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Oo WM, Linklater J, Siddiq MAB, Fu K, Hunter DJ. Comparison of ultrasound guidance with landmark guidance for symptomatic benefits in knee, hip and hand osteoarthritis: Systematic review and meta-analysis of randomised controlled trials. Australas J Ultrasound Med 2024; 27:97-105. [PMID: 38784696 PMCID: PMC11109994 DOI: 10.1002/ajum.12386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Introduction More than half of the patients with moderate and severe osteoarthritis (OA) report unsatisfactory pain relief, requiring consideration of intra-articular (IA) injections as the second-line management. Ultrasound-guided IA injection has proven evidence of higher accuracy in administering IA injectates into the joints than landmark-guided or blind IA injections. However, questions remain about translating higher accuracy rates of ultrasound-guided injection into better clinical improvements. Therefore, we examined the symptomatic benefits (pain, function and patient satisfaction) of ultrasound-guided injection in knee, hip and hand OA compared with blind injections by synthesising a systematic review and meta-analysis of randomised controlled trials (RCT). Methods PubMed, Medline and Embase databases were searched for eligible studies from their inception to August 28, 2023. Results Out of 295 records, our meta-analysis included four RCTs (338 patients with knee OA), demonstrating significant improvement in procedural pain [-0.89 (95% CI -1.25, -0.53)], pain at follow-up [-0.51 (95% CI -0.98, -0.04)] and function [1.30 (95% CI 0.86, 1.73)], favouring ultrasound guidance. One single study showed higher patient satisfaction with ultrasound guidance. Conclusion Ultrasound-guided IA injection provided superior clinical outcomes compared with landmark-guided IA injection.
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Affiliation(s)
- Win Min Oo
- Department of Physical Medicine and Rehabilitation, Mandalay General HospitalUniversity of MedicineMandalayMyanmar
- Rheumatology Department, Royal North Shore Hospital, and Sydney Musculoskeletal Health, Kolling Institute, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | | | - Md Abu Bakar Siddiq
- Rheumatology Department, Royal North Shore Hospital, and Sydney Musculoskeletal Health, Kolling Institute, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Kai Fu
- Rheumatology Department, Royal North Shore Hospital, and Sydney Musculoskeletal Health, Kolling Institute, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
- Department of Orthopedic SurgeryShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - David J. Hunter
- Rheumatology Department, Royal North Shore Hospital, and Sydney Musculoskeletal Health, Kolling Institute, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
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2
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Chen Q, Jin Y, Chen T, Zhou H, Wang X, Wu O, Chen L, Zhang Z, Guo Z, Sun J, Wu A, Qian Q. Injectable nanocomposite hydrogels with enhanced lubrication and antioxidant properties for the treatment of osteoarthritis. Mater Today Bio 2024; 25:100993. [PMID: 38440110 PMCID: PMC10909650 DOI: 10.1016/j.mtbio.2024.100993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 01/21/2024] [Accepted: 02/03/2024] [Indexed: 03/06/2024] Open
Abstract
Osteoarthritis (OA) is a chronic inflammatory joint disease characterized by progressive cartilage degeneration, synovitis, and osteoid formation. In order to effectively treat OA, it is important to block the harmful feedback caused by reactive oxygen species (ROS) produced during joint wear. To address this challenge, we have developed injectable nanocomposite hydrogels composed of polygallate-Mn (PGA-Mn) nanoparticles, oxidized sodium alginate, and gelatin. The inclusion of PGA-Mn not only enhances the mechanical strength of the biohydrogel through a Schiff base reaction with gelatin but also ensures efficient ROS scavenging ability. Importantly, the nanocomposite hydrogel exhibits excellent biocompatibility, allowing it to effectively remove ROS from chondrocytes and reduce the expression of inflammatory factors within the joint. Additionally, the hygroscopic properties of the hydrogel contribute to reduced intra-articular friction and promote the production of cartilage-related proteins, supporting cartilage synthesis. In vivo experiments involving the injection of nanocomposite hydrogels into rat knee joints with an OA model have demonstrated successful reduction of osteophyte formation and protection of cartilage from wear, highlighting the therapeutic potential of this approach for treating OA.
