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Medicina (Kaunas, Lithuania) May 2020There are an increasing number of patients applying for dental treatment who suffer from temporomandibular joint osteoarthritis (TMJOA). Osteoarthritis may be the cause... (Review)
Review
There are an increasing number of patients applying for dental treatment who suffer from temporomandibular joint osteoarthritis (TMJOA). Osteoarthritis may be the cause of the pain in the area of temporomandibular joints, but its course may also be absolutely asymptomatic. The aim of this study was to present an interdisciplinary approach to TMJOA, including current diagnostics and treatment modalities on the basis of the available literature. PubMed and Scopus databases were analyzed using the keywords: ((temporomandibular joint AND osteoarthritis) AND imaging) and ((temporomandibular joint AND osteoarthritis) AND treatment). The bibliography was supplemented with books related to the temporomandibular joint. After screening 2450 results, the work was based in total on 98 publications. Osteoarthritis is an inflammatory, age-related, chronic and progressive degenerative joint disease. Magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT), together with clinical symptoms, play significant roles in TMJOA diagnosis. Current MRI techniques seem to be clinically useful for assessment of bony changes in temporomandibular joint (TMJ) disorders. Treatment of TMJOA requires a complex, interdisciplinary approach. TMJOA treatment includes the cooperation of physiotherapists, rheumatologists, gnathologists, orthodontists and quite often also maxillofacial surgeons and prosthodontists. Sometimes additional pharmacotherapy is indicated. Thorough examination of TMJ function and morphology is necessary at the beginning of any orthodontic or dental treatment. Undiagnosed TMJ dysfunction may cause further problems with the entire masticatory system, including joints, muscles and teeth.
Topics: Humans; Magnetic Resonance Imaging; Osteoarthritis; Patient Care Team; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 32397412
DOI: 10.3390/medicina56050225 -
Osteoarthritis and Cartilage Dec 2021Prevention is an attractive solution for the staggering and increasingly unmanageable burden of osteoarthritis. Despite this, the field of osteoarthritis prevention is... (Review)
Review
Prevention is an attractive solution for the staggering and increasingly unmanageable burden of osteoarthritis. Despite this, the field of osteoarthritis prevention is relatively immature. To date, most of what is known about preventing osteoarthritis and risk factors for osteoarthritis is relative to the disease (underlying biology and pathophysiology) of osteoarthritis, with few studies considering risk factors for osteoarthritis illness, the force driving the personal, financial and societal burden. In this narrative review we will discuss what is known about osteoarthritis prevention, propose actionable prevention strategies related to obesity and joint injury which have emerged as important modifiable risk factors, identify where evidence is lacking, and give insight into what might be possible in terms of prevention by focussing on a lifespan approach to the illness of osteoarthritis, as opposed to a structural disease of the elderly. By targeting a non-specialist audience including scientists, clinicians, students, industry employees and others that are interested in osteoarthritis but who do not necessarily focus on osteoarthritis, the goal is to generate discourse and motivate inquiry which propel the field of osteoarthritis prevention into the mainstream.
Topics: Bone Malalignment; Exercise; Genetic Predisposition to Disease; Health Behavior; Health Promotion; Humans; Joints; Muscle Weakness; Osteoarthritis; Overweight; Patient Education as Topic; Risk Factors; Sex Factors
PubMed: 34560260
DOI: 10.1016/j.joca.2021.06.015 -
Folia Morphologica 2021Lumbar facet joints (LFJs) are diarthrodial joints which provide articulation between two adjacent lumbar vertebrae. LFJs represent complex anatomic structures with... (Review)
Review
Lumbar facet joints (LFJs) are diarthrodial joints which provide articulation between two adjacent lumbar vertebrae. LFJs represent complex anatomic structures with multifaceted biomechanical and functional characteristics. They are theorized as structures of crucial clinical significance since their degenerative morphologic alterations are frequently related to emergence of low back pain. Despite the emerging interest in describing LFJs anatomy in recent years, precise description of LFJs innervation remains controversial. In this comprehensive review, anatomy and biomechanical importance of LFJs and associated adjacent extra-articular structures are thoroughly presented. Furthermore, LFJs innervation in respect to current literature data is punctually analysed. Knowledge of anatomy and innervation LFJs of critical importance for clinicians and spine surgeons, so that patients are properly evaluated and related therapeutic procedures are rationally performed.
