Form Of Osteoarthritis Research Articles

TissueGene-C induces anti-inflammatory activity and M2 macrophage polarization via activation of prostaglandin E2 signaling

Osteoarthritis (OA) is the most common form of degenerative joint disease that commonly affects the knees, hips, and hands. OA is a mechano-inflammatory disease characterized by low-grade inflammation, which results in the breakdown of the cartilage extracellular matrix (ECM) within joints, leading to pain, stiffness, and inflammation. TissueGene-C (TG-C) is a cell and gene therapy investigational drug for treating knee OA that comprises human allogenic chondrocytes and an irradiated modified cell line stably expressing transforming growth factor-β1 (TGF-β1). Previous preclinical animal studies have shown that TG-C provides pain relief via its anti-inflammatory effects and cartilage structural improvement in rat OA model. The goal of this study was to investigate the mechanism of action of TG-C, explore its anti-inflammatory activity, and identify the TG-C-derived active factor(s) responsible for its efficacy. Our results showed that TG-C induces the polarization of M2 macrophages and the upregulation of interleukin-10 (IL-10) and interleukin-1 receptor antagonist (IL-1ra) while inhibiting tumor necrosis factor alpha (TNF-α) expression. Additionally, this study identified prostaglandin E2 (PGE2) as the main bioactive factor responsible for the anti-inflammatory activity of TG-C. Our results demonstrated that PGE2 is expressed by the TG-C chondrocyte component and modulated by TGF-β1 derived from the second component of TG-C. Finally, the present study provides insight into the mechanism of action of TG-C in the treatment of OA.

Activity Levels in Seven Cats with Osteoarthritis Monitored by GPS Tracker Following Frunevetmab Injection

Abstract Objective The goal of the current pilot study was to use a commercially available accelerometer (Tractive GPS Tracker for Cats) in a setting evaluating the activity level of cats exhibiting different forms of osteoarthritis in their natural habitat before and after treatment with frunevetmab, using each individual cat as its own control. We hypothesized that treatment with frunevetmab would be associated with increased activity level. Methods Activity data, measured as minutes of active time per day via accelerometer worn on a collar, were obtained from seven employee-owned cats with radiographically confirmed evidence of osteoarthritis. Cats were randomly assigned to two different protocols in which treatment and no treatment (control) were reversed; that is, undergoing the control period prior to treatment with frunevetmab (“standard” control) versus first assessed without treatment (control period) followed by frunevetmab treatment after minimum 30-day washout period (“inverse” control period). Results Activity time, on average, was 30 minutes longer per day for frunevetmab versus control (p = 0.007). Conclusions Based on measurements obtained with piloted use of the Tractive, the activity level in osteoarthritic cats appeared greater when treated with frunevetmab compared to self-control without frunevetmab treatment (either pretreatment or following washout period). The small sample size here does warrant caution in interpreting results for a broader population.

Quantification of Cartilage Poroelastic Material Properties Via Analysis of Loading-Induced Cell Death.

Articular cartilage (AC) is a load-bearing tissue that covers long bones in synovial joints. The biphasic/poroelastic mechanical properties of AC help it to protect joints by distributing loads, absorbing impact forces, and reducing friction. Unfortunately, alterations in these mechanical properties adversely impact cartilage function and precede joint degeneration in the form of osteoarthritis (OA). Thus, understanding what factors regulate the poroelastic mechanical properties of cartilage is of great scientific and clinical interest. Transgenic mouse models provide a valuable platform to delineate how specific genes contribute to cartilage mechanical properties. However, the poroelastic mechanical properties of murine articular cartilage are challenging to measure due to its small size (thickness ∼ 50 microns). In the current study, our objective was to test whether the poroelastic mechanical properties of murine articular cartilage can be determined based solely on time-dependent cell death measurements under constant loading conditions. We hypothesized that in murine articular cartilage subjected to constant, sub-impact loading from an incongruent surface, cell death area and tissue strain are closely correlated. We further hypothesized that the relationship between cell death area and tissue strain can be used-in combination with inverse finite element modeling-to compute poroelastic mechanical properties. To test these hypotheses, murine cartilage-on-bone explants from different anatomical locations were subjected to constant loading conditions by an incongruent surface in a custom device. Cell death area increased over time and scaled linearly with strain, which rose in magnitude over time due to poroelastic creep. Thus, we were able to infer tissue strain from cell death area measurements. Moreover, using tissue strain values inferred from cell death area measurements, we applied an inverse finite element modeling procedure to compute poroelastic material properties and acquired data consistent with previous studies. Collectively, our findings demonstrate in the key role poroelastic creep plays in mediating cell survival in mechanically loaded cartilage and verify that cell death area can be used as a surrogate measure of tissue strain that enables determination of murine cartilage mechanical properties.

