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Beynon RA, Saunders FR, Ebsim R, Frysz M, Faber BG, Gregory JS, Lindner C, Sarmanova A, Aspden RM, Harvey NC, Cootes T, Tobias JH. Dual-energy X-ray absorptiometry derived knee shape may provide a useful imaging biomarker for predicting total knee replacement: Findings from a study of 37,843 people in UK Biobank. Osteoarthr Cartil Open 2024; 6:100468. [PMID: 38655015 PMCID: PMC11035060 DOI: 10.1016/j.ocarto.2024.100468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/03/2024] [Indexed: 04/26/2024] Open
Abstract
Objective We aimed to create an imaging biomarker for knee shape using knee dual-energy x-ray absorptiometry (DXA) scans and investigate its potential association with subsequent total knee replacement (TKR), independently of radiographic features of knee osteoarthritis and established risk factors. Methods Using a 129-point statistical shape model, knee shape (expressed as a B-score) and minimum joint space width (mJSW) of the medial joint compartment (binarized as above or below the first quartile) were derived. Osteophytes were manually graded in a subset of images and an overall score was assigned. Cox proportional hazards models were used to examine the associations of B-score, mJSW and osteophyte score with TKR risk, adjusting for age, sex, height and weight. Results The analysis included 37,843 individuals (mean age 63.7 years). In adjusted models, B-score was associated with TKR: each unit increase in B-score, reflecting one standard deviation from the mean healthy shape, corresponded to a hazard ratio (HR) of 2.25 (2.08, 2.43), while a lower mJSW had a HR of 2.28 (1.88, 2.77). Among the 6719 images scored for osteophytes, mJSW was replaced by osteophyte score in the most strongly predictive model for TKR. In ROC analyses, a model combining B-score, osteophyte score, and demographics outperformed a model including demographics alone (AUC = 0.87 vs 0.73). Conclusions Using statistical shape modelling, we derived a DXA-based imaging biomarker for knee shape that was associated with kOA progression. When combined with osteophytes and demographic data, this biomarker may help identify individuals at high risk of TKR, facilitating targeted interventions.
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Affiliation(s)
- Rhona A. Beynon
- University of Bristol, Musculoskeletal Research Unit, Bristol Medical School, Bristol, United Kingdom
| | - Fiona R. Saunders
- University of Aberdeen, Centre for Arthritis and Musculoskeletal Health, Aberdeen, United Kingdom
| | - Raja Ebsim
- The University of Manchester, Division of Informatics, Imaging & Data Sciences, Manchester, United Kingdom
| | - Monika Frysz
- University of Bristol, Musculoskeletal Research Unit, Bristol Medical School, Bristol, United Kingdom
- University of Bristol, Medical Research Council Integrative Epidemiology Unit, Bristol, United Kingdom
| | - Benjamin G. Faber
- University of Bristol, Musculoskeletal Research Unit, Bristol Medical School, Bristol, United Kingdom
- University of Bristol, Medical Research Council Integrative Epidemiology Unit, Bristol, United Kingdom
| | - Jennifer S. Gregory
- University of Aberdeen, Centre for Arthritis and Musculoskeletal Health, Aberdeen, United Kingdom
| | - Claudia Lindner
- The University of Manchester, Division of Informatics, Imaging & Data Sciences, Manchester, United Kingdom
| | - Aliya Sarmanova
- University of Bristol, Musculoskeletal Research Unit, Bristol Medical School, Bristol, United Kingdom
| | - Richard M. Aspden
- University of Aberdeen, Centre for Arthritis and Musculoskeletal Health, Aberdeen, United Kingdom
| | - Nicholas C. Harvey
- University of Southampton, MRC Lifecourse Epidemiology Centre, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, United Kingdom
| | - Timothy Cootes
- The University of Manchester, Division of Informatics, Imaging & Data Sciences, Manchester, United Kingdom
| | - Jonathan H. Tobias
- University of Bristol, Musculoskeletal Research Unit, Bristol Medical School, Bristol, United Kingdom
- University of Bristol, Medical Research Council Integrative Epidemiology Unit, Bristol, United Kingdom
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Gan D, Jin X, Wang X, Tao C, Yan Q, Jia Q, Huo S, Chen D, Yao Q, Xiao G. Pathological progress and remission strategies of osteoarthritic lesions caused by long-term joint immobilization. Arthritis Res Ther 2023; 25:237. [PMID: 38062473 PMCID: PMC10702075 DOI: 10.1186/s13075-023-03223-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE While joint immobilization is a useful repair method for intra-articular ligament injury and periarticular fracture, prolonged joint immobilization can cause multiple complications. A better understanding how joint immobilization and remobilization impact joint function and homeostasis will help clinicians develop novel strategies to reduce complications. DESIGN We first determined the effects of long-term immobilization on joint pain and osteophyte formation in patients after an extraarticular fracture or ligament injury. We then developed a mouse model of joint immobilization and harvested the knee joint samples at 2, 4, and 8 weeks. We further determined the effects of remobilization on recovery of the osteoarthritis (OA) lesions induced by immobilization in mice. RESULTS We found that the long-term (6 weeks) joint immobilization caused significant joint pain and osteophytes in patients. In mice, 2-week immobilization already induced moderate sensory innervation and increased pain sensitivity and infiltration in synovium without inducing marked osteophyte formation and cartilage loss. Long-term immobilization (4 and 8 weeks) induced more severe sensory innervation and inflammatory infiltration in synovium, massive osteophyte formation on both sides of the femoral condyle, and the edge of the tibial plateau and significant loss of the articular cartilage in mice. Remobilization, which ameliorates normal joint load and activity, restored to certain extent some of the OA lesions and joint function in mice. CONCLUSIONS Joint immobilization caused multiple OA-like lesions in both mice and humans. Joint immobilization induced progressive sensory innervation, synovitis, osteophyte formation, and cartilage loss in mice, which can be partially ameliorated by remobilization.
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Affiliation(s)
- Donghao Gan
- Department of Biochemistry, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Xiaowan Jin
- Department of Biochemistry, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Xiangpeng Wang
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Chu Tao
- Department of Biochemistry, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Qinnan Yan
- Department of Biochemistry, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Qingyun Jia
- Department of Orthopedics, Linyi People's Hospital, Linyi, China
| | - Shaochuan Huo
- Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Di Chen
- Research Center for Computer-Aided Drug Discovery, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Qing Yao
- Department of Biochemistry, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, School of Medicine, Southern University of Science and Technology, Shenzhen, China.
| | - Guozhi Xiao
- Department of Biochemistry, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, School of Medicine, Southern University of Science and Technology, Shenzhen, China.
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Teoh YX, Othmani A, Lai KW, Goh SL, Usman J. Stratifying knee osteoarthritis features through multitask deep hybrid learning: Data from the osteoarthritis initiative. Comput Methods Programs Biomed 2023; 242:107807. [PMID: 37778138 DOI: 10.1016/j.cmpb.2023.107807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 08/02/2023] [Accepted: 09/08/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND AND OBJECTIVE Knee osteoarthritis (OA) is a debilitating musculoskeletal disorder that causes functional disability. Automatic knee OA diagnosis has great potential of enabling timely and early intervention, that can potentially reverse the degenerative process of knee OA. Yet, it is a tedious task, concerning the heterogeneity of the disorder. Most of the proposed techniques demonstrated single OA diagnostic task widely based on Kellgren Lawrence (KL) standard, a composite score of only a few imaging features (i.e. osteophytes, joint space narrowing and subchondral bone changes). However, only one key disease pattern was tackled. The KL standard fails to represent disease pattern of individual OA features, particularly osteophytes, joint-space narrowing, and pain intensity that play a fundamental role in OA manifestation. In this study, we aim to develop a multitask model using convolutional neural network (CNN) feature extractors and machine learning classifiers to detect nine important OA features: KL grade, knee osteophytes (both knee, medial fibular: OSFM, medial tibial: OSTM, lateral fibular: OSFL, and lateral tibial: OSTL), joint-space narrowing (medial: JSM, and lateral: JSL), and patient-reported pain intensity from plain radiography. METHODS We proposed a new feature extraction method by replacing fully-connected layer with global average pooling (GAP) layer. A comparative analysis was conducted to compare the efficacy of 16 different convolutional neural network (CNN) feature extractors and three machine learning classifiers. RESULTS Experimental results revealed the potential of CNN feature extractors in conducting multitask diagnosis. Optimal model consisted of VGG16-GAP feature extractor and KNN classifier. This model not only outperformed the other tested models, it also outperformed the state-of-art methods with higher balanced accuracy, higher Cohen's kappa, higher F1, and lower mean squared error (MSE) in seven OA features prediction. CONCLUSIONS The proposed model demonstrates pain prediction on plain radiographs, as well as eight OA-related bony features. Future work should focus on exploring additional potential radiological manifestations of OA and their relation to therapeutic interventions.
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Affiliation(s)
- Yun Xin Teoh
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, 50603, Malaysia; LISSI, Université Paris-Est Créteil, Vitry sur Seine, 94400, France
| | - Alice Othmani
- LISSI, Université Paris-Est Créteil, Vitry sur Seine, 94400, France.
| | - Khin Wee Lai
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, 50603, Malaysia.
| | - Siew Li Goh
- Sports Medicine Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia; Centre for Epidemiology and Evidence-Based Practice, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Juliana Usman
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
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Takami M, Tsutsui S, Okada M, Nagata K, Iwasaki H, Minamide A, Yukawa Y, Hashizume H, Taiji R, Murata S, Kozaki T, Yamada H. Unique Characteristics of New Bone Formation Induced by Lateral Lumbar Interbody Fusion Procedure. Spine Surg Relat Res 2023; 7:450-457. [PMID: 37841039 PMCID: PMC10569808 DOI: 10.22603/ssrr.2022-0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 03/31/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction Despite the absence of bone grafting in the area outside the cage, lateral bridging callus outside cages (LBC) formation is often observed here following extreme lateral interbody fusion (XLIF) conversely to conventional methods of transforaminal lumbar interbody fusion and posterior lumbar interbody fusion. The LBC, which may increase stabilization and decrease nonunion rate in treated segments, has rarely been described. This study aimed to identify the incidence and associated factors of LBC following XLIF. Methods We enrolled 136 consecutive patients [56 males, 80 females; mean age 69.6 (42-85) years] who underwent lumbar fusion surgery using XLIF, including L4/5 level with posterior fixation at a single institution between February 2013 and February 2018. One year postoperatively, the treated L4/5 segments were divided into the LBC formation and non-formation groups. Potential influential factors, such as age, sex, body mass index, bone density, height of cages, cage material (titanium or polyetheretherketone [PEEK]), presence or absence of diffuse idiopathic skeletal hyperostosis (DISH), and radiological parameters, were evaluated. Multivariate logistic regression analysis was performed for factors significantly different from the univariate analysis. Results The incidence of LBC formation was 58.8%. Multivariate logistic regression analysis showed that the length of osteophytes [+1 mm; odds ratio, 1.29; 95% confidence interval, 1.17-1.45; p<0.0001] was significant LBC formation predictive factors. Receiver operating characteristic curve analysis demonstrated that the cut-off value for osteophyte length was 14 mm, the sensitivity was 58.8%, the specificity was 84.4%, and the area under the ROC curve for this model was 0.79. Conclusions The incidence of LBC formation was 58.8% in L4/5 levels one year after the XLIF procedure. We demonstrated that the length of the osteophyte was significantly associated with LBC formation.
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Affiliation(s)
- Masanari Takami
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Shunji Tsutsui
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Motohiro Okada
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Keiji Nagata
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hiroshi Iwasaki
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Akihito Minamide
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Yasutsugu Yukawa
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hiroshi Hashizume
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Ryo Taiji
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Shizumasa Murata
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Takuhei Kozaki
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hiroshi Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
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Roemer FW, Engelke K, Li L, Laredo JD, Guermazi A. MRI underestimates presence and size of knee osteophytes using CT as a reference standard. Osteoarthritis Cartilage 2023:S1063-4584(23)00594-0. [PMID: 36796577 DOI: 10.1016/j.joca.2023.01.575] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 01/12/2023] [Accepted: 01/31/2023] [Indexed: 02/18/2023]
Abstract
OBJECTIVE To explore the diagnostic performance of routine magnetic resonance imaging (MRI) for the cross-sectional assessment of osteophytes (OPs) in all three knee compartments using computed tomography (CT) as a reference standard. METHODS The Strontium Ranelate Efficacy in Knee Osteoarthritis (SEKOIA) trial explored the effect of 3 years of treatment with strontium ranelate in patients with primary knee OA. OPs were scored for the baseline visit only using a modified MRI Osteoarthritis Knee Score (MOAKS) scoring system in the patellofemoral (PFJ), the medial tibiofemoral (TFJ) and the lateral TFJ. Size was assessed from 0 to 3 in 18 locations. Descriptive statistics were used to describe differences in ordinal grading between CT and MRI. In addition, weighted-kappa statistics were employed to assess agreement between scoring using the two methods. Sensitivity, specificity, positive predictive value and negative predictive value as well as area under the curve (AUC) measures of diagnostic performance were employed using CT as the reference standard. RESULTS Included were 74 patients with available MRI and CT data. Mean age was 62.9 ± 7.5 years. Altogether 1,332 locations were evaluated. For the PFJ, MRI detected 141 (72%) of 197 CT-defined OPs with a w-kappa of 0.58 (95% CI [0.52-0.65]). In the medial TFJ, MRI detected 178 (81%) of 219 CT-OPs with a w-kappa of 0.58 (95% CI [0.51-0.64]). For the lateral compartment these numbers were 84 (70%) of 120 CT-OPs with a w-kappa of 0.58 (95% CI [0.50-0.66]). CONCLUSION MRI underestimates presence of osteophytes in all three knee compartments. CT may be helpful particularly regarding assessment of small osteophytes particularly in early disease.
