) sway, including sway length (SL, mm) and sway area (SA, mm2)] and proprioception [average trajectory error (ATE, %) and completion time (CT, second)]. Additionally, pain and knee function scores were measured by the numerical rating scale (NRS) and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index, respectively. The assessments were conducted before and after intervention. Results The COP sway (SA and SL), ATE, NRS, and WOMAC showed a significant decline at week 4 in the two groups in contrast to their baseline (P < 0.05). Moreover, after 4-week intervention, the SA [(610.50 ± 464.26) mm2 vs. (538.69 ± 420.52) mm2], NRS [(1.56 ± 0.63) vs. (2.25 ± 0.86)], and WOMAC [(11.69 ± 2.50) vs. (16.19 ± 3.94)] showed a significantly greater decrease in the BG compared to the CG (P < 0.05, respectively). However, the proprioception (ATE and CT) was closely similar between both groups at week 4 (P > 0.05). Conclusion BW is an effective adjunct to conventional treatment in reducing pain, improving physical function and static stability for KOA patients. It should be taken into consideration when developing rehabilitation programs for people with KOA.
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