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1.
J Wound Care ; 31(5): 394-397, 2022 May 02.
Article in English | MEDLINE | ID: mdl-35579312

ABSTRACT

OBJECTIVE: Suppurative chondritis is a potentially devastating complication of burns to the ear. The infection and inflammation can liquify cartilage, leading to significant aesthetic deformities which are difficult to treat. This article reviews published measures for preventing post-burn chondritis. METHOD: A comprehensive search of all available literature up to September 2020 was performed, according to PRISMA guidelines, for studies assessing preventive measures for post-burn chondritis. Randomised controlled trials (RCT), cohort studies, case-control studies, case reports and series were eligible for inclusion. RESULTS: A total of 10 studies, including one RCT and nine retrospective observational analyses, were included, incorporating 1369 patients with burns to the ear. The most common interventions were pressure avoidance (70%), daily cleansing (60%), topical mafenide acetate (60%) and targeted debridement (30%). Packages of measures which included pressure avoidance were the most effective, all of which achieved a chondritis incidence of <6%. CONCLUSION: Low-level but strong published evidence suggests that important treatment principles include prevention by pressure relief, targeted debridement, prophylactic local antibiotics, local antisepsis and the avoidance of desiccation.


Subject(s)
Anti-Infective Agents, Local , Cartilage Diseases , Cartilage Diseases/etiology , Cartilage Diseases/prevention & control , Case-Control Studies , Humans , Inflammation , Retrospective Studies
2.
Knee Surg Sports Traumatol Arthrosc ; 30(11): 3708-3717, 2022 Nov.
Article in English | MEDLINE | ID: mdl-35484433

ABSTRACT

PURPOSE: The purpose of this study was to compare the long-term clinical and radiological outcomes between the immediate and delayed meniscus allograft transplantation (MAT). METHODS: Nine menisci were transplanted immediately after total meniscectomy (immediate group, IM), and 10 menisci were delayed transplanted in patients with the median of 35 months (range 9-92 months) after total meniscectomy (delayed group, DE). Patient's subjective clinical outcomes including VAS, IKDC, Lysholm and Tegner scores as well as muscle strength measures were compared. Joint degeneration was evaluated by both radiographs to assess joint space width narrowing, Kellegren-Lawrence (KL) grade and MRI with T2 mapping sequences to quantitatively analyze both cartilage and meniscal allograft degeneration. RESULTS: The median follow-up time was 10.8 years (range 10-14 years). The IKDC (IM vs DE, 89.8 vs 80.9, n.s.) and Lysholm scores (IM vs DE, 87.7 vs 78.0, n.s.) were close in two groups, while the IM group showed slightly lower VAS (IM vs DE, 0.2 vs 1.5, p = 0.031), higher Tegner score (IM vs DE, 7 vs 3.5 p = 0.021) and better quadriceps muscle strength. The IM group had less joint space narrowing (IM vs DE, 0.35 mm vs 0.71 mm, n.s.), less KL grade progression (IM vs DE, 0.6 vs 1.7, p = 0.041) on radiographs and less chondral lesions development on MRIs (Cartilage Degeneration Index, IM vs DE, 252 vs 2038, p = 0.025). All meniscal grafts exhibited degeneration by showing grade 3 signal on MRI, and 4 (4/9) in the IM group and 8 (8/10) cases in the DE group. The T2 value of cartilage and meniscal allograft in the IM group was close to that of the healthy control and was significantly lower than that of the DE group. CONCLUSION: Compared to the conventional delayed MAT, the immediate MAT achieved better cartilage and meniscus protection in the long-term, while its superiority in patient-reported outcomes was limited. LEVEL OF EVIDENCE: IV.


Subject(s)
Cartilage Diseases , Meniscus , Allografts/transplantation , Cartilage Diseases/diagnostic imaging , Cartilage Diseases/prevention & control , Cartilage Diseases/surgery , Follow-Up Studies , Humans , Menisci, Tibial/surgery , Menisci, Tibial/transplantation , Meniscus/diagnostic imaging , Meniscus/surgery , Transplantation, Homologous
3.
Oxid Med Cell Longev ; 2021: 4190098, 2021.
Article in English | MEDLINE | ID: mdl-34777686