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Morton AM, Peipert LJ, Moore DC, Ladd AL, Weiss APC, Molino J, Crisco JJ. Bone morphological changes of the trapezium and first metacarpal with early thumb osteoarthritis progression. Clin Biomech (Bristol, Avon) 2022; 100:105791. [PMID: 36228419 PMCID: PMC9742314 DOI: 10.1016/j.clinbiomech.2022.105791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/21/2022] [Accepted: 10/02/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Thumb carpometacarpal osteoarthritis is characterized by osteophyte growth and changes in the curvature of the articular surfaces of the trapezium and first metacarpal. The aim of this longitudinal study was to quantify in-vivo bone morphology changes with osteoarthritis progression. METHODS The study analyzed an observational dataset of 86 subjects with early thumb osteoarthritis and 22 age-matched asymptomatic controls. CT scans of subjects' affected hands were acquired at enrollment (year 0), and at 1.5, 3, 4.5, and 6-year follow-up visits. Osteoarthritic subjects were classified into stable and progressive groups, as defined by osteophyte volume and the rate of osteophyte growth. Trapezium height, width, and volar facet recession, along with first metacarpal volar beak recession and recession angle, were quantified. FINDINGS Mean trapezium width increased 12% over six years in the progressive osteoarthritis group. Trapezium volar recession of the progressive osteoarthritis group was significantly greater than stable at enrollment (P < 0.0001) and year 6 (P < 0.0001). The first metacarpal volar beak of the progressive osteoarthritis group recessed significantly faster than stable (P = 0.0004) and control (P = 0.0003). In year 6, volar beak surfaces in subjects with progressive osteoarthritis were flatter with reduced curvature, measuring -8.7 ± 4.0 degrees, compared to the stable osteoarthritis (P < 0.0001) and control groups (P = 0.0003), which maintained nominal curvatures, measuring 0.7 ± 2.5 and 0.2 ± 3.2 degrees, respectively. INTERPRETATION Our results demonstrate significant recession and reduction in the angle of the first metacarpal volar beak in progressive osteoarthritis. Flattening of the first metacarpal volar beak may have important associations with carpometacarpal joint contact and loading migrations, further propagating osteophyte formation and bony remodeling. This work highlights the volar beak of the first metacarpal as a region of morphology change with disease.
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Affiliation(s)
- Amy M. Morton
- Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, 1 Hoppin Street, CORO West Suite 404, Providence, RI 02903, USA
| | - Leah J. Peipert
- Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, 1 Hoppin Street, CORO West Suite 404, Providence, RI 02903, USA
| | - Douglas C. Moore
- Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, 1 Hoppin Street, CORO West Suite 404, Providence, RI 02903, USA
| | - Amy L. Ladd
- Robert A. Chase Hand & Upper Limb Center, Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Arnold-Peter C. Weiss
- Department of Orthopaedics, The Warren Alpert Medical School of Brown University/University Orthopedics, 2 Dudley Street, Suite 200, Providence, RI 02905, USA
| | - Janine Molino
- Department of Orthopaedics, The Warren Alpert Medical School of Brown University/University Orthopedics, 2 Dudley Street, Suite 200, Providence, RI 02905, USA
| | - Joseph J. Crisco
- Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, 1 Hoppin Street, CORO West Suite 404, Providence, RI 02903, USA,Corresponding author. (J.J. Crisco)
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Fan T, Chen S, Zeng M, Li J, Wang X, Ruan G, Cao P, Zhang Y, Chen T, Ou Q, Wang Q, Wluka AE, Cicuttini F, Ding C, Zhu Z. Osteophytes mediate the associations between cartilage morphology and changes in knee symptoms in patients with knee osteoarthritis. Arthritis Res Ther 2022; 24:217. [PMID: 36076236 PMCID: PMC9454107 DOI: 10.1186/s13075-022-02905-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
Aims To investigate whether the associations between cartilage defects and cartilage volumes with changes in knee symptoms were mediated by osteophytes. Methods Data from the Vitamin D Effects on Osteoarthritis (VIDEO) study were analyzed as a cohort. The Western Ontario and McMaster Universities Osteoarthritis Index was used to assess knee symptoms at baseline and follow-up. Osteophytes, cartilage defects, and cartilage volumes were measured using magnetic resonance imaging at baseline. Associations between cartilage morphology and changes in knee symptoms were assessed using linear regression models, and mediation analysis was used to test whether these associations were mediated by osteophytes. Results A total of 334 participants (aged 50 to 79 years) with symptomatic knee osteoarthritis were included in the analysis. Cartilage defects were significantly associated with change in total knee pain, change in weight-bearing pain, and change in non-weight-bearing pain after adjustment for age, sex, body mass index, and intervention. Cartilage volume was significantly associated with change in weight-bearing pain and change in physical dysfunction after adjustment. Lateral tibiofemoral and patellar osteophyte mediated the associations of cartilage defects with change in total knee pain (49–55%) and change in weight-bearing pain (61–62%) and the association of cartilage volume with change in weight-bearing pain (27–30%) and dysfunction (24–25%). Both cartilage defects and cartilage volume had no direct effects on change in knee symptoms. Conclusions The significant associations between cartilage morphology and changes in knee symptoms were indirect and were partly mediated by osteophytes. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-022-02905-8.
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Affiliation(s)
- Tianxiang Fan
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Shibo Chen
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Muhui Zeng
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jia Li
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiaoshuai Wang
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Guangfeng Ruan
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Peihua Cao
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yan Zhang
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Tianyu Chen
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Qianhua Ou
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Qianyi Wang
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Anita E Wluka
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Changhai Ding
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China. .,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. .,Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia. .,Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - Zhaohua Zhu
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China. .,Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
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Harlianto NI, Mohamed Hoesein FA, de Jong PA, Verlaan JJ, Westerink J. Pseudohypoparathyroidism mimicking cervical diffuse idiopathic skeletal hyperostosis with dysphagia: A case report and literature review. Bone Rep 2021; 15:101111. [PMID: 34381851 PMCID: PMC8339251 DOI: 10.1016/j.bonr.2021.101111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/20/2021] [Accepted: 07/24/2021] [Indexed: 11/26/2022] Open
Abstract
Dysphagia due to extensive ossification at anterior segments of the cervical spine is a rare occurrence and is usually attributable to diffuse idiopathic skeletal hyperostosis (DISH). We present the case of a 74-year-old female with dysphagia most likely due to ossification in pseudohypoparathyroidism type 1a (PHP1a). PHP1a is a rare, autosomal dominant disorder caused by mutations in the GNAS1 gene. Our patient had characteristic phenotype features of PHP1a, also known as Albright's hereditary osteodystrophy (AHO), which was diagnosed without genetic confirmation. She was conservatively treated with dietary measures and observation, and reported persisting symptoms of dysphagia at six-month follow-up. This is the first case to describe dysphagia in PHP1a with a similar presentation to DISH.
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Affiliation(s)
- Netanja I. Harlianto
- Department of Orthopedic Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands
- Department of Radiology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | | | - Pim A. de Jong
- Department of Radiology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Jorrit-Jan Verlaan
- Department of Orthopedic Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Jan Westerink
- Department of Vascular Medicine, University Medical Centre Utrecht, Utrecht, the Netherlands
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Snoeker BAM, Ishijima M, Kumm J, Zhang F, Turkiewicz AT, Englund M. Are structural abnormalities on knee MRI associated with osteophyte development? Data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2021; 29:1701-1708. [PMID: 34284113 DOI: 10.1016/j.joca.2021.06.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/26/2021] [Accepted: 06/28/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess which structural abnormalities on knee MRI are associated with development of osteophytes in middle-aged subjects without radiographic knee osteoarthritis. DESIGN We included subjects from the Osteoarthritis Initiative, aged 40-55 years, Kellgren & Lawrence grade 0 in both knees, and knee MRIs from both knees available at baseline, 24, 48 and 72 months. Structural exposures on MRI assessed using MOAKS included cartilage damage, bone marrow lesions, meniscal tear, meniscal extrusion, and Hoffa/effusion synovitis. We assessed whether each structural exposure was associated with the development of osteophytes on MRI in the medial and lateral tibiofemoral, and patellofemoral compartment. We estimated hazard ratios (HR) including 95% confidence intervals (CI) for osteophyte development using a mixed complementary log-log regression model adjusted for age, sex, and body mass index. RESULTS We included 680 knees from 340 subjects with a mean (SD) age of 50 years (3.0), and 51% men. In the medial tibiofemoral compartment, the absolute risk of osteophyte development in the first 24-month period was 4% in knees without, and 15% in knees with medial meniscal tear. Corresponding adjusted HR was 6.6 (95%CI = 3.4-12.9). In the lateral tibiofemoral compartment, the adjusted HR for developing osteophytes having a lateral meniscal tear was 3.3 (95%CI = 1.3-8.4). In the patellofemoral compartment, patellofemoral cartilage damage was most clearly associated with developing osteophytes (HR = 2.6, 95%CI = 1.8-3.7). CONCLUSIONS Meniscal tear seem to be the strongest structural risk factor for the development of tibiofemoral osteophytes, and patellofemoral cartilage damage for the development of patellofemoral osteophytes, respectively. Local biomechanical factors are important in early osteophyte development.
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Affiliation(s)
- B A M Snoeker
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund, Sweden.
| | - M Ishijima
- Department of Orthopaedic Surgery, Juntendo University, Tokyo, Japan
| | - J Kumm
- Department of Radiology, University of Tartu, Estonia
| | - F Zhang
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund, Sweden
| | - A T Turkiewicz
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund, Sweden
| | - M Englund
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund, Sweden
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10
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Hsia AW, Jbeily EH, Mendez ME, Cunningham HC, Biris KK, Bang H, Lee CA, Loots GG, Christiansen BA. Post-traumatic osteoarthritis progression is diminished by early mechanical unloading and anti-inflammatory treatment in mice. Osteoarthritis Cartilage 2021; 29:1709-1719. [PMID: 34653605 PMCID: PMC8678362 DOI: 10.1016/j.joca.2021.09.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 09/08/2021] [Accepted: 09/22/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Post-traumatic osteoarthritis (PTOA) is a degenerative joint disease initiated by injury. Early phase (0-7 days) treatments often include rest (unloading) and anti-inflammatory medications, but how those early interventions impact PTOA progression is unknown. We hypothesized that early unloading and anti-inflammatory treatment would diminish joint inflammation and slow PTOA progression. DESIGN Mice were injured with non-invasive ACL rupture followed by hindlimb unloading (HLU) or normal cage activity (ground control: GC) for 7 days, after which all mice were allowed normal cage activity. HLU and GC mice were treated with daily celecoxib (CXB; 10 mg/kg IP) or vehicle. Protease activity was evaluated using in vivo fluorescence imaging, osteophyte formation and epiphyseal trabecular bone were quantified using micro-computed tomography, and synovitis and articular cartilage were evaluated using whole-joint histology at 7, 14, 21, and 28 days post-injury. RESULTS HLU significantly reduced protease activity (-22-30% compared to GC) and synovitis (-24-50% relative to GC) at day 7 post-injury (during unloading), but these differences were not maintained at later timepoints. Similarly, trabecular bone volume was partially preserved in HLU mice at during unloading (-14-15% BV/TV for HLU mice, -21-22% for GC mice relative to uninjured), but these differences were not maintained during reloading. Osteophyte volume was reduced by both HLU and CXB, but there was not an additive effect of these treatments (HLU: -46%, CXB: -30%, HLU + CXB: -35% relative to vehicle GC at day 28). CONCLUSIONS These data suggest that early unloading following joint injury can reduce inflammation and potentially slow PTOA progression.