Conservative Physiotherapy for Grade 4 Osteoarthritis Secondary to Genu Varum Deformity: A Case Report

Osteoarthritis (OA) is a prevalent form of degenerative joint disease that primarily affects the knees, leading to a gradual loss of function, severe pain, joint stiffness, and reduced quality of life. Despite its severity, exercise treatment offers promising results and proves beneficial for a wide range of patients. Preoperative rehabilitation for OA patients often involves therapeutic approaches such as exercise treatment, electrotherapy, and manual therapy. The present case revolves around a 58-year-old male diagnosed with OA in both knees, with the presence of genu varum deformity. A personalised preoperative rehabilitation protocol was designed based on his specific symptoms of pain, stiffness, and difficulties in daily activities. The case study highlights the effectiveness of the preoperative physical therapy approach for managing bilateral osteoarthritic knees with genu varum deformity.

Outcomes of Operative Versus Nonoperative Management for Hallux Rigidus: A Tertiary Care Center Experience.

Background This study aims to investigate and report the outcomes of various management modalities used for hallux rigidus, a common form of degenerative joint disease affecting the foot and ankle. The research focuses on understanding the pathophysiology, classification systems, and nonoperative approaches such as medical therapy, intra-articular injections, shoe modifications, and physical therapy. Surgical techniques, including joint-sparing and joint-sacrificing procedures, are explored, considering factors such as disease stage and patient preferences. Methods A retrospectivecohortstudy was conducted at King Abdulaziz Medical City(KAMC), Riyadh.The study included all patientswho were diagnosed with hallux rigidus fromthe period 2016to 2022.Data were collected through theBESTCaresystem at KAMC.All the data were collected through Microsoft Excel(Microsoft Corporation, Redmond, Washington) and transferredfor analysis. Statistical analysis was performed using the IBM SPSS Statistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, New York). Frequencies and percentages were used to detail categorical variables, whereas continuous variables were examined by the mean and standard deviation.A p-value of <0.05 was considered to report the statistical significance. Results A total of 84 patients were included. The majority were women (60.7%). Diabetes and hypertension were prevalent comorbidities, affecting 21.4% and 35.7% of patients, respectively. Nonoperative management was the most common approach (66.7%). Complications were minimal (2.4% infections, 1.2% metatarsalgia), and 67.9% of patients reported no persistence of symptoms after treatment. Conclusion The low complication rates and the lack of significant associations between treatment modalities and outcomes suggest the generally safe and effective nature of the employed interventions. These findings can guide clinicians in making informed decisions regarding the management of hallux rigidus, while also highlighting areas for further research to improve treatment strategies and outcomes.

The Role of Matrix Metalloproteinase 13 and Vitamin D in Osteoarthritis: A Hospital-Based Observational Study.

