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Guo D, Ma S, Zhao Y, Dong J, Guo B, Li X. Self-administered acupressure and exercise for patients with osteoarthritis: A randomized controlled trial. Clin Rehabil 2021; 36:350-358. [PMID: 34658285 DOI: 10.1177/02692155211049155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Knee osteoarthritis is a prevalent degenerative joint disease and seriously affects the athletic abilities of middle-aged and elderly patients. Acupressure is a traditional non-pharmacological intervention that promotes blood circulation and muscle activity. Self-administrated acupressure and exercise can be potential management for knee osteoarthritis. DESIGN It is a randomized and controlled trial for knee osteoarthritis self-treatment. SETTINGS Cangzhou Hospital. INTERVENTIONS 221 patients with knee osteoarthritis were recruited and randomly divided into 4 groups: control group (n = 55), exercise group (n = 56), acupressure group (n = 55) and exercise & acupressure group (n = 55). In the first eight weeks, corresponding training courses were provided to different groups of patients. The patients were asked to carry out their own corresponding interventions for 16 weeks. The patient's condition was evaluated in the sixteenth week. MAIN MEASURES The Western Ontario and McMaster Universities global scores of knee osteoarthritis patients were assessed at the 8th and 16th week of our trial. RESULTS Self-administered acupressure and exercise significantly decreased visual analogue scale (3.75 ± 1.89 versus 2.93 ± 1.73, p < 0.05), pain (7.6 ± 2.8 versus 4.8 ± 2.7, p < 0.05), stiffness (3.75 ± 1.89 versus 2.93 ± 1.73, p < 0.05) at the 16th week (p < 0.05) in patients with knee osteoarthritis compared to other intervention. The combination of acupressure and exercise also improved the range of motion (114.4 ± 11.5 versus 120.4 ± 11.9, p < 0.05) and walk speed (1.48 ± 0.48 versus 1.76 ± 0.50, p < 0.05) of osteoarthritis patients (p < 0.05). CONCLUSION Self-administrated exercise and acupressure alleviate the arthritic symptoms (swelling, pain, joint dysfunction and joint deformities) and improve the joint functions, supporting its potential use in the clinical management for osteoarthritis.
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Affiliation(s)
- Donghui Guo
- Department of Orthopedics, Cangzhou Hospital of Integrated TCM-WM Hebei, Cangzhou, Hebei, China
| | - Shiqiang Ma
- Department of Orthopedics, Cangzhou Hospital of Integrated TCM-WM Hebei, Cangzhou, Hebei, China
| | - Yunchao Zhao
- Department of Orthopedics, Cangzhou Hospital of Integrated TCM-WM Hebei, Cangzhou, Hebei, China
| | - Jun Dong
- Department of Orthopedics, Cangzhou Hospital of Integrated TCM-WM Hebei, Cangzhou, Hebei, China
| | - Binfang Guo
- Department of Neonatology, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Xiaoming Li
- Department of Orthopedics, Cangzhou Hospital of Integrated TCM-WM Hebei, Cangzhou, Hebei, China
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CT Morphometric Analysis of Medial Tibial Condyles: Are the Currently Available Designs of Unicompartmental Knee Arthroplasty Suitable for Indian Knees? Indian J Orthop 2021; 55:1135-1143. [PMID: 34824713 PMCID: PMC8586401 DOI: 10.1007/s43465-021-00429-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/17/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND The main purpose of this study is to assess the compatibility of medial tibial condyle (MTC) morphometry of Indian population with that of six contemporary UKA prostheses tibial components. We hypothesized that from the currently available UKA designs at least one would fit the MTC morphometry optimally as per the manufacturer's recommendation. METHODS We used CT morphometric data of 100 (66 males and 34 females) consecutive nonarthritic adult knees with reference to the MTC to assess the compatibility of currently available (in India) UKA prostheses. Each MTC was measured in the anteroposterior dimension, mediolateral at pre-defined points and the MTC aspect ratio calculated. Proportion of knees which could be optimally fitted with the existing UKA tibial components was calculated. RESULTS The mean age was 39.6 (SD 15.9) years. Anteroposterior and mediolateral dimensions in males were higher as compared to females (p < 0.001). As the anteroposterior dimension increased, the MTC aspect ratio decreased. There was asymmetry of anteroposterior halves with maximum mediolateral width being posterior to the central mediolateral width by 5.5 (SD 2.8) mm. Optimal anteroposterior fit ranged from 66 to 93%. However, optimal mediolateral fit as well, ranged from 5 to 37% with underhang present in 17-61% and > 2 mm medial overhang present in 0-35% cases. In 23% of cases, not a single implant could be fitted optimally. CONCLUSION Currently available UKA implants do not provide optimal tibial fit in nearly 25% of Indian patients. A surgeon needs to be aware of these limitations of existing implants when considering UKA.
