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Yu L, Luo R, Qin G, Zhang Q, Liang W. Efficacy and safety of anti-interleukin-1 therapeutics in the treatment of knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res 2023; 18:100. [PMID: 36782214 PMCID: PMC9923921 DOI: 10.1186/s13018-023-03590-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 02/07/2023] [Indexed: 02/15/2023] Open
Abstract
OBJECTIVE We aimed to evaluate the efficacy and safety of anti-interleukin-1 therapeutics, including IL-1 antibodies, interleukin-1 receptor antagonists (IL-1 Ras) and IL-1 inhibitors, for knee osteoarthritis (KOA) treatment. METHODS Databases (Medline, Embase, Web of Science and CENTRAL) and ClinicalTrials.gov were systematically searched for randomized controlled trials (RCTs) of anti-interleukin-1 therapeutics from inception to August 31, 2022. The outcomes were the mean change in pain and function scores and the risk of adverse effects (AEs). RESULTS In the 12 studies included, anti-interleukin-1 therapeutics were superior to placebo in terms of pain relief (standardized mean difference [SMD] = - 0.38, 95% confidence interval [CI] = - 1.82 to - 0.40, p < 0.001, I2 = 77%) and functional improvement (SMD = - 1.11, 95% CI = - 1.82 to - 0.40, p = 0.002, I2 = 96%). The incidence of any AE (risk ratio [RR] = 1.02, 95% CI = 0.88-1.18, p < 0.001, I2 = 76%) was higher following treatment with anti-interleukin-1 therapeutics than placebo, while no significant difference was found in the incidence of serious AEs (SAEs) or discontinuations due to AEs. Subgroup analyses showed that IL-1 antibodies and the IL-1 inhibitor provided pain relief (IL-1 antibodies: SMD = - 0.61, 95% CI = - 0.92 to - 0.31, p < 0.001; IL-1 inhibitor: SMD = - 0.39, 95% CI = - 0.72 to - 0.06, p = 0.02, I2 = 74.0%) and functional improvement (IL-1 antibodies: SMD = - 1.75, 95% CI = - 2.10 to - 1.40, p < 0.001; IL-1 inhibitor: SMD = - 0.28, 95% CI = - 0.83 to 0.27, p = 0.31, I2 = 88%) superior to those of placebo, whereas IL-1 Ras did not. However, the IL-1 inhibitor increased the incidence of any AE (RR = 1.35, 95% CI = 0.92-1.98, p < 0.001, I2 = 85%) but not the risk of SAEs or discontinuations due to AEs. IL-1 antibodies and IL-1 Ras showed no difference in safety compared with placebo. CONCLUSIONS Anti-interleukin-1 therapeutics could relieve OA-related pain and improve function, but is probably associated with an increased risk of adverse events. Specially, IL-1 antibodies and an IL-1 inhibitor could relieve OA-related pain and improve function, whereas IL-1 Ras could not. IL-1 antibodies and IL-1 Ras were relatively safe options, but IL-1 inhibitors were associated with safety concerns.
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Affiliation(s)
- Lizhi Yu
- grid.440719.f0000 0004 1800 187XThe First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi University of Science and Technology, 124 Yuejin Road, Liuzhou, 545001 Guangxi Province China
| | - Raoshan Luo
- grid.440719.f0000 0004 1800 187XThe First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi University of Science and Technology, 124 Yuejin Road, Liuzhou, 545001 Guangxi Province China
| | - Gang Qin
- grid.440719.f0000 0004 1800 187XThe First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi University of Science and Technology, 124 Yuejin Road, Liuzhou, 545001 Guangxi Province China
| | - Qinyan Zhang
- grid.440719.f0000 0004 1800 187XThe First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi University of Science and Technology, 124 Yuejin Road, Liuzhou, 545001 Guangxi Province China
| | - Weiming Liang
- The First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi University of Science and Technology, 124 Yuejin Road, Liuzhou, 545001, Guangxi Province, China.
