Joint Changes Research Articles

Preventive and therapeutic effects of low-dose whole-body irradiation on collagen-induced rheumatoid arthritis in mice.

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by progressive joint inflammation, resulting in cartilage destruction and bone erosion. It was reported that low-dose radiation modulates immune disease. Here, we investigated whether low-dose whole-body irradiation has preventive and therapeutic effects in collagen-induced RA (CIA) mouse models. Fractionated low-dose irradiation (0.05Gy/fraction, total doses of 0.1, 0.5 or 0.8Gy) was administered either concurrently with CIA induction by Type II collagen immunization (preventive) or after CIA development (therapeutic). The severity of CIA was monitored using two clinical parameters, paw swelling and redness. We also measured total Immunoglobulin G (IgG) and inflammatory cytokines (interleukine (IL)-6, IL-1β and tumor necrosis factor-alpha (TNF-α)) in the serum by enzyme-linked immunosorbent assay, and we evaluated histological changes in the ankle joints by immunohistochemistry and hematoxylin and eosin staining. Low-dose irradiation reduced CIA clinical scores by up to 41% in the preventive model and by 28% in the therapeutic model, while irradiation in the preventive model reduced the typical CIA incidence rate from 82 to 56%. In addition, low-dose irradiation in the preventive model decreased total IgG by up to 23% and decreased IL-1β and TNF-α by 69 and 67%, and in the therapeutic model, decreased total IgG by up to 35% and decreased IL-1β and IL-6 by 59 and 42% with statistical significance (P < 0.01, 0.05 and 0.001). Our findings demonstrate that low-dose radiation has preventive and therapeutic anti-inflammatory effects against CIA by controlling the immune response, suggesting that low-dose radiation may represent an alternative therapy for RA, a chronic degenerative immune disease.

Admitting a patient with musculoskeletal pain following COVID-19 disease

A significant proportion of patients who have had COVID-19 continue to suffer from persistent symptoms such as severe weakness, shortness of breath, joint pain, mood swings and memory impairment during the recovery phase. More than half of the patients experienced joint pain for the first time after recovery from COVID-19. Three months after COVID-19 episode, joint pain continued to occur in more than a third of patients. We observed a 47-year-old patient with moderate shoulder pain that occurred for the first time after COVID-19. The examination also revealed changes in the hip joint. The diagnosis was made: post-COVID syndrome with reactive arthritis of the left shoulder joint, deforming osteoarthritis of the left hip joint stage I, degenerative-dystrophic changes in the lumbosacral spine, lower back pain. The therapy was prescribed – Chondroguard® intramuscularly every other day according to the following scheme: the first three injections (day 1, 3, and 5) 1 ml (100 mg), then, from the fourth injection (day 7) – 2 ml (200 mg) every other day, a course of 30 injections. Positive dynamics were achieved. No adverse events were noted during the treatment. The patient continued taking the nutraceutical Chondroguard® TRIO orally for 2 months. During the observational period, no adverse events were noted. Thus, in cases where post COVID-19 musculoskeletal pain is caused by joint involvement, chondroprotective therapy is effective: stage 1 – injections, stage 2 – oral therapy.

Surgical treatment of massive rotator cuff tears (literature review)

The prevalence of rotator cuff tears according to the literature ranges from 20 % to 40 %, and this injury occurs more often in people over 60 years of age. Massive rotator cuff tears account for 10–40 % of all rotator cuff tears. Massive rotator cuff tears are considered to be tears with a diastasis of more than 5 cm or tears involving two or more tendons. With such injuries, the kinematics of the shoulder joint changes: proximal subluxation of the humeral head and arthropathy of the shoulder joint occur, which subsequently causes pseudoparalysis. The main clinical manifestations are pain and dysfunction of the shoulder joint. Patients may experience a loss of active range of motion in the shoulder joint while maintaining passive range of motion. There is currently no unified approach to the choosing the tactics for surgical treatment. The most common options include partial rotator cuff repair, subacromial balloon plasty, replacement of tendon defects with allografts and autografts, proximal shoulder joint capsule plasty, muscle-tendon transfers, and shoulder joint arthroplasty. However, according to the literature data, the frequency of re-ruptures after surgery ranges from 11 % to 94 %. Despite the large number of methods for the treatment of massive rotator cuff tears, there are no clear algorithms for managing patients and choosing one or another surgical tactics. In addition, there is a high percentage of unsatisfactory outcomes of treatment. Taking all of these factors into account, the problem of improving the treatment of patients with massive rotator cuff tears remains relevant and timely.

