Osteoarthritis Of Knee Joint Research Articles

Clinical Trial on the Effect of Various Training Program on Biomarkers and other Parameters of Osteoarthritis Knee Joint

Clinical Trial on the Effect of Various Training Program on Biomarkers and other Parameters of Osteoarthritis Knee Joint

Extracellular vesicles from synovial fluid-derived mesenchymal stem cells confer chondroprotective effects on in vitro and in vivo osteoarthritic chondrocytes

IntroductionExtracellular vesicles (EVs) released by mesenchymal stem cells (MSCs) are theorized to mediate cartilage regeneration through paracrine actions. It is hypothesized that EVs derived from synovial fluid MSCs (SF-MSCs) will promote anabolic gene expressions and decrease catabolic markers of in vitro osteoarthritic chondrocytes. These EVs will also demonstrate increased cartilage regeneration as measured in a rat osteoarthritis (OA) model. ObjectivesThis study tested the in-vitro anti-inflammation effects of using EVs from SF-MSCs on chondrocytes and in vivo study on chondroprotective effects of EVs with OA environment. MethodsIn vitro, rat chondrocytes were exposed to EVs collected from SF-MSC that had been either exposed or unexposed to interleukin-1β (IL-1β). Gene expressions for various anabolic and catabolic markers were measured. In vivo, rats who received anterior cruciate ligament transection as an OA model with an osteoarthritic knee joint were exposed to weekly injections of SF-MSC-derived EVs at 2 different doses. The results were evaluated with histological study and scored using the Osteoarthritis Research Society International system. Serum cytokines were analyzed via enzyme-linked immunosorbent assay. ResultsIn vitro, chondrocytes exposed to SF-MSCs derived EVs demonstrated increased anabolic markers and decreased catabolic markers also with the EVs collected from interleukin-1β treated SF-MSCs. In vivo, rats that received EVs displayed lower Osteoarthritis Research Society International scores, more collagen type II alpha 1, and less matrix metalloproteinase-13 than the control groups. This anti-inflammation potential was systemic, as demonstrated by the decrease of serum proinflammatory cytokines. ConclusionsSF-MSCs-derived EVs were effective at promoting the expression of anabolic markers while simultaneously attenuating the production of proinflammatory markers in vitro and in vivo. These anti-inflammation effects were dose-dependent in vivo. The injection of EVs in the knee joint changed the cytokines in the serum.

Surgical treatment of knee osteoarthritis focusing on the patellofemoral joint

Background: Surgical management of the osteoarthritic knee joint consists of osteotomies such as a high tibial osteotomy (HTO), uni-compartmental knee arthroplasty (UKA), and total knee arthroplasty (TKA). These surgeries mainly treat the tibiofemoral joint but can also have an impact on the patellofemoral (PF) joint. These changes in PF joint can affect the surgical outcome.Current Concepts: PF joint problems are relative contraindications in UKA. However, recent studies have reported that these problems do not markedly affect the result of UKA. During HTO, the patella height and tracking can change, affecting the PF joint problem. The effect of the PF joint can be minimized through various methods of closing wedge HTO or modified opening wedge (OW) HTO, such as retro-tubercular biplanar OWHTO. However, this method is controversial regarding its impact on clinical outcomes. In TKA, pain caused by PF joint problems can be reduced using techniques such as patella resurfacing, patelloplasty, and denervation; however, there is no clear consensus.Discussion and Conclusion: The surgical treatment of degenerative knee osteoarthritis has an impact on the PF joint, which can affect the outcome of surgery and vice versa. However, these impacts only occasionally cause clinical difference. Conclusively, these surgeries should be done by considering the PF joint because changes in the joint can affect the surgical outcome.

