Osteophyte Size Research Articles

Posterior clearance increases the knee extension angle in cruciate retaining type total knee arthroplasty: Intraoperative evaluation using a navigation system

BackgroundPosterior osteophyte of the femur can impinge on the tibia insert in total knee arthroplasty (TKA). Although osteophyte removal [posterior clearance (PC)] improves the flexion angle, its influence on the gaps and extension angle are unclear. This study investigated the effect of PC on the gaps and range of motion (ROM) using a navigation system, as well as PC's relationship with osteophyte size. MethodsTwenty-seven knees that underwent cruciate-retaining (CR)-type TKA were examined. Before and after PC, the ROM, hip-knee-ankle (HKA) angle, and flexion and extension gaps were recorded using a navigation system. Osteophyte size was measured in the lateral view in radiographs, and in the sagittal and axial planes of computed tomography (CT) images. The effects of PC on the gaps and ROM were analysed statistically. ResultsPC caused the extension gap to increase by 0.7 ± 0.9 mm in the medial (p < 0.001), and 0.9 ± 1.5 mm in the lateral compartment (p = 0.006). The extension angle increased by 4.9 ± 1.6°, flexion angle increased by 6.5 ± 5.0°, and HKA decreased by 0.3°. The increase in extension angle by PC was significantly correlated with the preoperative HKA angle (r = 0.594) and with the osteophyte area in radiographs and CT (r = 0.626 to 0.681). ConclusionsThe extension and flexion gaps increased less than 1 mm in the medial and lateral compartments. PC achieving an additional 5° extension angle could promote full extension in severely deformed knees with a large posterior osteophyte. The extension angle increase by PC was correlated with the preoperative HKA angle and osteophyte size.

DEVELOPING THE COMMON MARMOSET AS A TRANSLATIONAL MODEL OF AGE-RELATED OSTEOARTHRITIS

Age is a primary risk factor for osteoarthritis (OA). The mechanisms that contribute to OA are poorly understood and disease modifying treatments have not been identified. A critical shortcoming in developing therapies is the limited number of translational models available to identify the causes of naturally occurring OA. Our goal is to use the common marmoset as a non-human primate (NHP) model of age-related OA. NHP are the closest evolutionary relative to humans and share many characteristics of human aging. The marmoset has advantages over other NHP for aging research because of their relatively short maximal lifespan and small size. Micro-computed tomography (uCT) was performed on whole-knee joints obtained from young (10 yrs, n=3) marmosets at necropsy. OA was evaluated using a clinical uCT scoring system and quantitative assessments of subchondral bone structure and ossified meniscal volume. Advancing age was positively correlated to increased uCT OA score (p<0.05, r=0.59 ), mainly through increased number and size of osteophytes and progressive subchondral bone sclerosis from the medial to both medial and lateral compartments. For marmosets displaying meniscal ossification, older marmosets had greater (p<0.05) ossified meniscal volume than middle-aged and younger marmosets, respectively. Trabecular (p=0.05) and cortical bone thickness (p<0.05) were also lower in older marmosets. These data are the first to indicate that the marmoset develops naturally occurring, age-related OA and support the pursuit of additional studies using the marmoset to identify OA mechanisms and test potential interventions.

Low-level cyclic tibial compression attenuates early osteoarthritis progression after joint injury in mice

Mechanical loading and joint health have a unique relationship in osteoarthritis (OA) onset and progression. Although high load levels adversely affect cartilage health, exercise that involves low to moderate load levels can alleviate OA symptoms. We sought to isolate the beneficial effects of mechanical loading using controlled invivo cyclic tibial compression. We hypothesized that low-level cyclic compression would attenuate post-traumatic OA symptoms induced by destabilization of the medial meniscus (DMM). 10-week-old C57Bl/6J male mice underwent DMM surgery (n=51). After a 5-day post-operative recovery period, we applied daily cyclic tibial compression to the operated limbs at low (1.0N or 2.0N) or moderate (4.5N) magnitudes for 2 or 6 weeks. At the completion of loading, we compared cartilage and peri-articular bone features of mice that underwent DMM and loading to mice that only underwent DMM. Compared to DMM alone, low-level cyclic compression for 6 weeks attenuated DMM-induced cartilage degradation (OARSI score, P=0.008, 95% confidence interval (CI): 0.093 to 0.949). Low-level loading attenuated DMM-induced osteophyte formation after 2 weeks (osteophyte size, P=0.033, 95% CI: 3.27-114.45μm), and moderate loading attenuated subchondral bone sclerosis after 6 weeks (tissue mineral density (TMD), P=0.011, 95% CI: 6.32-70.60mg HA/ccm) compared to limbs that only underwent DMM. Finally, loading had subtle beneficial effects on cartilage cellularity and aggrecanase activity after DMM. Low-level cyclic compression is beneficial to joint health after an injury. Therefore, the progression of early OA may be attenuated by applying well controlled, low-level loading shortly following joint trauma.

