Morphometric aspects of the articular cartilage of rats treated with low-level laser therapy and exercise in a rheumatoid arthritis model

INTRODUCTION: Rheumatoid arthritis (RA) is classified as an autoimmune, chronic disease affecting diarthrodial joints and periarticular structures. OBJECTIVE: To evaluate whether low-intensity laser treatment (LLLT) and/or exercise reduce the deleterious effects of tissue in a rheumatoid arthritis model. METHODS: 128 rats were divided into two inflammatory periods: acute (7 days) and chronic (28 days) and subdivided into control, injury and treatment. The protocol with Freund's Complete Adjuvant was used in two inoculations, one intradermal and one intraarticular in the tibiofemoral joint, the control animals received saline solution. For treatment, LLLT 660 nm, 5 J/cm² was used in the sensitized joint and climbing exercise in stairways with an overload of 100 grams. After the experimental period, the animals were euthanized and the joints were prepared for morphometric analysis of the total thickness, superficial, deep, and cellular density of the articular cartilage. Generalized Linear Models with Sidak post-test were chosen. RESULTS: The control group was found to be different from the lesion group with greater joint cartilage thickness, andthe animals treated with exercise alone increased the joint cartilage compared to thecontrol group. CONCLUSION: The animals treated with laser association and exercise showed improvement in the morphometric aspects of the articular cartilage.

Assessing the racial differences in Q angle measurements in relevance to articular cartilage of the femoral condyle: a retrospective ultrasound study / Evaluación de las diferencias raciales en las mediciones del ángulo Q en relación con el cartílago articular del cóndilo femoral: un estudio ecográfico retrospectivo

SUMMARY: The Q-angle is defined as the acute angle formed by the vectors for combined pull of the quadriceps femoris muscle and the patellar tendon. This study aimed to investigate the variations in Q angle with respect to race. Moreover, this study performed ultrasound to evaluate of the thickness of articular cartilage covering the medial and lateral femoral condyle in volunteers with an increased Q angle. The study included 487 Jordanian and 402 Malaysians with age range 18-23 years. Moreover, the study included 30 participants aged between 18 and 22 years, with a total of 15 volunteers with Q >14° and 15 patients with Q ≤14°. Both Q angle and condylar distance were measured by well-trained medical practitioners according to a well-established protocol. The thickness of articular cartilage covering the medial and lateral femoral condyle of the femoral bone was measured using ultrasound. Regardless of race, Q angle was greater in females. Furthermore, Q angle was significantly greater in Arab volunteers compared to Malay volunteers. Q angle significantly increase with increasing condylar distance in both races. Finally, the statistical analysis showed a significantly reduced thickness of articular cartilage on both medial and lateral femoral condyle (P = 0.05) in the Q >14° group. Multiple factors including race and condylar distance and even the articular cartilage of femoral condyle should be considered during the examination and management of knee fractures and condylar diseases.

RESUMEN: El ángulo Q se define como el ángulo agudo formado por los vectores de tracción combinada del músculo cuádriceps femoral y el tendón patelar. Este estudio tuvo como objetivo investigar las variaciones en el ángulo Q con respecto a la raza. Además, se realizó una ecografía para evaluar el grosor del cartílago articular que cubre los cóndilos femorales medial y lateral en voluntarios con un ángulo Q aumentado. El estudio incluyó a 487 jordanos y 402 malayos con un rango de edad de 18 a 23 años. Además, el estudio incluyó a 30 participantes con edades comprendidas entre 18 y 22 años, 15 voluntarios con Q> 14 ° y 15 pacientes con Q ≤ 14 °. Tanto el ángulo Q como la distancia condilar fueron medidos por médicos bien entrenados de acuerdo con un protocolo establecido. El grosor del cartílago articular que cubre los cóndilos femorales medial y lateral del fémur se midió mediante ecografía. Independientemente del grupo racial, el ángulo Q fue mayor en las mujeres. Además, el ángulo Q fue significativamente mayor en los voluntarios árabes en comparación con los voluntarios malayos. El ángulo Q se aumenta significativamente al incrementarse la distancia condilar en ambas grupos raciales. Finalmente, el análisis estadístico mostró una reducción significativa del grosor del cartílago articular en los cóndilos femorales medial y lateral (P = 0,05) en el grupo Q> 14. Durante la exploración y el tratamiento de las fracturas de rodilla y de las enfermedades condilares, se deben considerar múltiples factores, incluida la raza y la distancia condilar e incluso el cartílago articular del cóndilo femoral.