THE ROLE OF PARIJATA PATRA KASHAYA IN THE MANAGEMENT OF KATI SHOOLA AND JANU SANDHIGATA VATA: A CASE STUDY

Musculo skeletal disorders are a huge medical burden globally; multimodal analgesia and surgical procedures are the options for treatment in contemporary science. In Ayurveda, Acharya Charaka stated in the context of Anukta Vikara, the vitiated Vata reaches a region, causes Shoola (~ pain), Stambha (~ stiffness), Supti (~ numbness), etc. in that particular region. Kati shula and Janu Sandhigata Vata are among such conditions which can be equated with musculoskeletal disorders. A 47-year-old female patient with low back ache and bilateral knee joint osteoarthritis was treated conservatively with fresh Parijata Patra Kashaya. During treatment, improvement was seen in the initial weeks. By the end of 10 weeks, the treatment protocol was found to be significantly effective in symptomatic and assessment profiles as in NRS scale, SLR, and Lumbar range of movement. Hence, in the initial stages of the condition, Parijata Patra Kashaya would be a better choice against multimodal analgesics.

Ameliorative Effects of Prolotherapy on Histomorphology of Tibial Articular Cartilage of Chemically Induced Osteoarthritic Knee Joint in a Rat Model.

To determine the ameliorative effects of prolotherapy on monosodium iodoacetate (MIA) induced and histomorphological changes in the articular cartilage of tibial condyles at rat knee joint. An experimental study. Place and Duration of the Study: Department of Anatomy, Army Medical College Rawalpindi, NUMS, Rawalpindi, from August to November 2021. Thirty adult male Sprague Dawley rats were divided into three groups, each having 10 rats. Group A was control. Group B was injected with single dose of 1mg MIA intraarticularly in the right knee to induce osteoarthritic changes. Group C was injected with single dose of 1mg MIA intraarticularly, in right knee was followed by 0.1ml Prolotherapy (3ml of 25% dextrose, 2ml of 2% xylocaine, 1ml of injection neurobion, and 1ml of injection methecobal) as intra articular injection at week 2, 6 and 10 in right knee. Rats were sacrificed after one month of the last dose of Prolotherapy. Articular cartilage was collected for gross and histological examination and compared among the groups. Articular cartilage belonging to control group A was normal. While group B showed statistically significant deterioration in gross appearance (p = 0.001**), reduction in number of chondrocytes (p = 0.005*) and thickness of articular cartilage (p = 0.001**) in comparison to group A. In group C due to prolotherapy statistically significant improvement in gross appearance (p = 0.034*), increase in number of chondrocytes (p = 0.003*), and thickness of articular cartilage (p = 0.001**) was observed as compared to group B. Prolotherapy significantly ameliorates histomorphology of tibial articular cartilage against MIA induced osteoarthritic changes in rat knee joint. Articular cartilage, Knee joint, Monosodium iodoacetate, Osteoarthritis, Prolotherapy.

Role of Ultrasonography in The Diagnosis of Knee Joint Lesions

Introduction: Ultrasound can provide clinically useful information on a wide range of pathologic conditions affecting components of the knee joint, including the tendons, ligaments, muscles, synovial space, articular cartilage, nerves and surrounding soft tissues. The advantages of ultrasound include low cost, portability, real-time assessment, and facilitated side-by-side comparisons. The aim of the study was to study the various pathological conditions of painful knee joint by using ultrasound for early diagnosis and prompt therapeutic approach and to evaluate the osteoarthritic changes in the painful knee joint by ultrasound. Materials and Methods: This is a prospective observational study conducted in the Department of Radiology and Orthopedics& trauma surgery, National Medical College & teaching hospital, Birgunj, Parsa, Nepal for the 6 months duration, patients presented with knee joint pathology including swelling, and pain.Patients included in this study was above 20 years with unilateral (single) knee joint pain. With ethical clearance from the Institutional Review Committee of National Medical College and after obtaining the informed consent of the patient, prospective observational study was conducted. All ultrasound assessments were performed using the same machine with a 9 MHz linear transducer of GE Logiq P7 USG machine. A30–45-degree flexion of the knees was standardized by using the same wedge for all ultrasound assessments. Results: This study included 40 symptomatic patients with knee joints pain included in this study. In 40 patients 19 were females (47.5%) and 21 males (52.5%), with ages ranged from 20 to 70 years. Ultrasound findings showed joint effusions in 25 (62.5 %) as most common finding in painful knees,synovial thickening in 17 (42.5 %) knees, Synovitis in 14 (35.0%) and tendinopathy seen in only 1 (2.5%) knee joint pain. Osteoarthritis such as narrow joint space in 4 (10%) knees, marginal osteophytes in 4 (10%) knees, loose bodies in 3 (7.5%) knees, Baker’s cyst in 1 (2.5%) knee. Most common involved age group is 51-60 years with 17 cases followed by 41-50 years in 11 cases. Conclusion: Ultrasound is a simple and reproducible technique for the assessment of knee joint effusion, synovial changes and osteoarthritis related changes.

