Joint Osteoarthrosis Research Articles

Protective Effect of Genistein on Condylar Cartilage through Downregulating NF-κB Expression in Experimentally Created Osteoarthritis Rats.

Temporomandibular joint osteoarthrosis (TMJOA) is characterised by chronic inflammatory changes, with subsequent gradual loss of joint cartilage. NF-κB is a crucial transcription factor in the course of inflammatory and immune responses, which are involved in OA pathology activated by proinflammatory cytokines. Genistein is known to have anti-inflammation and modulation of metabolic pathways through repression of the NF-κB signaling pathway in inflammatory disease. But so far, studies on the effects of genistein on TMJOA are very limited. So, the purpose of this study is to investigate the protective effect of genistein against experimentally induced condylar cartilage degradation through downregulating NF-κB expression in created osteoarthritis rats in vivo. Male SD rats were created as temporomandibular joint osteoarthritis models and administered through oral gavage with low and high dosage genistein (30 mg/kg and 180 mg/kg, respectively) daily for 4 weeks. The morphological changes of the condylar cartilage were studied with HE and Masson staining. The expressions of p65 and inflammatory cytokines (IL-1β and TNFα) were detected using immunohistochemistry and real-time PCR. The results showed that experimentally created osteoarthritis reduced the condylar cartilage thickness of rats and increased the gene expression of cytokines (IL-1β and TNFα) and positive cells of p65. Genistein treatment had positive effects on the condylar cartilage renovation, while high dose genistein treatment had more significant effects on the reversing of OA changes and reduction of the expression of p65 and inflammatory cytokines (IL-1β and TNFα). The results indicated that high dose genistein treatment had obvious therapeutic effects on condyle cartilage damages of OA rats. The mechanism may be that genistein suppresses the NF-κB expression activated by inflammatory cytokines.

Application of various forms of meloxicam in the treatment of osteoarthrosis of the knee joints and the spine

Application of various forms of meloxicam in the treatment of osteoarthrosis of the knee joints and the spine

Functional and esthetic reconstruction of a case with tooth wear and temporomandibular joint osteoarthrosis

本文从牙列磨耗病因分析开始，设计一整套包括诊断饰面、诊断性临时修复体、数字技术复制临时修复体的治疗方案，完成1例牙列重度磨耗伴颞下颌关节骨关节病患者的功能与美学重建，疗效满意。可见颞下颌关节骨关节病并不完全是口腔修复治疗的绝对禁忌，但需选择合适的修复治疗时机。.

The drug-induced injury of the upper gastrointestinal tract: prophylaxis and treatment

It is well established that non-steroidal anti-inflammatory drugs (NSAIDs) are the causal factor of mucosa damage not only of in the stomach and duodenum, but also in esophagus, triggering the development of gastroesophageal reflux disease (GERD). It is known that NSAIDs’ intake (including low doses of aspirin) can significantly increase the likelihood of developing of the peptic esophagitis with the risk of ulceration, bleeding, or stricture formation. Recent years, there is an increasing number of papers, devoted to the investigation of esophageal lesions and mechanisms of GERD development, occurring during the NSAIDs’ administration (including low doses of acetylsalicylic acid) and other drugs. The structure of drug-induced lesions of the upper gastrointestinal tract in patients taking NSAIDs has been analyzed. The investigation has been performed to study the frequency and characteristics of esophageal lesions in patients with osteoarthrosis of large joints, receiving NSAID treatment, as well as to determine factors that increase risk of developing this pathology. With account of the considered risk factors, the most rational approach to the diagnosis and primary prevention of NSAID-induced esophagitis has been chosen, which in most cases should reduce the incidence of side effects of NSAID-associated lesions of the esophagus. The main directions in the treatment of NSAID-associated injuries of the esophagus, namely, lifestyle change, balanced diet, changing the dose and regimen of NSAIDs or switching to selective NSAIDs, modern pharmacotherapy and surgical treatment have been elucidated. Clinical examples of patients with esophagus and stomach injuries associated with the long-term administration of NSAIDs and antiplatelet drugs were used to discuss the prevention and treatment of this category of patients, using proton pump inhibitors and bismuth-containing drugs.

