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Wake JL, Chung B, Bottoni CR, Zhou L. Management Considerations for Unicompartmental Osteoarthritis in Athletic Populations: A Review of the Literature. J Knee Surg 2024; 37:693-701. [PMID: 35798349 DOI: 10.1055/s-0042-1750750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Unicompartmental osteoarthritis in the young athlete poses a challenge for both patients and providers. Coronal plane malalignment is frequently a concomitant finding that adds to the complexity of management. Military surgeons are presented unique challenges, in that they must consider optimal joint-preservation methods while returning patients to a high-demand occupational function. Management options range from lifestyle changes to surgical interventions. We present a concise review of the available literature on this subject, with a specific focus on indications and outcomes within the military and young athletic population.
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Affiliation(s)
- Jeffrey L Wake
- Department of Orthopaedic Surgery, Tripler Army Medical Center, Tripler AMC, Hawaii
| | - Brandon Chung
- Department of Orthopaedic Surgery, Tripler Army Medical Center, Tripler AMC, Hawaii
| | - Craig R Bottoni
- Department of Orthopaedic Surgery, Tripler Army Medical Center, Tripler AMC, Hawaii
| | - Liang Zhou
- Department of Orthopaedic Surgery, Tripler Army Medical Center, Tripler AMC, Hawaii
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2
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Liu F, Su F, Zhang T, Liu R, Liu N, Dong T. Relationship between knee osteophytes and calcitonin gene-related peptide concentrations of serum and synovial fluid in knee of osteoarthritis. Medicine (Baltimore) 2023; 102:e34691. [PMID: 37657066 PMCID: PMC10476791 DOI: 10.1097/md.0000000000034691] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/20/2023] [Indexed: 09/03/2023] Open
Abstract
To explore the relationship between knee osteophytes of osteoarthritic knee and calcitonin gene-related peptide (CGRP) concentrations of serum and synovial fluid (SF). 65 patients with knee medial compartment osteoarthritis (OA) were recruited and examined with weight-bearing radiographs of the entire lower limb. The concentrations of CGRP in serum/SF were also detected in surgery. The relationship between the concentrations of CGRP in serum/SF and osteophyte scores were detected with Spearman rank correlation coefficient. CGRP concentrations in serum and SF were significantly correlated with osteophyte score of overall knee respectively (R = 0.462, P < .001; R = 0.435, P < .001). In addition, a correlation tended to be observed about the relationship between CGRP concentrations in serum and SF and osteophyte scores of medial compartment (R = 0.426, P < .001; R = 0.363, P = .003), and osteophyte scores of lateral compartment (R = 0.429, P < .001; R = 0.444, P < .001). In this study, the relationship between CGRP in serum/SF and knee osteophyte scores in different subregions were explored, which showed significant positive correlations, that possibly reflecting the contribution of CGRP influencing osteophyte formation. Positive correlations between osteophyte scores and CGRP suggest that CGRP promote the growth of osteophyte formation. It has the potential to be selected as a biomarker for the assessment of severity in knee OA patients and predict the progression of knee OA. It also provides a potential therapeutic target to delay the progression and relieve the symptom of OA.
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Affiliation(s)
- Fan Liu
- Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Fan Su
- Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Tao Zhang
- Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Rui Liu
- Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Na Liu
- Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Tianhua Dong
- Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
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3
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Lineham B, Wijayathunga H, Moran E, Shuweihdi F, Gupta H, Pandit H, Wijayathunga N. A systematic review demonstrating correlation of MRI compositional parameters with clinical outcomes following articular cartilage repair interventions in the knee. OSTEOARTHRITIS AND CARTILAGE OPEN 2023; 5:100388. [PMID: 37560388 PMCID: PMC10407572 DOI: 10.1016/j.ocarto.2023.100388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 07/21/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVE Compositional-MRI parameters enable the assessment of cartilage ultrastructure. Correlation of these parameters with clinical outcomes is unclear. This systematic review investigated the correlation of various compositional- MRI parameters with clinical outcome measures following cartilage repair or regeneration interventions in the knee. DESIGN This study was registered with PROSPERO and reported in accordance with PRISMA. PubMed, Institute of Science Index, Scopus, Cochrane Central Register of Controlled Trials, and Embase databases were searched. All studies, regardless of type, that presented correlation of compositional- MRI parameters with clinical outcome measures were included. Two researchers independently performed data extraction and QUADAS-2 analysis. Compositional-MRI parameter change following intervention and correlation with clinical outcome measures were evaluated. RESULTS 19 studies were included. Risk of bias was generally low. 5 different compositional parameters were observed from the included studies. However, due to the significant variability in the reporting of compositional-MRI parameters across studies, meta-analyses were possible only for T2 values and T2 index values (T2 value of repair cartilage relative to normal cartilage). Correlation of T2 values of repair cartilage with clinical outcome score was r = 0.33 [0.15, 0.52]. Correlation of T2 index with clinical outcome score was r = 0.52 [0.32, 0.77]. CONCLUSIONS Correlation between T2 values and clinical outcome scores following knee cartilage repair were found. The heterogeneity of the correlations extracted from the included studies limited the scope for the meta-analysis. Thus, standardised, high-quality studies are required for better assessment of correlation between compositional MRI parameters and clinical outcome measures after cartilage repair. REGISTRATION NUMBER PROSPERO CRD42021287364.Study protocol available on PROSPERO website.