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Affiliation(s)
- A W Hsia
- University of California Davis Health, Department of Orthopaedic Surgery, Lawrence J. Ellison Musculoskeletal Research Center, 4635 2nd Ave, Suite 2000, Sacramento, CA 95817, USA.
| | - E H Jbeily
- University of California Davis Health, Department of Orthopaedic Surgery, Lawrence J. Ellison Musculoskeletal Research Center, 4635 2nd Ave, Suite 2000, Sacramento, CA 95817, USA.
| | - M E Mendez
- Lawrence Livermore National Laboratory, Physical and Life Sciences Directorate, 7000 East Avenue, L-452, Livermore, CA 94550, USA.
| | - H C Cunningham
- University of California Davis Health, Department of Orthopaedic Surgery, Lawrence J. Ellison Musculoskeletal Research Center, 4635 2nd Ave, Suite 2000, Sacramento, CA 95817, USA.
| | - K K Biris
- University of California Davis Health, Department of Orthopaedic Surgery, Lawrence J. Ellison Musculoskeletal Research Center, 4635 2nd Ave, Suite 2000, Sacramento, CA 95817, USA.
| | - H Bang
- University of California Davis Health, Department of Public Health Sciences, Sciences 1C, Suite 145, Davis, CA 95616, USA.
| | - C A Lee
- University of California Davis Health, Department of Orthopaedic Surgery, Lawrence J. Ellison Musculoskeletal Research Center, 4635 2nd Ave, Suite 2000, Sacramento, CA 95817, USA.
| | - G G Loots
- Lawrence Livermore National Laboratory, Physical and Life Sciences Directorate, 7000 East Avenue, L-452, Livermore, CA 94550, USA.
| | - B A Christiansen
- University of California Davis Health, Department of Orthopaedic Surgery, Lawrence J. Ellison Musculoskeletal Research Center, 4635 2nd Ave, Suite 2000, Sacramento, CA 95817, USA.
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11
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Chiba F, Inokuchi G, Hoshioka Y, Sakuma A, Makino Y, Torimitsu S, Yamaguchi R, Saitoh H, Kono M, Iwase H. Age estimation by evaluation of osteophytes in thoracic and lumbar vertebrae using postmortem CT images in a modern Japanese population. Int J Legal Med 2021; 136:261-267. [PMID: 34642821 DOI: 10.1007/s00414-021-02714-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/26/2021] [Indexed: 10/20/2022]
Abstract
Estimation of age at death is important in forensic investigations of unknown remains. There have been several reports on applying the degree of osteophyte formation-an age-related change in the vertebral body-for age estimation; however, this method is not yet established. This study investigated a method for age estimation of modern Japanese individuals using osteophytes measured on CT images. The sample included 250 cadavers (125 males) aged 20-95 years. The degree of osteophyte formation was evaluated as score O (0-5 points), and the degree of fusion of the osteophytes between the upper and lower vertebrae was evaluated as score B (0-2 points). Age estimation equations were developed using regression analyses with seven variables, determined by scores O and B, and the equation with the smallest standard error of estimate (SEE) was obtained when the number of vertebrae with score O ≥ 2 was used as the explanatory variable. Age estimation with SEE of about 10 years was possible even when partial vertebrae with a high degree of osteophyte formation were used, showing its potential for practical application. The cutoff value for age estimation was established using the receiver operating characteristic curve analysis, wherein good results were obtained for all variables (area under the curve ≥ 0.8). The combination of the estimation equation and the cutoff value can narrow the range of age estimates.
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Affiliation(s)
- Fumiko Chiba
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture, 260-8670, Japan. .,Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan.
| | - Go Inokuchi
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture, 260-8670, Japan.,Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan
| | - Yumi Hoshioka
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture, 260-8670, Japan
| | - Ayaka Sakuma
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture, 260-8670, Japan
| | - Yohsuke Makino
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture, 260-8670, Japan.,Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan
| | - Suguru Torimitsu
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture, 260-8670, Japan.,Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan
| | - Rutsuko Yamaguchi
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture, 260-8670, Japan.,Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan
| | - Hisako Saitoh
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture, 260-8670, Japan
| | - Mei Kono
- Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan
| | - Hirotaro Iwase
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture, 260-8670, Japan.,Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan
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12
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Fan T, Ruan G, Antony B, Cao P, Li J, Han W, Li Y, Yung SN, Wluka AE, Winzenberg T, Cicuttini F, Ding C, Zhu Z. The interactions between MRI-detected osteophytes and bone marrow lesions or effusion-synovitis on knee symptom progression: an exploratory study. Osteoarthritis Cartilage 2021; 29:1296-1305. [PMID: 34216729 DOI: 10.1016/j.joca.2021.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To investigate the longitudinal association between MRI-detected osteophyte scores and progression of knee symptoms, and whether the association was modified in the presence of bone marrow lesions (BMLs) or effusion-synovitis. METHODS Data from Vitamin D Effects on Osteoarthritis (VIDEO) study, a randomized, double-blinded and placebo-controlled clinical trial in symptomatic knee osteoarthritis (OA) patients, were analyzed as an exploratory study. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to assess knee symptoms. Osteophytes, BMLs and effusion-synovitis were measured using MRI. RESULTS 334 participants with MRI information and WOMAC score (baseline and follow-up) were included in the analyses, with 24.3% of them having knee pain increased 2 years later. Statistically significant interactions were found between MRI-detected osteophytes and BMLs or effusion-synovitis on increased knee symptoms. In participants with BMLs, higher baseline scores of MRI-detected osteophytes in most compartments were significantly associated with increased total knee pain, weight-bearing pain, stiffness, and physical dysfunction, after adjustment for age, sex, body mass index, intervention and effusion-synovitis. In participants with effusion-synovitis, higher baseline scores of MRI-detected osteophytes in almost all the compartments were significantly associated with increased total knee pain, weight-bearing pain, stiffness, and physical dysfunction, after adjustment for age, sex, body mass index, intervention and BMLs. In contrast, MRI-detected osteophyte scores were generally not associated with knee symptom progression in participants without baseline BMLs or effusion-synovitis. CONCLUSIONS MRI-detected OPs are associated with increased total knee pain, weight-bearing knee pain, stiffness and physical dysfunction in participants presenting BMLs or effusion-synovitis, but not in participants lacking BMLs or effusion-synovitis. This suggests they could interact with bone or synovial abnormalities to induce symptoms in knee OA.
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Affiliation(s)
- T Fan
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - G Ruan
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - B Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
| | - P Cao
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - J Li
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - W Han
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - Y Li
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - S N Yung
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - A E Wluka
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - T Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
| | - F Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - C Ding
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Z Zhu
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
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13
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Ley C, Ramer G, Leijon A, Ley CJ. Acetabular margin changes in feline hip joints - Implications for radiologic diagnosis and development of osteoarthritis. Res Vet Sci 2021; 137:243-51. [PMID: 34049111 DOI: 10.1016/j.rvsc.2021.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/22/2021] [Accepted: 05/18/2021] [Indexed: 11/23/2022]
Abstract
The development and early morphological features of feline hip osteoarthritis (OA) are largely unknown. Tears in the acetabular labrum and at the chondrolabral transition zone are suggested to be important in the pathogenesis of human hip OA, but in cats such lesions have not been described. We investigated associations between computed tomography (CT)-detected joint changes and microscopic articular cartilage lesions, the distribution of detected changes, and histologically evaluated the acetabular margin (AM) in hip joints from 20 cats. Histologic evaluation was undertaken on at least one joint from each cat. CT-detected joint changes and articular cartilage lesions were graded and the histological appearance of CT-detected osteophytes evaluated. The majority of CT-detected lesions and cartilage lesions were mild. Whole-joint CT scores and AM osteophyte CT scores showed moderate to strong correlation with cartilage scores. The odds were higher for presence of CT-detected osteophytes in craniodorsal, cranial, cranioventral, ventral and dorsal AM regions. Peripheral acetabular regions showed higher cartilage lesion grades than central regions. Tears, seen as fissures/clefts, in labral and perilabral tissues were common. CT-detected AM osteophytes morphologically presented as pointed sclerotic bone, spur-shaped bone or rounded chondro-osteophytes. The results suggest that CT is a valuable tool for diagnosing early feline hip OA. CT-detected osteophytes showed variable histologic morphologies, which may implicate different disease mechanisms and/or disease stages. Tears in the AM could represent an early event in feline hip OA and this warrants further investigation.
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14
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Goel A, Vaja T, Shah A, Rai S, Dandpat S, Vutha R, Darji H, Biswas C. Outcome of Osteophytes After Only-Fixation as Treatment for Multilevel Cervical Spondylosis-A Minimum of 12 Months Follow-Up. World Neurosurg 2020; 146:e876-e887. [PMID: 33197636 DOI: 10.1016/j.wneu.2020.11.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This report analyzes the significance of osteophytes in the overall pathologic scheme in patients with single-level or multilevel cervical spinal degeneration. METHODS From January 2010 to December 2018, 249 patients with cervical spondylosis were surgically treated. The alterations in ventral compression caused by disc bulges, osteophytes, and ligament buckling (disc-osteophye-ligament [DOL] complex) at single or multiple levels were evaluated after surgical treatment that involved only spinal fixation and did not involve any kind of bone or soft tissue decompression. Delayed (≥1 year after surgery) postoperative imaging was available in 165 patients and these patients formed the study group. Forty-five patients underwent facet distraction arthrodesis (group A), 106 patients underwent only-fixation involving transarticular screw insertion (group B), and 14 patients underwent hybrid fixation that involved both intra-articular spacers and transarticular fixation techniques (group C) as the surgical treatment. RESULTS The size of the DOL complex at the segments that underwent fixation was reduced in 136 patients. The size of the DOL complex or its related dural or neural compression did not increase in any of the cases evaluated. Reduction in the size of DOL was more pronounced in patients in group A in both immediate postoperative and delayed images and in patients in group C at spinal levels at which facet distraction was performed using facet distraction spacers. CONCLUSIONS Spinal stabilization reduces the size of osteophytes. Facet distraction spacers are more effective in reduction of the size of DOL in both immediate and delayed postoperative periods.
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Affiliation(s)
- Atul Goel
- Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai, India; Department of Neurosurgery, Lilavati Hospital and Research Centre, Bandra (E), Mumbai, India.
| | - Tejas Vaja
- Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai, India
| | - Abhidha Shah
- Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai, India
| | - Survendra Rai
- Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai, India
| | - Saswat Dandpat
- Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai, India
| | - Ravikiran Vutha
- Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai, India
| | - Hardik Darji
- Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai, India
| | - Chandrima Biswas
- Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai, India
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15
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Drobnič M, Vannini F, Kon E, Dulić O, Kecojević V, Andor B, Altschuler N, Robinson D. Treatment of hallux rigidus by a novel bi-phasic aragonite-based implant: results of a two year multi-centre clinical trial. Int Orthop 2020; 45:1033-1041. [PMID: 33184685 DOI: 10.1007/s00264-020-04872-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 11/03/2020] [Indexed: 01/18/2023]
Abstract
PURPOSE The two year results of a multi-centre clinical trial were examined to evaluate surgical treatment of hallux rigidus using a novel, bi-phasic, biodegradable, and cell-free aragonite-based scaffold (Agili-C™, CartiHeal Ltd, Israel). METHODS Twenty patients with moderate-to-severe hallux rigidus were recruited. After thorough metatarsophalangeal joint (MTPJ-1) debridement, the scaffolds were implanted into the defect centre. Eight patients received concomitant osteotomy. Treatment outcome was followed clinically (Pain VAS, FAAM-ADL, FAAM-Sport, AOFAS-HMIS, maximum active range of extension ROM-EXT, and flexion ROM-FLEX), and by medical imaging, at six month intervals for two years. Adverse events were recorded throughout the study follow-up period. RESULTS Significant clinical improvement over time was observed in all evaluated parameters (screening to final evaluation averages: Pain VAS 59 to 26, FAAM-ADL 57 to 77, FAAM-Sport 39 to 66, AOFAS-HMIS 51 to 81, ROM-EXT 18° to 36°), except for ROM-FLEX. Radiographs showed stable MTPJ-1 width over the two years in 17/18 cases (94%). MRI demonstrated progressive implant biodegradation, coupled with articular cartilage and subchondral bone regeneration, with a repair tissue defect fill of 75-100% in 14/17 (82%) subjects at their final visit. Revision surgery with implant removal was performed in two patients. CONCLUSION Bi-phasic, osteochondral, biodegradable, aragonite-based scaffold demonstrated positive clinical outcome and a good safety profile in the treatment of medium-to-advanced hallux rigidus. According to the medical imaging, this implant has the potential to restore the entire osteochondral unit of metatarsal head.