Комплексная гериатрическая оценка остеоартроза коленных суставов в старческом возрасте

Комплексная гериатрическая оценка остеоартроза коленных суставов в старческом возрасте

Five year long term results of total joint arthroplasties in the treatment of trapeziometacarpal osteoarthritis.

Introduction: Trapeziometacarpal (TMC) osteoarthritis is a common disease. Patients with advanced disease who have failed conservative treatment have different surgical options, including total joint prosthesis. The aim of this study was to investigate the long-term outcome and complications of trapeziometacarpal (TMC) total arthroplasty. Materials and Methods: One hundred and forty-seven patients with TMC osteoarthritis were surgically treated with TMC arthroplasty, and one hundred and thirty-seven patients were seen for follow-up (102 women and 35 men). At follow -up patients were asked to complete a visual linearanalogue scale (VAS) for satisfaction with the result of the operation and persisting pain from the thumb, the Spanish validated Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used to evaluate function of the affected hand.(9) The radiological examination consisted of posterior-anterior and oblique radiographs. In preoperative radiographs Eaton-Little was used, and in postoperative radiographs were assessed with regard to implant loosening and alignment. Results: The subjective outcome was satisfactory in 126 cases (92 %), 14 (12 %) patients would undergo the same procedure in the other hand. The DASH questionnaireswere 19.55 (range 5.6-33,5) on average, and EVA was 1 on average. The mean key pinch strength was 5.8 Kg at 5 years follow-up. The most frequent postoperative complication was De Quervain tenosynovitis (21%), other complications were: Cup loosening (3.6%), traumatic dislocation (3,6%). The prosthesis was removed in nine cases (7%). There were four intraoperative complications. The survival rate for ARPE prosthesis was 92,7% at 60,5 months. TMC total arthroplasty offers a reliable treatment alternative in patients with thumb carpometacarpal joint osteoarthrosis which conservatives’ treatment had failed. Conclusions: The TMC joint prosthesis is an option for patients with TCM osteoarthritis, provides satisfactory outcomes and has a low failure rate.(www.actabiomedica.it)

Клиническая эффективность электрического поля электрета при хирургическом лечении остеоартроза тазобедренного сустава

Клиническая эффективность электрического поля электрета при хирургическом лечении остеоартроза тазобедренного сустава

Balneotherapy as a key factor in the complex treatment of osteoarthrosis of large joints among elderly patients at a sanatorium-resort stage

Objective. Study of the clinical efficacy of iodine balm therapy in the treatment of osteoarthritis of the knee at the sanatorium-resort stage. Materials and methods. The study involved 48 patients at the age of 60 years and above with osteoarthritis of the knee joints conforms to the requirements of the American College of Rheumatology and II-III X-ray stages according to Kellegren Lawrence. The patients of the main group (n24) received the basic medical complex: iodide-bromine baths (every other day 10 procedures, with a water temperature of 36-37 C, duration 10 minutes) physical therapy daily number 10-12 procedures, magnetic therapy and manual massage of the joints (daily, number 8). Patients of the control group (n 24) were not prescribed balneotherapy by iodine-bromine baths. Results. In a general assessment of the effectiveness of treatment, a decrease in the intensity of pain was observed according to the visual analogue scale in all patients, regardless of the type of physiotherapy. In a general assessment of the effectiveness of treatment, a decrease in the intensity of pain was observed according to the visual analogue scale among all patients, regardless of the type of physiotherapy. The positive result noted among patients of the main group was more pronounced than in the control group. In 60 of patients the psycho-emotional background (mood, sleep) improved, in 67.5 the volume of movements in the joints recovered. In 20 of cases there was a decrease of the level of cholesterol in the blood and in 82 there was a decrease of the content of beta-cross laps (C-terminal telopeptides of I type of collagen) by 20 or more. Cunclusion. Iodine-bromine baths (as in combination with other procedures) are an effective treatment for elderly patients suffering from osteoarthritis of the knee joints

The role of polymorphic variants of matrix metalloproteinases genes in the formation of disruption of connective tissue homeostasis and pathology of the musculoskeletal system.

