Harpagophytum procumbens Root Extract Mediates Anti-Inflammatory Effects in Osteoarthritis Synoviocytes through CB2 Activation.

The endocannabinoid system is involved in the nociceptive and anti-inflammatory pathways, and a lowered expression of CB2 receptors has been associated with inflammatory conditions, such as osteoarthritis (OA). This suggests that CB2 modulators could be novel therapeutic tools to treat OA. In the present study, the involvement of Harpagophytum procumbens root extract, a common ingredient of nutraceuticals used to treat joint disorders, in CB2 modulation has been evaluated. Moreover, to clarify the effects of the pure single components, the bioactive constituent, harpagoside, and the main volatile compounds were studied alone or in a reconstituted mixture. Human fibroblast-like synoviocytes, extracted by joints of patients, who underwent a total knee replacement, were treated with an H. procumbens root extract dissolved in DMSO (HPEDMSO). The effectiveness of HPEDMSO to affect CB2 pathways was studied by analyzing the modulation of cAMP, the activation of PKA and ERK MAP kinase, and the modulation of MMP-13 production. HPEDMSO was able to inhibit the cAMP production and MAP kinase activation and to down-regulate the MMP-13 production. Pure compounds were less effective than the whole phytocomplex, thus suggesting the involvement of synergistic interactions. Present findings encourage further mechanistic studies and support the scientific basis of the use of H. procumbens in joint disorders.

Arthroscopic anatomy of the posterior ankle ligaments.

PURPOSE: Our objective was to define the arthroscopic anatomy of the posterior ankle ligaments. TYPE OF STUDY: Anatomic study. METHODS: Twenty fresh-frozen feet were dissected in order to examine the morphology of the posterior ankle ligaments and their variations. In addition, arthroscopic examination was performed in 8 feet with standard anteromedial and anterolateral portals. Posterior ligamentous structures were identified and marked with suture. Following arthroscopy, careful dissection was performed and previously marked anatomic structures were identified. RESULTS: At the time of anatomic dissection, the posteroinferior tibiofibular ligament, also called the tibial slip, was found to be a constant structure with varying size and shape, and well evident during arthroscopy due to its oblique course. The deep component of the posteroinferior tibiofibular ligament, also called the transverse ligament, is well defined during arthroscopy. The 2 ligaments not well visualized during arthroscopy are the superficial component of the posteroinferior tibiofibular ligament and the posterior talofibular ligament. CONCLUSIONS: These findings should be of interest in interpreting findings encountered during arthroscopic examination of ankle, and when a posterior soft-tissue impingement syndrome must be ruled out.