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Yang T, Ma H, Lai H, Lu Y, Ni K, Hu X, Zhou Y, Zhou Z, Li W, Fang J, Zhang Y, Chen Z, He D. Nitisinone attenuates cartilage degeneration and subchondral osteoclastogenesis in osteoarthritis and concomitantly inhibits the cGAS/STING/NF-κB pathway. Eur J Pharmacol 2024; 965:176326. [PMID: 38220141 DOI: 10.1016/j.ejphar.2024.176326] [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: 09/11/2023] [Revised: 12/20/2023] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
Osteoarthritis (OA) is a chronic degenerative joint disease characterized by cartilage degeneration and subchondral bone remodelling. Currently, conservative treatment strategies cannot effectively alleviate the progression of OA. In this study, we used computer network analysis to show that Nitisinone (NTBC) is closely related to extracellular matrix degradation in OA and mainly interferes with the TNF-α signaling pathway. NTBC is an orphan drug used to treat hereditary type I tyrosinemia by altering phenylalanine/tyrosine metabolic flow. In this study, we found that NTBC effectively reduced chondrocyte inflammation and extracellular matrix degradation induced by TNF-α. Mechanistically, NTBC inhibited the cGAS/STING signaling pathway and reduced activation of the STING-dependent NF-κB pathway to alleviate inflammation. In addition, NTBC inhibited osteoclastogenesis and delayed the occurrence of subchondral bone remodelling. In mice with ACLT-induced osteoarthritis, intra-articular injection of NTBC significantly reduced cartilage degradation and subchondral bone remodelling. NTBC showed impressive therapeutic efficacy as a potential pharmaceutical intervention for the treatment of OA.
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Affiliation(s)
- Tao Yang
- The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, 289 Kuocang Road, Lishui, Zhejiang, PR China, 323000
| | - Haiwei Ma
- The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, 289 Kuocang Road, Lishui, Zhejiang, PR China, 323000
| | - Hehuan Lai
- The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, 289 Kuocang Road, Lishui, Zhejiang, PR China, 323000
| | - Yahong Lu
- The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, 289 Kuocang Road, Lishui, Zhejiang, PR China, 323000
| | - Kainan Ni
- The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, 289 Kuocang Road, Lishui, Zhejiang, PR China, 323000
| | - Xingyu Hu
- The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, 289 Kuocang Road, Lishui, Zhejiang, PR China, 323000
| | - Yang Zhou
- The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, 289 Kuocang Road, Lishui, Zhejiang, PR China, 323000
| | - Zhiguo Zhou
- The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, 289 Kuocang Road, Lishui, Zhejiang, PR China, 323000
| | - Weiqing Li
- The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, 289 Kuocang Road, Lishui, Zhejiang, PR China, 323000
| | - Jiawei Fang
- The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, 289 Kuocang Road, Lishui, Zhejiang, PR China, 323000
| | - Yejin Zhang
- The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, 289 Kuocang Road, Lishui, Zhejiang, PR China, 323000
| | - Zhenzhong Chen
- The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, 289 Kuocang Road, Lishui, Zhejiang, PR China, 323000.
| | - Dengwei He
- The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, 289 Kuocang Road, Lishui, Zhejiang, PR China, 323000.
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Pamukoff DN, Holmes SC, Heredia CE, Shumski EJ, Garcia SA, Montgomery MM. Cartilage deformation following a walking bout in individuals with anterior cruciate ligament reconstruction. J Orthop Res 2024; 42:349-359. [PMID: 37772457 DOI: 10.1002/jor.25694] [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: 05/26/2023] [Revised: 08/16/2023] [Accepted: 09/20/2023] [Indexed: 09/30/2023]
Abstract
The purpose was to (1) compare the effect of a walking bout on femoral cartilage deformation between limbs with and without anterior cruciate ligament reconstruction (ACLR) and (2) examine the association between gait kinetics and the magnitude of cartilage deformation. A total of 30 individuals with primary unilateral ACLR completed this study [14 male, 16 female; age = 22.57 (3.78) years; body mass index (BMI) = 25.88 (5.68) kg/m2 ; time since ACLR = 61.00 (16.43) months]. Overground walking biomechanics were assessed on day 1, and a 30-min walking bout or 30-min resting bout (control) were completed on days 2 and 3 (counterbalanced order). Femoral cartilage thickness was measured using ultrasound before, immediately following, and 30-min following each intervention. Linear mixed effects models compared the effect of walking on cartilage thickness between the ACLR and contralateral limbs after adjusting for sex, BMI, speed, and the number of steps. Stepwise regression examined the association between the external knee flexion and adduction moments and cartilage deformation following walking. There was a significant limb × time interaction for medial cartilage thickness. Post hoc analyses indicated that cartilage thickness decreased immediately following walking in the contralateral but not ACLR limb. Main effects of limb were observed for medial, central, and lateral cartilage thickness indicating thicker cartilage in the ACLR compared with contralateral limb. A higher knee adduction moment was associated with greater cartilage deformation in the ACLR limb. Femoral cartilage in the ACLR limb exhibited a less dynamic response to walking than the uninvolved limb, which may be due to habitual underloading during gait.