Disruption of glucocorticoid signalling in osteoblasts attenuates age-related surgically induced osteoarthritis

Aging is a major risk factor for osteoarthritis (OA). Skeletal expression and activity of the glucocorticoid-activating enzyme 11β-hydroxysteroid-dehydrogenase type 1 increases progressively with age in humans and rodents. Here we investigated the role of endogenous osteocytic and osteoblastic glucocorticoid (GC) signalling in the development of osteoarthritic bone and cartilage damage in mice. We utilized transgenic (tg) mice in which glucocorticoid signalling is disrupted in osteoblasts and osteocytes via overexpression of the glucocorticoid-inactivating enzyme, 11β-hydroxysteroid-dehydrogenase type 2. Osteoarthritis was induced in 10- and 22-week-old male transgenic mice (tg-OA, n=6/group) and their wildtype littermates (WT-OA, n=7-8/group) by surgical destabilization ofthemedial meniscus (DMM). Sham-operated mice served as controls (WT- & tg-Sham, n=3-5 and 6-8/group at 10- and 22-weeks of age, respectively). Sixteen weeks after DMM surgery, mice developed features of cartilage degradation, subchondral bone sclerosis and osteophyte formation. These changes did not differ between WT and tg mice when OA was induced at 10-weeks of age. However, when OA was induced at 22-weeks of age, cartilage erosion was significantly attenuated in tg-OA mice compared to WT-OA littermates. Similarly, subchondral bone volume (-5.2%, 95% confidence intervals (CI) -9.1 to-1.2%, P=0.014) and osteophyte size (-4.0mm2, 95% CI -7.5 to-0.5mm2, P=0.029) were significantly reduced in tg-OA compared to WT-OA mice. Glucocorticoid signalling in cells of the osteoblast lineage promotes the development of surgically-induced osteoarthritis in older, but not younger, male mice. These data implicate osteoblasts and osteocytes in the progression of DMM-OA, via a glucocorticoid-dependent and age-related pathway.

Computed Tomography Features of Glenoid Osteophytes in Traumatic Anterior Shoulder Instability: Comparison Between Younger and Older Patients.

Background:Osteoarthritis that develops after traumatic anterior shoulder instability is known as dislocation arthropathy, but its frequency and characteristics are still unclear.Purpose:To evaluate glenoid osteophytes in shoulders with traumatic anterior instability by using computed tomography (CT) and to elucidate the influence of instability on the progression of dislocation arthropathy in different age groups.Study Design:Cross-sectional study; Level of evidence, 3.Methods:This study involved 214 unoperated patients with unilateral instability who underwent CT of both shoulders. The patients were divided into 2 groups according to age at the time of CT: ≤30 years (younger group; n = 172) and ≥31 years (older group; n = 42). Patient demographics as well as the presence, size, and location of glenoid osteophytes were compared between the 2 groups and also between patients with and without osteophytes. Furthermore, patients with osteophytes in the older group were divided into 2 subgroups according to age at the time of the initial injury: as a teenager (early-onset subgroup; n = 9) or at ≥31 years (late-onset subgroup; n = 14), and the same assessments were conducted.Results:Osteophytes were significantly more frequent on the affected side of the older group compared with the younger group (71.4% vs 13.9%, respectively; P < .001). In the younger group, patients with osteophytes had more multiple-instability events (P = .002) and a longer interval from injury to CT (P < .001) than those without osteophytes. Although there was no difference in osteophyte size between the 2 groups, most osteophytes were located at the anteroinferior part of the glenoid in the younger group, while osteophytes were usually circumferential around the glenoid in the older group. A comparison between the early- and late-onset subgroups in older patients with osteophytes revealed that the osteophytes were more frequently located at the anteroinferior glenoid region in the early-onset subgroup.Conclusion:CT allowed a detailed evaluation of glenoid osteophytes, revealing that osteophytes were not uncommon in younger patients. Instability itself might influence the progression of osteoarthritic changes in younger patients, while aging seems to have a greater effect in older patients.

