Hand osteoarthritis in the Abkhazian population

The aim of the study was to evaluate the prevalence and pattern of radiographic hand osteoarthritis (OA) in an Abkhazian community-based sample and its association with age, sex, body mass index (BMI) and place of residence.The study sample was comprised of 542 males with a mean age of 43.9, sd 15.6 years and 463 females with a mean age of 44.9, sd 13.9 years. OA was evaluated for 14 joints of the left hand according to the Kellgren and Lawrence grading scheme. Statistical analyses included prevalence estimation, multiple regression analysis and χ² tests.In the entire Abkhazian sample the average prevalence of hand OA was 33.6% for males and 35.4% for females. After age 65, the prevalence of hand OA was 87.5% for males and 83.3% for females. No sex differences were found in the prevalence or number of affected hand joints. Statistically significant association was found between the number of affected joints and BMI, but not between the prevalence of hand OA and BMI. Different prevalences of radiographic hand OA were found in individuals from different villages, after adjustment for age, sex and BMI.Additional studies are needed to explore the possible reasons for such differences.     

Finite-element simulation of flexor digitorum longus or flexor digitorum brevis tendon transfer for the treatment of claw toe deformity

Claw toe deformity sometimes leads to dorsiflexion of the metatarsophalangeal joint (MPJ) and plantar flexion of the proximal (PIPJ) and distal interphalangeal (DIPJ) joints. Flexor digitorum longus tendon transfer (FDL) is currently the gold standard for the correction of this problem. Transfer of the flexor digitorum brevis (FDB) has been recently proposed as an alternative method to treat such deformity. The aim of this work is to compare the biomechanical outcome of these two methods by means of finite-element simulation. The results show that the reduction in the dorsal displacement of the proximal phalanx (PP) for the second and third toes were very similar (about 4.3 mm for each intervention), both achieving a significant reduction in MPJ dorsiflexion when compared to no intervention (displacements are reduced by approximately 51%). In the fourth and fifth toes, only a small correction in the deformity was achieved with both the techniques (10% and 7%, respectively). FDB and FDL tendon transfer reduced the stress level when compared with the non-operated pathologic foot (the reduction of stresses for the second and third PP ranged between 20% and 40%). FDB transfer resulted in a more uniform distribution of stress along the entire toe, although differences were small in all cases. These results confirm that both the tendon-transfer techniques are effective in the treatment of claw toe deformity. Therefore, the choice of technique is at the discretion of the surgeon.     

Robusticity and osteoarthritis at the trapeziometacarpal joint in a Bronze Age population from Tell Abraq, United Arab Emirates

Osteoarthritis (OA) is a progressive disease of the joints and can cause pain, reduced range of motion and strength, and ultimately loss of function at affected joints. Osteoarthritis often occurs at sites where biomechanical stress is acutely severe or moderate but habitual over the course of a lifetime. Skeletal remains from an Umm an-Nar tomb at Tell Abraq, United Arab Emirates (ca. 2300 BC), were recovered and represented over 300 individuals of all ages. The remains were disarticulated, commingled, and mostly fragmented. An analysis of 650 well-preserved adult metacarpal and carpal bones, from the tomb's western chamber, revealed that over 53% of the trapeziometacarpal joint facets showed signs of OA varying from mild to severe. The first and second metacarpals and trapezium bones were sided and evaluated for OA at the trapeziometacarpal joint articulations. Osteoarthritis was detected on 53% of the first metacarpals, 40% of the second metacarpals, and 57% of the trapezium bones. All specimens appeared enlarged, and the first metacarpals were assessed for sexual identification and robusticity. Eighty-five percent of the bones were probable males, and more than 80% of them had a robusticity index of 60 or higher. A strong correlation was found between OA, sex, and robusticity. High levels of OA and robusticity at the thumb suggest that the people of Tell Abraq were habitually involved in biomechanically challenging work with their hands.     

What is the clinical and ethical importance of incidental abnormalities found by knee MRI?

Introduction

Magnetic resonance imaging (MRI) is increasingly used to examine joints for research purposes. It may detect both suspected and unsuspected abnormalities. This raises both clinical and ethical issues, especially when incidental abnormalities are detected. The prevalence of incidental, potentially clinically significant abnormalities identified by MRI and their clinical significance in a population undergoing knee MRI in research studies are unknown.

Methods

We examined the prevalence of such lesions in healthy asymptomatic adults and those with symptomatic knee osteoarthritis (OA) undergoing knee MRI with limited sequences for the purpose of research. The MRI findings in 601 asymptomatic subjects and 132 with knee OA who underwent at least one limited knee MRI scan for cartilage volume measurement were examined by an MRI radiologist for the presence of potentially clinically significant abnormalities.

