Joint Cartilage Research Articles

A Study to Assess the Effectiveness of Castor Oil Massage and Hot Water Application on Knee Joint Pain among Elderly Patients who are Attending the Orthopedic Department at HSK Hospital Bagalkot

Background of the Study: Joint Pain is a chronic, progressive process in which new tissue is produced in response to joint insults and cartilage deterioration. The most prevalent articular disease in adults can seen before 65 years of age and older. Osteoarthritis occurs more commonly in women than in men. It accounts for substantial disability as a result of its effect on the large weight bearing joints and the spine. There are various treatment and intervention are available to reduce joint pain such as hot application and castor oil application, active and passive etc. Aim: The aim of study was to assess the effectiveness of castor oil massage and hot water application on knee joint pain among elderly patients. Methodology: The present study is true experimental pre-test post-test control group design. The sampling technique adopted for this study is non-probability convenient sampling technique. Data divided into 2 groups of 60 elderly knee joint patients through simple random lottery method from HSK Hospital Bagalkot. The samples selected through non-probability convenient sampling technique and divided into two groups, 30 Elderly patients to experimental group and 30 elderly patients to control group. Data analysis done by using descriptive and inferential statistics in terms of frequency, percentage, mean, standard deviation, paired‘t’ test and chi square test. Results: Findings related to significance of difference between the experimental and control group mean pre-test and pain scores and standard deviation was [7.2±1.7100] and control group having [4.4±1.248] before giving the intervention and experimental group [3.666±0.922], control group [4.06667±1.201] after giving the intervention. The effectiveness was statistically tested by using paired‘t’ test which revealed that t value =15.37 and the result was found to be significant at p<0.001. Conclusion: The study proved that administration of Castor oil massage and Hot water application intervention on red

Optimizing NSAID Therapy in Elderly with Osteoarthritis: A Case Study from a Primary Care Setting in Indonesia

Osteoarthritis (OA) is a degenerative disease often found in the elderly population. This disease is characterized by joint cartilage damage that causes pain and disability. Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the commonly used pharmacological therapies to manage pain in OA patients. However, the use of NSAIDs in the elderly requires special attention due to the risk of side effects, including gastrointestinal, cardiovascular and renal disorders. This study aimed to assess the pattern of NSAID use in elderly OA patients at the Lasi Community Health Center. This study used a descriptive observational method with prospective data from 111 patients during March-May 2019. The results showed that ibuprofen was the most commonly used NSAID (19.8%), followed by diclofenac (10.8%). Most patients received doses according to standard therapy. However, there were some cases of mild side effects such as dyspepsia (3.6%) and constipation (2.7%). This study emphasizes the importance of close monitoring of NSAID use in the elderly to optimize therapy and minimize the risk of side effects.