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Sim HS, Ang KXM, How CH, Loh SYJ. Management of knee osteoarthritis in primary care. Singapore Med J 2020; 61:512-516. [PMID: 33225367 DOI: 10.11622/smedj.2020147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Hui Shan Sim
- Care and Health Integration, Changi General Hospital, Singapore
| | | | - Choon How How
- Care and Health Integration, Changi General Hospital, Singapore
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Al-Yamani A, Kalamegam G, Ahmed F, Abbas M, Sait KHW, Anfinan N, Al-Wasiyah MK, Huwait EA, Gari M, Al-Qahtani M. Evaluation of in vitro chondrocytic differentiation: A stem cell research initiative at the King Abdulaziz University, Kingdom of Saudi Arabia. Bioinformation 2018; 14:53-59. [PMID: 29618900 PMCID: PMC5879944 DOI: 10.6026/97320630014053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 02/01/2018] [Accepted: 02/01/2018] [Indexed: 12/15/2022] Open
Abstract
Mesenchymal stem cells (MSCs) from various sources have been used in cartilage differentiation with variable success. Therefore, it is
of interest to evaluate the in vitro differentiation potential of the hWJSCs derived from the human umbilical cords into chondrocytes at
the stem cell research facility at the King Abdulaziz University. hWJSCs are an attractive choice for tissue engineering and regenerative
medical applications including cartilage regeneration. We evaluated the hWJSCs using classical histological and cartilage related gene
expression studies. Some of the known parameters were re-examined for consistency at the current laboratory conditions. Early
passages (P1-P4) showed short fibroblastic morphology and high expression of MSC related surface markers namely CD29 (99.9%),
CD44 (97.8%), CD73 (99.6%), CD90 (95.1%) and CD105 (98.9%). MTT assay showed time dependent increase in hWJSCs proliferation by
61.06% and 206.31% at 48h and 72h respectively. Toluidine blue histology showed that hWJSCs were successfully differentiated into
chondrocytes in chondrocytic differentiation medium for 21 days. Differentiated hWJSCs also showed significantly increased
expression of collagen type II, aggrecan and SOX9 compared to the undifferentiated control. It should be noted that the determination
of the average cell yield, the population doubling time and histological staining wtih alcian blue and/or safronin O is required in future
studies for improved evaluation of differentiation. Painless derivation, abundance of stem cells that are hypo-immunogenic and safety
issues makes this method advantages to MSCs derived from other sources.