Topics: Humans; Low Back Pain; Lumbar Vertebrae; Lumbosacral Region; Zygapophyseal Joint
PubMed: 33084010
DOI: 10.5603/FM.a2020.0122 -
Biomedicine & Pharmacotherapy =... Sep 2020Osteoarthritis (OA) is the most prevalent joint degenerative disease leading to irreversible structural and functional changes in the joint and is a major cause of... (Review)
Review
Osteoarthritis (OA) is the most prevalent joint degenerative disease leading to irreversible structural and functional changes in the joint and is a major cause of disability and reduced life expectancy in ageing population. Despite the high prevalence of OA, there is no disease modifying drug available for the management of OA. Oxidative stress, a result of an imbalance between the production of reactive oxygen species (ROS) and their clearance by antioxidant defense system, is high in OA cartilage and is a major cause of chronic inflammation. Inflammatory mediators, such as interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) are highly upregulated in OA joints and induce ROS production and expression of matrix degrading proteases leading to cartilage extracellular matrix degradation and joint dysfunction. ROS and inflammation are interdependent, each being the target of other and represent ideal target/s for the treatment of OA. Plant polyphenols possess potent antioxidant and anti-inflammatory properties and can inhibit ROS production and inflammation in chondrocytes, cartilage explants and in animal models of OA. The aim of this review is to discuss the chondroprotective effects of polyphenols and modulation of different molecular pathways associated with OA pathogenesis and limitations and future prospects of polyphenols in OA treatment.
Topics: Animals; Anti-Infective Agents; Antioxidants; Antirheumatic Agents; Humans; Inflammation Mediators; Joints; Osteoarthritis; Oxidative Stress; Polyphenols; Reactive Oxygen Species; Signal Transduction
PubMed: 32768946
DOI: 10.1016/j.biopha.2020.110452 -
Cells Jun 2021Articular cartilage is a connective tissue lining the surfaces of synovial joints. When the cartilage severely wears down, it leads to osteoarthritis (OA), a...
Articular cartilage is a connective tissue lining the surfaces of synovial joints. When the cartilage severely wears down, it leads to osteoarthritis (OA), a debilitating disease that affects millions of people globally. The articular cartilage is composed of a dense extracellular matrix (ECM) with a sparse distribution of chondrocytes with varying morphology and potentially different functions. Elucidating the molecular and functional profiles of various chondrocyte subtypes and understanding the interplay between these chondrocyte subtypes and other cell types in the joint will greatly expand our understanding of joint biology and OA pathology. Although recent advances in high-throughput OMICS technologies have enabled molecular-level characterization of tissues and organs at an unprecedented resolution, thorough molecular profiling of articular chondrocytes has not yet been undertaken, which may be in part due to the technical difficulties in isolating chondrocytes from dense cartilage ECM. In this study, we profiled articular cartilage from healthy and injured mouse knee joints at a single-cell resolution and identified nine chondrocyte subtypes with distinct molecular profiles and injury-induced early molecular changes in these chondrocytes. We also compared mouse chondrocyte subpopulations to human chondrocytes and evaluated the extent of molecular similarity between mice and humans. This work expands our view of chondrocyte heterogeneity and rapid molecular changes in chondrocyte populations in response to joint trauma and highlights potential mechanisms that trigger cartilage degeneration.
Topics: Animals; Cartilage, Articular; Chondrocytes; Humans; Knee Injuries; Knee Joint; Male; Mice; Mice, Inbred C57BL; Osteoarthritis, Knee; RNA-Seq; Single-Cell Analysis; Transcriptome
PubMed: 34200880
DOI: 10.3390/cells10061462 -
Annals of the Rheumatic Diseases Mar 2023Fibroblasts in synovium include fibroblast-like synoviocytes (FLS) in the lining and + connective-tissue fibroblasts in the sublining. We aimed to investigate their...
OBJECTIVES
Fibroblasts in synovium include fibroblast-like synoviocytes (FLS) in the lining and + connective-tissue fibroblasts in the sublining. We aimed to investigate their developmental origin and relationship with adult progenitors.