P-22 INSIDIOUS, RARE, AND MIMICKING BONE DISEASE: PROGRESSIVE PSEUDORHEUMATOID DYSPLASIA

Abstract Introduction Progressive pseudorheumatoid dysplasia (PPD) is a rare autosomal recessive skeletal dysplasia that primarily affects joint cartilage, leading to progressive stiffness and enlargement without inflammation. Symptoms typically manifest between ages 3 and 6. Here we report a case of PPD with a prolonged undiagnosed period, despite early symptom onset. Clinical Case A 43-year-old female office manager presented with significant joint mobility limitations and walking difficulties. Her medical history revealed that she first sought medical attention at the age of two due to leg deformities, where genu varum was detected and initially treated as rickets with vitamin D supplementation. At ages 7 and 9, the patient underwent limb lengthening and corrective surgeries for bilateral lower extremity deformities. By age 12, worsening gait required assistive devices. At age 33, a right femoral head fracture necessitated prosthesis implantation, followed by a similar procedure on the left hip at age 36. In the last five years, mobility limitations and pain in the left shoulder and knee have increased. Her medical history was otherwise unremarkable, though her parents were noted to be consanguineous. Physical exam revealed 147 cm height and significant scoliosis. Flexion contractures were observed in the proximal and distal interphalangeal joints of both hands, along with significant mobility limitations in the metacarpophalangeal joints, wrists, and elbows, especially in extension. Additionally, there was limited extension in both knees, more severe on the left, and contractures in the left ankle. No signs of arthritis were present. Laboratory results showed a 25-OH Vitamin D level of 17.53 µg/L, leading to replacement therapy initiation. Acute phase reactants were normal. Radiographic imaging (Figure 1) showed osteoporotic bones, platyspondyly, scoliosis, vertebral endplate irregularities, narrowed disc spaces, and peripheral osteophytes in the vertebral column. Furthermore, epiphyseal enlargement, uniform joint space narrowing, irregular joint surfaces, and periarticular osteopenia were observed bilaterally in the shoulders, elbows, knees, ankles, radiocarpal, midcarpal, carpometacarpal, metacarpophalangeal, and interphalangeal joints. Despite these findings, bone mineral density (BMD) of the L1-L4 vertebrae measured 1.337 g/cm² (Z-score: 1.2) via dual-energy X-ray absorptiometry (DEXA). Based on the clinical, laboratory, and imaging findings, a diagnosis of PPD was established, and the patient was referred for physical therapy and rehabilitation. Conclusion This case illustrates a patient with PPD, marked by significant involvement of the hand joints, large joints, and spine, accompanied by short stature. Patients with PPD are frequently undiagnosed or misdiagnosed. The absence of inflammatory features is crucial in distinguishing PPD from juvenile idiopathic arthritis. The lack of extraskeletal involvement further characterizes this disease.Figure 1Figure 1a shows osteoporotic bones, platyspondyly, scoliosis, vertebral endplate irregularities, narrowed disc spaces, and peripheral osteophytes in the vertebral column. Figure 1b and 1c show epiphyseal enlargement, uniform joint space narrowing, irregular joint surfaces, and periarticular osteopenia in both knees and hands.

Recent advances in osteoarthritis research: A review of treatment strategies, mechanistic insights, and acupuncture.

Osteoarthritis (OA) is a chronic joint condition affecting millions worldwide, characterized by the gradual degeneration of joint cartilage, leading to pain, stiffness, and functional impairment. Although the pathogenesis of OA is not fully understood, the roles of inflammation, metabolic dysregulation, and biomechanical stress are increasingly recognized. Current treatments, including pharmacotherapy, physical therapy, and surgical interventions, aim to alleviate symptoms and improve quality of life, yet they face limitations and challenges. In recent years, researchers have explored a variety of new treatment strategies, such as molecular targeted therapy, biologic treatments, regenerative medicine, and lifestyle modifications, aiming to directly address the root causes and complex mechanisms of OA. This review aims to summarize the latest research advancements to provide fresh perspectives for clinical treatment and lay the foundation for future research and development of treatment strategies for OA.

Remodeling the Proinflammatory Microenvironment in Osteoarthritis through Interleukin-1 Beta Tailored Exosome Cargo for Inflammatory Regulation and Cartilage Regeneration.

Osteoarthritis (OA) presents a significant therapeutic challenge, with few options for preserving joint cartilage and repairing associated tissue damage. Inflammation is a pivotal factor in OA-induced cartilage deterioration and synovial inflammation. Recently, exosomes derived from human umbilical cord mesenchymal stem cells (HucMSCs) have gained recognition as a promising noncellular therapeutic modality, but their use is hindered by the challenge of harvesting a sufficient number of exosomes with effective therapeutic efficacy. Given that HucMSCs are highly sensitive to microenvironmental signals, we hypothesized that priming HucMSCs within a proinflammatory environment would increase the number of exosomes secreted with enhanced anti-inflammatory properties. Subsequent miRNA profiling and pathway analysis confirmed that interleukin-1 beta (IL-1β)-induced exosomes (C-Exos) exert positive effects through miRNA regulation and signaling pathway modulation. In vitro experiments revealed that C-Exos enhance chondrocyte functionality and cartilage matrix production, as well as macrophage polarization, thereby enhancing cartilage repair. C-Exos were encapsulated in hyaluronic acid hydrogel microspheres (HMs) to ensure sustained release, leading to substantial improvements in the inflammatory microenvironment and cartilage regeneration in a rat OA model. This study outlines a strategy to tailor exosome cargo for anti-inflammatory and cartilage regenerative purposes, with the functionalized HMs demonstrating potential for OA treatment.