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Cunningham R, Gruen ME, Thomson A, Lascelles BDX. Evaluation of a nutritional supplement for the alleviation of pain associated with feline degenerative joint disease: a prospective, randomized, stratified, double-blind, placebo-controlled clinical trial. J Feline Med Surg 2022; 24:962-974. [PMID: 34719996 PMCID: PMC10812307 DOI: 10.1177/1098612x211053484] [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] [Accepted: 09/22/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the pain-alleviating and activity-enhancing effects of glucosamine/chondroitin sulfate (Dasuquin) in cats that had degenerative joint disease (DJD) and owner-noted mobility/activity impairment. We hypothesized that the nutritional supplement would produce pain-relieving and activity-enhancing effects in cats with painful DJD. METHODS In this prospective, randomized, stratified, double-blind, placebo-controlled clinical trial, 59 cats with DJD pain were assigned to receive a placebo (n = 30) or supplement (n = 29) for 6 weeks after 2 weeks of placebo. Outcome measures (at-home accelerometry and client-specific outcome measures [feline (CSOMf); Feline Musculoskeletal Pain Index (FMPI); quality of life (QoL)]; and veterinarian examination) were collected at days 14, 28, 42 and 56. RESULTS Twenty-seven cats in the treatment group and 30 in the placebo group completed the trial. Within the first 2 weeks (placebo administration to all cats), 78% of all cats had an improvement in CSOMf scores. Both groups showed significant improvement at most time points in CSOMf, FMPI, QoL and pain scores, with the placebo group showing greater improvement than the supplement group (significant for CSOMf [P = 0.01]). Overall, no differences in activity were seen between the groups. Cumulative distribution function analysis indicated that for most levels of activity, the placebo-treated cats were more active; however, the least active cats were more active on the supplement (P = 0.013). CONCLUSIONS AND RELEVANCE This study showed a strong placebo effect. The glucosamine/chondroitin sulfate supplement did not show pain-relieving effects when compared with placebo.
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Affiliation(s)
- Rachael Cunningham
- Comparative Behavioral Research, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Translational Research in Pain (TRiP) Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Margaret E Gruen
- Comparative Behavioral Research, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Comparative Pain Research and Education Center, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Andrea Thomson
- Comparative Behavioral Research, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Translational Research in Pain (TRiP) Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - B Duncan X Lascelles
- Translational Research in Pain (TRiP) Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Center for Translational Pain Research, Department of Anesthesiology, Duke University, NC, USA
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Gwinnutt JM, Wieczorek M, Rodríguez-Carrio J, Balanescu A, Bischoff-Ferrari HA, Boonen A, Cavalli G, de Souza S, de Thurah A, Dorner TE, Moe RH, Putrik P, Silva-Fernández L, Stamm T, Walker-Bone K, Welling J, Zlatković-Švenda M, Guillemin F, Verstappen SMM. Effects of diet on the outcomes of rheumatic and musculoskeletal diseases (RMDs): systematic review and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs. RMD Open 2022; 8:rmdopen-2021-002167. [PMID: 35654458 PMCID: PMC9096533 DOI: 10.1136/rmdopen-2021-002167] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 04/01/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND A EULAR taskforce was convened to develop recommendations for lifestyle behaviours in rheumatic and musculoskeletal diseases (RMDs). In this paper, the literature on the effect of diet on the progression of RMDs is reviewed. METHODS Systematic reviews and meta-analyses were performed of studies related to diet and disease outcomes in seven RMDs: osteoarthritis (OA), rheumatoid arthritis (RA), systemic lupus erythematosus, axial spondyloarthritis, psoriatic arthritis, systemic sclerosis and gout. In the first phase, existing relevant systematic reviews and meta-analyses, published from 2013 to 2018, were identified. In the second phase, the review was expanded to include published original studies on diet in RMDs, with no restriction on publication date. Systematic reviews or original studies were included if they assessed a dietary exposure in one of the above RMDs, and reported results regarding progression of disease (eg, pain, function, joint damage). RESULTS In total, 24 systematic reviews and 150 original articles were included. Many dietary exposures have been studied (n=83), although the majority of studies addressed people with OA and RA. Most dietary exposures were assessed by relatively few studies. Exposures that have been assessed by multiple, well conducted studies (eg, OA: vitamin D, chondroitin, glucosamine; RA: omega-3) were classified as moderate evidence of small effects on disease progression. CONCLUSION The current literature suggests that there is moderate evidence for a small benefit for certain dietary components. High-level evidence of clinically meaningful effect sizes from individual dietary exposures on outcomes in RMDs is missing.