IL37 ameliorates experimental murine osteoarthritis

Purpose: Osteoarthritis (OA) is the world’s most common degenerative joint disorder and leads to pain and disability. Currently, no disease-modifying drugs are available, resulting in a large unmet clinical need. Recently, we have shown that the anti-inflammatory cytokine IL37 lowers pro-inflammatory cytokine production, MMP3 expression and sulfated glycosaminoglycan loss in ex vivo cultured chondrocytes and human OA cartilage explants. In this study, we further explored the ability of IL37 to ameliorate OA pathology by studying its effects both in vitro on synovial fibroblasts and in vivo in experimental OA in mice. Methods: Primary human synovial fibroblasts were obtained by enzymatic digestion of synovial biopsies of 10 patients undergoing total joint replacement surgery. IL37 was overexpressed in these fibroblasts using an adenovirus (Ad-IL37) and subsequently cells were challenged with IL1β or OA-synovium conditioned medium (OAS-cm). Experimental OA was induced by a single intra-articular injection of 3 units of collagenase type VII in the right knee joint of 10 weeks old female C57BL/6J mice, i.e. collagenase-induced OA (CiOA). Four days after collagenase injection, Ad-IL37 or Ad-Luc (= control) was injected in the same joint, and after two weeks this injection was repeated. Mice were sacrificed on day 7, 28 and 42 after collagenase injection. Synovial thickening, cartilage damage (OARSI score) and osteophyte formation (size) were measured histologically. IL37, MMP3 and VDIPEN expression were investigated by immunohistochemistry. Results: In primary synovial fibroblasts, IL1β- and OAS-cm-induced expression of MMP1, MMP3, IL1B and IL6 was reduced by more than 50% by IL37. Prolonged (28 days) overexpression of IL37 in naïve knee joints did not lead to synovial thickening, cartilage damage or osteophyte formation and no overt immune response was detected. Strikingly, at day 7 of CiOA, IL37 overexpression significantly reduced synovial thickness, whereas in cartilage MMP3 protein and the presence of the metalloproteinase-generated aggrecan-degradation neoepitope VDIPEN was reduced. At day 28 of CiOA, cartilage damage was significantly reduced by IL37 treatment at both the lateral and medial side of the femur by 46% and 41%, respectively. Furthermore, osteophyte size at the medial femur was reduced by 70%. At day 42 of CiOA, IL37 overexpression could no longer be detected, in contrast to day 7 and 28. Osteophyte size formation at the medial femur was still significantly reduced by 46%, but only a trend (p = 0.06) towards reduced cartilage damage was observed on both femur and tibia at this time point. Conclusions: Our results show that IL37 inhibits the production of catabolic mediators in OA synovial fibroblasts, similar to what we previously observed in cartilage and chondrocytes. Furthermore, IL37 clearly lowered synovial thickening and ameliorated cartilage damage and osteophyte formation in murine experimental OA. These results indicate that IL37 acts on multiple OA-related processes in multiple joint tissues, which supports IL37 as a potential therapeutic agent for OA.

Stifle joint osteoarthritis at the time of diagnosis of cranial cruciate ligament injury is higher in Boxers and in dogs weighing more than 35 kilograms

Osteoarthritis is a ubiquitous disease in dogs. The purpose of this retrospective study was to characterize the severity and distribution of osteoarthritis (OA) within the joint and to identify differences among dog breeds in the severity of OA in the cranial cruciate ligament (CCL)-deficient stifle joint. Radiographs of 240 stifles from 51 Boxers, 66 German Shepherds, 100 Labrador Retrievers, and 23 Siberian Huskies with confirmed CCL rupture were included. Radiographs of the stifle joint were evaluated and OA severity was graded at 33 sites within and around the joint, and patella alta was graded as present or absent for a potential total stifle OA score of 100. Osteophyte size was correlated to OA severity score. Total OA scores were calculated and compared within and between breeds globally as well as at each joint site. Dogs weighing>35 kg had a higher total OA score than those weighing<35 kg. Osteoarthritis scores were highest at the apical patella, proximolateral tibia, and sesamoid bones, corresponding to the proximal, lateral, and caudal aspects of the joint, respectively. No statistically significant differences were found among the mean OA scores of various stifle joint regions. Boxer dogs had a higher total OA score than other breeds. We concluded that dogs have a consistent distribution pattern of OA within the stifle joint after CCL injury. Radiographic OA is more severe in the proximal, lateral, and caudal aspects of the joint. Boxers had more severe OA than the other breeds evaluated in the study.