Comparative effectiveness of intraarticular injection of PRP and implantation of heparin-conjugated fibrin hydrogel in osteoarthrosis of the knee joint

Aim of the study. The article is devoted to the current trend of modern orthopedics – the surgical treatment of local full-thickness defects in the hyaline cartilage of the knee joint. This pathology is diagnosed in 5-10% of patients with diseases and injuries of the knee joint.Materials and methods. The authors of the article presented one of the most modern and available technologies for the restoration of cartilage defects – the implantation of Heparin-Conjugated Fibrin Hydrogel. This operation technique was used in 38 patients. The article presents the indications and technique of surgery, criteria for evaluating treatment outcomes.Results and discussion. Treatment outcomes in terms of up to 2 years were studied in 38 patients. Good treatment results were observed in 33 patients. In all cases, high-quality and regeneration of the cartilaginous surface of the femoral condyles was achieved.Conclusion. Analysis of the outcomes of treatment of patients after implantation implantation of Heparin- Conjugated Fibrin Hydrogel allows the authors of the article to recommend this technique for widespread use in clinical practice.

Long-Term Efficacy of Carboxymethyl-Chitosan in Advanced Knee Osteoarthritis: A Twelve-Month Follow-Up Study on Non-Responders to Hyaluronic Acid

Background: Knee osteoarthritis (OA) is a prevalent degenerative joint disease characterized by the degeneration of joint cartilage. Knee OA leads to pain, stiffness, swelling, and decreased mobility, significantly impacting the quality of life of affected people. Advanced-stage osteoarthritis often necessitates surgical intervention due to poor response to conventional treatments, such as intra-articular hyaluronic acid (HA). Carboxymethyl-chitosan (CM-C), an emerging therapeutic agent, has shown potential in reducing inflammation, improving lubrication, and enhancing joint function. This study aimed to evaluate the long-term efficacy of CM-C injections in patients with advanced knee osteoarthritis, non-responders to HA. Methods: This retrospective study included 16 patients (mean age: 79.56 years) with Kellgren–Lawrence grade 3–4 knee OA treated with a single intra-articular injection of CM-C. Pain and functional outcomes were assessed using the Visual Analogue Scale (VAS) and Knee Injury and Osteoarthritis Outcome Score (KOOS) at baseline (T0), one month (T1), three months (T2), six months (T3), and twelve months (T4). Results: Significant pain reduction was observed at early follow up, (VAS: T1 p = 0.0002, T2 p = 0.0265; KOOS Pain: T1 p = 0.0014). However, pain partially returned by T3 and T4. KOOS activities of daily living (p = 0.0005), QoL (p = 0.0396), and Sport and Free Time (p = 0.0367) subscales showed significant improvement at T1, though worsening trends were observed in subsequent follow up with raw values suggesting persistent benefits. Strong negative correlations were found between VAS and KOOS subscales at various follow ups. Conclusions: A single CM-C injection demonstrated early pain relief and functional improvement in advanced knee OA for non-responders to HA. However, the long-term effects may diminish over time, necessitating a careful consideration of re-treatment strategies or combined therapies.

Curcumin and Vitamin D Supplement Attenuates Knee Osteoarthritis Progression in ACLT + MMx Rat Model: Effect on Cartilage Protection and Pain Reduction.

Background: Knee osteoarthritis (OA) is a common and debilitating disorder marked by joint degradation, inflammation, and persistent pain. This study examined the possible therapeutic effects of curcumin and vitamin D on OA progression and pain in a rat knee OA model by anterior cruciate ligament transection and meniscectomy (ACLT + MMx). Methods: Male Wistar rats were categorized into five groups: control, curcumin-treated (100 mg/kg/day), vitamin D-treated (25 µg/kg/day), a combination of vitamin D and curcumin, and sham-operated. All supplements were administered orally on a daily basis for 12 weeks. Pain behaviors were assessed, serum biomarkers were measured, and knee histology was examined. Results: Both curcumin and vitamin D independently reduced pain, while the combined group exhibited better analgesic effects. Serum inflammatory cytokines demonstrated a decrease in pro-inflammatory cytokines and an elevation in anti-inflammatory cytokine interleukin-10 (IL-10) in the supplement groups. The antioxidative markers were partially recovered by curcumin and vitamin D supplement. However, the oxidative stress marker Cartilage Oligomeric Matrix Protein (COMP) was significantly reduced. Histology analysis revealed a preservation of joint architecture and cartilage integrity and decreased synovium inflammation in the groups treated with curcumin and vitamin D. Conclusions: Our findings indicate a dual mechanism that encompasses the role of anti-inflammation and antioxidation on knee OA progression and pain reduction, underscoring the potential of these natural chemicals as therapeutic agents for knee OA; curcumin and vitamin D supplement may be added in delaying knee OA progression and associated pain management in clinical patient care.

