Symptomatic Osteoarthritis Research Articles

External Rotation Strength After TSA in Osteoarthritic Shoulders with Eccentric Deformity Is Not Impacted by Posterior Rotator Cuff Deficiency.

Patients with persistent glenohumeral osteoarthritis symptoms despite nonoperative management may pursue anatomic total shoulder arthroplasty (TSA). TSA revision rates are higher in patients with preoperative eccentric (asymmetric posterior erosion) compared with concentric (symmetric) glenoid deformity. If posterior rotator cuff deficiency demonstrated preoperatively in patients with eccentric deformity persists after TSA, it may manifest as relative weakness in external compared with internal rotation secondary to deficient activity of the shoulder external rotator muscles. Persistent posterior rotator cuff deficiency is hypothesized to contribute to TSA failures. However, it remains unknown whether rotational strength is impaired after TSA in patients with eccentric deformity. Our goal was to determine if patients with eccentric deformity exhibit relative external rotation weakness that may be explained by posterior rotator cuff deficiency after TSA. Patients who were >1 year after TSA for primary glenohumeral osteoarthritis and had had preoperative eccentric or concentric deformity were prospectively recruited. Torque was measured and electromyography was performed during maximal isometric contractions in 26 three-dimensional direction combinations. Relative strength in opposing directions (strength balance) and muscle activity of 6 shoulder rotators were compared between groups. The internal (+) and external (-) rotation component of strength balance did not differ in patients with eccentric (mean internal-external rotation component of strength balance: -7.6% ± 7.4%) compared with concentric deformity (-10.3% ± 6.8%) (mean difference: 2.7% [95% confidence interval (CI), -1.3% to 6.7%]; p = 0.59), suggesting no relative external rotation weakness. Infraspinatus activity was reduced in patients with eccentric (43.9% ± 10.4% of maximum voluntary contraction [MVC]) compared with concentric (51.3% ± 10.4% of MVC) deformity (mean difference: -7.4% [95% CI, -13.4% to -1.4%] of MVC; p = 0.04). A relative external rotation strength deficit following TSA was not found, despite evidence of reduced infraspinatus activity, in the eccentric-deformity group. Reduced infraspinatus activity suggests that posterior rotator cuff deficiencies may persist following TSA in patients with eccentric deformities. Longitudinal study is necessary to evaluate muscle imbalance as a contributor to higher TSA failure rates. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

PENYULUHAN PENCEGAHAN TERHADAP PERMASALAHAN NYERI LUTUT PADA PETANI DI POSYANDU LANSIA MELATI 3 DESA GENTAN

Osteoarthritis is a degenerative joint disease in which there is damage to the cartilage which causes pain and loss of movement ability. Risk factors for OA include age, gender, obesity, trauma or injury, muscle and ligament weakness in the knee. Because many members of the community did not know about the symptoms of OA, we therefore held outreach to the people in Gentan village. The method of carrying out the activities that the author does is the educational outreach method with lectures and simulation training, using PowerPoint media. Results: In providing education and simulation training, it was found that 95% understood material related to knee pain and osteoarthritis, and 59.1% of participants stated that the exercises carried out had an effect on the knee pain they experienced. The activities carried out are very effective in increasing the knowledge of at-risk workers, especially farmers, regarding knee pain they experience and exercises that can be done when they feel knee pain.

A Clinical Case Study on Janu Sandhivata (Knee Arthritis) to evaluate the effect of Combined Panchakarma procedure and Internal Traditional Ayurvedic Formulations

Being commonest form of articular disorders Janu Sandhivata (Knee Arthritis) causes a huge hindrance in day to day activities of the sufferer like walking, dressing, bathing etc. It is the disease of old age. It’s mainly effect the weight bearing joint of the body specially knee, hip, lumber spine. As per the Ayurvedic classical references Shula, Sotha, Vata- Poornadriti Sparsha and difficulty in flexion and extension of the Sandhi are the symptoms. There are lots of treatment available in contemporary fields includes NSAID Administration, Intra articular Steroids or eventually surgical intervention in the form of Knee replacement. With this regard there is a need of safe effective and affordable treatment options. In present case study it is tried to explode the Panchakarma procedure like Abhangya, Patra Pinda Shedana therapy, Kashaya Vasti along with few traditional Ayurvedic formulations particularly for Bilateral Knee Osteoarthritis for 30 days duration of treatment it can be concluded that symptoms of severe Osteoarthritis may also be merged with Ayurvedic interventions significantly.

