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Li Z, Leung KL, Huang C, Huang X, Su S, Chung RC, Ding C, Fu SN. Associations amongst dynamic knee stiffness during gait, quadriceps stiffness, and the incidence of knee osteoarthritis over 24 months: a cohort study with a mediation analysis. BMC Musculoskelet Disord 2024; 25:511. [PMID: 38961407 PMCID: PMC11220956 DOI: 10.1186/s12891-024-07618-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 06/21/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Decreased strength and increased stiffness of the quadriceps have been associated with a higher risk of developing knee osteoarthritis (OA) in elders. Dynamic joint stiffness (DJS) represents collective resistance from active and passive knee structures for dynamic knee motions. Elevated sagittal knee DJS has been associated with worsening of cartilage loss in knee OA patients. Altered quadriceps properties may affect DJS, which could be a mediator for associations between quadriceps properties and knee OA. Hence, this study aimed to examine whether DJS and quadriceps properties would be associated with the development of clinical knee OA over 24 months, and to explore the mediation role of DJS in associations between quadriceps properties and knee OA. METHODS This was a prospective cohort study with 162 healthy community-dwelling elders. Gait analysis was conducted to compute DJS during the loading response phase. Quadriceps strength and stiffness were evaluated using a Cybex dynamometer and shear-wave ultrasound elastography, respectively. Knee OA was defined based on clinical criteria 24 months later. Logistic regression with generalized estimating equations was used to examine the association between quadriceps properties and DJS and incident knee OA. Mediation analysis was performed to explore the mediation role of DJS in associations between quadriceps properties and the incidence of knee OA. RESULTS A total of 125 participants (65.6 ± 4.0 years, 58.4% females) completed the 24-month follow-up, with 36 out of 250 knees identified as clinical knee OA. Higher DJS (OR = 1.86, 95%CI: 1.33-2.62), lower quadriceps strength (1.85, 1.05-3.23), and greater quadriceps stiffness (1.56, 1.10-2.21) were significantly associated with a higher risk of clinical knee OA. Mediation analysis showed that the DJS was not a significant mediator for the associations between quadriceps properties and knee OA. CONCLUSIONS Higher sagittal knee dynamic joint stiffness, lower quadriceps strength, and greater quadriceps stiffness are potential risk factors for developing clinical knee OA in asymptomatic elders. Associations between quadriceps properties and knee OA may not be mediated by dynamic joint stiffness. Interventions for reducing increased passive properties of the quadriceps and knee joint stiffness may be beneficial for maintaining healthy knees in the aging population.
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Affiliation(s)
- Zongpan Li
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hong Kong, Hong Kong, China
| | - Kam-Lun Leung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hong Kong, Hong Kong, China
| | - Chen Huang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hong Kong, Hong Kong, China
| | - Xiuping Huang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hong Kong, Hong Kong, China
| | - Shan Su
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hong Kong, Hong Kong, China
| | - Raymond Ck Chung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hong Kong, Hong Kong, China
| | - Changhai Ding
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Siu-Ngor Fu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hong Kong, Hong Kong, China.
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Miller EY, Lee W, Lowe T, Zhu H, Argote PF, Dresdner D, Kelly J, Frank RM, McCarty E, Bravman J, Stokes D, Emery NC, Neu CP. MRI-derived Articular Cartilage Strains Predict Patient-Reported Outcomes Six Months Post Anterior Cruciate Ligament Reconstruction. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.27.24306484. [PMID: 38746083 PMCID: PMC11092718 DOI: 10.1101/2024.04.27.24306484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Key terms Multicontrast and Multiparametric, Magnetic Resonance Imaging, Osteoarthritis, Functional Biomechanical Imaging, Knee Joint Degeneration What is known about the subject: dualMRI has been used to quantify strains in a healthy human population in vivo and in cartilage explant models. Previously, OA severity, as determined by histology, has been positively correlated to increased shear and transverse strains in cartilage explants. What this study adds to existing knowledge: This is the first in vivo use of dualMRI in a participant demographic post-ACL reconstruction and at risk for developing osteoarthritis. This study shows that dualMRI-derived strains are more significantly correlated with patient-reported outcomes than any MRI relaxometry metric. Background Anterior cruciate ligament (ACL) injuries lead to an increased risk of osteoarthritis, characterized by altered cartilage tissue structure and function. Displacements under applied loading by magnetic resonance imaging (dualMRI) is a novel MRI technique that can be used to quantify mechanical strain in cartilage while undergoing a physiological load. Purpose To determine if strains derived by dualMRI and relaxometry measures correlate with patient-reported outcomes at six months post unilateral ACL reconstruction. Study Design Cohort study. Methods Quantitative MRI (T2, T2*, T1ρ) measurements and transverse, axial, and shear strains were quantified in the medial articular tibiofemoral cartilage of 35 participants at six-months post unilateral ACL reconstruction. The relationships between patient-reported outcomes (WOMAC, KOOS, MARS) and all qMRI relaxation times were quantified using general linear mixed-effects models. A combined best-fit multicontrast MRI model was then developed using backwards regression to determine the patient features and MRI metrics that are most predictive of patient-reported outcome scores. Results Higher femoral strains were significantly correlated with worse patient-reported functional outcomes. Femoral shear and transverse strains were positively correlated with six-month KOOS and WOMAC scores, after controlling for covariates. No relaxometry measures were correlated with patient-reported outcome scores. We identified the best-fit model for predicting WOMAC score using multiple MRI measures and patient-specific information, including sex, age, graft type, femoral transverse strain, femoral axial strain, and femoral shear strain. The best-fit model significantly predicted WOMAC score (p<0.001) better than any one individual MRI metric alone. When we regressed the model-predicted WOMAC scores against the patient-reported WOMAC scores, we found that our model achieved a goodness of fit exceeding 0.52. Conclusions This work presents the first use of dualMRI in vivo in a cohort of participants at risk for developing osteoarthritis. Our results indicate that both shear and transverse strains are highly correlated with patient-reported outcome severity could serve as novel imaging biomarkers to predict the development of osteoarthritis.
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McWilliams DF, Yue B, Smith SL, Stocks J, Doherty M, Valdes AM, Zhang W, Sarmanova A, Fernandes GS, Akin-Akinyosoye K, Hall M, Walsh DA. Associations of Muscle Strength with Central Aspects of Pain: Data from the Knee Pain and Related Health in the Community (KPIC) Cohort. J Pers Med 2023; 13:1450. [PMID: 37888061 PMCID: PMC10608698 DOI: 10.3390/jpm13101450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/28/2023] Open
Abstract
Knee pain is associated with lower muscle strength, and both contribute to disability. Peripheral and central neurological mechanisms contribute to OA pain. Understanding the relative contributions of pain mechanisms to muscle strength might help future treatments. The Knee Pain and related health In the Community (KPIC) cohort provided baseline and year 1 data from people with early knee pain (n = 219) for longitudinal analyses. A cross-sectional analysis was performed with baseline data from people with established knee pain (n = 103) and comparative data from people without knee pain (n = 98). Quadriceps and handgrip strength indicated local and general muscle weakness, respectively. The indices of peripheral nociceptive drive were knee radiographic and ultrasound scores. The indices associated with central pain mechanisms were Pressure Pain detection Threshold (PPT) distal to the knee, and a validated self-report Central Aspects of Pain Factor (CAPF). The associations were explored using correlation and multivariable regression. Weaker quadriceps strength was associated with both high CAPF and low PPT at baseline. Year 1 quadriceps weakness was predicted by higher baseline CAPF (β = -0.28 (95% CI: -0.55, -0.01), p = 0.040). Weaker baseline and year 1 handgrip strength was also associated with higher baseline CAPF. Weaker baseline quadriceps strength was associated with radiographic scores in bivariate but not adjusted analyses. Quadriceps strength was not significantly associated with total ultrasound scores. Central pain mechanisms might contribute to muscle weakness, both locally and remote from the knee.