METHODS
To discriminate between -lineage cells deriving from the embryonic joint interzone and other -expressing fibroblasts and progenitors, adult mice were used and cartilage injury was induced to activate progenitors. Cells were isolated from knees, fibroblasts and progenitors were sorted by fluorescence-activated cell-sorting based on developmental origin, and analysed by single-cell RNA-sequencing. Flow cytometry and immunohistochemistry were used for validation. Clonal-lineage mapping was performed using mice.
RESULTS
In steady state, + sublining fibroblasts were of mixed ontogeny. In contrast, + lining fibroblasts predominantly derived from the embryonic joint interzone and included -expressing progenitors distinct from molecularly defined FLS. Clonal-lineage tracing revealed compartmentalisation of -lineage fibroblasts between lining and sublining. Following injury, lining hyperplasia resulted from proliferation and differentiation of -expressing progenitors, with additional recruitment of non--lineage cells, into FLS. Consistent with this, a second population of proliferating cells, enriched near blood vessels in the sublining, supplied activated multipotent cells predicted to give rise to + fibroblasts, and to feed into the FLS differentiation trajectory. Transcriptional programmes regulating fibroblast differentiation trajectories were uncovered, identifying Sox5 and Foxo1 as key FLS transcription factors in mice and humans.
CONCLUSIONS
Our findings blueprint a cell atlas of mouse synovial fibroblasts and progenitors in healthy and injured knees, and provide novel insights into the cellular and molecular principles governing the organisation and maintenance of adult synovial joints.
Topics: Humans; Adult; Mice; Animals; Receptor, Platelet-Derived Growth Factor alpha; Joints; Synovial Membrane; Synoviocytes; Fibroblasts
PubMed: 36414376
DOI: 10.1136/ard-2021-221682 -
Nature Communications Apr 2021Insufficient apoptosis of inflammatory macrophages and osteoclasts (OCs) in rheumatoid arthritis (RA) joints contributes toward the persistent progression of joint...
Insufficient apoptosis of inflammatory macrophages and osteoclasts (OCs) in rheumatoid arthritis (RA) joints contributes toward the persistent progression of joint inflammation and destruction. Here, we deliver celastrol (CEL) to selectively induce apoptosis of OCs and macrophages in arthritic joints, with enzyme-responsive nanoparticles (termed PRNPs) composed of RGD modified nanoparticles (termed RNPs) covered with cleavable PEG chains. CEL-loaded PRNPs (CEL-PRNPs) dually target OCs and inflammatory macrophages derived from patients with RA via an RGD-αvβ3 integrin interaction after PEG cleavage by matrix metalloprotease 9, leading to increased apoptosis of these cells. In an adjuvant-induced arthritis rat model, PRNPs have an arthritic joint-specific distribution and CEL-PRNPs efficiently reduce the number of OCs and inflammatory macrophages within these joints. Additionally, rats with advanced arthritis go into inflammatory remission with bone erosion repair and negligible side effects after CEL-PRNPs treatment. These findings indicate potential for targeting chemotherapy-induced apoptosis in the treatment of advanced inflammatory arthritis.
Topics: Animals; Apoptosis; Arthritis, Rheumatoid; Bone and Bones; Endocytosis; Female; Human Umbilical Vein Endothelial Cells; Humans; Inflammation; Joints; Lipopolysaccharides; Macrophages; Mice, Inbred C57BL; Nanoparticles; Oligopeptides; Osteoclasts; Pentacyclic Triterpenes; Rats; Synovial Membrane; Tissue Distribution; Triterpenes; X-Ray Microtomography; Mice
PubMed: 33846342
DOI: 10.1038/s41467-021-22454-z -
Journal of the American Academy of... Dec 2021Subtalar dislocations are uncommon injuries that involve disruption of the talocalcaneal and talonavicular joints. Whereas medial subtalar dislocations are usually...
