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Riedstra NS, Boel F, van Buuren M, Eygendaal D, Bierma-Zeinstra S, Runhaar J, Agricola R. Pincer Morphology Is Not Associated With Hip Osteoarthritis Unless Hip Pain Is Present: Follow-Up Data From a Prospective Cohort Study. Arthritis Care Res (Hoboken) 2024; 76:644-651. [PMID: 38130018 DOI: 10.1002/acr.25285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/10/2023] [Accepted: 12/19/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE The objective of this study was to assess the relationship between pincer morphology and radiographic hip osteoarthritis (RHOA) over 2, 5, 8, and 10 years' follow-up and to study the interaction between pincer morphology and pain. METHODS Individuals from the prospective Cohort Hip and Cohort Knee study were drawn. Anteroposterior pelvic and false profile radiographs were obtained. Hips free of definite RHOA (Kellgren and Lawrence [KL] grade 0 or 1) at baseline were included. Pincer morphology was defined as a lateral or anterior center edge angle or both ≥40° at baseline. Incident RHOA was defined as KL ≥ 2 or total hip replacement at follow-up. Multivariable logistic regression with generalized estimating equations estimated the associations at follow-up. Associations were expressed as unadjusted odds ratios (ORs) and adjusted ORs with 95% confidence intervals (CIs). An interaction term was added to investigate whether pincer morphology had a different effect on symptomatic hips. RESULTS Incident RHOA developed in 69 hips (5%) at 2 years' follow-up, in 178 hips (14%) at 5 years' follow-up, in 279 hips (24%) at 8 years' follow-up, and in 495 hips (42%) at 10 years' follow-up. No significant associations were found between pincer morphology and incident RHOA (adjusted OR 0.35 [95% CI 0.06-2.15]; adjusted OR 1.50 [95% CI 0.94-2.38]). Significant interactions between pain and anterior pincer morphology in predicting incident RHOA were found at 5, 8, and 10 years' follow-up (OR 1.97 [95% CI 1.03-3.78]; OR 3.41 [95% CI 1.35-8.61]). CONCLUSION No associations were found between radiographic pincer morphology and incident RHOA at any follow-up moment. Anteriorly located pincer morphology with hip pain, however, was significantly associated with incident RHOA. This highlights the importance of studying symptoms and hip morphology simultaneously.
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Affiliation(s)
| | - Fleur Boel
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | | | | | - Jos Runhaar
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Rintje Agricola
- Erasmus University Medical Center, Rotterdam, The Netherlands
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Brent M, Brent MB. Sports Participation and Osteoarthritis in Females: A Systematic Review. Sports (Basel) 2023; 12:15. [PMID: 38251289 PMCID: PMC10819498 DOI: 10.3390/sports12010015] [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: 11/29/2023] [Revised: 12/22/2023] [Accepted: 12/29/2023] [Indexed: 01/23/2024] Open
Abstract
Sports participation and the risk of osteoarthritis (OA) have been a concern for decades. Few research efforts have been dedicated to clarify this issue for females, although they are considered at greater risk of developing OA than males. In contrast, several reviews have established an association between sports participation and OA for males. The aim of the systematic review was to assess the association between OA and participation in popular sports for females. PubMed, Embase, and Google Scholar were searched and yielded 578 articles. Nine eligible studies were included and covered ballet (age range: 19-54 years), running or tennis (age range: 40-65 years), Olympic sports (age range: not specified), volleyball (age range: 16.0 ± 0.8 to 46.8 ± 5.1 years), and cross-country skiing (age range: 15 to ≥60 years). For females, participating in sports at an elite level was associated with a higher risk of OA and an increased need for surgical treatment. At non-elite level, it was associated with a higher risk of OA, but it did not materialize to an increased risk for surgical treatment. Few studies compared females and males, and these studies suggested that sex did not affect the risk of developing OA from participating in sports. Nevertheless, to isolate the precise effect of sports participation on the development of OA remains difficult as injuries are common among athletes and are independently associated with an increased risk of OA.
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Affiliation(s)
- Magnus Brent
- Department of Health Science and Technology, Aalborg University, 9200 Aalborg Øst, Denmark
| | - Mikkel Bo Brent
- Department of Biomedicine, Health, Aarhus University, 8000 Aarhus, Denmark
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Rucinski K, Leary E, Royse LA. Factors Important to Patients when Making Treatment Decisions for Knee Osteoarthritis. J Knee Surg 2023; 36:1413-1421. [PMID: 37072026 DOI: 10.1055/s-0043-56998] [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: 04/20/2023]
Abstract
Patient treatment decisions for knee osteoarthritis (OA) are driven largely by the patient's physical examination and radiograph findings. Because multiple treatment options may be medically appropriate, it is imperative that the patient's voice be considered to better facilitate patient-centered treatment decisions. Concordance between physicians and patients on optimal treatment can vary, with few studies identifying the factors important to patients when making treatment decisions for knee OA. The goal of this analysis is to identify and synthesize subjective factors in the literature found to influence patient decision-making in a presurgical knee OA population, such that physicians and health care teams can become better equipped to help patients realize their specific treatment goals. This review was registered with PROSPERO and conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. A systematic search was completed in four databases for search terms related to knee OA and decision-making. Articles were eligible for inclusion when they discussed (1) patients' thoughts, feelings, goals, and perceptions that factored into treatment deliberation and decision-making; and (2) related to knee OA. Twenty-four articles were identified, 11 qualitative studies and 13 quantitative studies. Synthesis of the included articles revealed three main themes that drive patient treatment decisions: (1) individual catalysts to pursue treatment including pain and mobility limitations, (2) interpersonal factors including social networks and clinician trust, and (3) risks versus benefits assessment including patients' beliefs and expectations. Only a few studies looked at nonoperative treatment decisions, and no studies looked at cohorts considering knee preservation surgeries. This study was completed to synthesize literature related to patient treatment decisions for nonoperative and surgical management of knee OA, finding that patients consider multiple subjective factors when choosing whether to move forward with treatment. Understanding how patients' beliefs determine their preferences for treatment can improve shared decision-making.
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Affiliation(s)
- Kylee Rucinski
- Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
| | - Emily Leary
- Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
| | - Lisa A Royse
- Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
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Abd-Eltawab AE, Elbandrawy AM, Ghanem HB, Ebrahim HA, El-Sherbiny M, Ibrahim AM, Eladl MA, Elsherbini DMA. Whole-Body Vibration Impacts on the Degree of Toe Angle and Its Correlation to the Knee Osteoarthritis Index during Level Walking among Female University Students: A Randomized Controlled Trial. J Clin Med 2023; 12:5735. [PMID: 37685802 PMCID: PMC10488986 DOI: 10.3390/jcm12175735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/19/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Whole-body vibration (WBV) training is used for ankle rehabilitation as it stimulates muscle spindles to excite tonic vibration reflexes, and improves muscle strength, power, joint proprioception, balance, and flexibility. Thus, this study aims to determine the impact of whole-body vibration on the degree of the toe angle and the correlation between the toe angle and knee osteoarthritis index during level walking among female university students. A randomized controlled trial was conducted with 42 participants divided into two groups. The control group performed only home-based exercise (HBE) after education, and the study group received WBV with HBE. The functional status of participants to predict osteoarthritis was evaluated using the Western Ontario and McMaster osteoarthritis index (WOMAC), where the toe angle degree and WOMAC index were assessed before and six weeks after training. The results showed a significant improvement in the toe-in angle of HBE + WBV compared to the HBE group (p = 0.02), and in HBE + WBV, an improvement of the toe angle showed a 43% decrease in the WOMAC index (p = 0.001). In conclusion, WBV for the ankle and foot training program positively affected the degree of the toe angle, that directly affected the subtalar and ankle joint mechanics. Trial registration in the Pan African Clinical Trial Registry PACTR202304816093190 (registered retrospectively, date of registration: 18 April 2023).
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Affiliation(s)
- Amany E. Abd-Eltawab
- Physical Therapy and Health Rehabilitation Department, Faculty of Applied Medical Sciences, Jouf University, Sakaka P.O. Box 2014, Saudi Arabia;
- Biomechanics Department, Faculty of Physical Therapy, Cairo University, Giza P.O. Box 12612, Egypt
| | - Asmaa M. Elbandrawy
- Department of Physical Therapy for Women’s Health, Faculty of Physical Therapy, Cairo University, Giza P.O. Box 12612, Egypt;
- Department of Physical Therapy for Women’s Health, Faculty of Physical Therapy, Al-Salam University, Tanta P.O. Box 31527, Egypt
| | - Heba B. Ghanem
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka P.O. Box 2014, Saudi Arabia;
- Medical Biochemistry Department, Faculty of Medicine, Tanta University, Tanta P.O. Box 31511, Egypt
| | - Hasnaa A. Ebrahim
- Department of Basic Medical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh P.O. Box 84428, Saudi Arabia;
| | - Mohamed El-Sherbiny
- Department of Basic Medical Sciences, College of Medicine, AlMaarefa University, Riyadh P.O. Box 71666, Saudi Arabia;
- Department of Anatomy, Faculty of Medicine, Mansoura University, Mansoura P.O. Box 35516, Egypt
| | - Ateya Megahed Ibrahim
- Department of Nursing, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj P.O. Box 11942, Saudi Arabia;
- Department of Family and Community Health Nursing, Faculty of Nursing, Port Said University, Port Said P.O. Box 42526, Egypt
| | - Mohamed Ahmed Eladl
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates;
| | - Dalia Mahmoud Abdelmonem Elsherbini
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka P.O. Box 2014, Saudi Arabia;
- Department of Anatomy, Faculty of Medicine, Mansoura University, Mansoura P.O. Box 35516, Egypt
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Huebner M, Lavallee ME. Arthralgia in female Masters weightlifters. BMC Musculoskelet Disord 2023; 24:670. [PMID: 37620827 PMCID: PMC10464145 DOI: 10.1186/s12891-023-06814-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 08/19/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Arthralgia or joint pain is a heterogeneous condition including organic and nonorganic joint pain. It is common in older populations, particularly in females. There is evidence that menopausal changes are associated with increased prevalence of arthralgia. While physical activities have been recommended to mitigate osteoarthritis (OA) and arthralgia, sport participation also carries risk factors due to excessive loading of some joints and possible injuries. The aim was to evaluate the association of training patterns, prior injuries, and severity of menopausal symptoms with arthralgia in female Masters weightlifters. METHODS Competitive female Masters weightlifters (n=868, 30-78 years) from 30 countries completed an online survey including joint pain for different anatomical sites, weightlifting training and performance, sport history, and menopausal symptoms. Logistic regression models were used to estimate the association of training patterns, prior sport participation, and menopausal symptom severity with arthralgia separately for shoulders, spine, hips, knees, ankles, elbows, and hands. RESULTS Arthralgia was most reported in knees (38.8%), shoulders (29.8%), hands/wrists (28.8%), and hips (24.9%). The prevalence of arthralgia was 51.5% in pre-menopausal women, 62.4% in women post natural menopause and 73.3% in women post medical or surgical menopause. Lifting heavier weights was associated with arthralgia in hips (OR=1.05, p=0.03), knees (OR=1.06, p=0.01), and hands/wrists (OR=1.05, p=0.04), but prior strength training was protective for arthralgia in the shoulders (OR=0.66, p=0.02). Prior injuries and psychological menopausal symptom severity were associated with an increased risk for arthralgia (p<0.01). CONCLUSIONS Arthralgia was common in competitive female weightlifters. Training frequency was not associated with arthralgia, but lifting heavier weights relative to age and body mass was. Prior injuries and menopausal symptoms were associated with arthralgia, but prior strength training was protective of arthralgia in the shoulders. Athletes, coaches and sports medicine professionals should be aware that prevalence of polyarthralgia increases in post-menopausal athletes.
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Affiliation(s)
- Marianne Huebner
- Department of Statistics and Probability, Michigan State University, East Lansing, MI, USA.