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Affiliation(s)
- Matej Drobnič
- Department of Orthopedic Surgery, University Medical Centre Ljubljana, Zaloška ulica 9, SI-1000, Ljubljana, EU, Slovenia. .,Chair of Orthopedics, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
| | - Francesca Vannini
- Clinic 1, Orthopedic Institute Rizzoli, Bologna University, Bologna, Italy
| | - Elizaveta Kon
- Humanitas Clinical and Research Center - IRCCS, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Department of Traumatology, Orthopedics and Disaster Surgery, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Oliver Dulić
- Department for Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina, Novi Sad, Serbia.,Medical Faculty, University of Novi Sad, Novi Sad, Serbia
| | - Vaso Kecojević
- Department for Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Bogdan Andor
- Department of Orthopedics, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | | | - Dror Robinson
- Faculty of Medicine, Hasharon Hospital Affiliated to Tel Aviv University, Petah Tikwa, Israel
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16
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Klose-Jensen R, Nielsen AW, Hartlev LB, Thomsen JS, Boel LWT, Laursen M, Keller KK, Hauge EM. Histomorphometric case-control study of subarticular osteophytes in patients with osteoarthritis of the hip. BMC Musculoskelet Disord 2020; 21:653. [PMID: 33023570 PMCID: PMC7542119 DOI: 10.1186/s12891-020-03648-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 09/15/2020] [Indexed: 01/11/2023] Open
Abstract
Objective The objective of this cross-sectional case-control study was to determine the prevalence and size of marginal and subarticular osteophytes in patients with osteoarthritis (OA), and to compare these to that of a control group. Design We investigated femoral heads from 25 patients with OA following hip replacement surgery, and 25 femoral heads from a control group obtained post-mortem. The area and boundary length of the femoral head, marginal osteophytes, and subarticular osteophytes were determined with histomorphometry. Marginal osteophytes were defined histologically as bony projections at the peripheral margin of the femoral head, while subarticular osteophytes were defined as areas of bone that expanded from the normal curvature of the femoral head into the articular cartilage. Results The prevalence of OA patients with marginal- and subarticular osteophytes were 100 and 84%, respectively. Whereas the prevalence of the participants in the control group with marginal- and subarticular osteophytes were 56 and 28%, respectively. The area and boundary length of marginal osteophytes was (median (Interquartile range)) 165.3mm2 (121.4–254.0) mm2 and 75.1 mm (50.8–99.3) mm for patients with OA compared to 0 mm2 (0–0.5) mm2 and 0 mm (0–0.5) mm for the control group (P < 0.001). For the subarticular osteophytes, the area and boundary length was 1.0 mm2 (0–4.4) mm2 and 1.4 mm (0–6.5) mm for patients with OA compared to 0 mm2 (0–0.5) mm2 and 0 mm (0–0.5) mm for the control group (P < 0.001). Conclusion As expected, both marginal- and subarticular osteophytes at the femoral head, were more frequent and larger in patients with OA than in the control group. However, in the control group, subarticular osteophytes were more prevalent than expected from the minor osteophytic changes at the femoral head margin, which may suggest that subarticular osteophytes are an early degenerative phenomenon that ultimately might develop into clinical osteoarthritis.
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Affiliation(s)
- Rasmus Klose-Jensen
- Department of Rheumatology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 45, 8200, Aarhus, Denmark. .,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Andreas Wiggers Nielsen
- Department of Rheumatology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 45, 8200, Aarhus, Denmark
| | - Louise Brøndt Hartlev
- Department of Rheumatology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 45, 8200, Aarhus, Denmark.,Department of Clinical Medicine, Randers Regional Hospital, Randers, Denmark
| | | | | | - Mogens Laursen
- Orthopaedic Surgery Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Kresten Krarup Keller
- Department of Rheumatology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 45, 8200, Aarhus, Denmark.,Diagnostic Centre, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Ellen-Margrethe Hauge
- Department of Rheumatology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 45, 8200, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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17
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Affiliation(s)
- M C Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - D T Felson
- Department of Rheumatology, Boston University School of Medicine, Boston, USA; University of Manchester Centre for Epidemiology, NIHR Manchester BRC, Manchester University NHS Trust, Manchester, UK.
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18
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Abstract
PURPOSE OF REVIEW This narrative review summarizes the last 5 years of published, peer-reviewed research on the use of musculoskeletal ultrasound (US) in osteoarthritis (OA). RECENT FINDINGS Multiple features relevant to OA can be visualized on US, including synovitis, erosion, enthesitis, osteophytes, cartilage damage, meniscal extrusion, and popliteal cysts. US can be used to confirm a diagnosis of OA or make an alternate diagnosis in the clinical setting. When a standardized protocol is used, US is a reliable modality for assessment of the features of OA. Findings on US can predict progression and response to therapy in OA of the hand and knee and can allow characterization of risk factors in a cost-effective, non-invasive, repeatable manner. US is becoming more widely used in OA imaging and has clear value in addition to radiography and clinical assessment. US will likely prove useful in defining phenotypes and providing treatment guidance in OA.
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Affiliation(s)
- Amanda E Nelson
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Doc J. Thurston Building, Campus Box #7280, Chapel Hill, NC, 27599-7280, USA.
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19
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Royer O, Couture ÉJ, Nicodème F, Kalavrousiotis D, Maruyama TC, Denault A, Langevin S. Esophageal Perforation with Transesophageal Echocardiography in an Elderly Patient with Prominent Vertebral Osteophytes: A Case Report and a Review of the Literature. ACTA ACUST UNITED AC 2020; 4:331-336. [PMID: 33117922 PMCID: PMC7581634 DOI: 10.1016/j.case.2020.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Iatrogenic esophageal perforation due to TEE is associated with high mortality. Vertebral osteophytes are a common radiologic finding in elderly patients. Pressure applied by the TEE probe on osteophytes can lead to esophageal laceration. Preoperative imaging should be reviewed before performing TEE. Severe osteophytosis in the elderly may be a relative contraindication to TEE.
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Affiliation(s)
- Olivier Royer
- Department of Anesthesiology and Critical Care, Université Laval, Québec, Québec, Canada
| | - Étienne J Couture
- Department of Anesthesiology and Critical Care, Université Laval, Quebec Heart and Lung Institute, Québec, Québec, Canada
| | - Frédéric Nicodème
- Department of Thoracic Surgery, Université Laval, Quebec Heart and Lung Institute, Québec, Québec, Canada
| | - Dimitri Kalavrousiotis
- Department of Cardiac Surgery, Université Laval, Quebec Heart and Lung Institute, Québec, Québec, Canada
| | - Takumi Codere Maruyama
- Department of Anesthesiology, Université Laval, Quebec Heart and Lung Institute, Québec, Québec, Canada
| | - André Denault
- Department of Anesthesiology and Critical Care, Université de Montréal, Montreal Heart Institute, Montréal, Québec, Canada
| | - Stephan Langevin
- Department of Anesthesiology and Critical Care, Université Laval, Quebec Heart and Lung Institute, Québec, Québec, Canada
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Fourcade G, Baillet A, Grange L, Gastaldi R. Dysphagia in a patient with ankylosing spondylitis. Comment on « Esophagus type cervical spondylosis » by Ma et al. Joint Bone Spine 2019;86:643. Joint Bone Spine 2020; 87:680-681. [PMID: 32622039 DOI: 10.1016/j.jbspin.2020.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/18/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Grégoire Fourcade
- Service de Rhumatologie, CHU de Grenoble Alpes, Avenue de Kimberley, 38130 Echirolles, France.
| | - Athan Baillet
- Service de Rhumatologie, CHU de Grenoble Alpes, Avenue de Kimberley, 38130 Echirolles, France
| | - Laurent Grange
- Service de Rhumatologie, CHU de Grenoble Alpes, Avenue de Kimberley, 38130 Echirolles, France
| | - Romain Gastaldi
- Service de Rhumatologie, CHU de Grenoble Alpes, Avenue de Kimberley, 38130 Echirolles, France
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21
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Myszka A, Piontek J, Tomczyk J, Lisowska-Gaczorek A, Zalewska M. Relationships between osteoarthritic changes ( osteophytes, porosity, eburnation) based on historical skeletal material. Ann Hum Biol 2020; 47:263-272. [PMID: 32295434 DOI: 10.1080/03014460.2020.1741682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Three main diagnostic types of osteoarthritic changes are distinguished in clinical and anthropological literature: osteophytes, porosity, and eburnation. The nature of the relationship between these changes and how lesions progress over time is still unclear.Aim: The aim of the present study is the analysis of the relationships between osteophytes, porosity, and eburnation based on skeletal material.Subjects and methods: The analysis employed the skeletal collection from Cedynia (199 individuals) from tenth to fourteenth-century Poland. Marginal osteophytes (OP), porosity (POR), and eburnation (EB) were examined on a shoulder, elbow, wrist, hip, knee, and ankle.Results: Osteophytes and porosity occurred independently of each other. Combinations of osteophytes and porosity (OP + POR) and osteophytes, porosity, and eburnation (OP + POR + EB) were rarely observed. Combinations of osteophytes and eburnation (OP + EB) or porosity and eburnation (POR + EB) were not found. There was a significant correlation between osteophytes and porosity in the scapula, proximal end of the ulna and proximal end of the femur. Osteophytes and eburnation were correlated at the distal end of the ulna. Porosity and eburnation were correlated at the distal end of the radius and distal end of the ulna. When all joints were considered together, all the types of osteoarthritic changes were correlated. However, the relationship between osteophytes and eburnation and between porosity and eburnation was only slightly significant. Osteophytes preceded porosity, but there were a few cases where more developed porosity accompanied less developed osteophytes.Conclusions: The findings indicate that correlations between osteoarthritic changes are weak, albeit statistically significant and further studies of the relationship between changes are necessary.
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Affiliation(s)
- Anna Myszka
- Institute of Biological Sciences, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - Janusz Piontek
- Institute of Anthropology, Adam Mickiewicz University in Poznań, Poznań, Poland
| | - Jacek Tomczyk
- Institute of Biological Sciences, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | | | - Marta Zalewska
- Department of the Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
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Temp J, Labuz D, Negrete R, Sunkara V, Machelska H. Pain and knee damage in male and female mice in the medial meniscal transection-induced osteoarthritis. Osteoarthritis Cartilage 2020; 28:475-485. [PMID: 31830592 DOI: 10.1016/j.joca.2019.11.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 10/18/2019] [Accepted: 11/18/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate sex effects on pain-related behaviors in the medial meniscal transection (MMT) knee osteoarthritis (OA) model. METHODS Experiments were performed in male and female C57BL/6J mice (12/group/sex). MMT was induced by transection of the medial collateral ligament and the medial meniscus. Sham-operated and naïve mice served as controls. Mechanical and heat sensitivity in hind paws, hind limb use, and locomotor activity were measured for 3 months. Knee histology was performed on week 12. RESULTS In males, MMT triggered a bi-phasic mechanical hypersensitivity and decreased load on OA limb, with an acute post-operative (1-5 days) and chronic (3-12 weeks) OA phases separated by a remission in the intermediate phase (1-2 weeks). Females showed a less pronounced bi-phasic pattern, with a greater mechanical hypersensitivity, but not poorer limb use, than males in the intermediate phase (maximal difference: 1.1 g, 95% confidence intervals (CI) [0.7, 1.5]). There were no major sex differences in the chronic phase. MMT did not induce heat hypersensitivity or change in locomotor activity in the chronic phase in both sexes. MMT caused more severe cartilage damage in males than in females (maximal difference: 1.1 score points, 95% CI [1.9, 0.3]), and a comparable between sexes osteophyte formation. The knee damage did not correlate with pain. CONCLUSIONS MMT modelled human knee OA well, capturing cartilage destruction and osteophyte formation, mechanical pain, and poorer limb use in both sexes. Sex differences in pain were modality- and time-dependent, reflecting complex sex-related features of human OA.
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Affiliation(s)
- J Temp
- Department of Experimental Anesthesiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany.
| | - D Labuz
- Department of Experimental Anesthesiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany.
| | - R Negrete
- Department of Experimental Anesthesiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany.
| | - V Sunkara
- Department of Mathematics and Computer Science, Freie Universität Berlin, Germany; Computational Medicine, Zuse Institute Berlin, Germany.
| | - H Machelska
- Department of Experimental Anesthesiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany.
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McCulloch K, Huesa C, Dunning L, Litherland GJ, Van 't Hof RJ, Lockhart JC, Goodyear CS. Accelerated post traumatic osteoarthritis in a dual injury murine model. Osteoarthritis Cartilage 2019; 27:1800-1810. [PMID: 31283983 DOI: 10.1016/j.joca.2019.05.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/16/2019] [Accepted: 05/21/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Joint injury involving destabilisation of the joint and damage to the articular cartilage (e.g., sports-related injury) can result in accelerated post-traumatic osteoarthritis (PTOA). Destabilised medial meniscotibial ligament (DMM) surgery is one of the most commonly used murine models and whilst it recapitulates Osteoarthritis (OA) pathology, it does not necessarily result in multi-tissue injury, as occurs in PTOA. We hypothesised that simultaneous cartilage damage and joint destabilisation would accelerate the onset of OA pathology. METHODS OA was induced in C57BL/6 mice via (a) DMM, (b) microblade scratches of articular cartilage (CS) or (c) combined DMM and cartilage scratch (DCS). Mice were culled 7, 14 and 28 days post-surgery. Microcomputed tomography (μCT) and histology were used to monitor bone changes and inflammation. Dynamic weight bearing, an indirect measure of pain, was assessed on day 14. RESULTS Osteophytogenesis analysis via μCT revealed that osteophytes were present in all groups at days 7 and 14 post-surgery. However, in DCS, osteophytes were visually larger and more numerous when compared with DMM and cartilage scratch (CS). Histological assessment of cartilage at day 14 and 28, revealed significantly greater damage in DCS compared with DMM and CS. Furthermore, a significant increase in synovitis was observed in DCS. Finally, at day 14 osteophyte numbers correlated with changes in dynamic weight bearing. CONCLUSION Joint destabilisation when combined with simultaneous cartilage injury accelerates joint deterioration, as seen in PTOA. Thus, DCS provides a novel and robust model for investigating multiple pathological hallmarks, including osteophytogenesis, cartilage damage, synovitis and OA-related pain.
