non-OA Patients Research Articles

Identification of genes involved in the initiation of osteoarthritis

Identification of genes involved in the initiation of osteoarthritis

Gait analysis as a quantifiable outcome measure in hip or knee osteoarthritis: A systematic review

ObjectivesKinematic gait analysis consisting of measuring gait parameters (stride length, gait speed, dynamic joint angles) is a potential outcome measure in osteoarthritis (OA). The aim of this study was to evaluate its psychometric properties. MethodsA systematic literature search was performed in PUBMED and the Cochrane database until January 2008 by selecting manuscripts assessing any psychometric property of gait analysis in knee or hip OA. Were assessed feasibility (cost, time and access); reliability; discriminant capacity by differences between OA and non-OA patients; construct validity by correlation between gait analysis and OA symptoms: pain or functional disability (Lequesne/WOMAC); and responsiveness by improvement of gait analysis after treatment of OA using effect size. ResultsAmong the 252 articles identified, the final analysis included 30 reports (i.e., 781 knee OA patients and 343 hip OA patients). Gait analysis presents various feasibility issues and there was limited evidence regarding reliability (three studies, 67 patients). Discriminant capacity showed significant reduction of gait speed, stride length and knee flexion in OA patients compared to healthy subjects. Few data were available concerning construct validity (three studies, 79 patients). Responsiveness of gait speed was moderate to large with effect size ranging respectively from 0.33 to 0.89 for total knee replacement, and from 0.50 to 1.41 for total hip replacement. ConclusionAvailable data concerning validity and reliability of kinematic gait analysis are insufficient to date to consider kinematic parameters as valuable outcome measures in OA. Further studies evaluating a large number of patients are needed.

Asporin and transforming growth factor-β gene expression in osteoblasts from subchondral bone and osteophytes in osteoarthritis

BackgroundTo clarify the significance of subchondral bone and osteophytes in the pathology of osteoarthritis (OA), we investigated the expression of asporin (ASPN), transforming growth factor-β1 (TGF-β1), TGF-β2, TGF-β3, and runt-related transcription factor-2 (Runx2) genes involved in bone metabolism. MethodsOsteoblasts were isolated from 19 patients diagnosed with knee OA and from 4 patients diagnosed with femoral neck fracture. Osteoblast expression of mRNA encoding ASPN, TGF-βi, TGF-β2, TGF-β3, and Runx2 was analyzed using real-time RT-PCR. ResultsExpression of ASPN, TGF-β1, and TGF-β3 mRNA in the subchondral bone and osteophytes of OA patients increased compared with that of non-OA patients. The ratio of ASPN to TGF-β1 mRNA in patients with severe cartilage damage was higher than that in patients with mild cartilage damage. ConclusionsThe increased ratio of ASPN mRNA to TGF-β1 mRNA in patients with severe relative to mild cartilage damage indicates that increased ASPN mRNA expression was significantly associated with the severity of cartilage degeneration. This finding suggests that ASPN may regulate TGF-β1-mediated factors in the development of OA, which may provide clues as to the underlying pathology of OA.

Advanced Osteoarthritis in Humans Is Associated With Altered Collagen VI Expression and Upregulation of ER-stress Markers Grp78 and Bag-1

To test the hypothesis that a perturbation of endoplasmic reticulum (ER) function is involved in the pathogenesis of osteoarthritis (OA), articular cartilage was isolated from non-OA patients secondary to resection of osteo- or chondrosarcomas. Intra-joint samples of minimal and advanced osteoarthritic cartilage were isolated from patients undergoing total knee arthroplasty and scored for disease severity. Glucose-regulated protein-78 (grp78) and bcl-2-associated athanogene-1 (bag-1) were detected via immunofluorescence as markers of non-homeostatic ER function. Additionally, the expression of type VI collagen and its integrin receptor, NG2, was determined to examine cartilage matrix health and turnover. There was an upregulation of grp78 in advanced OA, and variable expression in minimal OA. Non-OA cartilage was consistently grp78 negative. The downstream regulator bag-1 was also upregulated in OA compared with normal cartilage. Collagen VI was mainly cell-associated in non-OA cartilage, with a more widespread distribution observed in OA cartilage along with increased intracellular staining intensity. The collagen VI integral membrane proteoglycan receptor NG2 was downregulated in advanced OA compared with its patient-matched minimally involved cartilage sample. These results suggest that chondrocytes exhibit ER stress during OA, in association with upregulation of a large secreted molecule, type VI collagen.