Effect of Open-Wedge High Tibial Osteotomy and Lateral Retinacular Release on the Articular Cartilage of the Patellofemoral Joint: Analysis Using Magnetic Resonance Imaging T2 Mapping.

Background/Objectives: After open-wedge high tibial osteotomy (OWHTO), the patella is displaced distally, causing patellofemoral joint degeneration. The objective of this study was to ascertain whether the combination of OWHTO and lateral retinacular release (LRR) can prevent articular cartilage degeneration of the patellofemoral joint using magnetic resonance imaging T2 mapping. Methods: This study included 37 patients (37 knees) who underwent OWHTO alone (OWHTO group) and 37 patients (37 knees) who underwent OWHTO with LRR (OWHTO + LRR group) with a correction angle of <10° for varus knee osteoarthritis. MRI was performed on all knees prior to and 6 months after surgery to assess the patellar cartilage in sagittal images for T2 mapping. Three regions of interest, (the medial facet, patellar ridge, and lateral facet), were established for the articular cartilage on the patellar side. The T2 values were subsequently quantified. Lower limb alignment, patellar height, patellar tilt angle, and lateral shift ratio were evaluated pre-and post-surgery. Results: Mean T2 values at 6 months post-surgery of the medial facet and patellar ridge of the OWHTO group showed a significant increase after surgery; no significant changes were observed in either region in the OWHTO + LRR group. In both groups, a significant decrease in patellar tilt angle was observed postoperatively; no change was noted in the lateral shift ratio or congruence angle. The change in patellar tilt angle was significantly lower in the OWHTO + LRR group than in the OWHTO group. Conclusions: LRR combined with OWHTO prevented patellofemoral joint cartilage degeneration after surgery in cases of varus knee osteoarthritis.

Sequential Targeting Chondroitin Sulfate-Bilirubin Nanomedicine Attenuates Osteoarthritis via Reprogramming Lipid Metabolism in M1 Macrophages.

The infiltration and excessive polarization of M1 macrophages contribute to the induction and persistence of low-grade inflammation in joint-related degenerative diseases such as osteoarthritis (OA). The lipid metabolism dysregulation promotes M1 macrophage polarization by coordinating the compensatory pathways of the inflammatory and oxidative stress responses. Here, a self-assembling, licofelone-loaded nanoparticle (termed LCF-CSBN), comprising chondroitin sulfate and bilirubin joined by an ethylenediamine linker, is developed to selectively reprogram lipid metabolism in macrophage activation. LCF-CSBN is internalized by M1 macrophages via CD44-mediated endocytosis and targets the Golgi apparatus accompanied with the reactive oxygen species-responsive release of licofelone (LCF, dual inhibitor of arachidonic acid metabolism). LCF-CSBN effectively promotes M1 to M2 macrophage transition by reprogramming the Golgi apparatus-related sphingolipid metabolism and arachidonic acid metabolism. Intra-articularly injected LCF-CSBN retains in the joint for up to 28 days and accumulates into M1 macrophages. Moreover, LCF-CSBN can effectively attenuate joint inflammation, oxidative stress, and cartilage degeneration in OA model rats. These findings indicate the promising potential of lipid-metabolism-reprogramming LCF-CSBN in the targeted therapy of OA.

Swin UNETR Segmentation with Automated Geometry Filtering for Biomechanical Modeling of Knee Joint Cartilage.

Simulation studies, such as finite element (FE) modeling, offer insights into knee joint biomechanics, which may not be achieved through experimental methods without direct involvement of patients. While generic FE models have been used to predict tissue biomechanics, they overlook variations in population-specific geometry, loading, and material properties. In contrast, subject-specific models account for these factors, delivering enhanced predictive precision but requiring significant effort and time for development. This study aimed to facilitate subject-specific knee joint FE modeling by integrating an automated cartilage segmentation algorithm using a 3D Swin UNETR. This algorithm provided initial segmentation of knee cartilage, followed by automated geometry filtering to refine surface roughness and continuity. In addition to the standard metrics of image segmentation performance, such as Dice similarity coefficient (DSC) and Hausdorff distance, the method's effectiveness was also assessed in FE simulation. Nine pairs of knee cartilage FE models, using manual and automated segmentation methods, were developed to compare the predicted stress and strain responses during gait. The automated segmentation achieved high Dice similarity coefficients of 89.4% for femoral and 85.1% for tibial cartilage, with a Hausdorff distance of 2.3mm between the automated and manual segmentation. Mechanical results including maximum principal stress and strain, fluid pressure, fibril strain, and contact area showed no significant differences between the manual and automated FE models. These findings demonstrate the effectiveness of the proposed automated segmentation method in creating accurate knee joint FE models. The automated models developed in this study have been made publicly accessible to support biomechanical modeling and medical image segmentation studies ( https://data.mendeley.com/datasets/dc832g7j5m/1 ).