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Affiliation(s)
- K McCulloch
- Institute of Biomedical & Environmental Health Research, University of the West of Scotland, Paisley, PA1 2BE, UK
| | - C Huesa
- Institute of Biomedical & Environmental Health Research, University of the West of Scotland, Paisley, PA1 2BE, UK
| | - L Dunning
- Institute of Biomedical & Environmental Health Research, University of the West of Scotland, Paisley, PA1 2BE, UK
| | - G J Litherland
- Institute of Biomedical & Environmental Health Research, University of the West of Scotland, Paisley, PA1 2BE, UK
| | - R J Van 't Hof
- Institute of Ageing and Chronic Disease, University of Liverpool, WH Duncan Building, West Derby Street, Liverpool, L7 8TX, UK
| | - J C Lockhart
- Institute of Biomedical & Environmental Health Research, University of the West of Scotland, Paisley, PA1 2BE, UK.
| | - C S Goodyear
- Centre of Immunobiology, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, United Kingdom.
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Ericsson YB, Roos EM, Owman H, Dahlberg LE. Association between thigh muscle strength four years after partial meniscectomy and radiographic features of osteoarthritis 11 years later. BMC Musculoskelet Disord 2019; 20:512. [PMID: 31679520 PMCID: PMC6827177 DOI: 10.1186/s12891-019-2875-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 10/09/2019] [Indexed: 12/23/2022] Open
Abstract
Background Meniscus injury and meniscectomy both entail increased risk of knee osteoarthritis (OA). Thigh muscle weakness is a suggested mediator of OA but there is little evidence of its importance for knee OA development after meniscectomy. This study aimed to examine the association between thigh muscle strength after partial meniscectomy in middle-aged subjects with a non-traumatic meniscal tear and later radiographic knee OA changes. Methods Thirty-four out of 45 participants in an exercise-trial underwent testing for isokinetic thigh muscle strength 4 years after arthroscopic partial meniscectomy and had radiographic examination 11 years later (15 years post-surgery, mean age at follow-up of 57 years (range 50–61)). Outcomes were grade of joint space narrowing and osteophyte score in the medial tibiofemoral compartment of the operated knee and the contralateral knee. We tested the association between muscle strength at baseline and the radiographic outcomes at follow-up using logistic regression analyses adjusted for sex and overweight. Results At follow-up, 33/34 subjects had joint space narrowing and 27/34 subjects had osteophytes in the operated knee, in the contralateral knee joint space narrowing was found in 23 subjects. In the operated knee baseline knee extensor and flexor strength were negatively associated with grade of joint space narrowing at follow-up (OR 0.972 and 0.956, p = 0.028 and 0.026, respectively) and also with osteophyte score (OR 0.968 and 0.931, p = 0.017 and 0.011, respectively). In the contralateral knee longitudinal associations between strength and radiographic OA features were similar, OR 0.949–0.972, p < 0.05. Conclusion The finding that stronger thigh muscles 4 years after meniscectomy were associated with less severe osteoarthritic changes in the medial tibiofemoral compartment of both the operated and contralateral knee 11 years later, may suggest that strong thigh muscles can help to preserve joint integrity in middle-aged subjects at risk of knee OA.
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Affiliation(s)
- Ylva B Ericsson
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden. .,Department of Orthopaedics, Skane University Hospital, SE-205 02, Malmö, Sweden.
| | - Ewa M Roos
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Henrik Owman
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Leif E Dahlberg
- Department of Clinical Sciences Lund, Orthopaedics, Lund University, Skane University Hospital, Lund, Sweden
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25
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Crisco JJ, Morton AM, Moore DC, Kahan LG, Ladd AL, Weiss APC. Osteophyte growth in early thumb carpometacarpal osteoarthritis. Osteoarthritis Cartilage 2019; 27:1315-1323. [PMID: 31136802 PMCID: PMC6702046 DOI: 10.1016/j.joca.2019.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 04/09/2019] [Accepted: 05/03/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Osteophyte formation is a critical part of the degeneration of a joint with osteoarthritis (OA). While often qualitatively described, few studies have succeeded in quantifying osteophyte growth over time. Using computed tomography (CT) image data from a longitudinal, observational study of thumb carpometacarpal (CMC) OA, our aim was to quantify osteophyte growth volume and location over a three-year period in men and women. METHOD Ninety patients with early thumb OA were recruited and assessed at baseline, 1.5 years, and 3 years with CT imaging. Osteophyte volume and location on the trapezium and first metacarpal were determined using a library of 46 healthy subjects as a nonarthritic reference database. RESULTS There was a significant increase in osteophyte volume for women and men over the three-year follow-up in the trapezium (86.8 mm3-120.5 mm3 and 165.1 mm3-235.3 mm3, means respectively) and in the proximal metacarpal (63 mm3-80.4 mm3, and 115.8 mm3-161.7 mm3, respectively). The location of osteophyte initiation and growth was consistent across subjects and was located in non-opposing regions on the trapezium and first metacarpal. Osteophyte growth occurred about the radial and ulnar margins of the trapezial facet, while on the proximal metacarpal, growth occurred principally about the volar and dorsal margins of the facet. CONCLUSION Osteophyte growth occurred in early thumb osteoarthritis over three years. Growth was localized in specific, non-opposing regions on the trapezium and metacarpal, raising intriguing questions about the triggers for their formation, whether the mechanisms are mechanical, biological or a combination of both.
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Affiliation(s)
- Joseph J. Crisco
- Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, 1 Hoppin Street, CORO West Suite 404, Providence, RI 02903,Address correspondence and reprint requests to: J.J. Crisco, Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, 1 Hoppin Street, CORO West Suite 404, Providence, RI 02903,
| | - Amy M. Morton
- Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, 1 Hoppin Street, CORO West Suite 404, Providence, RI 02903
| | - Douglas C. Moore
- Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, 1 Hoppin Street, CORO West Suite 404, Providence, RI 02903
| | - Lindsey G. Kahan
- Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, 1 Hoppin Street, CORO West Suite 404, Providence, RI 02903
| | - Amy L. Ladd
- Department of Orthopaedics, The Warren Alpert Medical School of Brown University/University Orthopedics, 2 Dudley Street, Suite 200, Providence, RI 02905
| | - Arnold-Peter C. Weiss
- Robert A. Chase Hand & Upper Limb Center, Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA
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Berlin A, Simon D, Tascilar K, Figueiredo C, Bayat S, Finzel S, Klaus E, Rech J, Hueber AJ, Kleyer A, Schett G. The ageing joint-standard age- and sex-related values of bone erosions and osteophytes in the hand joints of healthy individuals. Osteoarthritis Cartilage 2019; 27:1043-1047. [PMID: 30890457 DOI: 10.1016/j.joca.2019.01.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 01/06/2019] [Accepted: 01/29/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To analyze the age-related changes of the physiological hand joint architecture. METHOD To address this concept, healthy individuals (each 10 women and 10 men in six different age decades spanning from 21 to 80 years) were recruited through a field campaign, investigated for the absence of rheumatic diseases and other comorbidities and received high-resolution quantitative computed tomography (HR-pQCT) examination of the hand joints. Number and extent of erosions and osteophytes were quantified across the ages and different sexes. RESULTS Bone erosions [median (Q1-Q3), 1 (0-2)] and osteophytes [2 (1-4)] were found in healthy women and men with no significant sex differences. Structural changes however accumulated with age: the overall incidence rate ratio (IRR) for the number of erosions and osteophytes per age were 1.04 (95% CI: erosions 1.03-1.06; osteophytes: 1.03-1.05). This means a 4% increase in the number of erosions and osteophytes per year. Using third decade as reference, healthy individuals in the age decades from 50 years had higher IRR for erosion numbers (sixth, seventh, eigth decade: 4.87 (2.20-11.75), 6.81 (3.08-16.46) and 6.92 (3.11-16.79)) compared to younger subjects (fourth, fifth decade: 1.80 (0.69-4.87), 1.53 (0.59-4.10)). The IRRs of osteophytes also indicate a gradual increase after the fifth decade, with IRRs of 2.32 (1.32-4.17), 4.17 (2.38-7.49) and 6.86 (3.97-12.20) for the sixth, seventh and eigth decades, respectively. CONCLUSIONS Structural changes in the hand joints of healthy individuals are age dependent. While being rare under 50 years of age, erosions and osteophytes accumulate above the age of 50, suggesting that the threshold between "normal" and "pathological" is shifted with the increase of age.
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Affiliation(s)
- A Berlin
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg (FAU) and Universitaetsklinikum Erlangen, Erlangen, Germany.
| | - D Simon
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg (FAU) and Universitaetsklinikum Erlangen, Erlangen, Germany.
| | - K Tascilar
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg (FAU) and Universitaetsklinikum Erlangen, Erlangen, Germany.
| | - C Figueiredo
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg (FAU) and Universitaetsklinikum Erlangen, Erlangen, Germany.
| | - S Bayat
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg (FAU) and Universitaetsklinikum Erlangen, Erlangen, Germany.
| | - S Finzel
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg (FAU) and Universitaetsklinikum Erlangen, Erlangen, Germany.
| | - E Klaus
- Institute of Medical Physics (IMP), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - J Rech
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg (FAU) and Universitaetsklinikum Erlangen, Erlangen, Germany.
| | - A J Hueber
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg (FAU) and Universitaetsklinikum Erlangen, Erlangen, Germany.
| | - A Kleyer
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg (FAU) and Universitaetsklinikum Erlangen, Erlangen, Germany.
| | - G Schett
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg (FAU) and Universitaetsklinikum Erlangen, Erlangen, Germany.
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Scholz C, Naseri Y, Hohenhaus M, Hubbe U, Klingler JH. Long-term results after surgical treatment of diffuse idiopathic skeletal hyperostosis (DISH) causing dysphagia. J Clin Neurosci 2019; 67:151-155. [PMID: 31221580 DOI: 10.1016/j.jocn.2019.05.057] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 05/28/2019] [Indexed: 01/30/2023]
Abstract
Diffuse idiopathic skeletal hyperostosis (DISH) is a non-inflammatory, systemic skeletal disease. The associated formation of anterior cervical osteophytes can cause severe dysphagia, so the osteophytes have to be surgically removed. Because the clinical syndrome is rare, long-term outcome after surgical therapy is likewise scarce. In this retrospective, single-center study, five consecutive patients with DISH causing dysphagia and following resection of osteophytes between 2005 and 2015 were included. Patient and surgical reports were evaluated regarding surgery-related and postoperative complications. For the short term, the outpatient visits three months and one year after the surgery were evaluated. For the long-term results, patients were followed via questionnaires concerning actual complaints, complications or further treatment associated to DISH. Five male patients (61.6 years old; range, 43-77) were operated. One patient had a transitory worsening of a preexisting hoarseness and one patient had permanent problems with singing postoperatively. All patients reported improvement of dysphagia after three months. One patient deceased five years after surgery independently of DISH without complaining about recurring dysphagia. After a mean follow-up of 70.3 months (range, 24-126 months), dysphagia was consistently improved in all remaining four patients. The patient with the slightest improvement and clinical deterioration in the course had an initially incomplete resection of osteophytes. Imaging showed a re-increase of ossifications 2.5 years after the surgery. Resection of symptomatic anterior osteophytes in DISH is a safe and promising procedure to improve dysphagia in the long-term, but the recurrence of osteophytes is possible years after initial treatment.
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Affiliation(s)
- Christoph Scholz
- Department of Neurosurgery, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, D-79106 Freiburg, Germany.
| | - Yashar Naseri
- Department of Neurosurgery, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, D-79106 Freiburg, Germany
| | - Marc Hohenhaus
- Department of Neurosurgery, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, D-79106 Freiburg, Germany
| | - Ulrich Hubbe
- Department of Neurosurgery, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, D-79106 Freiburg, Germany
| | - Jan-Helge Klingler
- Department of Neurosurgery, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, D-79106 Freiburg, Germany
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Leumann A, Leonard T, Nüesch C, Horisberger M, Mündermann A, Herzog W. The natural initiation and progression of osteoarthritis in the anterior cruciate ligament deficient feline knee. Osteoarthritis Cartilage 2019; 27:687-693. [PMID: 30641135 DOI: 10.1016/j.joca.2019.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 12/11/2018] [Accepted: 01/07/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim of this study was to document the natural history of development and long-term progression of osteoarthritis (OA) in the feline knee after minimally invasive anterior cruciate ligament (ACL) transection. DESIGN ACL transections of the left knee joint of 14 skeletally mature cats were performed. Radiographic scores, tibiofemoral and patellofemoral joint space and anterior tibial translation were assessed before, immediately and every 3 months after ACL transection (longest follow-up: 93 months). RESULTS After 26 months, all ACL transected knees had developed definite OA. The earliest changes were observed on the tibia plateau starting as early as 2 months after ACL transection, and at 12 months signs of OA were present in more than 80% of cats in the medial and in almost 80% of cats in the lateral compartment. In the first 24 months, medial tibiofemoral joint space decreased by 0.88 mm (95% confidence interval [-0.55;-1.21] mm) and lateral tibiofemoral joint space by 0.55 mm ([-0.26;-0.85] mm). In the same interval, the joint space in the patellofemoral joint increased by 0.98 mm ([0.59; 1.37] mm). Throughout the entire observation period, the anterior tibial translation was on average 5.3 mm greater than in the contralateral knee ([4.5; 6.0]mm). CONCLUSIONS Immediate changes in anterior tibial translation during an anterior drawer test clearly showed joint instability that persisted throughout the lifetime of the animals. Degenerative changes were observed on radiographs within 4 months of the injury only in the transected but not the contralateral limb suggesting the role of mechanical instability for the development and progression of knee OA.