ABSTRACT

Osteoarthritis (OA), a highly prevalent chronic joint disease, involves a complex network of inflammatory mediators that not only triggers pain and cartilage degeneration but also accelerates disease progression. Traditional Chinese medicinal shenjinhuoxue mixture (SHM) shows anti-inflammatory and analgesic effects against OA with remarkable clinical efficacy. This study explored the mechanism underlying anti-OA properties of SHM and evaluated its efficacy and safety via in vivo experiments. Through network pharmacology and published literature, we identified the key active phytochemicals in SHM, including ß-sitosterol, oleanolic acid, licochalcone A, quercetin, isorhamnetin, kaempferol, morusin, lupeol, and pinocembrin; the pivotal targets of which are TLR-4 and NF-κB, eliciting anti-OA activity. These phytochemicals can enter the active pockets of TLR-4 and NF-κB with docking score ≤ -3.86 kcal/mol, as shown in molecular docking models. By using surface plasmon resonance assay, licochalcone A and oleanolic acid were found to have good TLR-4-binding affinity. In OA rats, oral SHM at mid and high doses (8.72 g/kg and 26.2 g/kg) over 6 weeks significantly alleviated mechanical and thermal hyperalgesia (P < 0.0001). Accordingly, the expression of inflammatory mediators (TLR-4, interleukin (IL-) 1 receptor-associated kinase 1 (IRAK1), NF-κB-p65, tumor necrosis factor (TNF-) α, IL-6, and IL-1ß), receptor activator of the NF-κB ligand (RANKL), and transient receptor potential vanilloid 1 (TRPV1) in the synovial and cartilage tissue of OA rats was significantly decreased (P < 0.05). Moreover, pathological observation illustrated amelioration of cartilage degeneration and joint injury. In chronic toxicity experiment of rats, SHM at 60 mg/kg demonstrated the safety. SHM had an anti-inflammatory effect through a synergistic combination of active phytochemicals to attenuate pain and cartilage degeneration by inhibiting TLR-4 and NF-κB activation. This study provided the experimental foundation for the development of SHM into a more effective dosage form or new drugs for OA treatment.


Subject(s)
Cartilage Diseases/prevention & control , Inflammation/prevention & control , NF-kappa B/antagonists & inhibitors , Osteoarthritis/complications , Pain/prevention & control , Phytochemicals/pharmacology , Toll-Like Receptor 4/antagonists & inhibitors , Animals , Anti-Inflammatory Agents/pharmacology , Cartilage Diseases/etiology , Cartilage Diseases/metabolism , Cartilage Diseases/pathology , Disease Models, Animal , Inflammation/etiology , Inflammation/metabolism , Inflammation/pathology , Male , Medicine, Chinese Traditional , Mice , Mice, Inbred C57BL , Pain/etiology , Pain/metabolism , Pain/pathology , Plant Extracts/pharmacology , Protective Agents/pharmacology
5.
Arthroscopy ; 36(8): 2041-2042, 2020 08.
Article in English | MEDLINE | ID: mdl-32747053

ABSTRACT

"Arthroscrapes" are unintended iatrogenic articular cartilage injuries caused by the arthroscope or surgical instruments during arthroscopy. Even the most benign superficial injuries to articular cartilage, including temporary deformation, may result in chondrocyte death. We thus declare a call to action: arthroscopic and related surgeons must create techniques and instruments to diminish iatrogenesis imperfecta.


Subject(s)
Arthroscopy/adverse effects , Cartilage Diseases/prevention & control , Cartilage, Articular/injuries , Chondrocytes/pathology , Iatrogenic Disease/prevention & control , Arthroscopy/methods , Cartilage Diseases/etiology , Cartilage, Articular/surgery , Causality , Humans
6.
Adv Exp Med Biol ; 1228: 219-231, 2020.
Article in English | MEDLINE | ID: mdl-32342461

ABSTRACT

Osteoarthritis (OA) is a degenerative disease of the articular cartilage with subchondral bone lesions. Osteoarthritis etiologies are mainly related to age, obesity, strain, trauma, joint congenital anomalies, joint deformities, and other factors. Osteoarthritis seriously affects the quality of life; however, there is no effective way to cure osteoarthritis. Aerobic exercise refers to a dynamic rhythmic exercise involving the large muscle groups of the body with aerobic metabolism. More and more evidence shows that exercise has become a useful tool for the treatment of osteoarthritis. This chapter will discuss the role of exercise in the prevention and treatment of osteoarthritis.


Subject(s)
Exercise , Osteoarthritis , Animals , Cartilage Diseases/prevention & control , Cartilage Diseases/therapy , Cartilage, Articular/pathology , Humans , Osteoarthritis/prevention & control , Osteoarthritis/therapy , Quality of Life
7.
Inflammation ; 42(4): 1265-1275, 2019 Aug.
Article in English | MEDLINE | ID: mdl-30847744

ABSTRACT

Sinomenine (SIN) has been shown to protect against IL-1ß-induced chondrocyte apoptosis in vitro. However, the role of SIN in the anterior cruciate ligament transection (ACLT)-induced osteoarthritis (OA) mouse model and its underlying molecular mechanisms remain unclear. In the present study, the protective effect of SIN on ACLT-induced articular cartilage degeneration and IL-1ß-induced chondrocyte apoptosis miR-223-3p/NLRP3 signaling regulation was investigated. Safranin O staining was performed to evaluate the pathological changes of articular cartilage. Chondrocyte apoptosis was measured with Annexin V-fluorescein isothiocyanate/polyimide (annexin V-FITC/PI) staining using flow cytometry. Gene and protein expression were detected by RT-qPCR and Western blotting, respectively. SIN administration markedly improved articular cartilage degradation in mice undergoing ACLT surgery. In addition, SIN treatment downregulated the levels of inflammatory cytokines and the protein expression of NLRP3 inflammasome components and upregulated the expression of miR-223-3p in OA mice and IL-1ß-stimulated chondrocytes. In vitro, we found that NLRP3 was a direct target of miR-223-3p, and overexpression of miR-223-3p blocked IL-1ß-induced apoptosis and the inflammatory response in chondrocytes. These findings indicate that miR-223-3p/NLRP3 signaling could be used as a potential target of SIN for the treatment of OA.