Ejercicio en ratas con osteoartritis: aspectos morfológicos y una revisión de la literatura / Exercise in rats osteoarthritis: morphological aspects and literature review

La osteoartritis (OA) es una enfermedad crónica, degenerativa, muy invalidante, que destruye en forma gradual y progresiva el cartílago articular en diversas regiones: rodillas, caderas, hombros, manos, tobillos y columna vertebral. En este sentido, el ejercicio ha sido descrito como la intervención no farmacológica más recomendada para pacientes con OA. La práctica regular de ejercicio es considerada un componente integral del estilo de vida saludable; sin embargo, su efecto en el cartílago se mantiene como objeto de debate y especulaciones, así como la relación del ejercicio con el desarrollo de OA. Algunos estudios de modelos animales sugieren que el ejercicio puede ser beneficioso para la salud del cartílago, mientras otros demuestran su efecto nocivo. Una explicación general a estos resultados inconsistentes es que el correr a intensidad moderada tiene efectos beneficiosos, mientras que correr "vigorosamente" o de manera "extenuante" lleva a un efecto nocivo. El objetivo de este trabajo consistió en realizar una revisión de la literatura acerca de los efectos del ejercicio sobre el cartílago artícular, especialmente enfocado a modelos animales experimentales con ratas.

Osteoarthritis (OA) is a chronic, degenerative, and very disabling disease that gradually and progressively destroys articular cartilage in various regions: knees, hips, shoulders, hands, ankles and spine. In this sense, exercise has been described as the most recommended non-pharmacological intervention for patients with OA. Regular exercise is considered an integral component of the healthy lifestyle. However, its effect on cartilage remains the subject of debate and speculation, as well as the relationship between exercise and the development of OA. Some animal model studies suggest that exercise may be beneficial for cartilage health, while others demonstrate its harmful effect. A general explanation for these inconsistent results is that running at moderate intensity has beneficial effects, while running "vigorously" or "strenuously" leads to a harmful effect. The aim of this work was to make a literature review about the effects of exercise on cartilage, especially focused on experimental animal models with rats.

The effect of intra-articular levobupivacaine on shoulder cartilage at different doses - experimental study / O efeito de levobupivacaína intra-articular na cartilagem do ombro em doses diferentes-estudo experimental

Abstract Background and objectives: In this study it was aimed to examine the histological and morphometric effects on cartilage structure of intra-articular application of levobupivacaine to the shoulder joint. Methods: In twenty New Zealand adult male rabbits, 35 shoulders were used for the study and prepared in 5 groups of 7. These groups were defined as Groups L1, L2, L3 and L4 which were right shoulders administered with 0.25% and 0.5% levobupivacaine, Group C which were left shoulders as the control group and Groups S1 and S2 which were left shoulders administered with 0.9% saline. On the 2nd and 15th days the animals were killed, the glenohumeral joints were evaluated macroscopically then cartilage samples were taken. These samples were evaluated with Mankin score, and histomorphometrically by measuring the thickness of the cartilage between the superficial cartilage layer and the tidemark and the thickness of calcified cartilage between the tidemark and the subchondral bone. Results: Macroscopically, on the 15th day the joint fluid was seen to have reduced in all the groups. After microscopic evaluation, the highest Mankin score (mean: 3.14 ± 2.1/14) was in the L4 group (15th day 0.5% levobupivacaine) and was found to be statistically significant (p < 0.05). No statistically significant difference was determined between the other groups. Conclusions: Histologically, as the highest Mankin score was in the L4 group, this indicates that in a single intra-articular injection of levobupivacaine a low concentration should be selected. Level of evidence: Level 5, animal study.

Resumo Justificativa e objetivo: Neste estudo o objetivo foi examinar os efeitos histológicos e morfométricos sobre a estrutura da cartilagem da aplicação intra-articular de levobupivacaína em articulação do ombro. Métodos: Trinta e cinco ombros de 20 coelhos New Zealand, machos e adultos, foram usados para o estudo e divididos em cinco grupos de sete. Os grupos foram definidos como L1, L2, L3 e L4, consistiram em ombros direitos nos quais levobupivacaína a 0,25% e 0,5% foi administrada; o Grupo C, que consistiu em ombros esquerdos, foi o grupo controle; os grupos S1 e S2, que consistiram em ombros esquerdos, receberam solução salina a 0,9%. Os animais foram sacrificados no segundo e no 15º dia; as articulações glenoumerais foram avaliadas macroscopicamente e, em seguida, amostras de cartilagem foram coletadas. As amostras foram avaliadas com o escore de Mankin e histomorfometricamente. Mediu-se a espessura da cartilagem entre a camada superficial e a "linha de maré" (tidemark) e a espessura da cartilagem calcificada entre a tidemark e o osso subcondral. Resultados: Macroscopicamente, observou-se no 15º dia que o líquido articular havia reduzido em todos os grupos. Após a avaliação microscópica, o maior escore de Mankin (média: 3,14 ± 2,1/14) foi observado no grupo L4 (15º dia levobupivacaína a 0,5%), considerado estatisticamente significativo (p < 0,05). Nenhuma diferença estatisticamente significativa foi determinada entre os outros grupos. Conclusões: Histologicamente, como o maior escore de Mankin foi observado no Grupo L4, isso indica que em uma única injeção intra-articular de levobupivacaína uma concentração baixa deve ser selecionada. Nível de evidência: Nível 5, estudo em animais.