Adipose Tissue Stem Cells for Knee Arthritis and Cartilage Lesions: A Three-Year Follow Up.

The purpose of this research article is to evaluate the efficacy and the safety of injections of stromal vascular fraction (SVF), obtained with mini-lipoaspiration of fat tissue for knee osteoarthritis and cartilage lesions. Between January 2018 and February 2021, a total of 76 patients (45 females and 31 males, mean age 64 years; range 53-75 years, body mass index [BMI] no more than 30%, with symptomatic primary osteoarthritis of the knee, without previous arthroscopic intervention) underwent a local tumescent lipoaspiration procedure of 60-80cc of fat tissue from the abdomen. SVF was obtained after centrifugation according to the AdiPrep® Adipose Transfer System (Harvest-Terumo, Plymouth, Massachusetts) technique. The final product was checked with flow cytometry for absolute numbers, vitality, and the cluster of differentiation (CD) population. It was injected intraarticularly into the patients knees. Patients were divided in two groups: Group 1 had patients with knee osteoarthritis Kellgren-Lawrence grade early 4 and Group 2 with osteoarthritis K-L grade 2-3. The International Knee Documentation Committee (IKCD) and Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaires were used to evaluate clinical effects and measure patient's subjective assessment of pain, joint mobility, and physical disability before the injections. They were repeated at six months, one year, two years, and three years post injections. Knee cartilage lesions patients were divided in two subgroups: Group A (11 patients with OA K-L grade 2-3 and Outerbridge cartilage lesions grade 2-3) and Group B (7 patients with OA K-L grade early 4 and cartilage lesions Outerbridge grade late 3 to early 4) were estimated with quantitive analysis of magnetic resonance imaging (MRI) at one, two, and three years post injections. The average IKDC score in Group 1 was 45.9, 63.2, 62.4, 60, and 52. The KOOS score of the same group was 53, 79, 72, 69, and 62 at the end of the third year. At baseline, the average total IKDC score in Group 2 was 48.3, at 6 months 78.2, at one year 77, at two years 70.4, and at three years 61. The KOOS score of this group was 57, 84, 86, 79, and 69 at three years, respectively. For the patients with cartilage lesions, Group A presented lesser volume mean numbers of the lesion: 74% at the end of the first year post injection, 61% at the second, and 52% at the end of the third year with two out of seven patients in the group. The rest had no significant difference. Lesser volume mean number of the lesions in Group B was 85-88%, 70%, and 61% at the end of the third year in 5 out of 11 patients in the group. The rest had no significant difference. Adipose-derivedSVF, injected intraarticularly in arthritic knees, seems to provide good to excellent clinical results for three years and radiological results for cartilage lesions for two years post injections. All patients were satisfied with this treatment with reduction in pain and better joint mobility, especially after two to three months and up to three years. No serious side effects or complications were reported.