Clinical outcomes of patients with residual medial osteophytes following mobile bearing unicompartmental knee arthroplasty.

IntroductionThe surgical technique used in unicompartmental knee arthroplasty (UKA) is crucial for achieving good short and long term clinical outcomes. The medial mobile bearing UKA has shown excellent clinical outcomes and survivorship. But release of the medial collateral ligament during entering joint is cause of mobile bearing dislocation in short term outcomes and lateral compartment osteoarthritis may occur in the mid to long term outcomes. Removing all osteophytes at the time of UKA is sometime impossible due to their large size and extend to the inferior part of medial tibial plateau and removing them completely my result in release of the MCL. But no data exist on clinical outcomes in such patients.MethodsWe conducted a prospective study from 2010 to 2015 of patients undergoing mobile bearing UKA and classified them in to two groups: those with (Gp1) and without (Gp2) residual osteophytes. Osteophyte size was measured using Hernborg’s technique. The primary outcomes were pain score, functional score, and knee scores and the presence of reported medial knee pain.Results176 patients who underwent 199 mobile bearing UKAs were recruited: Gp1 = 42 patients (46 knees) and Gp2 = 134 patients (153 knees). Residual osteophyte sizes ranged from 2.13–9.42 mm (mean 4.12). The mean Gp1 Gp2 pain score (49.04, 48.92, p = 0.84), functional score (83.75, 84.04, p = 0.83) and knee score (89.86, 98.7, p = 0.0.78) scores were almost identical and no one complained of medial joint pain. Followed up ranged from 2 − 7 years (mean 4.23). No patients were lost to follow up.ConclusionThe patients with residual osteophytes of length less than 9 mm had good and similar clinical outcomes as patients without residual osteophytes following mobile bearing UKA.Level of evidenceLevel II-2, evidence obtained from well-designed cohort studies or case-control studies, preferably from more than one center or research group.

Synovial macrophage M1 polarisation exacerbates experimental osteoarthritis partially through R-spondin-2

ObjectivesTo investigate the roles and regulatory mechanisms of synovial macrophages and their polarisation in the development of osteoarthritis (OA).MethodsSynovial tissues from normal patients and patients with OA were collected. M1...

Relationship between osteophyte and arthroscopic findings in osteoarthritis of ankle

Category: Ankle Introduction/Purpose: Mortise view weight-bearing radiograph is widely used for the diagnosis of osteoarthritis of ankle. Thickness of the articular cartilage cannot be accurately evaluated in the evaluation of joint space from weight-bearing radiograph, because lateral tibiotalar joint space is maintained in valgus type osteoarthritis in some cases. There are few reports on the relation between osteophyte and the articular cartilage injury. We considered that it might be possible to estimate the cartilage injury more accurately by examining osteophytes. The purpose of this study is to analyze the relationship between the location and grade of osteophytes in weight-bearing radiograph and cartilage injury in arthroscopic findings was analyzed. Methods: Twenty-one anklets of 21 patients consisted of 10 males and 10 females, with mean age of 61.4 years (31-79 years), who underwent arthroscopic surgery for osteoarthritis in our department were included. Weight-bearing radiograph were taken before surgery. Location and grade of osteophytes were evaluated using Ankle and Hindfoot Radiographic Osteoarthritis Scoring reported by Kraus et al. Arthroscopic findings were evaluated with International Cartilage Repair Society (ICRS) Grade at a total of 20 sites (9 areas of tibia and talar in tibiotalar joint, medial malleolus and lateral malleolus). The correlation between radiographic findings and arthroscopic findings were analyzed. Results: In Mortise view, strong correlations were found between lateral tibial osteophyte grade and ICRS grade of the center (talus R = 0.69, tibia R = 0.76), the central lateral (tibia R = 0.79), the posterior center (talus R = 0.72, tibia R = 0.74) and the posterior lateral of the tibiotalar joint (talus R = 0.63, tibia R = 0.76). There are moderate correlations between distal fibular osteophyte grade and ICRS grade of the medial inner (tibia R = 0.74) and the posterior medial of the tibiotalar joint (talus R = 0.61, tibia = 0.63). In lateral view, there are moderate correlations between posterior talar osteophyte grade and ICRS grade at the center of the tibiotalar joint (talus R = 0.61, tibia R = 0.60). Conclusion: From this study, there was a strong correlation between location and grade osteophyte and the articular cartilage injury. Osteoarthritis progression is caused by degeneration of the cartilage because of the joint instability, and osteophytes were formed by traction force or impaction. This study showed that local cartilage injury is thought to be related to osteophytes. By evaluating the location and size of osteophytes, the articular cartilage injury might be predicted accurately before arthroscopic surgery.