Subtalar dislocations are uncommon injuries that involve disruption of the talocalcaneal and talonavicular joints. Whereas medial subtalar dislocations are usually caused by low-energy mechanisms and are reducible by closed means, lateral subtalar dislocations occur due to high-energy trauma, have associated foot injuries, and may require open reduction. Good outcomes can be expected for low-energy medial dislocations, whereas high-energy dislocations have guarded outcomes. Hindfoot deformity and chronic instability can result from nonanatomic reduction and inadequate stabilization. Arthrosis of the subtalar joint can occur despite anatomic reduction and is attributable to the cartilage damage at the time of injury.
Topics: Foot; Foot Injuries; Humans; Joint Dislocations; Open Fracture Reduction; Subtalar Joint
PubMed: 34936582
DOI: 10.5435/JAAOSGlobal-D-21-00295 -
Clinical Microbiology and Infection :... Jul 2020Little guidance is currently available for standardized diagnostic protocols and therapeutic recommendations for bone and joint infections (BJIs) of the hand. (Review)
Review
BACKGROUND
Little guidance is currently available for standardized diagnostic protocols and therapeutic recommendations for bone and joint infections (BJIs) of the hand.
OBJECTIVES
To summarize the available data in the scientific English-language literature on the diagnosis and treatment of native BJIs of the hand. To illustrate these concepts from a narrative point of view in areas where there is lack of evidence.
SOURCES
We performed a systematic PubMed and Internet search of studies that investigated hand BJIs in adult patients.
CONTENT
Few studies have systematically investigated and validated diagnostic concepts, classifications or surgical treatment protocols. Most concepts derive from traditional intra-institutional experience, expert opinions and extrapolations from infections in large joints and long bones. Similarly, there is no uniformly accepted infection definition of BJIs of the hand. The best-documented literature is available for microbiological findings and antibiotic treatment duration in uncomplicated native joint arthritis of the fingers. Retrospective studies and one prospective randomized trial suggest that post-surgical targeted antibiotic therapy of 2 weeks results in a microbiological cure rate of ≥88%.
IMPLICATIONS
Studies on diagnostic workup and infection definition and classification are urgently needed to compare inter-institutional outcome results and generate guidelines for the best patient care. For uncomplicated pyogenic arthritis of native joints, current evidence suggests that a 2-week course of antibiotic therapy following surgery cures the infection.
Topics: Anti-Bacterial Agents; Arthritis, Infectious; Combined Modality Therapy; Early Diagnosis; Female; Hand Bones; Hand Joints; Humans; Male; Osteomyelitis; Practice Guidelines as Topic; Randomized Controlled Trials as Topic; Standard of Care
PubMed: 31917233
DOI: 10.1016/j.cmi.2019.12.007 -
Osteoarthritis and Cartilage Mar 2020Mechanics play a critical - but not sole - role in the pathogenesis of osteoarthritis, and recent research has highlighted how mechanical constructs are relevant at the... (Review)
Review
Mechanics play a critical - but not sole - role in the pathogenesis of osteoarthritis, and recent research has highlighted how mechanical constructs are relevant at the cellular, joint, and whole-body level related to osteoarthritis outcomes. This review examined papers from April 2018 to April 2019 that reported on the role of mechanics in osteoarthritis etiology, with a particular emphasis on studies that focused on the interaction between movement and tissue biomechanics with other clinical outcomes relevant to the pathophysiology of osteoarthritis. Studies were grouped by themes that were particularly prevalent from the past year. Results of the search highlighted the large exposure of knee-related research relative to other body areas, as well as studies utilizing laboratory-based motion capture technology. New research from this past year highlighted the important role that rate of exerted loads and rate of muscle force development - rather than simply force capacity (strength) - have in OA etiology and treatment. Further, the role of muscle activation patterns in functional and structural aspects of joint health has received much interest, though findings remain equivocal. Finally, new research has identified potential mechanical outcome measures that may be related to osteoarthritis disease progression. Future research should continue to combine knowledge of mechanics with other relevant research techniques, and to identify mechanical markers of joint health and structural and functional disease progression that are needed to best inform disease prevention, monitoring, and treatment.
Topics: Biomechanical Phenomena; Humans; Joints; Muscle Strength; Muscle, Skeletal; Osteoarthritis; Weight-Bearing
PubMed: 31877382
DOI: 10.1016/j.joca.2019.12.003