- Department of Kinesiology, Michigan State University, East Lansing, MI, USA.
| | - Mark E Lavallee
- Department of Orthopedics, UPMC Central Pennsylvania, Harrisburg, PA, USA
- USA Weightlifting Sports Medicine Society, Colorado Springs, CO, USA
- Executive Medical Committee, International Weightlifting Federation, Lausanne, Switzerland
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Rosado SE. Osteoarthritis affects us too: an expert panel survey of factors important for younger adult wellbeing. SOCIAL WORK IN HEALTH CARE 2023; 62:73-92. [PMID: 36987586 DOI: 10.1080/00981389.2023.2191654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 02/04/2023] [Accepted: 03/10/2023] [Indexed: 06/19/2023]
Abstract
Research on quality of life (QOL) factors important for younger adults (ages 18-45 years old) with osteoarthritis (OA) is limited. This study utilizes an online survey method to conduct an expert panel review of QOL domains for this population. Health provider and young adult perspectives of living with OA were captured and compared. Results indicate that providers are underestimating the impact OA is having on a variety of QOL factors for younger adults. Overall, these results reveal critical QOL domains to consider during assessment and when considering intervention strategies aimed at improving the lives of younger adults with this chronic disease. Implications for social work are also discussed.
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Guo Y, Li R, Dang X. S100A10 regulates tumor necrosis factor alpha-induced apoptosis in chondrocytes via the reactive oxygen species/nuclear factor-kappa B pathway. Biotechnol Appl Biochem 2022; 69:2284-2295. [PMID: 34787893 DOI: 10.1002/bab.2285] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/11/2021] [Indexed: 01/06/2023]
Abstract
Aberrant chondrocyte apoptosis and inflammation are the most critical causes of osteoarthritis (OA) development. This study was designed to demonstrate the relationship between S100A10 and OA. In this study, S100A10 was overexpressed or silenced in rat chondrocytes. Cell viability, apoptosis, reactive oxidative species (ROS), and calcium ion detection were assessed using Cell Counting Kit-8 assay and flow cytometry. The levels of key oxidation-related enzymes and tumor necrosis factor-alpha (TNF-α) were quantified using enzyme-linked immunosorbent assay, quantitative polymerase chain reaction, and Western blotting. S100A10 was highly expressed in patients with OA and positively correlated with TNF-α level. Knockdown of S100A10 effectively counteracted TNF-α-induced ROS level, apoptosis, and calcium level and associated with decreased inflammation-related metalloproteinase 1 (MMP1), MMP13, and nuclear necrosis factor-kappa B (NF-κB)-p65 and increased survivin and cytoplasmic NF-κB-p65. Overexpression of S100A10 had an effect similar to TNF-α, which was significantly counteracted by pyrrolidine dithiocarbamate, an NF-κB inhibitor, or verapamil, a calcium-channel blocker. S100A10 contributed to chondrocyte apoptosis through the ROS/NF-κB pathway. This study has established the relationship between S100A10 and the NF-κB pathway, thus providing novel perspectives for exploring S100A10 functions.
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Affiliation(s)
- Yanjie Guo
- Department of Orthopaedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi Province, China
| | - Ruofei Li
- Department of Orthopaedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi Province, China
| | - Xiaoqian Dang
- Department of Orthopaedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi Province, China
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Mesenchymal Stem Cell Secreted-Extracellular Vesicles are Involved in Chondrocyte Production and Reduce Adipogenesis during Stem Cell Differentiation. Tissue Eng Regen Med 2022; 19:1295-1310. [DOI: 10.1007/s13770-022-00490-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/08/2022] [Accepted: 06/17/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background:
Extracellular vesicles (EVs) are derived from internal cellular compartments, and have potential as a diagnostic and therapeutic tool in degenerative disease associated with aging. Mesenchymal stem cells (MSCs) have become a promising tool for functional EVs production. This study investigated the efficacy of EVs and its effect on differentiation capacity.
Methods:
The characteristics of MSCs were evaluated by flow cytometry and stem cell differentiation analysis, and a production mode of functional EVs was scaled from MSCs. The concentration and size of EVs were quantitated by Nanoparticle Tracking Analysis (NTA). Western blot analysis was used to assess the protein expression of exosome-specific markers. The effects of MSC-derived EVs were assessed by chondrogenic and adipogenic differentiation analyses and histological observation.
Results:
The range of the particle size of adipose-derived stem cells (ADSCs)- and Wharton’s jelly -MSCs-derived EVs were from 130 to 150 nm as measured by NTA, which showed positive expression of exosomal markers. The chondrogenic induction ability was weakened in the absence of EVs in vitro. Interestingly, after EV administration, type II collagen, a major component in the cartilage extracellular matrix, was upregulated compared to the EV-free condition. Moreover, EVs decreased the lipid accumulation rate during adipogenic induction.
Conclusion:
The results indicated that the production model could facilitate production of effective EVs and further demonstrated the role of MSC-derived EVs in cell differentiation. MSC-derived EVs could be successfully used in cell-free therapy to guide chondrogenic differentiation of ADSC for future clinical applications in cartilage regeneration.
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Martel-Pelletier J, Pelletier JP. Is there a mitochondrial DNA haplogroup connection between osteoarthritis and elite athletes? A narrative review. RMD Open 2022; 8:rmdopen-2022-002602. [PMID: 36113964 PMCID: PMC9486370 DOI: 10.1136/rmdopen-2022-002602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/06/2022] [Indexed: 11/04/2022] Open
Abstract
Elite athletes are at greater risk of joint injuries linked to the subsequent risk of developing osteoarthritis (OA). Genetic factors such as mitochondrial (mt) DNA haplogroups have been associated with the incidence/progression of OA and athletic performance. This review highlights an area not yet addressed: is there a common pattern in the mtDNA haplogroups for OA occurrence in individuals and elite athletes of populations of the same descent? Haplotypes J and T confer a decreased risk of OA in Caucasian/European descent, while H and U increase this risk. Both J and T haplogroups are under-represented in Caucasian/European individuals and endurance athletes with OA, but power athletes showed a greater percentage of the J haplogroup. Caucasian/European endurance athletes had a higher percentage of haplogroup H, which is associated with increased athletic performance. In a Chinese population, haplogroup G appears to increase OA susceptibility and is over-represented in Japanese endurance athletes. In contrast, in Koreans, haplogroup B had a higher frequency of individuals with OA but was under-represented in the endurance athlete population. For Caucasian endurance athletes, it would be interesting to evaluate if those carrying haplotype H would be at an increased risk of accelerated OA, as well as the haplogroup G in Chinese and Japanese endurance athletes. The reverse might be studied for the Korean descent for haplogroup B. Knowledge of such genetic data could be used as a preliminary diagnosis to identify individuals at high risk of OA, adding prognostic information and assisting in personalising the early management of both populations.
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Affiliation(s)
- Johanne Martel-Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
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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 2022. [PMID: 35798349 DOI: 10.1055/s-0042-1750750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [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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Advantages of deep learning with convolutional neural network in detecting disc displacement of the temporomandibular joint in magnetic resonance imaging. Sci Rep 2022; 12:11352. [PMID: 35790841 PMCID: PMC9256683 DOI: 10.1038/s41598-022-15231-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 06/21/2022] [Indexed: 11/24/2022] Open
Abstract
This study investigated the usefulness of deep learning-based automatic detection of anterior disc displacement (ADD) from magnetic resonance imaging (MRI) of patients with temporomandibular joint disorder (TMD). Sagittal MRI images of 2520 TMJs were collected from 861 men and 399 women (average age 37.33 ± 18.83 years). A deep learning algorithm with a convolutional neural network was developed. Data augmentation and the Adam optimizer were applied to reduce the risk of overfitting the deep-learning model. The prediction performances were compared between the models and human experts based on areas under the curve (AUCs). The fine-tuning model showed excellent prediction performance (AUC = 0.8775) and acceptable accuracy (approximately 77%). Comparing the AUC values of the from-scratch (0.8269) and freeze models (0.5858) showed lower performances of the other models compared to the fine-tuning model. In Grad-CAM visualizations, the fine-tuning scheme focused more on the TMJ disc when judging ADD, and the sparsity was higher than that of the from-scratch scheme (84.69% vs. 55.61%, p < 0.05). The three fine-tuned ensemble models using different data augmentation techniques showed a prediction accuracy of 83%. Moreover, the AUC values of ADD were higher when patients with TMD were divided by age (0.8549–0.9275) and sex (male: 0.8483, female: 0.9276). While the accuracy of the ensemble model was higher than that of human experts, the difference was not significant (p = 0.1987–0.0671). Learning from pre-trained weights allowed the fine-tuning model to outperform the from-scratch model. Another benefit of the fine-tuning model for diagnosing ADD of TMJ in Grad-CAM analysis was the deactivation of unwanted gradient values to provide clearer visualizations compared to the from-scratch model. The Grad-CAM visualizations also agreed with the model learned through important features in the joint disc area. The accuracy was further improved by an ensemble of three fine-tuning models using diversified data. The main benefits of this model were the higher specificity compared to human experts, which may be useful for preventing true negative cases, and the maintenance of its prediction accuracy across sexes and ages, suggesting a generalized prediction.
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Masaracchio MF, Kirker K, Loghmani P, Gramling J, Mattia M, States R. The Prevalence of Tibiofemoral Knee Osteoarthritis Following Arthroscopic Partial Meniscectomy Is Variably Reported in General, and Over Time: A Systematic Review With a Minimum of 5-Year Follow-Up. Arthrosc Sports Med Rehabil 2022; 4:e1203-e1218. [PMID: 35747640 PMCID: PMC9210380 DOI: 10.1016/j.asmr.2022.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/17/2022] [Indexed: 01/08/2023] Open
Abstract
Purpose Methods Results Conclusions Level of Evidence
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Affiliation(s)
- Michael F. Masaracchio
- Department of Physical Therapy, Long Island University, Brooklyn, New York
- Address correspondence to Michael F. Masaracchio, P.T., Ph.D., 1 University Plaza HS 201, Brooklyn, NY 11201.
| | - Kaitlin Kirker
- Department of Physical Therapy, Long Island University, Brooklyn, New York
| | - Parisa Loghmani
- Department of Physical Therapy, Long Island University, Brooklyn, New York
| | - Jillian Gramling
- Department of Physical Therapy, Long Island University, Brooklyn, New York
| | - Michael Mattia
- Physical Therapist Assistant Program, Department of Allied Health, Kingsborough Community College, Brooklyn, New York, U.S.A
| | - Rebecca States
- Department of Physical Therapy, Long Island University, Brooklyn, New York
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Bonakdari H, Pelletier JP, Abram F, Martel-Pelletier J. A Machine Learning Model to Predict Knee Osteoarthritis Cartilage Volume Changes over Time Using Baseline Bone Curvature. Biomedicines 2022; 10:biomedicines10061247. [PMID: 35740270 PMCID: PMC9220338 DOI: 10.3390/biomedicines10061247] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/12/2022] [Accepted: 05/19/2022] [Indexed: 01/27/2023] Open
Abstract
The hallmark of osteoarthritis (OA), the most prevalent musculoskeletal disease, is the loss of cartilage. By using machine learning (ML), we aimed to assess if baseline knee bone curvature (BC) could predict cartilage volume loss (CVL) at one year, and to develop a gender-based model. BC and cartilage volume were assessed on 1246 participants using magnetic resonance imaging. Variables included age, body mass index, and baseline values of eight BC regions. The outcome consisted of CVL at one year in 12 regions. Five ML methods were evaluated. Validation demonstrated very good accuracy for both genders (R ≥ 0.78), except the medial tibial plateau for the woman. In conclusion, we demonstrated, for the first time, that knee CVL at one year could be predicted using five baseline BC region values. This would benefit patients at risk of structural progressive knee OA.
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Affiliation(s)
- Hossein Bonakdari
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC H2X 0A9, Canada; (H.B.); (J.-P.P.)
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC H2X 0A9, Canada; (H.B.); (J.-P.P.)
| | - François Abram
- Medical Imaging Consultant, ArthroLab Inc., Montreal, QC H2X 0A9, Canada;
| | - Johanne Martel-Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC H2X 0A9, Canada; (H.B.); (J.-P.P.)