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Affiliation(s)
- Derek N Pamukoff
- School of Kinesiology, Western University, London, Ontario, Canada
| | - Skylar C Holmes
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | | | - Eric J Shumski
- Department of Kinesiology, University of Georgia, Athens, Georgia, USA
| | - Steven A Garcia
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Melissa M Montgomery
- Department of Kinesiology, California State University, Fullerton, Fullerton, California, USA
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Ueyama H, Nakagawa S, Fukunaga K, Koyanagi J, Takemura S, Nakamura S, Yamamura M, Minoda Y. Improvement of rotational arc during deep flexion range of a novel designed polyethylene insert for posterior-stabilised total knee arthroplasty. Knee 2024; 46:108-116. [PMID: 38071923 DOI: 10.1016/j.knee.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/29/2023] [Accepted: 11/13/2023] [Indexed: 02/20/2024]
Abstract
BACKGROUND One of the remaining issues in total knee arthroplasty (TKA) is achieving sufficient rotational arc during deep flexion range of the knee for specific postures such as the 'seiza' or cross-legged sitting. This study aimed to evaluate whether there was a change in the actual in vivo rotational arc during deep flexion range before and after a design change of polyethylene (PE) inserts. METHODS In 50 posterior-stabilised TKA cases, knee kinematics, including rotational movement, were measured intraoperatively using an image-free navigation system to compare a newly designed PE insert with reduced the posterior lip with a conventional PE insert. Femoral-tibial rotational angles at 30°, 45°, 60°, 90°, 120°, and 130° knee flexion were evaluated. Varus/valgus instability, knee range of motion, and femoral rollback were also measured. Obtained parameters were compared between new and conventional PE inserts. The independent factors associated with rotational arc during deep flexion range (120° and 130° knee flexion) were analysed using multivariate analysis. RESULTS The newly designed PE insert demonstrated a significant increase in the rotational arc at 120° (22.9 ± 8.7° vs. 30.1 ± 11.9°, P < 0.001) and 130° (24.3 ± 9.5° vs. 32.5 ± 12.4°, P < 0.001) knee flexion compared with that with the conventionally designed posterior-stabilised insert. Multivariate analysis demonstrated that using the newly designed PE insert was an independent predictor of improved rotational arc during deep flexion range: regression coefficient was 11.2 (95% confidence interval 7.1-15.3, P < 0.001). CONCLUSION The design change, which reduced the posterior lip of the PE insert, contributed to improved rotational arc in 120° and 130° deep flexion ranges.
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Affiliation(s)
- Hideki Ueyama
- Department of Orthopaedic Surgery, Osaka Rosai Hospital, Osaka, Japan.