A clinical assessment of the presence of osteoarthritis (OA) with various localizations, undifferentiated connective tissue dysplasia (uCTD) and joint hypermobility (JHM) in 484 individuals of both sexes of different age groups was carried out. We searched for associations of 4 polymorphic variants of matrix metalloproteinase genes (rs35068180 (MMP3), rs2252070 (MMP13) ), rs226794 and rs2830585 (ADAMTS5)) with the development of osteoarthrosis as a whole, taking into account the localization of the pathological process, the age of the patients, the ethnic origin of the study groups and the presence of undifferentiated connective tissue dysplasia as a whole and its individual phenotypic markers, as well as in the comorbid state with osteoarthritis was carried out. 158 patients had osteoarthritis, 252 had a symptom complex of uCTD, 92 of them were in the comorbid state with OA. The significance of the polymorphic loci of MMP3, MMP13, ADAMTS5 genes in the formation of the symptom complex of uCTD in general and its individual phenotypes was detected. The polymorphic locus of MMP3 gene was associated with OA in the comorbid state with uCTD. Statistically significant models based on clinical-genetic data using the method of multiple logistic regression, that allow predicting the development of osteoarthrosis of knee, hip joints and polyosteoarthrosis were calculated.

Anterior open bite due to temporomandibular joint osteoarthrosis with muscle dysfunction treated with temporary anchorage devices

Skeletal Class II high-angle open bite is often accompanied by osteoarthrosis of the temporomandibular joint (TMJ-OA). This type of malocclusion is challenging to correct, and it has been reported that patients with TMJ-OA treated with orthognathic surgery often experience skeletal relapse and a poor prognosis. This case report describes the treatment of a 25-year-old woman with retrognathia and TMJ-OA, whose masseter and temporal muscle activities were weak. Temporary anchorage devices were placed in the maxilla and the mandible, and the first molars were intruded. We used improved superelastic nickel-titanium alloy wires with tip-back bends for both arches, and intermaxillary elastics were used to upright the molars. After treatment, intrusion of the maxillary and mandibular first molars, counterclockwise rotation of the mandible, and improvement of occlusion and profile had been achieved. The patient's condyles were repositioned into ideal positions, and masticatory muscle activity was augmented and balanced. After 2years of retention, the mandibular and condylar positions were stable, and acceptable occlusion was maintained without recurrence of TMJ symptoms; harmonious activity of the masticatory muscles was retained. The findings of this case report suggest that molar intrusion using temporary anchorage devices for a patient with severe anterior open bite and TMJ-OA may be useful for improving stomatognathic function, occlusion, and facial esthetics.

Optical Analysis of Synovial Fluid of Patients with Knee Joint Osteoarthrosis

The results of the study of synovial fluid (SF) of patients with knee joint osteoarthritis (OA). The optical analysis of the SF samples, harvested during exploratory punctures of knee joints of patients suffering the osteoarthrosis in different stages using the standard method, was made. A certain component composition of surface of SF samples that differs for healthy people and the patients, having knee joint osteoarthrosis in different stages, is possible to identify as a result of analysis with the use of Raman spectroscopy method. The introduced optical coefficients help to estimate the spectral composition of surface of SF samples of the patients, suffering the early and late stages of ОА.