- Correspondence: ; Tel.: +1-514-890-8000 (ext. 27281); Fax: +1-514-412-7582
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Characteristic and Chondrogenic Differentiation Analysis of Hybrid Hydrogels Comprised of Hyaluronic Acid Methacryloyl (HAMA), Gelatin Methacryloyl (GelMA), and the Acrylate-Functionalized Nano-Silica Crosslinker. Polymers (Basel) 2022; 14:polym14102003. [PMID: 35631885 PMCID: PMC9144778 DOI: 10.3390/polym14102003] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 04/29/2022] [Accepted: 05/10/2022] [Indexed: 02/04/2023] Open
Abstract
Developing a biomaterial suitable for adipose-derived stem cell (ADSCs)-laden scaffolds that can directly bond to cartilage tissue surfaces in tissue engineering has still been a significant challenge. The bioinspired hybrid hydrogel approaches based on hyaluronic acid methacryloyl (HAMA) and gelatin methacryloyl (GelMA) appear to have more promise. Herein, we report the cartilage tissue engineering application of a novel photocured hybrid hydrogel system comprising HAMA, GelMA, and 0~1.0% (w/v) acrylate-functionalized nano-silica (AFnSi) crosslinker, in addition to describing the preparation of related HAMA, GelMA, and AFnSi materials and confirming their related chemical evidence. The study also examines the physicochemical characteristics of these hybrid hydrogels, including swelling behavior, morphological conformation, mechanical properties, and biodegradation. To further investigate cell viability and chondrogenic differentiation, the hADSCs were loaded with a two-to-one ratio of the HAMA-GelMA (HG) hybrid hydrogel with 0~1.0% (w/v) AFnSi crosslinker to examine the process of optimal chondrogenic development. Results showed that the morphological microstructure, mechanical properties, and longer degradation time of the HG+0.5% (w/v) AFnSi hydrogel demonstrated the acellular novel matrix was optimal to support hADSCs differentiation. In other words, the in vitro experimental results showed that hADSCs laden in the photocured hybrid hydrogel of HG+0.5% (w/v) AFnSi not only significantly increased chondrogenic marker gene expressions such as SOX-9, aggrecan, and type II collagen expression compared to the HA and HG groups, but also enhanced the expression of sulfated glycosaminoglycan (sGAG) and type II collagen formation. We have concluded that the photocured hybrid hydrogel of HG+0.5% (w/v) AFnSi will provide a suitable environment for articular cartilage tissue engineering applications.
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15
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Govil G, Tomar L, Dhawan P. Knee-Spine Syndrome: Management Dilemma When Knee Osteoarthritis Coexists With Spine Degeneration. Cureus 2022; 14:e24939. [DOI: 10.7759/cureus.24939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2022] [Indexed: 11/05/2022] Open
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16
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Bush NJ, Schick MR, Spillane NS, Boissoneault J. Stress Mediates the Association Between Pain and Alcohol Use in College Students. J Pain Res 2022; 15:757-766. [PMID: 35356267 PMCID: PMC8958199 DOI: 10.2147/jpr.s351837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/19/2022] [Indexed: 11/23/2022] Open
Abstract
Background Alcohol use in young adults is highly prevalent and associated with numerous consequences, including academic difficulties and motor vehicle accidents. Pain is one factor that has been increasingly shown to be associated with higher rates of alcohol consumption and riskier patterns of drinking among undergraduate students. Although pain has traditionally been viewed as a lesser concern for young adults, current research demonstrates that pain may be more prevalent in younger populations than originally thought. However, little is known about how common psychosocial factors, such as stress and subjective social status (SSS), influence the association between pain and alcohol consumption in college students. Objective The study's goal was to examine the effect of stress and SSS on the relationship between pain and alcohol consumption. Participants and Methods Participants (N = 445, 39.3% women, Mage = 22.98) were 18- to 25-year-old college students who completed an online questionnaire. Results Pain was significantly associated with total weekly alcohol consumption (r(445) = .22, p < 0.001); this association was significantly mediated by stress (b = 0.15, SE = 0.04, 95% CI = [.07,0.23]). SSS was significantly positively associated with alcohol consumption (r(445) = .22, p < 0.001) but was not found to significantly moderate the relationship between stress and alcohol use. Conclusion Results suggest that efforts to reduce college student alcohol use should include assessment of pain and stress given their association with alcohol consumption. Further, findings suggest that future studies are warranted to prospectively examine pain as an antecedent for alcohol use and to examine the utility of incorporating stress management techniques in pain-focused interventions to indirectly target alcohol use.
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Affiliation(s)
- Nicholas J Bush
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Melissa R Schick
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Nichea S Spillane
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Jeff Boissoneault
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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17
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A Survey on Design and Control of Lower Extremity Exoskeletons for Bipedal Walking. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12052395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Exoskeleton robots are electrically, pneumatically, or hydraulically actuated devices that externally support the bones and cartilage of the human body while trying to mimic the human movement capabilities and augment muscle power. The lower extremity exoskeleton device may support specific human joints such as hip, knee, and ankle, or provide support to carry and balance the weight of the full upper body. Their assistive functionality for physically-abled and disabled humans is demanded in medical, industrial, military, safety applications, and other related fields. The vision of humans walking with an exoskeleton without external support is the prospect of the robotics and artificial intelligence working groups. This paper presents a survey on the design and control of lower extremity exoskeletons for bipedal walking. First, a historical view on the development of walking exoskeletons is presented and various lower body exoskeleton designs are categorized in different application areas. Then, these designs are studied from design, modeling, and control viewpoints. Finally, a discussion on future research directions is provided.
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18
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Therapeutic Exercise and Conservative Injection Treatment for Early Knee Osteoarthritis in Athletes: A Scoping Review. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58010069. [PMID: 35056377 PMCID: PMC8778069 DOI: 10.3390/medicina58010069] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 12/30/2021] [Accepted: 12/30/2021] [Indexed: 02/06/2023]
Abstract
Background and Objectives: Recent evidence highlighted a higher prevalence of knee osteoarthritis (kOA) among young and former ex-professional athletes. Although the practice of a highly demanding sport is considered a predisposing factor for the knee joint cartilage degeneration, articular cartilage seems to positively respond to a moderate load increase. We aim to investigate recent evidence on the conservative management of early kOA in athletes, with a particular emphasis on therapeutic exercise and injection treatment, in order to highlight whether there are any indications that can influence clinical and rehabilitation practice. Materials and Methods: A scoping review was conducted, screening MEDLINE and PEDro databases for studies published over the past twenty years on the topic. Studies in English, with accessible abstracts, were included in the review. The PICO framework was used (P—patient: athletes, I—Intervention: conservative treatment with therapeutic exercise or injection therapies, C—Comparison: not needed, O—Outcomes: clinical outcomes). Clinical trials, randomized controlled trials, and longitudinal studies were considered. Results: Four studies were finally included in the review. Therapeutic exercise seems to have beneficial effects on prevention of cartilage degeneration, on pain reduction, and on physical function enhancement. On the other hand, in mild to moderate stages of kOA the intra-articular viscosupplementation with Hyaluronic Acid showed a medium to long-term improvement in joint pain and function. The Platelet Rich Plasma treatment also showed a significant improvement in pain and function up to 12 months. Conclusions: Despite the heterogeneity of the studies considered, a multimodal treatment combining therapeutic exercise and moderate aerobic activity (such as running) should be indicated to prevent kOA development. In cases of symptomatic kOA it may be indicated to add minimally invasive injection therapy that seems to contribute to the improvement of motor function and symptomatology.
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19
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Lawande M, Daftary A, Ahuja A, Sabnis B. Role of imaging in surgical decision making in young knee osteoarthrosis. Eur J Radiol Open 2022; 9:100436. [PMID: 36061258 PMCID: PMC9429574 DOI: 10.1016/j.ejro.2022.100436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 07/31/2022] [Accepted: 08/16/2022] [Indexed: 11/28/2022] Open
Abstract
Osteoarthrosis is the most common form of knee arthritis, characterized by pain and discomfort from primarily articular cartilage wear. Traditionally in its end stage, it has been treated with total knee arthroplasty, a permanent process with a life span of ten to fifteen years and challenges with revision. With an increasing longevity and epidemic of obesity that the population is facing, naturally, we are seeing more and more patients with osteoarthrosis at a younger age. This makes it imperative to extend the life of the native knee by conservative measures, injections of steroid, hyaluronic acid, or biologicals and finally a slew of surgical alternatives ranging from joint realignment to partial and total joint replacement. Besides the clinical presentation, decisions are made based on joint alignment, extent and degree of cartilage wear and the status of the subchondral bone. Imaging plays an invaluable role in surgical decision making. In this article, we will discuss how imaging is used in our practice during decision making for the management of the young osteoarthritic knee. Prevalence of knee osteoarthrosis is increasing in younger population. Surgical treatment of osteoarthrosis at a younger age has its own challenges of need to return to higher levels of physical activity and longer life expectancy. Osteoarthrosis is now considered a whole organ dynamic disease. Imaging plays an important role in decision making in treatment and management of osteoarthrosis.
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Affiliation(s)
- Malini Lawande
- Innovision Imaging, Sportsmed, 2nd Floor, Parel premises, Junction of Gokhale and Sayani road, Parel west, Mumbai 400025, Maharashtra, India
- Corresponding author.
| | - Aditya Daftary
- Innovision Imaging, Sportsmed, 2nd Floor, Parel premises, Junction of Gokhale and Sayani road, Parel west, Mumbai 400025, Maharashtra, India
| | - Ankita Ahuja
- Innovision Imaging, Sportsmed, 2nd Floor, Parel premises, Junction of Gokhale and Sayani road, Parel west, Mumbai 400025, Maharashtra, India
| | - Bhushan Sabnis
- Department of Orthopaedics, Sportsmed, 2nd Floor, Parel premises, Junction of Gokhale and Sayani road, Parel west, Mumbai 400025, Maharashtra, India
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20
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Islam M, Lantada AD, Mager D, Korvink JG. Carbon-Based Materials for Articular Tissue Engineering: From Innovative Scaffolding Materials toward Engineered Living Carbon. Adv Healthc Mater 2022; 11:e2101834. [PMID: 34601815 DOI: 10.1002/adhm.202101834] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Indexed: 12/14/2022]
Abstract
Carbon materials constitute a growing family of high-performance materials immersed in ongoing scientific technological revolutions. Their biochemical properties are interesting for a wide set of healthcare applications and their biomechanical performance, which can be modulated to mimic most human tissues, make them remarkable candidates for tissue repair and regeneration, especially for articular problems and osteochondral defects involving diverse tissues with very different morphologies and properties. However, more systematic approaches to the engineering design of carbon-based cell niches and scaffolds are needed and relevant challenges should still be overcome through extensive and collaborative research. In consequence, this study presents a comprehensive description of carbon materials and an explanation of their benefits for regenerative medicine, focusing on their rising impact in the area of osteochondral and articular repair and regeneration. Once the state-of-the-art is illustrated, innovative design and fabrication strategies for artificially recreating the cellular microenvironment within complex articular structures are discussed. Together with these modern design and fabrication approaches, current challenges, and research trends for reaching patients and creating social and economic impacts are examined. In a closing perspective, the engineering of living carbon materials is also presented for the first time and the related fundamental breakthroughs ahead are clarified.