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Affiliation(s)
- Daniel F. McWilliams
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham NG7 2RD, UK (S.L.S.); (J.S.); (M.D.); (A.M.V.); (W.Z.); (A.S.); (M.H.); (D.A.W.)
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK
- Academic Rheumatology, Division of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK
| | - Bin Yue
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham NG7 2RD, UK (S.L.S.); (J.S.); (M.D.); (A.M.V.); (W.Z.); (A.S.); (M.H.); (D.A.W.)
- Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen 518033, China
| | - Stephanie L. Smith
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham NG7 2RD, UK (S.L.S.); (J.S.); (M.D.); (A.M.V.); (W.Z.); (A.S.); (M.H.); (D.A.W.)
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK
- Academic Rheumatology, Division of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK
| | - Joanne Stocks
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham NG7 2RD, UK (S.L.S.); (J.S.); (M.D.); (A.M.V.); (W.Z.); (A.S.); (M.H.); (D.A.W.)
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK
- Academic Rheumatology, Division of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK
- Centre for Sports, Exercise, and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham NG7 2UH, UK
| | - Michael Doherty
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham NG7 2RD, UK (S.L.S.); (J.S.); (M.D.); (A.M.V.); (W.Z.); (A.S.); (M.H.); (D.A.W.)
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK
- Academic Rheumatology, Division of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK
| | - Ana M. Valdes
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham NG7 2RD, UK (S.L.S.); (J.S.); (M.D.); (A.M.V.); (W.Z.); (A.S.); (M.H.); (D.A.W.)
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK
- Academic Rheumatology, Division of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK
| | - Weiya Zhang
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham NG7 2RD, UK (S.L.S.); (J.S.); (M.D.); (A.M.V.); (W.Z.); (A.S.); (M.H.); (D.A.W.)
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK
- Academic Rheumatology, Division of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK
| | - Aliya Sarmanova
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham NG7 2RD, UK (S.L.S.); (J.S.); (M.D.); (A.M.V.); (W.Z.); (A.S.); (M.H.); (D.A.W.)
- Academic Rheumatology, Division of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK
| | | | - Kehinde Akin-Akinyosoye
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham NG7 2RD, UK (S.L.S.); (J.S.); (M.D.); (A.M.V.); (W.Z.); (A.S.); (M.H.); (D.A.W.)
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK
- Academic Rheumatology, Division of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK
| | - Michelle Hall
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham NG7 2RD, UK (S.L.S.); (J.S.); (M.D.); (A.M.V.); (W.Z.); (A.S.); (M.H.); (D.A.W.)
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK
- Division of Physiotherapy Education, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - David A. Walsh
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham NG7 2RD, UK (S.L.S.); (J.S.); (M.D.); (A.M.V.); (W.Z.); (A.S.); (M.H.); (D.A.W.)
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK
- Academic Rheumatology, Division of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK
- Sherwood Forest Hospitals NHS Foundation Trust, Mansfield NG17 4JL, UK
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Li Z, Leung KL, Huang C, Huang X, Chung R, Fu SN. Passive stiffness of the quadriceps predicts the incidence of clinical knee osteoarthritis in twelve months. Eur J Phys Rehabil Med 2023; 59:65-74. [PMID: 36598343 PMCID: PMC10037105 DOI: 10.23736/s1973-9087.22.07634-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Quadriceps weakness is a known risk factor for the onset of knee osteoarthritis (OA). In addition to muscle weakness, increased passive stiffness of the quadriceps may affect knee biomechanics and hence contribute to the pathogenesis of knee OA. However, the association between quadriceps stiffness and the risk of knee OA development has not been prospectively investigated. AIM The aim of this study was to investigate how baseline quadriceps passive stiffness predicts the incidence of clinical knee OA at the 12-month follow-up. DESIGN Prospective cohort study. SETTING University laboratory. POPULATION Community-dwelling adults aged 60-80 years were recruited. We excluded participants with: 1) knee pain or known arthritis; 2) knee injury; 3) knee or hip joint replacement, 4) cognitive impairment; or 5) neurological conditions. METHODS At baseline, passive stiffness of the three superficial quadriceps muscle heads (rectus femoris [RF], vastus lateralis [VL], and vastus medialis oblique [VMO]) was evaluated using shear-wave ultrasound elastography. Knee muscle (quadriceps and hamstrings) strength was tested using a Cybex dynamometer. Knee OA was defined based on clinical criteria 12 months after baseline measurements. Generalized estimating equations were used to examine the associations of quadriceps stiffness and knee muscle strength with the risk of knee OA, controlling for age, sex, Body Mass Index, comorbidities, and activity level. RESULTS The analyses included 158 knees (58.2% females, age: 65.6±4.1 years). Twenty-eight knees (17.7%) were classified as having clinical OA at 12 months. Compared with the lowest stiffness tertiles, the highest stiffness tertiles of the RF (relative risk =5.31, 95% CI: 1.34-21.0), VMO (4.15, 1.04-16.6), and total superficial quadriceps (6.35, 1.48-27.3) at baseline were significantly associated with a higher risk of knee OA at the follow-up. The highest strength tertile of quadriceps has a trend of association with a lower risk of knee OA than the lowest tertile (0.18, 0.03-1.25, P=0.083). CONCLUSIONS Greater passive stiffness of the quadriceps at baseline was associated with a higher risk of clinical knee OA incidence at the 12-month follow-up. CLINICAL REHABILITATION IMPACT Interventions for reducing the passive stiffness of the quadriceps should be included in preventative training programs for older adults.
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Affiliation(s)
- Zongpan Li
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Kam L Leung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Chen Huang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Xiuping Huang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Raymond Chung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Siu N Fu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China -
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Iliuță D, Tarniță D, Petcu A, Zlatian O, Rogoveanu O, Tarniță DN. Research on the Influence of MUVON PLUS Treatment Upon the Biomechanical Behavior of the Human Osteoarthritic Knee. CURRENT HEALTH SCIENCES JOURNAL 2023; 49:75-84. [PMID: 37786768 PMCID: PMC10541506 DOI: 10.12865/chsj.49.01.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 11/19/2022] [Indexed: 10/04/2023]
Abstract
BACKGROUND This study aimed to investigate the effects of MUVON PLUS, a dietary supplement containing hydrolized collagen, chondroitin sulfate, and vitamin C, on the biomechanical behavior of the knee joint in patients with second-degree osteoarthritis (OA). MATERIAL AND METHOD The study included 15 participants who underwent biomechanical testing before and after 3 and 6 months of supplement administration. Biometrics and SimiMotion software were used to process and analyze the data. Results showed significant improvements in biomechanical parameters such as joint range of motion, joint torque, and joint stiffness for all patients during the treatment. Improvements were observed across various tests, including horizontal walking, stairs climbing and descending, sitting/standing up from a chair, and knee squats. This improvement in biomechanical performance was also reflected in the patients' reported quality of life. For the stairs climbing test, the maximum flexion-extension angle increased by approximately 7% after 3 months and 12% after 6 months. In the stairs descending test, the maximum flexion-extension angle increased by approximately 8% after 3 months and 19% after 6 months. These results highlight an improvement in mobility for the study participants. CONCLUSIONS Significant improvements of the biomechanical parameters of the knee joint were found in all patients during the treatment with the MUVON PLUS in all tests, which indicates the clear clinical benefit, revealed by improving the quality of life reported by patients. Overall, the study demonstrated the effectiveness of MUVON PLUS in enhancing the biomechanical behavior of the knee joint in patients with OA, providing valuable insights for future research and treatment.