Special peculiarities of clinical course of osteoarthrosis of knee joints depending on 6-hydroxymelatonin-sulfate urinary excretion profile

The study objective was to define the special features of the clinical course of knee joint osteoarthrosis depending on 6-sulfatoxymelatonin urinaryexcretion profile.Materials and methods.We surveyed 141 patients with radiological Stage II-III osteoarthrosis (OA) of the knee joints (18 female subjects). Diagnosis of OA was established on the basis of ACR criteria (1991) and EULAR (2010) recommendations. We determined the AO clinical indexes (Lequesne, WOMAC, KOOS), HAQ functional index, sleep quality and psycho-emotional state indicators. ELISA was used to assess 6-sulfatoxymelatonin urinary excretion profile.Results. It was established that 66% of patients with OA of knee joints had a reduced 6-sulfatoxymelatonin urinary excretion compared to this of practically healthy individuals. AO patients with low 6-SMT urinary excretion profiles had higher incidence of severe insomnia and depressive disorders. Reduction in 6-SMT excretion was associated with a moderate increase in pain syndrome and deterioration of physical functions by Lequesne, WOMAC, KOOS, and HAQ indexes.Conclusion.The reducedmelatonin production in ОА patients is a factor of more severe clinical course of the disease due to deterioration of the psycho-emotional state, the development of pain syndrome, and functional disorders.

Anterior intermeniscal ligament: frequency in MRI studies and spatial relationship to the entry point for intramedullary tibial nailing related to the risk of iatrogenic violation.

Anterior knee pain is the most common complication after intramedullary tibial nailing. Often, the cause is multifactorial and individually different. Violation of the anterior intermeniscal ligament (AIL) during intramedullary tibial nailing might be a possible origin of postsurgical anterior knee pain. Both the importance and function of the AIL remain somewhat ambivalent, and even the figures quoted in the literature for its existence in the population vary drastically. Our aim was to verify the estimated frequency of the AIL in the literature by retrospectively analysing the data of MRI studies conducted at our hospital. In addition, we attempted to assess the potential risk of AIL violation during intramedullary tibial nailing, based on the spatial arrangement. Two independent examiners analysed the images generated in 351 MRI studies conducted at our hospital between June 2013 and May 2014. All cases who did not reveal any previous knee-joint injury or osteoarthritis of the knee were allocated to group I. All other cases were included in group II. To estimate the potential risk of AIL injury during the nailing procedure, the distance between the AIL and the theoretical entry point for intramedullary nailing was measured. We identified the AIL on the images of nearly all patients (96.5%) in group I. In group II, the presence of the AIL was confirmed in only 51.4% of cases (p < 0.001). The average distance between the AIL and theoretical entry point for intramedullary tibial nailing was 10.1mm (range 3.48-18.88mm). Because we were able to confirm the presence of the AIL in nearly all patients without a history of knee joint injuries or osteoarthrosis, we presume that the AIL may play a role in knee joint function. Violation of the AIL during intramedullary nailing appears likely due to the close position of the AIL in relation to the entry point for the inserted nail. As a result and due to its rich sensory innervation, a connection between AIL violation during tibial nailing and postoperative onset of anterior knee pain seems likely. To eliminate one risk factor of anterior knee pain development and in view of the unresolved issues of AIL function, violation of the ligament during any operative procedure should be avoided.

Correlation of benign incidental findings seen on whole-body PET-CT with knee MRI: patterns of 18F-FDG avidity, intra-articular pathology, and bone marrow edema lesions.

To correlate patterns of 18F-FDG uptake on whole-body PET-CT with MR findings and compare the degree of FDG activity between symptomatic and asymptomatic knees. Retrospective database query was performed using codes for knee MRI as well as whole-body PET-CT. Patients with malignant disease involving the knee or hardware were excluded. Patients who had both studies performed within 1year between 2012 and 2017 were included for analysis. Knee joint osteoarthrosis, meniscal and ligamentous integrity, presence of joint effusion, and synovitis were assessed and recorded. Bone marrow edema lesions (BMELs) were identified, segmented, and analyzed using volumetric analysis. SUVmax was assessed over the suprapatellar joint space, intercondylar notch and Hoffa's fat pad. Symptomatic and asymptomatic knees were compared in patients with unilateral symptoms. Twenty-two cases (20 patients) with mean age 63.3years (range, 36-91years) were included. Two patients had bilateral pain. The most FDG avid regions in both symptomatic and asymptomatic knees were the intercondylar notch (SUVmax = 1.84 vs. 1.51), followed by suprapatellar pouch (SUVmax = 1.74 vs. 1.29) and Hoffa's fat pad (SUVmax = 1.01 vs. 0.87). SUVmax was significantly associated with cartilage loss (mean modified Outerbridge score) (r = 0.60, p = 0.003) and degree of synovitis (r = 0.48, p = 0023). Overall, mean SUVmax was significantly higher in the presence of a meniscal tear (1.83 ± 0.67 vs. 1.22 ± 0.40, p = 0.030). Nine patients had BMELs (volume: range = 0.6-27.8, mean = 7.79) however there was no significant association between BMEL volume and SUVmax. Higher FDG activity correlates with intra-articular derangement and the intercondylar notch represents the most metabolically active region of the knee.