Introduction Osteoarthritis (OA) is the most common form of degenerative joint disease characterized by the progressive degeneration of articular cartilage, osteophyte formation, and joint space narrowing. Matrix metalloproteinases (MMPs) are potential biomarkers for osteoarthritis. Aims and objective The study's aim is the estimation of serum and synovial fluid matrix metalloproteinase (MMP) 13 and serum vitamin D levels in the grade 3 and grade 4 stages of osteoarthritis according to the Kellgren and Lawrence (KL) system of classification. Materials and methods A total of 100 subjects were included; of them, 25 patients with grade 3 and 25 patients with grade 4 knee osteoarthritis diagnosed clinically and radiologically according to the Kellgren and Lawrence criteria have been enrolled in the study, and 50 patients with knee pain having a diagnosis other than degenerative OA of the knee were taken as controls. Venous blood and synovial fluid have been collected from all of them for the estimation of MMP-13 and vitamin D. The enzyme-linked immunosorbent assay (ELISA) and chemiluminescent microparticle immunoassay (CMIA) methods were used for the estimation of MMP-13 and vitamin D, respectively. Results The mean value of synovial fluid MMP-13 was found to be elevated in grade 4 as compared to grade 3 and the control group, whereas the mean value of serum MMP-13 was found to be elevated in grade 3 as compared to grade 4 and control. The level of serum vitamin D was found deficient in OA patients as compared to control. The Kruskal-Wallis test was performed to compare these groups, and there was a significant difference between these groups(p-value of <0.05). Summary and conclusion High synovial and serum MMP-13 is associated with knee structural abnormalities in patients with knee OA as compared to the control groupsuggesting that MMP-13 can be a biomarker in knee OA, whereas the decreased level of vitamin D may be associated with an increased risk for the progression of OA; hence, serum vitamin D may be a good indicator for the prediction of the initiation of OA.

Prevalence of primary osteoarthritis of knee in tea garden community of Jorhat District, Assam

: The most prevalent form of degenerative joint disease, osteoarthritis (OA), is one of the major causes of pain and disability, particularly in middle-aged and older people. OA typically affects the knees, hips, spine, hands, and feet. The knee joint is one of the most commonly affected joint in the lower limb. Though OPD attendance due to OA is quite high, only a few community-based studies are available about its prevalence, especially in the North-Eastern states of India.Assess prevalence of OA of Knee in the Tea Garden community of Jorhat district of Assam.Community-based cross-sectional study was carried out among 320 adults living in various tea gardens in Jorhat District of Assam from June 2019 to May 2020. Diagnosis of OA was made using weight-bearing AP plain radiograph of both knees graded on the Kellgren and Lawrence Scale and WOMAC Score.: Out of 320 adults examined, 29.4% have OA of knee. Prevalence was higher in females, and age more than 50 years.: The burden of OA in this community is relatively high and appropriate measures must be taken to reduce it.

Orientin inhibits inflammation in chondrocytes and attenuates osteoarthritis through Nrf2/NF-κB and SIRT6/NF-κB pathway.

Osteoarthritis (OA) is the most common form of degenerative joint disease. and chondrocyte inflammation plays an important role in OA development. The natural flavonoid compound Orientin (Orientin) has anti-inflammatory bioactive properties in the treatment of various diseases. Studies have not explored whether Orientin modulates OA progression. In our study, we researched the anti-osteoarthritis effects of Orientin, as well as the potential mechanisms that underlie its action. Effects of Orientin on OA were detected in chondrocytes and OA mouse model. Effects of Orientin on murine chondrocytes treated with interleukin-1β (IL-1β) were evaluated using qPCR, western blot analysis, ELISA and immunofluorescent staining in vitro. In vivo, We established a standard OA model by performing the destabilized medial meniscus (DMM) surgery on C57BL/6 mice, and assessed healing effect of Orientin by X-ray imaging, histopathological analysis, immunohistochemical staining. A significant suppression in IL-1β-mediated pro-inflammatory mediators and the degradation of cartilage extracellular matrix (ECM) was observed in vitro after a treatment with Orientin. In addition, Orientin abrogated DMM surgery induced cartilage degradation in mice. Mechanistic studies showed that Orientin suppressed OA development by downregulating activation of NF-κB by activating Nrf2/HO-1 axis and SIRT6 signaling pathway. The study indicates that Orientin inhibits inflammation of chondrocytes and ECM degradation, which are key contributors to OA progression. Effects of Orientin are mediated through Nrf2/NF-κB and the SIRT6/NF-κB pathways. These results provide evidence that Orientin serves as a potentially viable compound for the treatment of OA. This article is protected by copyright. All rights reserved.