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Affiliation(s)
- Daniel Iliuță
- PhD Student, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Daniela Tarniță
- PhD Student, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Alin Petcu
- Department of Applied Mechanics, Faculty of Mechanics, University of Craiova, Romania
| | - Ovidiu Zlatian
- Department of Bacteriology-Virusology-Parasitology, University of Medicine and Pharmacy of Craiova, Romania
| | - Otilia Rogoveanu
- Department of Physical Medicine and Rehabilitation, University of Medicine and Pharmacy of Craiova, Romania
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Gong Z, Li J, He Z, Li S, Cao P, Ruan G, Zhang Y, Zeng Q, Chen R, Zheng P, Fan T, Zhao Y, Lu P, Zhu Z, Huang G. Quadriceps strength is negatively associated with knee joint structural abnormalities-data from osteoarthritis initiative. BMC Musculoskelet Disord 2022; 23:784. [PMID: 35978313 PMCID: PMC9382744 DOI: 10.1186/s12891-022-05635-9] [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: 04/30/2022] [Accepted: 07/06/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The aim of this study was to explore the longitudinal associations between baseline quadriceps strength and knee joint structural abnormalities in knee osteoarthritis (KOA). METHODS This study is a longitudinally observational study based on Osteoarthritis Initiative (OAI) cohort, including men and women aged 45-79. Quadriceps strength was measured by isometric knee extension testing at baseline. Knee joint structural abnormalities, including cartilage damage, bone marrow lesions (BMLs), effusion-synovitis and Hoffa-synovitis, were evaluated by Magnetic Resonance Imaging Osteoarthritis Knee Score (MOAKS) at baseline and 1-year follow-up. Generalized estimating equations were employed to examine the associations between quadriceps strength and knee structural abnormalities. All analyses were stratified by sex. RESULTS One thousand three hundred thirty-eight participants (523 men and 815 women) with a mean age of 61.8 years and a mean BMI of 29.4 kg/m2 were included in this study. For men, no significantly longitudinal association of quadriceps strength with structural abnormalities was detected. In contrast, quadriceps strength was significantly and negatively associated with changes in cartilage damage and BMLs in lateral patellofemoral joint (PFJ) (cartilage damage: OR: 0.91, 95% CI 0.84 to 0.99, P = 0.023; BMLs: OR: 0.85, 95% CI 0.74 to 0.96, P = 0.011) and effusion-synovitis (OR = 0.88, 95% CI 0.78 to 0.99, P = 0.045) among females longitudinally. Higher quadriceps strength was significantly associated with less progression of lateral PFJ cartilage damage, BMLs and effusion-synovitis in females. CONCLUSIONS Higher quadriceps strength was associated with changes in cartilage damage and BMLs within the lateral PFJ and effusion-synovitis among females, suggesting the potential protective role of quadriceps strength on joint structures in women.
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Affiliation(s)
- Ze Gong
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China
| | - Jia Li
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zijun He
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China
| | - Shilin Li
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China
| | - Peihua Cao
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Haizhu District 510280, Guangzhou, Guangdong, China
| | - Guangfeng Ruan
- Clinical Research Centre, School of Medicine, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, China
| | - Yan Zhang
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Haizhu District 510280, Guangzhou, Guangdong, China
| | - Qing Zeng
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China
| | - Rong Chen
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China
| | - Peng Zheng
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China
| | - Tao Fan
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China
| | - Yijin Zhao
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China
| | - Pengcheng Lu
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China
| | - Zhaohua Zhu
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Haizhu District 510280, Guangzhou, Guangdong, China.
| | - Guozhi Huang
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China. .,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China.
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Chemically engineered mesoporous silica nanoparticles-based intelligent delivery systems for theranostic applications in multiple cancerous/non-cancerous diseases. Coord Chem Rev 2022. [DOI: 10.1016/j.ccr.2021.214309] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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van den Noort JC, van der Leeden M, Stapper G, Wirth W, Maas M, Roorda LD, Lems WF, Dekker J, van der Esch M. Muscle weakness is associated with non-contractile muscle tissue of the vastus medialis muscle in knee osteoarthritis. BMC Musculoskelet Disord 2022; 23:91. [PMID: 35086518 PMCID: PMC8796405 DOI: 10.1186/s12891-022-05025-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 01/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Quadriceps weakness is assumed to be associated with compositional properties of the vastus medialis muscle in patients with knee osteoarthritis (OA). METHODS The aim was to determine the association of non-contractile muscle tissue in the vastus medialis muscle, measured with routine MRI, with muscle extensor strength in patients with knee OA. Sagittal T1-weighted 3T MRI of 94 patients with knee OA, routinely acquired in clinical practice were used for analysis. Using the MRI's, the amount of non-contractile muscle tissue in the vastus medialis muscle was measured, expressed as a percentage of (non)-contractile tissue, dichotomized into a low and a high non-contractile percentage group. Muscle strength was assessed by isokinetic measurement of knee extensors and by conduction of the Get-Up and Go (GUG) test. In regression analyses, associations of percentage of non-contractile muscle tissue with muscle strength and GUG time were determined and controlled for sex, age, BMI and radiographic severity. RESULTS A high percentage of non-contractile muscle tissue (> 11.2%) was associated with lower muscle strength (B = -0.25, P = 0.006) and with longer GUG time (B = 1.09, P = 0.021). These associations were specifically confounded by sex and BMI, because these two variables decreased the regression coefficient (B) with > 10%. CONCLUSIONS A high percentage of non-contractile muscle tissue in the vastus medialis muscle measured by clinical T1-weighted 3T MRI is associated with muscle weakness. The association is confounded by sex and BMI. Non-contractile muscle tissue seems to be an important compositional property of the vastus medialis muscle underlying quadriceps weakness.
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Affiliation(s)
- Josien C van den Noort
- Department of Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Medical Imaging Quantification Center (MIQC), Amsterdam UMC, Univ of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands. .,Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands.