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Affiliation(s)
- Beth Lineham
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, UK
| | | | - Emma Moran
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Harun Gupta
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Hemant Pandit
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, UK
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4
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Efficacy of Fu's Subcutaneous Needling in Treating Soft Tissue Pain of Knee Osteoarthritis: A Randomized Clinical Trial. J Clin Med 2022; 11:jcm11237184. [PMID: 36498758 PMCID: PMC9740707 DOI: 10.3390/jcm11237184] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
Purpose: Fu’s subcutaneous needling (FSN) is a new acupuncture technique that produces a long-lasting effect in soft-tissue injuries. In patients with degenerative knee osteoarthritis (OA), myofascial trigger points (MTrPs) are common in the lower-limb muscles. In this randomized clinical trial, we evaluated the immediate, 1-week and 2-week effectiveness of FSN therapy in the treatment of degenerative knee OA. Patients and methods: We randomly divided 32 patients with knee OA into the FSN group (mean age: 65.73 ± 6.79 years) or the transcutaneous electrical nerve stimulation (TENS) group (mean age: 62.81 ± 5.72 years). The pressure pain threshold (PPT) and tissue hardness (TH) of the muscle and tendon attachment sites, knee range of motion, and physical ability (average walking speed) were measured. The subjective pain intensity index, Western Ontario and McMaster Universities OA Index (WOMAC), and Lequesne index were used to determine the efficacy of FSN on MTrP-induced soft-tissue pain compared with that of TENS. Results: A significantly greater improvement in pain qualities in the VAS (p < 0.05) was found in the FSN group. Moreover, in muscle and tendon qualities (including PPT and TH), a significant difference in the PPT of the quadriceps muscle (p < 0.05) was also observed among the immediate treatments in the FSN group. As for the functional index questionnaire assessment, the FSN group exhibited significant improvements among the immediate, 1-week and 2-week efficacies in terms of WOMAC (p < 0.05) and Lequesne index scores (p < 0.05). Conclusion: FSN was effective in treating soft-tissue pain in degenerative knee OA in terms of alleviating pain, strengthening walking ability, and improving overall functional performance. Pain relief was the primary benefit of FSN and a significant correlation between pain relief and knee joint mobility improvement was found. Trial registration: ClinicalTrials.gov Protocol Registration and Results System (registration number: NCT04356651).
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5
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Hunter CW, Deer TR, Jones MR, Chang Chien GC, D'Souza RS, Davis T, Eldon ER, Esposito MF, Goree JH, Hewan-Lowe L, Maloney JA, Mazzola AJ, Michels JS, Layno-Moses A, Patel S, Tari J, Weisbein JS, Goulding KA, Chhabra A, Hassebrock J, Wie C, Beall D, Sayed D, Strand N. Consensus Guidelines on Interventional Therapies for Knee Pain (STEP Guidelines) from the American Society of Pain and Neuroscience. J Pain Res 2022; 15:2683-2745. [PMID: 36132996 PMCID: PMC9484571 DOI: 10.2147/jpr.s370469] [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: 04/13/2022] [Accepted: 08/12/2022] [Indexed: 11/23/2022] Open
Abstract
Knee pain is second only to the back as the most commonly reported area of pain in the human body. With an overall prevalence of 46.2%, its impact on disability, lost productivity, and cost on healthcare cannot be overlooked. Due to the pervasiveness of knee pain in the general population, there are no shortages of treatment options available for addressing the symptoms. Ranging from physical therapy and pharmacologic agents to interventional pain procedures to surgical options, practitioners have a wide array of options to choose from – unfortunately, there is no consensus on which treatments are “better” and when they should be offered in comparison to others. While it is generally accepted that less invasive treatments should be offered before more invasive ones, there is a lack of agreement on the order in which the less invasive are to be presented. In an effort to standardize the treatment of this extremely prevalent pathology, the authors present an all-encompassing set of guidelines on the treatment of knee pain based on an extensive literature search and data grading for each of the available alternative that will allow practitioners the ability to compare and contrast each option.
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Affiliation(s)
- Corey W Hunter
- Ainsworth Institute of Pain Management, New York, NY, USA.,Department of Rehabilitation & Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Timothy R Deer
- The Spine and Nerve Center of the Virginias, Charleston, WV, USA
| | | | | | - Ryan S D'Souza
- Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA
| | | | - Erica R Eldon
- Department of Rehabilitation & Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Johnathan H Goree
- Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Lissa Hewan-Lowe
- Department of Rehabilitation & Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jillian A Maloney
- Department of Anesthesiology, Division of Pain Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Anthony J Mazzola
- Department of Rehabilitation & Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | | - Jeanmarie Tari
- Ainsworth Institute of Pain Management, New York, NY, USA
| | | | | | - Anikar Chhabra
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, AZ, USA
| | | | - Chris Wie
- Interventional Spine and Pain, Dallas, TX, USA
| | - Douglas Beall
- Comprehensive Specialty Care, Oklahoma City, OK, USA
| | - Dawood Sayed
- Department of Anesthesiology, Division of Pain Medicine, University of Kansas Medical Center, Kansas City, KS, USA
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6
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Zhao J, She J, Wang D, Wang F. Extreme Gradient Boosting for Surface Electromyography Classification on Time-Domain Features. JOURNAL OF ADVANCED COMPUTATIONAL INTELLIGENCE AND INTELLIGENT INFORMATICS 2022. [DOI: 10.20965/jaciii.2022.p0722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Surface electromyography (sEMG) signals play an essential role in disease diagnosis and rehabilitation. This study applied a powerful machine learning algorithm called extreme gradient boosting (XGBoost) to classify sEMG signals acquired from muscles around the knee for distinguishing patients with knee osteoarthritis (KOA) from healthy subjects. First, to improve data quality, we preprocessed the data via interpolation and normalization. Next, to ensure the description integrity of model input, we extracted nine time-domain features based on the statistical characteristics of sEMG signals over time. Finally, we classified the samples using XGBoost and cross-validation (CV) and compared the results to those produced by the support vector machine (SVM) and the deep neural network (DNN). Experimental results illustrate that the presented method effectively improves classification performance. Moreover, compared with the SVM and the DNN, XGBoost has higher accuracy and better classification performance, which indicates its advantages in the classification of patients with KOA based on sEMG signals.