Knee Joint Osteoarthritis in Overweight Cats: The Clinical and Radiographic Findings.

Despite a high prevalence of osteoarthritis (OA) reported in the domesticated cat population, studies on feline knee joint OA are scarcer. Knee joint OA is a painful, age-related, chronic degenerative joint disease that significantly affects cats' activity and quality of life. In dogs and humans, one may consider overweight as a risk factor for the development and progression of knee joint OA; therefore, this study aims to assess the severity of knee joint OA in the body-weight-related groups of cats concerning clinical symptoms and radiographic signs. The study was conducted on sixty-four (n = 64) cats with confirmed OA. The demographic data on sex, neutering, age, and breed were collected. Then, the body condition score (BCS) was assessed, and each cat was allocated to the underweight, normal-weight, or overweight group. Within clinical symptoms, joint pain, joint swelling, joint deformities, lameness, reluctance to move, and apathy were graded. Based on the radiographic signs, minor OA, mild OA, moderate OA, and severe OA were scored. Prevalence and co-occurrence of the studied variables were then assessed. Joint pain was elicited in 20-31% of the OA-affected joints, joint deformities in 21-30%, and lameness in 20-54%, with no differences between weight-related groups. Severe OA was detected in 10-16% of the OA-affected joints, with no differences between weight-related groups. Severe OA in feline knee joints appears with similar frequency in overweight, underweight, and normal-weight cats. However, the general prevalence of clinical symptoms and radiographic signs is different in overweight cats.

Complex Approach in Examination of Function of the Knee Joint in Patients with Osteoarthritis

INTRODUCTION: Osteoarthritis (OA) of the knee joint (KJ) is a common problem. The basic factors impairing the function of the KJ are pain and restriction of movement. Evaluation of function of the KJ in OA is an indispensable part of the diagnostic and treatment process. There exists a problem of a quantitative evaluation of pain and restriction of movement of the KJ in OA, associated with the absence of a single standard for evaluation of the KJ function. In the article, the data are given on the modern possibilities for evaluation of the KJ function in OA. The KJ function is evaluated in clinical examination, functional tests, numerous functional questionnaires, as well as with the use of devices for record of movements. Clinical picture of OA of the KJ is evaluated in the clinical examination which includes diagnostic tests, evaluation of the volume of movement, force of muscles, with conclusions about the phenotype of the disease. Functional tests recommended by OARSI (Osteoarthritis Research Society International) are preferable for express-testing, but not all of them have reference values. Functional questionnaires for evaluation of the KJ function exist in many variants, which impedes their choice and interaction between specialists, and they are characterized by different labor intensity in use. There exists a diversity of devices for evaluation of function of the KJ, some of which are expensive, require special rooms, training of the specialist, and take considerable time. Others are simpler in use and inexpensive, but give less reliable results.
 CONCLUSION: The authors showed the possibilities of a comprehensive evaluation, described the problem of the lack of a single standard for investigation of the KJ function. A conclusion is made about the necessity to develop a software-hardware complex that maximally satisfies the criteria of objectivity, accessibility and quickness of use for evaluation of function of the KJ in OA.

Applications of Tissue Engineering in Meniscus Repair

Knee meniscus injury has a high incidence, which can change the load-bearing structure of the knee joint, causing pain and further cartilage damage and osteoarthritis and other related diseases, and is difficult to prevent and treat effectively. Therefore, how to treat meniscus injury has become one of the hot issues concerned by patients and medical staff in recent years. Compared with simple meniscectomy, tissue engineering meniscectomy has fewer adverse effects and some techniques have achieved satisfactory results. At present, the meniscus tissue engineering treatment method is continuously developing and innovating. In this paper, the promising techniques of collagen scaffold implantation, silk fibroin scaffold implantation, hydrogel implantation and bone marrow stimulation were discussed, we hope to provide the basis for the further development of meniscus repair.