| | - Marike van der Leeden
- Amsterdam Rehabilitation Research Center Reade, Amsterdam, Netherlands.,Department of Rehabilitation Medicine, EMGO Institute for Health and Care Research, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
| | - Gerard Stapper
- Amsterdam Rehabilitation Research Center Reade, Amsterdam, Netherlands
| | - Wolfgang Wirth
- Institute of Anatomy, PMU, Salzburg, Austria.,Chondrometrics GmbH, Ainring, Germany
| | - Mario Maas
- Department of Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Medical Imaging Quantification Center (MIQC), Amsterdam UMC, Univ of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands
| | - Leo D Roorda
- Amsterdam Rehabilitation Research Center Reade, Amsterdam, Netherlands
| | - Willem F Lems
- Department of Rheumatology, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands.,Department of Rheumatology, Amsterdam Rehabilitation Center Reade, Amsterdam, Netherlands
| | - Joost Dekker
- Department of Rehabilitation Medicine, EMGO Institute for Health and Care Research, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands.,Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
| | - Martin van der Esch
- Amsterdam Rehabilitation Research Center Reade, Amsterdam, Netherlands.,Amsterdam University of Applied Sciences, Faculty of Health, Amsterdam, Netherlands
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Han Y, Yang J, Zhao W, Wang H, Sun Y, Chen Y, Luo J, Deng L, Xu X, Cui W, Zhang H. Biomimetic injectable hydrogel microspheres with enhanced lubrication and controllable drug release for the treatment of osteoarthritis. Bioact Mater 2021; 6:3596-3607. [PMID: 33869900 PMCID: PMC8022850 DOI: 10.1016/j.bioactmat.2021.03.022] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 12/23/2022] Open
Abstract
The occurrence of osteoarthritis (OA) is highly associated with the reduced lubrication property of the joint, where a progressive and irreversible damage of the articular cartilage and consecutive inflammatory response dominate the mechanism. In this study, bioinspired by the super-lubrication property of cartilage and catecholamine chemistry of mussel, we successfully developed injectable hydrogel microspheres with enhanced lubrication and controllable drug release for OA treatment. Particularly, the lubricating microspheres (GelMA@DMA-MPC) were fabricated by dip coating a self-adhesive polymer (DMA-MPC, synthesized by free radical copolymerization) on superficial surface of photo-crosslinked methacrylate gelatin hydrogel microspheres (GelMA, prepared via microfluidic technology), and encapsulated with an anti-inflammatory drug of diclofenac sodium (DS) to achieve the dual-functional performance. The tribological test and drug release test showed the enhanced lubrication and sustained drug release of the GelMA@DMA-MPC microspheres. In addition, the functionalized microspheres were intra-articularly injected into the rat knee joint with an OA model, and the biological tests including qRT-PCR, immunofluorescence staining assay, X-ray radiography and histological staining assay all revealed that the biocompatible microspheres provided significant therapeutic effect against the development of OA. In summary, the injectable hydrogel microspheres developed herein greatly improved lubrication and achieved sustained local drug release, therefore representing a facile and promising technique for the treatment of OA.
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Affiliation(s)
- Ying Han
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
| | - Jielai Yang
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Weiwei Zhao
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
| | - Haimang Wang
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
| | - Yulong Sun
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
| | - Yuji Chen
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
| | - Jing Luo
- Beijing Research Institute of Automation for Machinery Industry Co., Ltd, Beijing, 100120, China
| | - Lianfu Deng
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xiangyang Xu
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Wenguo Cui
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Hongyu Zhang
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
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Zhao W, Wang H, Wang H, Han Y, Zheng Z, Liu X, Feng B, Zhang H. Light-responsive dual-functional biodegradable mesoporous silica nanoparticles with drug delivery and lubrication enhancement for the treatment of osteoarthritis. NANOSCALE 2021; 13:6394-6399. [PMID: 33629094 DOI: 10.1039/d0nr08887k] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Visible light-responsive dual-functional biodegradable mesoporous silica nanoparticles with drug delivery and lubrication enhancement were constructed by supramolecular interaction between azobenzene-modified mesoporous silica nanoparticles (bMSNs-AZO) and β-cyclodextrin-modified poly(2-methacryloyloxyethyl phosphorylcholine) (CD-PMPC). Visible light could effectively trigger azobenzene isomerization and thus induce drug release after passing through the dermal tissue. Additionally, the hydration layer formed by CD-PMPC on the surface of the nanoparticles played an important role in lubrication enhancement, which was beneficial for the treatment of osteoarthritis.
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Affiliation(s)
- Weiwei Zhao
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China.
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11
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Knee effusion evaluated by ultrasonography warns knee osteoarthritis patients to develop their muscle atrophy: a three-year cohort study. Sci Rep 2020; 10:8444. [PMID: 32439881 PMCID: PMC7242413 DOI: 10.1038/s41598-020-65368-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 04/29/2020] [Indexed: 11/08/2022] Open
Abstract
This study aimed to elucidate the relationship between the quantitative value of suprapatellar effusion and the longitudinal changes in lower-extremity muscle mass (MM) in a cohort with knee osteoarthritis (KOA). Fifty-three subjects (106 legs) with bilateral radiographic KOA at baseline (BL) were enrolled. MM was calculated by bioimpedance analysis three times at BL, and at the one-year (1Y) and three-year (3Y) follow-ups. The longitudinal change in the lower-extremity MM was calculated by subtracting MMBL from MM1Y, and MM1Y from MM3Y. Subjects with ≥1.0 z-score loss were defined as having severe MM loss (SMML). Effusion was evaluated as the sagittal area of suprapatellar pouch (mm2) by ultrasonography. The ROC curve was drawn to determine the cut-off of effusion area. General estimating equations (GEEs) were conducted with the prevalence of SMML as the dependent variable and with the cut-off of effusion area as the independent variable. Sixteen legs (15.1%) demonstrated SMMLBL-1Y and another sixteen legs demonstrated SMML1Y-3Y. GEEs revealed that individuals with ≥90 mm2 effusion had significantly higher odds of SMMLBL-1Y prevalence (Odds ratio: 21.561; P-value: 0.003). Individuals with leachate knee effusion at BL had a significant risk of losing MM through the first year of the initial knee effusion assessment.
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12
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De Roeck J, Van Houcke J, Almeida D, Galibarov P, De Roeck L, Audenaert EA. Statistical Modeling of Lower Limb Kinetics During Deep Squat and Forward Lunge. Front Bioeng Biotechnol 2020; 8:233. [PMID: 32300586 PMCID: PMC7142215 DOI: 10.3389/fbioe.2020.00233] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 03/06/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose Modern statistics and higher computational power have opened novel possibilities to complex data analysis. While gait has been the utmost described motion in quantitative human motion analysis, descriptions of more challenging movements like the squat or lunge are currently lacking in the literature. The hip and knee joints are exposed to high forces and cause high morbidity and costs. Pre-surgical kinetic data acquisition on a patient-specific anatomy is also scarce in the literature. Studying the normal inter-patient kinetic variability may lead to other comparable studies to initiate more personalized therapies within the orthopedics. Methods Trials are performed by 50 healthy young males who were not overweight and approximately of the same age and activity level. Spatial marker trajectories and ground reaction force registrations are imported into the Anybody Modeling System based on subject-specific geometry and the state-of-the-art TLEM 2.0 dataset. Hip and knee joint reaction forces were obtained by a simulation with an inverse dynamics approach. With these forces, a statistical model that accounts for inter-subject variability was created. For this, we applied a principal component analysis in order to enable variance decomposition. This way, noise can be rejected and we still contemplate all waveform data, instead of using deduced spatiotemporal parameters like peak flexion or stride length as done in many gait analyses. In addition, this current paper is, to the authors’ knowledge, the first to investigate the generalization of a kinetic model data toward the population. Results Average knee reaction forces range up to 7.16 times body weight for the forwarded leg during lunge. Conversely, during squat, the load is evenly distributed. For both motions, a reliable and compact statistical model was created. In the lunge model, the first 12 modes accounts for 95.26% of inter-individual population variance. For the maximal-depth squat, this was 95.69% for the first 14 modes. Model accuracies will increase when including more principal components. Conclusion Our model design was proved to be compact, accurate, and reliable. For models aimed at populations covering descriptive studies, the sample size must be at least 50.