Osteoarthritis induced by destabilization of the medial meniscus is reduced in germ-free mice

To determine the contribution of the gut microbiota to the development of injury-induced osteoarthritis (OA). OA was induced using the destabilized medial meniscus (DMM) model in 20 germ-free (GF) C57BL/6J male mice housed in a gnotobiotic facility and 23 strain-matched specific pathogen free (SPF) mice in 2 age groups-13.5 weeks avg age at DMM (17 SPF and 15GF) and 43 weeks avg age at DMM (6 SPF and 5GF). OA severity was measured using scores for articular cartilage structure (ACS), loss of safranin O (SafO) staining, osteophyte size, and synovial hyperplasia. Microbiome analysis by 16S rRNA amplicon sequencing was performed on stool samples and LPS and LPS binding protein (LBP) were measured in plasma. Compared to the SPF DMM mice, the maximum (MAX) ACS score per joint was 28% lower (p=0.036) in GF DMM mice while the SafO sum score of all sections evaluated per joint was decreased by 31% (p=0.009). The differences between SPF and GF mice in these scores were greater when only the younger mice were included in the analysis. The younger GF DMM mice also had significant reductions in osteophyte size (36%, P=0.0119) and LBP (27%, P=0.007) but not synovial scores or LPS. Differences in relative abundance of a number of Operational Taxonomic Units (OTUs) were noted between SPF mice with high vs low maximum ACS scores. These results suggest factors related to the gut microbiota promote the development of OA after joint injury.

CCL17 blockade as a therapy for osteoarthritis pain and disease

BackgroundGranulocyte macrophage-colony stimulating factor (GM-CSF) has been implicated in the pathogenesis of a number of inflammatory diseases and in osteoarthritis (OA). We identified previously a new GM-CSF→Jmjd3→interferon regulatory factor 4 (IRF4)→chemokine (c-c motif) ligand 17 (CCL17) pathway, which is important for the development of inflammatory arthritis pain and disease. Tumour necrosis factor (TNF) can also be linked with this pathway. Here we investigated the involvement of the pathway in OA pain and disease development using the GM-CSF-dependent collagenase-induced OA (CiOA) model.MethodsCiOA was induced in C57BL/6 wild-type (WT), Irf4−/−, Ccl17E/E, Ccr4−/−, Tnf−/− and GM-CSF−/− mice. Additionally, therapeutic targeting of CCL17, Jmjd3 and cyclooxygenase 2 (COX-2) was evaluated. Development of pain (assessment of weight distribution) and OA disease (histologic scoring of synovitis, cartilage destruction and osteophyte size) were assessed. Synovial joint cells, including neutrophils, macrophages, fibroblasts and endothelial cells, were isolated (cell sorting) and gene expression analyzed (quantitative PCR).ResultsStudies in the gene-deficient mice indicated that IRF4, CCL17 and the CCL17 receptor, CCR4, but not TNF, were required for CiOA pain and optimal cartilage destruction and osteophyte size. Therapeutic neutralization of CCL17 and Jmjd3 ameliorated both pain and disease, whereas the COX-2 inhibitor only ameliorated pain. In the synovium Ccl17 mRNA was expressed only in the macrophages in a GM-CSF-dependent and IRF4-dependent manner.ConclusionsThe GM-CSF→Jmjd3→IRF4→CCL17 pathway is important for the development of CiOA, with CCL17 thus being a potential therapeutic target for the treatment of both OA pain and disease.

Frequency of osteophyte formation at posterior notch of the femur among healthy knees of 40's and 50's