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Affiliation(s)
- A Leumann
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada; OrthoPraxis Leumann Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland
| | - T Leonard
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - C Nüesch
- Department of Clinical Research, University of Basel, Basel, Switzerland; Department of Orthopedics and Traumatology, University of Basel Hospital, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Switzerland
| | - M Horisberger
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada; Department of Orthopedics and Traumatology, University of Basel Hospital, Basel, Switzerland
| | - A Mündermann
- Department of Clinical Research, University of Basel, Basel, Switzerland; Department of Orthopedics and Traumatology, University of Basel Hospital, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Switzerland
| | - W Herzog
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
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Zhu Z, Aitken D, Cicuttini F, Jones G, Ding C. Ambulatory activity interacts with common risk factors for osteoarthritis to modify increases in MRI-detected osteophytes. Osteoarthritis Cartilage 2019; 27:650-658. [PMID: 30654117 DOI: 10.1016/j.joca.2018.12.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 12/10/2018] [Accepted: 12/24/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the longitudinal association between objectively measured ambulatory activity (AA) and knee MRI-detected osteophytes (OPs), and to test whether this relationship was modified by common risk factors for OA including sex, obesity, disease severity and knee injury history. METHODS 408 community-dwelling adults aged 51-81 years were assessed at baseline and 2.7 years. T1-weighted fat-suppressed MRI was used to evaluate knee OPs at both time points. AA was assessed at baseline by pedometers and categorized as: less active (≤7499 steps per day), moderately active (7500-9999 steps per day) and highly active (≥10,000 steps per day). RESULTS Statistically significant interactions were detected between knee OA risk factors and AA on increases in MRI-detected OPs (all P < 0.05). In stratified analyses, being moderately active, compared to being less active, was protective against an increase in MRI-detected OPs (score change of ≥1) in females (relative risk (RR) = 0.42, 95%CI, 0.25-0.70, P < 0.01), those who were obese (RR = 0.50, 95%CI, 0.30-0.83, P < 0.01), those with radiographic OA (ROA) (RR = 0.68, 95%CI, 0.47-0.97, P = 0.02) and those with a history of knee injury (RR = 0.27, 95%CI, 0.08-0.88, P = 0.02) in almost every knee compartment, after adjustment for confounders. No statistically significant associations were found in males, non-obese, non-ROA or non-injury groups. CONCLUSIONS Being moderately active is protective against an increase in MRI-detected OPs in females, those with ROA, those who are obese and those with a history of knee injury. These findings suggest that being moderately active is beneficial for individuals who are at higher risk of knee OA.
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Affiliation(s)
- Z Zhu
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - D Aitken
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - F Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - G Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - C Ding
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Rheumatology and Immunology, Arthritis Research Institute, The First Affiliate Hospital of Anhui Medical University, Hefei, China.
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Abstract
UNLABELLED Low back pain (LBP) is a common presenting complaint in our hospital in Enugu Nigeria. Three hundred thirty-three radiographs of patients with LBP were studied. A lot of them had bony outgrowths (osteophytes) on the spine. Plain radiograph of the spine is useful in studying these patients' condition. INTRODUCTION Low back pain (LBP) is one of the common symptoms which bring patients to hospital and ultimately to radiology department for medical assistance. Plain radiographs of lumbar spine are usually the initial imaging tools requested by clinicians. The objective of this study is to evaluate commonest finding in patients with LBP to guide physicians for improved management. METHODS This work was a retrospective study. Plain films of these patients with LBP at the University of Nigeria Teaching Hospital, Enugu, were assessed by two radiologists. Findings documented and analyzed using IBM'S SPSS 22. Association was determined using chi-square with level of significance, p < 0.05. RESULTS Total number of radiographs reviewed was 333. One hundred and eighty-three (55.0%) patients were females. Age ranged from 14 to 101 years. Mean age of 53.4 ± 15.9 years. Disc space was normal in majority (55.3%, 184/333) of patients; narrowing was observed in most others (43.2%, 144/333), about half of the narrowing occurring along with vacuum phenomenon. Osteophytes were commonest finding in a total of 284/333 (85.3%) existing alone or in combination with other findings. Proportion of patients with osteophytes was highest in sixth to eighth decade of life (98.8% of 61-80 age group), followed by 41-60 age group (92.9%). This association between age group and the presence of osteophytes was statistically significant (p < 0.000). Anterior vertebral body was affected in 85.0% (284/333) of patients. CONCLUSIONS Osteophytes are common radiologic features in LBP. Anterior vertebral body is most affected. It is commoner in the older age group. Plain radiograph is an invaluable imaging tool in the management of LBP in this part of the world.
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Balkovec C, Veldhuis J, Baird JW, Wayne Brodland G, McGill SM. Digital tracking algorithm reveals the influence of structural irregularities on joint movements in the human cervical spine. Clin Biomech (Bristol, Avon) 2018; 56:11-7. [PMID: 29738991 DOI: 10.1016/j.clinbiomech.2018.04.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 04/19/2018] [Accepted: 04/25/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Disc height loss and osteophytes change the local mechanical environment in the spine; while previous research has examined kinematic dysfunction under degenerative change, none has looked at the influence of disc height loss and osteophytes throughout movement. METHODS Twenty patients with pain related to the head, neck or shoulders were imaged via videofluoroscopy as they underwent sagittal-plane flexion and extension. A clinician graded disc height loss and osteophytes as "severe/moderate", "mild", or "none". A novel tracking algorithm quantified motions of each vertebra. This information was used to calculate intervertebral angular and shear displacements. The digital algorithm made it practical to track individual vertebrae in multiple patients through hundreds of images without bias. FINDINGS Cases without height loss/osteophytes had a consistent increase in intervertebral angular displacement from C2/C3 to C5/C6, like that of healthy individuals, and mild height losses did not produce aberrations that were systematic or necessarily discernable. However, joints with moderate to severe disc height loss and osteophytes exhibited reduced range of motion compared to adjacent unaffected joints in that patient and corresponding joints in patients without structural irregularities. INTERPRETATION Digitally-obtained motion histories of individual joints allowed anatomical joint changes to be linked with changes in joint movement patterns. Specifically, disc height loss and osteophytes were found to influence cervical spine movement in the sagittal plane, reducing angular motions at affected joints by approximately 10% between those with and without height loss and osteophytes. Further, these joint changes were associated with perturbed intervertebral angular and shear movements.
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Alves-Cardoso F, Assis S. Can osteophytes be used as age at death estimators? Testing correlations in skeletonized human remains with known age-at-death. Forensic Sci Int 2018; 288:59-66. [PMID: 29729497 DOI: 10.1016/j.forsciint.2018.04.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 04/07/2018] [Accepted: 04/16/2018] [Indexed: 12/19/2022]
Abstract
Age-at-death estimation is one of the major challenges when establishing an adult skeleton biological profile. The presence of degenerative joint changes - e.g. osteophytes - has been regarded as a good postmaturity age indicator. This study assessed if a clear relationship between age and osteophytes exists. To accomplish this goal, a total of 16 joint surfaces, from the shoulder, elbow, wrist, hip, knee, and ankle, were examined in 604 adult individuals, of both sexes from two Portuguese Identified collections. Individuals had between 20 and 98 year old at death. Statistically significant results were found between age-at-death and degrees of severity of osteophytes throughout all the articular surfaces analyzed (p>0.001). However, the strength of the correlation varies from moderate to low in the majority of the joints, for both sexes. The only strong correlation effects (r=0.567 in females and r=0.552 in males) were found associated with the left and right glenoid cavity in females and males respectively. More noticeable changes were consistently found in association with older individuals (>62 years old). Results indicate that significant relationships exist between age and the presence of osteophytes in the joint margins. However, correlation effects were low to moderate in most cases, therefore the use of osteophytes to predict age-at-death is not without significant error of interpretation.
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Affiliation(s)
- Francisca Alves-Cardoso
- LABOH - Laboratório de Antropologia Biológica e Osteologia Humana, CRIA/FCSH, Universidade NOVA de Lisboa, Portugal; CRIA - Centro em Rede de Investigação em Antropologia, Faculdade de Ciencias Sociais e Humanas, Universidade NOVA de Lisboa, 1069-061 Lisboa, Portugal.
| | - Sandra Assis
- LABOH - Laboratório de Antropologia Biológica e Osteologia Humana, CRIA/FCSH, Universidade NOVA de Lisboa, Portugal; CRIA - Centro em Rede de Investigação em Antropologia, Faculdade de Ciencias Sociais e Humanas, Universidade NOVA de Lisboa, 1069-061 Lisboa, Portugal
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Bensler S, Agten CA, Pfirrmann CWA, Sutter R. Osseous spurs at the fovea capitis femoris-a frequent finding in asymptomatic volunteers. Skeletal Radiol 2018; 47:69-77. [PMID: 28840285 DOI: 10.1007/s00256-017-2763-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 08/07/2017] [Accepted: 08/11/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE 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. MATERIAL AND METHODS Sixty-five patients (mean age 63.6 years) with radiographically confirmed osteoarthritis of the hip and 59 asymptomatic healthy volunteers (mean age 33.9 years) 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. RESULTS 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 1-2 mm) than osteophyte size in patients (range 1-4 mm) (p ≤ 0.035). In volunteers and patients, the spurs/osteophytes were most frequently located at the anterior border of the fovea capitis femoris. CONCLUSION Smaller osseous spurs (<2 mm) at the border of the fovea capitis femoris are very common in asymptomatic volunteers and do not seem to be pathologic.
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Zhu Z, Laslett LL, Han W, Antony B, Pan F, Cicuttini F, Jones G, Ding C. Associations between MRI-detected early osteophytes and knee structure in older adults: a population-based cohort study. Osteoarthritis Cartilage 2017; 25:2055-2062. [PMID: 28935436 DOI: 10.1016/j.joca.2017.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 09/01/2017] [Accepted: 09/11/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To describe prevalence of osteophytes (OPs) detected only by magnetic resonance imaging (MRI) but not by standard X-ray in older adults and to evaluate longitudinal associations with knee structural changes. METHODS 837 participants were randomly selected from the local community and had MRI scans to assess knee OPs and other structures. OPs detected only by MRI but not by standard X-ray were defined as MRI-detected early OPs (MRI-OPs for short). OPs detected by both MRI and X-ray were defined as established-OPs. RESULTS The prevalence of MRI-OPs was 50% while the prevalence of established-OPs was 10% and no-OPs was 40% at total tibiofemoral (TF) compartment at baseline. Compared with no-OPs, participants with MRI-OPs had greater risks of increased cartilage defects in all TF compartments (RR 1.37, 95%CI 1.07-1.74) and bone marrow lesions (BMLs) only in medial TF compartment (RR 1.49, 95%CI 1.06-2.11), after adjustment for age, sex, BMI, cartilage defects, BMLs and/or joint space narrowing; participants with established-OPs had greater cartilage volume loss at total (β -2.02, 95%CI -3.86, -0.17) and lateral tibial sites (β -5.63, 95%CI -9.93, -1.32), greater risks of increased cartilage defects in total (RR 1.66, 95%CI 1.15-2.40) and medial TF compartments (RR 1.49, 95%CI 1.20-1.69) and BMLs in all TF compartments (RR 1.88, 95%CI 1.22-2.89), after adjustment for covariates. CONCLUSION MRI-OPs were associated with changes in knee structures, and the associations were similar but not as prominent as those for established-OPs. These suggest MRI-OPs may have a role to play in knee early-stage osteoarthritic progression.