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Affiliation(s)
- Monsur Islam
- Karlsruhe Institute of Technology Institute of Microstructure Technology Hermann‐von‐Helmholtz‐Platz 1 Eggenstein‐Leopoldshafen 76344 Germany
| | - Andrés Díaz Lantada
- Department of Mechanical Engineering Universidad Politécnica de Madrid José Gutiérrez Abascal 2 Madrid 28006 Spain
| | - Dario Mager
- Karlsruhe Institute of Technology Institute of Microstructure Technology Hermann‐von‐Helmholtz‐Platz 1 Eggenstein‐Leopoldshafen 76344 Germany
| | - Jan G. Korvink
- Karlsruhe Institute of Technology Institute of Microstructure Technology Hermann‐von‐Helmholtz‐Platz 1 Eggenstein‐Leopoldshafen 76344 Germany
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21
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Acevedo Rua L, Mumme M, Manferdini C, Darwiche S, Khalil A, Hilpert M, Buchner DA, Lisignoli G, Occhetta P, von Rechenberg B, Haug M, Schaefer DJ, Jakob M, Caplan A, Martin I, Barbero A, Pelttari K. Engineered nasal cartilage for the repair of osteoarthritic knee cartilage defects. Sci Transl Med 2021; 13:eaaz4499. [PMID: 34516821 DOI: 10.1126/scitranslmed.aaz4499] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Lina Acevedo Rua
- Department of Biomedicine, University Hospital Basel, University of Basel, Hebelstrasse 20, 4031 Basel, Switzerland
| | - Marcus Mumme
- Department of Biomedicine, University Hospital Basel, University of Basel, Hebelstrasse 20, 4031 Basel, Switzerland.,Department of Surgery, University Hospital Basel, Hebelstrasse 20, 4031 Basel, Switzerland
| | - Cristina Manferdini
- IRCCS Istituto Ortopedico Rizzoli, Laboratorio di Immunoreumatologia e Rigenerazione Tissutale, Via di Barbiano 1/10, 40136 Bologna, Italy
| | - Salim Darwiche
- Musculoskeletal Research Unit MSRU, Equine Department, University of Zurich, 8057 Zürich, Switzerland
| | - Ahmad Khalil
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH 44106 , USA
| | - Morgane Hilpert
- Department of Biomedicine, University Hospital Basel, University of Basel, Hebelstrasse 20, 4031 Basel, Switzerland
| | - David A Buchner
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH 44106 , USA
| | - Gina Lisignoli
- IRCCS Istituto Ortopedico Rizzoli, Laboratorio di Immunoreumatologia e Rigenerazione Tissutale, Via di Barbiano 1/10, 40136 Bologna, Italy
| | - Paola Occhetta
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Brigitte von Rechenberg
- Competence Center for Applied Biotechnology and Molecular Medicine CABMM, University of Zurich, 8057 Zürich, Switzerland
| | - Martin Haug
- Department of Surgery, University Hospital Basel, Hebelstrasse 20, 4031 Basel, Switzerland
| | - Dirk J Schaefer
- Department of Surgery, University Hospital Basel, Hebelstrasse 20, 4031 Basel, Switzerland
| | - Marcel Jakob
- Department of Surgery, University Hospital Basel, Hebelstrasse 20, 4031 Basel, Switzerland
| | - Arnold Caplan
- Department of Biology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Ivan Martin
- Department of Biomedicine, University Hospital Basel, University of Basel, Hebelstrasse 20, 4031 Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14-16, 4123 Allschwil, Switzerland Switzerland
| | - Andrea Barbero
- Department of Biomedicine, University Hospital Basel, University of Basel, Hebelstrasse 20, 4031 Basel, Switzerland
| | - Karoliina Pelttari
- Department of Biomedicine, University Hospital Basel, University of Basel, Hebelstrasse 20, 4031 Basel, Switzerland
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22
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Jellyfish Collagen: A Biocompatible Collagen Source for 3D Scaffold Fabrication and Enhanced Chondrogenicity. Mar Drugs 2021; 19:md19080405. [PMID: 34436244 PMCID: PMC8400217 DOI: 10.3390/md19080405] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/11/2021] [Accepted: 07/13/2021] [Indexed: 02/03/2023] Open
Abstract
Osteoarthritis (OA) is a multifactorial disease leading to degeneration of articular cartilage, causing morbidity in approximately 8.5 million of the UK population. As the dense extracellular matrix of articular cartilage is primarily composed of collagen, cartilage repair strategies have exploited the biocompatibility and mechanical strength of bovine and porcine collagen to produce robust scaffolds for procedures such as matrix-induced chondrocyte implantation (MACI). However, mammalian sourced collagens pose safety risks such as bovine spongiform encephalopathy, transmissible spongiform encephalopathy and possible transmission of viral vectors. This study characterised a non-mammalian jellyfish (Rhizostoma pulmo) collagen as an alternative, safer source in scaffold production for clinical use. Jellyfish collagen demonstrated comparable scaffold structural properties and stability when compared to mammalian collagen. Jellyfish collagen also displayed comparable immunogenic responses (platelet and leukocyte activation/cell death) and cytokine release profile in comparison to mammalian collagen in vitro. Further histological analysis of jellyfish collagen revealed bovine chondroprogenitor cell invasion and proliferation in the scaffold structures, where the scaffold supported enhanced chondrogenesis in the presence of TGFβ1. This study highlights the potential of jellyfish collagen as a safe and biocompatible biomaterial for both OA repair and further regenerative medicine applications.
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23
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Clayton P, Hill M, Bogoda N, Subah S, Venkatesh R. Palmitoylethanolamide: A Natural Compound for Health Management. Int J Mol Sci 2021; 22:5305. [PMID: 34069940 PMCID: PMC8157570 DOI: 10.3390/ijms22105305] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/06/2021] [Accepted: 05/06/2021] [Indexed: 01/23/2023] Open
Abstract
All nations which have undergone a nutrition transition have experienced increased frequency and falling latency of chronic degenerative diseases, which are largely driven by chronic inflammatory stress. Dietary supplementation is a valid strategy to reduce the risk and severity of such disorders. Palmitoylethanolamide (PEA) is an endocannabinoid-like lipid mediator with extensively documented anti-inflammatory, analgesic, antimicrobial, immunomodulatory and neuroprotective effects. It is well tolerated and devoid of side effects in animals and humans. PEA's actions on multiple molecular targets while modulating multiple inflammatory mediators provide therapeutic benefits in many applications, including immunity, brain health, allergy, pain modulation, joint health, sleep and recovery. PEA's poor oral bioavailability, a major obstacle in early research, has been overcome by advanced delivery systems now licensed as food supplements. This review summarizes the functionality of PEA, supporting its use as an important dietary supplement for lifestyle management.
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Affiliation(s)
- Paul Clayton
- Institute of Food, Brain and Behaviour, Beaver House, 23-28 Hythe Bridge Street, Oxford OX1 2EP, UK
| | - Mariko Hill
- Gencor Pacific Limited, Discovery Bay, Lantau Island, New Territories, Hong Kong, China; (M.H.); (N.B.); (S.S.)
| | - Nathasha Bogoda
- Gencor Pacific Limited, Discovery Bay, Lantau Island, New Territories, Hong Kong, China; (M.H.); (N.B.); (S.S.)
| | - Silma Subah
- Gencor Pacific Limited, Discovery Bay, Lantau Island, New Territories, Hong Kong, China; (M.H.); (N.B.); (S.S.)
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24
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Carneiro I, Silva J, Lopes T, Carvalho JL. Ultrasound-guided thermal radiofrequency ablation to treat refractory knee and hip pain: Outcomes of a case series. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2021. [DOI: 10.1177/22104917211003307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A number of options are currently available to treat symptomatic knee and hip pain. Among them, there is the use of thermal radiofrequency ablation. It is a more recent technique and we still have a lack regarding safety and effectiveness. In this report, we briefly present a case series of patients with refractory knee and hip pain, treated with thermal radiofrequency ablation, where we discuss the results in safety and effectiveness, concerning not only the pain control, but also the return to participation in activities.
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Affiliation(s)
- Ismael Carneiro
- North Rehabilitation Center, Physical Medicine and Rehabilitation, Vila Nova de Gaia, Portugal
| | - Joana Silva
- North Rehabilitation Center, Physical Medicine and Rehabilitation, Vila Nova de Gaia, Portugal
| | - Tiago Lopes
- North Rehabilitation Center, Physical Medicine and Rehabilitation, Vila Nova de Gaia, Portugal
| | - José Luís Carvalho
- North Rehabilitation Center, Physical Medicine and Rehabilitation, Vila Nova de Gaia, Portugal
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25
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Vapniarsky N, Kwon H, Paschos NK, Haudenschild AK, Brown WE, DuRaine GD, Hu JC, Athanasiou KA. Adult Dermal Stem Cells for Scaffold-Free Cartilage Tissue Engineering: Exploration of Strategies. Tissue Eng Part C Methods 2020; 26:598-607. [PMID: 33198584 DOI: 10.1089/ten.tec.2020.0207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Dermis-isolated adult stem (DIAS) cells, abundantly available, are attractive for regenerative medicine. Strategies have been devised to isolate and to chondroinduce DIAS cells from various animals. This study aimed to characterize DIAS cells from human abdominal skin (human dermis-isolated adult stem [hDIAS] cells) and to compare and to refine various chondroinduction regimens to form functional neocartilage constructs. The stemness of hDIAS cells was verified (Phase I), three chondroinduction pretreatments were compared (Phase II), and, from these, one regimen was carried forward for refinement in Phase III for improving the mechanical properties of hDIAS cell-derived constructs. Multilineage differentiation and mesenchymal stem cell markers were observed. Among various chondroinduction pretreatments, the nodule formation pretreatment yielded constructs at least 72% larger in diameter, with higher glycosaminoglycan (GAG) content by 44%, compared with other pretreatments. Furthermore, it was found that culturing cells on nontissue culture-treated surfaces yielded constructs (1) on par with constructs derived from aggrecan-coated surfaces and (2) with superior mechanical properties than constructs derived from cells cultured on tissue culture-treated surfaces. After the nodule formation pretreatment, combined supplementation of TGF-β1, IGF-I, and fetal bovine serum significantly enhanced aggregate modulus and shear modulus by 75% and 69%, respectively, over the supplementation by TGF-β1 alone. In summary, human skin-derived DIAS cells are responsive to chondroinduction for forming neocartilage. Furthermore, the mechanical properties of the resultant human constructs can be improved by treatments shown to be efficacious in animal models. Advances made toward tissue-engineering cartilage using animal cells were shown to be applicable to hDIAS cells for cartilage repair and regeneration.
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Affiliation(s)
- Natalia Vapniarsky
- Department of Pathology, Microbiology, and Immunology, University of California, Davis, Davis, California, USA
| | - Heenam Kwon
- Department of Biomedical Engineering, Samueli School of Engineering, University of California, Irvine, Irvine, California, USA
| | - Nikolaos K Paschos
- Department of Biomedical Engineering, University of California, Davis, Davis, California, USA
| | - Anne K Haudenschild
- Department of Biomedical Engineering, University of California, Davis, Davis, California, USA
| | - Wendy E Brown
- Department of Biomedical Engineering, Samueli School of Engineering, University of California, Irvine, Irvine, California, USA
| | - Grayson D DuRaine
- Department of Biomedical Engineering, University of California, Davis, Davis, California, USA
| | - Jerry C Hu
- Department of Biomedical Engineering, Samueli School of Engineering, University of California, Irvine, Irvine, California, USA
| | - Kyriacos A Athanasiou
- Department of Biomedical Engineering, Samueli School of Engineering, University of California, Irvine, Irvine, California, USA
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26
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Enabling early detection of osteoarthritis from presymptomatic cartilage texture maps via transport-based learning. Proc Natl Acad Sci U S A 2020; 117:24709-24719. [PMID: 32958644 DOI: 10.1073/pnas.1917405117] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Many diseases have no visual cues in the early stages, eluding image-based detection. Today, osteoarthritis (OA) is detected after bone damage has occurred, at an irreversible stage of the disease. Currently no reliable method exists for OA detection at a reversible stage. We present an approach that enables sensitive OA detection in presymptomatic individuals. Our approach combines optimal mass transport theory with statistical pattern recognition. Eighty-six healthy individuals were selected from the Osteoarthritis Initiative, with no symptoms or visual signs of disease on imaging. On 3-y follow-up, a subset of these individuals had progressed to symptomatic OA. We trained a classifier to differentiate progressors and nonprogressors on baseline cartilage texture maps, which achieved a robust test accuracy of 78% in detecting future symptomatic OA progression 3 y prior to symptoms. This work demonstrates that OA detection may be possible at a potentially reversible stage. A key contribution of our work is direct visualization of the cartilage phenotype defining predictive ability as our technique is generative. We observe early biochemical patterns of fissuring in cartilage that define future onset of OA. In the future, coupling presymptomatic OA detection with emergent clinical therapies could modify the outcome of a disease that costs the United States healthcare system $16.5 billion annually. Furthermore, our technique is broadly applicable to earlier image-based detection of many diseases currently diagnosed at advanced stages today.