Identification of a novel disulfidptosis-related gene signature in osteoarthritis using bioinformatics analysis and experimental validation

Osteoarthritis (OA) is a degenerative bone disease characterized by the destruction of joint cartilage and synovial inflammation, involving intricate immune regulation processes. Disulfidptosis, a novel form of programmed cell death, has recently been identified; however, the effects and roles of disulfidptosis-related genes (DR-DEGs) in OA remain unclear. We obtained six OA datasets from the GEO database, using four as training sets and two as validation sets. Differential expression analysis was employed to identify DR-DEGs, and unique molecular subtypes of OA were constructed based on these DR-DEGs. Subsequently, the immune microenvironment of OA patients was comprehensively analyzed using the “CIBERSORT” algorithm for immune infiltration. Various machine learning algorithms were utilized to screen characteristic DR-DEGs, and nomogram models and ROC curves were built based on these genes. The scRNA dataset (GSE169454) was used to classify chondrocytes in OA samples into distinct cell types, further exploring the gene distribution and correlation of characteristic DR-DEGs with specific cell subpopulations. Moreover, the expression levels of four characteristic DR-DEGs were validated through OA cell models and rat models. In our study, we identified 10 DR-DEGs with significant differences in expression within OA samples. Based on these DR-DEGs, two distinct molecular subtypes were recognized (cluster 1 and 2). ZNF484 and NDUFS1 were found to be significantly overexpressed in subtype 1, while the infiltration abundance of activated mast cells was markedly elevated in subtype 2. Moreover, significant differences were observed in the infiltration proportions of 11 immune cell types between OA and control samples, with 9 DR-DEGs demonstrating substantial correlations with immune cell infiltration levels. Further analysis of the scRNA dataset revealed that SLC3A2 and NDUFC1 were predominantly expressed in the preHTC subpopulation. All 10 DR-DEGs exhibited notably higher expression in the EC subpopulation across various cell types. The proportion of EC subgroups with high SLC3A2 expression increased, mainly enriching pathways related to inflammation, such as the IL-17 signaling pathway and TGF-beta signaling pathway. Using machine learning, we identified four characteristic DR-DEGs, which, in combination with the nomogram and ROC models, demonstrated promising performance in the diagnosis of OA. Additionally, in vivo validation confirmed a significant elevation of PPM1F expression in OA models. This study identified DR-DEGs as potential biomarkers for the diagnosis and classification of OA and provided a preliminary understanding of their role in the immune microenvironment. However, further experimental and clinical studies are required to validate their diagnostic value and therapeutic potential.

Research progress of Sinomenium in the treatment of rheumatoid arthritis and suggestions for future research.

Rheumatoid arthritis (RA) is a chronic autoimmune joint disease. Its main pathological manifestations are joint cartilage, bone tissue injury, synovial hyperplasia, and chronic inflammation. At present, the pathogenesis of the disease has not been fully defined, and delaying the disease to improve joint function is the existing treatment. Sinomenium (SIN) is an effective ingredient in Sinomenium acutum (Thunb.) Rehd. et Wils., with anti-inflammatory, analgesic, immunosuppressive, anti-tumor, and other pharmacological activities, which is quite effective in the treatment of RA. There are many SIN compound preparations in the market, such as Zhengqing Fengtongning capsule, Zhubi Huoluo prescription, and Qinxitong tablet. They all exhibit good anti-RA effect with less adverse reactions. This study summarized the mechanism of action of SIN in the treatment of RA and further explored the possibility of SIN in the treatment of RA combined with other diseases for future research.