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Affiliation(s)
- Qizhu Chen
- Department of Orthopaedics, Key Laboratory of Structural Malformations in Children of Zhejiang Province, Key Laboratory of Orthopaedics of Zhejiang Province, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Yuxin Jin
- Department of Orthopaedics, Key Laboratory of Structural Malformations in Children of Zhejiang Province, Key Laboratory of Orthopaedics of Zhejiang Province, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Tao Chen
- Department of Orthopaedics, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Tongji Hospital of Tongji University, Shanghai, 200065, China
| | - Hao Zhou
- Department of Orthopaedics, Key Laboratory of Structural Malformations in Children of Zhejiang Province, Key Laboratory of Orthopaedics of Zhejiang Province, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Xinzhou Wang
- Department of Orthopaedics, Key Laboratory of Structural Malformations in Children of Zhejiang Province, Key Laboratory of Orthopaedics of Zhejiang Province, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Ouqiang Wu
- Department of Orthopaedics, Key Laboratory of Structural Malformations in Children of Zhejiang Province, Key Laboratory of Orthopaedics of Zhejiang Province, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Linjie Chen
- Department of Orthopaedics, Key Laboratory of Structural Malformations in Children of Zhejiang Province, Key Laboratory of Orthopaedics of Zhejiang Province, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Zhiguang Zhang
- Department of Orthopaedics, Key Laboratory of Structural Malformations in Children of Zhejiang Province, Key Laboratory of Orthopaedics of Zhejiang Province, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Zhengyu Guo
- Department of Orthopaedics, Key Laboratory of Structural Malformations in Children of Zhejiang Province, Key Laboratory of Orthopaedics of Zhejiang Province, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Jin Sun
- Department of Orthopaedics, Key Laboratory of Structural Malformations in Children of Zhejiang Province, Key Laboratory of Orthopaedics of Zhejiang Province, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Aimin Wu
- Department of Orthopaedics, Key Laboratory of Structural Malformations in Children of Zhejiang Province, Key Laboratory of Orthopaedics of Zhejiang Province, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Qiuping Qian
- Zhejiang Engineering Research Center for Tissue Repair Materials, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, Zhejiang, 325000, China
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Kamel SI, Rosas HG, Gorbachova T. Local and Systemic Side Effects of Corticosteroid Injections for Musculoskeletal Indications. AJR Am J Roentgenol 2024; 222:e2330458. [PMID: 38117096 DOI: 10.2214/ajr.23.30458] [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: 12/21/2023]
Abstract
Corticosteroid injections can be associated with a range of potential side effects, which may be classified as local or systemic and further stratified as immediate or delayed in onset. Radiologists performing image-guided musculoskeletal injections should recognize the potential side effects of corticosteroid medication when counseling patients before injection and consider such side effects in planning individual injections. This Review summarizes the available evidence regarding the local and systemic side effects of corticosteroid injections performed for musculoskeletal indications. Local side effects include postinjection flare, skin hypopigmentation and atrophy, infection, tendon rupture, accelerated progression of osteoarthritis, and osseous injury. Systemic side effects include adrenal suppression or insufficiency, facial flushing, hypertension, hyperglycemia, and osteoporosis. Additional targeted counseling is warranted regarding side effects that are specific to certain patient populations (i.e., premenopausal women, patients with diabetes, athletes, and pediatric patients). Corticosteroid injections are contraindicated in the presence of superficial or deep infection, fracture, or a prosthetic joint. Guidelines on the frequency, duration, and maximal lifetime use of corticosteroid injections are currently lacking. Further research is needed regarding the long-term complications of continuous corticosteroid use, particularly with regard to osseous effects.
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Affiliation(s)
- Sarah I Kamel
- Department of Radiology, Thomas Jefferson University Hospital, 111 S 11th St, Philadelphia, PA 19107
| | - Humberto G Rosas
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI
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Chakraborty A, Zhuang T, Shapiro LM, Amanatullah DF, Kamal RN. Is There Variation in Time to and Type of Treatment for Hip Osteoarthritis Based on Insurance? J Arthroplasty 2024; 39:606-611.e6. [PMID: 37778640 DOI: 10.1016/j.arth.2023.09.029] [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: 05/04/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Disparities in care access based on insurance exist for total hip arthroplasty (THA), but it is unclear if these lead to longer times to surgery. We evaluated whether rates of THA versus nonoperative interventions (NOI) and time to THA from initial hip osteoarthritis (OA) diagnosis vary by insurance type. METHODS Using a national claims database, patients who had hip OA undergoing THA or NOI from 2011 to 2019 were identified and divided by insurance type: Medicaid-managed care; Medicare Advantage; and commercial insurance. The primary outcome was THA incidence within 3 years after hip OA diagnosis. Multivariable logistic regression models were created to assess the association between THA and insurance type, adjusting for age, sex, region, and comorbidities. RESULTS Medicaid patients had lower rates of THA within 3 years of initial diagnosis (7.4 versus 10.9 or 12.0%, respectively; P < .0001) and longer times to surgery (297 versus 215 or 261 days, respectively; P < .0001) compared to Medicare Advantage and commercially-insured patients. In multivariable analyses, Medicaid patients were also less likely to receive THA (odds ratio (OR) = 0.62 [95% confidence intervals (CI): 0.60 to 0.64] versus Medicare Advantage, OR = 0.63 [95% CI: 0.61 to 0.64] versus commercial) or NOI (OR = 0.92 [95% CI: 0.91 to 0.94] versus Medicare Advantage, OR = 0.81 [95% CI: 0.79 to 0.82] versus commercial). CONCLUSIONS Medicaid patients experienced lower rates of and longer times to THA than Medicare Advantage or commercially-insured patients. Further investigation into causes of these disparities, such as costs or access barriers, is necessary to ensure equitable care.