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7
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Sorriento A, Cafarelli A, Spinnato P, Russo A, Lisignoli G, Rabusseau F, Cabras P, Dumont E, Ricotti L. Design, Development and Validation of a Knee Brace to Standardize the US Imaging Evaluation of Knee Osteoarthritis. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2022; 10:1800308. [PMID: 35391755 PMCID: PMC8979410 DOI: 10.1109/jtehm.2021.3137628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/09/2021] [Accepted: 12/17/2021] [Indexed: 11/13/2022]
Abstract
Objective: A repeatable and reliable follow-up of knee injuries would be desirable to prevent delayed diagnosis and to monitor the efficacy of the applied treatment over time. Ultrasound (US) techniques are an attractive option to this purpose, since they are safe, low-cost and non-invasive. However, its use in the clinical practice is limited by the high dependency on the operator’s experience. Hence, the objective of this study is to provide a standardization of the US image acquisition process for knee osteoarthritis (OA) allowing an extended clinical use of US technologies in this domain. Methods: Clinical specifications were provided by expert musculoskeletal radiologists thus identifying the subject poses and the US probe positions needed to evaluate the cartilage structure, signs of synovitis and joint effusion. Such considerations were used to derive the technical requirements needed for the development of a wearable brace equipped with specific openings to guide the correct placement of the probe. The feasibility of the developed wearable brace was tested on three healthy volunteers, which were asked to acquire informative US images, similar to the reference images performed by the musculoskeletal radiologist. Results: Thanks to the knee brace, the untrained subjects were able to self-acquire informative B-mode images comparable to the corresponding images acquired by an expert clinician. Discussion/Conclusion: The use of a knee brace intended for knee OA US diagnosis demonstrated the possibility to standardize the acquisition protocol and make its application achievable also for untrained subjects, representing a key step toward tele-ultrasonography.
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Affiliation(s)
- A Sorriento
- BioRobotics Institute, Scuola Superiore Sant'Anna 56127 Pisa Italy
- Department of Excellence in Robotics and AIScuola Superiore Sant'Anna 56127 Pisa Italy
| | - A Cafarelli
- BioRobotics Institute, Scuola Superiore Sant'Anna 56127 Pisa Italy
- Department of Excellence in Robotics and AIScuola Superiore Sant'Anna 56127 Pisa Italy
| | - P Spinnato
- Diagnostic and Interventional RadiologyIRCCS Istituto Ortopedico Rizzoli 40136 Bologna Italy
| | - A Russo
- Clinica 2, IRCCS Istituto Ortopedico Rizzoli 40136 Bologna Italy
| | - G Lisignoli
- SC Laboratorio di Immunoreumatologia e Rigenerazione TissutaleIRCSS Istituto Ortopedico Rizzoli 40136 Bologna Italy
| | - F Rabusseau
- Image Guided Therapy (IGT) 33600 Pessac France
| | - P Cabras
- Image Guided Therapy (IGT) 33600 Pessac France
| | - E Dumont
- Image Guided Therapy (IGT) 33600 Pessac France
| | - L Ricotti
- BioRobotics Institute, Scuola Superiore Sant'Anna 56127 Pisa Italy
- Department of Excellence in Robotics and AIScuola Superiore Sant'Anna 56127 Pisa Italy
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8
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Lawson T, Joenathan A, Patwa A, Snyder BD, Grinstaff MW. Tantalum Oxide Nanoparticles for the Quantitative Contrast-Enhanced Computed Tomography of Ex Vivo Human Cartilage: Assessment of Biochemical Composition and Biomechanics. ACS NANO 2021; 15:19175-19184. [PMID: 34882411 DOI: 10.1021/acsnano.1c03375] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Nanoparticle-based contrast agents, when used in concert with imaging modalities such as computed tomography (CT), enhance the visualization of tissues and boundary interfaces. However, the ability to determine the physiological state of the tissue via the quantitative assessment of biochemical or biomechanical properties remains elusive. We report the synthesis and characterization of tantalum oxide (Ta2O5) nanoparticle (NP) contrast agents for rapid, nondestructive, and quantitative contrast-enhanced computed tomography (CECT) to assess both the glycosaminoglycan (GAG) content and the biomechanical integrity of human metacarpal phalangeal joint (MCPJ) articular cartilage. Ta2O5 NPs 3-6 nm in diameter and coated with either nonionic poly(ethylene) glycol (PEG) or cationic trimethylammonium ligands readily diffuse into both healthy and osteoarthritic MCPJ cartilage. The CECT attenuation for the cationic and neutral NPs correlates with the glycosaminoglycan (GAG) content (R2 = 0.8975, p < 0.05 and 0.7054, respectively) and the equilibrium modulus (R2 = 0.8285, p < 0.05 and 0.9312, p < 0.05, respectively). The results highlight the importance of the surface charge and size in the design of NP agents for targeting and imaging articular cartilage. Further, nanoparticle CECT offers the visualization of both soft tissue and underlying bone unlike plain radiography, which is the standard for imaging bone in musculoskeletal diseases, and the ability to provide a real-time quantitative assessment of both hard and soft tissues to provide a comprehensive image of the disease stage, as demonstrated herein.