Meta-analysis of erosive hand osteoarthritis identifies four common variants that associate with relatively large effect

ObjectivesErosive hand osteoarthritis (EHOA) is a severe subset of hand osteoarthritis (OA). It is unclear if EHOA is genetically different from other forms of OA. Sequence variants at ten loci...

Consumer Interest in Total Ankle Replacements Over the Last 10 Years: A Google Trends™ Analysis From 2009 to 2019

With an aging population, the incidence of osteoarthritis (OA) continues to grow. After exhausting conservative therapy for many forms of OA, patients regularly opt for surgical intervention in the form of total joint replacement surgery. One form, total ankle replacement, has continued to gain favorability in the medical community. Improved implant design and surgical technique have enabled success rates of total ankle replacements to approach those of the hip and knee. As a new and improving therapy to address end-stage ankle OA, knowledge of patient-interest has yet to be determined. We used search inquiry data for the keywords “ankle arthritis” “ankle replacement” and “ankle fusion” available from Google Trends™ to identify trends in patient and geographic interest from 2009 to 2019. Search inquiries significantly increased for all keywords over time (p < .001). Trend analysis over this 10-year period revealed a strong correlation for ankle arthritis (0.88) and ankle replacement (0.76). Moreover, the correlation between “ankle arthritis” and “ankle replacement” was strong (0.83) during this period. The geographic distribution of these search terms showed the greatest increase in interest for the keywords “ankle arthritis” “ankle replacement” and “ankle fusion” in Arizona, New York, and Virginia respectively. Results of this study illustrate a similar increasing patient interest in ankle arthritis and ankle replacements. This data can be used effectively identify, educate, and treat populations interested in ankle replacements. To the best of our knowledge, this is the first study to utilize Google Trends™ to analyze patient interest in foot and ankle surgery.

THE EFFECT OF STRENGTHENING EXERCISE ON THE QUADRICEPT AND HAMSTRING MUSCLES ON CHANGING FUNCTIONAL KNEES FOR PATIENTS WITH KNEE OSTEOARTHRITIS

Introduction Osteoarthritis is a failure to repair damage in the joints caused by excessive mechanical stress. This disease is chronic, degenerative, non-inflammatory, and slowly progressive, one of which is characterized by decreased function. Osteoarthritis is a form of osteoarthritis that affects people in old age or adulthood. The cause of osteoarthritis is not known with certainty, but age, gender, race, genetics, obesity, and physical activity are risk factors that lead to pathological changes and affect the decreased functional ability. This decrease in functional ability in osteoarthritis can be overcome by isometric exercise.Methods: The research design used was a pre-experimental design with an approach of pretest-posttest one group design. The sampling technique used was total sampling, with a total of 20 respondents aged 40–70 years. Exercise with a frequency of 2 times a week for 8 weeks at an intensity of 3 repetitions for 15 minutes. The measuring instrument in this study used WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index). Normality test using the Shapiro-Wilk test, hypothesis testing using the Wilcoxon Test.The results showed the level of functional ability before being given the intervention had an average value of 2.30 and after being given the intervention had an average value of 1.40. Statistical test results showed p-value = 0.000 (p 0.005). This shows that there is an effect of isometric exercise on changes in functional abilities of patients with Samarinda knee osteoarthritis at AW Sjahranie Hospital.Conclusion: Giving isometric exercise to the quadriceps and hamstrings has an effect on improving the functional ability of the knee in patients with osteoarthritis.

Post COVID community based self-care management of disabling osteoarthritis: importance and possible targeted needs