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Affiliation(s)
- Aritra Chakraborty
- Department of Orthopaedic Surgery, VOICES Health Policy Research Center, Stanford University School of Medicine, Redwood City, California
| | - Thompson Zhuang
- Department of Orthopaedic Surgery, VOICES Health Policy Research Center, Stanford University School of Medicine, Redwood City, California
| | - Lauren M Shapiro
- Department of Orthopaedic Surgery, University of California - San Francisco, San Francisco, California
| | - Derek F Amanatullah
- Department of Orthopaedic Surgery, VOICES Health Policy Research Center, Stanford University School of Medicine, Redwood City, California
| | - Robin N Kamal
- Department of Orthopaedic Surgery, VOICES Health Policy Research Center, Stanford University School of Medicine, Redwood City, California
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5
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Sabatini FM, Cohen-Rosenblum A, Eason TB, Hannon CP, Mounce SD, Krueger CA, Gwathmey FW, Duncan ST, Landy DC. Incidence of Rapidly Progressive Osteoarthritis Following Intra-articular Hip Corticosteroid Injection: A Systematic Review and Meta-Analysis. Arthroplast Today 2023; 24:101242. [PMID: 37941925 PMCID: PMC10630590 DOI: 10.1016/j.artd.2023.101242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/05/2023] [Accepted: 09/14/2023] [Indexed: 11/10/2023] Open
Abstract
Background The American Academy of Orthopedic Surgery recommends intra-articular corticosteroid injections (CSIs) for managing hip osteoarthritis (OA) based on short-term, prospective studies. Recent retrospective studies have raised concerns that CSIs may lead to rapidly progressive OA (RPOA). We sought to systematically review the literature of CSIs for hip OA to estimate the incidence of RPOA. Methods MEDLINE, Embase, and Cochrane Library were searched to identify original research of hip OA patients receiving CSIs. Overall, 27 articles involving 5831 patients published from 1988 to 2022 were included. Study design, patient characteristics, CSI details, follow-up, and cases of RPOA were recorded. Studies were classified by their ability to detect RPOA based on follow-up. Random effects meta-analysis was used to calculate the incidence of RPOA for studies able to detect RPOA. Results The meta-analytic estimate of RPOA incidence was 6% (95% confidence interval, 3%-9%) based on 10 articles classified as able to detect RPOA. RPOA definitions varied from progression of OA within 6 months to the presence of destructive changes. These studies were subject to bias from excluding patients with missing post-CSI radiographs. The remaining 17 articles were classified as unable to detect RPOA, including all of the studies cited in the American Academy of Orthopedic Surgery recommendation. Conclusions The incidence of RPOA after CSIs remains unknown due to variation in definitions and follow-up. While RPOA following CSIs may be 6%, many cases are not severe, and this may reflect selection bias. Further research is needed to understand whether clinically significant RPOA is incident enough to limit CSI use.