A comparative clinical study of Janu Basti (medicated oil retention over knee) and Matra Basti (medicated oil enema) with Sahachara Taila along with Adityapaka Guggulu on osteoarthritis of knee joint

Background: Osteoarthritis (OA) of knee is a chronic inflammatory condition of knee joints characterized by pain, swelling, and functional restriction of the joint. In Ayurveda, it can be correlated with Sandhigata Vata. The two most promising therapies for the Ayurveda management are Janu Basti (medicated oil retention over knee) and Matra Basti (medicated oil enema). The present study was conducted to assess the comparative effect of the two Ayurveda procedure which could assist in clinical decision-making for maximum benefit and minimum discomfort for variable requirements of the patients. Aim: The aim of the study was to ascertain the better management among the two therapies. The objective of the study was to assess changes in pain in knee joints through the Visual Analog Scale (VAS) and disability through Western Ontario and McMaster Universities OA Index (WOMAC) from baseline to 30th day in both the therapies and compare the effect of the both therapies on pain and disability. Materials and methods: In this study, a total of 30 patients having the complaints of OA of knee joint were randomly divided into two groups. Fifteen patients were treated in group A with Janu Basti (external oleation through retention of oil over knee joints for 30 min) with Sahachara Taila along with Adityapaka Guggulu (oral medication) and 15 patients were treated in group B with Matra Basti (enema with medicated oil) with Sahachara Taila along with Adityapaka Guggulu. For the assessment, VAS for pain scoring, WOMAC for disability, Ritchie articular index for tenderness were used, and X-ray were graded on the basis of Kellgren–Lawrence system for OA severity. All the results were calculated by using InStat GraphPad 3 software. For intra-group comparison nonparametric data; “Wilcoxon matched-pairs signed ranks test” and “Paired-t-test” was used. For calculating the inter-group comparison, “Mann–Whitney test” and “unpaired-t-test” was used. All the statistical tests were interpreted as significance at 5% level (P < 0.05). Results: There were significant changes in VAS, WOMAC score, and tenderness of the affected joint in both the groups. On intergroup comparison, Matra Basti with Sahachara Taila in group B has provided better relief in Sandhigatavata of Janu Snadhi along with Adityapaka Guggulu. Conclusion: The result shows that Ayurvedic management with Matra Basti and Janu Basti along with Adityapaka Guggulu are effective in the management of osteoarthritis (OA) of knee joint. However, Matra Basti along with Adityapaka Guggulu is a better management option than Janu Basti.

A case of total knee replacement in a patient with osteoarthritis of knee joint with malunited distal femur fracture with stiffness

A case of total knee replacement in a patient with osteoarthritis of knee joint with malunited distal femur fracture with stiffness

The effect of a barley-based food product in alleviating knee osteoarthritis discomfort symptoms in Egyptian female patients

Background/aim Osteoarthritis is a common joint condition that causes cartilage to erode. There are numerous conventional treatments available, including nonsteroidal anti-inflammatory medicines and pharmaceuticals containing glucosamine; however, taking them can result in serious side effects. The aim of this study was to prepare barley-based food product enriched with ginger, curcumin, garlic powder, and onion powder and to evaluate the effect of consumption of the prepared macaroni for 2 months, in alleviating knee osteoarthritis discomfort symptoms in female patients complaining of grade 2–3 knee osteoarthritis. Patients and methods The present study enrolled 51 Egyptian middle age females patients with a mean age of 51±8.37 years, diagnosed with bilateral grade two to three knee osteoarthritis were recruited from the National Research Centre rheumatology and rehabilitation clinic. Anthropometric measurements and blood samples were collected after 8 weeks of daily barley based macaroni supplementation (75 grams raw). Serum levels of IL1β, IL4 and IL6 were measured using Elisa techniques, while Total Antioxidant Capacity, Malondialdehyde, and Glutathione S-transferase were measured by the colorimetric methods. Results Chemical composition analysis of the prepared barley-based macaroni demonstrated a decrease in total carbohydrate content and an increase in crude fiber, protein, and fat content compared with the control (semolina wheat-based macaroni); 100 grams of the prepared uncooked barley macaroni provided 342.46 Kcal. The reevaluation of the anthropometric parameters after 8 weeks of daily macaroni supplementation denoting improvement without statistical significance (P>0.05), and the clinical characteristics of knee joint osteoarthritis (Lequesne Index, WOMAC score, and Timed Up and Go test) significantly improved which meant less pain and stiffness. The serum pro-inflammatory cytokines IL1β and IL6 declined significantly and the serum anti-inflammatory cytokine IL4 raised significantly (P≤0.05), besides, barley based macaroni supplementation significantly improved the antioxidant status, which was achieved through the rise of serum Total Antioxidant Capacity and the decline of Malondialdehyde and Glutathione S-transferase activity (P≤0.05). Conclusion Barley-based prepared macaroni enriched with curcumin and ginger must be considered in alleviating the severity of knee OA symptoms to aid patients in getting their life back to near normal.