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Affiliation(s)
- Aisha Al-Yamani
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Gauthaman Kalamegam
- Stem Cell Unit, Centre of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia.,Sheikh Salem Bin Mahfouz Scientific Chair for Treatment of Osteoarthritis by Stem Cells, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Farid Ahmed
- Stem Cell Unit, Centre of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Abbas
- Sheikh Salem Bin Mahfouz Scientific Chair for Treatment of Osteoarthritis by Stem Cells, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Orthopaedic Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khalid Hussein Wali Sait
- Department of Obstetrics and Gynaecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nisreen Anfinan
- Department of Obstetrics and Gynaecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad Khalid Al-Wasiyah
- Stem Cell Unit, Centre of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Etimad A Huwait
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Mamdouh Gari
- Stem Cell Unit, Centre of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Mohammed Al-Qahtani
- Stem Cell Unit, Centre of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
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Winter AR, Collins JE, Katz JN. The likelihood of total knee arthroplasty following arthroscopic surgery for osteoarthritis: a systematic review. BMC Musculoskelet Disord 2017; 18:408. [PMID: 28978308 PMCID: PMC5628417 DOI: 10.1186/s12891-017-1765-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 09/21/2017] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Arthroscopic surgery is a common treatment for knee osteoarthritis (OA), particularly for symptomatic meniscal tear. Many patients with knee OA who have arthroscopies go on to have total knee arthroplasty (TKA). Several individual studies have investigated the interval between knee arthroscopy and TKA. Our objective was to summarize published literature on the risk of TKA following knee arthroscopy, the duration between arthroscopy and TKA, and risk factors for TKA following knee arthroscopy. METHODS We searched PubMed, Embase, and Web of Science for English language manuscripts reporting TKA following arthroscopy for knee OA. We identified 511 manuscripts, of which 20 met the inclusion criteria and were used for analysis. We compared the cumulative incidence of TKA following arthroscopy in each study arm, stratifying by type of data source (registry vs. clinical), and whether the study was limited to older patients (≥ 50) or those with more severe radiographic OA. We estimated cumulative incidence of TKA following arthroscopy by dividing the number of TKAs among persons who underwent arthroscopy by the number of persons who underwent arthroscopy. Annual incidence was calculated by dividing cumulative incidence by the mean years of follow-up. RESULTS Overall, the annual incidence of TKA after arthroscopic surgery for OA was 2.62% (95% CI 1.73-3.51%). We calculated the annual incidence of TKA following arthroscopy in four separate groups defined by data source (registry vs. clinical cohort) and whether the sample was selected for disease progression (either age or OA severity). In unselected registry studies the annual TKA incidence was 1.99% (95% CI 1.03-2.96%), compared to 3.89% (95% CI 0.69-7.09%) in registry studies of older patients. In unselected clinical cohorts the annual incidence was 2.02% (95% CI 0.67-3.36%), while in clinical cohorts with more severe OA the annual incidence was 4.13% (95% CI 1.81-6.44%). The mean and median duration between arthroscopy and TKA (years) were 3.4 and 2.0 years. CONCLUSIONS Clinicians and patients considering knee arthroscopy should discuss the likelihood of subsequent TKA as they weigh risks and benefits of surgery. Patients who are older or have more severe OA are at particularly high risk of TKA.
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Affiliation(s)
- Amelia R. Winter
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopedic Surgery, Boston, MA USA
| | - Jamie E. Collins
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopedic Surgery, Boston, MA USA
- Harvard Medical School, Boston, MA USA
| | - Jeffrey N. Katz
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopedic Surgery, Boston, MA USA
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 60 Fenwood St, Suite 5016, Boston, MA 02115 USA
- Harvard Medical School, Boston, MA USA
- Departments of Epidemiology and Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA USA
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[Pain after major elective orthopedic surgery of the lower limb and type of anesthesia: does it matter?]. Rev Bras Anestesiol 2016; 66:628-636. [PMID: 27639506 DOI: 10.1016/j.bjan.2016.08.001] [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: 04/14/2015] [Accepted: 06/05/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Total knee arthroplasty and total hip arthroplasty are associated with chronic pain development. Of the studies focusing on perioperative factors for chronic pain, few have focused on the differences that might arise from the anesthesia type performed during surgery. METHODS This was a prospective observational study performed between July 2014 and March 2015 with patients undergoing unilateral elective total knee arthroplasty (TKA) or total hip arthroplasty (THA) for osteoarthritis. Data collection and pain evaluation questionnaires were performed in three different moments: preoperatively, 24hours postoperatively and at 6 months after surgery. To characterize pain, Brief Pain Inventory (BPI) was used and SF-12v2 Health survey was used to further evaluate the sample's health status. RESULTS Forty and three patients were enrolled: 25.6% men and 74.4% women, 51,2% for total knee arthroplasty and48.8% for total hip arthroplasty, with a mean age of 68 years. Surgeries were performed in 25.6% of patients under general anesthesia, 55.8% under neuraxial anesthesia and 18.6% under combined anesthesia. Postoperatively, neuraxial anesthesia had a better pain control. Comparing pain evolution between anesthesia groups, neuraxial anesthesia was associated with a decrease in "worst", "medium" and "now" pain at six months. Combined anesthesia was associated with a decrease of "medium" pain scores at six months. Of the three groups, only those in neuraxial group showed a decrease in level of pain interference in "walking ability". TKA, "worst" pain preoperatively and general were predictors of pain development at six months. CONCLUSIONS Patients with gonarthrosis and severe pain preoperatively may benefit from individualized pre- and intraoperative care, particularly preoperative analgesia and neuraxial anesthesia.