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Affiliation(s)
- Joris De Roeck
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - J Van Houcke
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - D Almeida
- Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Leiria, Portugal
| | | | - L De Roeck
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Emmanuel A Audenaert
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium.,Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, Ghent, Belgium.,Department of Trauma and Orthopaedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.,Department of Electromechanics, Op3Mech Research Group, University of Antwerp, Antwerp, Belgium
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13
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Ji X, Yan Y, Sun T, Zhang Q, Wang Y, Zhang M, Zhang H, Zhao X. Glucosamine sulphate-loaded distearoyl phosphocholine liposomes for osteoarthritis treatment: combination of sustained drug release and improved lubrication. Biomater Sci 2019; 7:2716-2728. [PMID: 31033977 DOI: 10.1039/c9bm00201d] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Osteoarthritis (OA) is a chronic joint disease resulting from joint inflammation and damage. In this study, we employed a boundary lubricant known as a 1,2-distearoyl-sn-glycero-3-phosphocholine (DSPC) liposome for loading of an anti-inflammatory drug d-glucosamine sulphate (GAS) to construct a treatment strategy allowing for sustained anti-inflammation and reduced damage. This kind of drug-loaded nanocarrier integrates the anti-inflammatory effect of the GAS and the lubrication ability of DSPC liposomes without the involvement of complex synthesis processes leading to easier popularization. Our experimental results indicated that the GAS-loaded DSPC liposomes could release GAS in a sustained manner while providing good lubrication in pure water (H2O) and phosphate buffered saline (PBS). Moreover, the GAS-loaded DSPC liposomes prepared at a 2 : 8 molar ratio in PBS exhibited a greater entrapment efficiency, lower GAS release rate and smaller friction coefficient as compared to those prepared in H2O. The superiority of the drug release and lubrication ability achieved with the GAS-loaded DSPC liposomes in PBS were elucidated on the basis of salt-induced enhancement in liposomal stability and hydration lubrication by the hydrated salt ions. Such GAS release accelerated the viability and proliferation of primary mouse chondrocytes while also providing the anti-inflammatory and chondroprotective potential for tumor necrosis factor (TNF-α) induced chondrocyte degeneration through the down-regulation of pro-inflammatory cytokines, pain related gene and catabolic proteases, as well as the up-regulation of anabolic components. We envision that the GAS-loaded DSPC liposomes could represent a promising new strategy for clinical treatment of OA in the future.
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Affiliation(s)
- Xiuling Ji
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China.
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Han Y, Liu S, Sun Y, Gu Y, Zhang H. Bioinspired Surface Functionalization of Titanium for Enhanced Lubrication and Sustained Drug Release. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2019; 35:6735-6741. [PMID: 31030507 DOI: 10.1021/acs.langmuir.9b00338] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Titanium and its alloys have long been used as implantable biomaterials in orthopedics; however, to the best of our knowledge, few studies were reported to investigate surface functionalization of titanium for enhanced lubrication and sustained drug release. In the present study, titania nanotube arrays (TNTs) were prepared by anodization as effective drug nanocarriers, using titanium as the substrate. Meanwhile, motivated by articular cartilage-inspired superlubricity and mussel-inspired adhesion, a copolymer containing both dopamine methacrylamide and 2-methacryloyloxyethyl phosphorylcholine was synthesized (DMA-MPC) and spontaneously grafted onto the TNT surface, which was validated by characterization techniques such as scanning electron microscopy, water contact angle measurements, and X-ray photoelectron spectroscopy. Additionally, the lubrication test showed that copolymer-grafted TNTs have remarkably reduced friction coefficients compared with bare TNTs. Furthermore, the drug release test demonstrated that copolymer-grafted TNTs inhibited burst drug release and achieved sustained drug release in comparison with bare TNTs. In conclusion, the bioinspired surface functionalization strategy developed here, namely DMA-MPC copolymer-grafted TNTs, can be applied to modify orthopedic biomaterials (such as titanium) for enhanced lubrication and sustained drug release.
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Affiliation(s)
- Ying Han
- State Key Laboratory of Tribology, Department of Mechanical Engineering , Tsinghua University , Beijing 100084 , China
| | - Sizhe Liu
- State Key Laboratory of Tribology, Department of Mechanical Engineering , Tsinghua University , Beijing 100084 , China
| | - Yulong Sun
- State Key Laboratory of Tribology, Department of Mechanical Engineering , Tsinghua University , Beijing 100084 , China
| | - Yanhong Gu
- Beijing Key Laboratory of Pipeline Critical Technology and Equipment for Deepwater Oil & Gas Development , Beijing Institute of Petrochemical Technology , Beijing 102617 , China
| | - Hongyu Zhang
- State Key Laboratory of Tribology, Department of Mechanical Engineering , Tsinghua University , Beijing 100084 , China
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15
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Passive anterior tibia translation in anterior cruciate ligament-injured, anterior cruciate ligament-reconstructed and healthy knees: a systematic review. Musculoskelet Surg 2018; 103:121-130. [PMID: 30328030 PMCID: PMC6656892 DOI: 10.1007/s12306-018-0572-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 10/06/2018] [Indexed: 01/01/2023]
Abstract
Abstract Anterior tibia translation (ATT) is mainly prevented by the anterior cruciate ligament. Passive ATT tests are commonly used to diagnose an anterior cruciate ligament (ACL) injury, to select patients for an ACL reconstruction (ACLR), and as an outcome measure after an ACLR. The aim of this review was to present an overview of possible factors determining ATT. A second purpose was to give a summary of the ATT measured in the literature in healthy, ACL-injured and ACLR knees and a comparison between those groups. A literature search was conducted with PubMed. Inclusion criteria were full-text primary studies published in English between January 2006 and October 2016. Studies included reported ATT in explicit data in healthy as well as ACL-injured or ACLR knees or in ACL-injured as well as ACLR knees. Sixty-one articles met inclusion criteria. Two articles measured the ATT in healthy as well as ACL-injured knees, 51 in ACL-injured as well as in ACLR knees, three in ACLR as well as in healthy knees and three in healthy, ACL-injured and ACLR knees. A difference in ATT is found between healthy, contralateral, ACLR and ACL-injured knees and between chronic and acute ACL injury. Graft choices and intra-articular injuries are factors which could affect the ATT. The mean ATT was lowest to highest in ACLR knees using a bone–patella tendon–bone autograft, ACLR knees using a hamstring autograft, contralateral healthy knees, healthy knees, ACLR knees with an allograft and ACL-injured knees. Factors which could affect the ATT are graft choice, ACL injury or reconstruction, intra-articular injuries and whether an ACL injury is chronic or acute. Comparison of ATT between studies should be taken with caution as a high number of different measurement methods are used. To be able to compare studies, more consistency in measuring devices used should be introduced to measuring ATT. The clinical relevance is that an autograft ACLR might give better results than an allograft ACLR as knee laxity is greater when using an allograft tendon. Level of evidence III.
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Phospholipid-Coated Mesoporous Silica Nanoparticles Acting as Lubricating Drug Nanocarriers. Polymers (Basel) 2018; 10:polym10050513. [PMID: 30966547 PMCID: PMC6415400 DOI: 10.3390/polym10050513] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 04/29/2018] [Accepted: 04/30/2018] [Indexed: 01/07/2023] Open
Abstract
Osteoarthritis (OA) is a severe disease caused by wear and inflammation of joints. In this study, phospholipid-coated mesoporous silica nanoparticles (MSNs@lip) were prepared in order to treat OA at an early stage. The phospholipid layer has excellent lubrication capability in aqueous media due to the hydration lubrication mechanism, while mesoporous silica nanoparticles (MSNs) act as effective drug nanocarriers. The MSNs@lip were characterized by scanning electron microscope, transmission electron microscope, Fourier transform infrared spectrum, X-ray photoelectron spectrum, thermogravimetric analysis and dynamic light scattering techniques to confirm that the phospholipid layer was coated onto the surface of MSNs successfully. A series of tribological tests were performed under different experimental conditions, and the results showed that MSNs@lip with multi-layers of phospholipids greatly reduced the friction coefficient in comparison with MSNs. Additionally, MSNs@lip demonstrated sustained drug release behavior and were biocompatible based on CCK-8 assay using MC3T3-E1 cells. The MSNs@lip developed in the present study, acting as effective lubricating drug nanocarriers, may represent a promising strategy to treat early stage OA by lubrication enhancement and drug delivery therapy.