Subject(s)
Cartilage Diseases/prevention & control , Cartilage, Articular/pathology , Inflammasomes/chemistry , MicroRNAs/metabolism , Morphinans/pharmacology , NLR Family, Pyrin Domain-Containing 3 Protein/metabolism , Animals , Antirheumatic Agents , Gene Expression Regulation , Mice , Morphinans/therapeutic use , Protective Agents , Signal Transduction
8.
Osteoarthritis Cartilage ; 27(7): 1084-1093, 2019 07.
Article in English | MEDLINE | ID: mdl-30890456

ABSTRACT

OBJECTIVE: The aim of the study was to examine how mechanical unloading affects articular cartilage degeneration in the patellofemoral (PF) and tibiofemoral (TF) joints of a monosodium iodoacetate (MIA)-induced rat model of osteoarthritis (OA). DESIGN: The study involved 60 male rats. OA was induced by intra-articular injecting MIA into both knee joints. All animals were equally divided into two groups: sedentary (SE) and hindlimb unloading (HU) groups. Histopathological changes in the articular cartilage of the PF and TF joints were evaluated using the Osteoarthritis Research Society International (OARSI) score and modified Mankin score at 2 and 4 weeks after MIA injection. RESULTS: In the SE and HU groups, representative histopathological changes in OA were detected in the PF and TF joints. The OARSI and modified Mankin scores for the PF and TF joints tended to increase over time after the injection of 0.2 mg or 1.0 mg of MIA in the SE and HU groups. Both the scores for the HU group were significantly lower than those for the SE group [OARSI score: P < 0.0001 (1.0-mg injection at 4 weeks); modified Mankin score: P = 0.0116 (0.2-mg injection at 4 weeks); P = 0.0004 and < 0.0001 (1.0-mg injection at 2 and 4 weeks, respectively)]. CONCLUSION: This study revealed new histological evidence that indicates that unloading condition suppresses articular cartilage degeneration and is beneficial in many areas of basal and clinical research involving OA.


Subject(s)
Cartilage Diseases/pathology , Cartilage Diseases/prevention & control , Cartilage, Articular/pathology , Osteoarthritis, Knee/pathology , Analysis of Variance , Animals , Arthritis, Experimental/diagnostic imaging , Arthritis, Experimental/pathology , Biopsy, Needle , Cartilage, Articular/physiopathology , Disease Models, Animal , Immunohistochemistry , Injections, Intra-Articular , Iodoacetates/pharmacology , Male , Osteoarthritis, Knee/chemically induced , Random Allocation , Rats , Rats, Wistar , Sedentary Behavior , Stress, Mechanical
9.
J Cell Biochem ; 120(3): 4599-4612, 2019 03.
Article in English | MEDLINE | ID: mdl-30537038

ABSTRACT

Total knee arthroplasty is a commonly performed safe procedure and typically executed in severe knee arthritis, but it also triggers ischemia-reperfusion injury (IRI). More recently, microRNAs (miRs) have been reported to play a contributory role in IRI through the key signaling pathway. Hence, the current study aimed to investigate the effect and specific mechanism of microRNA-23b (miR-23b), murine double minute 4 (MDM4), and the p53 signaling pathway in IRI rat models. First, the IRI model was established, and the expression pattern of miR-23b, MDM4, and the p53 signaling pathway-related genes was characterized in cartilaginous tissues. Then, miR-23b mimics or inhibitors were applied for the elevation or the depletion of the miR-23b expression and siRNA-MDM4 for the depletion of the MDM4 expression in the articular chondrocytes. By means of immunohistochemistry, quantitative real-time polymerase chain reaction, and Western blot analysis, IRI rats exhibited increased miR-23b expression, activated p53 signaling pathway, and decreased MDM4 expression. MDM4 was verified as a target gene of miR-23b through. Downregulated miR-23b increased the expression of MDM4, AKT, and Bcl-2, but decreased the expression of p53, p21, and Bax. In addition, a series of cell experiments demonstrated that downregulated miR-23b promoted articular chondrocyte proliferation and cell cycle entry, but inhibited articular chondrocyte apoptosis. The absence of the effects of miR-23b was observed after MDM4 knocked down. Our results indicate that silencing miR-23b could act to attenuate IRI and reduce the apoptosis of articular chondrocytes through inactivation of the p53 signaling pathway by upregulating MDM4, which provide basic therapeutic considerations for a novel target against IRI.