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Pain after major elective orthopedic surgery of the lower limb and type of anesthesia: does it matter? Braz J Anesthesiol 2016; 66:628-636. [PMID: 27793238 DOI: 10.1016/j.bjane.2015.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 06/05/2015] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Total knee arthroplasty and total hip arthroplasty are associated with chronic pain development. Of the studies focusing on perioperative factors for chronic pain, few have focused on the differences that might arise from the anesthesia type performed during surgery. METHODS This was a prospective observational study performed between July 2014 and March 2015 with patients undergoing unilateral elective total knee arthroplasty (TKA) or total hip arthroplasty (THA) for osteoarthritis. Data collection and pain evaluation questionnaires were performed in three different moments: preoperatively, 24 hours postoperatively and at 6 months after surgery. To characterize pain, Brief Pain Inventory (BPI) was used and SF-12v2 Health survey was used to further evaluate the sample's health status. RESULTS Forty and three patients were enrolled: 25.6% men and 74.4% women, 51,2% for total knee arthroplasty and48.8% for total hip arthroplasty, with a mean age of 68 years. Surgeries were performed in 25.6% of patients under general anesthesia, 55.8% under neuraxial anesthesia and 18.6% under combined anesthesia. Postoperatively, neuraxial anesthesia had a better pain control. Comparing pain evolution between anesthesia groups, neuraxial anesthesia was associated with a decrease in "worst", "medium" and "now" pain at six months. Combined anesthesia was associated with a decrease of "medium" pain scores at six months. Of the three groups, only those in neuraxial group showed a decrease in level of pain interference in "walking ability". TKA, "worst" pain preoperatively and general were predictors of pain development at six months. CONCLUSIONS Patients with gonarthrosis and severe pain preoperatively may benefit from individualized pre- and intraoperative care, particularly preoperative analgesia and neuraxial anesthesia.
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Lisik JP, Dowsey MM, Petterwood J, Choong PFM. Review of knee arthroscopic practice and coding at a major metropolitan centre. ANZ J Surg 2016; 87:380-384. [PMID: 27677890 DOI: 10.1111/ans.13664] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 01/11/2016] [Accepted: 05/12/2016] [Indexed: 01/29/2023]
Abstract
BACKGROUND Arthroscopic knee surgery has been a topic of significant controversy in recent orthopaedic literature. Multiple studies have used administrative (Victorian Admitted Episodes Dataset and Centre for Health Record Linkage) data to identify trends in practice. This study explored the usage and reporting of arthroscopic knee surgery by conducting a detailed audit at a major Victorian public hospital. METHODS A database of orthopaedic procedures at St Vincent's Hospital Melbourne was used to retrospectively identify cases of knee arthroscopy from 1 December 2011 to 1 April 2014. Procedures were categorized as diagnostic or interventional, and native and prosthetic joints were analysed separately. Procedure codes were reviewed by comparing a registrar, auditor and hospital coders for agreement. RESULTS Of the 401 cases for analysis, 375 were conducted in native knees and 26 in prosthetic joints. Of native knees, 369 (98.4%) were considered interventional. The majority of these were conducted for meniscal pathology (n = 263, 70.1%), osteoarthritis (OA) (n = 25, 6.7%) and infection (n = 28, 7.6%). Comparison of codes assigned by different parties were found to be between 57% (k = 0.324) and 70% (k = 0.572) agreement, but not statistically significant. CONCLUSIONS In this study, the most common indication for arthroscopy was meniscal pathology. Arthroscopy was rarely performed for OA in the absence of meniscal pathology. Diagnostic arthroscopy was rarely performed in the native knee, and fair to moderate agreement existed between parties in assigning Medicare Benefits Schedule procedure codes.