노인 여성 관절염 환자의 보행시간에 따른 지면반력의 특징

The purpose of this study was to analyze and compare the effect of gait time on the gait patterns in elderly female OA and non-OA patients. The intensity of the subjects joint pain was surveyed by using WOMAC. Twelve subjects participated in this study. Measurements were taken for every the 10 minutes for 30 minutes after walking by a force plate. The following variables were recorded; double stance support time, Fx, Fy, Fx_time, Fz and so on. From the investigation of these variables the following was observed and concluded. The Fz values for the OA group was 1.01BW at the start and after 30 minutes was 1.04BW on the other hand the non-OA group's Fz1 was 1.08BW and 1.10BW. There was no significant difference calculated between the two groups and at the start and end of the experiment about all the variables. Therefore, it is concluded that there was no negative effect caused by walking for the 30 minutes and that it was an effective way of strengthen both respiratory and muscle function.

Determining predictor variables for treatment outcomes of arthrocentesis and hydraulic distention of the temporomandibular joint.

Arthrocentesis and hydraulic distention of the temporomandibular joint (TMJ) has been described as an effective modality in the treatment of patients demonstrating clinical findings consistent with the diagnosis of disc displacement without reduction. The purpose of this study was to investigate whether the clinical variable of TMJ pain chronicity and the magnetic resonance (MR) imaging variable of osteoarthrosis (OA) may predict treatment outcomes of arthrocentesis and hydraulic distention of the TMJ. The study consisted of 29 TMJ pain patients, who were assigned a unilateral clinical temporomandibular disorder (TMD) of "TMJ pain associated with an internal derangement (ID) type III (disc displacement without reduction)," and a TMJ pain side-related MR imaging diagnosis of disc displacement without reduction. Bilateral sagittal and coronal MR images were obtained immediately preoperatively to establish the presence or absence of ID and OA. TMJ pain level of function and mandibular range of motion were assessed preoperatively and compared with the respective 2-month follow-up findings. Outcome criteria of success were 1). an absence of signs and symptoms characteristic of a diagnosis of ID type III and/or 2). a reduction in pain level of 85% or greater. A multiple logistic regression analysis was used to compute the odds ratio for TMJ pain chronicity (duration >6 months and <2 years) and OA for successful outcomes versus nonsuccessful outcomes. The pretreatment data revealed no significant relationship between the clinical disorder "TMJ pain associated with ID type III" and the MR imaging finding of OA (P =.103). At 2-month follow-up, clinical evaluation showed a significant reduction in TMJ pain during function (P =.000), a significant reduction in clinical diagnoses of TMDs (P =.000), and a significant increase in mandibular range of motion (P =.000). Significant increase in risk of a nonsuccessful outcome (pain reduction <85%) occurred with TMJ pain chronicity (odds ratio of 41.0) (P =.018). Significant increase in benefit of a successful outcome (absence of ID type III) occurred with TMJ OA (odds ratio 1:16.7, P =.06) (P =.044). Arthrocentesis in chronic TMJ pain patients was less successful than in nonchronic patients with regard to treatment outcome of pain reduction. Arthrocentesis in patients with TMJ OA was more beneficial with regard to the disappearance of ID type III than in non-OA patients. Predictive modeling may provide clinicians with the opportunity to identify "at-benefit" patients early and initiate specific treatments.