Honey improves radiographic features of monosodium iodoacetate-induced stifle (knee) joint osteoarthritis in a rat model

Osteoarthritis (OA) is the most common form of joint disease with over half of all people older than 65 years demonstrating radiographic changes of osteoarthritis in the knees. Honey is known to contain bioactive compounds that exert chondroprotective effects by counteracting the homeostatic dysregulation of the joint. However, its effect on the radiographic features of osteoarthritis has not been proven. This study was carried out to evaluate the effect of honey on radiographic features of monosodium iodoacetate (MIA)- induced knee osteoarthritis in female Wistar rats. Thirty female Wistar rats were randomly divided into five groups of six animals each. Animals in group one were healthy (control) rats, while animals in groups two to five were subjected to experimental osteoarthritis of the right knee joint induced by a single intra-articular injection of 1mg of MIA. The animals in groups two, three, four, and five were treated with normal saline (1ml/kg b. w.), arthocare (glucosamine/chondroitin sulfate 6.67/8.33mg/kg b. w.), low dose honey (250mg/kg b. w.) and high dose honey (1,000mg/kg b. w.) respectively. All treatments were administered orally once daily using an oral cannula for twenty-one days. All animals were subjected to radiographic assessment of the right knee joint before and after induction of OA, and after treatment. High and low-dose honey reversed the loss of joint space; sclerosis of the tibial plateau, medial, and lateral femoral condyles, when compared to the arthocare-treated and untreated groups. In conclusion, honey improved radiographic features of knee osteoarthritis in a rat model induced by monosodium iodoacetate.

Study on the relationship between severe knee osteoarthritis and bone marrow edema

To investigate the relationship between bone marrow edema and pathological changes, symptoms and signs of severe knee osteoarthritis. From January 2020 to March 2021, 160 patients with severe knee osteoarthritis who underwrent MRI of the knee at the Department of Bone and Joint, Wangjing Hospital, China Academy of Chinese Medical Sciences were included. Eighty patients with bone marrow edema were selected as the case group, including 12 males and 68 females, aged from 51 to 80 years old with an average of (66.58±8.10) years old, the duration of disease 5 to 40 months with an average of (15.61±9.25) months. Eighty patients without bone marrow edema were selected as the control group, including 15 males and 65 females, aged from 50 to 80 years old with an average of (67.82±8.05) years old, the duration of disease 6 to 37 months with an average of (15.75±8.18) months, BMI was (28.26±3.13) kg·m-2 ranged from 21.39 to 34.46 kg·m-2. The degree of bone marrow edema was evaluated by knee whole oragan magnetic resonance imaging score (WORMS). The degree of knee osteoarthritis was evaluated by Kellgren- Lawrence(K-L) grade and Western Ontario and McMaster University Osteoarthritis Index (WOMAC). The degree of joint pain was evaluated by visual analogue scale(VAS) and WOMAC pain score, the joint signs were evaluated by tenderness, percussion pain, joint swelling and joint range of motion. To explore the relationship between bone marrow edema and knee osteoarthritis, the prevalence of bone marrow edema and K-L grade were compared between the two groups. Furthermore the WORMS score and WOMAC index, pain-related score, and sign-related score correlation coefficient were analyzed to further explore the relationship between bone marrow edema and knee osteoarthritis index, joint pain symptoms and signs. There was 68.75% (55/80) of the patients in the case group were in K-L grade Ⅳ, and 52.5% (42/80) in the control group, indicating a higher proportion of patients with grade Ⅳ in the case group than the control group (χ2=4.425, P<0.05). In the case group, there was a strong correlation between bone marrow edema WORMS score and knee osteoarthritis WOMAC index. (r=0.873>0.8, P<0.001), a moderate correlation between WORMS score and VAS score and WOMAC pain score(r=0.752, 0.650>0.5, P<0.001), a moderate correlation between WORMS score and percussion pain score (r=0.784>0.5, P<0.001), and a weak correlation between WORMS score and VAS and tenderness score, joint swelling score and joint range of motion score (r=0.194, 0.259, 0.296<0.3, P<0.001). Our study suggests that severe knee osteoarthritis is associated with an increased risk of bone marrow edema. Bone marrow edema can also lead to knee osteoarthritis joint pain, with percussion pain being a positive sign, but tenderness, joint swelling and limitation of activity are not significantly related to bone marrow edema.