Two-stage video-based convolutional neural networks for adult spinal deformity classification.

Assessment of human gait posture can be clinically effective in diagnosing human gait deformities early in life. Currently, two methods-static and dynamic-are used to diagnose adult spinal deformity (ASD) and other spinal disorders. Full-spine lateral standing radiographs are used in the standard static method. However, this is a static assessment of joints in the standing position and does not include information on joint changes when the patient walks. Careful observation of long-distance walking can provide a dynamic assessment that reveals an uncompensated posture; however, this increases the workload of medical practitioners. A three-dimensional (3D) motion system is proposed for the dynamic method. Although the motion system successfully detected dynamic posture changes, access to the facilities was limited. Therefore, a diagnostic approach that is facility-independent, has low practice flow, and does not involve patient contact is required. We focused on a video-based method to classify patients with spinal disorders either as ASD, or other forms of ASD. To achieve this goal, we present a video-based two-stage machine-learning method. In the first stage, deep learning methods are used to locate the patient and extract the area where the patient is located. In the second stage, a 3D CNN (convolutional neural network) device is used to capture spatial and temporal information (dynamic motion) from the extracted frames. Disease classification is performed by discerning posture and gait from the extracted frames. Model performance was assessed using the mean accuracy, F1 score, and area under the receiver operating characteristic curve (AUROC), with five-fold cross-validation. We also compared the final results with professional observations. Our experiments were conducted using a gait video dataset comprising 81 patients. The experimental results indicated that our method is effective for classifying ASD and other spinal disorders. The proposed method achieved a mean accuracy of 0.7553, an F1 score of 0.7063, and an AUROC score of 0.7864. Additionally, ablation experiments indicated the importance of the first stage (detection stage) and transfer learning of our proposed method. The observations from the two doctors were compared using the proposed method. The mean accuracies observed by the two doctors were 0.4815 and 0.5247, with AUROC scores of 0.5185 and 0.5463, respectively. We proved that the proposed method can achieve accurate and reliable medical testing results compared with doctors' observations using videos of 1 s duration. All our code, models, and results are available at https://github.com/ChenKaiXuSan/Walk_Video_PyTorch. The proposed framework provides a potential video-based method for improving the clinical diagnosis for ASD and non-ASD. This framework might, in turn, benefit both patients and clinicians to treat the disease quickly and directly and further reduce facility dependency and data-driven systems.

Influence of running on femoroacetabular joint bone-to-bone distances.

There is limited data quantifying the influence of running on hip cartilage mechanics. The goal of this investigation was to quantify changes in hip joint bone-to-bone distance in response to a 3-mile treadmill run. We acquired magnetic resonance (MR) images of the dominant hip of eight young, asymptomatic runners (five males, three females) before and immediately after they ran 3 miles at a self-selected pace on a level treadmill. The femoral heads and acetabula were semiautomatically segmented from the pre- and post-exercise MR images to generate three-dimensional models of each participant's hip that were used to compute changes in the bone-to-bone distances incurred by the running exercise. We observed a significant 3% decrease in bone-to-bone distance from 3.47 ± 0.20 to 3.36 ± 0.22 mm between the femoral head and acetabulum after a 3-mile treadmill run (mean ± 95% confidence interval; p = 0.03). These findings provide new baseline data describing how running impacts the hip joint in young, asymptomatic runners.