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27
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Alves CJ, Couto M, Sousa DM, Magalhães A, Neto E, Leitão L, Conceição F, Monteiro AC, Ribeiro-da-Silva M, Lamghari M. Nociceptive mechanisms driving pain in a post-traumatic osteoarthritis mouse model. Sci Rep 2020; 10:15271. [PMID: 32943744 PMCID: PMC7499425 DOI: 10.1038/s41598-020-72227-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 08/20/2020] [Indexed: 11/29/2022] Open
Abstract
In osteoarthritis (OA), pain is the dominant clinical symptom, yet the therapeutic approaches remain inadequate. The knowledge of the nociceptive mechanisms in OA, which will allow to develop effective therapies for OA pain, is of utmost need. In this study, we investigated the nociceptive mechanisms involved in post-traumatic OA pain, using the destabilization of the medial meniscus (DMM) mouse model. Our results revealed the development of peripheral pain sensitization, reflected by augmented mechanical allodynia. Along with the development of pain behaviour, we observed an increase in the expression of calcitonin gene-related peptide (CGRP) in both the sensory nerve fibers of the periosteum and the dorsal root ganglia. Interestingly, we also observed that other nociceptive mechanisms commonly described in non-traumatic OA phenotypes, such as infiltration of the synovium by immune cells, neuropathic mechanisms and also central sensitization were not present. Overall, our results suggest that CGRP in the sensory nervous system is underlying the peripheral sensitization observed after traumatic knee injury in the DMM model, highlighting the CGRP as a putative therapeutic target to treat pain in post-traumatic OA. Moreover, our findings suggest that the nociceptive mechanisms involved in driving pain in post-traumatic OA are considerably different from those in non-traumatic OA.
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Affiliation(s)
- C J Alves
- Neuro-Skeletal Circuits Group, Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal. .,Instituto de Engenharia Biomédica (INEB), Universidade do Porto, Porto, Portugal.
| | - M Couto
- Neuro-Skeletal Circuits Group, Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,Instituto de Engenharia Biomédica (INEB), Universidade do Porto, Porto, Portugal
| | - D M Sousa
- Neuro-Skeletal Circuits Group, Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,Instituto de Engenharia Biomédica (INEB), Universidade do Porto, Porto, Portugal
| | - A Magalhães
- Neuro-Skeletal Circuits Group, Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,Instituto de Biologia Molecular e Celular (IBMC), Universidade do Porto, Porto, Portugal
| | - E Neto
- Neuro-Skeletal Circuits Group, Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,Instituto de Engenharia Biomédica (INEB), Universidade do Porto, Porto, Portugal
| | - L Leitão
- Neuro-Skeletal Circuits Group, Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,Instituto de Engenharia Biomédica (INEB), Universidade do Porto, Porto, Portugal.,Instituto Ciências Biomédicas Abel Salazar (ICBAS), Universidade de Porto, Porto, Portugal
| | - F Conceição
- Neuro-Skeletal Circuits Group, Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,Instituto de Engenharia Biomédica (INEB), Universidade do Porto, Porto, Portugal.,Instituto Ciências Biomédicas Abel Salazar (ICBAS), Universidade de Porto, Porto, Portugal
| | - A C Monteiro
- Neuro-Skeletal Circuits Group, Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,Instituto de Engenharia Biomédica (INEB), Universidade do Porto, Porto, Portugal
| | - M Ribeiro-da-Silva
- Neuro-Skeletal Circuits Group, Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,Instituto de Engenharia Biomédica (INEB), Universidade do Porto, Porto, Portugal.,Faculdade de Medicina, Universidade do Porto (FMUP), Porto, Portugal.,Serviço de Ortopedia e Traumatologia, Centro Hospitalar São João, Porto, Portugal
| | - M Lamghari
- Neuro-Skeletal Circuits Group, Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,Instituto de Engenharia Biomédica (INEB), Universidade do Porto, Porto, Portugal.,Instituto Ciências Biomédicas Abel Salazar (ICBAS), Universidade de Porto, Porto, Portugal
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Muhammad SA, Nordin N, Hussin P, Mehat MZ, Abu Kasim NH, Fakurazi S. Protective effects of stem cells from human exfoliated deciduous teeth derived conditioned medium on osteoarthritic chondrocytes. PLoS One 2020; 15:e0238449. [PMID: 32886713 PMCID: PMC7473555 DOI: 10.1371/journal.pone.0238449] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/15/2020] [Indexed: 02/06/2023] Open
Abstract
Treatment of osteoarthritis (OA) is still a major clinical challenge due to the limited inherent healing capacity of cartilage. Recent studies utilising stem cells suggest that the therapeutic benefits of these cells are mediated through the paracrine mechanism of bioactive molecules. The present study evaluates the regenerative effect of stem cells from human exfoliated deciduous teeth (SHED) conditioned medium (CM) on OA chondrocytes. The CM was collected after the SHED were cultured in serum-free medium (SFM) for 48 or 72 h and the cells were characterised by the expression of MSC and pluripotency markers. Chondrocytes were stimulated with interleukin-1β and treated with the CM. Subsequently, the expression of aggrecan, collagen type 2 (COL 2), matrix metalloproteinase-13 (MMP-13), nuclear factor-kB (NF-kB) and the level of inflammatory and anti-inflammatory markers were evaluated. SHED expressed mesenchymal stromal cell surface proteins but were negative for haematopoietic markers. SHED also showed protein expression of NANOG, OCT4 and SOX2 with differential subcellular localisation. Treatment of OA chondrocytes with CM enhanced anti-inflammation compared to control cells treated with SFM. Furthermore, the expression of MMP-13 and NF-kB was significantly downregulated in stimulated chondrocytes incubated in CM. The study also revealed that CM increased the expression of aggrecan and COL 2 in OA chondrocytes compared to SFM control. Both CM regenerate extracellular matrix proteins and mitigate increased MMP-13 expression through inhibition of NF-kB in OA chondrocytes due to the presence of bioactive molecules. The study underscores the potential of CM for OA treatment.
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Affiliation(s)
- Suleiman Alhaji Muhammad
- Institute of Bioscience, Universiti Putra Malaysia, Selangor, Malaysia
- Department of Biochemistry, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Norshariza Nordin
- Department of Biomedical Science, Universiti Putra Malaysia, Selangor, Malaysia
| | - Paisal Hussin
- Department of Orthopaedics, Columbia Asia Hospital, Selangor, Malaysia
| | | | - Noor Hayaty Abu Kasim
- Dean’s Office, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Sharida Fakurazi
- Institute of Bioscience, Universiti Putra Malaysia, Selangor, Malaysia
- Department of Human Anatomy, Universiti Putra Malaysia, Selangor, Malaysia
- * E-mail:
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29
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Mandlik V, Achenbach L, Rüwe M, Kuhr M, Fehske K. Traumatic injuries to the hand and wrist in youth elite handball are most frequently localised to the thumb and proximal interphalangeal joints. SPORTVERLETZUNG-SPORTSCHADEN 2020; 35:142-146. [PMID: 32854131 DOI: 10.1055/a-1175-1364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Hand and wrist injuries have been described as the second most common severe injuries in handball. However, no evidence exists regarding the specific characteristics of these injuries. The aim of this study was to determine the injury pattern of hand and wrist injuries in youth handball. MATERIALS AND METHODS Two-hundred and ninety-six adolescent elite handball players (mean age: 14.0 ± 0.8 years) completed a retrospective survey regarding their hand and wrist injuries during the previous season. The injury questionnaire was adapted from sports-specific questionnaires to the demands of hand and wrist injuries in handball and included injury location, type of injury and injury severity. RESULTS One-hundred and twenty-three (42 %) players reported 156 injuries (0.53 injuries per season per player) to their hands or wrists in the past season. Injuries to the proximal interphalangeal joints were most frequently described (n = 74, 47 %). The thumb was involved in 46 (29 %) cases. Sprains (n = 113, 72 %) were the most common type of injury. Thirty-six percent of moderate and severe injuries (> 7 days time loss) had not been treated by a physician. CONCLUSIONS The rates of hand and wrist injuries are high in youth elite handball. Injury prevention strategies and return to competition criteria should focus on the thumb and the interphalangeal joints. Further research into these injuries is essential to identify risk factors and to develop adequate injury prevention measures.
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Affiliation(s)
- Veronika Mandlik
- Isaklinikum, Klinik für Plastische, Rekonstruktive und Ästhetische Chirurgie
| | - Leonard Achenbach
- Universitätsklinikum Würzburg, Klinik für Unfall-, Hand-, Plastische und Rekonstruktive Chirurgie
| | - Marc Rüwe
- Universitätsklinikum Regensburg, Klinik für Hand-, Plastische und Rekonstruktive Chirurgie
| | | | - Kai Fehske
- Universitätsklinikum Würzburg, Klinik für Unfall-, Hand-, Plastische und Rekonstruktive Chirurgie
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30
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Potty AG, Gupta A, Rodriguez HC, Stone IW, Maffulli N. Intraosseous Bioplasty for a Subchondral Cyst in the Lateral Condyle of Femur. J Clin Med 2020; 9:jcm9051358. [PMID: 32384650 PMCID: PMC7290357 DOI: 10.3390/jcm9051358] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 11/16/2022] Open
Abstract
Several conditions can lead to the development of a subchondral cyst. The mechanism by which the cysts form, their location, and their severity depend on the underlying pathology, although the exact pathogenesis is not fully elucidated. Treatment options vary according to the location of the cyst, with less invasive procedures such as calcium phosphate cement injection to a joint arthroplasty when there is an extensive cyst in communication with the joint space. If the cyst is circumscribed, an intraosseous bioplasty (IOBP) can be performed. Described in this paper is an IOBP, a minimally invasive technique that preserves the joint and can be applied to most subchondral cysts. In our patient, both the appearance of the cyst at imaging and pain after IOBP greatly improved with the combined use of decompression and grafting. In those patients in whom conservative management fails to ameliorate symptoms, IOBP should be considered.
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Affiliation(s)
- Anish G.R. Potty
- South Texas Orthopaedic Research Institute, Laredo, TX 78045, USA; (A.G.R.P.); (A.G.); (H.C.R.)
- School of Osteopathic Medicine, University of the Incarnate Word, San Antonio, TX 78209, USA;
- Laredo Sports Medicine Clinic, Laredo, TX 78041, USA
| | - Ashim Gupta
- South Texas Orthopaedic Research Institute, Laredo, TX 78045, USA; (A.G.R.P.); (A.G.); (H.C.R.)
- Department of Psychology, Illinois Wesleyan University, Bloomington, IL 61701, USA
- Future Biologics, Lawrenceville, GA 30043, USA
- BioIntegrate, Lawrenceville, GA 30043, USA
| | - Hugo C. Rodriguez
- South Texas Orthopaedic Research Institute, Laredo, TX 78045, USA; (A.G.R.P.); (A.G.); (H.C.R.)