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Affiliation(s)
- James M Gwinnutt
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Maud Wieczorek
- EA 4360 Apemac, Université de Lorraine, Nancy, France,Center on Aging and Mobility, University of Zurich, Zurich, Switzerland
| | - Javier Rodríguez-Carrio
- Area of Immunology, Department of Functional Biology, Universidad de Oviedo, Oviedo, Spain,Department of Metabolism, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Andra Balanescu
- Department of Internal Medicine and Rheumatology, ‘Sf Maria’ Hospital, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest, Romania
| | - Heike A Bischoff-Ferrari
- Center on Aging and Mobility, University of Zurich, Zurich, Switzerland,Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland,University Clinic for Aging Medicine, City Hospital Zurich - Waid, Zurich, Switzerland
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Giulio Cavalli
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Savia de Souza
- Centre for Rheumatic Diseases, King's College London, London, UK
| | - Annette de Thurah
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark,Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas E Dorner
- Centre for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria,Social Insurance Fund for Public Service, Railway and Mining Industries, Sitzenberg-Reidling, Austria,Karl-Landsteiner Institute for Health Promotion Research, Sitzenberg-Reidling, Austria
| | - Rikke Helene Moe
- National Advisory Unit for Rehabilitation in Rheumatology, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Polina Putrik
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Lucía Silva-Fernández
- Rheumatology Department, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Tanja Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Karen Walker-Bone
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Joep Welling
- NVLE Dutch Patient Organization for Systemic Autoimmune Diseases, Utrecht, The Netherlands
| | - Mirjana Zlatković-Švenda
- Institute of Rheumatology, University of Belgrade School of Medicine, Belgrade, Serbia,Department of Internal Medicine, University of East Sarajevo Faculty of Medicine Foča, Republika Srpska, Bosnia and Herzegovina
| | - Francis Guillemin
- EA 4360 Apemac, Université de Lorraine, Nancy, France,Inserm, CHRU Nancy, CIC-1433 Epidémiologie Clinique, Université de Lorraine, Nancy, France
| | - Suzanne M M Verstappen
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK .,MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Min GY, Park JM, Joo IH, Kim DH. Inhibition effect of Caragana sinica root extracts on Osteoarthritis through MAPKs, NF-κB signaling pathway. Int J Med Sci 2021; 18:861-872. [PMID: 33456343 PMCID: PMC7807197 DOI: 10.7150/ijms.52330] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/30/2020] [Indexed: 02/07/2023] Open
Abstract
Osteoarthritis (OA) is a common joint disease characterized by degradation and inflammation of cartilage extracellular matrix. We aimed to evaluate the protective effect of Caragana sinica root (CSR) on interleukin (IL)-1β-stimulated rat chondrocytes and a monosodium iodoacetate (MIA)-induced model of OA. In vitro, cell viability of CSR-treated chondrocytes was measured by MTT assay. The mRNA expression of Matrix metallopeptidases (MMPs), a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTSs) and extracellular matrix (ECM) were analyzed by quantitative real-time PCR (qRT-PCR). Moreover, the protein expression of MAPK (phosphorylation of EKR, JNK, p38), inhibitory kappa B (IκBα) and nuclear factor-kappa B (NF-κB p65) was detected by western blot analysis. In vivo, the production of nitric oxide (NO) was detected by Griess reagent, while those of inflammatory mediators, MMPs and ECM were detected by ELISA. The degree of OA was evaluated by histopathological analyses, Osteoarthritis Research Society International (OARSI) score and micro-CT analysis. CSR significantly inhibited the expression of MMPs, ADAMTSs and the degradation of ECM in IL-1β-stimulated chondrocytes. Furthermore, CSR significantly suppressed IL-1β-stimulated of MAPKs, NF-κB signaling pathway. In vivo, CSR and Indomethacin inhibited the production of inflammatory mediators, MMPs and degradation of ECM in MIA-induced model of OA. In addition, CSR improved the severity of OA. Taken together, these results suggest CSR is a potential therapeutic active agent in the treatment of OA.
