氧化应激反应与膝关节骨性关节炎的相关性探究

目的:了解膝关节骨性关节炎患者机体的氧化应激状态,探讨氧化应激反应与膝关节骨性关节炎发生、发展的关系。方法:收集膝关节骨性关节炎患者及健康人群的血清,采用分光光度法测定和比较其SOD、GSH-Px、MDA水平。结果:与健康对照人群相比,膝关节骨性关节炎患者体内SOD、GSH-Px酶类抗氧化剂活力显著增强(P0.05);MDA脂质过氧化损伤产物明显降低(P0.05)。结论:膝关节骨性关节炎患者体内氧化还原状态发生了改变,可能处于抗氧化应激的慢性代偿状态;氧化应激反应参与了骨性关节炎的发生、发展过程。     

Change in knee contact force with simulated change in body weight

The relationship between obesity, weight gain and progression of knee osteoarthritis is well supported, suggesting that excessive joint loading may be a mechanism responsible for cartilage deterioration. Examining the influence of weight gain on joint compressive forces is difficult, as both muscles and ground reaction forces can have a significant impact on the forces experienced during gait. While previous studies have examined the relationship between body weight and knee forces, these studies have used models that were not validated using experimental data. Therefore, the objective of this study was to evaluate the relationship between changes in body weight and changes in knee joint contact forces for an individual's gait pattern using musculoskeletal modeling that is validated against known internal compressive forces. Optimal weighting constants were determined for three subjects to generate valid predictions of knee contact forces (KCFs) using in vivo data collection with instrumented total knee arthroplasty. A total of five simulations per walking trial were generated for each subject, from 80% to 120% body weight in 10% increments, resulting in 50 total simulations. The change in peak KCF with respect to body weight was found to be constant and subject-specific, predominantly determined by the peak force during the baseline condition at 100% body weight. This relationship may be further altered by any change in kinematics or body mass distribution that may occur as a result of a change in body weight or exercise program.     

Stance and swing phase knee flexion recover at different rates following total knee arthroplasty: An inertial measurement unit study

Total knee arthroplasty (TKA) is the most common joint replacement in the United States. Range of motion (ROM) monitoring includes idealized clinic measures (e.g. goniometry during passive ROM) that may not accurately represent knee function. Accordingly, a novel, portable, inertial measurement unit (IMU) based ROM measurement method was developed, validated, and implemented. Knee flexion was computed via relative motion between two IMUs and validated via optical motion capture (p > 0.05). Prospective analyses of 10 healthy individuals (5M, 50 ± 19 years) and 20 patients undergoing TKA (3 lost to follow up, 10M, 65 ± 6 years) were completed. Controls wore IMUs for 1-week. Patients wore IMUs for 1-week pre-TKA, 6-weeks immediately post-TKA, and 1-week at 1-year post-TKA. Flexion was computed continuously each day (8–12 h). Metrics included daily maximum flexion and flexion during stance/swing phases of gait. Maximum flexion was equal between cohorts at all time points. Contrastingly, patient stance and swing flexion were reduced pre-TKA, yet improved post-TKA. Specifically, patient stance and swing flexion were reduced below control/pre-TKA values during post-TKA week 1. Stance flexion exceeded pre-TKA and equaled control levels after week 2. However, swing flexion only exceeded pre-TKA and equaled control levels at 1-year post-TKA. This novel method improves upon the accuracy/portability of current methods (e.g. goniometry). Interestingly, surgery did not impact maximum ROM, yet improved the ability to flex during gait allowing more efficient and safe ambulation. This is the first study continuously monitoring long-term flexion before/after TKA. The results offer richer information than clinical measures about expected TKA rehabilitation.     

Long noncoding RNA MALAT-1 inhibits apoptosis and matrix metabolism disorder in interleukin-1β-induced inflammation in articular chondrocytes via the JNK signaling pathway