Hip joint stress distribution changes depending on three-dimensional pelvic orientation: Finite-element analysis

BackgroundPelvis experiences changes in its orientation due to the alignment of the hip joint and spine, and its orientation might affect both joints. Pelvic tilt on the sagittal plane has been widely discussed; however, the pelvis is oriented also on the coronal and horizontal planes. This study aimed to examine how stress distribution on intact hip joint changes under the three-dimensional pelvic orientation. MethodsComputed tomography data of five patients with unilateral pelvic girdle were analyzed. Thirteen models were evaluated by the MECHANICAL FINDER: neutral position at 0°; 10° and 20° anterior and posterior pelvic tilt; 10° and 20° pelvic hike and drop; 10° and 20° pelvic forward and backward rotation. Stress assessment was performed in four parts of the acetabulum: anterosuperior, posterosuperior, posteroinferior, and central parts. ResultsCompared with the neutral position, the mean value of the equivalent stress and maximum principal stress in the anterosuperior part significantly increased by 1.51 times and 1.57 times at 20° posterior tilt, respectively. The maximum principal stress in the anterosuperior part significantly increased by 1.44 times at 20° hike. A significant increase of 1.45 times was found in the maximum principal stress in the anterosuperior part at 20° forward rotation. ConclusionsLocal stress accumulated in the anterosuperior acetabulum at the posterior pelvic tilt, pelvic hike, and pelvic forward rotation, which might lead to hip overload. The effect of posterior pelvic tilt appears to be greater for the hip joint than at the pelvic hike or forward rotation.

Multifidus Denervation After Radiofrequency Ablation of the Medial Nerve Alters the Biomechanics of the Spine-A Computational Study.

Radiofrequency ablation of the medial branch is commonly used to treat chronic low back pain involving facet joints, which accounts for 12% to 37% of the total cases of chronic low back pain. An adverse effect of this procedure is the denervation of the multifidus muscle, which may lead to its atrophy which can affect the spine and possibly disc degeneration. This study aims to quantify changes in joint angles and loading caused by multifidus denervation after radiofrequency ablation. AnyBody model of the torso was used to evaluate intervertebral joints in flexion, lateral bending, and torsion. Force-dependent kinematics was used to calculate joint angles and forces. These dependent variables were investigated in intact multifidus, unilateral, and bilateral ablations of L3L4, L4L5, and L5S1 joints. The results showed pronounced angular joint changes, especially in bilateral ablations in flexion, when compared with other cases. The same changes' trend from intact to unilaterally then bilaterally ablated multifidus occurred in joint angles of lateral bending. Meanwhile, joint forces were not adversely affected. These results suggest that multifidus denervation after radiofrequency ablation affects spinal mechanics. Such changes may be associated with abnormal tissue deformations and stresses that can potentially alter their mechanobiology and homeostasis, thereby possibly affecting the health of the spine.

Anti-Arthritis Effect of Ethanol Extract of Sacha Inchi (Plukenetia volubilis L.) Leaves Against Complete Freund's Adjuvant-Induced Arthritis Model in Mice.

Sacha inchi (Plukenetia volubilis L.) is a well-known oleaginous plant used as food source and traditional medicine by indigenous people for a long time. This study was conducted to evaluate anti-arthritis effect of ethanol extract of Sacha inchi leaves and provide scientific evidence to develop the new anti-arthritis remedy from Sacha inchi. Rheumatoid arthritis model was established by injection of complete Freund's adjuvant into right hind footpads of mice and three doses of ethanol extract of Sacha inchi leaves (100, 200 and 300 mg/kg body weight) were used for treatment. The severity of arthritis was evaluated by measuring the ankle diameter and arthritic score, hematological and biochemical parameters (erythrocytes, leukocytes, lymphocytes, monocytes, granulocytes counts, erythrocyte sedimentation rate, C-reactive protein and rheumatoid factor). The pro-and anti-inflammatory cytokines (TNF-α, INF-γ, IL-1β, IL-6, and IL-10) and the histology change of joint were also examined. All three doses of extracts significantly alleviated ankle diameter and arthritic score. Furthermore, the extracts could ameliorate the alternation of inflammatory cytokines as well histological features of CFA-induced mice. The efficacy of extract dose of 300 mg/kg body weight is comparable with reference drug (Mobic, 0.2 mg/kg body weight). This study indicates Sacha inchi leaf extract as the promising remedy for treatment of arthritis.