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Affiliation(s)
- Ga-Yul Min
- Department of Pathology, College of Oriental Medicine, Daejeon University, Daejeon 34520, Republic of Korea
| | - Jong-Min Park
- Department of Pathology, College of Oriental Medicine, Daejeon University, Daejeon 34520, Republic of Korea
| | - In-Hwan Joo
- Department of Pathology, College of Oriental Medicine, Daejeon University, Daejeon 34520, Republic of Korea
| | - Dong-Hee Kim
- Department of Pathology, College of Oriental Medicine, Daejeon University, Daejeon 34520, Republic of Korea
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5
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Parker DA, Scholes C, Neri T. Non-operative treatment options for knee osteoarthritis: current concepts. J ISAKOS 2018. [DOI: 10.1136/jisakos-2016-000094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Abstract
Osteoarthritis has one of the highest associations for all-cause mortality in the United States. Comorbidities are common in patients with end-stage disease. In most cases, it is critical to exhaust conservative modalities of care before resorting to surgical intervention. This article discusses common conservative approaches focusing on injectable treatments that can be employed prior to total knee replacement. [Orthopedics. 2018; 41(5):256-260.].
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Lee SA, Moon SM, Han SH, Hwang EJ, Park BR, Kim JS, Kim DK, Kim CS. Chondroprotective effects of aqueous extract of Anthriscus sylvestris leaves on osteoarthritis in vitro and in vivo through MAPKs and NF-κB signaling inhibition. Biomed Pharmacother 2018; 103:1202-1211. [PMID: 29864899 DOI: 10.1016/j.biopha.2018.04.183] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 04/24/2018] [Accepted: 04/24/2018] [Indexed: 12/21/2022] Open
Abstract
Osteoarthritis (OA) is a common degenerative joint disease, characterized by cartilage degradation and inflammation, in the elderly population. Anthriscus sylvestris has been used in Korean traditional medicine and contains many polyphenolic compounds such as cynaroside and chlorogenic acid, which are major active components responsible for its antioxidant effect. In this study, we aimed to evaluate the chondroprotective effect of an aqueous extract of A. sylvestris leaves (AE-ASL) on OA, both in vitro and in vivo. Rat primary chondrocytes were pretreated with AE-ASL for 1 h before interleukin-1β (20 ng/mL) stimulation. The production of nitrite, PGE2, aggrecan, and collagen type II were detected by Griess reagent and ELISAs. The mRNA levels of iNOS, COX-2, MMP-3, and MMP-13 were measured by RT-PCR. In addition, protein levels of iNOS, COX-2, MMP-3, MMP-13, ADAMTS-4, MAPKs, and NF-κB p65 subunit were measured by western blot analysis. Sulfated glycosaminoglycan (sGAGs) were detected by dimethylmethylene blue (DMMB) assay. During in vivo study, the effects of AE-ASL were evaluated for 8 weeks in a rat model of destabilization of the medial meniscus (DMM) surgery-induced OA. AE-ASL significantly inhibited expression of nitrite, iNOS, PGE2, COX-2, MMP-3, MMP-13, and ADAMTS-4 in IL-1β-stimulated chondrocytes. Moreover, it decreased the IL-1β-induced degradation of aggrecan, collagen type II, and proteoglycan. In addition, AE-ASL suppressed IL-1β-induced phosphorylation of MAPKs and NF-κB p65 subunit translocation to nucleus. In vivo, AE-ASL inhibited DMM surgery-induced cartilage destruction and proteoglycan loss. Taken together, these results suggest that AE-ASL may be a potential therapeutic agent for the alleviation of OA progression.