An Atlas of the Knee Joint Proteins and Their Role in Osteoarthritis Defined by Literature Mining

Osteoarthritis (OA) is the most prevalent rheumatic pathology. However, OA is not simply a process of wear and tear affecting articular cartilage but rather a disease of the entire joint. One of the most common locations of OA is the knee. Knee tissues have been studied using molecular strategies, generating a large amount of complex data. As one of the goals of the Rheumatic and Autoimmune Diseases initiative of the Human Proteome Project, we applied a text-mining strategy to publicly available literature to collect relevant information and generate a systematically organized overview of the proteins most closely related to the different knee components. To this end, the PubPular literature-mining software was employed to identify protein-topic relationships and extract the most frequently cited proteins associated with the different knee joint components and OA. The text-mining approach searched over eight million articles in PubMed up to November 2022. Proteins associated with the six most representative knee components (articular cartilage, subchondral bone, synovial membrane, synovial fluid, meniscus, and cruciate ligament) were retrieved and ranked by their relevance to the tissue and OA. Gene ontology analyses showed the biological functions of these proteins. This study provided a systematic and prioritized description of knee-component proteins most frequently cited as associated with OA. The study also explored the relationship of these proteins to OA and identified the processes most relevant to proper knee function and OA pathophysiology.

Cartilaginous glycoprotein‑39 as laboratory marker of dynamics of course and effectiveness of treatment in patients with osteoarthritis

Backgrounds. Osteoarthritis (OA) occupies the first rank among diseases of the musculoskeletal system and accounts for 18.4% of the structure of this pathology. Currently, OA is considered as a disease in which there is a violation of the processes of remodeling (degradation and synthesis) of cartilage tissues, subchondral bone, joint capsule, tendon-ligamentous and muscular apparatus. An increased concentration of cartilage glycoprotein-39 (CGP-39) in the circulation is associated with inflammatory diseases and the processes of active tissue restructuring. To date, CGP-39 is a marker of chondrocyte activation and a sign of progressive OA, which determines its clinical significance. Along with this, the role of this biomarker in evaluating the effectiveness of anti-inflammatory therapy is relevant.The purpose. Comparative assessment of the quantitative content of CGP-39 in patients with knee joint OA, depending on the severity of inflammatory changes in the joints, the dynamics of the disease and the effectiveness of therapy.Methods. The study included 36 patients with OA and 30 practically healthy volunteers, identical in gender and age to the examined patients. The mean age of patients was 64 years, the average duration of the disease was 6 years. The diagnosis was determined according to the diagnostic criteria of the American College of Rheumatology (ACR, 1991). Along with the generally accepted clinical, laboratory and instrumental diagnosis of OA, in all patients and in control persons the levels of circulating CGP-39 were measured by enzyme immunoassay (ELISA). All examined patients received Ambene® Bio for 20 days, followed by repeated determination of the level of CGP-39. For statistical processing of the obtained data, we have used the programs Microsoft Excel 2007 and Statistica 10.0. Using the application program KRelRisk 1.1, the relative risk indicator for the studied factor was determined.Results. In the blood of patients with OA, a significant increase in the levels of CGP-39 has been found in comparison with the group of healthy individuals, which indicates increased degradation of articular cartilage in OA. As the severity of knee OA increased, the concentration of CGP-39 in the blood serum significantly raised, including in comparison with the control group. Reliable direct correlations were found between CGP-39 and clinical indices of knee OA severity. The content of CGP-39 in serum in patients with stage III radiological OA was significantly higher than in patients with stage I–II. The highest level of CGP-39 in patients with OA is associated with the presence of synovitis. TThe level of CGP-39 significantly decreased in patients with knee OA after a course of Ambene® Bio therapy, which confirms the participation of CGP-39 in inflammation on the one hand and the possibility of its use as an indicator of the effectiveness of anti-inflammatory therapy on the other hand.Conclusions. CGP-39 as a marker of inflammation and degradation of articular cartilage reflects the severity of the course of OA. The investigation of this biomarker is useful not only for diagnostic purposes, but also to assess the response to anti-inflammatory treatment in patients with knee OA.

