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Hand Clinics Aug 2020Infections in the joints of the hand and wrist carry the risk of significant morbidity. Common presenting symptoms include joint redness, swelling, and pseudoparalysis... (Review)
Review
Infections in the joints of the hand and wrist carry the risk of significant morbidity. Common presenting symptoms include joint redness, swelling, and pseudoparalysis that occurs several days following a penetrating trauma. Diagnostic workup should be expedited, including a laboratory evaluation and arthrocentesis. Imaging, including radiographs, ultrasound, computed tomography, and/or MRI, are helpful tools in diagnosis. Once infection is identified, prompt surgical debridement and antibiotics are required. Once the infection has been managed, hand therapy is initiated to decrease the risk of stiffness. Stiffness is the most common complication following infection; additional reported complications include arthritis, ankylosis, and amputation."
Topics: Algorithms; Anti-Bacterial Agents; Arthritis, Infectious; Arthroscopy; Debridement; Drainage; Finger Joint; Humans; Immunocompromised Host; Wrist Joint
PubMed: 32586459
DOI: 10.1016/j.hcl.2020.03.006 -
Injury Apr 2015Lisfranc injuries are commonly asked about in FRCS Orthopaedic trauma vivas. The term "Lisfranc injury" strictly refers to an injury where one or more of the metatarsals... (Review)
Review
Lisfranc injuries are commonly asked about in FRCS Orthopaedic trauma vivas. The term "Lisfranc injury" strictly refers to an injury where one or more of the metatarsals are displaced from the tarsus. The term is more commonly used to describe an injury to the midfoot centred on the 2nd tarsometatarsal joint. The injury is named after Jacques Lisfranc de St. Martin (1790-1847), a French surgeon and gynaecologist who first described the injury in 1815. 'Lisfranc injury' encompasses a broad spectrum of injuries, which can be purely ligamentous or involve the osseous and articular structures. They are often difficult to diagnose and treat, but if not detected and appropriately managed they can cause long-term disability. This review outlines the anatomy, epidemiology, classification, investigation and current evidence on management of this injury.
Topics: Foot Injuries; Fracture Fixation, Internal; Fractures, Bone; Humans; Joint Dislocations; Ligaments, Articular; Metatarsal Bones; Practice Guidelines as Topic; Tarsal Joints; Treatment Outcome
PubMed: 25543185
DOI: 10.1016/j.injury.2014.11.026 -
Klinicheskaia Meditsina 2016Osgood-Schlatter disease is a specific disorder related to osteochondropathies that affects young subjects and is localized in the tuberositas tibiae. The disease... (Review)
Review
Osgood-Schlatter disease is a specific disorder related to osteochondropathies that affects young subjects and is localized in the tuberositas tibiae. The disease frequently develops after injuries including loading ones. It is apparent as gradual swelling of the knee joint(s) that becomes painful. Pain increases during walking, lower limb flexion an extension or stair climbing but may die down at rest. Diagnostics is based on the clinical picture. Radiodiagnostic methods my be helpful but their efficacy is inferior to that of clinical examination. Anti-inflammatory and chondroprotective therapy, immobilization of the affected joint, controlled exercises, and balneotherapy are indicated.
Topics: Humans; Knee Joint; Osteochondrosis; Tibia
PubMed: 27459765
DOI: No ID Found -
MMW Fortschritte Der Medizin Oct 2022
Review
Topics: Arthritis, Rheumatoid; Edema; Finger Joint; Humans; Joints
PubMed: 36198964
DOI: 10.1007/s15006-022-1844-5 -
Veterinary Journal (London, England :... Apr 2017The maintenance of joint homeostasis is integral to joint health. Knowledge of the influence of exercise on joint homeostasis is not only relevant for determining... (Review)
Review
The maintenance of joint homeostasis is integral to joint health. Knowledge of the influence of exercise on joint homeostasis is not only relevant for determining sustainable levels of equine athletic training, but also for the study of early development of osteoarthritis or cartilage repair in animal models. This review provides an overview of findings derived from in vivo studies and postmortem analyses investigating exercise effects on various joint tissue components in the horse, supplemented where appropriate with data from small animal models. The concept of joint homeostasis and possible methods to quantify this are also discussed, with special attention to the potential benefits and pitfalls of biomarker analysis in synovial fluid. The main conclusion is that biomechanical loading in the form of deliberate exercise has a major influence on the delicate homeostatic balance within the tissues constituting the diarthrodial joint and on their interactions, which is crucial for proper and durable joint function. The amount and intensity of exercise can have a lasting effect on tissue characteristics in juvenile animals, but affects joint homeostasis in mature animals and can affect the delicate balance between physiologic adaptation and development of pathology. Biomarkers in synovial fluid can be helpful in assessing joint homeostasis, but their use and interpretation require caution and are often far from straightforward.