Subject(s)
Cartilage Diseases , Cell Cycle Proteins/metabolism , Down-Regulation , MicroRNAs/biosynthesis , Reperfusion Injury , Signal Transduction , Tumor Suppressor Protein p53/metabolism , Animals , Cartilage/metabolism , Cartilage/pathology , Cartilage Diseases/metabolism , Cartilage Diseases/pathology , Cartilage Diseases/prevention & control , Cell Proliferation , Chondrocytes/metabolism , Chondrocytes/pathology , Rats , Rats, Sprague-Dawley , Reperfusion Injury/metabolism , Reperfusion Injury/pathology , Reperfusion Injury/prevention & control
10.
Knee Surg Sports Traumatol Arthrosc ; 26(12): 3738-3753, 2018 Dec.
Article in English | MEDLINE | ID: mdl-29876862

ABSTRACT

PURPOSE: To evaluate the association between surgical timing and the incidence of secondary meniscal or chondral damage in children and adolescents with anterior cruciate ligament (ACL) ruptures. METHODS: Three electronic databases, PubMed, MEDLINE, and EMBASE, were systematically searched from database inception until October 16, 2017 by two reviewers independently and in duplicate. The inclusion criteria were English language studies that reported the incidence of meniscal and articular cartilage damage in children or adolescent athletes with ACL injuries as well as the timing of their ACL reconstruction (ACLR). Risk ratios were combined in a meta-analysis using a random effects model. RESULTS: A total of nine studies including 1353 children and adolescents met the inclusion criteria. The mean age of patients included was 14.2 years (range 6-19), and 45% were female. There was a significantly decreased risk of concomitant medial meniscal injury in those reconstructed early (26%) compared to those with delayed reconstruction (47%) [pooled risk ratio (RR) = 0.49, 95% CI 0.36-0.65, p < 0.00001]. There was also a significantly reduced risk of medial femoral chondral (RR = 0.48, 95% CI 0.31-0.75, p = 0.001), lateral femoral chondral (RR = 0.38, 95% CI 0.20-0.75, p = 0.005), tibial chondral (RR = 0.45, 95% CI 0.27-0.75, p = 0.002), and patellofemoral chondral (RR = 0.41, 95% CI 0.20-0.82, p = 0.01) damage in the early reconstruction group in comparison to the delayed group. CONCLUSION: Pooled results from observational studies suggest that early ACLR results in a significantly decreased risk of secondary medial meniscal injury, as well as secondary medial, lateral, and patellofemoral compartment chondral damage in children and adolescents. This study provides clinicians with valuable information regarding the benefits of early ACL reconstruction in children and adolescents, and can be used in the decision making for athletes in this population. LEVEL OF EVIDENCE: IV.


Subject(s)
Anterior Cruciate Ligament Injuries/surgery , Anterior Cruciate Ligament Reconstruction , Cartilage, Articular/pathology , Menisci, Tibial/pathology , Adolescent , Anterior Cruciate Ligament Injuries/complications , Cartilage Diseases/etiology , Cartilage Diseases/prevention & control , Child , Humans , Knee Injuries/complications , Knee Injuries/pathology , Knee Injuries/surgery , Retrospective Studies , Tibial Meniscus Injuries/etiology , Tibial Meniscus Injuries/prevention & control , Time Factors
11.
Cartilage ; 9(1): 80-88, 2018 01.
Article in English | MEDLINE | ID: mdl-29219023

ABSTRACT

Objective The objective of this study was to determine whether intra-articular injections of tenascin-C (TNC) could prevent cartilage damage in murine models of osteoarthritis (OA). Design Fluorescently labeled TNC was injected into knee joints and its distribution was examined at 1 day, 4 days, 1 week, 2 weeks, and 4 weeks postinjection. To investigate the effects of TNC on cartilage degeneration after surgery to knee joints, articular spaces were filled with 100 µg/mL (group I), 10 µg/mL (group II) of TNC solution, or control (group III). TNC solution of 10 µg/mL was additionally injected twice after 3 weeks (group IV) or weekly after 1 week, 2 weeks, and 3 weeks (group V). Joint tissues were histologically assessed using the Mankin score and the modified Chambers system at 2 to 8 weeks after surgery. Results Exogenous TNC was maintained in the cartilage and synovium for 1 week after administration. Histological scores in groups I and II were better than scores in group III at 4 and 6 weeks, but progressive cartilage damage was seen in all groups 8 weeks postoperatively. Sequential TNC injections (groups IV and V) showed significantly better Mankin score than single injection (group II) at 8 weeks. Conclusion TNC administered exogenously remained in the cartilage of knee joints for 1 week, and could decelerate articular cartilage degeneration in murine models of OA. We also showed that sequential administration of TNC was more effective than a single injection. TNC could be an important molecule for prevention of articular cartilage damage.