Ceramic-on-Metal Bearing in Total Hip Arthroplasty—Was It So Bad? A Narrative Review and a Critical Analysis of the Literature

Hip replacement has significantly improved the quality of life of patients with symptomatic hip osteoarthritis. Various bearings have been developed over the years. Each of these has advantages and disadvantages. On the one hand, Metal-on-Metal (MoM) has been associated with a high level of wear and metal ion release of chromium (Cr) and cobalt (Co). On the other hand, Ceramic-on-Ceramic (CoC) bearings, known to have a wear rate close to zero, have been associated with an increased risk of squeaking and component fracture. Ceramic-on-Metal (CoM), a hybrid hard-on-hard bearing, was proposed to overcome the CoC and MoM limits. Preliminary clinical and radiographical results have been described as favourable. Due to the failure of MoM and the increased risk of ion release and metal toxicity, CoM was withdrawn from the market without causing significant clinical complications. Data from the literature showed that CoM bearings are reliable and safe at medium- and long-term follow-up, if correctly implanted. In this narrative review, we analysed the real risks and benefits associated with the implantation of CoM bearings.

ROLE OF DIACERIN IN DIFFERENT GRADES OF OSTEOARTHRITIS

Osteoarthritis (OA) is a joint disease that causes pain and degeneration in the affected area. There are no standard guidelines for agents that can slow down or modify the disease's progress. Diacerin is one such agent used to improve symptoms of OA. The objective was to analyze its efficacy in different grades of OA. A quasi-experimental study was conducted at Ghurki Trust Teaching Hospital in Lahore over six months from Jan 2023 to July 2023. After obtaining informed consent and meeting inclusion and exclusion criteria, we included 78 patients with grade II and III OA (39 each). All patients were given Diacerin (100mg twice daily). The baseline Western Ontario and McMaster Universities Arthritis Index (WOMAC) and pain on the Visual Analogue Scale (VAS) were used to measure the treatment's efficacy in improving symptoms after six months. The data was analyzed using SPSS 23.0. The mean age of the participants was 53.98+6.17 years. The mean WOMAC score was 49.62+7.81 before treatment, which decreased significantly to 38.34+8.79 after six months of treatment (p-value <0.05). The mean VAS score before and after treatment was 7.41+0.98 and 4.82+1.07, respectively. These findings suggest that Diacerein significantly reduces pain and improves functional ability in patients with OA of the knee joint. This treatment was safe and well-tolerated. Its use is recommended in early grades of OA.

A Short Review on Chondroitin Sulphate and Its Based Nanomaterials for Bone Repair and Bone Remodelling Applications

Joint damage is a major symptom of osteoarthritis, a degenerative disease that worsens over time. The purpose of this review was to assess the effectiveness and safety of nanomaterials as an alternative to the widely used methods. Due to its poor regenerative and self-healing properties, cartilage repair after lesions or debilitating disease is a major clinical issue. Here, we use the organometallic chemistry identity of chondroitin sulphate to repair cartilage lesions by creating a nano-elemental particle through electrostatic interactions. As an integral part of the extracellular matrix, chondroitin sulphate (CS) is shown to improve osteogenesis in this review. The injectability of hydrated cement products was greatly improved by the addition of CS, but there was no discernible change in their phase, morphology, apparent porosity, or compressive strength. This review article provides a thorough analysis of the results from the use of nanocomposites in orthopaedic drug delivery and bone remodelling engineering.

Understanding muscle coordination during gait based on muscle synergy and its association with symptoms in patients with knee osteoarthritis.

We aimed to investigate the muscle coordination differences between a control group and patients with mild and severe knee osteoarthritis (KOA) using muscle synergy analysis and determine whether muscle coordination was associated with symptoms of KOA. Fifty-three women with medial KOA and 19 control patients participated in the study. The gait analyses and muscle activity measurements of seven lower limb muscles were assessed using a motion capture system and electromyography. Gait speed and knee adduction moment impulse were calculated. The spatiotemporal components of muscle synergy were extracted using non-negative matrix factorization, and the dynamic motor control index during walking (walk-DMC) was computed. The number of muscle synergy and their spatiotemporal components were compared among the mild KOA, severe KOA, and control groups. Moreover, the association between KOA symptoms with walk-DMC and other gait parameters was evaluated using multi-linear regression analysis. The number of muscle synergies was lower in mild and severe KOA compared with those in the control group. In synergy 1, the weightings of biceps femoris and gluteus medius in severe KOA were higher than that in the control group. In synergy 3, the weightings of higher tibial anterior and lower gastrocnemius lateralis were confirmed in the mild KOA group. Regression analysis showed that the walk-DMC was independently associated with knee-related symptoms of KOA after adjusting for the covariates. Muscle coordination was altered in patients with KOA. The correlation between muscle coordination and KOA may be attributed to the knee-related symptoms. Key points • Patients with knee osteoarthritis (OA) experienced a deterioration in muscle coordination when walking. • Loss of muscle coordination was associated with severe knee-related symptoms in knee OA. • Considering muscle coordination as a knee OA symptom-related factor may provide improved treatment.