- School of Osteopathic Medicine, University of the Incarnate Word, San Antonio, TX 78209, USA;
| | - Ian W. Stone
- School of Osteopathic Medicine, University of the Incarnate Word, San Antonio, TX 78209, USA;
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of Salerno, 84084 Fisciano, Italy
- Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Queen Mary University of London, London E1 4DG, UK
- School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Stoke on Trent ST4 7QB, UK
- Correspondence:
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31
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Cotter EJ, Frank RM, Mandelbaum B. Management of osteoarthritis - biological approaches: current concepts. J ISAKOS 2020. [DOI: 10.1136/jisakos-2019-000377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Alrowaili MG. Magnetic resonance evaluation of knee osteoarthritis among the Saudi Population. Pak J Med Sci 2019; 35:1575-1581. [PMID: 31777496 PMCID: PMC6861498 DOI: 10.12669/pjms.35.6.874] [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] [Indexed: 11/15/2022] Open
Abstract
Background and Objectives Osteoarthritis (OA) is the most prevalent worldwide joint degenerative disorder with high morbidities and disabilities. The current study aimed to investigate the prevalence of knee osteoarthritis (KOA) in Arar by using magnetic resonance imaging (MRI). Methods The prevalence of KOA was studied in Arar through MRI evaluation of randomly chosen sample from patients and their relatives attending the Prince Abdul Aziz Bin Mussad Hospital from October 2015 to November 2016. Results A total of 410 participants were enrolled in the study [328 (80%) male and 82 (20%) females]. After MRI, 163 participants [39.75% (95% CI) = 35.14 - 44.57%)] were diagnosed with KOA. The prevalence of OA was about 25.6% (95% CI = 20.8 - 31.1%) below the age of 40 years, which was found to increase by age in the enrolled volunteers. KOA prevalence was higher in females than males (75.6% and 27.7% respectively). There was a significant association between the age and genders of the participants and the prevalence of OA (p-value < 0.0001 for both variables). There was also a significant association between the age and gender of the participants and the MRI-estimated grading (p-value < 0.0001 and 0.0044 respectively). Conclusion KOA is a common disease among Arar young population, especially females. Its prevalence increases by age with higher grades of severity affecting the elderly.
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Affiliation(s)
- Majed Gorayan Alrowaili
- Dr. Majed Gorayan Alrowaili, Department of Surgery (Orthopedic Division), Faculty of Medicine, Northern Border University, Arar, Saudi Arabia
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33
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Knee Osteoarthritis and Meniscal Injuries in the Runner. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2019. [DOI: 10.1007/s40141-019-00235-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kaplan Y, Witvrouw E. When Is It Safe to Return to Sport After ACL Reconstruction? Reviewing the Criteria. Sports Health 2019; 11:301-305. [PMID: 31136725 DOI: 10.1177/1941738119846502] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
CONTEXT There is an ever-increasing trend toward sports, fitness, and recreation activities, so the incidence of anterior cruciate ligament sports injuries has increased. Perhaps the greatest challenge for sports clinicians is to return the injured athlete back to his/her original sport at an even greater level of functional ability than preinjury. For this, rigorous and well-researched criteria are needed. EVIDENCE ACQUISITION Using medical subject headings and free-text words, an electronic search was conducted up to October 2018. Subject-specific search was based on the terms return to play and return to sport in combination with guidelines, criteria, and anterior cruciate ligament reconstruction. STUDY DESIGN Descriptive review. LEVEL OF EVIDENCE Level 2. RESULTS Five principal criteria were found, including psychological factors, performance/functional tests, strength tests, time, and modifiable and nonmodifiable risk factors. CONCLUSION The psychological readiness of the player is a major factor in successful safe return to sport (SRTS) decision making. Although strength, performance, and functional tests presently form the mainstay of SRTS criteria, there exists very little scientific evidence for their validity. More protection should be provided to athletes with known risk factors. Movement quality is important, if not more important than the quantifiable measures. As a result of the significantly high rerupture rate in young individuals, delayed SRTS should be considered preferably beyond 9 months postsurgery.
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Affiliation(s)
- Yonatan Kaplan
- Jerusalem Sports Medicine Institute, Lerner Sports Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Erik Witvrouw
- Department of Rehabilitation Sciences & Physiotherapy at the Ghent University, Ghent, Belgium
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35
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Habib MK, Khan ZA. Radiological, functional, and anatomical outcome in patients with osteoarthritic knee undergoing high tibial osteotomy. SICOT J 2019; 5:12. [PMID: 31050336 PMCID: PMC6498865 DOI: 10.1051/sicotj/2019009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 04/07/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To determine the radiological, functional, and anatomical outcome in patients with osteoarthritic knee undergoing high tibial osteotomy (HTO). DESIGN OF STUDY Descriptive case series. Study duration and settings: The present study was a descriptive case series carried out at the Orthopedic Departments of District Head Quarter Hospital Faisalabad affiliated with Faisalabad Medical University, Faisalabad from Jan 2014 to March 2018. METHODOLOGY This study involved 40 patients of both genders, aged between 40 and 65 years having advanced degenerative disease of knee limited to medial compartment of joint. These patients were treated by medial open wedge high tibial osteotomy (OWHTO) and outcome was evaluated after 5 years of surgery in terms of radiological knee mechanics, functional outcome scores, and arthroscopic evidence of cartilage regeneration in the medial compartment. A signed written consent was taken from every patient. FINDINGS There was a female predominance with a male-to-female ratio of 1:4. The mean age of the patients was 53.2 ± 6.9 years. The values of the radiographic parameters significantly changed from pre-operative condition after HTO; mechanical tibiofemoral angle [MTFA, (-8.1 ± 1.2° vs. 2.5 ± 1.2°; p-value < 0.0001)], tibial plateau inclination [TPI, (5.3 ± 1.1° vs. 3.4 ± 1.1°; p-value < 0.0001)], knee joint line orientation relative to the ground [G-KJLO, (0.3 ± 0.1° vs. 4.6 ± 1.5°; p-value < 0.0001)], and ankle joint line orientation relative to the ground [G-AJLO (8.3 ± 3.2° vs. 2.3 ± 1.7°; p-value < 0.0001)]. There was significant improvement in patient's functional status; KOOS-ADL score (45.5 ± 7.8 vs. 73.7 ± 8.6; p-value < 0.0001), International Knee Documentation Committee (IKDC) score (42.4 ± 6.9 vs. 68.5 ± 12.7; p-value < 0.0001), International Knee Society (IKS) score (149.4 ± 11.9 vs. 179.4 ± 10.2; p-value < 0.0001), Knee Society Score [KSS, (54.2 ± 5.6 vs. 69.7 ± 12.7; p-value < 0.0001)], and Hospital for Special Surgery [HSS, (50.8 ± 3.3 vs. 64.8 ± 10.7; p-value < 0.0001)]. 42.5% patients showed excellent regeneration of femoral and 30.0% patients showed excellent regeneration of tibial cartilage in the medial compartment. CONCLUSION By significantly alternating the knee biomechanics, HTO was found to unload the medial compartment leading to regeneration of the articular cartilage and significant improvement in patient's symptoms and quality of life. It is therefore recommended in the management of patients with arthritic changes limited to medial compartment only.
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36
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Noronha NDC, Mizukami A, Caliári-Oliveira C, Cominal JG, Rocha JLM, Covas DT, Swiech K, Malmegrim KCR. Priming approaches to improve the efficacy of mesenchymal stromal cell-based therapies. Stem Cell Res Ther 2019; 10:131. [PMID: 31046833 PMCID: PMC6498654 DOI: 10.1186/s13287-019-1224-y] [Citation(s) in RCA: 302] [Impact Index Per Article: 60.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Multipotent mesenchymal stromal cells (MSC) have been widely explored for cell-based therapy of immune-mediated, inflammatory, and degenerative diseases, due to their immunosuppressive, immunomodulatory, and regenerative potentials. Preclinical studies and clinical trials have demonstrated promising therapeutic results although these have been somewhat limited. Aspects such as low in vivo MSC survival in inhospitable disease microenvironments, requirements for ex vivo cell overexpansion prior to infusions, intrinsic differences between MSC and different sources and donors, variability of culturing protocols, and potency assays to evaluate MSC products have been described as limitations in the field. In recent years, priming approaches to empower MSC have been investigated, thereby generating cellular products with improved potential for different clinical applications. Herein, we review the current priming approaches that aim to increase MSC therapeutic efficacy. Priming with cytokines and growth factors, hypoxia, pharmacological drugs, biomaterials, and different culture conditions, as well as other diverse molecules, are revised from current and future perspectives.
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Affiliation(s)
- Nádia de Cássia Noronha
- Center for Cell-based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.,Graduate Program on Bioscience and Biotechnology, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Amanda Mizukami
- Center for Cell-based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Juçara Gastaldi Cominal
- Center for Cell-based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.,Graduate Program on Bioscience and Biotechnology, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - José Lucas M Rocha
- Center for Cell-based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.,Graduate Program on Basic and Applied Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Dimas Tadeu Covas
- Center for Cell-based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Kamilla Swiech
- Center for Cell-based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.,Department of Pharmaceutical Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Kelen C R Malmegrim
- Center for Cell-based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil. .,Department of Clinical, Toxicological and Bromatological Analysis, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n°, Ribeirão Preto, SP, 14010-903, Brazil.
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Lie MM, Risberg MA, Storheim K, Engebretsen L, Øiestad BE. What's the rate of knee osteoarthritis 10 years after anterior cruciate ligament injury? An updated systematic review. Br J Sports Med 2019; 53:1162-1167. [PMID: 30936063 DOI: 10.1136/bjsports-2018-099751] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND This updated systematic review reports data from 2009 on the prevalence, and risk factors, for knee osteoarthritis (OA) more than 10 years after anterior cruciate ligament (ACL) tear. METHODS We systematically searched five databases (PubMed, EMBASE, AMED, Cinahl and SPORTDiscus) for prospective and retrospective studies published after 1 August 2008. Studies were included if they investigated participants with ACL tear (isolated or in combination with medial collateral ligament and/or meniscal injuries) and reported symptomatic and/or radiographic OA at a minimum of 10 years postinjury. We used a modified version of the Downs and Black checklist for methodological quality assessment and narrative synthesis to report results. The study protocol was registered in PROSPERO. RESULTS Forty-one studies were included. Low methodological quality was revealed in over half of the studies. At inclusion, age ranged from 23 to 38 years, and at follow-up from 31 to 51 years. Sample sizes ranged from 18 to 780 participants. The reported radiographic OA prevalence varied between 0% and 100% >10 years after injury, regardless of follow-up time. The studies with low and high methodological quality reported a prevalence of radiographic OA between 0%-100% and 1%-80%, respectively. One study reported symptomatic knee OA for the tibiofemoral (TF) joint (35%), and one study reported symptomatic knee OA for the patellofemoral (PF) joint (15%). Meniscectomy was the only consistent risk factor determined from the data synthesis. CONCLUSION Radiographic knee OA varied between 0% and 100% in line with our previous systematic review from 2009. Symptomatic and radiographic knee OA was differentiated in two studies only, with a reported symptomatic OA prevalence of 35% for the TF joint and 15% for PF joint. Future cohort studies need to include measurement of symptomatic knee OA in this patient group. PROSPERO REGISTRATION NUMBER CRD42016042693.
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Affiliation(s)
- Marthe Mehus Lie
- Institute of Physiotherapy, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - May Arna Risberg
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Kjersti Storheim
- Institute of Physiotherapy, OsloMet - Oslo Metropolitan University, Oslo, Norway.,Research and Communication unit for Musculoskeletal Health (FORMI), Oslo University Hospital, Oslo, Norway
| | - Lars Engebretsen
- Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.,Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| | - Britt Elin Øiestad
- Institute of Physiotherapy, OsloMet - Oslo Metropolitan University, Oslo, Norway
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Madaleno FO, Santos BA, Araújo VL, Oliveira VC, Resende RA. Prevalence of knee osteoarthritis in former athletes: a systematic review with meta-analysis. Braz J Phys Ther 2018; 22:437-451. [PMID: 29636304 PMCID: PMC6235824 DOI: 10.1016/j.bjpt.2018.03.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 03/13/2018] [Accepted: 03/22/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Prevalence of knee osteoarthritis in former athletes is still unclear. OBJECTIVE To investigate prevalence of knee osteoarthritis in former athletes. Moreover, the secondary aim was to investigate whether poor methodological quality of included studies, different diagnosis criteria for knee osteoarthritis, different sports modality or sex impact on overall estimated prevalence of knee osteoarthritis in former athletes. METHODS Searches on MEDLINE, EMBASE, AMED, SPORTDiscus and CINAHL from the earliest record to February 2018 and hand-searching identified studies investigating prevalence of knee osteoarthritis in former athletes. Meta-analysis was conducted and the GRADE system summarized strength of the current recommendations. Sensitivity analyses investigated whether methodological quality, diagnostic criteria, type of sports or sex impacted on the overall estimated prevalence in former athletes. This review was registered at PROSPERO (CRD42016050903). RESULTS Fifteen studies were included and pooling of 3100 participants estimated overall prevalence of knee osteoarthritis in former athletes of 30.0% (95% CI: 20.0 to 40.0%). The strength of the current recommendations was low-quality. Sensitivity analyses suggested that different diagnostic criteria for knee osteoarthritis and type of sports may impact on the overall estimated prevalence. CONCLUSIONS Prevalence of knee osteoarthritis in former athletes was 30.0%. Researchers, clinicians and policymakers should be careful about potential prevalence differences among type of sports and diagnostic criteria. Current low-quality evidence shows that future high-quality studies are likely to impact on the estimated prevalence.