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Affiliation(s)
- Taylor Lawson
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, United States
- Department of Mechanical Engineering, Boston University, Boston, Massachusetts 02215, United States
| | - Anisha Joenathan
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, United States
- Division of Material Science, Boston University, Boston, Massachusetts 02215, United States
| | - Amit Patwa
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, United States
- Department of Chemistry, School of Science, Navrachana University, Vadodara, Gujarat 391410, India
| | - Brian D Snyder
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, United States
- Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02215, United States
| | - Mark W Grinstaff
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, United States
- Department of Medicine, Boston University, Boston, Massachusetts 02215 United States
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9
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Sodhi N, Jacofsky DJ, Chee A, Mont MA. Benefits of CT Scanning for the Management of Knee Arthritis and Arthroplasty. J Knee Surg 2021; 34:1296-1303. [PMID: 32268407 DOI: 10.1055/s-0040-1708041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This review investigated the potential value of computed tomography (CT) scans for the evaluation and management of knee arthritis and arthroplasty. Specifically, we evaluated the following: (1) assessment of arthritis within knee compartments, (2) patellofemoral joint assessment, (3) implant sizing prediction, (4) component alignment, (5) soft-tissue protection, and (6) potential concerns with radiation exposure. To compare if CT or X-ray imaging is more accurate and clinically relevant, a search was performed using Boolean search operators and terms: "CT," "radiograph," "joint alignment," "knee," and "arthroplasty," which yielded 661 results. Studies were evaluated based on (1) assessment of arthritis within knee compartments, (2) patellofemoral joint assessment, (3) implant sizing prediction, (4) component alignment, (5) soft-tissue protection, and (6) potential concerns with radiation exposure. Correlative and comparative analyses of imaging modalities to pre-, intra-, and postoperative clinical and patient-related factors were performed for the 63 included studies. CT scans were found to better detect medial and lateral arthritic changes, bony deformities, subchondral cysts, and cartilage losses. CT scans were shown to 99% accurately predict prosthetic sizes preoperatively. CT scans can also help better visualize surrounding anatomy, such as the posterior cruciate ligament, and have therefore been linked to better soft tissue protection during total knee arthroplasty. Although radiation is a potential concern, newer imaging protocols have comparable exposure to plain radiographs. Compared with plain radiographs, CT scans were found to be more accurate and provide more clinically relevant data. Therefore, the authors recommend the use of CT for the evaluation of certain patients with arthritis and for preoperative planning for knee arthroplasty.
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Affiliation(s)
- Nipun Sodhi
- Long Island Jewish Medical Center, Northwell Health, New York, New York
| | - David J Jacofsky
- Department of Orthopaedic Surgery, Adult Reconstruction, The CORE Institute, Phoenix, Arizona
| | - Alexander Chee
- Department of Orthopaedic Surgery, State University of New York Downstate Medical Center, Brooklyn, New York
| | - Michael A Mont
- Department of Orthopedic Surgery, Northwell Hospital Lenox Hill, New York, New York
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10
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Erhart-Hledik JC, Mahtani GB, Asay JL, Migliore E, Nguyen MM, Andriacchi TP, Chu CR. Changes in knee adduction moment wearing a variable-stiffness shoe correlate with changes in pain and mechanically stimulated cartilage oligomeric matrix levels. J Orthop Res 2021; 39:619-627. [PMID: 32497304 DOI: 10.1002/jor.24770] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 04/27/2020] [Accepted: 06/01/2020] [Indexed: 02/04/2023]
Abstract
This study aimed to determine if changes in knee adduction moment (KAM) after 6 months of variable-stiffness shoe wear are associated with changes in symptoms or serum levels of cartilage oligomeric matrix protein (COMP) following a mechanical stimulus in subjects with medial knee osteoarthritis (OA). Twenty-five subjects were enrolled in the study and assigned a variable-stiffness shoe, and 19 subjects completed the 6-month follow-up. At baseline and follow-up subjects underwent gait analysis in control and variable-stiffness shoes, completed Western Ontario and McMaster Universities (WOMAC) questionnaires, and serum COMP concentrations were measured immediately before, 3.5 and 5.5 hours after a 30-minute walking activity. Relationships between changes in KAM (first peak and impulse) and changes in (a) COMP levels in response to the 30-minute walking activity and (b) WOMAC scores from baseline to 6-month follow-up were assessed by Pearson correlation coefficients. Changes in first peak KAM were associated with changes in COMP levels 5.5 hours postactivity from baseline to follow-up (R = .564, P = .045). Subjects with greater reductions in KAM had larger decreases in COMP (expressed as a percent of preactivity levels) at follow-up. Subjects with greater reductions in KAM impulse had significantly greater improvements in WOMAC Pain (R = -.56, P = .015) and Function (R = -.52, P = .028) scores at follow-up. The study results demonstrated the magnitude of reduction in the KAM wearing a variable-stiffness shoe is associated with decreases in mechanically stimulated COMP levels and pain/function. This work suggests that interactions between COMP and joint loading during walking should be further investigated in future studies of treatment outcomes in OA.