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Lo GH, Strayhorn MT, Driban JB, Price LL, Eaton CB, Mcalindon TE. Subjective Crepitus as a Risk Factor for Incident Symptomatic Knee Osteoarthritis: Data From the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2017; 70:53-60. [PMID: 28470832 DOI: 10.1002/acr.23246] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 03/21/2017] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Subjective crepitus is the reporting of hearing grating, cracking, or popping sounds in and/or around a joint. We aimed to evaluate whether there is an association between crepitus and incident symptomatic knee osteoarthritis (OA) in the Osteoarthritis Initiative (OAI), a multicenter longitudinal US cohort. METHODS Knees without baseline symptomatic OA were included. Crepitus frequency was assessed using a question from the Knee Injury and Osteoarthritis Outcome Score at baseline and at 12, 24, and 36 months. Frequent knee pain and radiographs were assessed at baseline and at annual visits up to 48 months. Radiographic OA was defined as a tibiofemoral Kellgren/Lawrence grade ≥2. Symptomatic OA was defined as a knee with both frequent symptoms and radiographic OA. We performed a repeated-measures analysis with a predictor of crepitus and outcome of incident symptomatic OA, adjusting for age, sex, and body mass index (BMI), with those never reporting crepitus as the referent group. RESULTS There were a total of 3,495 participants (42.2% male), with mean ± SD age of 61.1 ± 9.2 years and a mean ± SD BMI of 28.2 ± 4.7 kg/m². The odds of incident symptomatic OA were higher with greater frequency of crepitus (never, rarely, sometimes, often, and always, with adjusted odds ratios of (referent), 1.5, 1.8, 2.2, and 3.0, respectively; P < 0.0001 for trend). The group with radiographic OA at OAI baseline but without symptoms contributed 26% of the observations but more than 75% of the incident symptomatic OA cases. CONCLUSION In those without symptomatic OA, subjective knee crepitus predicts incident symptomatic OA longitudinally, with most cases occurring in those with preexisting tibiofemoral radiographic OA but without frequent knee pain. However, an important limitation is that patellofemoral OA was not systematically evaluated within the OAI. Subjective crepitus offers utility for the identification of at-risk individuals, predictive modeling, and future research.
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Affiliation(s)
- Grace H Lo
- Baylor College of Medicine and Houston VA Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Medical Center, Houston, Texas
| | - Michael T Strayhorn
- Baylor College of Medicine and Houston VA Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Medical Center, Houston, Texas
| | | | | | - Charles B Eaton
- Memorial Hospital of Rhode Island and Alpert Medical School, Brown University, Pawtucket, Rhode Island
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Herzog MM, Driban JB, Cattano NM, Cameron KL, Tourville TW, Marshall SW, Pietrosimone B. Risk of Knee Osteoarthritis Over 24 Months in Individuals Who Decrease Walking Speed During a 12-Month Period: Data from the Osteoarthritis Initiative. J Rheumatol 2017; 44:1265-1270. [PMID: 28572470 PMCID: PMC6061917 DOI: 10.3899/jrheum.170093] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To assess the association between change in walking speed over a 12-month period and risk of developing radiographic knee osteoarthritis (rKOA) over a 24-month period. METHODS We included participants without rKOA from the Osteoarthritis Initiative. Change in walking speed was determined from a 20-m walk assessment, calculated using walking speed at 12-month followup minus baseline speed and/or 24-month followup walking speed minus 12-month speed. Incident rKOA was defined as progressing to Kellgren-Lawrence arthritis grading scale ≥ 2 within 24 months (i.e., incidence between 12 and 36 mos or 24 and 48 mos). Self-reported significant knee injury during the exposure period, age, body mass index (BMI), and Physical Activity Scale for the Elderly (PASE) score were adjusted for analytically. RESULTS We included 2638 observations among 1460 unique participants (58% women; aged 59 ± 9 yrs, range 45-79). The mean change in walking speed over 12 months was 0.001 ± 0.13 m/s (range -0.6271 to 1.4968). About 5% of the sample (n = 122) developed rKOA over a 24-month period. After controlling for significant knee injury, age, BMI, and PASE score, we found an 8% relative increase in risk of developing rKOA for every 0.1 m/s decrease in walking speed over a 12-month period (risk ratio 1.08, 95% CI 1.00-1.15, p = 0.05). CONCLUSION Evaluating change in speed over a 12-month period using a 20-m walk test may be useful in identifying individuals at increased risk of developing rKOA over the subsequent 24 months. Identification of patients at high risk for developing rKOA would allow medical providers to implement early interventions to maximize joint health.
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Affiliation(s)
- Mackenzie M Herzog
- From the Department of Epidemiology, Gillings School of Global Public Health, and the Injury Prevention Research Center, and the Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts; Department of Sports Medicine, West Chester University, West Chester, Pennsylvania; Keller Army Community Hospital, West Point, New York; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA.
- M.M. Herzog, MPH, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Driban, PhD, Division of Rheumatology, Tufts Medical Center; N.M. Cattano, PhD, Department of Sports Medicine, West Chester University; K.L. Cameron, PhD, Keller Army Community Hospital; T.W. Tourville, PhD, Department of Rehabilitation and Movement Science, University of Vermont; S.W. Marshall, PhD, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, and Department of Exercise and Sport Science, University of North Carolina at Chapel Hill; B. Pietrosimone, PhD, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.