Fadiga óssea: causa de dor em joelhos na osteoartrite / Bone attrition: a cause of knee pain in osteoarthritis

A dor no joelho é o sintoma mais comum na osteoartrite, sendo a principal causa de incapacidade crônica em idosos e uma das principais fontes de morbidade atribuível à osteoartrite em geral. As causas de dor no joelho em pessoas com osteoartrite não são facilmente entendidas e o conhecimento sobre as causas da dor é fundamental para que futuramente sejam realizadas intervenções específicas. A fadiga óssea representa o remodelamento do osso subcondral na osteoartrite, levando a uma consequente alteração na forma do osso e/ou perda óssea. No entanto, a fadiga óssea não é algo facilmente interpretado, pois é de difícil detecção na ausência de defeitos claros da cortical e pela sobreposição de estruturas ósseas nas radiografias convencionais. A fadiga óssea está associada não apenas a dor no joelho, mas também a rigidez e incapacidade. Se a fadiga ocorre antes da osteoartrite avançada, isso sugere que alterações no osso subcondral podem ocorrer simultaneamente a alterações da cartilagem e que tratamentos visando sua preservação podem não ser eficazes. Lesões com padrão de edema ósseo estão associadas e são fatores preditivos para fadiga óssea. Este trabalho tem por objetivo rever a literatura mostrando a importância da fadiga óssea e de como diagnosticar esta alteração nos exames de imagem.

Knee pain is the most frequent symptom in osteoarthritis, a condition that is the leading cause of chronic disability in the elderly and one of the main sources of morbidity attributable to osteoarthritis in general. The causes of knee pain in individuals with osteoarthritis cannot be easily understood, and the knowledge of such causes is critical for determining future specific interventions. Bone attrition represents remodelling of the subchondral bone envelope in osteoarthritis, leading to a consequential change in bone shape and/or bone loss. However, bone attrition is not a feature that can be easily read, since it is hardly detected in the absence of clear defects of cortical bone integrity and because of overlap of bone structures at radiography. Bone attrition is associated not only with knee pain, but also with stiffness and disability. If attrition occurs prior to advanced osteoarthritis, this would suggest that changes in subchondral bone occur concurrently with cartilage loss and that treatments targeting cartilage loss alone are unlikely to be effective. Association with edema-like bone marrow lesions may be observed and constitute predictive factors for subchondral bone attrition. The present study was aimed at reviewing the literature, demonstrating the relevance of bone attrition and explaining how to diagnose this entity on imaging studies.

Effects of aging and physical activity on articular cartilage: a literature review

The overall aim of this literature review is, by making use of major databases, to introduce the conceptsabout the articular cartilage structure and the effects of aging on articular cartilage. The effects of physicalexercises on those cartilages are also discussed. The most important observations found are: cartilage thicknessdecreases gradually with age as well the content of proteoglycans and water, and there is an increase and thecollagen fibrils, which may be associated with the increased rigidity and fragility of the articular cartilage. Whenproperly done, physical activities produce compressive stimuli which enhance the activity of chondrocytesincreasing its nuclear volume density per area, as well as the width of the layers leading to greater resistance tocompression. Another consequence is extracellular matrix hydration resulting in greater mechanical resistanceand elasticity and a consequent increase the number of collagen fibrils which generates greater resistance todeformation and implies less rigidity. These facts reduce the risk of breakdown of cartilage when it is subjectedto high mechanical demand.