Purpose: Our previous study revealed osteophyte formation at posterior notch of the femur detected with MRI was a predictive biomarker for future development of osteoarthritis of the knee (KOA) using data from the osteoarthritis initiative (OAI). We named the osteophyte as hidden osteophyte formation on plain x-ray (HOPX) because conventional antero-posterior, lateral, sky-line x-rays could not detect the osteophyte. In that study, participants with grade 0 or 1 on Kellgren and Lawrence grade (K/L) were divided into two groups and those with HOPX at baseline were highly likely to develop radiographic KOA in 48 months, defined by equal or more than K/L grade 2, comparing to those without HOPX. As a next step to utilize HOPX for mas-screening purpose, we have formulated x-ray technique to detect HOPX and named the technique as HOPX view. The purpose of the present study was to examine the frequency of HOPX among healthy knees of 40's and 50's using HOPX view, which presumably enable us to estimate the frequency of pre-early KOA among healthy knees. Methods: Inclusion criteria for the study were, 1) age from 40 to 59, 2) no knee pain during recent 3 months on both knees, 3) no history of surgeries nor immobilization with a cast, 4) no history of inflammatory joint diseases such as rheumatoid arthritis. Exclusion criteria was pregnancy. Participants received 4 kinds of x-ray examination on both knees (antero-posterior, lateral, sky-line, and HOPX view) to determine KL grade and formation of osteophytes on different locations. Size of osteophytes were scored with osteophyte score of the whole organ magnetic resonance imaging (WORMS). Results: There were 87 female (174 knees) and 11 male (22 knees) participants. The number of male was too small for further study so the only results concerning female participants were presented. Fifty-three were in their 40's and 34 were 50's.1.Frequency of equal or more than K/L 2 knees were 4.7% (5/106) in 40's and 10.3% (7/68) in 50's. Total of 3 participants had bilateral KL II knees and 6 participants were unilateral. KL II knees were excluded in further examination.2.Frequencies of HOPX positive knees were 39.6% (40/101) in 40's and 49.2% (30/61) in 50's when defining score 1 or more of WORMS score as positive whereas 5.9% (6/101) in 40's and 11.5% (7/61) in 50's when defining score of 2 as threshold.3.Aside from HOPX, frequencies of osteophytes formation were high in medial tibial plateau and tibial spine. Osteophytes with the WORMS score of 1 or more were observed in 13.9% (14/101) in 40's and 19.7% (12/61) at medial tibial plateau. Those at tibial spine were 10.9% (11/101) in 40's and 14.8% (9/61) in 50's. Conclusions: KL grade 2 knees already existed in 4.7% (5/106) of knees in 40's and 10.3% (7/68) in 50's without any pain. Although true importance of HOPX view has to be determined by longitudinal study and not by this cross-sectional study, our result implicated high prevalence of knees were at risk in developing radiographic KOA in relatively short period of time in female in their 40's or 50's.

Superolateral Hoffa's fat pad (SHFP) edema and patellar cartilage volume loss: quantitative analysis using longitudinal data from the foundation for the national institute of health (FNIH) osteoarthritis biomarkers consortium

Purpose: To determine the association of superolateral Hoffa's fat pad (SHFP) edema and patellofemoral joint structural damages in participants of Foundation for the National Institute of Health Osteoarthritis Biomarkers Consortium study. Methods: Baseline and 24-month MRI of 600 subjects were assessed. The presence of SHFP edema and patellar morphology metrics were determined using baseline MRI. Quantitative patellar cartilage volume and semi-quantitative MRI Osteoarthritis Knee Score (MOAKS) variables were extracted. The associations between SHFP edema and patellar cartilage damage, bone marrow lesion (BML), osteophyte, and morphology were evaluated in cross-sectional model. In longitudinal analysis, the association between edema and cartilage volume loss (defined using reliable change index) and MOAKS worsening were evaluated. Results: In cross-sectional evaluations, SHFP edema was associated with simultaneous lateral patellar cartilage/BML defects and inferior-medial patellar osteophyte size. A significant positive correlation between the degree of patella alta and SHFP edema was detected. The presence of edema was associated with 24-month cartilage volume loss (odds ratio(OR):2.11, 95%confidence interval:1.46–3.06) and medial patellar BML size (OR:1.92(1.15–3.21)) and number (OR:2.50(1.29–4.88)) worsening. Conclusions: The presence of SHFP edema could be considered as a predictor of future patellar cartilage loss and BML worsening, and an indicator of simultaneous cartilage, BML, and osteophyte defects.

Intraperitoneal injection of the SIRT1 activator SRT1720 attenuates the progression of experimental osteoarthritis in mice.