Highly sensitive strain sensors based on dispensing technology for human–machine interaction

Flexible strain sensors have stable and sensitive sensing performance under deformation conditions such as pressing, bending, and stretching. However, the preparation process of high-performance strain sensors is still very complex, which also limits the application and production of sensors. At the same time, most sensors are unstable and inefficient, so they cannot meet people’s expectations for high sensitivity and stability. In order to solve the above problems, this paper proposes a resistive strain sensor based on dispensing technology, with carbon black and polyurethane mixture as printing ink. Then, a sensor-sensitive layer with a right-angle serpentine structure is printed directly by air pressure extrusion. The sensor can detect changes at 0.1% strain and withstand 2400 tensile cycles while maintaining a sensitivity of 28.07 in the range of 0%–40%. In addition, the sensor can accurately and stably reflect the changes in different joints of the human body. At the same time, the data glove based on the strain sensor shows great application potential in the fields of gesture recognition and human–machine interaction.

Characterization of Joint Disease in Women with Hemophilia: The Carriers Ultrasound Project (CUP) Study

Introduction: Women with hemophilia (WWH) are at risk for bleeding despite normal or mildly reduced plasma factor VIII (FVIII) or IX (FIX) activity levels. Subclinical joint bleeds can contribute to longstanding and irreversible joint damage. Although joint health has been well-studied among men with hemophilia, there is currently a gap in knowledge on the prevalence, clinical characteristics, and natural history of joint health in women with hemophilia. No prior studies have utilized point-of-care musculoskeletal ultrasound (POC-MSKUS) to assess the presence and characteristics of joint changes in carrier women. Aim: This multi-institutional, cross-sectional study primarily aimed to evaluate and compare the prevalence and extent of joint-related symptoms and joint changes in WWH compared to age-matched controls utilizing validated clinical tools including the Hemophilia Early Arthropathy Detection with Ultrasound (HEAD-US) protocol. We also aimed to examine the relationship between innate FVIII and FIX levels and presence of joint disease changes in this population. Methods: Between 2017-2023, women aged 18 to 40 years were enrolled and divided in 2 cohorts. The “carrier cohort” included women with a confirmed hemophilia A or B diagnosis, regardless of factor activity level. The “control cohort” included women without personal or family history of a bleeding disorder. Individuals were excluded if they had history of joint trauma or surgery within 12 months prior to enrollment or any history of joint replacement. Collected clinical information included presence of bleeding symptoms, joint-related symptoms, and historical use of hemostatic medications. Participants underwent clinical and radiological assessment of bilateral elbows, knees, and ankles using the Hemophilia Joint Health Score (HJHS) and HEAD-US protocol. Factor activity levels were measured in the carrier cohort. Descriptive and interferential statistics were performed using SPSS software with p&amp;lt;0.05 considered statistically significant. Results: Fifty-eight women, including 30 controls (51.7%) and 28 carriers (48.3%) were enrolled. The mean age at enrollment was 30.7 years (range: 19-39 years). Most women were White (79.3%) and Hispanic (51.7%). Of the 28 carriers, 85.6% (n=24) were hemophilia A carriers and 14.3% (n=4) hemophilia B carriers, respectively ( TABLE 1). Among carriers, the mean and median factor activity levels were 56% and 54% (range 20-120%) respectively. Carriers reported significantly higher prevalence of bleeding symptoms when compared to controls, including heavy menstrual bleeding (64.3% vs. 10%, p&amp;lt;0.001), epistaxis (25% vs. 3.3%, p=0.017), gingival bleeding (25% vs. 3.3%, p=0.017), and easy bruising (50% vs. 3.3%, p&amp;lt;0.001). The majority (53.5%, n=15) of carriers reported presence of joint-related symptoms when compared to controls, including joint pain (50% vs. 3.3%, p&amp;lt;0.001) and joint swelling (28.6% vs. 0%, p=0.02). Three (10.7%) carriers reported history of overt joint bleeds. Carriers had significantly higher mean HJHS scores (4.7 vs. 1.5, p&amp;lt;0.001) than did controls, however no significant changes in HEAD-US scores were found. A high body mass index (BMI) (&amp;gt;25kg/m2) was significantly associated with an increased prevalence of joint bleeding (25% vs. 0%, p=0.03) among carriers. When dividing carriers in 2 groups based on their baseline factor activity level (&amp;gt;40% versus &amp;lt;40%), the prevalence of bleeding manifestations and joint-related symptoms were similar ( TABLE 2). Carriers with factor levels &amp;lt;40% were more likely to require factor replacement on-demand (60% vs. 17.4%, p=0.046) and anti-fibrinolytics (60% vs. 17.4%, p=0.046) than carriers with factor levels &amp;gt;40%. There were no changes in mean HJHS or mean HEAD-US scores among the two groups. Conclusions: Women with hemophilia are at increased risk of bleeding manifestations and joint-related symptoms, regardless of factor activity levels. This population also seems to have poorer joint health than do non-carrier women as assessed by HJHS. Dedicated follow-up to help prevent and treat joint-related complications among WWH seems imperative. Our study did not detect significant ultrasonographic joint changes in the carrier cohort. However, joint findings may become more evident later in life or when assessed with magnetic resonance imaging. Further long-term studies are needed to support our hypothesis.