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Affiliation(s)
- Franco M. Sabatini
- Department of Orthopaedic Surgery, University of Kentucky, Lexington, KY
| | | | - Travis B. Eason
- Department of Orthopaedic Surgery, University of Kentucky, Lexington, KY
| | - Charles P. Hannon
- Department of Orthopedic Surgery, Washington University, St. Louis, MO
| | - Samuel D. Mounce
- Department of Orthopaedic Surgery, University of Kentucky, Lexington, KY
| | - Chad A. Krueger
- Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Philadelphia, PA
| | - F. Winston Gwathmey
- Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA
| | - Stephen T. Duncan
- Department of Orthopaedic Surgery, University of Kentucky, Lexington, KY
| | - David C. Landy
- Department of Orthopaedic Surgery, University of Kentucky, Lexington, KY
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6
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Taveesuksiri R, Kulalert P, Jitapunkul C, Apivatgaroon A. Efficacy of three different techniques in the fluoroscopy-guided intra-articular steroid injection of the hip: a randomized controlled trial. Sci Rep 2023; 13:17214. [PMID: 37821601 PMCID: PMC10567744 DOI: 10.1038/s41598-023-44595-5] [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: 03/06/2023] [Accepted: 10/10/2023] [Indexed: 10/13/2023] Open
Abstract
Fluoroscopy-guided injection via the anterior (A), anterolateral (AL), or proximal anterolateral (PAL) approaches are the common hip injection techniques without comparing the efficacy of the three techniques. The prospective randomized controlled trial was conducted from August 2020 to March 2022. Included patients with intra-articular hip disorders indicated an intra-articular steroid injection. Excluded significant spine pathology with radiculopathy or significant neurological deficits, previous hip surgery of the injection side, suspected tumor or infection origins, steroid or contrast media allergy, and body mass index > 35 kg/m2. The primary outcome was the injection attempt defining one attempt and multiple attempts. 90 patients were recruited and allocated to 30 per group. There were no differences between A, AL, and PAL respectively regarding the success in one attempt rate (80%, 80%, 90%; p = 0.533), VAS during local anesthetic injection (4.33 ± 1.99, 3.70 ± 2.34, 4.27 ± 2.49; p = 0.500), VAS during intra-articular injection (4.27 ± 1.87, 4.70 ± 2.37, 4.13 ± 2.37; p = 0.587), radiation doses (0.558 ± 0.313, 0.526 ± 0.485, 0.492 ± 0.275 mGy; p = 0.788), radiation time (0.043 ± 0.017, 0.039 ± 0.021, 0.041 ± 0.015 seconds; p = 0.723), and complications. The post-injection mHHS was improved in all three approaches without significant differences.
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Affiliation(s)
- Rakop Taveesuksiri
- Department of Orthopaedics, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Prapasri Kulalert
- Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Chane Jitapunkul
- Department of Orthopaedics, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Adinun Apivatgaroon
- Department of Orthopaedics, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand.
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7
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Guermazi A, Hunter DJ, Kloppenburg M. Debate: Intra-articular steroid injections for osteoarthritis - harmful or helpful? ☆,☆☆. OSTEOARTHRITIS IMAGING 2023; 3:100163. [PMID: 38313846 PMCID: PMC10836165 DOI: 10.1016/j.ostima.2023.100163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
Intra-articular corticosteroids injections are a widely used treatment for pain from symptomatic osteoarthritis. Systematic reviews show that the treatment effect is modest compared with intra-articular saline (often considered as placebo) and lasts for 2-4 weeks on average. Potentially as a consequence of limited therapeutic duration, repeated injections are often given up to 4 injections annually. In this context of repeat injections, recent evidence has emerged that intra-articular corticosteroids might be associated with more MRI-assessed quantitative cartilage thickness loss than saline injections. Guidelines vary in the recommendation for use of intra-articular corticosteroids. Given the frequency with which intra-articular corticosteroids injections are used, the size and scale of the population with osteoarthritis, it is critical to fully understand the benefits and drawbacks of intra-articular corticosteroids injections. That is the focus of this debate article.
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Affiliation(s)
- Ali Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building, 4th floor, Boston, MA, 02118, USA
- Department of Radiology, VA Boston Healthcare System, 1400 VFW Parkway, Suite 1B105, West Roxbury, MA, 02132, USA
| | - David J Hunter
- Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Reserve Rd, St. Leonards, 2065, NSW, Australia
| | - Margreet Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
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8
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Liu B, Xu HY, Zhang R, Han L, Li Y, Sun XF. An Update on Clinical Utility of Musculoskeletal Ultrasonography in Knee Osteoarthritis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:1413-1422. [PMID: 36715025 DOI: 10.1002/jum.16176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/27/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
In knee osteoarthritis (KOA), timely and accurate assessment of the severity is essential to help orthopedic surgeons determine the most appropriate therapeutic strategies and evaluate disease outcomes and responses for corresponding treatments. In KOA, musculoskeletal ultrasonography (MSUS) could effectively help detect various abnormalities, including synovitis, osteophytes, and cartilage damage. Further, MSUS could be used to monitor the response to different therapies in KOA, to guide local diagnostic and therapeutic procedures. In the future, applications based on continuously evolving US tools could enhance the clinical utility of MSUS in KOA.