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Affiliation(s)
- Jennifer C Erhart-Hledik
- Department of Orthopaedic Surgery, Stanford University, Stanford, California.,VA Palo Alto Health Care System, Palo Alto, California
| | - Gordhan B Mahtani
- Department of Orthopaedic Surgery, Stanford University, Stanford, California.,VA Palo Alto Health Care System, Palo Alto, California
| | - Jessica L Asay
- VA Palo Alto Health Care System, Palo Alto, California.,Department of Mechanical Engineering, Stanford University, Stanford, CA
| | - Eleonora Migliore
- Department of Orthopaedic Surgery, Stanford University, Stanford, California.,VA Palo Alto Health Care System, Palo Alto, California
| | - Michelle M Nguyen
- VA Palo Alto Health Care System, Palo Alto, California.,Department of Radiology, Stanford University, Stanford, CA
| | - Thomas P Andriacchi
- VA Palo Alto Health Care System, Palo Alto, California.,Department of Mechanical Engineering, Stanford University, Stanford, CA
| | - Constance R Chu
- Department of Orthopaedic Surgery, Stanford University, Stanford, California.,VA Palo Alto Health Care System, Palo Alto, California
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11
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He B, Jiang D. HOTAIR-induced apoptosis is mediated by sponging miR-130a-3p to repress chondrocyte autophagy in knee osteoarthritis. Cell Biol Int 2019; 44:524-535. [PMID: 31642563 DOI: 10.1002/cbin.11253] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 10/19/2019] [Indexed: 12/13/2022]
Abstract
Knee osteoarthritis (KOA) is a multifactorial disease characterized by the loss of articular cartilage. Hox transcript antisense intergenic RNA (HOTAIR) long non-coding RNA (lncRNA) is highly expressed in some cases of OA; however, its role in chondrocyte apoptosis in KOA and the mechanism by which HOTAIR mediates apoptosis in chondrocytes are not completely understood. Here, we evaluated the effects of HOTAIR on chondrocyte apoptosis in KOA. Our results showed that HOTAIR expression was significantly upregulated in cartilage tissues located at the femoral condyles or tibial plateaus of OA resection regions when compared with control regions in patients with normal non-weight-bearing area femoral condyle articular cartilage. Overexpression of HOTAIR caused a sharp increase in apoptosis rates and a reduction in the viability of chondrocytes. These effects were accompanied by the upregulation of Bax expression and the proteolytic cleavage of caspase 3 expression and downregulation of survivin and Bcl-2 expression. The silencing of HOTAIR produced the opposite effects. Moreover, the cartilaginous expression of miR-130a-3p was notably reduced in the OA resection regions of KOA patients. Luciferase assays showed that HOTAIR-adsorbed and reduced the levels of miR-130a-3p in chondrocytes. Further, inhibition of miR-130a-3p remarkably promoted the apoptosis of chondrocytes and repressed cell growth, while the silencing of HOTAIR could rescue the apoptosis mediated by miR-130a-3p inhibition. Chondrocyte autophagy was suppressed in a HOTAIR-dependent, miR-130a-3p inhibitor-mediated manner. Overall, our data revealed that aberrantly high expression of HOTAIR resulted in massive apoptosis events caused by the sponging of miR-130a-3p to suppress autophagy in chondrocytes, which, in turn, might trigger KOA. Therefore, inhibition of HOTAIR-mediated apoptosis might be a potential mechanism that can be targeted by gene therapy of KOA.
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Affiliation(s)
- Bin He
- Department of Orthopaedics, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P.R. China
| | - Dianming Jiang
- Department of Orthopaedics, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P.R. China
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12
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Li X, He P, Hou Y, Chen S, Xiao Z, Zhan J, Luo D, Gu M, Lin D. Berberine inhibits the interleukin-1 beta-induced inflammatory response via MAPK downregulation in rat articular chondrocytes. Drug Dev Res 2019; 80:637-645. [PMID: 31032997 DOI: 10.1002/ddr.21541] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 04/05/2019] [Accepted: 04/13/2019] [Indexed: 12/11/2022]
Abstract
Osteoarthritis (OA) is one of the most chronic degenerative arthritic diseases, which gradually results in chondrocyte changes, articular cartilage degeneration, subchondral bone sclerosis, joint pain, swelling, and dysfunction. Berberine (BBR) has various confirmed biological activities, such as anti-inflammatory and antioxidant activities. However, the effect of BBR on the production of inflammation-associated proteins, including inducible nitric oxide synthase (iNOS), cyclooxygenase (Cox)-2, metalloproteinases (MMPs), Collagen II, TNF-α, and IL-6 via the MAPK (mitogen-activated protein kinases) pathway in IL-1β-stimulated rat chondrocytes, has not yet been studied. Thus, the purpose of this study was to evaluate whether BBR would decrease the production of inflammation-associated proteins through the MAPK signal pathway. Rat chondrocytes were cultured and pretreated with BBR at different concentrations (0, 25, 50, and 100 μM) and then stimulated with or without IL-1β (10 ng/mL). The mRNA expression of iNOS, COX-2, MMP-3, MMP-13, TNF-α, and IL-6 was measured by real-time polymerase chain reaction (RT-PCR), and the protein expression of iNOS, COX-2, Collagen II, MMP-3,MMP-13, and MAPKs were measured by Western blotting. The results showed that the expression of iNOS, COX-2, MMP-3, MMP-13, TNF-α, and IL-6 increased in the IL-1β-treated group and BBR showed an ability to inhibit the elevated expression under the pretreatment. Furthermore, the IL-1β-induced downregulation of Collagen II could be ameliorated by BBR. Moreover, the expression of MAPKs was significantly decreased by BBR. These results demonstrated that BBR had the anti-catabolic and anti-inflammation abilities that were through the MAPKs in IL-1β-induced rat chondrocytes. These findings may provide a novel therapeutic choice for treatment of OA using BBR.