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Affiliation(s)
- James P Lisik
- Department of Surgery, The University of Melbourne, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Michelle M Dowsey
- Department of Surgery, The University of Melbourne, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.,Department of Orthopaedics, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Joshua Petterwood
- Department of Surgery, The University of Melbourne, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Peter F M Choong
- Department of Surgery, The University of Melbourne, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.,Department of Orthopaedics, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
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Wang W, Li W, Song M, Wei S, Liu C, Yang Y, Wu H. Effects of electromagnetic fields on the metabolism of lubricin of rat chondrocytes. Connect Tissue Res 2015; 57:152-60. [PMID: 26631347 DOI: 10.3109/03008207.2015.1121249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Electromagnetic fields (EMFs) can improve pain, stiffness and physical function in osteoarthritis (OA) patients and have been proposed for the treatment of OA. However, the precise mechanisms involved in this process are still not fully understood. In the present study, we investigated the effects of exposure for different durations with 75 Hz, 2.3 mT sinusoidal EMFs (SEMFs) on the metabolism of lubricin of rat chondrocytes cultured in vitro. Our results showed that SEMFs exposure promoted lubricin synthesis in a time-dependent manner, and the expression of transforming growth factor (TGF)-β1 was also enhanced after SEMFs treatment. The up-regulation effect of the expression of lubricin under SEMF was partly reduced by SB431542, an inhibitor of TGF-RI kinase. The Smad pathway was also investigated in our study. Smad2 synthesis was higher in EMF-exposed condition than in controls, whereas no effects were observed on inhibitory Smads (Smad6 and Smad7) production. Altogether, these data suggest that SEMF exposure can promote lubricin synthesis of rat chondrocytes in a time-dependent manner and that the TGF-β/Smads signaling pathway plays a partial role.
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Affiliation(s)
- Wei Wang
- a Department of Orthopedics, Tongji Hospital , Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China.,b Department of Orthopedics, WuHan Orthopedics Hospital/Puai Hospital , Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Wenkai Li
- a Department of Orthopedics, Tongji Hospital , Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Mingyu Song
- a Department of Orthopedics, Tongji Hospital , Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Sheng Wei
- a Department of Orthopedics, Tongji Hospital , Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Chaoxu Liu
- a Department of Orthopedics, Tongji Hospital , Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Yong Yang
- a Department of Orthopedics, Tongji Hospital , Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Hua Wu
- a Department of Orthopedics, Tongji Hospital , Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
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Perceptions of orthopaedic surgeons regarding arthroscopic surgery for osteoarthritis of the knee - an international survey. CURRENT ORTHOPAEDIC PRACTICE 2015. [DOI: 10.1097/bco.0000000000000180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gao SG, Zeng C, Li LJ, Luo W, Zhang FJ, Tian J, Cheng C, Tu M, Xiong YL, Jiang W, Xu M, Lei GH. Correlation between senescence-associated beta-galactosidase expression in articular cartilage and disease severity of patients with knee osteoarthritis. Int J Rheum Dis 2013; 19:226-32. [PMID: 26112901 DOI: 10.1111/1756-185x.12096] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The purposes of this study were to investigate senescence-associated beta-galactosidase (SA-beta-Gal) levels in articular cartilage of knee osteoarthritis (OA) and the relationship with severity of the disease. METHODS All the 50 cartilage tissues, including normal (controls) and OA cartilage were ascribed to four groups of normal, mild lesions, moderate lesions and severe lesions on the basis of the modified Mankin score. Immunohistochemistry was used to assess the SA-beta-Gal expression in articular cartilage. RESULTS No SA-beta-Gal staining was observed in the normal articular cartilage samples. SA-beta-Gal staining was found in a subset of the chondrocytes close to the lesion site of mild, moderate and severe damaged knee OA cartilage. The percentage of SA-beta-Gal-positive chondrocytes in articular cartilage was 0% in controls, 13.00 ± 5.77% in mild lesions, 31.65 ± 6.91% in moderate lesions and 51.95 ± 6.21% in severe lesions. SA-beta-Gal expression in mild lesions, moderate lesions and severe lesions was higher compared with that of controls (P < 0.0001). SA-beta-Gal expression in moderate lesions and severe lesions were higher with respect to mild lesion samples (P < 0.0001). SA-beta-Gal expression in severe lesions was elevated compared with those of moderate lesions (P < 0.0001). Subsequent analysis showed that articular cartilage SA-beta-Gal levels correlated with severity of disease (Spearman's ρ = 0.94, P < 0.0001). CONCLUSION SA-beta-Gal expression in articular cartilage is associated with progressive knee OA joint damage and is a potential indictor of disease severity.