MYOGENIC CONTRIBUTORS TO PHYSICAL FUNCTION IN OLDER ADULTS WITH SYMPTOMATIC KNEE OSTEOARTHRITIS

Abstract Knee osteoarthritis (OA) is a leading cause of mobility disability among middle-aged and older adults, and contributes to significant global disease burden. The impact of knee OA on physical function varies widely across individuals, and the factors contributing to this heterogeneity are poorly understood. Recent compelling research suggests that myogenic factors, including muscle quality (MQ), may underly symptoms in knee OA. While MQ is gaining attention in aging research, the role of MQ on functional outcomes in persons with knee OA remains unknown. This pilot study examined morphological and neuromuscular biomarkers of MQ among adults aged 50 years and older (N=44) who met clinical criteria for symptomatic knee OA. Physical performance was assessed using the Short Physical Performance Battery (SPPB). MQ was quantified using B-mode ultrasound (echo intensity) and isokinetic strength measures (force/body mass). Associations between MQ and physical performance were determined, with consideration for clinical pain, age, sex, and body mass index. Pearson correlation analysis indicated SPPB scores were associated with clinical pain, strength, and MQ (r values ranged -.42 – 0.60, p’s< 0.05). Multivariable backward stepwise linear regression analysis demonstrated that MQ biomarkers contributed 39% to variance for SPPB score independent of clinical pain and strength, after adjustment for age, sex, and BMI (b’s = -0.32 – 0.45; p’s < 0.05). MQ is an important consideration for physical function in older adults with chronic knee OA pain, regardless of pain severity, and represents a potentially potent treatment target for disability prevention.

Daily low-intensity pulsed ultrasound stimulation mitigates joint degradation and pain in a post-traumatic osteoarthritis rat model

ObjectivesThe aim of this study was to investigate the effects of low-intensity pulsed ultrasound (LIPUS) in a post-traumatic osteoarthritis (OA) rat model and in vitro. MethodsThirty-eight male, four-month-old Sprague Dawley rats were randomly assigned to Sham, Sham ​+ ​US, OA, and OA ​+ ​US. Sham surgery was performed to serve as a negative control, and anterior cruciate ligament transection was used to induce OA. Three days after the surgical procedures, Sham ​+ ​US and OA ​+ ​US animals received daily LIPUS treatment, while the rest of the groups received sham ultrasound (US) signals. Behavioral pain tests were performed at baseline and every week thereafter. After 31 days, the tissues were collected, and histological analyses were performed on knees and innervated dorsal root ganglia (DRG) neurons traced by retrograde labeling. Furthermore, to assess the activation of osteoclasts by LIPUS treatment, RAW264.7 ​cells were differentiated into osteoclasts and treated with LIPUS. ResultsJoint degradation in cartilage and bone microarchitecture were mitigated in OA ​+ ​US compared to OA. OA ​+ ​US showed improvements in behavioral pain tests. A significant increase of large soma-sized DRG neurons was located in OA compared to Sham. In addition, a greater percentage of large soma-sized innervated neurons were calcitonin gene-related peptide-positive. Daily LIPUS treatment suppressed osteoclastogenesis in vitro, which was confirmed via histological analyses and mRNA expression. Finally, lower expression of netrin-1, a sensory innervation-related protein, was found in the LIPUS treated cells. ConclusionOur findings demonstrate that early intervention using LIPUS treatment has protective effects from the progression of knee OA, including reduced tissue degradation, mitigated pain characteristics, improved subchondral bone microarchitecture, and less sensory innervation. Furthermore, daily LIPUS treatment has a suppressive effect on osteoclastogenesis, which may be linked to the suppression of sensory innervation in OA. The translational potential of this articleThis study presents a new potential for early intervention in treating OA symptoms through the use of LIPUS, which involves the suppression of osteoclastogenesis and the alteration of DRG profiles. This intervention aims to delay joint degradation and reduce pain.