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Affiliation(s)
- Fernanda O Madaleno
- Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bruna A Santos
- Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Vanessa L Araújo
- Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Vinicius C Oliveira
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Renan A Resende
- Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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DiNubile N. Glucosamine and Chondroitin Sulfate: What Has Been Learned Since the Glucosamine/chondroitin Arthritis Intervention Trial. Orthopedics 2018; 41:200-207. [PMID: 29771395 DOI: 10.3928/01477447-20180511-06] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 12/13/2017] [Indexed: 02/03/2023]
Abstract
Glucosamine and chondroitin sulfate, alone or in combination, are used worldwide by individuals suffering from osteoarthritis pain. They are by prescription in some countries but are available as over-the-counter dietary supplements in other countries, such as the United States. The inconclusive results of the National Institutes of Health-sponsored Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) did little to clarify the efficacy of these agents. However, some newer studies have provided a better perspective on the potential benefits that they can offer. Because the 2 in combination showed a significant level of efficacy in the moderate-to-severe knee osteoarthritis subgroup of the GAIT, this review examines the randomized, controlled trials published from that time to the present. The findings of these studies are mixed, owing in some cases to the high rate of placebo response added to by the ethical incorporation of rescue analgesics into protocols designed to evaluate the slow-acting, subtle effects of glucosamine and chondroitin sulfate in combination. The strong influence of the placebo effect and confounding of results by rescue analgesics point to the importance of objective measurement tools such as osteoarthritis biomarker panels in long-term glucosamine/chondroitin sulfate clinical trials with less reliance on the subjective measurement tools commonly used in osteoarthritis trials of pharmaceuticals. [Orthopedics. 2018; 41(4):200-207.].
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Mohsin Z, Asghar AA, Faiq A, Khalid I, Ul-Haque I, Rehman S, Ahmed SI, Basalat ST, Aimen A, Shafique S, Hanif A, Iqbal MW, Samad SA, Siddiqui F, Hameed I, Safri M. Prevalence of Rheumatic Diseases in a Tertiary Care Hospital of Karachi. Cureus 2018; 10:e2858. [PMID: 30148011 PMCID: PMC6107035 DOI: 10.7759/cureus.2858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Rheumatic diseases are referred to as conditions affecting joints, muscles, ligaments, tendons, and bones. According to a report by World Health Organization, rheumatic and musculoskeletal diseases were labeled as the second most reported cause of disability around the globe. The purpose of this study was to estimate the prevalence of rheumatic diseases in a tertiary care hospital of Karachi; additionally, associations with age groups, gender and comorbidities were obtained as well. METHODS A cross-sectional study was conducted at the Orthopedic Out Patient Department (OPD) of Dr. Ruth KM Pfau Civil Hospital, Karachi over a span of three months in 2018 (February till May). All 346 patients were follow-up diagnosed cases in the age range of 11-90 years, divided into groups of adolescents, young adults, adults, and older adults. The subjects were questioned about their symptoms, duration of illness, presence of comorbidities, genetic background and the therapy they are undergoing along with compliance. Simple statistical analysis of frequency was done, whereas chi-square test was applied to study associations with gender, age groups, and comorbidities. RESULTS During the study period, a total of 2000 patients visited the orthopedic OPD, 346 of which were diagnosed cases of rheumatic diseases, yielding a prevalence of 17.3%. The mean age of rheumatic patients who partook in the study was 46.15 ± 15.49 (Range: 12 - 84). Osteoarthritis was recorded as the most prevalent condition, followed by non-specific low back pain and rheumatoid arthritis. Osteoarthritis was statistically significant in young adults, adults, and older adults, while non-specific low back pain had significant associations with gender, young adults, and adults. Diabetes was significantly associated with osteoarthritis, non-specific low back pain, shoulder pain syndrome and psoriatic arthritis, while hypertension significantly co-existed with systemic lupus erthematosus. CONCLUSION Rheumatic diseases constitute a major disease burden in almost all of the age groups, especially in young patients (18-40 years) within our setup.
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Affiliation(s)
- Zainab Mohsin
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Arifa A Asghar
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Arisha Faiq
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Ilma Khalid
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Ibtehaj Ul-Haque
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi , PAK
| | - Sameen Rehman
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Saffia I Ahmed
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, PAK
| | | | - Abeeha Aimen
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Shiza Shafique
- Dow University of Health Sciences, Civil Hospital, Karachi, PAK
| | - Ayesha Hanif
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan, Karachi, PAK
| | - Muhammad Waqas Iqbal
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan, Karachi, PAK
| | - Syed A Samad
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan, Karachi, PAK
| | - Faiza Siddiqui
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan, Karachi, PAK
| | - Ishaque Hameed
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan, Karachi, PAK
| | - Marzia Safri
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan, Karachi, PAK
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Abstract
Osteoarthritis of the knee is a degenerative condition that is commonly seen in the elderly population and sometimes occurs earlier in the athletic population. Pain and stiffness are common features, which can be debilitating. Clinical assessment of the knee joint requires consideration of its associated muscles, ligaments, tendons, bursae and menisci. The aim of this article is to provide an overview of knee pain assessment, to discuss the diagnosis of knee osteoarthritis, and to review some evidence-based management options.
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Abstract
Osteoarthritis (OA) is the most prevalent joint disease characterized by pain and degenerative lesions of the cartilage, subchondral bone, and other joint tissues. The causes of OA remain incompletely understood. Over the years, it has become recognized that OA is a multifactorial disease. In particular, aging and trauma are the main risk factors identified for the development of OA; however, other factors such as genetic predisposition, obesity, inflammation, gender and hormones, or metabolic syndrome contribute to OA development and lead to a more severe outcome. While this disease mainly affects people older than 60 years, OA developed after joint trauma affects all range ages and has a particular impact on young individuals and people who have highest levels of physical activity such as athletes. Traumatic injury to the joint often results in joint instability or intra-articular fractures which lead to posttraumatic osteoarthritis (PTOA). In response to injury, several molecular mechanisms are activated, increasing the production and activation of different factors that contribute to the progression of OA.In this chapter, we have focused on the interactions and contribution of the multiple factors involved in joint destruction and progression of OA. In addition, we overview the main changes and molecular mechanisms related to OA pathogenesis.
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Adriani E, Moio M, Di Paola B, Salustri W, Alfieri A, Parisi P, Ruggiero M, Borab Z, Carlesimo B. Percutaneous Fat Transfer to Treat Knee Osteoarthritis Symptoms: Preliminary Results. JOINTS 2017; 5:89-92. [PMID: 29114637 PMCID: PMC5672865 DOI: 10.1055/s-0037-1603672] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Purpose This study aims to evaluate the safety and efficacy of autologous aspirated and purified fat tissue injected percutaneously into the knee joint for the treatment of symptomatic osteoarthritis (OA). Methods We reviewed 30 patients, who received an autologous percutaneous fat injection for the treatment of knee OA, from January 2012 to March 2015. Mean patients' age was 63.3 ± 5.3 years (range, 50-80 years). Body mass index was 25.1 ± 1.7. Clinical evaluation was based on pain visual analog scale (VAS) and WOMAC score for functional and subjective assessment. We also noted the adverse reactions and the consumption of nonsteroidal anti-inflammatory drugs in the posttreatment period. Results All patients reported improvements with respect to pain: average VAS was 7.7 ± 1.2 at baseline, 5.2 ± 0.2 at 1-month follow-up, and 4.3 ± 1 at 3-month follow-up. A slight deterioration (5.0 ± 1.1) was evidenced at 1 year. Total WOMAC score was 89.9 ± 1.7 at baseline, 66.3 ± 1 at 1 month, 68.6 ± 1.7 at 3 months, and 73.2 ± 1.8 at 12 months of follow-up. Conclusion Our preliminary findings suggest that autologous percutaneous fat injections are a valid treatment option for knee OA. Level of Evidence Level IV, therapeutic case series.
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Affiliation(s)
- Ezio Adriani
- Department of Orthopedics and Traumatology, Sport Clinique, Rome, Italy
| | - Mariagrazia Moio
- Department of Plastic Surgery, Policlinico Umberto I, "La Sapienza" University of Rome, Rome, Italy
| | | | - Walter Salustri
- Department of Orthopedics and Traumatology, Sport Clinique, Rome, Italy
| | - Andrea Alfieri
- Department of Orthopedics and Traumatology, Sport Clinique, Rome, Italy
| | - Paola Parisi
- Department of Plastic Surgery, Policlinico Umberto I, "La Sapienza" University of Rome, Rome, Italy
| | - Marco Ruggiero
- Department of Plastic Surgery, Policlinico Umberto I, "La Sapienza" University of Rome, Rome, Italy
| | - Zack Borab
- Department of Plastic Surgery, Policlinico Umberto I, "La Sapienza" University of Rome, Rome, Italy
| | - Bruno Carlesimo
- Department of Plastic Surgery, Policlinico Umberto I, "La Sapienza" University of Rome, Rome, Italy
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Boeth H, MacMahon A, Poole AR, Buttgereit F, Önnerfjord P, Lorenzo P, Klint C, Pramhed A, Duda GN. Differences in biomarkers of cartilage matrix turnover and their changes over 2 years in adolescent and adult volleyball athletes. J Exp Orthop 2017; 4:7. [PMID: 28229430 PMCID: PMC5321644 DOI: 10.1186/s40634-017-0081-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 02/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed the feasibility to assess longitudinal changes in biomarkers of cartilage turnover and to determine their relationship with patient-rated outcomes over 2 years in volleyball athletes. METHODS Thirty-seven athletes were studied: 18 adolescents (age 15.9 ± 0.64 years) in a 2-year intensive volleyball training program and 19 adult recreational volleyball players (age 46.5 ± 4.9 years). Blood and serum samples were taken at baseline (BL) and 2-year follow-up (FU). Subjects completed the International Knee Documentation Committee (IKDC) Subjective Knee Form and the Short-Form 36 (SF-36) at BL. RESULTS Thirteen adolescents (72%) had open growth plates at BL (BL open adolescents), the rest had closed growth plates at BL (BL closed adolescents), and all but one adolescent had closed growth plates at FU as assessed by MRI. BL open and closed adolescents had greater levels of the cartilage degradation-based biomarkers 45 mer collagenase peptide of type II collagen (C2C-HUSA) and C-telopeptide of type II collagen (CTX-II) than adults. BL open adolescents showed decreases in C2CHUSA, collagen synthesis marker C-propeptide of type II procollagen (CPII), and CTXII, and adults showed increases in cartilage intermediate layer protein 2 (CILP-2) and C2C-HUSA. In adolescents, IKDC scores were correlated with CPII changes. In adults, SF-36 Physical Component Scores were correlated with cartilage oligomeric matrix protein (COMP) changes. CONCLUSION Significant differences in biomarker levels over time show the feasibility to assess their changes. Greater levels of C2C-HUSA and CTX-II in adolescents than in adults may reflect increased cartilage turnover in response to higher joint loading. CPII and COMP may be more reflective of subjective patient outcomes. These biomarkers may thus be useful in assessing mechanical loading-induced cartilage changes, their associated symptoms, and Osteoarthritis risk in athletes.