| | - Jeffrey B Driban
- From the Department of Epidemiology, Gillings School of Global Public Health, and the Injury Prevention Research Center, and the Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts; Department of Sports Medicine, West Chester University, West Chester, Pennsylvania; Keller Army Community Hospital, West Point, New York; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA
- M.M. Herzog, MPH, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Driban, PhD, Division of Rheumatology, Tufts Medical Center; N.M. Cattano, PhD, Department of Sports Medicine, West Chester University; K.L. Cameron, PhD, Keller Army Community Hospital; T.W. Tourville, PhD, Department of Rehabilitation and Movement Science, University of Vermont; S.W. Marshall, PhD, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, and Department of Exercise and Sport Science, University of North Carolina at Chapel Hill; B. Pietrosimone, PhD, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Nicole M Cattano
- From the Department of Epidemiology, Gillings School of Global Public Health, and the Injury Prevention Research Center, and the Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts; Department of Sports Medicine, West Chester University, West Chester, Pennsylvania; Keller Army Community Hospital, West Point, New York; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA
- M.M. Herzog, MPH, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Driban, PhD, Division of Rheumatology, Tufts Medical Center; N.M. Cattano, PhD, Department of Sports Medicine, West Chester University; K.L. Cameron, PhD, Keller Army Community Hospital; T.W. Tourville, PhD, Department of Rehabilitation and Movement Science, University of Vermont; S.W. Marshall, PhD, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, and Department of Exercise and Sport Science, University of North Carolina at Chapel Hill; B. Pietrosimone, PhD, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Kenneth L Cameron
- From the Department of Epidemiology, Gillings School of Global Public Health, and the Injury Prevention Research Center, and the Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts; Department of Sports Medicine, West Chester University, West Chester, Pennsylvania; Keller Army Community Hospital, West Point, New York; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA
- M.M. Herzog, MPH, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Driban, PhD, Division of Rheumatology, Tufts Medical Center; N.M. Cattano, PhD, Department of Sports Medicine, West Chester University; K.L. Cameron, PhD, Keller Army Community Hospital; T.W. Tourville, PhD, Department of Rehabilitation and Movement Science, University of Vermont; S.W. Marshall, PhD, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, and Department of Exercise and Sport Science, University of North Carolina at Chapel Hill; B. Pietrosimone, PhD, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Timothy W Tourville
- From the Department of Epidemiology, Gillings School of Global Public Health, and the Injury Prevention Research Center, and the Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts; Department of Sports Medicine, West Chester University, West Chester, Pennsylvania; Keller Army Community Hospital, West Point, New York; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA
- M.M. Herzog, MPH, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Driban, PhD, Division of Rheumatology, Tufts Medical Center; N.M. Cattano, PhD, Department of Sports Medicine, West Chester University; K.L. Cameron, PhD, Keller Army Community Hospital; T.W. Tourville, PhD, Department of Rehabilitation and Movement Science, University of Vermont; S.W. Marshall, PhD, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, and Department of Exercise and Sport Science, University of North Carolina at Chapel Hill; B. Pietrosimone, PhD, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Stephen W Marshall
- From the Department of Epidemiology, Gillings School of Global Public Health, and the Injury Prevention Research Center, and the Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts; Department of Sports Medicine, West Chester University, West Chester, Pennsylvania; Keller Army Community Hospital, West Point, New York; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA
- M.M. Herzog, MPH, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Driban, PhD, Division of Rheumatology, Tufts Medical Center; N.M. Cattano, PhD, Department of Sports Medicine, West Chester University; K.L. Cameron, PhD, Keller Army Community Hospital; T.W. Tourville, PhD, Department of Rehabilitation and Movement Science, University of Vermont; S.W. Marshall, PhD, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, and Department of Exercise and Sport Science, University of North Carolina at Chapel Hill; B. Pietrosimone, PhD, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Brian Pietrosimone
- From the Department of Epidemiology, Gillings School of Global Public Health, and the Injury Prevention Research Center, and the Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts; Department of Sports Medicine, West Chester University, West Chester, Pennsylvania; Keller Army Community Hospital, West Point, New York; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA
- M.M. Herzog, MPH, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Driban, PhD, Division of Rheumatology, Tufts Medical Center; N.M. Cattano, PhD, Department of Sports Medicine, West Chester University; K.L. Cameron, PhD, Keller Army Community Hospital; T.W. Tourville, PhD, Department of Rehabilitation and Movement Science, University of Vermont; S.W. Marshall, PhD, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, and Department of Exercise and Sport Science, University of North Carolina at Chapel Hill; B. Pietrosimone, PhD, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
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19
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Abstract
Chronic, low-grade inflammation in osteoarthritis (OA) contributes to symptoms and disease progression. Effective disease-modifying OA therapies are lacking, but better understanding inflammatory pathophysiology in OA could lead to transformative therapy. Networks of diverse innate inflammatory danger signals, including complement and alarmins, are activated in OA. Through inflammatory mediators, biomechanical injury and oxidative stress compromise the viability of chondrocytes, reprogramming them to hypertrophic differentiation and proinflammatory and pro-catabolic responses. Integral to this reprogramming are 'switching' pathways in transcriptional networks, other than the well-characterized effects of NFκB and mitogen-activated protein kinase signalling; HIF-2α transcriptional signalling and ZIP8-mediated Zn(2+) uptake, with downstream MTF1 transcriptional signalling, have been implicated but further validation is required. Permissive factors, including impaired bioenergetics via altered mitochondrial function and decreased activity of bioenergy sensors, interact with molecular inflammatory responses and proteostasis mechanisms such as the unfolded protein response and autophagy. Bioenergy-sensing by AMPK and SIRT1 provides 'stop signals' for oxidative stress, inflammatory, and matrix catabolic processes in chondrocytes. The complexity of molecular inflammatory processes in OA and the involvement of multiple inflammatory mediators in tissue repair responses, raises daunting questions about how to therapeutically target inflammatory processes and macroscopic inflammation in OA. Bioenergy sensing might provide a pragmatic 'entry point'.
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Affiliation(s)
- Ru Liu-Bryan
- San Diego VA Healthcare System and Division of Rheumatology, Allergy and Immunology, Department of Medicine, University of California San Diego, 111K, 3350 La Jolla Village Drive, San Diego, CA 92161, USA
| | - Robert Terkeltaub
- San Diego VA Healthcare System and Division of Rheumatology, Allergy and Immunology, Department of Medicine, University of California San Diego, 111K, 3350 La Jolla Village Drive, San Diego, CA 92161, USA
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20
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Weak associations between structural changes on MRI and symptoms, function and muscle strength in relation to knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2014; 22:2013-25. [PMID: 23377800 DOI: 10.1007/s00167-013-2434-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 01/23/2013] [Indexed: 02/07/2023]
Abstract
PURPOSE To explore associations between MRI-defined structural abnormalities and clinical features related to knee osteoarthritis (OA). METHODS Structural and clinical knee OA features were assessed in 87 women (45 with knee OA symptoms). Structural features were quantified by the Kellgren and Lawrence grade on radiography and by the Boston-Leeds Osteoarthritis Knee Score on MRI. Clinical features were assessed using the Knee Injury and Osteoarthritis Outcome Score, functional tests and muscle strength measurements. Associations were examined using regression analyses. RESULTS Limited significant associations between structural and clinical features were found. An increased meniscal signal was associated with more pain/symptoms (P < 0.027). An anterior cruciate ligament tear was associated with poorer stair climbing test performance (P = 0.045). In a stepwise linear regression model, patellofemoral cartilage integrity and pain explained 28 % of the isometric quadriceps strength variability. The amount of cartilage lesions, loose bodies and pain explained 38 % of the isokinetic quadriceps strength variability. Synovitis/effusion and patellofemoral cartilage integrity combined with pain explained 34 % of the isometric hamstring strength variability. CONCLUSION Although MRI-detected cartilage lesions, synovitis/effusion and loose bodies did explain part of the muscle strength variability, results suggest that MRI does not improve the link between joint degeneration and the clinical expression of knee OA. MRI contributes less than expected to the understanding of pain and function in knee OA and possibly offers little opportunity to develop structure-modifying treatments in knee OA that could influence the patient's pain and function. LEVEL OF EVIDENCE Case series with no comparison groups, Level IV.
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21
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Abstract
Magnetic resonance imaging (MRI) has become an increasingly important imaging technique in osteoarthritis (OA) research, and is widely used in the ongoing endeavor to understand the pathogenesis of OA and to develop structure and disease-modifying OA drugs. MRI offers semiquantitative, quantitative and compositional evaluation of knee OA, and enables visualization of tissues that are not seen by radiography, including but not limited to cartilage, meniscus, bone marrow lesions, synovitis, and muscles. It is now recognized that contrast-enhanced MRI enables more accurate evaluation of synovitis than MRI without contrast. Because of its ability to visualize multiple pain-related tissue pathology in three dimensions, MRI is the best modality for imaging of OA.
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22
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Sanchez-Ramirez DC, van der Leeden M, van der Esch M, Roorda LD, Verschueren S, van Dieën JH, Dekker J, Lems WF. Elevated C-reactive protein is associated with lower increase in knee muscle strength in patients with knee osteoarthritis: a 2-year follow-up study in the Amsterdam Osteoarthritis (AMS-OA) cohort. Arthritis Res Ther 2014; 16:R123. [PMID: 24928303 PMCID: PMC4095611 DOI: 10.1186/ar4580] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 05/29/2014] [Indexed: 12/13/2022] Open
Abstract
Introduction The aim of this study was to examine the associations of elevated serum C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) with change in muscle strength in patients with established knee osteoarthritis (OA), at 2 years. Methods Data from 186 patients with knee OA were gathered at baseline and at 2-year follow-up. CRP (in milligrams per liter) and ESR (in millimeters per hour) were measured in serum from patients’ blood. Strength of quadriceps and hamstrings muscles was assessed by using an isokinetic dynamometer. The association of inflammatory markers with change in knee muscle strength was analyzed by using uni- and multi-variate linear regression models. Results Patients with elevated CRP values at both baseline and 2-year follow-up exhibited a lower increase in knee muscle strength for a period of 2 years (β = -0.22; P = 0.01) compared with the group with non-elevated levels at both times of assessment. The association persisted after adjustment for relevant confounders. Elevated ESR values at both times of assessment were not significantly associated with change in knee muscle strength (β = -0.05; P = 0.49). Conclusions Our results indicate that elevated CRP values are related to a lower gain in muscle strength over time in patients with established knee OA. Although the mechanism to explain this relationship is not fully elucidated, these results suggest inflammation as a relevant factor influencing muscle strength in this group of patients.