Senolytics Cocktail Dasatinib and Quercetin alleviate chondrocyte senescence and facet joint osteoarthritis in mice

Background contextLow back pain (LBP) is a pervasive issue, causing substantial economic burden and physical distress worldwide. Facet joint osteoarthritis (FJ OA) is believed to be a significant contributor to this problem. However, the precise role of chondrocyte senescence in FJ OA remains unclear, as does whether the clearance of chondrocyte senescence can alleviate the progression of FJ OA. PurposeThe goal of this study was to understand the potential of Dasatinib (D) and Quercetin (Q) as a treatment to clear chondrocyte senescence during the progression of FJ OA. Study designWe used a preclinical bipedal standing mice model with the administration of Dasatinib (D) (5 mg/kg) and Quercetin (Q) (50 mg/kg) after 10 weeks of bipedal standing. Materials and methodsHuman degenerative lumbar facet joint (LFJ) samples were obtained to investigate the relationship between chondrocyte cellular senescence and LFJ osteoarthritis (OA). Subsequently, we established an in vitro model of excessive mechanical stress on chondrocytes and an in vivo bipedal standing mice model to induce LFJ OA. IHC (immunohistochemistry) staining in vivo and SA-β-gal staining, qRT-PCR and Western blot analysis were applied to test the senolytic effect of the combination of Dasatinib (D) and Quercetin (Q). IHC staining and X-ray microscope were also performed to examine the contribution of D+Q to the anabolism in cartilage and subchondral bone recoupling. Immunofluorescence and Western blot analysis in vitro and IHC staining in vivo were conducted to assess the impact of D+Q on the regulation of the NF-κB pathway activation during chondrocyte senescence. ResultsWe observed that facet joint cartilage degeneration is associated with chondrocyte cellular senescence in both human and mouse degenerative samples. Following treatment with D+Q in vitro, cellular senescence was significantly reduced. Upon oral gavage administration of D+Q in the bipedal standing mice model, decreased cellular senescence and reversed chondrocyte anabolism were observed. Furthermore, administration of D+Q maintained subchondral bone remodeling homeostasis and potentially reversed the activation of the NF-κB pathway in chondrocytes of the lumbar facet joint. ConclusionsIn summary, our investigation unveiled a significant correlation between chondrocyte senescence and LFJOA. Treatment with the senolytic combination of D+Q in FJ OA yielded a notable reduction in chondrocyte senescence, along with a decrease in the release of SASP factors. Additionally, it facilitated the promotion of cartilage anabolism, maintenance of subchondral bone coupling, and amelioration of NF-κB pathway activation. Clinical significanceOur outcomes revealed that D+Q, the renowned combination used for senolytic treatment, alleviate the progression of LFJ OA. The utilization of D+Q as a senolytic demonstrates a novel and promising alternative for LFJ OA treatment.

T2 Mapping of Articular Cartilage of the Adult Knee Joint: Changes in the Relaxation Time and Thickness of Knee Cartilage with Age among Normal Adult Patients in 3 Tesla MRI

Abstract Background Degenerative joint disease, such as osteoarthritis, is characterized by the breakdown of cartilage in the joints, resulting in a decreased range of motion and stiffness. The T2 mapping approach is a very useful tool for detecting early osteoarthritis. The main goal of the study was to assess the variations in the relaxation time and articular cartilage thickness of knee cartilage across different age groups among healthy adults using the T2 mapping technique in 3 Tesla magnetic resonance imaging. Methods A total of 42 measurements were taken from each individual's knee cartilage and were confirmed to have no cartilage damage. The relaxation time was calculated from T2 maps using 21 circular regions of interest and the articular cartilage thickness was measured using 21 linear measurements from a self-created fusion image. The thickness was measured in the same regions where the relaxation time was measured. Overall, 2,142 measurements (1,071 circular regions of interest from T2 maps and 1,071 linear measurements from fusion images) were taken from 51 participants. Results The majority of the variables of T2 relaxation time show a positive linear correlation with age groups. As age increases, cartilage relaxation time increases, which may be connected to an increase in cartilage degeneration. However, half of the variables associated with knee cartilage thickness show a negative linear correlation with age group. As age increases, the thickness of the cartilage starts to decrease. T2 relaxation times of the middle lateral tibial condyle, middle superior patella, and central inferior patella differ significantly between healthy males and females (p &lt; 0.05). The cartilage thickness of the posterior lateral tibial condyle, middle medial patella, central superior patella, central middle patella, and lateral middle patella varied significantly between healthy males and females (p &lt; 0.05). Conclusion Using an additional T2 articular cartilage mapping sequence to a routine sequence in the knee joint can reveal age-related changes in relaxation time and cartilage thickness in knee cartilage. The T2 mapping technique also can help detect early changes in osteoarthritis, track progression, and plan treatment.