Results

These were present in 2.3% of healthy and 2.3% of OA subjects. All required further investigation to exclude non-benign disease, including four with bone marrow expansion (0.7%), requiring further investigation and management. A single potentially life-threatening lesion, a myeloma lesion, was identified in a subject with symptomatic knee OA on their second MRI scan in a longitudinal study.

Conclusion

As musculoskeletal MRI is increasingly used clinically and for research purposes, the potential for detecting unsuspected abnormalities that require further investigation should be recognized. Incorporating a system to detect these, to characterize unexpected findings, and to facilitate appropriate medical follow-up when designing studies using this technology should be considered ethical research practice.     

Alleviation of osteoarthritis by Trichostatin A, a histone deacetylase inhibitor, in experimental osteoarthritis

This study investigated the effects of the histone deacetylase (HDAC) inhibitor trichostatin A (TSA) on cartilage degradation in an experimental model of osteoarthritis (OA). Thirty-two male New Zealand rabbits underwent unilateral anterior cruciate ligament transection (ACLT) on left knee joints to induce OA and were randomly divided into two groups (n = 16), the TSA group was injected intra-articularly with 0.3 ml TSA [250 ng/ml in the dimethylsulphoxide (DMSO)], the OA group received DSMO since 4 weeks after operation once a week for 5 weeks. Rabbits were killed seven days after the last injection. Left knee cartilage was harvested for morphological, histological and genetic analysis. Another ten rabbits were used for normal control and received no injection. The TSA group showed less cartilage degradation as compared to the OA group assessed by morphological and histological evaluation. Gene expression of matrix metalloproteinase-1 (MMP-1), MMP-3, MMP-13, and interleukin-1 (IL-1) was increased significantly in the OA group compared to the normal group. The elevated expression was reduced by TSA. Our results suggest that TSA could be considered as a potential agent for treatment for OA.     

Caseous lymphadenitis in sheep and goats: Clinical,epidemiological and preventive studies

This study was carried out on 1466 animals (977 sheep and 489 goats) during the period from January 2008 to December 2008 to determine some epidemiological, clinical and preventive measures associated with caseous lymphadenitis (CLA). The prevalence was 19.23% on the basis of clinical examination and 17.32% on the basis of bacteriological examination. The prevalence was 23.33% in sheep and 11.04% in goats on the basis of clinical examination whereas it was 22.10% in sheep and 7.77% in goats on the basis of bacteriological examination. The disease prevalence was significantly higher in females (19.67%) than in males (12.42%). Higher prevalence was recorded in animals of the age group from 1 to 2 yeas (47.36%) followed by animals of the age group over 2 years (18.69%) and lastly of the age group under 1 year (3.07%). The clinical picture appeared in the form of enlargement and abscessation of the superficial lymph nodes. Parotid lymph nodes were the most commonly affected nodes in sheep whereas superficial cervical lymph nodes were the most commonly affected nodes in goats. The superficial lymph nodes of the anterior body half showed the highest infection rate. Corynebacterium pseudotuberculosis was detected in 90.07% of the clinically infected cases. The disease was significantly higher in private flocks (45.52%) than in governmental flock (1.59%). Control measures using penicillin at day zero of shearing in addition to disinfection of shearing instrument and wounds greatly reduced the disease occurrence.     

Urolithin A improves mitochondrial health,reduces cartilage degeneration,and alleviates pain in osteoarthritis

Osteoarthritis (OA) is the most common age‐related joint disorder with no effective therapy. According to the World Health Organization, OA affects over 500 million people and is characterized by degradation of cartilage and other joint tissues, severe pain, and impaired mobility. Mitochondrial dysfunction contributes to OA pathology. However, interventions to rescue mitochondrial defects in human OA are not available. Urolithin A (Mitopure) is a natural postbiotic compound that promotes mitophagy and mitochondrial function and beneficially impacts muscle health in preclinical models of aging and in elderly and middle‐aged humans. Here, we showed that Urolithin A improved mitophagy and mitochondrial respiration in primary chondrocytes from joints of both healthy donors and OA patients. Furthermore, Urolithin A reduced disease progression in a mouse model of OA, decreasing cartilage degeneration, synovial inflammation, and pain. These improvements were associated with increased mitophagy and mitochondrial content, in joints of OA mice. These findings indicate that UA promotes joint mitochondrial health, alleviates OA pathology, and supports Urolithin A''s potential to improve mobility with beneficial effects on structural damage in joints.     