Topics: Animals; Biomarkers; Homeostasis; Horses; Joints; Physical Conditioning, Animal; Synovial Fluid
PubMed: 28392152
DOI: 10.1016/j.tvjl.2017.03.004 -
Current Sports Medicine Reports 2016Studies investigating the effect of running on risk for developing osteoarthritis at weight-bearing joints have reported with conflicting results. Generally,... (Review)
Review
Studies investigating the effect of running on risk for developing osteoarthritis at weight-bearing joints have reported with conflicting results. Generally, moderate-level running is not likely detrimental to joint health. However, many factors may be associated with the increased risk of developing osteoarthritis in runners. Factors often implicated in the development of osteoarthritis comprise those that increase joint vulnerability and those which increase joint loading. It is therefore suggested that running has different effects on different people. Efforts should be made to identify those with joint vulnerability and joint loading, and measures should be taken to have those factors and/or their running programs modified to run safely. Further investigations are needed to examine the effect of running on joint health under different conditions to confirm the association between exposure to risk factors and development of osteoarthritis, as well as to validate the effectiveness of measures for preventing running-related osteoarthritis.
Topics: Cumulative Trauma Disorders; Evidence-Based Medicine; Humans; Joints; Models, Biological; Osteoarthritis; Risk Factors; Running
PubMed: 27618244
DOI: 10.1249/JSR.0000000000000294 -
Proceedings of the Institution of... Feb 2023Empirical joint contact mechanics measurement (EJCM; e.g. contact area or force, surface velocities) enables critical investigations of the relationship between changing... (Review)
Review
Empirical joint contact mechanics measurement (EJCM; e.g. contact area or force, surface velocities) enables critical investigations of the relationship between changing joint mechanics and the impact on surface-to-surface interactions. In orthopedic biomechanics, understanding the changes to cartilage contact mechanics following joint pathology or aging is critical due to its suggested role in the increased risk of osteoarthritis (OA), which might be due to changed kinematics and kinetics that alter the contact patterns within a joint. This article reviews and discusses EJCM approaches that have been applied to articulating joints such that readers across different disciplines will be informed of the various measurement and analysis techniques used in this field. The approaches reviewed include classical measurement approaches (radiographic and sectioning, dye staining, casting, surface proximity, and pressure measurement), stereophotogrammetry/motion analysis, computed tomography (CT), magnetic resonance imaging (MRI), and high-speed videoradiography. Perspectives on approaches to advance this field of EJCM are provided, including the value of considering relative velocity in joints, tractional stress, quantification of joint contact area shape, consideration of normalization techniques, net response (superposition) of multiple input variables, and establishing linkages to regional cartilage health status. EJCM measures continue to provide insights to advance our understanding of cartilage health and degeneration and provide avenues to assess the efficacy and guide future directions of developing interventions (e.g. surgical, biological, rehabilitative) to optimize joint's health and function long term.
Topics: Humans; Mechanical Phenomena; Osteoarthritis; Biomechanical Phenomena; Cartilage; Motion; Cartilage, Articular
PubMed: 36468563
DOI: 10.1177/09544119221137397 -
Progress in Molecular Biology and... 2017Matrix metalloproteinases (MMPs) are zinc-dependent enzymes. These enzymes play a critical role in the destruction of articular cartilage in rheumatoid arthritis (RA),... (Review)
Review
Matrix metalloproteinases (MMPs) are zinc-dependent enzymes. These enzymes play a critical role in the destruction of articular cartilage in rheumatoid arthritis (RA), osteoarthritis (OA), psoriatic arthritis (PsA), and the spondyloarthropathies. MMP gene expression is upregulated in these synovial joint pathologies in response to elevated levels of proinflammatory cytokines and soluble mediators such as tumor necrosis factor-α, interleukin-1 (IL-1), IL-6, IL-17, and interferon-γ. These molecules are capable of activating the mitogen-activated protein kinase and Janus kinase/signal transducers and activators of transcription (JAK/STAT) pathways by binding the cytokine to their respective receptors on immune cells, macrophages, chondrocytes, synoviocytes, and osteocytes leading to increased synthesis of MMPs. Biologic drugs and/or small-molecule inhibitors designed to block cytokine to cytokine receptor interactions or to selectively inhibit JAKs have clinical efficacy in RA, PsA, and ankylosing spondylitis which correlated with a reduction in MMPs. Although there are currently no OA-selective drugs, it is likely that such a drug would have to reduce MMP gene expression to have clinical efficacy.