Potentiating TRPA1 by Sea Anemone Peptide Ms 9a-1 Reduces Pain and Inflammation in a Model of Osteoarthritis.

Progressive articular surface degradation during arthritis causes ongoing pain and hyperalgesia that lead to the development of functional disability. TRPA1 channel significantly contributes to the activation of sensory neurons that initiate neurogenic inflammation and mediates pain signal transduction to the central nervous system. Peptide Ms 9a-1 from the sea anemone Metridium senile is a positive allosteric modulator of TRPA1 and shows significant anti-inflammatory and analgesic activity in different models of pain. We used a model of monosodium iodoacetate (MIA)-induced osteoarthritis to evaluate the anti-inflammatory properties of Ms 9a-1 in comparison with APHC3 (a polypeptide modulator of TRPV1 channel) and non-steroidal anti-inflammatory drugs (NSAIDs) such as meloxicam and ibuprofen. Administration of Ms 9a-1 (0.1 mg/kg, subcutaneously) significantly reversed joint swelling, disability, thermal and mechanical hypersensitivity, and grip strength impairment. The effect of Ms 9a-1 was equal to or better than that of reference drugs. Post-treatment histological analysis revealed that long-term administration of Ms9a-1 could reduce inflammatory changes in joints and prevent the progression of cartilage and bone destruction at the same level as meloxicam. Peptide Ms 9a-1 showed significant analgesic and anti-inflammatory effects in the model of MIA-induced OA, and therefore positive allosteric modulators could be considered for the alleviation of OA symptoms.

The effects of 12 weeks resistance training and vitamin D administration on neuromuscular joint, muscle strength and power in postmenopausal women

BackgroundThis study aimed to examine the effects of 12 weeks of resistance training (RT) and vitamin D (VitD) supplementation on muscle strength and C-terminal agrin fragment (CAF) and Neurotrophin-3 (NT-3) concentrations as potential biomarkers in postmenopausal women. MethodsThis was a randomized double-blind placebo-controlled study. Forty-four healthy postmenopausal women (55.84 ± 4.70 years and 29.61 ± 4.26 kg/m2) were randomly assigned into four groups: (1) Resistance training + placebo (RT + PLA), (2) Vitamin D supplementation (VitD), (3) Resistance training + vitamin D (RT + VitD), and (4) Placebo (PLA). VitD was supplemented as an oral capsule containing 50000 IU of cholecalciferol every two weeks. RT involved leg press, chest press, leg extension, leg curl, and shoulder press exercises, performed with 3–4 sets at 70–85 % of 1RM, three times a week. ResultsCirculating levels of CAF and NT-3 did not significantly change following the intervention period in the study groups (p > 0.05). There were significant increases in upper and lower body muscle strength and power for RT + VitD and RT + PLA ( < 0.05), but not for VitD or PLA (p > 0.05). The muscle function gains for RT + VitD and RT + PLA were higher than those for VitD and PLA but did not differ between them. Conclusion12-week of RT interventions resulted in significant increases in muscle strength and power in postmenopausal women. However, VitD supplementation did not result in any additional benefits. The positive changes in muscle function promoted by RT do not seem to be associated with changes in the neuromuscular joint via the CAF or NT-3 as potential biomarkers.