Visible and Near-Infrared Spectroscopy Enables Differentiation of Normal and Early Osteoarthritic Human Knee Joint Articular Cartilage

Osteoarthritis degenerates cartilage and impairs joint function. Early intervention opportunities are missed as current diagnostic methods are insensitive to early tissue degeneration. We investigated the capability of visible light-near-infrared spectroscopy (Vis-NIRS) to differentiate normal human cartilage from early osteoarthritic one. Vis-NIRS spectra, biomechanical properties and the state of osteoarthritis (OARSI grade) were quantified from osteochondral samples harvested from different anatomical sites of human cadaver knees. Two support vector machines (SVM) classifiers were developed based on the Vis-NIRS spectra and OARSI scores. The first classifier was designed to distinguish normal (OARSI: 0–1) from general osteoarthritic cartilage (OARSI: 2–5) to check the general suitability of the approach yielding an average accuracy of 75% (AUC = 0.77). Then, the second classifier was designed to distinguish normal from early osteoarthritic cartilage (OARSI: 2–3) yielding an average accuracy of 71% (AUC = 0.73). Important wavelength regions for differentiating normal from early osteoarthritic cartilage were related to collagen organization (wavelength region: 400–600 nm), collagen content (1000–1300 nm) and proteoglycan content (1600–1850 nm). The findings suggest that Vis-NIRS allows objective differentiation of normal and early osteoarthritic tissue, e.g., during arthroscopic repair surgeries.

Intra-articular injection of kartogenin promotes fibrocartilage stem cell chondrogenesis and attenuates temporomandibular joint osteoarthritis progression.

Introduction: Kartogenin (KGN) is a small-molecule compound that has been reported to improve the chondrogenic differentiation of mesenchymal stem cells in vitro and to alleviate knee joint osteoarthritis in animal models. However, whether KGN has any effect on temporomandibular joint osteoarthritis (TMJOA) remains unclear. Methods: We first performed partial temporomandibular joint (TMJ) discectomy to induce TMJOA in rats. Histological analysis, tartrate-resistant acid phosphatase staining, and immunohistochemistry were used to assess the therapeutic effect of KGN on TMJOA in vivo. CCK8 and pellet cultures were used to determine whether KGN treatment could promote the proliferation and differentiation of FCSCs in vitro. Quantitative real-time polymerase chain reaction (qRT-PCR) was conducted to determine the expression of aggrecan, Col2a1, and Sox9 in FCSCs. Furthermore, we performed western blot to analysis the effect of KGN treatment on the expression of Sox9 and Runx2 in FCSCs. Results and discussion: Histological analysis, tartrate-resistant acid phosphatase staining, and immunohistochemistry showed that intra-articular injection of KGN attenuated cartilage degeneration and subchondral bone resorption in vivo. Further analyses of the underlying mechanisms revealed that KGN enhanced chondrocyte proliferation, increased the number of cells in both superficial and proliferative zones of TMJ condylar cartilage in vivo, enhanced the proliferation and chondrogenic differentiation of fibrocartilage stem cells (FCSCs), and upregulated the expression of chondrogenesis-related factors in vitro. Collectively, in our study, KGN was shown to promote FCSC chondrogenesis and restore TMJ cartilage, suggesting that KGN injections might be a potential treatment for TMJOA.