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Affiliation(s)
- Seul Ah Lee
- Department of Oral Biochemistry, College of Dentistry, Chosun University, 375 Seosuk-dong, Dong-gu, Gwangju 501-759, Republic of Korea
| | - Sung-Min Moon
- CStech Research Institute, 38 Chumdanventuresoro, Gwangju 61007, Republic of Korea
| | - Seul Hee Han
- CStech Research Institute, 38 Chumdanventuresoro, Gwangju 61007, Republic of Korea
| | - Eun Ju Hwang
- Department of Oral Biochemistry, College of Dentistry, Chosun University, 375 Seosuk-dong, Dong-gu, Gwangju 501-759, Republic of Korea
| | - Bo-Ram Park
- Department of Dental Hygiene, Chodang University, Muan-ro, Muan-eup, Muan 534-701, Republic of Korea
| | - Jae-Sung Kim
- Oral Biology Research Institute, College of Dentistry, Chosun University, 375 Seosuk-dong, Dong-gu, Gwangju, 501-759, Republic of Korea
| | - Do Kyung Kim
- Oral Biology Research Institute, College of Dentistry, Chosun University, 375 Seosuk-dong, Dong-gu, Gwangju, 501-759, Republic of Korea
| | - Chun Sung Kim
- Department of Oral Biochemistry, College of Dentistry, Chosun University, 375 Seosuk-dong, Dong-gu, Gwangju 501-759, Republic of Korea.
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Alternatives to Biologics in Management of Knee Osteoarthritis: A Systematic Review. Sports Med Arthrosc Rev 2018; 26:79-85. [PMID: 29722769 DOI: 10.1097/jsa.0000000000000190] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Knee osteoarthritis (KOA) is a common condition encountered by physicians. KOA is addressed by a wide array of modalities including a number of nonbiological treatments. METHODS PubMed, ISI Web of Science, and SPORTDiscus were searched for level 1 to 4 studies published from inception to August 2017. RESULTS A total of 18 studies were evaluated and results demonstrated moderate supporting evidence for prolotherapy and limited evidence for botulinum toxin type A, sodium bicarbonate and calcium gluconate, and low-molecular weight fraction of 5% human serum albumin. Evidence for local anesthetic agents was conflicting. CONCLUSION There is moderate supportive evidence for the effectiveness of prolotherapy in improving pain and function in both, short-term and long-term. Limited supporting evidence found for botulinum toxin type A, sodium bicarbonate and calcium gluconate, and low-molecular weight fraction of 5% human serum albumin in improving pain and function. There is conflicting evidence for the use of local anesthetic agents in patients with KOA.