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Affiliation(s)
- Xing Li
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 111 Dade Road, Guangzhou, Guangdong, China.,Department of Orthopedic Surgery, Lingnan Medical Research Center of Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangzhou University of Chinese Medicine, No. 12, Jichang Road, Baiyun District, Guangzhou, P. R. China
| | - Peiheng He
- Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yu Hou
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 111 Dade Road, Guangzhou, Guangdong, China.,Department of Orthopedic Surgery, Lingnan Medical Research Center of Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangzhou University of Chinese Medicine, No. 12, Jichang Road, Baiyun District, Guangzhou, P. R. China
| | - Shudong Chen
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 111 Dade Road, Guangzhou, Guangdong, China.,Department of Orthopedic Surgery, Lingnan Medical Research Center of Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangzhou University of Chinese Medicine, No. 12, Jichang Road, Baiyun District, Guangzhou, P. R. China
| | - Zhifeng Xiao
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 111 Dade Road, Guangzhou, Guangdong, China.,Department of Orthopedic Surgery, Lingnan Medical Research Center of Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangzhou University of Chinese Medicine, No. 12, Jichang Road, Baiyun District, Guangzhou, P. R. China
| | - Jiheng Zhan
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 111 Dade Road, Guangzhou, Guangdong, China.,Department of Orthopedic Surgery, Lingnan Medical Research Center of Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangzhou University of Chinese Medicine, No. 12, Jichang Road, Baiyun District, Guangzhou, P. R. China
| | - Dan Luo
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 111 Dade Road, Guangzhou, Guangdong, China.,Department of Orthopedic Surgery, Lingnan Medical Research Center of Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangzhou University of Chinese Medicine, No. 12, Jichang Road, Baiyun District, Guangzhou, P. R. China
| | - Minghui Gu
- Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Dingkun Lin
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 111 Dade Road, Guangzhou, Guangdong, China.,Department of Orthopedic Surgery, Lingnan Medical Research Center of Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangzhou University of Chinese Medicine, No. 12, Jichang Road, Baiyun District, Guangzhou, P. R. China
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13
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Chen IJ, Lin SH, Wong CS. Oral shea nut oil triterpene concentrate supplement ameliorates pain and histological assessment of articular cartilage deterioration in an ACLT injured rat knee osteoarthritis model. PLoS One 2019; 14:e0215812. [PMID: 31002699 PMCID: PMC6474620 DOI: 10.1371/journal.pone.0215812] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 04/09/2019] [Indexed: 01/25/2023] Open
Abstract
Osteoarthritis (OA) is a multifactorial joint disease and a common disabling condition in the elderly population. The associated pain and pathohistological changes in cartilage are common features of OA in both humans and animal models. Shea nut oil extract (SheaFlex75) contains a high triterpenoid concentration and has demonstrated anti-inflammatory and antiarthritic effects in both human and animal studies. In this study, we aim to investigate the potential of SheaFlex75 to prevent articular cartilage deterioration in a rat model of chronic OA progression. By employing anterior cruciate ligament transection (ACLT) with medial meniscectomy (MMx)-induced OA, we found attenuation of both early and chronic onset OA pain and cartilage degeneration in ACLT+MMx rats receiving SheaFlex75 dietary supplementation. Under long-term oral administration, the rats with induced OA presented sustained protection of both pain and OA cartilage integrity compared to the OA-control rats. Moreover, rats subjected to long-term SheaFlex75 ingestion showed normal biochemical profiles (AST, BUN and total cholesterol) and presented relatively lower triglycerides (TGs) and body weights than the OA-control rats, which suggested the safety of prolonged use of this oil extract. Based on the present evidence, preventive management is advised to delay/prevent onset and progression in OA patients. Therefore, we suggest that SheaFlex75 may be an effective management strategy for symptom relief and cartilage protection in patients with both acute and chronic OA.
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Affiliation(s)
- Ing-Jung Chen
- Department of Medical Research, Cathay General Hospital, Taipei, Taiwan
- Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan
| | - Sheng-Hsiung Lin
- Planing and Management Office, Tri-Service General Hospital, Taipei, Taiwan
| | - Chih-Shung Wong
- Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
- * E-mail:
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14
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Okano T, Mamoto K, Di Carlo M, Salaffi F. Clinical utility and potential of ultrasound in osteoarthritis. Radiol Med 2019; 124:1101-1111. [DOI: 10.1007/s11547-019-01013-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 02/21/2019] [Indexed: 02/06/2023]
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15
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Ammann N, Schiapparelli FF, Moser LB, Rasch H, Amsler F, Hirschmann MT. Good correlation between bone tracer uptake in SPECT/CT and intraoperative findings of chondral lesions graded with the ICRS scoring. J Orthop Res 2019; 37:522-528. [PMID: 30378184 DOI: 10.1002/jor.24171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 10/15/2018] [Indexed: 02/04/2023]
Abstract
The question if bone tracer uptake in SPECT/CT reflects the intraoperative cartilage status of the knee is still unanswered. In this study, thirty-three consecutive patients (male:female = 11:22; mean age ± standard deviation 61 ± 15) with bi- or tri-compartmental knee osteoarthritis who underwent SPECT/CT before total knee arthroplasty (TKA) were collected. The knee was graded in eleven different anatomical regions. In each region, the maximal relative bone tracer uptake (mrBTU) was measured twice by two observers with a six weeks interval. The intraclass correlation coefficients (ICC) showed excellent correlations and mean values were used. Intraoperatively every region was assessed with the macroscopic International Cartilage Repair Society (ICRS) scoring. A factorial analysis and a non-parametrical Spearman's correlation were calculated among the 11 knee regions on both mrBTU and ICRS scores and significant correlations were seen between regions belonging to the same knee compartment (p < 0.05). A non-parametrical Spearman's correlation was also performed to investigate the correlation between rmBTU in SPECT/CT and intraoperative ICRS cartilage grading. Significant correlations were seen on the medial compartment, on the proximal femoral trochlea and on the medial patellar facet (p < 0.05). A significant correlation between SPECT/CT and intraoperative findings was so demonstrated in several regions. The low accuracy of the macroscopic ICRS scoring system on grade I-II lesions could have affected the missing correlations on the lateral compartment since the selected presented mainly a varus gonarthrosis. The use of an objective measure as the rmBTU could overcome the limit of the subjectivity of MRI findings in early osteoarthritis. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:522-528, 2019.