Prevalence of Radiographic Osteoarthritis of the Knee and Its Relationship to Self-Reported Pain

Background and Aim

Osteoarthritis (OA) of the knee is one of the most common skeletal disorders, yet little data are available in Asian populations. We sought to assess the prevalence and pattern of radiographic OA of the knee, and its relationship to self-reported pain in a Vietnamese population.

Methods

The study was based on a sample of 170 men and 488 women aged ≥40 years who were randomly sampled from the Ho Chi Minh City (Vietnam). Radiographs of the knee were graded from 0 to 4 according to the Kellgren and Lawrence scale. Osteoarthritis was defined as being present in a knee if radiographic grades of 2 or higher were detected. Knee pain and symptoms were ascertained by direct interview using a structured questionnaire.

Results

The point prevalence of radiographic OA of the knee was 34.2%, with women having higher rate than men (35.3% vs 31.2%). The prevalence of knee OA increased with advancing age: 8% among those aged 40–49 years, 30% in those aged 50–59 years, and 61.1% in those aged ≥60 years. Greater BMI was associated with higher risk of knee OA. Self-reported knee pain was found in 35% of men and 62% of women. There was a statistically significant association between self-reported knee pain and knee OA (prevalence ratio 3.1; 95% CI 2.0 to 4.6).

Conclusions

These data indicate that approximately a third of Vietnamese men and women have radiographic OA in the knee, and that self-reported knee pain may be used as an indicator of knee osteoarthritis.     

Treatment of osteoarthritis with mesenchymal stem cells

Osteoarthritis(OA)is one of the most prevalent joint diseases with prominent symptoms affecting the daily life of millions of middle aged and elderly people.Despite this,there are no successful medical interventions that can prevent the progressive destruction of OA joints.The onset of pathological changes in OA is associated with deviant activity of mesenchymal stem cells(MSCs),the multipotent precursors of connective tissue cells that reside in joints.Current therapies for OA have resulted in poor clinical outcomes without repairing the damaged cartilage.Intra-articular delivery of culture-expanded MSCs has opened new avenues of OA treatment.Pre-clinical and clinical trials demonstrated the feasibility,safety,and efficacy of MSC therapy.The Wnt/β-catenin,bone morphogenetic protein 2,Indian hedgehog,and Mitogen-activated protein kinase signaling pathways have been demonstrated to be involved in OA and the mechanism of action of MSC therapies.     

Climate is associated with prevalence and severity of radiographic hand osteoarthritis

The aim of this study was to evaluate whether geographic location and climatic factors are associated with prevalence and severity of radiographic hand osteoarthritis (OA) in several samples of the same ethnicity.The total sample included 2079 ethnic Russians (900 males and 1179 females), belonging to 7 samples from different geographic locations in the former USSR. Places of residence were characterized by latitude, longitude, altitude and climatic parameters (mean temperatures, humidity, and daylight duration of January and July). Radiographs of the left hand were obtained from each individual. Osteoarthritis (OA) was evaluated in 14 hand joints according to Kellgren and Lawrence's grading system. OA was characterized by the presence of at least one affected joint and its severity by the number of affected joints (NAJ). Statistical analysis included prevalence estimation, polynomial and logistic regressions, ANOVA and correlation analyses.Prevalence of hand OA and NAJ were significantly associated with latitude and altitude and with most climatic parameters (except the inter-seasonal temperature amplitude and the mean atmospheric pressure of January and July). The highest correlations of hand OA prevalence were found with altitude (r = 0.29, p < 0.001), annual precipitation (r = −0.26, p < 0.001) and the mean temperatures of July (r = 0.26, p < 0.001). The highest correlations of NAJ were found with altitude (r = 0.51, p < 0.001), mean humidity in January (r = −0.44, p < 0.001) and the mean day duration in January (r = 0.0.37, p < 0.001).The present study demonstrates that the differences in prevalence and severity of radiographic hand OA among Russian samples are most likely dependent on climatic conditions in the place of residence.     