Radiographic findings and body mass index in elderly patients with knee osteoarthritis: A cross-sectional study

Background: Osteoarthritis (OA) is a chronic condition characterized by the gradual wearing down of joint cartilage. Its prevalence is increasing due to aging populations and obesity rates. The Kellgren and Lawrence classification system is commonly used to assess OA severity based on radiologic findings.Objective: This study aims to determine the relationship between body mass index (BMI) and the radiological severity of knee OA as classified by the Kellgren and Lawrence system, in elderly patients.Methods: We conducted a cross-sectional analysis of outpatients diagnosed with knee OA at a Dr. Moewardi Regional Public Hospital from January 2020 to August 2023. Patient records and knee X-rays graded by the Kellgren and Lawrence system were reviewed. Two radiologists independently assessedthe X-rays to ensure accuracy. BMI was calculated using the formula weight (kg) divided by height (m2), with weight and height measured suing calibrated instruments. Spearman's rho bivariate correlation analysis was performed to analyze the data.Results: A total of 96 patients were analyzed, with the majority being female (62.50%) and aged 60-69 years (59.30%). The most prevalent OA severity was grade 3 (46.89%), and the most common OA location was bilateral (73.96%). There was a significant moderate correlation between Kellgren &amp; Lawrence and BMI (p=0.000; rho=0.401).Conclusion: A moderate correlation exists between the severity of knee OA and BMI in elderly patients. Those with a higher BMI tend to present with more severe OA.

Direct Scaffold-Coupled Electrical Stimulation of Chondrogenic Progenitor Cells through Graphene Foam Bioscaffolds to Control Mechanical Properties of Graphene Foam - Cell Composites.

Osteoarthritis, a major global cause of pain and disability, is driven by the irreversible degradation of hyaline cartilage in joints. Cartilage tissue engineering presents a promising therapeutic avenue, but success hinges on replicating the native physiological environment to guide cellular behavior and generate tissue constructs that mimic natural cartilage. Although electrical stimulation has been shown to enhance chondrogenesis and extracellular matrix production in 2D cultures, the mechanisms underlying these effects remain poorly understood, particularly in 3D models. Here, we report that direct scaffold-coupled electrical stimulation applied to 3D graphene foam bioscaffolds significantly enhances the mechanical properties of the resulting graphene foam - cell constructs. Using custom 3D-printed electrical stimulus chambers, we applied biphasic square impulses (20, 40, 60 mVpp at 1 kHz) for 5 minutes daily over 7 days. Stimulation at 60 mVpp increased the steady-state energy dissipation and equilibrium modulus by approximately 65% and 25%, respectively, compared to unstimulated controls, while also yielding the highest cell density among stimulated samples. In addition, our custom chambers facilitated full submersion of the hydrophobic graphene foam in media, leading to enhanced cell attachment and integration across the scaffold surface and within its hollow branches. To assess this cellular integration, we employed co-localized confocal fluorescence microscopy and X-ray microCT imaging enabled by colloidal gold nanoparticle and fluorophore staining, which allowed visualization of cell distribution within the opaque scaffold's internal structure. These findings highlight the potential of direct scaffold-coupled electrical stimulus to modulate the mechanical properties of engineered tissues and offer new insights into the emergent behavior of cells within conductive 3D bioscaffolds.

Sliding Hydrogels Reveal the Modulation of Mechanosensing Attenuates the Inflammatory Phenotype of Osteoarthritic Chondrocytes in 3D