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Affiliation(s)
- Bo Liu
- Department of Cadre's Wards Ultrasound Diagnostics,Ultrasound Diagnostic Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Hui-Ying Xu
- Department of Cadre's Wards Ultrasound Diagnostics,Ultrasound Diagnostic Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Rui Zhang
- Department of Cadre's Wards Ultrasound Diagnostics,Ultrasound Diagnostic Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Lu Han
- Department of Cadre's Wards Ultrasound Diagnostics,Ultrasound Diagnostic Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yang Li
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Xiao-Feng Sun
- Department of Cadre's Wards Ultrasound Diagnostics,Ultrasound Diagnostic Center, The First Hospital of Jilin University, Changchun, Jilin, China
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9
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Li G, Liu S, Chen Y, Zhao J, Xu H, Weng J, Yu F, Xiong A, Udduttula A, Wang D, Liu P, Chen Y, Zeng H. An injectable liposome-anchored teriparatide incorporated gallic acid-grafted gelatin hydrogel for osteoarthritis treatment. Nat Commun 2023; 14:3159. [PMID: 37258510 DOI: 10.1038/s41467-023-38597-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 05/10/2023] [Indexed: 06/02/2023] Open
Abstract
Intra-articular injection of therapeutics is an effective strategy for treating osteoarthritis (OA), but it is hindered by rapid drug diffusion, thereby necessitating high-frequency injections. Hence, the development of a biofunctional hydrogel for improved delivery is required. In this study, we introduce a liposome-anchored teriparatide (PTH (1-34)) incorporated into a gallic acid-grafted gelatin injectable hydrogel (GLP hydrogel). We show that the GLP hydrogel can form in situ and without affecting knee motion after intra-articular injection in mice. We demonstrate controlled, sustained release of PTH (1-34) from the GLP hydrogel. We find that the GLP hydrogel promotes ATDC5 cell proliferation and protects the IL-1β-induced ATDC5 cells from further OA progression by regulating the PI3K/AKT signaling pathway. Further, we show that intra-articular injection of hydrogels into an OA-induced mouse model promotes glycosaminoglycans synthesis and protects the cartilage from degradation, supporting the potential of this biomaterial for OA treatment.
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Affiliation(s)
- Guoqing Li
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Su Liu
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Yixiao Chen
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Jin Zhao
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Huihui Xu
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Jian Weng
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Fei Yu
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Ao Xiong
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Anjaneyulu Udduttula
- Centre for Biomaterials, Cellular and Molecular Theranostics (CBCMT), Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, 632014, India
| | - Deli Wang
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Peng Liu
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China.
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China.
| | - Yingqi Chen
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China.
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China.
| | - Hui Zeng
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China.
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China.
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, 1120 Lianhua Road, Futian District, Shenzhen, Guangdong Province, PR China.
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10
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Malhotra G, Hansford BG, Felcher C, Wuerfel KA, Yablon CM. Fluoroscopic-guided procedures of the lower extremity. Skeletal Radiol 2023; 52:855-874. [PMID: 35930079 PMCID: PMC9362560 DOI: 10.1007/s00256-022-04139-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 02/02/2023]
Abstract
This article reviews the literature and the authors' experiences regarding the performance of lower extremity fluoroscopically guided procedures from the hip to the toes. An overview of injections and aspirations, their indications, risks, and complications are provided, focusing on anesthetics, corticosteroids, and contrast agents. A variety of approaches to each joint and the associated pearls and pitfalls of each approach will be discussed.
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Affiliation(s)
- Gunjan Malhotra
- grid.214458.e0000000086837370Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI 48109 USA
| | - Barry G. Hansford
- grid.5288.70000 0000 9758 5690Department of Radiology, Oregon Health & Science University, 3181 SW Jackson Park Rd., Portland, OR 97239 USA
| | - Cindy Felcher
- grid.214458.e0000000086837370Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI 48109 USA
| | - Kristie A. Wuerfel
- grid.214458.e0000000086837370Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI 48109 USA
| | - Corrie M. Yablon
- grid.214458.e0000000086837370Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI 48109 USA
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11
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Jennings JW. The Safety and Potential Harm of Intraarticular Steroid Injections: The Debate Continues. Radiology 2022; 304:370-371. [PMID: 35536140 DOI: 10.1148/radiol.220700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jack W Jennings
- From the Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St Louis, MO 63110; and Siteman Cancer Center, St Louis, Mo
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