Subject(s)
Cartilage Diseases/pathology , Cartilage, Articular/drug effects , Knee Joint/pathology , Osteoarthritis, Knee/drug therapy , Synovial Membrane/drug effects , Tenascin/pharmacology , Animals , Cartilage Diseases/prevention & control , Cartilage, Articular/pathology , Cartilage, Articular/ultrastructure , Collagen Type II/metabolism , Disease Models, Animal , Injections, Intra-Articular , Knee Joint/ultrastructure , Male , Mice , Mice, Inbred BALB C/metabolism , Osteoarthritis, Knee/prevention & control , Synovial Membrane/pathology , Tenascin/administration & dosage
12.
Endocr Metab Immune Disord Drug Targets ; 18(2): 98-109, 2018 Feb 13.
Article in English | MEDLINE | ID: mdl-29141572

ABSTRACT

BACKGROUND AND OBJECTIVE: Rheumatoid arthritis (RA) is a predominant inflammatory autoimmune disorder. The incidence and prevalence of RA is increasing with considerable morbidity and mortality worldwide. The pathophysiology of RA has become clearer due to many significant research outputs during the last two decades. Many inflammatory cytokines involved in RA pathophysiology and the presence of autoantibodies are being used as potential biomarkers via the use of effective diagnostic techniques for the early diagnosis of RA. Currently, several disease-modifying anti-rheumatic drugs are being prescribed targeting RA pathophysiology, which have shown significant contributions in improving the disease outcomes. DISCUSSION: Even though innovations in treatment strategies and monitoring are helping the patients to achieve early and sustained clinical and radiographic remission, the high cost of drugs and limited health care budgets are restricting the easy access of RA treatment. Both direct and indirect high cost of treatment are creating economic burden for the patients and affecting their quality of life. CONCLUSION: The aim of this review is to describe the updated concept of RA pathophysiology and highlight current diagnostic tools used for the early detection as well as prognosis - targeting several biomarkers of RA. Additionally, we explored the updated treatment options with side effects besides discussing the global economic burden.


Subject(s)
Arthritis, Rheumatoid/therapy , Autoimmunity , Cost of Illness , Global Health , Health Care Costs , Quality of Life , Arthritis, Rheumatoid/diagnosis , Arthritis, Rheumatoid/economics , Arthritis, Rheumatoid/physiopathology , Autoimmunity/drug effects , Biomarkers/blood , Bone Resorption/etiology , Bone Resorption/immunology , Bone Resorption/prevention & control , Cartilage Diseases/etiology , Cartilage Diseases/immunology , Cartilage Diseases/prevention & control , Combined Modality Therapy/adverse effects , Combined Modality Therapy/economics , Combined Modality Therapy/trends , Drug Therapy, Combination/adverse effects , Drug Therapy, Combination/economics , Drug Therapy, Combination/trends , Early Diagnosis , Humans , Prognosis , Synovitis/etiology , Synovitis/immunology , Synovitis/prevention & control
13.
Khirurgiia (Mosk) ; (11): 51-55, 2017.
Article in Russian | MEDLINE | ID: mdl-29186097

ABSTRACT

AIM: The comparison of the efficiency of the standard scheme of a conservative medicinal therapy of an OA of a hip joint and the modified scheme (with the muscle relaxant of the central action - Tolperisone) was the research objective. MATERIAL AND METHODS: The prospective research of the complex conservative therapy of two pools of patients with initial stages of a coxarthrosis from 2014 for 2017 with the subject assessment articulary treatment components is conducted. RESULTS: As a result of the studying of the clinical performance of the modified scheme in comparison with the standard scheme of the therapy at patients with the prevalence of an arthritic component of a disease established the best results of the therapy.


Subject(s)
Osteoarthritis, Hip , Range of Motion, Articular/drug effects , Tolperisone/administration & dosage , Cartilage Diseases/physiopathology , Cartilage Diseases/prevention & control , Cartilage, Articular/drug effects , Conservative Treatment/methods , Drug Therapy, Combination/methods , Female , Humans , Male , Middle Aged , Muscle Relaxants, Central/administration & dosage , Osteoarthritis, Hip/diagnosis , Osteoarthritis, Hip/drug therapy , Osteoarthritis, Hip/physiopathology , Patient Acuity , Protective Agents/administration & dosage , Symptom Assessment/methods , Treatment Outcome
14.
Biochem Biophys Res Commun ; 490(3): 834-840, 2017 08 26.
Article in English | MEDLINE | ID: mdl-28647370

ABSTRACT

Hyperglycemia-induced cartilage degeneration induces osteoarthritis (OA). Since oleanolic acid (OLA) have several pharmacological effects such as anti-inflammatory, anti-oxidant, we hypothesized it possesses protection against high glucose injured cartilage. We now report that OLA decreased type X collagen and reversed the cartilage degeneration in growth plate from db/db mice. OLA increased type Ⅱ collagen expression in a concentration-dependent manner (10-50 µΜ) in high glucose-treated chondrocytes. OLA prevented the high glucose induced cell injury and decreased the level of MMP-13, PGE2 and IL-6 due to decreasing mitochondrial membrane potential and stimulated the ATP production. Moreover, OLA treatment inhibited apoptosis. And the reversed SOD2 expression and activity may be ascribed to decreased SOD2 protein degradation by OLA treatment, via PPPAγ. In conclusion, OLA protected against the high-glucose-induced cartilage injury via PPARγ/SOD2 pathway.