[ effect of soybean meal on the maintenance of cartilage in animal knee joints]

The soybean is one of the most important diet protein resources and induces a reduction of joint pain. The aim of the present study was to determine the incidence of joint disorders and arthritis, especially in the knee joint. According to the feed regimens, 36 female mice [balb/c; 3 weeks old] were divided into 3 groups including Group 1: Low protein for 6 months; Group 2: Low protein for 3 months and then followed by complete [or full] protein without soybean meal for the next 3 months and Group 3: Low protein for the first 3 months and then followed by complete protein with 20% soybean meal for the next 3 months. Finally the serum alkaline phosphatase [ALP] was measured and sections from the tibial cartilage were histomorphometrically studied. The thickness of the middle part of the tibial cartilage and the number of chondrocytes in the group used soybean meal [148/84 +/- 14/05, 12/77 +/- 1/57, respectively] showed a significant difference compared with the other groups [p<0.001]. Meanwhile, serum ALPlevels [76/402L/U] and the concentrations of the inter-cellular substance in the 3th group showed no significant difference compared with the other groups. It is concluded that soybean may effect on the growth of the knee joint cartilage in animals and also may induce stability of the knee joint cartilage in individuals with protein deficiency since childhood

Sulfato de condroitina e hialuronato de sódio no tratamento da doença articular degenerativa em cães: estudo histológico da cartilagem articular e membrana sinovial / Chondroitin sulfate and sodium hyaluronate in the treatment of the degenerative joint disease in dogs: histological features of articular cartilage and synovium

Quinze cães, sem raça definida, de ambos os sexos, de peso entre 18 e 25kg, foram submetidos à secção artroscópica do ligamento cruzado cranial (LCCr) para indução da doença articular degenerativa (DAD). Após três semanas de instabilidade articular, o LCCr foi substituído pela fáscia lata segundo a técnica de Schwalder (1989) e os animais foram distribuídos em três grupos de cinco. Os animais do grupo I, controle, não receberam tratamento medicamentoso; os do grupo II, 24mg/animal de sulfato de condroitina, por via IM, de cinco em cinco dias, totalizando seis aplicações; e os do grupo III foram tratados com hialuronato de sódio na dose de 20mg/animal, por via IV, de cinco em cinco dias num total de três administrações. Ao final de 90 dias, os animais foram eutanasiados e procedeu-se à colheita e ao processamento histológico da membrana sinovial e da cartilagem articular para avaliações morfológica e morfométrica. No grupo I foram observadas alterações degenerativas de DAD mais acentuadas que nos demais grupos, como redução do número de condrócitos, presença de pânus, fibrilações, fissuras, erosões e irregularidades na superfície articular. No grupo II observou-se elevação do número de condrócitos com aumento da atividade de síntese da matriz e redução das lesões na superfície da cartilagem. No grupo III houve aumento do número de condrócitos que eram, muitas vezes, morfologicamente inviáveis. Todos os grupos apresentaram proliferação da membrana sinovial e presença de infiltrado linfoplasmocitário na subíntima e na perivascular. Nos grupos I e III, a proliferação da membrana sinovial era exuberante com formação de pânus, presença de sinoviócitos achatados ou ausência de sinóvia com tecido de granulação. Os resultados sugerem que o sulfato de condroitina estimulou a cartilagem articular, diminuindo ou retardando as alterações da DAD e o hialuronato de sódio não interferiu no processo degenerativo da cartilagem articular. Não foi constatada ...

Fifteen mongrel dogs, both genders, weighting from 18 to 25kg were used and Degenerative Joint Disease (DJD) was induced through cranial cruciate ligament (CCrL) artroscopical section. After three weeks, CCrL was reconstructed by Schawalder's (1989) technique. Then, dogs were distributed in three groups and the following protocols were used: group I, control, no other treatment but the CCrL reconstruction; group II received chondroitin sulfate 24mg per animal every five days, intramuscularly, in a total of six injections; and group III received sodium hyaluronate 20mg per animal every five days, intravenously, in a total of three injections. Clinical observation was done until 90 days after treatments. By that time, the articular cartilage and synovium were collected and their morphology was evaluated. In group I, the degenerative alterations of the DJD were the most intense. Thus, decrease of chondrocytes number, pannus, fibrillations, grooves, erosion, and irregular articular surface were observed on the cartilage. In group II, raise of chondrocytes number was observed, with increase of synthesis activity of matrix and decrease of lesions on the articular surface. There was an increase of chondrocytes in group III, but the cells were morphologically unviable. All the groups showed proliferation of the synovial membrane, with limpho-plasma cells infiltrated in subintim and perivascular. In groups I and III, the proliferation of synovium was abundant, with formation of pannus, flattened synoviocytes or synovium absent with granulation tissue. Those results suggest that the chondroitin sulfate stimulated the articular cartilage; decreasing or delaying the alterations of DJD, as well as, the sodium hyaluronate did not interfere on degenerative process in articular cartilage. No favorable action of these drugs in the synovial membrane was verified.