ABSTRACTOsteoarthritis (OA) is a prevalen degenerative joint disease with no FDA‐approved therapies that can halt or reverse its progression. Current treatments address symptoms like pain and inflammation, but not underlying disease mechanisms. OA progression is marked by increased inflammation and extracellular matrix (ECM) degradation of the joint cartilage. While the role of biochemical cues has been widely studied for OA, how matrix mechanical cues influence OA phenotype remains poorly understood. Using sliding hydrogels (SGs) as a tool, we examine how local matrix compliance in 3D modulates OA chondrocyte phenotype and associated mechanosensing. We demonstrate that local matrix compliance reduces the inflammatory phenotype of OA chondrocytes, as indicated by decreased gene expression of catabolic markers and proinflammatory cytokine secretion. This is achieved via significantly reduced nuclear NF‐κB expression and signaling in OA chondrocytes. Live cell imaging shows enhanced cellular and nuclear dynamics with increased matrix deformation in the compliant SG. Blocking cellular dynamics negates SG compliance‐induced benefits in reducing OA inflammatory phenotype. Further, SG alters nuclear mechanosensing in OA as indicated by increased nuclear lamin reinforcement and chromatin condensation. Finally, we demonstrate that a drug inhibiting histone lysine demethylase to modulate chromatin accessibility reduces OA inflammation in 3D hydrogels. These findings advance our understanding of how ECM mechanics regulate OA mechanobiology and progression and highlight potential disease‐modifying treatments via epigenetic and mechanosensing‐based therapies.

Chondrocyte-targeted bilirubin/rapamycin carrier-free nanoparticles alleviate oxidative stress and modulate autophagy for osteoarthritis therapy.

Osteoarthritis (OA) is a prevalent chronic disease, characterized by the destruction of joint cartilage and synovitis, affects over 7 % of people worldwide. Disease-modifying treatments for OA still face significant challenges. Chondrocytes, as the exclusive cellular component of articular cartilage, play a pivotal role in synthesizing the intricate matrix of cartilage, thereby assuming a critical responsibility in facilitating its renewal and repair processes. However, oxidative stress within chondrocytes and subsequent apoptotic cell death plays significant roles in the progression of OA. Therefore, targeting apoptosis inhibition and mitigation of oxidative stress in chondrocytes represents a promising therapeutic strategy for OA. This study develops a type II collagen-targeting peptide (WYRGRLC) modified bilirubin/rapamycin carrier-free nanoparticle (PP/BRRP) and evaluate its therapeutic potential for OA. The PP/BRRP system exhibits remarkable chondrocyte-targeting ability, enabling the rupture of highly oxidized chondrocytes and subsequent release of bilirubin and rapamycin. This dual payload effectively scavenges reactive oxygen species, triggers autophagy, and suppresses the mTOR pathway, thereby augmenting anti-inflammatory and anti-apoptotic effects. The in vivo experiments further validate the retention and therapeutic efficacy of PP/BRRP in rat joints affected by OA. Overall, PP/BRRP exhibits significant potential for intervention and treatment of OA.

A Standardized Boswellia serrata Extract Improves Knee Joint Function and Cartilage Morphology in Human Volunteers with Mild to Moderate Osteoarthritis in a Randomized Placebo-Controlled Study

Background and objective Boswellia serrata Roxb. ex Colebr. (Family: Burseraceae; Genus: Boswellia) gum resin (Salai guggul) has profound therapeutic value in Ayurvedic and Unani medicines in alleviating several chronic inflammatory illnesses, including arthritis, asthma, skin and blood diseases, fever, etc. SN13108F (Aflapin®) is a proprietary, standardized Boswellia serrata gum resin extract. This 180-day randomized, placebo-controlled clinical study aimed to evaluate cartilage morphology using magnetic resonance imaging (MRI), pain and joint function and long-term safety in the SN13108F-supplemented volunteers with knee osteoarthritis (KOA). Materials and methods Eighty adult male and female subjects with the Kellgren-Lawrence grade II - III KOA were supplemented with SN13108F (100 mg/day) or a matched placebo for 180 consecutive days. Results SN13108F reduced (p < 0.001; vs. baseline and placebo) Western Ontario and McMaster Universities Osteoarthritis Index, Visual Analogue Scale, Lequesne’s Functional Index scores, improved six-minute walk test, and stair climb test. Post-trial MRI assessments of the tibiofemoral joints revealed that the cartilage volume, thickness, and joint space width were increased (p < 0.001; vs. placebo), and levels of high-sensitivity C-reactive protein, matrix metalloproteinase-3, Fibulin-3, type II collagen degradation peptide in serum, and cross-linked C-terminal telopeptide of type II collagen in urine were significantly reduced (p < 0.001; vs. baseline and placebo) in the SN13108F-supplemented subjects. Hematology, complete serum biochemistry, urine analysis, and the participants’ vital signs did not alter between the groups. Conclusion SN13108F supplementation is safe, and it mitigates joint pain and improves musculoskeletal function and cartilage morphology in KOA.