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Ude CC, Shamsul BS, Ng MH, Chen HC, Ohnmar H, Amaramalar SN, Rizal AR, Johan A, Norhamdan MY, Azizi M, Aminuddin BS, Ruszymah BHI. Long-term evaluation of osteoarthritis sheep knee, treated with TGF-β3 and BMP-6 induced multipotent stem cells. Exp Gerontol 2018; 104:43-51. [PMID: 29421350 DOI: 10.1016/j.exger.2018.01.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 12/09/2017] [Accepted: 01/16/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Hyaline articular cartilage, which protects the bones of diarthrodial joints from forces associated with load bearing, frictions, and impacts has very limited capacities for self-repair. Over the years, the trend of treatments has shifted to regenerations and researchers have been on the quest for a lasting regeneration. We evaluated the treatment of osteoarthritis by chondrogenically induced ADSCs and BMSCs for a long time functional recovery. METHODS Osteoarthritis was induced at the right knee of sheep by complete resection of ACL and medial meniscus. Stem cells from sheep were induced to chondrogenic lineage. Test sheep received 5 mls single doses of 2 × 107 autologous PKH26-labelled ADSCs or BMSCs, while controls received basal medium. Functional recovery of the knees was evaluated via electromyography. RESULTS Induced ADSCs had 625, 255, 393, 908, 409, 157 and 1062 folds increases of collagen I, collagen II, aggrecan, SOX9, cartilage oligomeric protein, chondroadherin and fibromodullin compare to uninduced cells, while BMSCs had 702, 657, 321, 276, 337, 233 and 1163 respectively; p = .001. Immunocytochemistry was positive for these chondrogenic markers. 12 months post-treatment, controls scored 4 in most regions using ICRS, while the treated had 8; P = .001. Regenerated cartilages were positive to PKH26 and demonstrated the presence of condensing cartilages on haematoxylin and eosin; and Safranin O. OA degenerations caused significant amplitude shift from right to left hind limb. After treatments, controls persisted with significant decreases; while treated samples regained balance. CONCLUSIONS Both ADSCs and BMSCs had increased chondrogenic gene expressions using TGF-β3 and BMP-6. The treated knees had improved cartilage scores; PKH26 can provide elongated tracking, while EMG results revealed improved joint recoveries. These could be suitable therapies for osteoarthritis.
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Affiliation(s)
- C C Ude
- Tissue Engineering Centre, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, K.L, Malaysia; Bioartificial Organ and Regenerative Medicine Unit, National Defence University of Malaysia, Sungai Besi Camp 57000, K.L, Malaysia
| | - B S Shamsul
- Tissue Engineering Centre, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, K.L, Malaysia
| | - M H Ng
- Tissue Engineering Centre, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, K.L, Malaysia
| | - H C Chen
- Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400 Serdang, Malaysia.
| | - Htwe Ohnmar
- Rehab Unit, Department of Orthopedic & Traumatology, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, K.L, Malaysia
| | - S N Amaramalar
- Rehab Unit, Department of Orthopedic & Traumatology, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, K.L, Malaysia
| | - A R Rizal
- Department of Orthopedic & Traumatology, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, K.L, Malaysia.
| | - A Johan
- Department of Orthopedic & Traumatology, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, K.L, Malaysia
| | - M Y Norhamdan
- Department of Orthopedic & Traumatology, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, K.L, Malaysia
| | - M Azizi
- Bioartificial Organ and Regenerative Medicine Unit, National Defence University of Malaysia, Sungai Besi Camp 57000, K.L, Malaysia
| | - B S Aminuddin
- Tissue Engineering Centre, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, K.L, Malaysia; ENT Consultant Clinic, Ampang Putri Specialist Hospital, 68000 Ampang, Malaysia
| | - B H I Ruszymah
- Tissue Engineering Centre, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, K.L, Malaysia; Department of Physiology, Medical Faculty, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif Bandar Tun Razak Muda Abdul Aziz, Campus, 56000 K.L, Malaysia..
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Celik C, Mogal VT, Hui JHP, Loh XJ, Toh WS. Injectable Hydrogels for Cartilage Regeneration. GELS HORIZONS: FROM SCIENCE TO SMART MATERIALS 2018. [DOI: 10.1007/978-981-10-6077-9_12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Otero-López A, Beaton-Comulada D. Clinical Considerations for the Use Lower Extremity Arthroplasty in the Elderly. Phys Med Rehabil Clin N Am 2017; 28:795-810. [PMID: 29031344 DOI: 10.1016/j.pmr.2017.06.011] [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] [Indexed: 11/19/2022]
Abstract
There is an increase in the aging population that has led to a surge of reported cases of osteoarthritis and a greater demand for lower extremity arthroplasty. This article aims to review the current treatment options and expectations when considering lower extremity arthroplasty in the elderly patient with an emphasis on the following subjects: (1) updated clinical guidelines for the management of osteoarthritis in the lower extremity, (2) comorbidities and risk factors in the surgical patient, (3) preoperative evaluation and optimization of the surgical patient, (4) surgical approach and implant selection, and (5) rehabilitation and life after lower extremity arthroplasty.