ObjectivesThis study aimed to examine the effects of SRT1720, a potent SIRT1 activator, on osteoarthritis (OA) progression using an experimental OA model.MethodsOsteoarthritis was surgically induced by destabilization of the medial meniscus in eight-week-old C57BL/6 male mice. SRT1720 was administered intraperitoneally twice a week after surgery. Osteoarthritis progression was evaluated histologically using the Osteoarthritis Research Society International (OARSI) score at four, eight, 12 and 16 weeks. The expression of SIRT1, matrix metalloproteinase 13 (MMP-13), a disintegrin and metalloproteinase with thrombospondin motifs-5 (ADAMTS-5), cleaved caspase-3, PARP p85, and acetylated nuclear factor (NF)-κB p65 in cartilage was examined by immunohistochemistry. Synovitis was also evaluated histologically. Primary mouse epiphyseal chondrocytes were treated with SRT1720 in the presence or absence of interleukin 1 beta (IL-1β), and gene expression changes were examined by real-time polymerase chain reaction (PCR).ResultsThe OARSI score was significantly lower in mice treated with SRT1720 than in control mice at eight and 12 weeks associated with the decreased size of osteophytes at four and eight weeks. The delayed OA progression in the mice treated with SRT1720 was also associated with increased SIRT1-positive chondrocytes and decreased MMP-13-, ADAMTS-5-, cleaved caspase-3-, PARP p85-, and acetylated NF-κB p65-positive chondrocytes and decreased synovitis at four and eight weeks. SRT1720 treatment partially rescued the decreases in collagen type II alpha 1 (COL2A1) and aggrecan caused by IL-1β, while also reducing the induction of MMP-13 by IL-1β in vitro.ConclusionThe intraperitoneal injection of SRT1720 attenuated experimental OA progression in mice, indicating that SRT1720 could be a new therapeutic approach for OA.Cite this article: K. Nishida, T. Matsushita, K. Takayama, T. Tanaka, N. Miyaji, K. Ibaraki, D. Araki, N. Kanzaki, T. Matsumoto, R. Kuroda. Intraperitoneal injection of the SIRT1 activator SRT1720 attenuates the progression of experimental osteoarthritis in mice. Bone Joint Res 2018;7:252–262. DOI: 10.1302/2046-3758.73.BJR-2017-0227.R1.

The Clinical Significance of Osteophytes in Compartments of the Knee Joint With Normal Articular Cartilage.

The purpose of this study is to determine whether marginal osteophytes in compartments with normal cartilage would be more frequently observed in knees with cartilage lesions and osteophytes in other compartments. This retrospective study reviewed 500 consecutive knee MRI examinations performed within 6 months of arthroscopic knee surgery conducted for 497 patients with symptoms (289 male patients and 208 female patients; age range, 17-74 years; median age, 43 years). The highest grade of cartilage lesion detected at MRI and arthroscopy was recorded. Marginal osteophytes were graded on MRI with use of a standardized scoring system, with grade 0 denoting no osteophyte; grade 1, small osteophyte; grade 2, medium-size osteophyte; and grade 3, large osteophyte). The frequency of false-positive osteophytes, defined as osteophytes present in compartments (the patellofemoral, medial tibiofemoral, and lateral tibiofemoral compartments) with normal cartilage observed on MRI and arthroscopy, was calculated. The Goodman and Kruskal gamma statistic was used to test the association of osteophyte size between compartments. Logistic regression was used to test the association between osteophyte size and the severity of the cartilage lesions. Marginal osteophytes were seen in compartments with normal cartilage on MRI and arthroscopy in 60.5% of knees (75 of 124) with cartilage lesions and osteophytes in other compartments and accounted for all false-positive grade 2 and grade 3 osteophytes. Marginal osteophytes were seen in 12.7% of knees (13 of 102) that had no cartilage lesions in any compartment on MRI or arthroscopy, and all of these were grade 1 osteophytes. The presence of larger sized osteophytes in the compartments with cartilage lesions was associated with the presence of larger sized osteophytes in the compartments with normal cartilage. More severe cartilage lesions were associated with larger osteophyte size. Compartments with marginal osteophytes and normal cartilage are commonly seen in knees that have other compartments with osteophytes and cartilage lesions.

Anterior Cervical Osteophytes and Sympathetic Hyperactivity in Patients with Tinnitus: Size Matters