The Microbiome of Osteoarthritic Hip and Knee Joints: A Prospective Multicenter Investigation.

Recent advances in high-throughput DNA sequencing technologies have made it possible to characterize the microbial profile in anatomical sites previously assumed to be sterile. We used this approach to explore the microbial composition within joints of osteoarthritic patients. This prospective multicenter study recruited 113 patients undergoing hip or knee arthroplasty between 2017 and 2019. Demographics and prior intra-articular injections were noted. Matched synovial fluid, tissue, and swab specimens were obtained and shipped to a centralized laboratory for testing. Following DNA extraction, microbial 16S-rRNA sequencing was performed. Comparisons of paired specimens indicated that each was a comparable measure for microbiological sampling of the joint. Swab specimens were modestly different in bacterial composition from synovial fluid and tissue. The 5 most abundant genera were Escherichia, Cutibacterium, Staphylococcus, Acinetobacter, and Pseudomonas. Although sample size varied, the hospital of origin explained a significant portion (18.5%) of the variance in the microbial composition of the joint, and corticosteroid injection within 6 months before arthroplasty was associated with elevated abundance of several lineages. The findings revealed that prior intra-articular injection and the operative hospital environment may influence the microbial composition of the joint. Furthermore, the most common species observed in this study were not among the most common in previous skin microbiome studies, suggesting that the microbial profiles detected are not likely explained solely by skin contamination. Further research is needed to determine the relationship between the hospital and a "closed" microbiome environment. These findings contribute to establishing the baseline microbial signal and identifying contributing variables in the osteoarthritic joint, which will be valuable as a comparator in the contexts of infection and long-term arthroplasty success. Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.

A spike in circulating cytokines TNF-α and TGF-β alters barrier function between vascular and musculoskeletal tissues

Molecular transport between the circulatory and musculoskeletal systems regulates articular joint physiology in health and disease. Osteoarthritis (OA) is a degenerative joint disease linked to systemic and local inflammation. Inflammatory events involve cytokines, which are secreted by cells of the immune system and modulate molecular transport across tissue interfaces (referred to as tight junction [TJ] barrier function). In a previous study from our group, OA knee joint tissues were shown to exhibit size separation of different sized molecules delivered as a single bolus to the heart (Ngo et al. in Sci. Rep. 8:10254, 2018). Here, in a follow up study of parallel design, we test the hypothesis that two common cytokines, with multifaceted roles in the etiology of osteoarthritis as well as immune state in general, modulate the barrier function properties of joint tissue interfaces. Specifically, we probe the effect of an acute cytokine increase (spike) on molecular transport within tissues and across tissue interfaces of the circulatory and musculoskeletal systems. A single bolus of fluorescent-tagged 70 kDa dextran, was delivered intracardially, either alone, or with either the pro-inflammatory cytokine TNF-α or the anti-inflammatory cytokine TGF-β, to skeletally mature (11 to 13-month-old) guinea pigs (Dunkin-Hartley, a spontaneous OA animal model). After five minutes' circulation, whole knee joints were serial sectioned and fluorescent block face cryo-imaged at near-single-cell resolution. The 70 kDa fluorescent-tagged tracer is analogous in size to albumin, the most prevalent blood transporter protein, and quantification of tracer fluorescence intensity gave a measure of tracer concentration. Within five minutes, a spike (acute doubling) in circulating cytokines TNF-α or TGF-β significantly disrupted barrier function between the circulatory and musculoskeletal systems, with barrier function essentially abrogated in the TNF-α group. In the entire volume of the joint (including all tissue compartments and the bounding musculature), tracer concentration was significantly decreased in the TGF-β- and TNF-α- compared to the control-group. These studies implicate inflammatory cytokines as gatekeepers for molecular passage within and between tissue compartments of our joints and may open new means to delay the onset and mitigate the progression of degenerative joint diseases such as OA, using pharmaceutical and/or physical measures.