Impact dynamic response of large aperture space deployable antenna supporting structures based on a dual-scale model

This study investigates the joint damage patterns and changes in shape accuracy of large aperture space deployable antenna supporting structures subject to hypervelocity impacts from micro space debris. Based on the dual-scale method, a joint scale model is constructed for a hexagonal prismatic space deployable truss antenna supporting structure with an aperture of six meters and 37 modules. ANSYS/AUTODYN is used for the impact damage analysis, with an equivalent model of impact force integrating the structure's actual damage characteristics in the structure scale model. The dynamic response and deformation performance of the antenna supporting structure under impact velocities from 2.5 to 15.0 km/s, with spherical space debris of 2.5 mm and 5.0 mm diameters, impacting modular central points in both positive and negative directions, are analyzed. The results show that the primary damage to the joint scale model after impact includes cratering, perforation, punch failure, and joint failure. The debris diameter significantly influences joint damage and deformation of the bolt hole diameter. Additionally, the debris cloud post-impact significantly affects the vertical bar's inner wall, spalling the wall and reducing the rod's strength. As the impact point moves towards the structure's centroid, the antenna's overall response increases. With higher impact velocities, the antenna supporting structure's overall deformation first increases, then decreases. At an impact velocity of 12.5 km/s, the impact area of the structure gradually reduces post-impact. Our proposed joint damage forms and three-case damage classification (no effect, repairable, and joint failure) may serve as a valuable reference for designing structural protection and impact identification for space deployable antennas.

Muscle dynamics analysis by clustered categories during jogging in patients with anterior cruciate ligament deficiency

BackgroundPatients with anterior cruciate ligament (ACL) deficiency (ACLD) tend to have altered lower extremity dynamics. Little is known about the changes in dynamic function and activation during jogging in patients with ACLD.MethodsTwenty patients with an injured ACL before ACL reconstruction (ACLD group) and nine healthy male volunteers (control group) were recruited. Each volunteer repeated the jogging experiment five times. Based on the experimental data measured, a musculoskeletal multibody dynamics model was employed to simulate the tibiofemoral joint dynamics during jogging. Eighteen muscles were used for analysis. The obtained dynamics data were used for clustering and curve difference analysis.ResultsThe 18 muscles studied were divided into 3 categories. All the quadriceps, the soleus, the gastrocnemius, and the popliteus were classified as label 1. All the hamstrings were classified as label 2, and the sartorius muscles were classified as label 3. Among them, the classification of the short head of the biceps femoris was significantly different between the two groups (P < 0.001). The force curves of all 18 muscles and the between-group differences were studied according to clustered categories. Most muscle force in label 1 was approaching zero in the terminal stance phase, which was significantly lower than that in the control group (P < 0.05). The muscle force in label 2 had areas with significant differences in the stance phase. Muscle force in label 3 was significantly lower than that in the control group in the pre-swing phase.ConclusionsThis study showed that there are various changes of muscle function and activation in patients with ACLD. Through clustering and curve analysis, the joint reactions and changes of different muscle forces in the gait cycle between the ACLD and control groups could be further clarified.

Residual varus alignment after posterior-stabilized total knee arthroplasty limits medial soft tissue remodeling

BackgroundProper lower limb alignment and soft tissue balance are significant indicators to measure the success of total knee arthroplasty (TKA). Previous studies have confirmed that soft tissue relaxation around the knee after TKA will change over time; however, the relationship between lower limb alignment and soft tissue balance after TKA remains unclear. We studied (1) whether the change of soft tissue balance around the knee with time after posterior-stabilized (PS) TKA would affect the alignment of the lower limbs; (2) Whether the accuracy of lower limb alignment during PS TKA affects postoperative soft tissue remodeling.MethodsIn this study, 100 patients were recruited after PS TKA. Among them, 50 patients with a hip knee ankle (HKA) angle of ≤ ± 3° were set as the neutral group, and 50 patients with an HKA angle of > ± 3° were set as the deviation group. The imaging results measured the HKA angle before the operation as well as the HKA, varus, and valgus angles at 1, 3, 6, 12, and 24 months after TKA. Clinical assessment included range of motion (ROM), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee Society Score (KSS).ResultsEight people were excluded from the study. After the exclusion, the study enrolled 47 patients in the neutral group and 45 patients in the deviant group and were followed for up to 2 years. There was no statistical significance in mean varus angles as well as HKA angle changes during the follow-up phase of each groups (P > 0.05). The mean valgus angles of the patients in the neutral group group were 2.47°, 3.45°, 3.63°, 3.60° and 3.63°, and in the deviation group were 2.45° (P = 0.841), 2.88° (P < 0.001), 3.07° (P < 0.001), 3.06° (P < 0.001), and 3.10° (P < 0.001). ROM, WOMAC and KSS of the two groups were significantly improved after operation, with no difference between the two groups.ConclusionThis study shows that whether the alignment is accurate or not in the early stage after TKA, the relaxation of the medial and lateral soft tissues of the knee joint change; however, this change will not significantly affect the alignment of the lower limbs. Postoperative residual varus deformity limits medial soft tissue remodeling.Level of evidenceIII.