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Affiliation(s)
- Z Zhu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - L L Laslett
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - W Han
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Translational Research Centre, Academy of Orthopaedics, Guangdong Province, China
| | - B Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - F Pan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - F Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - G Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - C Ding
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Translational Research Centre, Academy of Orthopaedics, Guangdong Province, China; School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong, China; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
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Ganova P, Gyurkovska V, Belenska-Todorova L, Ivanovska N. Functional complement activity is decisive for the development of chronic synovitis, osteophyte formation and processes of cell senescence in zymosan-induced arthritis. Immunol Lett 2017; 190:213-220. [PMID: 28860038 DOI: 10.1016/j.imlet.2017.08.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 08/19/2017] [Accepted: 08/22/2017] [Indexed: 01/09/2023]
Abstract
Synovial inflammation plays a critical role in the symptoms and structural progression of arthritis which leads to irreversible damage of the adjacent cartilage and bone. Activation of complement system is strongly implicated as a factor in the pathogenesis of chronic synovitis in human rheumatoid arthritis (RA). In this study, we show that the depletion of functional complement activity at the time of the initiation of zymosan-induced arthritis, significantly reduced the expression of TGF-beta1/3, BMP2 and pSmad2 and decreased the number of Sudan Black B positive cells in the synovium. Also, the excessive synthesis of proteoglycans and glycosaminoglycans was diminished. The appearance of apoptotic and senescent cells among the adherent bone marrow cells cultivated in vitro was not observed in complement depleted mice. Therefore, the lack of functional complement prevented the development of chronic synovitis, osteophyte formation and the generation of pathologic senescent arthritic cells.
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Affiliation(s)
- Petya Ganova
- Department of Immunology, Institute of Microbiology, Sofia, Bulgaria
| | | | | | - Nina Ivanovska
- Department of Immunology, Institute of Microbiology, Sofia, Bulgaria.
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Zhu Z, Laslett LL, Jin X, Han W, Antony B, Wang X, Lu M, Cicuttini F, Jones G, Ding C. Association between MRI-detected osteophytes and changes in knee structures and pain in older adults: a cohort study. Osteoarthritis Cartilage 2017; 25:1084-1092. [PMID: 28115233 DOI: 10.1016/j.joca.2017.01.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 12/14/2016] [Accepted: 01/12/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe cross-sectional and longitudinal associations between magnetic resonance imaging (MRI)-detected osteophytes (OPs) and knee structural abnormalities and knee pain in older adults. METHOD A prospective population-based cohort study of 895 participants aged 50-80 years (mean age 62 years, 50% female) was performed. T1-or T2-weighted fat suppressed MRI was used to assess knee OPs, cartilage volume, cartilage defects and bone marrow lesions (BMLs) at baseline and after 2.6 years. Radiographically-detected OPs were scored according to the Osteoarthritis Research Society International (OARSI) atlas. Knee pain was assessed using a self-administered questionnaire at baseline, 2.6 and 5 years later. RESULTS 85% of participants had MRI-detected OPs at baseline, while 10% of participants had radiographically-detected OPs. Cross-sectionally, higher gardes of MRI-detected OPs in all compartments were significantly, independently and site-specifically associated with higher prevalences of cartilage defects and BMLs, lower cartilage volume and higher prevalence of knee pain. Longitudinally, higher gardes of baseline MRI-detected OPs site-specifically predicted greater risks of any increase in cartilage defects or BMLs, and loss of cartilage volume in medial and lateral tibiofemoral (LTF) and total compartments over 2.6 years in multivariable analyses. These significant associations were similar in those without radiographically-detected OPs. MTF and total OP scores were significantly associated with change in total knee pain over 2.6 and 5 years but these became non-significant after adjustment for cartilage defects and BMLs. CONCLUSION MRI-detected knee OPs are common and appear to be clinically relevant to knee structural changes in older adults.
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Affiliation(s)
- Z Zhu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - L L Laslett
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - X Jin
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - W Han
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Translational Research Centre, Academy of Orthopedics, Guangdong Province, China; School of Basic Medical Science, Southern Medical University, Guangzhou, Guangdong, China
| | - B Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - X Wang
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - M Lu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - F Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - G Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - C Ding
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Translational Research Centre, Academy of Orthopedics, Guangdong Province, China; School of Basic Medical Science, Southern Medical University, Guangzhou, Guangdong, China; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
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Hamilton TW, Choudhary R, Jenkins C, Mellon SJ, Dodd CAF, Murray DW, Pandit HG. Lateral osteophytes do not represent a contraindication to medial unicompartmental knee arthroplasty: a 15-year follow-up. Knee Surg Sports Traumatol Arthrosc 2017; 25:652-9. [PMID: 27631646 DOI: 10.1007/s00167-016-4313-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 08/31/2016] [Indexed: 12/18/2022]
Abstract
PURPOSE Lateral osteophytes have been reported to be associated with lateral compartment disease and as such it is unclear whether medial unicompartmental knee arthroplasty should be performed if these are present. METHODS Using the OARSI classification system, 0 (no osteophyte) to 3 (large osteophyte), radiographs from a series of cemented meniscal-bearing unicompartmental knee arthroplasty implanted in the setting of full-thickness lateral cartilage where lateral osteophytes were not considered a contraindication were identified and factors associated with the presence and size of lateral osteophytes, and their impact on clinical outcomes and implant survival were assessed. RESULTS Pre-operative radiographs from 458 knees (392 patients), independently followed up for a mean 10.5 years (range 5.3-16.6), were assessed. Lateral osteophytes were present in 62 % of knees with 18 % scored as Grade 3. Inter-observer reliability was good (kappa = 0.70). The presence and size of lateral osteophytes was associated with younger age at joint replacement (p = 0.01) and increasing BMI (p = 0.01). No association was seen with gender, pre-operative status, assessed using the Oxford Knee Score (OKS), American Knee Society (AKSS) Objective or Functional Score, Tegner activity score, or size of medial tibial lesion. Subgroup analysis of Grade 3 Osteophytes revealed that these were associated with a greater degree of macroscopic ACL damage. At 10 years there was no difference in function (n.s.), and at 15 years no difference in implant survival or mechanism of failure between groups (n.s.). Subgroup analysis of Grade 3 osteophytes found no significant difference in functional outcome at 10 years or implant survival at 15 years. CONCLUSION The presence of lateral osteophytes is not a contraindication to medial meniscal-bearing unicompartmental knee arthroplasty. The clinical relevance of this study is that it highlights the importance of an appropriate pre-operative assessment of the lateral compartment as in the setting of full-thickness cartilage at operation lateral osteophytes do not compromise long-term functional outcome or implant survival. LEVEL OF EVIDENCE IV.
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Chu JG, Dai MW, Wang Y, Tian FM, Song HP, Xiao YP, Shao LT, Zhang YZ, Zhang L. Strontium ranelate causes osteophytes overgrowth in a model of early phase osteoarthritis. BMC Musculoskelet Disord 2017; 18:78. [PMID: 28187731 PMCID: PMC5303224 DOI: 10.1186/s12891-017-1399-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 01/11/2017] [Indexed: 11/24/2022] Open
Abstract
Background Osteoarthritis (OA) involves cartilage changes as well as modifications of subchondral bone and synovial tissues. Strontium ranelate (SR), an anti-osteoporosis compound, which is currently in phase III clinical trial for treatment of OA. Evidences suggest that SR preferably deposited in osteophyte, other than in subchondral bone in early phase of OA. This phenomenon raises concern about its utility for OA treatment as a disease-modifying drug. To evaluate the effect of SR on cartilage, subchondral bone mass and subchondral trabecular bone structure in medial meniscectomized (MNX) guinea pigs. Method Thirty-six 3-month-old male Dunkin Hartley albino guinea pigs received either sham or medial meniscectomy operations. One week after the procedure, meniscectomized animals began 12 weeks of SR (625 mg/kg, daily) treatment by oral gavage for MNX + SR group, or normal saline for MNX + V group. All animals were euthanized 12 weeks later, cartilage degeneration and subchondral bone micro-architecture was analyzed. Results Both OARSI scores (P = 0.523 for marcoscopic scores, P = 0.297 for histological scores) and Cartilage thickness (P = 0.335) in MNX + SR group were comparable to MNX + V group. However, osteophyte sizes were larger in MNX + SR group (P = 0.014), and collapsed osteophytes in MNX + SR group (7 by 12) were significantly more than in MNX + V group (1 by 12) (P = 0.027), while immunohistochemistry indicates catabolic changes in osteophyte/plateau junction. Micro-CT analysis showed bone mineral density (BMD) (P = 0.001), bone volume fraction (BV/TV) (P = 0.008), trabecular spacing (Tb.Sp) (P = 0.020), trabecular thickness (Tb.Th) (P = 0.012) and structure model index (SMI) (P = 0.005) levels to be significantly higher in the MNX + SR group than in the MNX + V group. Conclusions SR (625 mg/kg/day) did not protect cartilage from degeneration in MNX guinea pigs but subchondral bone was significantly enhanced. In early phase OA, SR administration causes osteophyte overgrowth, which may be related to incorporation into mineralizing osteophytes. This adverse effect is important for future studies of SR in OA.
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Affiliation(s)
- Jian-Guo Chu
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, China
| | - Mu-Wei Dai
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, China
| | - Yu Wang
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Fa-Ming Tian
- Medical Research Center, North China University of Science and Technology, Tangshan, China
| | - Hui-Ping Song
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Ya-Ping Xiao
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Li-Tao Shao
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Ying-Ze Zhang
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, China
| | - Liu Zhang
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, China. .,Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China.
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Xu HT, Dong JT, Wang J, Gao SJ. Surgical Technique of Total Knee Arthroplasty without Soft Tissue Balance. Orthop Surg 2016; 8:519-522. [PMID: 28032705 DOI: 10.1111/os.12289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 10/08/2016] [Indexed: 11/30/2022] Open
Abstract
Total knee arthroplasty (TKA) without soft tissue balance can create a balanced knee to a mechanical axis of near neutral with bone cuts, and remove osteophytes thoroughly. In this study, the authors present detailed steps for performing TKA. The attached video demonstrates the TKA procedure. The patient is a 77-year-old man who had suffered from knee pain for 12 years. Physical examination showed the Apley test to be positive and that the range of motion (ROM) decreased. An X-ray filmed at the positive lateral of the knee joint and the double lower extremity revealed a progression of degenerative osteoarthritis with genu varum. The key point of no soft tissue release is to make a rectangular extensional space by osteotomy. In addition, the osteophytes, especially syndesmophytes, should be removed thoroughly. As a result, the ligaments can achieve ideal length and the flexion contracture can also be remedied. Moreover, in surgeries without soft tissue release, bone mass and normal tissue are retained. Patients are satisfied to the surgery not only with less blood loss, anterior knee pain and DVT, but also faster rehabilitation. In summary, TKA without soft tissue balance is an efficient procedure for patients with knee osteoarthritis which can result in good prognosis.
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Affiliation(s)
- Hong-Tao Xu
- Department of Joint Surgery, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Jiang-Tao Dong
- Department of Joint Surgery, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Juan Wang
- Department of Joint Surgery, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Shi-Jun Gao
- Department of Joint Surgery, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
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Junker S, Frommer KW, Krumbholz G, Tsiklauri L, Gerstberger R, Rehart S, Steinmeyer J, Rickert M, Wenisch S, Schett G, Müller-Ladner U, Neumann E. Expression of adipokines in osteoarthritis osteophytes and their effect on osteoblasts. Matrix Biol 2016; 62:75-91. [PMID: 27884778 DOI: 10.1016/j.matbio.2016.11.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 11/09/2016] [Accepted: 11/09/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Osteophyte formation in osteoarthritis (OA) is mediated by increased osteoblast activity, which is -in turn- regulated by the Wnt signaling pathway. Obesity is regarded a risk factor in OA, yet little is known about the interaction between adipose tissue-derived factors, the adipokines, and bone formation, although adipokines are associated with the pathogenesis of OA. Therefore, the effect of adipokines on bone and cartilage forming cells and osteophyte development was analyzed. METHODS Human OA osteophytes were histologically characterized and adipokine expression was evaluated by immunohistochemistry. Osteoblasts and chondrocytes were isolated from OA tissue and stimulated with adiponectin, resistin, or visfatin. Cytokine and osteoblast/chondrocyte markers were quantified and activation of Wnt and p38 MAPK signaling was analyzed. RESULTS Adiponectin, resistin, and visfatin were expressed in OA osteophytes by various articular cell types. Stimulation of OA osteoblasts with adiponectin and of OA chondrocytes with visfatin led to an increased release of proinflammatory mediators but not to osteoblast differentiation or activation. Additionally, visfatin increased matrix degrading factors in chondrocytes. Wnt signaling was not altered by adipokines, but adiponectin induced p38 MAPK signaling in osteoblasts. CONCLUSION Adipokines are present in OA osteophytes, and adiponectin and visfatin increase the release of proinflammatory mediators by osteoblasts and chondrocytes. The effects of adiponectin were mediated by p38 MAPK but not Wnt signaling in osteoblasts. Therefore, the results support the idea that adipokines do not directly influence osteophyte development but the proinflammatory conditions in OA.