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Affiliation(s)
- Antonio Otero-López
- Department of Orthopaedic Surgery, School of Medicine, University of Puerto Rico, University of Puerto Rico Medical Sciences Campus, PO Box 365067, San Juan, PR 00936-5067, USA.
| | - David Beaton-Comulada
- Department of Orthopaedic Surgery, School of Medicine, University of Puerto Rico, University of Puerto Rico Medical Sciences Campus, PO Box 365067, San Juan, PR 00936-5067, USA
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Hassan F, Trebinjac S, Murrell WD, Maffulli N. The effectiveness of prolotherapy in treating knee osteoarthritis in adults: a systematic review. Br Med Bull 2017; 122:91-108. [PMID: 28334196 DOI: 10.1093/bmb/ldx006] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 02/10/2017] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Osteoarthritis (OA) often leads to symptoms such as pain, stiffness and decreased function. OA is treated with a wide range of modalities, both conservatively and surgically. Prolotherapy has been used to treat various musculoskeletal problems and has shown some promise. SOURCES OF DATA Searches of the electronic databases, PubMed, ISI web of science, PEDro and SPORTDiscus, were conducted for all Level 1-4 studies published from inception through to December 2016. AREAS OF AGREEMENT Ten studies were evaluated and results show significant improvement in scores for pain, function and range of motion, both in the short term and long term. Patient satisfaction was also high in these patients (82%). AREAS OF CONTROVERSY Meta-analysis was not possible due to heterogeneity of outcome measures and populations. GROWING POINTS Moderate evidence suggests that prolotherapy is safe and can help achieve significant symptomatic control in individuals with OA. AREAS FOR DEVELOPING RESEARCH Future research should focus on larger sample size, standardization of treatment protocol and basic science evidence.
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Affiliation(s)
- Fadi Hassan
- Good Hope Hospital, Heart of England NHS Foundation Trust, Birmingham, B75 7RR, UK
| | - Suad Trebinjac
- Dubai Physiotherapy & Rehabilitation Center, Al Garhoud Private Hospital, Al Garhoud, United Arab Emirates
| | - William D Murrell
- Deparment of Orthopaedic Sports Medicine, Dr Humeira Badsha Medical Center, Dubai, United Arab Emirates.,Department of Orthopaedics, Rehabilitation and Podiatry, Ft. Belvoir Community Hospital, Ft. Belvoir, VA, USA
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, University of Salerno School of Medicine and Dentistry, Salerno, Italy.,Queen Mary University of London, Barts and the London School of Medicine and Dentistry Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London E1 4DG, England
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Murphy NJ, Eyles JP, Hunter DJ. Hip Osteoarthritis: Etiopathogenesis and Implications for Management. Adv Ther 2016; 33:1921-1946. [PMID: 27671326 PMCID: PMC5083776 DOI: 10.1007/s12325-016-0409-3] [Citation(s) in RCA: 137] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Indexed: 01/05/2023]
Abstract
Highly prevalent among the elderly, hip osteoarthritis (OA) carries a heavy burden of disease. Guidelines for the management of hip OA are often extrapolated from knee OA research, despite clear differences in the etiopathogenesis and response to treatments of OA at these sites. We propose that hip OA requires specific attention separate from other OA phenotypes. Our understanding of the etiopathogenesis of hip OA has seen significant advance over the last 15 years, since Ganz and colleagues proposed femoroacetabular impingement (FAI) as an important etiological factor. This narrative review summarizes the current understanding of the etiopathogenesis of hip OA and identifies areas requiring further research. Therapeutic approaches for hip OA are considered in light of the condition’s etiopathogenesis. The evidence for currently adopted management strategies is considered, especially those approaches that may have disease-modifying potential. We propose that shifting the focus of hip OA research and public health intervention to primary prevention and early detection may greatly improve the current management paradigm.