“You don't put it down to arthritis”: A qualitative study of the first symptoms recalled by individuals with knee osteoarthritis

ObjectiveAs part of the first phase of the OARSI Early-stage Symptomatic Knee Osteoarthritis (EsSKOA) initiative, we explored the first symptoms and experiences recalled by individuals with knee osteoarthritis (OA). DesignThis qualitative study, informed by qualitative description, was a secondary analysis of focus groups (n ​= ​17 groups) and one-on-one interviews (n ​= ​3) conducted in 91 individuals living with knee OA as part of an international study to better understand the OA pain experience. In each focus group or interview, participants were asked to describe their first symptoms of knee OA. We inductively coded these transcripts and conducted thematic analysis. ResultsMean age of participants was 70 years (range 47–92) and 68 ​% were female. We developed four overarching themes: Insidious and Episodic Onset, Diverse Early Symptoms, Must be Something Else, and Adjustments. Participants described the gradual and intermittent way in which symptoms of knee OA developed over many years; many could not identify a specific starting point. Participants described diverse initial knee symptoms, including activity-exacerbated joint pain, stiffness and crepitus. Most participants dismissed early symptoms or rationalized their presence, employing various strategies to enable continued participation in recreational and daily activities. Few sought medical attention until physical functioning was demonstrably impacted. ConclusionsThe earliest symptoms of knee OA are frequently insidious in onset, episodic and present long before individuals present to health professionals. These results highlight challenges to identifying people with knee OA early and support the development of specific classification criteria for EsSKOA to capture individuals at an early stage.

Effectiveness of a novel hydrolysate collagen formulation in the complex treatment and rehabilitation of patients with symptomatic knee osteoarthritis

BACKGROUND: Knee osteoarthritis is a chronic disease that can eventually lead to surgical arthroplasty. Overuse, inflammation, metabolic disorders, and hormonal changes play important roles in the pathogenetic development of osteoarthritis of the knee. Recent studies have shown that collagen hydrolysate slows down the degenerative processes in cartilage tissue and has analgesic and anti-inflammatory effects.
 AIMS: To examine the effect of a dietary supplement of collagen hydrolysate (COLLA GEN) on the treatment and rehabilitation of patients with symptomatic knee osteoarthritis.
 MATERIALS AND METHODS: This prospective, blinded, placebo-controlled study included 99 patients diagnosed with radiographic knee osteoarthritis. All patients were randomly divided into two groups. Both groups were prescribed a course of therapeutic exercises. Group I was also prescribed a food supplement of collagen hydrolysate (COLLA GEN), whereas group II received placebo. The effectiveness of collagen hydrolysate in symptomatic osteoarthritis was evaluated based on the comparison of the WOMAC and VAS scores before the treatment and rehabilitation process and after 1, 3, and 6 months.
 RESULTS: Daily intake of 40 g of collagen hydrolysate dietary supplement of collagen hydrolysate («COLLA GEN») for 3 months, in combination with exercise therapy, in patients with symptomatic osteoarthritis, allowed statistically significant (p 0.05), compared with the placebo group, to improve such indicators on the WOMAC scale as «pain» (3.9±1.5 in group I and 5.4±1.8 in group II), «physical function» (8.7±3.2 in group I and 13.7±2.9 in group II), and «total score» (14.5±5.2 in group I and 21.5±4.9 in group II) by 6 months of observation. When analyzing the indicators on the VAS scale at the end of the 3rd and 6th month of treatment, a statistically significant difference (p 0.05) was observed between the indicators of regression of pain symptoms, which were 2.17 and 3.72 points in group I and 0.83 and 2.03 points in group II, respectively.
 CONCLUSION: The use of a novel hydrolysate collagen formulation in the complex treatment and rehabilitation of patients with symptomatic knee osteoarthritis has potential therapeutic effects.