Moxibustion intervention improves synovitis by down-regulating NLRP3/Caspase-1/IL-1β signaling of synovial tissue in rats with adjuvant arthritis.

To observe the effect of moxibustion on activities of NOD-like receptor family protein 3 (NLRP3)/cysteine aspartic acid specific protease-1 (Caspase-1)/interleukin-1β (IL-1β) signaling pathway in rats with adjuvant arthritis (AA), so as to explore its mechanisms underlying improvement of rheumatoid arthritis (RA). Me-thods Thirty male Wistar rats were randomly divided into normal control, AA model and moxibustion groups, with 10 rats in each group. The AA model was replicated by raising in wind, cold and damp environment combined with complete Freund's adjuvant injection. In the moxibustion group, moxibustion was applied to bilateral "Shenshu" (BL23) and "Zusanli"(ST36) for 20 min each time, once daily for 21 days. Changes of joint swelling degree (JSD) and arthritis index (AI) in each group were observed. The ultrastructural changes of synovial cells in each group were observed by transmission electron microscopy. The protein expression levels of NLRP3, apoptosis-associated speck-like protein (ASC), Caspase-1, tumor necrosis factor-α (TNF-α) and IL-1β in the synovial tissues of the knee joint were measured by Western blot. Compared with the normal control group, JSD, AI and the protein expressions of NLRP3, ASC, Caspase-1, TNF-α and IL-1β in the synovial tissues were significantly increased (P<0.01) in the model group. In comparison with the model group, JSD, AI and the protein expression levels of NLRP3, ASC, Caspase-1, TNF-α and IL-1β were significantly decreased (P<0.01) in the moxibustion group. Results of transmission electron microscope showed an irregular and vague nuclear membrane of synovial cells, and unclear mitochondrial membrane boundary with sparse, swelling crests in the model group, which was relatively milder in the damage degree in the moxibustion group. Moxibustion can relieve the inflammatory response in the synovial membrane of AA rats, which may be related to its function in down-regulating synovial NLRP3/Caspase-1/IL-1β inflammatory signaling.

Effect of acupuncture on arthritic pathological injury in rats with type Ⅱ collagen-induced rheumatoid arthritis.

To observe the effect of acupuncture stimulation of "Yanglingquan"(GB34), "Zusanli"(ST36) and "Xuanzhong" (GB39) on arthritis index (AI), joint synovial membrane pathology, serum-related immunoinflammatory factors, and expressions of tumor suppressor gene mt-p53, nuclear factor kappa B (NF-κB) and peroxisome proliferator activated receptor gamma (PPARγ) in knee joint synovial tissue of rats with type Ⅱ collagen-induced arthritis (CIA), so as to explore its possible mechanisms underlying improvement of rheumatoid arthritis (RA). Male SD rats were used in the present study. The CIA model was established by subcutaneous injection of collagen emulsion (200 μL/rat) in the tail root region on the first day and repeat (100 μL/rat) once on the 9th day. Eighteen successful CIA rats were randomized into model, medication and acupuncture groups, with 6 rats in each group. Other 6 normal rats were used as the normal control group. For rats of the medication group, leflunomide (1.9 mg/kg) was administrated by gavage, once a day, and for rats of the acupuncture group, manual acupuncture stimulation was applied to bilateral GB34, ST36, GB39 for 30 min, once a day, for 12 weeks. The arthritis index (AI) score (0-4 points) was evaluated once every week. The contents of IL-6, IL-17 and TNF-α in the serum were determined by ELISA. Histopathological changes of the ankle joint were observed by H.E. staining. The protein and mRNA expression levels of mt-p53, NF-κB p65, and PPARγ in the knee joint synovial tissue were determined by Western blot and quantitative real time PCR, separately. Compared with the normal control group, the AI scores at different time-points after modeling, contents of serum TNF-α, IL-6 and IL-17, expression levels of mt-p53, NF-κB p65, PPARγ proteins and mRNAs were significantly increased in the model group (P<0.01, P<0.05). In comparison with the model group, the AI scores at the 10th week in the medication group and at the 3rd, 9th and 10th week in the acupuncture group, contents of serum TNF-α, IL-6 and IL-17, and the expression levels of mt-p53 and NF-κB p65 proteins in both medication and acupuncture groups, as well as mt-p53 and NF-κB p65 mRNAs in the medication group were apparently decreased (P<0.01, P<0.05), while the expression levels of PPARγ protein in both medication and acupuncture group and PPARγ mRNA in the medication group were significantly up-regulated (P<0.05, P<0.01). No significant differences were found between the acupuncture and medication groups in down-regulating the AI score and serum TNF-α, IL-6 and IL-17 contents. The effect of acupuncture was weaker than that of medication in down-regulating the expression of mt-p53 and NF-κB p65 proteins and mRNAs and in up-regulating PPARγ mRNA (P<0.01). H.E. results showed ankle cartilage hyperplasia, reduced joint cavity, mild fibroproliferation and inflammatory cell infiltration in the surrounding soft tissue of the ankle joint in rats of the model group, which was milder in both medication and acupuncture groups. Acupuncture stimulation can improve the degree of joint inflammation and swelling in CIA rats, which may be related to its effects in inhibiting the overexpression of immunoinflammatory factors in serum and regulating expression of mt-p53, NF-κB p65, PPARγ mRNAs and proteins in the synovial tissue.