Proinflammatory cytokine such as interleukin (IL)-1β causes inflammation of articular cartilage. In this current study, we explored the chondroprotective effects of long noncoding RNA (lncRNA) MALAT-1 on cell proliferation, apoptosis, and matrix metabolism in IL-1β-induced inflammation in articular chondrocytes. Articular chondrocytes from knee joints of normal rats were isolated and cultured, followed by identification through observation of toluidine blue and COL II immunocytochemical stainings. The proliferation of chondrocytes at passage 2 was detected by the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. The inflammatory chondrocytes induced by 10 ng/mL IL-1β were observed and identified by toluidine blue and COL II immunocytochemical stainings. pcDNA 3.1 and pcDNA-MALAT-1 were transfected in the chondrocytes. Ultrastructure of chondrocytes was observed by using a transmission electron microscope. The MTT assay was carried out to evaluate chondrocyte viability. Hoechst 33258 staining and flow cytometry were adopted to assess chondrocyte apoptosis. The chondrocytes at passage 2 with the biological characteristics of chondrocytes were used for subsequent experiments. In IL-1β-treated chondrocytes, the growth rate of chondrocytes slowed down, the cells became narrow and long, the vacuoles were seen in the cells, and the morphology of the chondrocytes was irregular. The toluidine blue staining and the immunohistochemical staining of COL II became weaker. In response to IL-1β induction, articular chondrocytes showed reduced MALAT-1 expression; moreover, obvious cartilage injury was observed with decreased chondrocyte viability and Col II expression and elevated chondrocyte apoptosis, MMP-13 expression, and p-JNK expression. With the treatment of pcDNA-MALAT-1, the cartilage injury was alleviated with increased chondrocyte viability and type II collagen (Col II) expression and reduced chondrocyte apoptosis, MMP-13 expression and p-JNK expression. Taken together these results, lncRNA MALAT-1 blocked the activation of the JNK signaling pathway; thereby, IL-1β-induced inflammation in articular chondrocytes was reduced with enhanced chondrocyte proliferation and suppressed chondrocyte apoptosis and extracellular matrix degradation.     

The effects of normalization method on antagonistic activity patterns during eccentric and concentric isokinetic knee extension and flexion

The purpose of this study was to compare different normalization methods of electromyographic (EMG) activity of antagonists during isokinetic eccentric and concentric knee movements. Twelve women performed three maximum knee extensions and flexions isometrically and at isokinetic concentric and eccentric angular velocities of 30 °·s⁻¹, 90 °·s⁻¹, 120 °·s⁻¹ and 150 °·s⁻¹. The EMG activity of the vastus lateralis, rectus femoris, vastus medialis and hamstrings was recorded. The antagonist integrated IEMG values were normalized relative to the EMG of the same muscle during an isometric maximal action (static method). The values were also expressed as a percentage of the EMG activity of the same muscle, at the same angle, angular velocity and muscle action (dynamic method) when the muscle was acting as an agonist. Three-way analysis of variance (ANOVA) designs indicated significantly greater IEMG normalized with the dynamic method compared to the EMG derived using the static method (P < 0.05). These differences were more evident at concentric angular velocities and at the first and last 20 ° of the movement. The present findings demonstrate that the method of normalization significantly influences the conclusions on antagonistic activity during isokinetic maximum voluntary efforts. The dynamic method of normalization is more appropriate because it considers the effects of muscle action, muscle length and angular velocity on antagonist IEMG.     

Motor unit recruitment strategy of knee antagonist muscles in a step-wise, increasing isometric contraction

The purpose of this study was to determine if differences exist between the control strategies of two antagonist thigh muscles during knee flexion and extension muscular coactivation. Surface myoelectric signal (MES) of the quadriceps (rectus femoris) and the hamstrings (semitendinosus) were obtained from both muscles while performing step-wise increasing contractions during flexion and extension with the knee at 1.57 rad of flexion (90 degrees). The median frequency of the power density spectrum, which is related to the average muscle fiber action potential conduction velocity and therefore to motor unit recruitment, was calculated from each MES. The results suggest that, in all the subjects tested, when the muscle acts as antagonist most motor units are recruited up to 50% of the maximal voluntary force, whereas when the muscle acts as antagonist motor units are recruited up to 40% of the maximal voluntary force. The force range past 40–50% of the maximal force is also characterized by differences between the agonist/antagonist.     

A Pilot Clinical Study of Hyperacute Serum Treatment in Osteoarthritic Knee Joint: Cytokine Changes and Clinical Effects

The serum fraction of platelet-rich fibrin (hyperacute serum) has been shown to improve cartilage cell proliferation in in vitro osteoarthritic knee joint models. We hypothesize that hyperacute serum may be a potential regenerative therapeutic for osteoarthritic knees. In this study, the cytokine milieu at the synovial fluid of osteoarthritic knee joints exposed to hyperacute serum intraarticular injections was investigated. Patients with knee osteoarthritis received three injections of autologous hyperacute serum; synovial fluid was harvested before each injection and clinical monitoring was followed-up for 6 months. Forty osteoarthritic-related cytokines, growth factors and structural proteins from synovial fluid were quantified and analysed by Multivariate Factor Analysis. Hyperacute serum provided symptomatic relief regarding pain and joint stability for OA patients. Both patients “with” and “without effusion knees” had improved VAS, KOOS and Lysholm-Tegner scores 6 months after of hyperacute serum treatment. Synovial fluid analysis revealed two main clusters of proteins reacting together as a group, showing strong and significant correlations with their fluctuation patterns after hyperacute serum treatment. In conclusion, hyperacute serum has a positive effect in alleviating symptoms of osteoarthritic knees. Moreover, identified protein clusters may allow the prediction of protein expression, reducing the number of investigated proteins in future studies.