Topics: Animals; Humans; Joints; Matrix Metalloproteinases; Models, Biological; Synovial Membrane
PubMed: 28662824
DOI: 10.1016/bs.pmbts.2017.03.003 -
Clinical and Experimental Rheumatology 2016Calcium pyrophosphate crystal deposition (CPPD) associates with ageing, osteoarthritis (OA), uncommon metabolic diseases, mutations and polymorphisms in the ankylosis... (Review)
Review
Calcium pyrophosphate crystal deposition (CPPD) associates with ageing, osteoarthritis (OA), uncommon metabolic diseases, mutations and polymorphisms in the ankylosis human gene (ANKH). CPPD is frequently polyarticular, occurs due to a generalised articular predisposition, and the association between CPPD and OA is joint specific, for example CPPD associates with knee OA, but not with hip OA. Other recently identified associations include knee malalignment (knee CC), low cortical BMD and soft-tissue calcification. CPPD is generally asymptomatic. A recent study reported that knees with OA plus CC at the index joint, or at distant joints (in absence of index joint CC), were more likely to have attrition. CPPD can cause acute CPP crystal arthritis, chronic CPP crystal inflammatory arthritis, and is frequently present in joints with OA. Joint aspiration remains the gold standard for diagnosing CPPD, although other promising techniques are emerging. Patients with polyarticular or young onset CPPD should be screened for underlying metabolic abnormalities, however, such testing can be unrewarding. The treatment of CPPD is symptomatic. Acute CPP crystal arthritis is treated with rest, local application of ice-packs, joint aspiration, colchicine and/or intra-articular corticosteroid injection (once infection is excluded). Colchicine, low-dose corticosteroids, hydroxychloroquine and radiosynovectomy are recommended for the treatment of chronic or recurrent acute CPP crystal arthritis. Recent RCTs did not confirm any benefit from methotrexate, and although there is increasing interest in the use of anti-IL1 agents for acute or chronic CPP crystal arthritis, their efficacy has not been formally examined. Unlike gout, currently there are no treatments to eliminate CPP crystal deposits.
Topics: Animals; Anti-Inflammatory Agents; Arthroplasty, Replacement; Calcium Pyrophosphate; Crystal Arthropathies; Crystallization; Humans; Joint Prosthesis; Joints; Risk Factors; Treatment Outcome
PubMed: 27586801
DOI: No ID Found -
Journal of Biomechanics Mar 2015The mechanics of contacting cartilage layers is fundamentally important to understanding the development, homeostasis and pathology of diarthrodial joints. Because of... (Review)
Review
The mechanics of contacting cartilage layers is fundamentally important to understanding the development, homeostasis and pathology of diarthrodial joints. Because of the highly nonlinear nature of both the materials and the contact problem itself, numerical methods such as the finite element method are typically incorporated to obtain solutions. Over the course of five decades, we have moved from an initial qualitative understanding of articular cartilage material behavior to the ability to perform complex, three-dimensional contact analysis, including multiphasic material representations. This history includes the development of analytical and computational contact analysis methods that now provide the ability to perform highly nonlinear analyses. Numerical implementations of contact analysis based on the finite element method are rapidly advancing and will soon enable patient-specific analysis of joint contact mechanics using models based on medical image data. In addition to contact stress on the articular surfaces, these techniques can predict variations in strain and strain through the cartilage layers, providing the basis to predict damage and failure. This opens up exciting areas for future research and application to patient-specific diagnosis and treatment planning applied to a variety of pathologies that affect joint function and cartilage homeostasis.
Topics: Cartilage, Articular; Humans; Joints; Patient-Specific Modeling
PubMed: 25698236
DOI: 10.1016/j.jbiomech.2014.12.020