Effectiveness of Lateral Shoe Wedging along with Quadriceps Strengthening and Life Style Modification in Knee Osteoarthritis

Background: Knee osteoarthritis (OA), a common degenerative joint disorder, significantly impairs quality of life due to pain and functional limitations. Non-surgical interventions like lateral shoe wedging and quadriceps strengthening exercises are increasingly considered viable options for managing OA symptoms. Objective: To assess the efficacy of lateral shoe wedges, both alone and in combination with quadriceps strengthening exercises, in treating medial knee OA. Methods: In this randomized controlled trial, 60 adults with medial knee OA were assigned to one of three groups: Group A received only lateral shoe wedges; Group B received lateral shoe wedges and quadriceps strengthening exercises; Group C received lateral shoe wedges with lifestyle modifications. Measurements for pain, stiffness, and physical function were taken using the Numeric Pain Scale and WOMAC scale at baseline, 8 weeks, and 16 weeks. Results: By Week 16, Group A (wedge only) reported a 70% compliance rate, with no significant changes in WOMAC stiffness and physical function scores. Group B (wedge & exercise) showed an 80% compliance rate, with pain scores reducing from 2.50±0.945 to 1.40±1.231 and significant improvements in WOMAC stiffness (1.40±1.231) and physical function (1.50±1.147). Group C (wedge & lifestyle modification) achieved a 100% compliance rate, with moderate improvements in all measured parameters. Conclusion: The study concludes that the combination of lateral shoe wedging and quadriceps strengthening exercises (Group B) was most effective in alleviating pain and improving physical function in patients with medial knee OA. This suggests that a multimodal approach may be superior to singular interventions for managing OA symptoms.

Plantar pressures in people with midfoot osteoarthritis: cross-sectional findings from the Clinical Assessment Study of the Foot

BackgroundMidfoot osteoarthritis (OA) is a common condition, however its aetiology is not well understood. Understanding how plantar pressures differ between people with and without midfoot OA may provide insight into the aetiology and how best to manage this condition. Research questionTo compare plantar pressures between people with and without symptomatic radiographic midfoot OA. MethodsThis was a cross-sectional study of adults aged ≥ 50 years registered with four UK general practices who reported foot pain in the past year. Symptomatic radiographic midfoot OA was defined as midfoot pain in the last four weeks, combined with radiographic OA in one or more midfoot joints. Cases were matched 1:1 for sex and age ( ± 5 years) to controls. Peak plantar pressure and maximum force in 10 regions of the foot were determined using a pressure platform (RSscan International, Olen, Belgium) and compared between the groups using independent samples t-tests and effect sizes (Cohen’s d). ResultsWe included 61 midfoot OA cases (mean age 67.0, SD 8.1, 31 males, 30 females) and matched these to 61 controls (mean age 66.0, SD 7.9). Midfoot OA cases displayed greater force (d=0.79, medium effect size, p = <0.001) and pressure at the midfoot (d=0.70, medium effect size, p = <0.001), greater force at the fourth metatarsophalangeal (MTP) joint (d=0.28, small effect size, p = 0.13), and fifth MTP joint (d=0.37, small effect size, p = 0.10) and greater pressure at the fifth MTP joint (d=0.34, small effect size, p = 0.13). They also displayed lower force (d=0.40, small effect size, p = 0.02) and pressure at the hallux (d=0.50, medium effect size, p = <0.001) and lower force (d=0.54, medium effect size, p = <0.001) and pressure at the lesser toes (d=0.48, small effect size, p = <0.001) compared with controls. SignificanceMidfoot OA appears to be associated with lowering of the medial longitudinal arch, greater lateral push off and less propulsion at toe off. Longitudinal studies are needed to establish causal relationships.