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Affiliation(s)
- Nicholas J Murphy
- Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia
| | - Jillian P Eyles
- Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia
| | - David J Hunter
- Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia.
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Shea Nut Oil Triterpene Concentrate Attenuates Knee Osteoarthritis Development in Rats: Evidence from Knee Joint Histology. PLoS One 2016; 11:e0162022. [PMID: 27583436 PMCID: PMC5008785 DOI: 10.1371/journal.pone.0162022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 08/16/2016] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Shea nut oil triterpene concentrate is considered to have anti-inflammatory and antioxidant properties. Traditionally, it has been used to treat arthritic conditions in humans. This study aimed to investigate the effect of attenuating osteoarthritis (OA)-induced pain and joint destruction in rats by administering shea nut oil triterpene concentrate (SheaFlex75, which is more than 50% triterpenes). METHODS An anterior cruciate ligament transaction (ACLT) with medial meniscectomy (MMx) was used to induce OA in male Wistar rats. Different doses of SheaFlex75 (111.6 mg/kg, 223.2 mg/kg, and 446.4 mg/kg) were then intragastrically administered daily for 12 weeks after surgery. Body weight and the width of the knee joint were measured weekly. Additionally, incapacitance tests were performed at weeks 2, 4, 6, 8, 10 and 12 to measure the weight bearing of the hind limbs, and the morphology and histopathology of the medial femoral condyles were examined and were evaluated using the Osteoarthritis Research Society International (OARSI) scoring system. RESULTS This study showed that SheaFlex75 reduced the swelling of the knee joint with OA and rectified its weight bearing after ACLT plus MMx surgery in rats. Treatment with SheaFlex75 also decreased ACLT plus MMx surgery-induced knee joint matrix loss and cartilage degeneration. CONCLUSION SheaFlex75 relieves the symptoms of OA and protects cartilage from degeneration. SheaFlex75 thus has the potential to be an ideal nutraceutical supplement for joint protection, particularly for injured knee joints.
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Lubowitz JH. Editorial Commentary: Platelet-Rich Plasma Improves Knee Pain and Function in Patients With Knee Osteoarthritis. Arthroscopy 2015; 31:2222-3. [PMID: 26542203 DOI: 10.1016/j.arthro.2015.08.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 08/18/2015] [Indexed: 02/02/2023]
Abstract
Systematic review of overlapping meta-analyses shows that platelet-rich plasma improves knee pain and function in patients with knee osteoarthritis. Ultimately, biologics hold promise for chondroprotection in addition to symptomatic relief.
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Abstract
Arthritis treatment must be analyzed with regard to outcome. Pain is one important outcome measure. Pain relief is variable among individual patients; individually discerning, personalized, or precision medical indications for nonsurgical treatment of osteoarthritis must be more specifically determined.
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Lubowitz JH, Provencher MT, Brand JC, Rossi MJ. Editorial commentary revisited and the spin move refined. Arthroscopy 2015; 31:593-5. [PMID: 25842226 DOI: 10.1016/j.arthro.2015.02.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 02/12/2015] [Indexed: 02/02/2023]
Abstract
First, editorial commentary: editorial commentary may be educational and may be controversial, but above all else, authors come first. Second, The Spin Move: The Spin Move is effective, cost-effective, and ubiquitous because, while many techniques are specific to a single joint, The Spin Move can be performed as a part of any arthroscopic and related procedure. However, like many advanced procedures, The Spin Move, when poorly executed, entails substantial risk. Preoperative planning is essential, and The Spin Move must be reviewed by inexperienced practitioners, in detailed text, figures tables, and video, at www.arthroscopytechniques.org. Practice makes perfect.
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