TMJ osteoarthritis: a new approach to diagnosis

Disorders of the temporomandibular joint (TMJ), including TMJ osteoarthritis (TMJ OA), are the topic of intensive clinical research; however, this is not the case in the archaeological literature, with the majority of work on the subject ceasing with the early 1990s. The methods employed in the diagnosis of TMJ OA within the archaeological work appear nonrepresentative of the disease and may have led to erroneous assumptions about the pattern and prevalence of OA. This current work presents a new method for evaluating OA specifically for the TMJ, considering both the biomechanics of the joint and the mechanisms of the disease. Totally, 496 specimens (including a group of modern documented specimens) were analyzed for the presence of TMJ OA using the following criteria: eburnation, osteophytes (marginal and new bone on joint surface), porosity, and alteration to joint contour. The results suggest that eburnation occurs rarely in the TMJ, so should not be used as an exclusive criterion. Rather a combination of at least two of the other criteria should be used, with osteophytes and porosity occurring the most frequently on both the mandibular condyle and articular eminence. Additionally, the prevalence of TMJ OA in the modern assemblage was similar to that observed in current clinical research, suggesting that the method employed here was able to produce a reasonable approximation of what is found in contemporary living populations.     

Relationship between T1rho magnetic resonance imaging,synovial fluid biomarkers,and the biochemical and biomechanical properties of cartilage

Non-invasive techniques for quantifying early biochemical and biomechanical changes in articular cartilage may provide a means of more precisely assessing osteoarthritis (OA) progression. The goals of this study were to determine the relationship between T1rho magnetic resonance (MR) imaging relaxation times and changes in cartilage composition, cartilage mechanical properties, and synovial fluid biomarker levels and to demonstrate the application of T1rho imaging to evaluate cartilage composition in human subjects in vivo. Femoral condyles and synovial fluid were harvested from healthy and OA porcine knee joints. Sagittal T1rho relaxation MR images of the condyles were acquired. OA regions of OA joints exhibited an increase in T1rho relaxation times as compared to non-OA regions. Furthermore in these regions, cartilage sGAG content and aggregate modulus decreased, while percent degraded collagen and water content increased. In OA joints, synovial fluid concentrations of sGAG decreased and C2C concentrations increased compared to healthy joints. T1rho relaxation times were negatively correlated with cartilage and synovial fluid sGAG concentrations and aggregate modulus and positively correlated with water content and permeability. Additionally, we demonstrated the application of these in vitro findings to the study of human subjects. Specifically, we demonstrated that walking results in decreased T1rho relaxation times, consistent with water exudation and an increase in proteoglycan concentration with in vivo loading. Together, these findings demonstrate that cartilage MR imaging and synovial fluid biomarkers provide powerful non-invasive tools for characterizing changes in the biochemical and biomechanical environments of the joint.     

Olive leaf extract prevents cartilage degeneration in osteoarthritis of STR/ort mice

The chondroprotective effect of olive leaf extract (OLE) on knee osteoarthritis (OA) was studied with STR/ort mice (n = 5). OLE was administrated with a dosage of 100 mg/kg for 8 weeks and the OA severity score of hind limb knee joints was then measured. The Mankin scores of the knee joints of the non-OA control group, OA control group and OLE-treated group were 3.50, 11.13 and 7.20, respectively. This suggests that oral OLE supplements help prevent cartilage degeneration in STR/ort mice. In vitro, the synthesis of high molecular weight hyaluronan in synovial cells (HIG-82) was increased by OLE stimulation. This suggests that OLE modulates hyaluronan metabolism in synovial cells and improves OA symptoms. Our findings indicate that OLE intake inhibits cartilage destruction by increasing high molecular weight hyaluronan and thus preventing OA progress.     

Chondrocalcinosis is common in the absence of knee involvement

Introduction

We aimed to describe the distribution of radiographic chondrocalcinosis (CC) and to examine whether metacarpophalangeal joint (MCPJ) calcification and CC at other joints occurs in the absence of knee involvement.

Methods

This was a cross-sectional study embedded in the Genetics of Osteoarthritis and Lifestyle study (GOAL). All participants (n = 3,170) had radiographs of the knees, hands, and pelvis. These were scored for radiographic changes of osteoarthritis (OA), for CC at knees, hips, symphysis pubis, and wrists, and for MCPJ calcification. The prevalence of MCPJ calcification and CC overall, at each joint, and in the presence or absence of knee involvement, was calculated.

Results

The knee was the commonest site of CC, followed by wrists, hips, and symphysis pubis. CC was more likely to be bilateral at knees and wrists but unilateral at hips. MCPJ calcification was usually bilateral, and less common than CC at knees, hips, wrists, and symphysis pubis. Unlike that previously reported, CC commonly occurred without any knee involvement; 44.4% of wrist CC, 45.9% of hip CC, 45.5% of symphysis pubis CC, and 31.3% of MCPJ calcification occurred in patients without knee CC. Those with meniscal or hyaline articular cartilage CC had comparable ages (P = 0.21), and neither preferentially associated with fibrocartilage CC at distant joints.