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Affiliation(s)
- Nora Ammann
- Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), CH-4101 Bruderholz, Switzerland
| | - Filippo-Franco Schiapparelli
- Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), CH-4101 Bruderholz, Switzerland
| | - Lukas B Moser
- Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), CH-4101 Bruderholz, Switzerland
| | - Helmut Rasch
- Institute of Radiology and Nuclear Medicine, Kantonsspital Baselland, CH-4101 Bruderholz, Switzerland
| | | | - Michael T Hirschmann
- Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), CH-4101 Bruderholz, Switzerland.,University of Basel, Basel, Switzerland
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16
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Mohammed RHA, Kotb H, Amir M, Di Matteo A. Subclinical crystal arthropathy: a silent contributor to inflammation and functional disability in knees with osteoarthritis-an ultrasound study. J Med Ultrason (2001) 2019; 46:137-146. [PMID: 30327988 DOI: 10.1007/s10396-018-0912-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 09/21/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE This study aimed at investigating the prevalence of crystal deposits with knee osteoarthritis (OA) by ultrasonography and measure the inflammatory burden associated with crystal deposits in OA using WOMAC score. METHODS Adult patients with primary knee OA diagnosed according to the American College of Rheumatology criteria were included. Participants were subjected to history taking, clinical examination, knee US, and plain radiography. The EULAR and the OMERACT ultrasonography definitions and scanning protocols were used. RESULTS Fifty-three patients (44 females, 9 males) were enrolled. Mean values were 53.5 years ± 8.3 SD for age and 42.5 months ± 49.5 SD for disease duration. Crystals were detected by US in 73/106 knees (68.9%). Plain radiography revealed chondrocalcinosis in three patients. Mean values for WOMAC pain, stiffness, and disability scores were 14.38 ± 3.99, 4.93 ± 2.06, and 49.61 ± 13.06, respectively, with insignificant differences relative to presence of crystals (P > 0.05). Regression analysis revealed a 4.1-fold increase in the incidence of sonographic crystals with bursitis (OR = 4.13, CI = 1.5-11.2, p = 0.01) and a 3.2-fold increase in the incidence of sonographic crystals with synovial effusion (OR = 3.16, CI = 1.34-7.44, p = 0.01). CONCLUSION Subclinical crystals were detected in a considerable number of patients with primary knee OA. The incidence of crystal deposits was significantly higher in patients with bursitis and knee effusion.
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Affiliation(s)
- Reem Hamdy A Mohammed
- Department of Rheumatology and Rehabilitation, School of Medicine, Cairo University Hospitals, Cairo, Egypt.
| | - Hanan Kotb
- Department of Rheumatology and Rehabilitation, School of Medicine, Cairo University Hospitals, Cairo, Egypt
| | - Marian Amir
- Department of Rheumatology and Rehabilitation, School of Medicine, Cairo University Hospitals, Cairo, Egypt
| | - Andrea Di Matteo
- Rheumatology Department, Università Politecnica delle Marche, "Carlo Urbani" Hospital, Iesi, Ancona, Italy
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17
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Fox MG, Chang EY, Amini B, Bernard SA, Gorbachova T, Ha AS, Iyer RS, Lee KS, Metter DF, Mooar PA, Shah NA, Singer AD, Smith SE, Taljanovic MS, Thiele R, Tynus KM, Kransdorf MJ. ACR Appropriateness Criteria® Chronic Knee Pain. J Am Coll Radiol 2018; 15:S302-S312. [DOI: 10.1016/j.jacr.2018.09.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 09/07/2018] [Indexed: 12/12/2022]
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18
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Association between gait mechanics and ultrasonographic measures of femoral cartilage thickness in individuals with ACL reconstruction. Gait Posture 2018; 65:221-227. [PMID: 30558935 DOI: 10.1016/j.gaitpost.2018.07.174] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 07/02/2018] [Accepted: 07/23/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Individuals with anterior cruciate ligament reconstruction (ACLR) are at greater risk for knee osteoarthritis, which may be in part due to altered gait biomechanics. Articular cartilage thickness is typically imaged using magnetic resonance imaging, which is costly and lacks portability. Ultrasonography may provide an alternative imaging method for articular cartilage. It is unclear if ultrasonographic measurements of cartilage thickness are associated with gait biomechanics in individuals with ACLR. RESEARCH QUESTION To evaluate the association between sagittal and frontal plane knee mechanics during gait and resting femoral cartilage thickness from ultrasonography. METHODS Twenty-five females with ACLR (age = 21.7 ± 2.6 years, time since ACLR = 60.6 ± 24.8 months) completed assessments of walking biomechanics and resting femoral cartilage thickness. Linear regression examined the association between gait biomechanics and cartilage thickness at the medial (MC) and lateral (LC) femoral condyles, and intercondylar notch (IC) after accounting for time since ACLR, meniscal injury, and gait speed. RESULTS In the ACLR limb, larger vertical ground reaction force (ΔR2 = 0.21, pΔ = 0.03), knee flexion angle (ΔR2 = 0.15, pΔ = 0.05), knee flexion excursion (KFE) (ΔR2 = 0.16, pΔ = 0.04), and knee flexion impulse (KFI) (ΔR2 = 0.23, pΔ = 0.02) were associated with thicker MC cartilage. A larger knee adduction angle (ΔR2 = 0.20, pΔ = 0.03) and knee adduction moment (KAM) (ΔR2 = 0.20, pΔ = 0.03) were associated with thinner MC thickness. Larger KFE (ΔR2 = 0.20, pΔ = 0.03) was associated with thicker LC cartilage. Gait biomechanics were not associated with IC cartilage thickness. After accounting for co-variates, the combination of KFI and KAM was predictive of MC thickness (ΔR2 = 0.37, pΔ = 0.01; Total R2 = 0.52, p = 0.02). Meniscal injury, KAM, and KFI were significant predictors in the model. In the contralateral limb, KFE was associated with thicker MC cartilage (ΔR2 = 0.16, pΔ = 0.05). SIGNIFICANCE Sagittal and frontal plane knee mechanics during gait are uniquely associated with ultrasonographic measurements of femoral cartilage thickness in individuals with ACLR. Furthermore, concomitant medial meniscal injury was associated with thinner MC cartilage.