Background: Osteoarthritis, a highly common, disabling joint disease affecting a large number of older adults is presently incurable, and not always amenable to surgery or pharmacologic interventions. Purpose: Further complicated by multiple past and ongoing COVID-19 pandemic issues and disease consequences, the purpose was to examine what current data reveal as to the prevailing epidemiological features of osteoarthritis and its pathology. Another was to review the utility of some non-pharmacological and non-operative treatment strategies that have been advocated for alleviating the pain and disability of this disease in later life. Methods: Building on a 35 year prior review conducted in 2015, this current review was conducted to identify relevant literature published on this topic over the last 5 years, particularly since COVID-19 onset in 2019. Key words included osteoarthritis, COVID-19, prevention, and intervention. Results: As in prior years, osteoarthritis continues to induce considerable physical disability and consistently impedes the attainment of a high life quality for many older adults. Although not studied to any degree, COVID-19 factors may be expected to render further challenges that compound the disease presentation and its mitigation over time, especially among the long COVID affected older adult. In the face of closures, limited resources, and complex disease presentations, it does appear a variety of non-operative and non-pharmacologic approaches may yet influence the disease process and functional outcomes more positively than not with low safety risks. They may help the older adult more effectively even if surgery is indicated and multiple medications are yet required. Conclusion: The application of one or more carefully designed conservative interventions is likely to reduce the functional disability and pain experienced by older people with any form of osteoarthritis, regardless of whether surgical and or pharmacologic strategies are indicated.

Encapsulation of rat bone marrow-derived mesenchymal stem cells (rBMMSCs) in collagen type I containing platelet-rich plasma for osteoarthritis treatment in rat model.

Osteoarthritis (OA) is the most common form of degenerative joint disease, affecting more than 25% of the adults despite its prevalence in the elderly population. Most of the current therapeutic modalities aim at symptomatic treatment which lingers the disease progression. In recent years, regenerative medicine such as stem cell transplantation and tissue engineering has been suggested as a potential curative intervention for OA. The objective of this current study was to assess the safety and efficacy of an injectable tissue-engineered construct composed of rat bone marrow mesenchymal stem cells (rBMMSCs), platelet-rich plasma (PRP), and collagen type I in rat model of OA. To produce collagen type I, PRP and rBMMSCs, male Wistar rats were ethically euthanized. After isolation, culture, expansion and characterization of rBMMSCs, tissue-engineered construct was formed by a combination of appropriate amount of collagen type I, PRP and rBMMSCs. In vitro studies were conducted to evaluate the effect of PRP on chondrogenic differentiation capacity of encapsulated cells. In the following, the tissue-engineered construct was injected in knee joints of rat models of OA (24 rats in 4 groups: OA, OA + MSC, OA + collagen + MSC + PRP, OA + MSC + collagen). After 6weeks, the animals were euthanized and knee joint histopathology examinations of knee joint samples were performed to evaluate the effect of each treatment on OA. Tissue-engineered construct was successfully manufactured and in vitro assays demonstrated the relevant chondrogenic genes and proteins expression were higher in PRP group than that of others. Histopathological findings of the knee joint samples showed favorable regenerative effect of rBMMSCs + PRP + collagen group compared to others. We introduced an injectable tissue-engineered product composed of rBMMSCs + PRP + collagen with potential regenerative effect on cartilage that has been damaged by OA.

The concept of first metacarpal M1-M2 arch. New interest in trapeziometacarpal prostheses

Analysis of the M1-M2 arch, otherwise known as the M1-M2 metacarpal hanger, objectively helps all surgeons treating basal thumb osteoarthritis to fit a trapeziometacarpal prosthesis that respects the physiological length of the thumb column and thus the physiological tensions of the APL, EPL, and EPB tendons as well as the interossei and thenar muscles. Kapandji X-ray views are a gold-standard in the radiological study of basal thumb osteoarthritis, to classify progression, measure trapezium height, and assess the deformity. Ledoux’s M1/M2 ratio is the only method for assessing the normal length of the thumb column but cannot be easily used during surgery. We describe the first metacarpal arch, obtained by a radiological anteroposterior X-ray of the hand and wrist with the thumb in 45° abduction. It may be broken or conserved, depending on the form of osteoarthritis. It can objectively predict whether a prosthesis must be placed iso-long or so as to lengthen the thumb column. This overcomes the subjectivity of the notion of “intraoperative piston” and avoids excessive tensioning of the prosthesis, which would increase stress on the prosthetic components and thus the risk of wear and complications. We applied this technical principle to 148 dual mobility prostheses fitted between January 2019 and May 2021. By respecting the arch, the right trade-off is found between intraoperative stability and mobility while protecting the long-term performance of the prosthesis.