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Affiliation(s)
- Susann Junker
- Dept Internal Medicine and Rheumatology, Justus-Liebig-University Giessen, Kerckhoff-Klinik Bad Nauheim, Germany
| | - Klaus W Frommer
- Dept Internal Medicine and Rheumatology, Justus-Liebig-University Giessen, Kerckhoff-Klinik Bad Nauheim, Germany
| | - Grit Krumbholz
- Dept Internal Medicine and Rheumatology, Justus-Liebig-University Giessen, Kerckhoff-Klinik Bad Nauheim, Germany
| | - Lali Tsiklauri
- Dept Internal Medicine and Rheumatology, Justus-Liebig-University Giessen, Kerckhoff-Klinik Bad Nauheim, Germany
| | - Rüdiger Gerstberger
- Dept Veterinary Physiology and Biochemistry, Justus-Liebig-University Giessen, Germany
| | - Stefan Rehart
- Dept Orthopaedics and Trauma Surgery, Agaplesion-Markus-Hospital, Frankfurt, Germany
| | - Jürgen Steinmeyer
- Dept Orthopaedics and Orthopaedic Surgery, University Hospital Giessen and Marburg, Giessen, Germany
| | - Markus Rickert
- Dept Orthopaedics and Orthopaedic Surgery, University Hospital Giessen and Marburg, Giessen, Germany
| | - Sabine Wenisch
- Clinic for Small Animals, Institute for Veterinary Anatomy, Histology und Embryology, Justus-Liebig-University Giessen, Germany
| | - Georg Schett
- Medical Clinic 3, Rheumatology and Immunology, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany
| | - Ulf Müller-Ladner
- Dept Internal Medicine and Rheumatology, Justus-Liebig-University Giessen, Kerckhoff-Klinik Bad Nauheim, Germany
| | - Elena Neumann
- Dept Internal Medicine and Rheumatology, Justus-Liebig-University Giessen, Kerckhoff-Klinik Bad Nauheim, Germany.
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de Munter W, van den Bosch MH, Slöetjes AW, Croce KJ, Vogl T, Roth J, Koenders MI, van de Loo FA, van den Berg WB, van der Kraan PM, van Lent PL. High LDL levels lead to increased synovial inflammation and accelerated ectopic bone formation during experimental osteoarthritis. Osteoarthritis Cartilage 2016; 24:844-55. [PMID: 26687826 DOI: 10.1016/j.joca.2015.11.016] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 11/03/2015] [Accepted: 11/24/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE A relation between osteoarthritis (OA) and increased cholesterol levels is apparent. In the present study we investigate OA pathology in apolipoprotein E (ApoE)(-)(/-) mice with and without a cholesterol-rich diet, a model for high systemic low density lipoprotein (LDL) cholesterol levels independent of weight. METHOD Wild type (WT), Apoe(-)(/-), S100a9(-/-) and Apoe(-)(/-)S100a9(-/-) mice (C57BL/6 background) received a standard or cholesterol-rich diet. Experimental OA was induced by intra-articular injection of collagenase and animals were sacrificed at day 10 and day 36. RESULTS Although minimal differences in cartilage damage were found between the WT and ApoE(-)(/-) mice, increased synovial thickening was found in the latter. Thirty-six days after OA-induction, ApoE(-)(/-) mice on a standard diet showed increased ectopic bone formation, particularly at the medial collateral ligament, compared with OA in WT mice. Furthermore, a significant increase in synovial gene expression of both S100a8 and S100a9 and S100A8/S100A9 protein levels was found in ApoE(-)(/-) mice, suggesting an activated inflammatory status of synovial cells. In both ApoE(-)(/-) and WT mice, addition of a cholesterol-rich diet resulted in excessive bone formation in the medial collateral ligament at late-time-point OA. Interestingly, at the early time point, proteoglycan deposition was already significantly increased in ApoE(-)(/-) mice compared with WT mice. Mice deficient for both ApoE and S100a9 also showed increased ectopic bone formation, but not synovial activation, suggesting a role for S100-proteins in cholesterol-mediated synovial activation. CONCLUSIONS Increased cholesterol levels strongly elevate synovial activation and ectopic bone formation in early-stage collagenase-induced OA.
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Affiliation(s)
- W de Munter
- Experimental Rheumatology, Radboud university medical center, Nijmegen, The Netherlands.
| | - M H van den Bosch
- Experimental Rheumatology, Radboud university medical center, Nijmegen, The Netherlands.
| | - A W Slöetjes
- Experimental Rheumatology, Radboud university medical center, Nijmegen, The Netherlands.
| | - K J Croce
- Center for Interdisciplinary Cardiovascular Sciences, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - T Vogl
- Institute of Immunology, University of Muenster, Muenster, Germany.
| | - J Roth
- Institute of Immunology, University of Muenster, Muenster, Germany.
| | - M I Koenders
- Experimental Rheumatology, Radboud university medical center, Nijmegen, The Netherlands.
| | - F A van de Loo
- Experimental Rheumatology, Radboud university medical center, Nijmegen, The Netherlands.
| | - W B van den Berg
- Experimental Rheumatology, Radboud university medical center, Nijmegen, The Netherlands.
| | - P M van der Kraan
- Experimental Rheumatology, Radboud university medical center, Nijmegen, The Netherlands.
| | - P L van Lent
- Experimental Rheumatology, Radboud university medical center, Nijmegen, The Netherlands.
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Junker S, Krumbholz G, Frommer KW, Rehart S, Steinmeyer J, Rickert M, Schett G, Müller-Ladner U, Neumann E. Differentiation of osteophyte types in osteoarthritis - proposal of a histological classification. Joint Bone Spine 2016; 83:63-7. [PMID: 26076655 DOI: 10.1016/j.jbspin.2015.04.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 04/27/2015] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Osteoarthritis is not only characterized by cartilage degradation but also involves subchondral bone remodeling and osteophyte formation. Osteophytes are fibrocartilage-capped bony outgrowths originating from the periosteum. The pathophysiology of osteophyte formation is not completely understood. Yet, different research approaches are under way. Therefore, a histological osteophyte classification to achieve comparable results in osteophyte research was established for application to basic science research questions. METHODS The osteophytes were collected from knee joints of osteoarthritis patients (n=10, 94 osteophytes in total) after joint replacement surgery. Their size and origin in the respective joint were photo-documented. To develop an osteophyte classification, serial tissue sections were evaluated using histological (hematoxylin and eosin, Masson's trichrome, toluidine blue) and immunohistochemical staining (collagen type II). RESULTS Based on the histological and immunohistochemical evaluation, osteophytes were categorized into four different types depending on the degree of ossification and the percentage of mesenchymal connective tissue. Size and localization of osteophytes were independent from the histological stages. CONCLUSION This histological classification system of osteoarthritis osteophytes provides a helpful tool for analyzing and monitoring osteophyte development and for characterizing osteophyte types within a single human joint and may therefore contribute to achieve comparable results when analyzing histological findings in osteophytes.
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Van Spil WE, Nair SC, Kinds MB, Emans PJ, Hilberdink WKHA, Welsing PMJ, Lafeber FPJG. Systemic biochemical markers of joint metabolism and inflammation in relation to radiographic parameters and pain of the knee: data from CHECK, a cohort of early-osteoarthritis subjects. Osteoarthritis Cartilage 2015; 23:48-56. [PMID: 25205017 DOI: 10.1016/j.joca.2014.09.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 08/07/2014] [Accepted: 09/01/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate associations of biochemical markers of joint metabolism and inflammation with minimum joint space width (JSW) and osteophyte area (OP area) of knees showing no or doubtful radiographic osteoarthritis (OA) and to investigate whether these differed between painful and non-painful knees. DESIGN Serum (s-) and urinary (u-) levels of the cartilage markers uCTX-II, sCOMP, sPIIANP, and sCS846, bone markers uCTX-I, uNTX-I, sPINP, and sOC, synovial markers sPIIINP and sHA, and inflammation markers hsCRP and erythrocyte sedimentation rate (ESR) were assessed in subjects from CHECK (Cohort Hip and Cohort Knee) demonstrating Kellgren and Lawrence grade ≤1 OA on knee radiographs. Minimum JSW and OP area of these knees were quantified in detail using Knee Images Digital Analysis (KIDA). RESULTS uCTX-II levels showed negative associations with minimum JSW and positive associations with OP area. sCOMP and sHA levels showed positive associations with OP area, but not with minimum JSW. uCTX-I and uNTX-I levels showed negative associations with minimum JSW and OP area. Associations of biochemical marker levels with minimum JSW were similar between painful and non-painful knees, associations of uCTX-II, sCOMP, and sHA with OP area were only observed in painful knees. CONCLUSIONS In these subjects with no or doubtful radiographic knee OA, uCTX-II might not only reflect articular cartilage degradation but also endochondral ossification in osteophytes. Furthermore, sCOMP and sHA relate to osteophytes, maybe because synovitis drives osteophyte development. High bone turnover may aggravate articular cartilage loss. Metabolic activity in osteophytes and synovial tissue, but not in articular cartilage may be related to knee pain.
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Affiliation(s)
- W E Van Spil
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
| | - S C Nair
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
| | - M B Kinds
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
| | - P J Emans
- Department of Orthopaedic Surgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
| | - W K H A Hilberdink
- Allied Health Care Center for Rheumatology and Rehabilitation Groningen, Helpermolenstraat 25, 9721 BT, Groningen, The Netherlands.
| | - P M J Welsing
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
| | - F P J G Lafeber
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
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Panahifar A, Jaremko JL, Tessier AG, Lambert RG, Maksymowych WP, Fallone BG, Doschak MR. Development and reliability of a multi-modality scoring system for evaluation of disease progression in pre-clinical models of osteoarthritis: celecoxib may possess disease-modifying properties. Osteoarthritis Cartilage 2014; 22:1639-50. [PMID: 25278073 DOI: 10.1016/j.joca.2014.06.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 06/03/2014] [Accepted: 06/13/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE We sought to develop a comprehensive scoring system for evaluation of pre-clinical models of osteoarthritis (OA) progression, and use this to evaluate two different classes of drugs for management of OA. METHODS Post-traumatic OA (PTOA) was surgically induced in skeletally mature rats. Rats were randomly divided in three groups receiving either glucosamine (high dose of 192 mg/kg) or celecoxib (clinical dose) or no treatment. Disease progression was monitored utilizing micro-magnetic resonance imaging (MRI), micro-computed tomography (CT) and histology. Pertinent features such as osteophytes, subchondral sclerosis, joint effusion, bone marrow lesion (BML), cysts, loose bodies and cartilage abnormalities were included in designing a sensitive multi-modality based scoring system, termed the rat arthritis knee scoring system (RAKSS). RESULTS Overall, an inter-observer correlation coefficient (ICC) of greater than 0.750 was achieved for each scored feature. None of the treatments prevented cartilage loss, synovitis, joint effusion, or sclerosis. However, celecoxib significantly reduced osteophyte development compared to placebo. Although signs of inflammation such as synovitis and joint effusion were readily identified at 4 weeks post-operation, we did not detect any BML. CONCLUSION We report the development of a sensitive and reliable multi-modality scoring system, the RAKSS, for evaluation of OA severity in pre-clinical animal models. Using this scoring system, we found that celecoxib prevented enlargement of osteophytes in this animal model of PTOA, and thus it may be useful in preventing OA progression. However, it did not show any chondroprotective effect using the recommended dose. In contrast, high dose glucosamine had no measurable effects.
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Singla A, Shankar V, Mittal S, Agarwal A, Garg B. Baastrup’s disease: The kissing spine. World J Clin Cases 2014; 2:45-47. [PMID: 24579072 PMCID: PMC3936220 DOI: 10.12998/wjcc.v2.i2.45] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 11/13/2013] [Accepted: 01/16/2014] [Indexed: 02/05/2023] Open
Abstract
A 67-year-old male presented with a gradually progressive low back pain of 2 years duration. The patient was leading a retired life and there was no history of chronic fever or significant trauma. There was no radiation of pain or any features suggestive of claudication. There was no history of any comorbidity. The pain was aggravated with extension of the spine and relieved with flexion. There was no swelling or neurological deficit, but muscle spasm was present. Radiographs of the spine revealed degenerative changes in the lumbosacral spine, along with articulation of spinous processes at in lumbar spine at all levels level suggestive of Baastrup’s disease, commonly known as “kissing spine”. Routine blood investigations were within normal limits. The patient was managed conservatively. He was given a week’s course of analgesics and muscle relaxants and then started on spinal flexion exercises, with significant improvement being noted at 6 months follow up.
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Abstract
Osteoarthritis presents in primary and secondary forms. The primary, or idiopathic, form occurs in previously intact joints without any inciting agent, whereas the secondary form is caused by underlying predisposing factors (eg, trauma). The diagnosis of osteoarthritis is primarily based on thorough history and physical examination findings, with or without radiographic evidence. Although some patients may be asymptomatic initially, the most common symptom is pain. Treatment options are generally classified as pharmacologic, nonpharmacologic, surgical, and complementary and/or alternative, typically used in combination to achieve optimal results. The goals of treatment are alleviation of symptoms and improvement in functional status.
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Affiliation(s)
- Rafaelani L Taruc-Uy
- Family Medicine Program, Department of Family Medicine, Mount Sinai Hospital Chicago, 15th Street at California Avenue, Chicago, IL 60608, USA.
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