Intra-articular administration of PLGA resveratrol sustained-release nanoparticles attenuates the development of rat osteoarthritis

Our previous studies have confirmed that resveratrol (RSV) can prevent the development of osteoarthritis through a variety of mechanisms, such as apoptosis inhibition, autophagy induction and SIRT 1 activation. However, the pharmaceutical application of RSV is mainly limited by its low bioavailability. Here, we designed and synthesized RSV-loaded poly (D, l-lactide-coglycolide acid) (PLGA)-nanoparticles (NPs). The average particle size, polydispersity index and positive charge of RSV-loaded PLGA NPs were 50.40 nm, 0.217 and 12.57 mV, respectively. These nanoparticles had marked encapsulation efficiency (92.35 %) and drug loading (15.1 %) for RSV. It was found that RSV-loaded PLGA NPs not only inhibited the apoptosis of chondrocytes induced by IL-1, but also rescued GAG loss in vitro. Pharmacokinetic data showed that RSV-loaded PLGA NPs demonstrated a significantly profound and prolonged concentration profile in joint tissues, with quantifiable RSV concentrations over 35 days. The therapeutic effects of RSV-loaded PLGA NPs were then examined in rat osteoarthritis models. In vitro magnetic resonance imaging results showed that RSV-loaded PLGA NPs treatment dramatically reduced both T1ρ and T2 relaxation times at 4, 8, 12 weeks during administration, implying that cartilage destruction was alleviated. Histological assessments showed that RSV-loaded PLGA NPs significantly improved osteoarthritis symptoms. Gene expression analysis revealed that osteoarthritis mediator genes were downregulated in rats treated with RSV-PLGA NPs. Mechanistic studies indicated that RSV-loaded PLGA NPs inhibit apoptosis and promote autophagy. Collectively, this study demonstrates that intra-articular delivery of RSV via PLGA NPs might be an effective therapeutic approach for osteoarthritis.

Trapeziometacarpal osteoarthritis: do not forget other disorders

A retrospective study of patients with symptomatic trapeziometacarpal osteoarthritis was conducted to assess the prevalence of other disorders of the hand. Another disorder of the hand was associated in 49% of cases. A systematic clinical examination of the whole hand must be performed preoperatively.

Myostatin and CXCL11 promote nervous tissue macrophages to maintain osteoarthritis pain

Pain is the most debilitating symptom of knee osteoarthritis (OA) that can even persist after total knee replacement. The severity and duration of pain do not correlate well with joint tissue alterations, suggesting other mechanisms may drive pain persistence in OA. Previous work identified that macrophages accumulate in the dorsal root ganglia (DRG) containing the somas of sensory neurons innervating the injured knee joint in a mouse OA model and acquire a M1-like phenotype to maintain pain. Here we aimed to unravel the mechanisms that govern DRG macrophage accumulation and programming. The accumulation of F4/80+iNOS+ (M1-like) DRG macrophages was detectable at day 3 after mono-iodoacetate (MIA)-induced OA in the mouse. Depletion of macrophages prior to induction of OA resolved pain-like behaviors by day 7 without affecting the initial development of pain-like behaviors. Analysis of DRG transcript identified CXCL11 and myostatin. CXCL11 and myostatin were increased at 3 weeks post OA induction, with CXCL11 expression partially localized in satellite glial cells and myostatin in sensory neurons. Blocking CXCL11 or myostatin prevented the persistence of OA pain, without affecting the initiation of pain. CXCL11 neutralization reduced the number of total and F4/80+iNOS+ DRG macrophages, whilst myostatin inhibition diminished the programming of F4/80+iNOS+ DRG macrophages. Intrathecal injection of recombinant CXCL11 did not induce pain-associated behaviors. In contrast, intrathecal myostatin increased the number of F4/80+iNOS+ DRG macrophages concurrent with the development of mechanical hypersensitivity that was prevented by macrophages depletion or CXCL11 blockade. Finally, myostatin inhibition during established OA, resolved pain and F4/80+iNOS+ macrophage accumulation in the DRG. In conclusion, DRG macrophages maintain OA pain, but are not required for the induction of OA pain. Myostatin is a key ligand in neuro-immune communication that drives the persistence of pain in OA through nervous tissue macrophages and represent a novel therapeutic target for the treatment of OA pain.