PATHOGENETIC SUBSTANTIATION OF COMPREHENSIVE TREATMENT OF PATIENTS WITH CHRONIC PANCREATITIS COMBINED WITH OSTEOARTHROSIS AND OBESITY CONCERNING THE CORRECTION OF THE DISORDERS IN THE PROTEINASE INHIBITOR SYSTEM AND METABOLISM OF THE CONNECTIVE TISSUE COM

Introduction. The incidence of the co-morbid course of chronic pancreatitis (CP) and obesity has recently increased significantly both in Ukraine and all over the world, especially in individuals being in the second half of their adulthood and in the elderly ones. This combination of interdependent diseases is often complemented by osteoarthrosis (OA) of the large joints, which is characterized by severe, rapidly progressing course. The basis CP and OA progression, among various mechanisms of pathogenesis, is the proteinase-inhibitor imbalance, which leads to proteolytic damage and destruction of acinar epithelium and cartilage tissue, polymorphocyte infiltration of the tissue of the pancreas and synovial epithelium (reactive synovitis) under the influence of increased expression and activation of cellular adhesion factors, hyperproduction of proinflammatory cytokines, growth factors of anabolic action, acidosis, hypoxia, etc.Objective. Тo identify the mechanisms of mutual aggravation of chronic pancreatitis and osteoarthrosis of large joints in obese patients on the basis of the study of protein and carbohydrate-protein components of the extracellular matrix of the proteinase inhibitor system, to increase the efficiency of comprehensive treatment for this polymorbidity.Materials and methods. Тhe study involved 90 patients with CP, aged 45 to 63 years old , 22 of whom had normal body weight (1group 1), 27 patients with CP suffered from the first degree obesity (group 2), 41 patients had CP with comorbid first degree obesity and І-ІІ stage osteoarthritis of the of the hip and knee joints (group 3).To evaluate the effectiveness of the proposed treatment, the patients of group 3 were divided into two subgroups: 3A and 3B. Group 3А (21 individuals) received basic treatment of CP exacerbation: a hypocaloric diet with elimination of extractive foods, antisecretory (proton pump inhibitor), antispasmodic (mebeverine hydrochloride) for 1 month, multienzyme (kreon10-20 thousand units) preparations, L-carnitine (solution) 1.0 (10 ml) twice a day for 90 days. Group 3B (20 people), in addition to the above therapy, received the drinking form of L-carnitine 1.0 (10 ml) twice a day and L-glutathione (hepaval) 250 mg twice a day for 90 days.Results. Тhe proposed therapy contributed to the normalization of proteinase inhibitor homeostasis. Without proteinase inhibitors in the basic therapy the complex application of L-carnitine and L-glutathione contributed to a reliable decrease in the intensity of azole albumin lysis in patients of both groups: 1.2 and 1.6 times, respectively (p &lt;0.05), due to significant inhibition of hyperproduction of proteinase inhibitors: the content of α2- macroglobulins in the blood dropped by 1.6 and 2.2 times (p &lt;0.05) with normalization of the values.Conclusions. Patients with chronic pancreatitis, comorbid obesity and osteoarthrosis of large joints were studied during their therapy, the mechanisms of mutual aggravation were identified: hyperproduction of the extracellular matrix components, acute phase proteins, an increased degradation of fucoglycoproteins and proteinase-inhibitor imbalance.The integrated therapy of patients with CP and obesity which includes antioxidant (L-glutathione) and a metabolism stabilizer (L-carnitine) against the basic treatment resulted in the balance of the processes of synthesis and decomposition of collagen and glycoproteins, proteinase-inhibitor system homeostasis, collagenolysis enhancement with the achievement of the balance in the metabolism of the connective tissue components, homeostasis of hydrogen sulfide, which underlies the achievement of stable remission of CP and OA, reducing the risk of their progression.