Subject(s)
Cartilage Diseases/prevention & control , Diabetes Complications/prevention & control , Diabetes Mellitus, Experimental/complications , Hyperglycemia/complications , Oleanolic Acid/therapeutic use , PPAR gamma/metabolism , Protective Agents/therapeutic use , Animals , Cartilage/drug effects , Cartilage/metabolism , Cartilage/pathology , Cartilage Diseases/etiology , Cartilage Diseases/metabolism , Cartilage Diseases/pathology , Cells, Cultured , Diabetes Complications/etiology , Diabetes Complications/metabolism , Diabetes Complications/pathology , Diabetes Mellitus, Experimental/metabolism , Diabetes Mellitus, Experimental/pathology , Hyperglycemia/metabolism , Hyperglycemia/pathology , Membrane Potential, Mitochondrial/drug effects , Mice, Inbred C57BL , Mitochondria/drug effects , Mitochondria/metabolism , Mitochondria/pathology , Oleanolic Acid/pharmacology , Protective Agents/pharmacology
15.
Orthop Clin North Am ; 48(3): 265-273, 2017 Jul.
Article in English | MEDLINE | ID: mdl-28577776

ABSTRACT

This study compared patients who failed a cartilage restoration procedure and underwent ipsilateral knee arthroplasty with matched control subjects undergoing knee arthroplasty without prior cartilage restoration. Although patients with a failed cartilage procedure derived benefit from knee arthroplasty, their magnitude of improvement and final outcomes scores were lower than the matched control subjects. In this cohort, the cartilage patients also experienced little to no benefit from cartilage restoration, suggesting that unmeasured shared patient characteristics may play a role. This information can be used to counsel this difficult patient population on expected outcomes following arthroplasty procedures. Further research identifying characteristics of responders to treatment remains critical to refine clinical decision-making for this difficult patient group.


Subject(s)
Arthroplasty, Replacement, Knee , Cartilage Diseases , Cartilage, Articular , Osteoarthritis, Knee , Pain, Postoperative , Adult , Arthroplasty, Replacement, Knee/adverse effects , Arthroplasty, Replacement, Knee/methods , Cartilage Diseases/diagnosis , Cartilage Diseases/etiology , Cartilage Diseases/physiopathology , Cartilage Diseases/prevention & control , Cartilage, Articular/injuries , Cartilage, Articular/physiopathology , Cartilage, Articular/surgery , Female , Humans , Male , Middle Aged , Osteoarthritis, Knee/pathology , Osteoarthritis, Knee/physiopathology , Osteoarthritis, Knee/surgery , Pain, Postoperative/diagnosis , Pain, Postoperative/etiology , Pain, Postoperative/physiopathology , Pain, Postoperative/prevention & control , Reoperation/adverse effects , Reoperation/methods , Retrospective Studies , Treatment Outcome
16.
Eur J Endocrinol ; 176(6): 779-790, 2017 Jun.
Article in English | MEDLINE | ID: mdl-28348071

ABSTRACT

BACKGROUND: Arthropathy is a prevalent and invalidating complication of acromegaly with a characteristic radiographic phenotype. We aimed to further characterize cartilage and bone abnormalities associated with acromegalic arthropathy using magnetic resonance imaging (MRI). METHODS: Twenty-six patients (23% women, mean age 56.8 ± 13.4 years), with active (n = 10) and controlled acromegaly (n = 16) underwent a 3.0 T MRI of the right knee. Osteophytes, cartilage defects, bone marrow lesions and subchondral cysts were assessed by the Knee Osteoarthritis Scoring System (KOSS) method. Cartilage thickness and cartilage T2 relaxation times, in which higher values reflect increased water content and/or structural changes, were measured. Twenty-five controls (52% women, mean age: 59.6 ± 8.0 years) with primary knee OA were included for comparison. RESULTS: Both in active and controlled acromegaly, structural OA defects were highly prevalent, with thickest cartilage and highest cartilage T2 relaxation times in the active patients. When compared to primary OA subjects, patients with acromegaly seem to have less cysts (12% vs 48%, P = 0.001) and bone marrow lesions (15% vs 80%, P = 0.006), but comparable prevalence of osteophytosis and cartilage defects. Patients with acromegaly had 31% thicker total joint cartilage (P < 0.001) with higher cartilage T2 relaxation times at all measured sites than primary OA subjects (P < 0.01). CONCLUSIONS: Patients with active acromegaly have a high prevalence of structural OA abnormalities in combination with thick joint cartilage. In addition, T2 relaxation times of cartilage are high in active patients, indicating unhealthy cartilage with increased water content, which is (partially) reversible by adequate treatment. Patients with acromegaly have a different distribution of structural OA abnormalities visualized by MRI than primary OA subjects, especially of cartilage defects.