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Knoop J, Dekker J, van der Leeden M, van der Esch M, Klein JP, Hunter DJ, Roorda LD, Steultjens MPM, Lems WF. Is the severity of knee osteoarthritis on magnetic resonance imaging associated with outcome of exercise therapy? Arthritis Care Res (Hoboken) 2014; 66:63-8. [PMID: 23982988 DOI: 10.1002/acr.22128] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 08/13/2013] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To evaluate associations between severity of knee osteoarthritis (OA) on magnetic resonance imaging (MRI) and treatment outcomes in knee OA patients treated with exercise therapy in an exploratory study. METHODS Ninety-five participants with knee OA in a 12-week exercise program had obtained 3.0T MRI scans of the knee joint prior to treatment. MRI data were systematically assessed for OA severity of multiple features (cartilage integrity, bone marrow lesions, osteophyte formation, effusion/synovitis, and meniscal abnormalities) according to the Boston Leeds Osteoarthritis Knee Score method. Regression analyses were performed to analyze associations between OA severity on MRI (for the tibiofemoral and patellofemoral [PF] compartments) and outcome of exercise therapy, i.e., changes in activity limitations (Western Ontario and McMaster Universities Osteoarthritis Index physical function; primary outcome), pain and upper leg muscle strength, and treatment response (Outcome Measures in Rheumatology/Osteoarthritis Research Society International criteria). RESULTS Improvements of 24%, 34%, and 21% on average in activity limitations, pain, and muscle strength, respectively, after 12-week exercise therapy were found (P < 0.001). Severity of abnormalities in PF cartilage integrity was significantly associated with fewer improvements in both activity limitations (P = 0.01) and muscle strength (P = 0.04). Severity of PF osteophyte formation was significantly associated with fewer improvements in muscle strength (P < 0.01). All other features on MRI were not associated with treatment outcome. CONCLUSION Effectiveness of exercise therapy seems to be independent of OA severity on MRI, except for abnormalities in cartilage integrity and osteophyte formation, both in the PF compartment. Our study suggests that all grades of OA severity on MRI can benefit from professionally supervised exercise therapy, although the effects might be reduced in patients with advanced PF OA.
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Affiliation(s)
- J Knoop
- Amsterdam Rehabilitation Research Center
- Reade, Amsterdam, The Netherlands
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24
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Mosher TJ, Walker EA, Petscavage-Thomas J, Guermazi A. Osteoarthritis year 2013 in review: imaging. Osteoarthritis Cartilage 2013; 21:1425-35. [PMID: 23891696 DOI: 10.1016/j.joca.2013.07.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 06/24/2013] [Accepted: 07/13/2013] [Indexed: 02/02/2023]
Abstract
PURPOSE To review recent original research publications related to imaging of osteoarthritis (OA) and identify emerging trends and significant advances. METHODS Relevant articles were identified through a search of the PubMed database using the query terms "OA" in combination with "imaging", "radiography", "MRI", "ultrasound", "computed tomography", and "nuclear medicine"; either published or in press between March 2012 and March 2013. Abstracts were reviewed to exclude review articles, case reports, and studies not focused on imaging using routine clinical imaging measures. RESULTS Initial query yielded 932 references, which were reduced to 328 citations following the initial review. MRI (118 references) and radiography (129 refs) remain the primary imaging modalities in OA studies, with fewer reports using computed tomography (CT) (35 refs) and ultrasound (23 refs). MRI parametric mapping techniques remain an active research area (33 refs) with growth in T2*- and T1-rho mapping publications compared to prior years. Although the knee is the major joint studied (210 refs) there is interest in the hip (106 refs) and hand (29 refs). Imaging continues to focus on evaluation of cartilage (173 refs) and bone (119 refs). CONCLUSION Imaging plays a major role in OA research with publications continuing along traditional lines of investigation. Translational and clinical research application of compositional MRI techniques is becoming more common driven in part by the availability of T2 mapping data from the Osteoarthritis Initiative (OAI). New imaging techniques continue to be developed with a goal of identifying methods with greater specificity and responsiveness to changes in the joint, and novel functional neuroimaging techniques to study central pain. Publications related to imaging of OA continue to be heavily focused on quantitative and semiquantitative MRI evaluation of the knee with increasing application of compositional MRI techniques in the hip.
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Affiliation(s)
- T J Mosher
- Department of Radiology, Penn State Hershey Medical Center, Hershey, PA, USA.
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Henak CR, Anderson AE, Weiss JA. Subject-specific analysis of joint contact mechanics: application to the study of osteoarthritis and surgical planning. J Biomech Eng 2013; 135:021003. [PMID: 23445048 PMCID: PMC3705883 DOI: 10.1115/1.4023386] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 01/03/2013] [Accepted: 01/18/2013] [Indexed: 11/08/2022]
Abstract
Advances in computational mechanics, constitutive modeling, and techniques for subject-specific modeling have opened the door to patient-specific simulation of the relationships between joint mechanics and osteoarthritis (OA), as well as patient-specific preoperative planning. This article reviews the application of computational biomechanics to the simulation of joint contact mechanics as relevant to the study of OA. This review begins with background regarding OA and the mechanical causes of OA in the context of simulations of joint mechanics. The broad range of technical considerations in creating validated subject-specific whole joint models is discussed. The types of computational models available for the study of joint mechanics are reviewed. The types of constitutive models that are available for articular cartilage are reviewed, with special attention to choosing an appropriate constitutive model for the application at hand. Issues related to model generation are discussed, including acquisition of model geometry from volumetric image data and specific considerations for acquisition of computed tomography and magnetic resonance imaging data. Approaches to model validation are reviewed. The areas of parametric analysis, factorial design, and probabilistic analysis are reviewed in the context of simulations of joint contact mechanics. Following the review of technical considerations, the article details insights that have been obtained from computational models of joint mechanics for normal joints; patient populations; the study of specific aspects of joint mechanics relevant to OA, such as congruency and instability; and preoperative planning. Finally, future directions for research and application are summarized.
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Affiliation(s)
- Corinne R. Henak
- Department of Bioengineering,University of Utah,Salt Lake City, UT 84112;Scientific Computing and Imaging Institute,University of Utah,Salt Lake City, UT 84112
| | - Andrew E. Anderson
- Department of Bioengineering,University of Utah,Salt Lake City, UT;Scientific Computing and Imaging Institute,University of Utah,Salt Lake City, UT;Department of Orthopaedics,University of Utah,Salt Lake City, UT 84108;Department of Physical Therapy,University of Utah,Salt Lake City, UT 84108
| | - Jeffrey A. Weiss
- Department of Bioengineering,University of Utah,Salt Lake City, UT 84108;Scientific Computing and Imaging Institute,University of Utah,Salt Lake City, UT 84108;Department of Orthopaedics,University of Utah,Salt Lake City, UT 84108e-mail:
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