| | - Shigeru Nakagawa
- Department of Orthopaedic Surgery, Hanwa Memorial Hospital, Osaka, Japan
| | - Kenji Fukunaga
- Department of Orthopaedic Surgery, Osaka Rosai Hospital, Osaka, Japan
| | | | - Susumu Takemura
- Department of Orthopaedic Surgery, Osaka Rosai Hospital, Osaka, Japan
| | - Suguru Nakamura
- Department of Orthopaedic Surgery, Osaka Rosai Hospital, Osaka, Japan
| | | | - Yukihide Minoda
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine Osaka, Japan
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Thorsen T, Wen C, Porter J, Reinbolt J, Weinhandl JT, Zhang S. Tibiofemoral compressive force during downhill walking in patients with primary total knee arthroplasty: A statistical parametric mapping approach. Clin Biomech (Bristol, Avon) 2023; 102:105900. [PMID: 36739666 DOI: 10.1016/j.clinbiomech.2023.105900] [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: 06/25/2022] [Revised: 01/09/2023] [Accepted: 01/26/2023] [Indexed: 02/07/2023]
Abstract
BACKGROUND Downhill walking is a necessary part of daily life and an effective activity in post-operative rehabilitation following total knee arthroplasty. The purpose of this study was to determine differences in the behavior of total, medial, and lateral tibiofemoral compressive forces as well as knee extensor and flexor muscle forces between different limbs of patients with total knee arthroplasty (replaced, non-replaced) during downhill and level walking. METHODS Musculoskeletal modeling and simulation were implemented to determine muscle forces and tibiofemoral compressive forces in 25 patients with total knee arthroplasty. A 2 × 2 [Limb (replaced, non-replaced) × Slope (0°, 10°)] Statistical parametric mapping repeated measures analysis of variance was conducted on selected variables. FINDINGS Statistical parametric mapping did not identify any between-limb differences for compressive or muscle forces. Differences in joint compressive and muscle forces persisted throughout different intervals of stance-phase between level and downhill walking. Knee extensor muscle forces were distinctly greater during level walking for nearly all of stance phase. Knee flexor muscle force was greater during downhill walking for >60% of stance. Statistical parametric mapping did identify regions of significance between level and downhill walking that coincided temporally (near loading response and push off) with peak joint moment and joint compressive forces traditionally reported using discrete variable analyses. INTERPRETATION Downhill walking may be a safe and useful rehabilitation tool for post-knee arthroplasty rehabilitation that will not disproportionally load either the replaced or the non-replaced joint and where the quadriceps muscles can be strengthened during a gait-specific task.
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Affiliation(s)
- Tanner Thorsen
- School of Kinesiology and Nutrition, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Chen Wen
- Department of Kinesiology, Recreation and Sport Studies, The University of Tennessee, Knoxville, TN, USA
| | - Jared Porter
- Department of Kinesiology, Recreation and Sport Studies, The University of Tennessee, Knoxville, TN, USA
| | - Jeffery Reinbolt
- Department of Mechanical, Aerospace, and Biomedical Engineering, The University of Tennessee, Knoxville, TN, USA
| | - Joshua T Weinhandl
- Department of Kinesiology, Recreation and Sport Studies, The University of Tennessee, Knoxville, TN, USA
| | - Songning Zhang
- Department of Kinesiology, Recreation and Sport Studies, The University of Tennessee, Knoxville, TN, USA.
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Zeng X, Xie Z, Zhong G, Chen Y, Wen B, Li Y, Ma L, Huang W, Yang T, Zhang Y. The 6DOF knee kinematics of healthy subjects during sloped walking compared to level walking. Gait Posture 2022; 95:198-203. [PMID: 35526472 DOI: 10.1016/j.gaitpost.2022.05.004] [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: 03/04/2022] [Revised: 04/23/2022] [Accepted: 05/02/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Level Walking is a frequent functional movement during daily life. However, sloped walking is also common. Exploring 6DOF knee kinematics during sloped walking is important. It provides a reference for the rehabilitation, safety, and knee health of patients with knee diseases walking on sloped surfaces. RESEARCH QUESTION The study aimed to explore 6DOF knee kinematics characteristics during sloped walking compared to level walking. We hypothesized that tibial anteroposterior translation and flexion angle (the sagittal plane) were significantly different from those of level walking. METHODS One hundred young, healthy adults (50 males and 50 females) were recruited for this study. A three-dimensional gait analysis system was used to collect 6DOF knee kinematics during level and sloped walking. The slope was set to ± 15% when the sloped walking was performed. RESULTS Sloped walking mainly increased knee flexion angle (upslope, 2.5-26.2°, 1-100% gait cycle (GC), p < 0.05; downslope, 1.7-11.9°, 15-95% GC, p < 0.05) and anterior tibial translation (upslope, 0.7-4.1 mm, 3-54% GC & 0.6-2.1 mm, 80-94% GC; downslope, 1.0-2.2 mm, 21-69% GC) in the participants' knees. However, participants' other 4DOF knee kinematics during sloped walking were significantly different from those during level walking (p < 0.05). Participants had 'drastically changeable' knee kinematic alterations in the transverse and coronal plane (the other 4DOF knee kinematics) during sloped walking compared to level walking. SIGNIFICANCE Our results confirmed the hypothesis. Sloped walking significantly increased anterior tibial translation (in most GC) and flexion angle. These kinematic changes in healthy subjects should be evaluated and further explored for patients with knee diseases, such as anterior cruciate ligament deficiency. Our findings are meaningful for their rehabilitation or safety or knee health while walking on sloped surfaces. Our study may provide a pilot reference for the 6DOF knee kinematic exploration of sloped walking.