Effect of Video Camera Angle on the Detection of Compensatory Movements during Motion Observation.

When exercise instructions are provided over the Internet, such as in online personal training, an instructor checks the user's form by watching their motion video recorded using a single camera device. However, fixed shooting angles may affect the detection of incorrect forms, including compensatory movements. This study aimed to verify whether differences in the shooting direction could influence compensatory movement detection by conducting motion observation using training motion videos shot from two angles. Videos of four training movements, including compensatory movements, were simultaneously captured from the front and side. Ten university students studying physical therapy watched the videos from each angle to detect compensatory movements. This study revealed significant differences between the plane of motion in which the compensatory action occurred and the direction of shooting for the false responses in the compensatory action detection for the three movements (p < 0.05). The results indicated that the shooting direction and the plane of motion in which the compensatory action occurred affected the detection of compensatory movements, which was attributable to differences in information on the amount of joint change depending on the direction of joint motion observation and to a lack of binocular visual information necessary for depth motion detection.

Studying positional changes of the disc-condyle-fossa complex in ADDWoR patients after TMJ disc repositioning surgery.

To investigate the positional changes in the temporomandibular joint (TMJ) disc-condyle-fossa complex of patients with anterior disc displacement without reduction (ADDWoR) and to evaluate the effect of disc repositioning (DR) surgery. Fifteen patients with unilateral ADDWoR (30 joints) were included. MRI of the TMJ was performed at T0 (1week before surgery), T1 (1month after surgery), and T2 (9-12months after surgery). The glenoid fossa, disc, and condyle were reconstructed and analyzed using Mimics software. In the patients with unilateral ADDWoR, the disc on the ADD side showed a tendency to downward shift in the coronal direction and forward shift in the sagittal direction; the condyle of ADD side showed a tendency to backward shift in the sagittal direction and upward shift in the coronal direction. When comparing the same ADDwoR TMJ at T0, T1, and T2, the disc was found to move upward and backward after DR surgery at T1 and T2, and the condyle was found to move upward and backward after DR surgery at T1 but returned to the original position at T2. ADDWoR leads to forward and downward displacement of the disc relative to the condyle and upward displacement of the condyle relative to the tuberosity. DR surgery improved upon the structural abnormalities of the TMJ complex, for which stability was maintained as determined in the 9 to 12 month postoperative follow-up. DR surgery effectively and constantly improves the positional abnormalities of the TMJ complex.

Possibilities of Magnetic Resonance and Computed Tomography in Early Detection of Joint Changes In Rheumatoid Arthritis Disease

Early detection of joint damage by MRI and CT methods relative to the stage of the disease in patients with rheumatoid arthritis observed