Subject(s)
Acromegaly/physiopathology , Joint Diseases/etiology , Knee Joint/diagnostic imaging , Acromegaly/pathology , Acromegaly/therapy , Adult , Aged , Bone Cysts/diagnostic imaging , Bone Cysts/epidemiology , Bone Cysts/etiology , Bone Cysts/prevention & control , Bone Marrow Diseases/diagnostic imaging , Bone Marrow Diseases/epidemiology , Bone Marrow Diseases/etiology , Bone Marrow Diseases/prevention & control , Cartilage/diagnostic imaging , Cartilage/pathology , Cartilage Diseases/diagnostic imaging , Cartilage Diseases/epidemiology , Cartilage Diseases/etiology , Cartilage Diseases/prevention & control , Cross-Sectional Studies , Female , Follow-Up Studies , Humans , Joint Diseases/diagnostic imaging , Joint Diseases/epidemiology , Joint Diseases/prevention & control , Magnetic Resonance Imaging , Male , Middle Aged , Netherlands/epidemiology , Osteoarthritis/diagnostic imaging , Osteoarthritis/pathology , Pilot Projects , Prevalence , Remission Induction , Severity of Illness Index
17.
BMC Musculoskelet Disord ; 17: 188, 2016 Apr 27.
Article in English | MEDLINE | ID: mdl-27118194

ABSTRACT

BACKGROUND: Cross-linked hyaluronan--also called Hylan G-F 20--is a medical device developed to treat osteoarthritis of the knee. However, it is still controversial whether Hylan G-F 20 has a cartilage protective effect in trauma-induced osteoarthritis. We investigated whether Hylan G-F 20 delayed osteoarthritis progression in a partial meniscectomized rat model. METHODS: Lewis rats were used for the experiments. The anterior medial meniscus was resected at the level of the medial collateral ligament in both knees. From 1 week after the surgery, 50 µl of Hylan G-F 20 was injected weekly into the left knee and phosphate buffered saline was injected into the right knee. Cartilage was evaluated for macroscopic findings, histology with safranin-o, and expression of type II collagen at 2, 4, and 8 weeks. Synovitis was also evaluated, and immunohistochemical analysis was performed for ED1. RESULTS: Macroscopic findings demonstrated that India ink positive area, representing fibrillated cartilage, was significantly smaller in the Hylan G-F 20 group than in the control group at 2, 4, and 8 weeks (n = 5). There were no significant differences in osteophyte score between the Hylan G-F 20 group and the control group at 2, 4, and 8 weeks. Histologically, the cartilage in the medial tibial plateau was destroyed at 8 weeks in the control group, while type II collagen expression was still observed at 8 weeks in the Hylan G-F 20 group. OARSI score for cartilage histology was significantly lower in the Hylan G-F 20 group than in the control group at 4 and 8 weeks (n = 5). There were no significant differences in synovial cell number or modified synovitis score between the Hylan G-F 20 group and the control group at 2, 4, and 8 weeks (n = 5). In the Hylan G-F 20 group, foreign bodies surrounded by ED1 positive macrophages were observed in the synovium. CONCLUSION: Weekly injections of Hylan G-F 20 starting 1 week after surgery delayed cartilage degeneration after meniscectomy in a rat model. Synovitis induced by meniscectomy was not alleviated by Hylan G-F 20. Insoluble gels were observed in the synovium after the Hylan G-F 20 injection.


Subject(s)
Biocompatible Materials/administration & dosage , Hyaluronic Acid/analogs & derivatives , Menisci, Tibial/surgery , Osteoarthritis, Knee/prevention & control , Osteoarthritis, Knee/surgery , Animals , Cartilage Diseases/pathology , Cartilage Diseases/prevention & control , Cartilage Diseases/surgery , Drug Administration Schedule , Hyaluronic Acid/administration & dosage , Knee Joint/drug effects , Knee Joint/pathology , Knee Joint/surgery , Male , Menisci, Tibial/drug effects , Menisci, Tibial/pathology , Osteoarthritis, Knee/pathology , Rats , Rats, Inbred Lew
18.
Osteoarthritis Cartilage ; 24(3): 514-20, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26485068

ABSTRACT

OBJECTIVE: To evaluate the efficacy of Danshen on histological parameters and antioxidative activity in the articular cartilage of rabbits with osteoarthritis (OA). DESIGN: Twenty-four rabbits were randomly divided into three groups (control, OA, and Danshen OA; eight rabbits per group). Anterior cruciate ligament transection (ACLT) of the left hind knees was performed in all rabbits in the OA and Danshen OA group for induction of OA. The rabbits in the control group underwent a sham operation. After surgery, 3 g/kg body weight of Danshen granules dissolved in 5 mL distilled water was administered by gastric intubation once per day and over a 6-week period to the Danshen OA group. The same volume of distilled water was administered to the OA and control groups. After 6 weeks, the medial femoral condyles and synoviums of the left hind knees in all three groups were harvested and used for histological and biochemical analyses. RESULTS: Severe articular cartilage degeneration as well as lower proteoglycan (PG) content were noted in the OA group compared to the Danshen OA group (P < 0.05). The glutathione (GSH) levels in the synovium and articular cartilage of the rabbits in the Danshen OA group were significantly higher compared to the OA group (P < 0.001). The malondialdehyde (MDA) levels of the synovium and articular cartilage in the Danshen OA group was markedly depleted compared to the OA group (P < 0.001). CONCLUSION: Danshen can prevent articular cartilage degeneration in OA through the defense against oxidative stress.