Conclusions

CC visualized on a plain radiograph commonly occurs at other joints in the absence of radiographic knee CC. Therefore, knee radiographs alone are an insufficient screening test for CC. This has significant implications for clinical practice, for epidemiologic and genetic studies of CC, and for the definition of OA patients with coexistent crystal deposition.     

Synovial mesenchymal progenitor derived aggrecan regulates cartilage homeostasis and endogenous repair capacity

Aggrecan is a critical component of the extracellular matrix of all cartilages. One of the early hallmarks of osteoarthritis (OA) is the loss of aggrecan from articular cartilage followed by degeneration of the tissue. Mesenchymal progenitor cell (MPC) populations in joints, including those in the synovium, have been hypothesized to play a role in the maintenance and/or repair of cartilage, however, the mechanism by which this may occur is unknown. In the current study, we have uncovered that aggrecan is secreted by synovial MPCs from healthy joints yet accumulates inside synovial MPCs within OA joints. Using human synovial biopsies and a rat model of OA, we established that this observation in aggrecan metabolism also occurs in vivo. Moreover, the loss of the “anti-proteinase” molecule alpha-2 macroglobulin (A2M) inhibits aggrecan secretion in OA synovial MPCs, whereas overexpressing A2M rescues the normal secretion of aggrecan. Using mice models of OA and cartilage repair, we have demonstrated that intra-articular injection of aggrecan into OA joints inhibits cartilage degeneration and stimulates cartilage repair respectively. Furthermore, when synovial MPCs overexpressing aggrecan were transplanted into injured joints, increased cartilage regeneration was observed vs. wild-type MPCs or MPCs with diminished aggrecan expression. Overall, these results suggest that aggrecan secreted from joint-associated MPCs may play a role in tissue homeostasis and repair of synovial joints.Subject terms: Mesenchymal stem cells, Cartilage, Experimental models of disease     

Arthritis patterns in familial Mediterranean fever patients and association with M694V mutation

Familial Mediterranean fever (FMF) is an autosomal recessive disorder characterized by recurrent attacks of febrile peritonitis, pleuritis and synovitis. Arthritis is a common and important feature of FMF. The clinical spectrum of arthritis in 71 FMF patients was retrospectively investigated. Mutations in the familial Mediterranean (MEFV) gene were screened. Unlike the previous reports on arthritis of FMF, most of the FMF patients (59%) in this study had symmetric two-joint arthritis whereas monoarticular, oligoarticular and polyarticular arthritis was presented in 20, 8 and 10% of the patients, respectively. Knees were affected in 45 (63%) patients, ankles in 30 (42%), elbows in 11 (15%), wrists in 12 (17%), hips in 12 (17%), small joints of the hands 7 (10%), small joints of the feet 2 (3%) and sacroiliac in 1 (1%). Destruction of the hip was observed in 2 (3%) patients and required hip replacement. Amyloidosis developed in 2 (3%) of our patients. Mutations in the MEFV gene were identified in 50 (71%) patients and the most dominant mutation detected was M694V (64%). Since FMF can be diagnosed by a simple DNA mutation analysis, all arthritis patients of certain origins (Arabs, Turks, Armenians and Jews) should be tested for FMF in order to prevent the complications (amyloidosis and protracted arthritis) by introducing colchicine which is the treatment of choice for FMF.     

Large-scale gene expression profiles,differentially represented in osteoarthritic synovium of the knee joint using cDNA microarray technology

Osteoarthritis (OA) is one of the most common age-related chronic disorders of articular cartilage, joints and bone tissue. Diagnosis of OA commonly depends on clinical and radiographic findings. However, changes in cartilage associated with the early stage of OA cannot be detected using radiographs, because significant cartilage degeneration must occur before radiographic findings show alterations of the appearance of cartilage. To identify new biomarkers of OA, we analysed gene expression profiles of synovium from 43 patients with OA, ten patients with rheumatoid arthritis (RA), and eight non-OA/non-RA patients using a novel cDNA microarray chip. We identified 21 genes with simultaneous significant differences in expression between OA and non-OA/non-RA groups and between OA and RA groups. Linear discriminant analysis showed that the three groups could be well separated using those 21 genes. Statistical analysis also revealed that several of the 21 genes were associated with disease progression and clinical presentation. The graphical modelling method indicated that some of the 21 genes are significantly associated with a particular clinical presentation, suggesting biological relationships among those genes. This is the first report of the use of cDNA microarray technology to create large-scale gene expression profiles differentially expressed in situ in OA synovium of the knee joint.