Wharton's jelly and osteoarthritis of the knee.

The existing treatment modalities for knee osteoarthritis (OA) do not actually address the pathology. Biological therapies, including those using material derived from perinatal tissues, represent a ground-breaking approach to alleviating the symptoms of OA of the knee. Current scientific literature published in PubMed (MEDLINE), Embase and Scopus databases. Trials registered in various clinical trial databases. Perinatal tissues including Wharton's jelly (WJ) and associated mesenchymal stem cells (MSCs) can be used for the management of knee OA. The efficacy of WJ and associated MSCs in the management of knee OA is still controversial. The use of WJ and associated MSCs in the management of knee OA is safe and appears to be effective. The present published evidence suggests that WJ tissue and associated MSCs offer an encouraging alternative for the management of knee OA. The published in vitro, preclinical and clinical investigations demonstrate the therapeutic potential of WJ and promote further research in this field to provide symptomatic relief to patients suffering from OA, aiming also to regenerate the osteoarthritic hyaline cartilage, with disease-modifying effects. Future adequately powered randomized controlled trials should be undertaken to establish whether WJ is helpful in the management of OA of the knee.

Platelet-rich plasma injections for hip osteoarthritis : a systematic review

Osteoarthritis (OA) is the most prevalent type of joint disorder. Symptomatic hip OA was observed in 9.2% of adults aged 45 and above, with 27% displaying radiographic evidence of the condition. While there is no definitive cure for OA, numerous research studies have explored the application of PRP (Platelet-Rich Plasma) for addressing knee OA, there is a relatively limited number of investigations dedicated to hip OA. It is important to note that the hip joint possesses distinct characteristics compared to the other three joints. Therefore, in this systematic review, we wanted to focus on hip osteoarthritis and gave a brief update from the previous studies. This systematic review was conducted in accordance with the Preferred Reporting Items of Systematic Reviews (PRISMA) guidelines. All randomized control trials that compared injection of Platelet-Rich Plasma and Hyaluronic Acid in hip osteoarthritis patients using English language from 2018 until 2023 will be included. Six studies involved in this study with total samples of 237 in PRP group and 220 in HA group. The injection site, injection volume, number of injections, interval, and follow up were varied between these studies. All of the patients are undergoing treatment with ultrasound-guided intraarticular injections of PRP. The outcomes tabulated were Visual Analog Scale (VAS), Harris Hip Score (HHS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score which showed improvements from the baseline. All of the studies showed improvement of the score from the baseline. Although, there were improvements, it can be concluded that there was not enough evidence to promote the utilization of intra-articular PRP injections as a treatment for hip osteoarthritis. Since international guidelines only recommend intra-articular steroid injections for managing hip OA, it would be advantageous to conduct additional studies comparing PRP to steroids to assess the effectiveness of PRP injections in treating hip OA.

Association between hyperuricaemia and hand osteoarthritis: data from the Xiangya Osteoarthritis Study

ObjectiveThe pathogenesis of hand osteoarthritis (OA) remains unknown. Hyperuricaemia, which is related to inflammation, may play a role in hand OA, but evidence is lacking. In a large population-based study,...