Galectin-3 serum profile in patients with knee osteoarthrosis: association with the disease course

Aim of the work was to study the level of galectin-3 in serum in patients with osteoarthrosis of knee joints and to evaluate its association with the course of the disease. Materials and methods. We examined 141 patients with osteoarthrosis (OA) of knee joints (76.6% of women), an average age of 58.4 ± 7.91 years, a disease duration of 10.5 ± 6.50 years, an II-III radiological stage. 33.3% of patients had a combination of OA knee and hip joints. Diagnosis of OA was established on the basis of criteria ACR 1991 and recommendations EULAR (2010). The Lequesne algo-functional index, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS) were determined. Functional disorders were evaluated by the Health Assessment Questionnaire (HAQ). The content of galectin-3 in the blood was determined by the enzyme-linked immuno sorbent assay. Results. It has been established that in 75% of patients with OA of knee joints aberrant levels of galectin-3 in the blood are detected, including 44% of subjects with a registered high level of the index (>15.8 ng/ml). The weak associative relationships between the level of galectin-3 and the age of patients and the duration of OA were established. Among patients with aberrant levels of galectin-3, persons with severe clinical manifestations of OA appeared more often. The increase in the level of galectin-3 was associated with a significant increase in the pain syndrome and the deterioration of physical function by the indexes of Lequesne, WOMAC, KOOS, HAQ. Conclusions. In patients with OA, the increase in the production of galectin-3 is a factor in the deterioration of the clinical course of the disease, the increase in pain syndrome and functional disorders. A close associative relationship was found between the level of galectin-3 and the clinical severity indexes of OA and the weak associative relationship between the level of galectin-3 and the age and duration of the disease

Clinical and Radiological Mid- to Long-term Outcomes Following Ankle Fusion.

The aims of this study were to establish the likelihood of additional surgery after ankle fusion, determine the interval for developing osteoarthrosis in the ipsilateral subtalar or Chopart joints, and evaluate its clinical relevance. A retrospective clinical and radiological study with a minimum follow-up of 24 months was performed. Short-Form 36 Heath Survey, Foot Function Index, American Orthopaedic Foot and Ankle Society Score (AOFAS) and a visual analog scale (VAS) were used to evaluate pain level and quality of life in at least 62 adult patients. A total of 57% of our patients developed osteoarthrosis in at least one of the related joints and 28% of them required additional surgery due to pain. Patients who received workers' compensation had significantly lower AOFAS and higher VAS pain values. More than half of the study cohort developed osteoarthrosis in the related joints after ankle fusion, but fewer than one-third required further joint fusion surgery as a consequence.

RELACIÓN DE LOS ESTADIOS DE LA OSTEOARTROSIS TEMPOROMANDIBULAR CON LOS CAMBIOS DIMENSIONALES DEL ESPACIO ARTICULAR TEMPOROMANDIBULAR, EVALUADO CON TOMOGRAFÍA COMPUTARIZADA CONE BEAM