Extracellular matrix of ostrich articular cartilage

The composition and organization of the extracellular matrix of ostrich articular cartilage was investigated, using samples from the proximal and distal surfaces of the tarsometatarsus. For morphological analysis, sections were stained with toluidine blue and analyzed by polarized light microscopy. For biochemical analysis, extracellular matrix components were extracted with 4 M guanidinium chloride, fractionated on DEAE-Sephacel and analyzed by SDS-PAGE. Glycosaminoglycans were analyzed by electrophoresis in agarose gels. Structural analysis showed that the fibrils were arranged in different directions, especially on the distal surface. The protein and glycosaminoglycan contents of this region were higher than in the other regions.SDS-PAGE showed the presence of proteins with molecular masses ranging from 17 to 121 kDa and polydisperse components of 67, 80-100, and 250-300 kDa in all regions. The analysis of glycosaminoglycans in agarosepropylene diamine gels revealed the presence of only chondroitin-sulfate. The electrophoretic band corresponding to putative decorin was a small proteoglycan containing chondroitin-sufate and not dermatan-sulfate, unlike other cartilages. The higher amounts of proteins and glycosaminoglycans and the multidirectional arrangement of fibrils seen in the distal region may be correlated with the higher compression normally exerted on this region

Estudo macroscópico e histológico de reparos osteocondrais biologicamente aceitáveis / Macroscopic and histological study of biologically acceptable osteochondral repairs

Este estudo teve como finalidade avaliar macroscopicamente e histológicamente defeitos osteocondrais já cicatrizados, também conhecidos como reparos. Foram utilizados seis coelhos machos, adultos, albinos da raca Nova Zelândia. Defeitos cilíndricos osteocondrais de 3.2 mm de diâmetro por 4.0 mm de profundidade foram criados cirurgicamente em ambos côndilos femorais mediais. O cilindro osteocondral retirado do joelho esquerdo (defeito não tratado) foi implantado no joelho direito (joelho tratado). Comparou-se macroscopicamente e histológicamente ambos tipos de defeitos após doze semanas de evolucão. A avaliacão macroscópica de todos os defeitos mostrou evolucão para reparos denominados biologicamente aceitáveis. O termo "biologicamente aceitável" foi utilizado para definir reparos, que à observacão macroscópica, se apresentaram como tecido neo-formado semelhante à fibrocartilagem, brilhante, liso, firme, em continuidade com a cartilagem adjacente. Como todos os defeitos, tratados e não tratados, eram macroscopicamente semelhantes, realizou-se um estudo histológico comparativo para averiguar qual tipo de tecido de reparacão se formava em ambos defeitos. Pela análise histológica dos reparos biologicamente aceitáveis, concluiu-se que houve formacão de tecido cartilaginoso hialino nos defeitos tratados com enxerto autólogo e de tecido fibrocartilaginoso nos defeitos não tratados.

Osteoartritis de la articulación temporomandibular. Parte I: anatomía, definición, sinonimia y generalidades / Osteoarthritis affecting the temporomandibular joint. Part I

La osteoartritis es la enfermedad más común que afecta al sistema musculoesquelético. Se caracteriza por ser un proceso dinámico, donde ocurren alteraciones degenerativas en la articulación completa. La osteoartritis se puede presentar en cualquier articulación del organismo, entre ellas, en la articulación temporomandibular. Sin embargo los factores etiológicos y su historia no se han dilucidado aún. Es importante conocer las estructuras anatómicas de la articulación afectadas por la enfermedad, la definición, la sinonimia, y las generalidades, para discutir posteriormente la etiopatogénesis, las manifestaciones histopatológicas, clínicas, serológicas y radiográficas y el tratamiento y pronóstico de la osteoartritis de la articulación temporomandibular

Osteoartritis de la articulación temporomandibular. Parte II: etiopatogénesis / Osteoarthritis affecting the temporomandibular joint. Part II

En la actualidad, se desconocen los mecanismos intrínsecos que dan inicio a la osteoartritis y a la historia natural de la misma. Patológicamente, se sabe que en la osteoartritis se observa un deterioro del cartílago articular y un remodelado del hueso subyacente. Existen diversas teorías que intentan explicar la etiología y describir la patogénesis de la osteoartritis en las articulaciones sinoviales y en la articulación temporomandibular, no abstante éstas no han sido dilucidadas aún. Se cree que son múltiples los factores etiológicos que pueden causar daño en la célula del cartílago