Synovial fluid chondroitin sulphate epitopes 3B3 and 7D4, and glycosaminoglycan in human knee osteoarthritis after exercise.

OBJECTIVE: Walking exercise alleviates some symptoms, such as pain, in patients with mild to moderate knee osteoarthritis (OA). However, a major concern is that weightbearing exercise on osteoarthritic joints may exacerbate articular cartilage degradation. Loading of proteoglycan depleted articular cartilage in vitro increased expression of the chondroitin sulphate epitope 3B3, suggesting that loading may influence metabolism of osteoarthritic cartilage. This study aimed at evaluating the effects of walking exercise on articular cartilage metabolism in patients with knee OA, as reflected by changes in concentrations of synovial fluid markers. METHODS: Thirty elderly patients with knee OA (Kellgren-Lawrence grades II to IV) were randomly allocated to control (n = 15) and 12 week exercise (n = 15) groups. Synovial fluid obtained from 21 of the patients at time zero and after 12 weeks was examined by enzyme linked immunosorbent assay (ELISA) for the chondroitin sulphate epitopes 3B3 and 7D4, and by a dye binding assay with 1, 9-dimethylmethylene blue for total sulphated glycosaminoglycan (GAG) concentrations. The 3B3/GAG and 7D4/GAG ratios were calculated. RESULTS: No significant changes in concentrations of 3B3, 7D4, GAG, 3B3/GAG, or 7D4/GAG between time zero and 12 weeks were found in either group. However, there were significant declines in 3B3 (p=0. 001), GAG (p=0.007), and the 3B3/GAG ratio (p=0.049) with aging. CONCLUSION: Twelve weeks of walking exercise had no demonstrable adverse effects on articular cartilage metabolism, as reflected by the concentrations of synovial fluid GAG or the chondroitin sulphate epitopes 3B3 and 7D4.

Screening for cervical carcinoma in developmentally disabled women in residential facilities.

OBJECTIVE: Our aim was to describe the results of Papanicolaou (Pap) smears obtained during routine pelvic examinations on virginal developmentally disabled women and to compare the incidence rate of abnormal cervical cytology to the general population. MATERIALS AND METHODS: This study was descriptive and comparative. Subjects were a convenience sample of 230 developmentally disabled virginal women (mean age, 31 ± 9.6 years) who were living in a state-operated residential facility and had screening pelvic examinations and Pap smears. Cytological diagnoses were compared with a general population (n = 92, 151). RESULTS: Overall rate of abnormal Pap smears was significantly lower than the age-adjusted rate in the general population (z = 2.88, p <.01). All subsequent cytology in the study population reverted to normal. No evidence of cervical neoplasia was seen in the study population. CONCLUSIONS: Routine screening for cervical carcinoma is not indicated for this population of developmentally disabled women who have not had sexual inter-course.

Effects of exercise on knee joints with osteoarthritis: a pilot study of biologic markers.

OBJECTIVE: To determine the effects of low intensity weight-bearing exercise on osteoarthritis (OA) of the knee. METHODS: Synovial fluid keratan sulfate (KS) and hydroxyproline were measured as markers of cartilage degradation. The Arthritis Impact Measurement Scales (AIMS) were used to measure health status, and a visual analog scale for pain assessment was used before and after intervention. An exercise (EX) group (n = 15) received a thrice-weekly 12-week low intensity exercise program and a weekly educational program, and a minimal treatment (Min RX) group (n = 15) received only the education program. RESULTS: Pain levels declined in the EX group, and the Min RX group showed improvement on the AIMS. Synovial fluid was obtained in 11 subjects before and after the intervention. Levels of KS and hydroxyproline did not change. CONCLUSION: Further study of exercise effects should include both clinical and biologic parameters to examine the outcome of exercise as a therapeutic intervention in OA of the knee.