Сравнительная оценка возможности обнаружения ранних признаков суставных изменений височно-нижнечелюстного сустава при помощи конусно-лучевой компьютерной томографии и ультразвукового исследования

The purpose of the study was to carry out a comparative analysis of the possibility of detecting early signs of articular changes in the temporomandibular joint with cone-beam computed tomography and ultrasound. Materials and methods. 20 patients with complaints of temporomandibular joint (16 women and 4 men) were examined who stated that the first symptoms associated with the joint appeared from 6 months to 1 year. Examination of patients with temporomandibular joint pathology included consultation of the patient by a dentist with the involvement of radiation research methods. During the examination by dentist, the odontogenic nature of the temporomandibular joint disorders was excluded or confirmed. Cone-beam computed tomography and ultrasound of the temporomandibular joint were performed in all patients according to standard methods. The comparative analysis was carried out on the basis of clinical examples with the conclusions of a specialist doctor in the field of radiation diagnostics and radiation therapy. Results and discussion. Pathology of the temporomandibular joint due to morphological and functional changes occurs in 40-75% of adult and occupies the third place in the list of the main nosological forms of dental diseases. At the same time, it is known that the use of radiation methods for diagnostics of surgical pathology in maxillofacial area of odontogenic and non-odontogenic etiology in the Republic of Belarus is provided by clinical protocols. A comparative analysis of the conclusion of patients who underwent cone-beam computed tomography and ultrasound of the temporomandibular joints allows us to conclude that ultrasound examination allows us to state early changes occurring in the temporomandibular joint. Therefore, the possibility of early diagnosis contributes to the appointment of an adequate and rational complex of therapeutic and rehabilitation measures which is important for stopping the progress of pathological changes. Also with the help of ultrasound, it is possible to establish signs of the development of various forms of osteoarthritis which are not detected on the cone-beam computed tomography at the initial stages of development. In addition, ultrasound allows to visualize changes occurring in soft tissues such as the articular disc which is not available for cone-beam computed tomography. Conclusion. The obtained results allow us to recommend ultrasound examination of the temporomandibular joint as a screening method and a method of the first level of examination in order to detect pathological changes from both bone and soft tissue structures of the joint as early as possible

Schmerzen im Daumen und anderen Fingern

Pain In the Thumb and Other Fingers Abstract. As the population ages, symptoms of osteoarthritis in the hand are seen with increasing frequency. It can lead to substantial pain, physical disability and impair the patient's capacity to work in a population with an increasing retirement age. This article gives an overview about the most prevalent forms of osteoarthritis in the hand, its diagnosis and current treatment options, stressing that the multimodal form of therapy is the most effective.

The Role of Proteinases in Osteoarthritis: A Brief Review of New Potent Cartilage Metabolism Therapeutic Target

Osteoarthritis (OA) is the most frequent form of degenerative joint disease that becomes a major source of disability worldwide. The loss of articular cartilage is the central etiology of osteoarthritis. Cartilage is solely composed of one cell type, the chondrocytes, which are surrounded by a large volume of extracellular matrix (ECM). Extracellular matrix components consist of two main macromolecules, namely collagen and aggrecan. The degradation of these molecules plays a significant role in OA pathological process, although degradation of less abundant molecules composing the matrix organization is also likely to contribute to disease progression. Several proteinases, including matrix metalloproteinase 13 (MMP-13) and A Disintegrin And Metalloproteinase with Thrombospondin Motifs (ADAMTS) -4 and -5, are known to involve in the matrix degradation of cartilage structure. A comprehensive understanding of the various factors and pathways involved in the regulation of MMP-13, ADAMTS-4, and ADAMTS-5 is essential in regard to osteoarthritis management, as they have great potential in future therapies.

Disease-Modifying Potential of Metformin and Alendronate in an Experimental Mouse Model of Osteoarthritis.