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Affiliation(s)
- Shu-Guang Gao
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Orthopaedics Institute of Central South University, Changsha, Hunan, China
| | - Chao Zeng
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Liang-Jun Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Department of Orthopaedics, Changsha Central Hospital, Changsha, Hunan, China
| | - Wei Luo
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Fang-Jie Zhang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jian Tian
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chao Cheng
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Min Tu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yi-Lin Xiong
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Wei Jiang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Mai Xu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Guang-Hua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Orthopaedics Institute of Central South University, Changsha, Hunan, China
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Corallo C, Battisti E, Albanese A, Vannoni D, Leoncini R, Landi G, Gagliardi A, Landi C, Carta S, Nuti R, Giordano N. Proteomics of human primary osteoarthritic chondrocytes exposed to extremely low-frequency electromagnetic fields (ELF EMFs) and to therapeutic application of musically modulated electromagnetic fields (TAMMEF). Electromagn Biol Med 2013; 33:3-10. [PMID: 23713417 DOI: 10.3109/15368378.2013.782316] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Osteoarthritis (OA) is the most frequent joint disease, characterized by degradation of extracellular matrix and alterations in chondrocyte metabolism. Some authors reported that electromagnetic fields (EMFs) can positively interfere with patients affected by OA, even though the nature of the interaction is still debated. Human primary osteoarthritic chondrocytes isolated from the femoral heads of OA-patients undergoing to total hip replacement, were cultured in vitro and exposed 30 min/day for two weeks to extremely-low-frequency electromagnetic field (ELF) with fixed frequency (100 Hz) and to therapeutic application of musically modulated electromagnetic fields (TAMMEF) with variable frequencies, intensities and waveforms. Sham-exposed (S.E.) cells served as control group. Cell viability was measured at days 2, 7 and 14. After two weeks, cell lysates were processed using a proteomic approach. Chondrocyte exposed to ELF and TAMMEF system demonstrated different viability compared to untreated chondrocytes (S.E.). Proteome analysis of 2D-Electrophoresis and protein identification by mass spectrometry showed different expression of proteins derived from nucleus, cytoplasm and organelles. Function analysis of the identified proteins showed changes in related-proteins metabolism (glyceraldeyde-3-phosphate-dehydrogenase), stress response (Mn-superoxide-dismutase, heat-shock proteins), cytoskeletal regulation (actin), proteinase inhibition (cystatin-B) and inflammation regulatory functions (S100-A10, S100-A11) among the experimental groups (ELF, TAMMEF and S.E.). In conclusion, EMFs do not cause damage to chondrocytes, besides stimulate safely OA-chondrocytes and are responsible of different protein expression among the three groups. Furthermore, protein analysis of OA-chondrocytes treated with ELF and the new TAMMEF systems could be useful to clarify the pathogenetic mechanisms of OA by identifying biomarkers of the disease.
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Affiliation(s)
- Claudio Corallo
- Department of Internal Medicine, Endocrine-Metabolic Sciences and Biochemistry
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Matthews DJ, Hossain FS, Patel S, Haddad FS. A Cohort Study Predicts Better Functional Outcomes and Equivalent Patient Satisfaction Following UKR Compared with TKR. HSS J 2013; 9:21-4. [PMID: 24426840 PMCID: PMC3640712 DOI: 10.1007/s11420-012-9326-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 12/06/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND Total knee replacement (TKR) is considered the gold standard treatment for advanced osteoarthritis of the knee (Choong and Dowsey, Int J Rheum Dis 14:167-74, 2011; Satku, Singapore Med J 44:554-556, 2003). Unicompartmental disease can be treated with unicompartmental knee replacement (UKR) or TKR. Some surgeons prefer the proven track record of TKR, while others prefer the more normal joint kinematics, enhanced proprioception and range of movement achieved with UKR (Hopper and Leach, Knee Surg Sports Traumatol Arthrosc 16:973-9, 2008; Satku, Singapore Med J 44:554-556, 2003). However, there is reported low satisfaction amongst younger patients undergoing UKR (Robertson et al., Acta Orthop Scand 71:262-7, 2000). QUESTIONS/PURPOSES The purpose of this study is to compare patient-reported outcomes, satisfaction and perception of knee normality in age-matched groups of postoperative TKR and UKR patients aiming to answer the following question: Does UKR have lower patient satisfaction than TKR in younger patients? METHODS Sixty-eight patients were recruited from the care of a single surgeon. Patients with isolated medial compartment osteoarthritis, stable ACL and less than grade 3 lateral patellar disease underwent UKR. All other patients underwent TKR. Patients were assessed with validated knee scores. Satisfaction was assessed with a visual analogue scale. RESULTS There was no statistical difference in patient satisfaction or perception of knee normality scores between the two groups, despite better functional scores including WOMAC, SF-36 and Oxford knee in the UKR group. CONCLUSION Patient satisfaction is similar amongst TKR and UKR patients despite better functional outcome in terms of recreation and sport with UKR. This may reflect higher preoperative expectations in patients undergoing UKR. Further work is needed to assess this.