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Affiliation(s)
- Heide Boeth
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | - Aoife MacMahon
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A Robin Poole
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Frank Buttgereit
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Patrik Önnerfjord
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Pilar Lorenzo
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Cecilia Klint
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Anna Pramhed
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Georg N Duda
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Alahmari KA, Silvian PS, Reddy RS, Ahmad I, Kakaraparthi VN, Alam MM. Mediating role of body mass index in knee osteoarthritis. J Taibah Univ Med Sci 2017; 12:150-156. [PMID: 31435230 PMCID: PMC6695076 DOI: 10.1016/j.jtumed.2016.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 11/05/2016] [Accepted: 11/06/2016] [Indexed: 11/30/2022] Open
Abstract
Objective This study explores the role of knee circumference, body mass index (BMI), and range of motion (ROM) in predicting knee osteoarthritis (KOA). The objective is to elucidate the mediating role of BMI in influencing the relationship between age, knee circumference and pain in knee osteoarthritis, as measured with the help of the knee outcome survey (KOS) questionnaire. Methods The design used in this study was causal comparative. The study consisted of 66 patients with symptomatic KOA and 60 matched asymptomatic individuals. Result BMI was significantly and positively correlated with both pain and knee girth for the symptomatic KOA group. This finding signifies a relationship between KOA and other indicators, such as age and knee circumference. Conclusions The results of the study would indicate an important milestone in clinical rehabilitation, especially for physical therapists, enabling them to plan, modify, and design interventions to improve the health status of KOA patients.
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Affiliation(s)
- Khalid A Alahmari
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, KSA
| | - Paul S Silvian
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, KSA
| | - Ravi S Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, KSA
| | - Irshad Ahmad
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, KSA
| | - Venkata N Kakaraparthi
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, KSA
| | - Mohammad M Alam
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, KSA
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Frederick ED, Hausburg MA, Thomas GW, Rael LT, Brody E, Bar-Or D. The low molecular weight fraction of human serum albumin upregulates COX2, prostaglandin E2, and prostaglandin D2 under inflammatory conditions in osteoarthritic knee synovial fibroblasts. Biochem Biophys Rep 2016; 8:68-74. [PMID: 28955943 PMCID: PMC5613771 DOI: 10.1016/j.bbrep.2016.08.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 08/10/2016] [Accepted: 08/10/2016] [Indexed: 11/24/2022] Open
Abstract
Background The ability to decrease inflammation and promote healing is important in the intervention and management of a variety of disease states, including osteoarthritis of the knee (OAK). Even though cyclooxygenase 2 (COX2) has an established pro-inflammatory role, evidence suggests it is also critical to the resolution that occurs after the initial activation phase of the immune response. In this study, we investigated the effects of the low molecular weight fraction of 5% human serum albumin (LMWF-5A), an agent that has proven to decrease pain and improve function in OAK patients after intra-articular injection, on the expression of COX2 and its downstream products, prostaglandins (PGs). Methods Fibroblast-like synoviocytes from the synovial membrane of OAK patients were treated with LMWF-5A or saline as a control with or without the addition of interleukin-1β (IL-1β) or tumor necrosis factor α (TNFα) to elicit an inflammatory response. Cells were harvested for RNA and protein at 2, 4, 8, 12, and 24 h, and media was collected at 24 h for analysis of secreted products. COX2 mRNA expression was determined by qPCR, and COX2 protein expression was determined by western blot analysis. Levels of prostaglandin E2 (PGE2) and prostaglandin D2 (PGD2) in the media were quantified by competitive ELISA. Results In the presence of either IL-1β or TNFα, LMWF-5A increased the expression of both COX2 mRNA and protein, and this increase was significant compared to that observed with IL-1β- or TNFα-stimulated, saline-treated cells. Downstream of COX2, the levels of PGE2 were increased only in TNFα-stimulated, LMWF-5A-treated cells; however, in both IL-1β- and TNFα-stimulated cells, LMWF-5A increased the release of the anti-inflammatory prostaglandin PGD2. Conclusion LMWF-5A appears to trigger increased anti-inflammatory PG signaling, and this may be a primary component of its therapeutic mode of action in the treatment of OAK. Proposed mechanism of action for biologic drug to treat osteoarthritis of the knee. LMWF-5A affects the COX2 pathway in primary synoviocytes from osteoarthritic knees. LMWF-5A may promote resolution of inflammation, healing, and cartilage regeneration.
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Key Words
- 15d-PGJ2, 15-deoxy-Δ12,14-prostaglandin J2
- COX, cyclooxygenase
- Cyclooxygenase 2
- DMEM/F12, Dulbecco’s Modified Eagle Medium/Nutrient Mixture F-12
- ELISA, enzyme-linked immunosorbent assay
- FBS, fetal bovine serum
- HSA, human serum albumin
- HSF-OAs, human synovial fibroblasts from patients with osteoarthritis
- Human serum albumin
- IL, interleukin
- IgG, immunoglobulin G
- Inflammation
- LMWF-5A, molecular weight fraction of human serum albumin under 5000 Da
- LOD, limit of detection
- NF-κB, nuclear factor-κB
- NSAIDs, non-steroidal anti-inflammatory drugs
- OA, osteoarthritis
- OAK, osteoarthritis of the knee
- Osteoarthritis
- PBMCs, peripheral blood mononuclear cells
- PG, prostaglandin
- PGD2, prostaglandin D2
- PGE2, prostaglandin E2
- PGH2, prostaglandin H2
- PPARγ, peroxisome proliferator-activated receptor γ
- PVDF, polyvinylidene fluoride
- Prostaglandin
- SDS-PAGE, sodium dodecyl sulfate-polyacrylamide gel electrophoresis
- SEM, standard error of the mean
- Synovial fibroblast
- TNF, tumor necrosis factor
- hMSCs, human mesenchymal stem cells
- qPCR, quantitative real-time polymerase chain reaction
- ΔΔCT, comparative threshold cycle
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Affiliation(s)
- Elizabeth D Frederick
- Swedish Medical Center, 501 E. Hampden Ave, Englewood, CO 80113, USA.,Ampio Pharmaceuticals Inc., 373 Inverness Pkwy, Englewood, CO 80112, USA
| | - Melissa A Hausburg
- Swedish Medical Center, 501 E. Hampden Ave, Englewood, CO 80113, USA.,Ampio Pharmaceuticals Inc., 373 Inverness Pkwy, Englewood, CO 80112, USA
| | - Gregory W Thomas
- Swedish Medical Center, 501 E. Hampden Ave, Englewood, CO 80113, USA.,Ampio Pharmaceuticals Inc., 373 Inverness Pkwy, Englewood, CO 80112, USA
| | - Leonard T Rael
- Swedish Medical Center, 501 E. Hampden Ave, Englewood, CO 80113, USA.,Ampio Pharmaceuticals Inc., 373 Inverness Pkwy, Englewood, CO 80112, USA
| | - Edward Brody
- SomaLogic Inc., 2945 Wilderness Place, Boulder, CO 80301, USA
| | - David Bar-Or
- Swedish Medical Center, 501 E. Hampden Ave, Englewood, CO 80113, USA.,Ampio Pharmaceuticals Inc., 373 Inverness Pkwy, Englewood, CO 80112, USA.,St. Anthony Hospital, Trauma Research Department, 11600 W. 2nd Pl, Lakewood, CO 80228, USA.,Medical Center of Plano, Trauma Research Department, 3901 W. 15th St., Plano, TX 75075, USA.,Rocky Vista University, 8401 S. Chambers Rd., Parker, CO 80134, USA.,Penrose Hospital, 2417 Cascade Ave, Colorado Springs, CO 80907, USA
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Bar-Or D, Thomas GW, Rael LT, Gersch ED, Rubinstein P, Brody E. Low Molecular Weight Fraction of Commercial Human Serum Albumin Induces Morphologic and Transcriptional Changes of Bone Marrow-Derived Mesenchymal Stem Cells. Stem Cells Transl Med 2015; 4:945-55. [PMID: 26041739 DOI: 10.5966/sctm.2014-0293] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 04/13/2015] [Indexed: 12/27/2022] Open
Abstract
Osteoarthritis (OA) is the most common chronic disease of the joint; however, the therapeutic options for severe OA are limited. The low molecular weight fraction of commercial 5% human serum albumin (LMWF5A) has been shown to have anti-inflammatory properties that are mediated, in part, by a diketopiperazine that is present in the albumin preparation and that was demonstrated to be safe and effective in reducing pain and improving function when administered intra-articularly in a phase III clinical trial. In the present study, bone marrow-derived mesenchymal stem cells (BMMSCs) exposed to LMWF5A exhibited an elongated phenotype with diffuse intracellular F-actin, pronounced migratory leading edges, and filopodia-like projections. In addition, LMWF5A promoted chondrogenic condensation in "micromass" culture, concurrent with the upregulation of collagen 2α1 mRNA. Furthermore, the transcription of the CXCR4-CXCL12 axis was significantly regulated in a manner conducive to migration and homing. Several transcription factors involved in stem cell differentiation were also found to bind oligonucleotide response element probes following exposure to LMWF5A. Finally, a rapid increase in PRAS40 phosphorylation was observed following treatment, potentially resulting in the activation mTORC1. Proteomic analysis of synovial fluid taken from a preliminary set of patients indicated that at 12 weeks following administration of LMWF5A, a microenvironment exists in the knee conducive to stem cell infiltration, self-renewal, and differentiation, in addition to indications of remodeling with a reduction in inflammation. Taken together, these findings imply that LMWF5A treatment may prime stem cells for both mobilization and chondrogenic differentiation, potentially explaining some of the beneficial effects achieved in clinical trials.
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Affiliation(s)
- David Bar-Or
- Swedish Medical Center, Trauma Research Department, Englewood, Colorado, USA; St. Anthony Hospital, Trauma Research Department, Lakewood, Colorado, USA; Medical Center of Plano, Trauma Research Department, Plano, Texas, USA; Ampio Pharmaceuticals Inc., Englewood, Colorado, USA; New York Blood Center, New York, New York, USA; SomaLogic Inc., Boulder, Colorado, USA
| | - Gregory W Thomas
- Swedish Medical Center, Trauma Research Department, Englewood, Colorado, USA; St. Anthony Hospital, Trauma Research Department, Lakewood, Colorado, USA; Medical Center of Plano, Trauma Research Department, Plano, Texas, USA; Ampio Pharmaceuticals Inc., Englewood, Colorado, USA; New York Blood Center, New York, New York, USA; SomaLogic Inc., Boulder, Colorado, USA
| | - Leonard T Rael
- Swedish Medical Center, Trauma Research Department, Englewood, Colorado, USA; St. Anthony Hospital, Trauma Research Department, Lakewood, Colorado, USA; Medical Center of Plano, Trauma Research Department, Plano, Texas, USA; Ampio Pharmaceuticals Inc., Englewood, Colorado, USA; New York Blood Center, New York, New York, USA; SomaLogic Inc., Boulder, Colorado, USA
| | - Elizabeth D Gersch
- Swedish Medical Center, Trauma Research Department, Englewood, Colorado, USA; St. Anthony Hospital, Trauma Research Department, Lakewood, Colorado, USA; Medical Center of Plano, Trauma Research Department, Plano, Texas, USA; Ampio Pharmaceuticals Inc., Englewood, Colorado, USA; New York Blood Center, New York, New York, USA; SomaLogic Inc., Boulder, Colorado, USA
| | - Pablo Rubinstein
- Swedish Medical Center, Trauma Research Department, Englewood, Colorado, USA; St. Anthony Hospital, Trauma Research Department, Lakewood, Colorado, USA; Medical Center of Plano, Trauma Research Department, Plano, Texas, USA; Ampio Pharmaceuticals Inc., Englewood, Colorado, USA; New York Blood Center, New York, New York, USA; SomaLogic Inc., Boulder, Colorado, USA
| | - Edward Brody
- Swedish Medical Center, Trauma Research Department, Englewood, Colorado, USA; St. Anthony Hospital, Trauma Research Department, Lakewood, Colorado, USA; Medical Center of Plano, Trauma Research Department, Plano, Texas, USA; Ampio Pharmaceuticals Inc., Englewood, Colorado, USA; New York Blood Center, New York, New York, USA; SomaLogic Inc., Boulder, Colorado, USA
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