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Affiliation(s)
- Xiaolong Zeng
- School of Medicine, South China University of Technology, Guangzhou 510006, Guangdong, China; Department of Orthopaedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, China
| | - Zhenyan Xie
- Department of Orthopaedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, China; Shantou Central Hospital, Shantou 515000, Guangdong, China
| | - Guoqing Zhong
- Department of Orthopaedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, China; Shantou Central Hospital, Shantou 515000, Guangdong, China
| | - Ying Chen
- Shantou Central Hospital, Shantou 515000, Guangdong, China
| | - Baohong Wen
- Shantou Central Hospital, Shantou 515000, Guangdong, China
| | - Yixi Li
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510000, Guangdong, China
| | - Limin Ma
- Department of Orthopaedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, China
| | - Wenhan Huang
- Department of Orthopaedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, China
| | - Tao Yang
- School of Medicine, South China University of Technology, Guangzhou 510006, Guangdong, China; Department of Orthopaedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, China
| | - Yu Zhang
- School of Medicine, South China University of Technology, Guangzhou 510006, Guangdong, China; Department of Orthopaedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, China.
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Yocum DS, Valenzuela KA, Standifird TW, Cates HE, Zhang S. Altered biomechanics in bilateral total knee replacement patients during stair negotiation. Knee 2022; 34:9-16. [PMID: 34875499 DOI: 10.1016/j.knee.2021.11.009] [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: 12/10/2020] [Revised: 09/16/2021] [Accepted: 11/16/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Many total knee replacement (TKR) patients need to have a contralateral knee replacement. Biomechanical differences between first and second replaced limbs of bilateral TKR have not been examined during stair negotiation. Additionally, it is unknown whether hip and ankle biomechanics of bilateral patients are altered. We examined hip, knee, and ankle biomechanics of first and second replaced limbs bilateral patients, as well as replaced and non-replaced limbs of unilateral patients, during stair ascent and descent. METHODS Eleven bilateral TKR patients (70.09 ± 5.41 years, 1.71 ± 0.08 m, 91.78 ± 13.00 kg) and 15 unilateral TKR patients (64.93 ± 5.11 years, 1.75 ± 0.09 m, 89.18 ± 17.55 kg) were recruited. Patients performed three to five trials of stair ascent and descent. The second step, during ascent, was the step of interest when analyzing each limb. A 2 × 2 (limb × group) analysis of variance was performed to determine differences between limbs and groups. RESULTS During ascent, bilateral patients exhibited decreased peak loading-response knee extension (KEM) and push-off plantarflexion moments. Unilateral replaced limb KEM was lower than non-replaced limbs. During descent, bilateral patients descended the staircase significantly slower, had lower peak loading-response vertical ground reaction force and KEM, and push-off KEM. Bilateral patients had higher peak loading-response hip extension and push-off plantarflexion moments, and increased knee adduction ROM, compared with unilateral TKA patients. CONCLUSIONS Bilateral patients exhibited similar hip, knee, and ankle joint moments between first and second replaced limbs. Substantial differences in hip, knee, and ankle biomechanics during stair negotiation in bilateral patients compared with unilateral patients may indicate a more complex adaptation strategy present in these patients.
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Affiliation(s)
- Derek S Yocum
- South Bend Orthopaedics, South Bend, IN, USA; Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN, USA
| | - Kevin A Valenzuela
- Department of Kinesiology, California State University Long Beach, Long Beach, CA, USA
| | - Tyler W Standifird
- Department of Exercise Science and Outdoor Recreation, Utah Valley University, Orem, UT, USA
| | | | - Songning Zhang
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN, USA.
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