Osteoarthritis (OA) is the most common degenerative joint disease causing progressive damages of the cartilage and subchondral bone, synovial inflammation, and severe pain. Despite the complex pathomorphological changes that occur in OA, the approach to different forms of OA is standardized. The global results from pharmacological treatment are not satisfactory. Hence, this study aimed to explore the effects of metformin, alendronate, and their combination on OA development and progression in mice with collagenase-induced osteoarthritis (CIOA). Female ICR (CD-2) mice were randomized to five groups: control group, CIOA untreated, CIOA + metformin, CIOA + alendronate, and CIOA + metformin + alendronate. OA was induced by the intra-articular (i.a.) injection of collagenase. OA phenotype was analyzed by flow cytometry (bone marrow cell differentiation), ELISA (serum levels of the adipokines leptin and resistin), and histology (pathological changes of the knee joint). Treatment with metformin, alendronate, or their combination inhibited the expression of RANK and RANKL on osteoblasts and osteoclasts obtained by ex vivo cultivation of bone marrow cells in mineralization or osteoclastogenic media. In addition, metformin treatment was effective for the attenuation of fibroblast differentiation, but not of mesenchymal stem cells (MSCs), while alendronate had an opposite effect. The combination of metformin and alendronate had a suppressive effect on both MSCs and fibroblasts differentiation. Treatment with metformin, alendronate, and their combination decreased serum concentrations of leptin and resistin in the chronic phase of arthritis. The histopathological examination showed that compared with the untreated CIOA group (OA score 9), the groups treated with metformin (OA score 4) or alendronate (OA score 6) had lower scores for cartilage changes. Metformin combined with alendronate significantly decreased the degree of cartilage degeneration (OA score 2), suggesting that this combination might be a useful approach for the treatment of OA patients.

Deep Squat – Should We Be Afraid?

PURPOSE Squats are among the basic exercises that have become an integral part of exercise programs. It is commonly used by athletes in many sports. Its potential is shown in the development of strength, power, and overall sports performance. The aim of the study was to verify inconsistent views on deep squats, technical design, and related health risks. METHODS For the purposes of the review, the terms "squat, knee, biomechanics, deep, patellofemoral, back squat, performance, arthritis, health, injury, risk" were used. RESULTS It turns out that the technique of performing a deep squat has its strict principles, which must be respected and which have a significant impact on the benefits and risks. From loading, the lower position represents an increase in compressive and shear forces on the patellofemoral joint, however, this is a natural state that is not risky. Health hazards cannot be based on analytical-mathematical models, which are insufficient in this aspect. Extreme long-term exposure carries the risk of permanent consequences in the form of osteoarthritis. For prophylaxis or convalescence, it is possible to use effective aids like sleeves, kinesio taping, bandage or "knee savers". CONCLUSIONS With optimal technique and sensible exercise selection, there is no greater risk in healthy individuals without degenerative anatomical changes. In order to assess the effects of the squat forces on the ankle, knee, hip, spine, it is necessary to consider the technique and also individual anatomical differences.

Use of tanezumab for chronic pain treatment

The problem of chronic musculoskeletal pain, the cause of severe suffering and disability of hundreds of millions of people on our planet, is far from being solved. Pain control is particularly difficult in patients with severe forms of osteoarthritis (OA) and chronic non-specific low back pain (CLBP). Popular analgesics – nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids, demonstrate moderate effectiveness and a high risk of adverse events (AE). This leads to the search for new approaches for analgesic therapy. Tanezumab is a monoclonal antibody that specifically blocks nerve growth factor, which plays a key role in the development of chronic pain. A series of phase II and III studies showed that tanezumab was administered intravenously or subcutaneously at a dose of 2.5 mg to 20 mg once every 8 weeks. In patients with OA or CNSLBP, it has a pronounced and persistent analgesic effect that exceeds the effect of placebo, and is equal to or superior to the effect of many months of daily intake of naproxen, celecoxib, diclofenac, oxycodone and tramadol. Tanezumab can cause various AE, primarily rapid progression of OA (in 2.6–6.0%) and neurological disorders (paresthesia and hyposthesia, in ≈5%). At the same time, the progression of OA was significantly more often observed with the combined use of tanezumab and NSAIDs. Nevertheless, taking into account the characteristics of patients who used tanezumab (patients with pain refractory to standard treatment; severe forms of OA), the good analgesic potential of tanezumab allows us to consider it as a promising tool for the control of chronic musculoskeletal pain, which will be widely used in real clinical practice.