Subject(s)
Antioxidants/therapeutic use , Arthritis, Experimental/prevention & control , Cartilage Diseases/prevention & control , Cartilage, Articular/drug effects , Drugs, Chinese Herbal/therapeutic use , Osteoarthritis/prevention & control , Animals , Arthritis, Experimental/metabolism , Arthritis, Experimental/pathology , Cartilage Diseases/metabolism , Cartilage Diseases/pathology , Cartilage, Articular/metabolism , Cartilage, Articular/pathology , Drug Evaluation, Preclinical/methods , Female , Glutathione/metabolism , Male , Malondialdehyde/metabolism , Osteoarthritis/metabolism , Osteoarthritis/pathology , Oxidative Stress/drug effects , Proteoglycans/metabolism , Rabbits , Random Allocation , Salvia miltiorrhiza , Synovial Membrane/metabolism
19.
Knee Surg Sports Traumatol Arthrosc ; 24(5): 1617-26, 2016 May.
Article in English | MEDLINE | ID: mdl-25661676

ABSTRACT

UNLABELLED: Articular cartilage defects of the knee are common among athletes where the physical demands of sport result in significant stresses on joints. Chondral defects are associated with pain and functional impairment that limit sporting participation and may progress to joint degeneration and frank arthritis. Management of established chondral lesions aims to allow athletes to return to high-impact sports and can be considered in terms of protection of existing cartilage, chondrofacilitation, and resurfacing. Repaired and regenerated cartilage must closely resemble and function like normal hyaline cartilage, and this ability may be the most significant factor for the return to sport. Based on our experiences and the available literature, we outline how athletes can best protect their cartilage, how physicians can facilitate intrinsic repair of established lesions, and which methods of cartilage restoration or resurfacing should be used in different situations. LEVEL OF EVIDENCE: IV.


Subject(s)
Athletic Injuries/therapy , Cartilage Diseases/therapy , Cartilage, Articular/injuries , Knee Injuries/therapy , Algorithms , Athletic Injuries/prevention & control , Cartilage/transplantation , Cartilage Diseases/prevention & control , Cartilage, Articular/cytology , Cartilage, Articular/pathology , Cartilage, Articular/surgery , Chondrocytes/transplantation , Humans , Knee Injuries/prevention & control , Knee Joint/cytology , Knee Joint/pathology , Knee Joint/surgery , Return to Sport
20.
Exp Biol Med (Maywood) ; 241(1): 14-24, 2016 Jan.
Article in English | MEDLINE | ID: mdl-26202375

ABSTRACT

Gastrectomy (Gx) leads to osteopenia/osteoporosis in humans and animals. However, little is known about the influence of Gx on the cartilage in this regard. Recent studies have demonstrated a protective effect of 2-oxoglutaric acid (2-Ox) on bone and cartilage. Hence, the purpose of this study was to investigate whether 2-Ox can mitigate eventual Gx-induced cartilage impairment. Twenty female Sprague-Dawley rats were subjected to Gx and randomly divided into two groups: Gx + 2-Ox and Gx. Another 20 rats were sham-operated (ShO) and randomly divided into two groups: ShO + 2-Ox and ShO. The daily dose of 2-Ox administered to the rats in the drinking water was 0.43 g per 100 g rat. After eight weeks, rats were euthanized and femora and tibiae were collected. Histology and histomorphometry analyses of the articular cartilage and the growth plate were done. Gx resulted in a 32% (±44.5 femur, ±35.8 tibia) decrease in overall thickness of articular cartilage in both bones (femur: ShO 279.1 ± 48.5 vs. Gx 190.2 ± 38.4 µm, tibia: ShO 222.9 ± 50.3 µm vs. Gx 151.3 ± 52.6 µm) (in some zones up to 58 ± 28.0%), and in the growth plate up to 20% (±22.4) (femur: ShO 243.0 ± 34.0 vs. Gx 207.0 ± 33.7 µm, tibia: ShO 220.0 ± 24.6 µm vs. Gx 171.1 ± 16.1 µm). Gx altered the spatial distribution of thick and thin collagen fibers, and chondrocyte shape and size. 2-Ox administration prevented the reduction in both cartilages thickness (Gx + 2-Ox: articular cartilage 265.2 ± 53.8 µm, 235.6 ± 42.7 µm, growth plate 236.7 ± 39.2 µm, 191.3 ± 16.5 µm in femur and tibia, respectively), and abolished the spatial changes in collagen distribution and structure induced by Gx. Gx affects cartilage structure and thickness, however, 2-Ox administration mitigates these effects and showed protective and stimulatory properties. Our observations suggest that dietary 2-Ox can be used to offset some of the changes in hyaline cartilage, in particular articular cartilage, following bariatric surgeries.


Subject(s)
Cartilage Diseases/etiology , Cartilage Diseases/prevention & control , Diet/methods , Dietary Supplements , Gastrectomy/adverse effects , Ketoglutaric Acids/administration & dosage , Animals , Cartilage/pathology , Disease Models, Animal , Female , Rats, Sprague-Dawley , Treatment Outcome
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