Context: Pathological changes secondary to degeneration of the cervical intervertebral disc may cause irritation of sympathetic nerve fibers, leading to sympathetic symptoms and tinnitus. Objectives: The aim of this study was to relate the effect of percutaneous radiofrequency treatment of superior cervical sympathetic ganglion in patients with tinnitus to cervical pathology. Method: A retrospective study of 74 consecutive patients who underwent treatment of the superior cervical sympathetic ganglion for tinnitus that persisted for 1 month or longer from October 2016 to January 2018. The work-up of a patient with tinnitus consisted of a standardized clinical history, a bilateral audiogram and a cervical spine radiograph. Results: All patients had a test blockade of superior cervical sympathetic ganglion first, and 54% of these patients (n=40) responded with a reduction of their tinnitus. These patients underwent a radiofrequency lesion and 53% (n=21) responded with a reduction of their tinnitus at 7 weeks following treatment. The size of anterior osteophyte at the fifth cervical vertebrae was related to a positive response at 7 weeks following this treatment. Patients with tinnitus and an anterior osteophyte at vertebrae C5 more than 17% of the width of those vertebrae had a success rate of 52% following treatment of the superior cervical sympathetic ganglion, compared to 13%, when the anterior osteophyte at C5 was 17% or less. Conclusions: The size of anterior cervical osteophytes is associated with a higher success rate of radiofrequency lesions of the superior sympathetic ganglion for tinnitus. The current results imply a role for cervical sympathetic nervous system irritation in the development of tinnitus in a subgroup of patients.

Analysis of Osteophyte Size in Knees of Patients with Rheumatoid Arthritis

Analysis of Osteophyte Size in Knees of Patients with Rheumatoid Arthritis

Association of medial meniscal extrusion with medial tibial osteophyte distance detected by T2 mapping MRI in patients with early-stage knee osteoarthritis

BackgroundMedial meniscal extrusion (MME) is associated with progression of medial knee osteoarthritis (OA), but no or little information is available for relationships between MME and osteophytes, which are found in cartilage and bone parts. Because of the limitation in detectability of the cartilage part of osteophytes by radiography or conventional magnetic resonance imaging (MRI), the rate of development and size of osteophytes appear to have been underestimated. Because T2 mapping MRI may enable us to evaluate the cartilage part of osteophytes, we aimed to examine the association between MME and OA-related changes, including osteophytes, by using conventional and T2 mapping MRI.MethodsPatients with early-stage knee OA (n = 50) were examined. MRI-detected OA-related changes, in addition to MME, were evaluated according to the Whole-Organ Magnetic Resonance Imaging Score. T2 values of the medial meniscus and osteophytes were measured on T2 mapping images. Osteophytes surgically removed from patients with end-stage knee OA were histologically analyzed and compared with findings derived by radiography and MRI.ResultsMedial side osteophytes were detected by T2 mapping MRI in 98% of patients with early-stage knee OA, although the detection rate was 48% by conventional MRI and 40% by radiography. Among the OA-related changes, medial tibial osteophyte distance was most closely associated with MME, as determined by multiple logistic regression analysis, in the patients with early-stage knee OA (β = 0.711, p < 0.001). T2 values of the medial meniscus were directly correlated with MME in patients with early-stage knee OA, who showed ≥ 3 mm of MME (r = 0.58, p = 0.003). The accuracy of osteophyte evaluation by T2 mapping MRI was confirmed by histological analysis of the osteophytes removed from patients with end-stage knee OA.ConclusionsOur study demonstrates that medial tibial osteophyte evaluated by T2 mapping MRI is frequently observed in the patients with early-stage knee OA, showing close association with MME, and that MME is positively correlated with the meniscal degeneration.

Osseous spurs at the fovea capitis femoris-a frequent finding in asymptomatic volunteers.

To investigate the different morphologic types of the fovea capitis femoris and the spectrum of osseous spurs/osteophytes of the fovea in asymptomatic volunteers and patients with hip osteoarthritis. Sixty-five patients (mean age 63.6years) with radiographically confirmed osteoarthritis of the hip and 59 asymptomatic healthy volunteers (mean age 33.9years) underwent non-contrast MRI of the hip joint. Two radiologists independently evaluated all images. Fovea morphology (standard type, diamond type, flat type, triangular type) as well as the frequency, size and location of spurs/osteophytes of the fovea were assessed. Descriptive and inferential statistics were applied. The most frequent morphologic type of the fovea capitis femoris was the standard type for both asymptomatic volunteers (average 45%) and patients (average 49%). Osseous spurs were detected in 70% of the asymptomatic volunteers, and 97% of the patients had osteophytes. Spur size at all locations was significantly smaller in asymptomatic volunteers (range 1-2mm) than osteophyte size in patients (range 1-4mm) (p≤0.035). In volunteers and patients, the spurs/osteophytes were most frequently located at the anterior border of the fovea capitis femoris. Smaller osseous spurs (<2mm) at the border of the fovea capitis femoris are very common in asymptomatic volunteers and do not seem to be pathologic.