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19
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PAMUKOFF DEREKN, MONTGOMERY MELISSAM, MOFFIT TYLERJ, VAKULA MICHAELN. Quadriceps Function and Knee Joint Ultrasonography after ACL Reconstruction. Med Sci Sports Exerc 2018; 50:211-217. [DOI: 10.1249/mss.0000000000001437] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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20
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Paterson KL, Kasza J, Hunter DJ, Hinman RS, Menz HB, Peat G, Bennell KL. Longitudinal association between foot and ankle symptoms and worsening of symptomatic radiographic knee osteoarthritis: data from the osteoarthritis initiative. Osteoarthritis Cartilage 2017; 25:1407-1413. [PMID: 28506843 PMCID: PMC5565691 DOI: 10.1016/j.joca.2017.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 04/11/2017] [Accepted: 05/02/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess whether foot and/or ankle symptoms are associated with an increased risk of worsening of knee pain and radiographic change in people with knee osteoarthritis (OA). METHODS The presence and laterality of foot/ankle symptoms were recorded at baseline in 1368 participants from the Osteoarthritis Initiative (OAI) with symptomatic radiographic knee OA. Knee pain severity (measured using the Western Ontario and McMaster Universities Osteoarthritis Index pain subscale) and minimum medial tibiofemoral joint space (minJSW) width measured on X-ray were assessed yearly over the subsequent 4 years. Associations between foot/ankle symptoms and worsening of (1) knee pain, and (2) both knee pain and minJSW (i.e., symptomatic radiographic knee OA) were assessed using logistic regression. RESULTS Foot/ankle symptoms in either foot/ankle significantly increased the odds of knee pain worsening (adjusted OR 1.54, 95% CI 1.25 to 1.91). Laterality analysis showed ipsilateral (adjusted OR 1.50, 95% CI 1.07 to 2.10), contralateral (adjusted OR 1.44, 95% CI 1.02 to 2.06) and bilateral foot/ankle symptoms (adjusted OR 1.61, 95% CI 1.22 to 2.13) were all associated with knee pain worsening in the follow up period. There was no association between foot/ankle symptoms and worsening of symptomatic radiographic knee OA. CONCLUSION The presence of foot/ankle symptoms in people with symptomatic radiographic knee OA was associated with increased risk of knee pain worsening, but not worsening of symptomatic radiographic knee OA, over the subsequent 4 years. Future studies should investigate whether treatment of foot/ankle symptoms reduces the risk of knee pain worsening in people with knee OA.
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Affiliation(s)
- Kade L Paterson
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
| | - Jessica Kasza
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - David J Hunter
- Institute of Bone and Joint Research, Kolling Institute, University of Sydney, and Rheumatology Department, Royal North Shore Hospital Australia, Sydney, Australia
| | - Rana S Hinman
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
| | - Hylton B Menz
- School of Allied Health, La Trobe University, Melbourne, Australia
| | - George Peat
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, United Kingdom
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
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Zhou Y, Liu S, Ming J, Li Y, Deng M, He B. Sustained release effects of berberine-loaded chitosan microspheres on in vitro chondrocyte culture. Drug Dev Ind Pharm 2017; 43:1703-1714. [PMID: 28585864 DOI: 10.1080/03639045.2017.1339076] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Yan Zhou
- Department of Orthopedics, Central Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shiqing Liu
- Department of Orthopedics, Central Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jianghua Ming
- Department of Orthopedics, Central Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yaming Li
- Department of Orthopedics, Central Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ming Deng
- Department of Orthopedics, Central Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Bin He
- Department of Orthopedics, Central Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
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Okano T, Filippucci E, Di Carlo M, Draghessi A, Carotti M, Salaffi F, Wright G, Grassi W. Ultrasonographic evaluation of joint damage in knee osteoarthritis: feature-specific comparisons with conventional radiography. Rheumatology (Oxford) 2016; 55:2040-2049. [DOI: 10.1093/rheumatology/kew304] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 07/13/2016] [Indexed: 01/07/2023] Open
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Comparison of Diagnostic Performance of Semi-Quantitative Knee Ultrasound and Knee Radiography with MRI: Oulu Knee Osteoarthritis Study. Sci Rep 2016; 6:22365. [PMID: 26926836 PMCID: PMC4772126 DOI: 10.1038/srep22365] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 02/12/2016] [Indexed: 12/24/2022] Open
Abstract
Osteoarthritis (OA) is a common degenerative musculoskeletal disease highly prevalent in aging societies worldwide. Traditionally, knee OA is diagnosed using conventional radiography. However, structural changes of articular cartilage or menisci cannot be directly evaluated using this method. On the other hand, ultrasound is a promising tool able to provide direct information on soft tissue degeneration. The aim of our study was to systematically determine the site-specific diagnostic performance of semi-quantitative ultrasound grading of knee femoral articular cartilage, osteophytes and meniscal extrusion, and of radiographic assessment of joint space narrowing and osteophytes, using MRI as a reference standard. Eighty asymptomatic and 79 symptomatic subjects with mean age of 57.7 years were included in the study. Ultrasound performed best in the assessment of femoral medial and lateral osteophytes, and medial meniscal extrusion. In comparison to radiography, ultrasound performed better or at least equally well in identification of tibio-femoral osteophytes, medial meniscal extrusion and medial femoral cartilage morphological degeneration. Ultrasound provides relevant additional diagnostic information on tissue-specific morphological changes not depicted by conventional radiography. Consequently, the use of ultrasound as a complementary imaging tool along with radiography may enable more accurate and cost-effective diagnostics of knee osteoarthritis at the primary healthcare level.
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Ahmed U, Thornalley PJ, Rabbani N. New development in a blood-based diagnostic test for early-stage arthritis. Biomark Med 2015; 9:943-5. [PMID: 26439368 DOI: 10.2217/bmm.15.77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Usman Ahmed
- The Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham, B31 2AP, UK
| | - Paul J Thornalley
- Warwick Medical School, Clinical Sciences Research Laboratories, University of Warwick, University Hospital, Coventry, CV2 2DX, UK.,Warwick Systems Biology Centre, Senate House, University of Warwick, Coventry, CV4 7AL, UK
| | - Naila Rabbani
- Warwick Systems Biology Centre, Senate House, University of Warwick, Coventry, CV4 7AL, UK
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