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Affiliation(s)
| | | | - Shelain Patel
- University College London Hospital, 235 Euston Road, London, NW1 2BU UK
| | - Fahad S. Haddad
- University College London Hospital, 235 Euston Road, London, NW1 2BU UK
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Solorio LD, Vieregge EL, Dhami CD, Alsberg E. High-density cell systems incorporating polymer microspheres as microenvironmental regulators in engineered cartilage tissues. TISSUE ENGINEERING PART B-REVIEWS 2012; 19:209-20. [PMID: 23126333 DOI: 10.1089/ten.teb.2012.0252] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
To address the significant clinical need for tissue-engineered therapies for the repair and regeneration of articular cartilage, many systems have recently been developed using bioactive polymer microspheres as regulators of the chondrogenic microenvironment within high-density cell cultures. In this review, we highlight various densely cellular systems utilizing polymer microspheres as three-dimensional (3D) structural elements within developing engineered cartilage tissue, carriers for cell expansion and delivery, vehicles for spatiotemporally controlled growth factor delivery, and directors of cell behavior via regulation of cell-biomaterial interactions. The diverse systems described herein represent a shift from the more traditional tissue engineering approach of combining cells and growth factors within a biomaterial scaffold, to the design of modular systems that rely on the assembly of cells and bioactive polymer microspheres as building blocks to guide the creation of articular cartilage. Cell-based assembly of 3D microsphere-incorporated structures represents a promising avenue for the future of tissue engineering.
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Affiliation(s)
- Loran D Solorio
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106, USA
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Bhandari M, Smith J, Miller LE, Block JE. Clinical and economic burden of revision knee arthroplasty. CLINICAL MEDICINE INSIGHTS-ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2012; 5:89-94. [PMID: 23239930 PMCID: PMC3520180 DOI: 10.4137/cmamd.s10859] [Citation(s) in RCA: 121] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Surgery is indicated for symptomatic knee osteoarthritis (OA) when conservative measures are unsuccessful. High tibial osteotomy (HTO), unicompartmental knee arthroplasty (UKA), and total knee arthroplasty (TKA) are surgical options intended to relieve knee OA pain and dysfunction. The choice of surgical intervention is dependent on several factors such as disease location, patient age, comorbidities, and activity levels. Regardless of surgical treatment, complications such as infection, loosening or lysis, periprosthetic fracture, and postoperative pain are known risks and are indications for revision surgery. The clinical and economic implications for revision surgery are underappreciated. Over 55,000 revision surgeries were performed in 2010 in the US, with 48% of these revisions in patients under 65 years. Total costs associated with each revision TKA surgery have been estimated to be in excess of $49,000. The current annual economic burden of revision knee OA surgery is $2.7 billion for hospital charges alone. By 2030, assuming a 5-fold increase in the number of revision procedures, this economic burden will exceed $13 billion annually. It is appealing to envision a therapy that could delay or obviate the need for arthroplasty. From an actuarial standpoint, this would have the theoretical downstream effect of substantially reducing the number of revision procedures. Although no known therapies currently meet these criteria, such a breakthrough would have a tremendous impact in lessening the clinical and economic burden of knee OA revision surgery.
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Affiliation(s)
- Mohit Bhandari
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
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