Introducción: El objetivo de este estudio es determinar la relación entre los estadios de la OA temporomandibular y los cambios dimensionales del espacio articular temporomandibular. Métodos: Se analizó los tomogramas de 120 articulaciones de 60 pacientes de 14 a 60 años atendidos en clínicas privadas, agosto 2009 / enero 2012 Lima. Con signos de artrosis degenerativa, a través de (CBCT), la ATM izquierda y derecha se evaluaron de forma independiente para cada paciente. La evaluación incluye: cambios óseos del cóndilo (erosión, aplanamiento, osteofitos, esclerosis) y de la fosa mandibular (erosión, esclerosis), clasificándolo en cada estadio de OA para luego realizar las mediciones de los espacios articulares anterior, superior y posterior de cada articulación en el plano sagital. Fueron analizados estadísticamente por el ANOVA de un factor y la prueba post hoc Bonferroni para ver la diferencia significativa de los espacios articulares entre cada estadio. Resultados: Se mostró que hubo diferencias significativas a un nivel de significancia de p&lt;0.05 de los espacios articulares anterior (p&lt;0.000), superior (p&lt;0.000) y posterior (p&lt;0.004). Siendo diferentes en el estadio inicial y terminal en los espacios articulares anterior y superior, el estadio intermedio y terminal en el espacio posterior. No mostrando diferencia en el estadio inicial e intermedio en los espacios articulares anterior y superior, y estadio intermedio y terminal en el espacio posterior. Conclusiones: El presente estudio demostró que las dimensiones de los espacios articulares (anterior, superior y posterior), comparado con parámetros normales, disminuye en cada estadio de osteoartrosis temporomandibular.

EFFECT OF THE DRUG FROM SOYBEAN AND AVOCADO ON THE COURSE OF OSTEOARTHROSIS OF THE KNEE JOINTS WITH CONCOMITANT METABOLIC SYNDROME IN WOMEN IN THE MENOPAUSAL PERIOD

The most common articular pathology is osteoarthrosis of the knee joints. More than 10 % of the world's population suffers from this disease. The development of osteoarthrosis (OA) is also affected by metabolic syndrome (MS), which is characterized by abdominal obesity, dyslipidemia, arterial hypertension and disturbance of carbohydrate metabolism. The combination of MS and osteoarthrosis creates conditions of overload for the functioning of axial joints, which is one of the main causes of premature disability and invalidization of the population. Treatment of OA of the knee joints in women in the menopausal period with concomitant metabolic syndrome presents great difficulties. To achieve a stable result of treatment, therapy with chondroprotectors and nonsteroidal anti-inflammatory drugs (NSAIDs) is used. Treatment was carried out in 60 women in the menopausal period with MS, suffering from OA of knee joints. In the group of women in the menopausal period with OA of knee joints and MS who took therapy with the inclusion of the soybean and avocado drug alongside with NSAIDs, a significant effect was obtained with regard to arresting the pain syndrome, improving the quality of life, reducing the degree of inflammation as well as increased joint mobility compared with the group of patients, who took only chondroprotectors and NSAIDs

Synovial fluid‑derived synovial fragments represent an improved source of synovial mesenchymal stem cells in the temporomandibular joint.

Surgery-obtained synovium specimens (SSSs) can provide a source of synovial mesenchymal stem cells (SMSCs) for experimental studies. However, these specimens contain diverse tissues, including the intima and subintima; therefore, these SMSCs are not entirely derived from the intima and their cell source is heterogeneous. The present study isolated synovial fragments (SFs) from synovial fluid dilutions extracted from patients with temporomandibular joint (TMJ) osteoarthrosis. Unlike SSSs, SFs, which are membranous and translucent, consist of only several cell layers, indicating the presence of only the intima. In the present study, SF cells (SFCs) and SSS cells (SSSCs) exhibited a homogeneous, fibroblast-like, spindle-shaped morphology after passaging in vitro. Furthermore, both cell types exhibited similar proliferative and differentiation potentials in vitro. However, SFCs exhibited more uniform surface markers compared with SSSCs when analysed by flow cytometry. Taken together, these results indicated that SFs contained a greater amount of unmixed intima than SSSs, and that SFCs exhibited more homogeneous characteristics than SSSCs, thereby offering an improved source of SMSCs in the TMJ.