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Clinics in Orthopedic Surgery Jun 2024Posterior femoral condylar osteophytes were frequently observed in patients with the ultra-congruent (UC) deep-dish design prosthesis. Therefore, the purpose of the... (Comparative Study)
Comparative Study
BACKGROUND
Posterior femoral condylar osteophytes were frequently observed in patients with the ultra-congruent (UC) deep-dish design prosthesis. Therefore, the purpose of the present study was to verify the clinical relevance of osteophyte formation in the UC design.
METHODS
From March 2014 to February 2018, a comparative study was conducted on 96 knees using the UC design. They were divided into 2 groups (group 1: osteophyte +, group 2: osteophyte -). Intraoperative findings, indirect femoral rollback assessment using 30° flexion and active full flexion lateral radiographs, serial change of the osteophyte, and outcomes were compared.
RESULTS
The mean follow-up period was 49.35 ± 3.47 months in group 1 and 47.52 ± 3.37 months in group 2. Posterior component coverage was significantly different between the groups: group 1 exhibited more underhang and group 2 exhibited more overhang ( = 0.022). On the indirect assessment of the femoral rollback, there was a statistically significant difference in deep flexion and change in distance ( < 0.001 and < 0.001, respectively). There was no statistical difference between the 2 groups in the American Knee Society knee and function score, and group 2 showed significant improvement in pain compared to group 1 in Western Ontario and McMaster University Arthritis Index pain score ( = 0.029).
CONCLUSIONS
Posterior condylar osteophyte formation was related to posterior impingement. It was more frequently observed in the underhang of the femoral component and insufficient femoral rollback. In addition, it changed with time and caused negative effects, including a gradual decrease in flexion and more pain.
Topics: Humans; Osteophyte; Female; Male; Aged; Arthroplasty, Replacement, Knee; Middle Aged; Radiography; Knee Prosthesis; Prosthesis Design; Range of Motion, Articular; Retrospective Studies; Osteoarthritis, Knee; Clinical Relevance
PubMed: 38827750
DOI: 10.4055/cios23061 -
International Journal of Computer... Oct 2021Osteophytes are common radiographic markers of osteoarthritis. However, they are not accurately depicted using conventional imaging, thus hampering surgical...
PURPOSE
Osteophytes are common radiographic markers of osteoarthritis. However, they are not accurately depicted using conventional imaging, thus hampering surgical interventions that rely on pre-operative images. Studies have shown that ultrasound (US) is promising at detecting osteophytes and monitoring the progression of osteoarthritis. Furthermore, three-dimensional (3D) ultrasound reconstructions may offer a means to quantify osteophytes. The purpose of this study was to compare the accuracy of osteophyte depiction in the knee joint between 3D US and conventional computed tomography (CT).
METHODS
Eleven human cadaveric knees were pre-screened for the presence of osteophytes. Three osteoarthritic knees were selected, and then, 3D US and CT images were obtained, segmented, and digitally reconstructed in 3D. After dissection, high-resolution structured light scanner (SLS) images of the joint surfaces were obtained. Surface matching and root mean square (RMS) error analyses of surface distances were performed to assess the accuracy of each modality in capturing osteophytes. The RMS errors were compared between 3D US, CT and SLS models.
RESULTS
Average RMS error comparisons for 3D US versus SLS and CT versus SLS models were 0.87 mm ± 0.33 mm (average ± standard deviation) and 0.95 mm ± 0.32 mm, respectively. No statistical difference was found between 3D US and CT. Comparative observations of imaging modalities suggested that 3D US better depicted osteophytes with cartilage and fibrocartilage tissue characteristics compared to CT.
CONCLUSION
Using 3D US can improve the depiction of osteophytes with a cartilaginous portion compared to CT. It can also provide useful information about the presence and extent of osteophytes. Whilst algorithm improvements for automatic segmentation and registration of US are needed to provide a more robust investigation of osteophyte depiction accuracy, this investigation puts forward the potential application for 3D US in routine diagnostic evaluations and pre-operative planning of osteoarthritis.
Topics: Humans; Knee Joint; Osteoarthritis, Knee; Osteophyte; Tomography, X-Ray Computed; Ultrasonography
PubMed: 34313914
DOI: 10.1007/s11548-021-02456-4 -
Osteoarthritis and Cartilage Nov 2012To perform a molecular mechanism-based investigation of the chondroprotective potential of hylan G-F 20.
OBJECTIVE
To perform a molecular mechanism-based investigation of the chondroprotective potential of hylan G-F 20.
METHOD
The effects of hylan G-F 20 on IL-1β-induced glycosaminoglycan (GAG) depletion and matrix metalloproteinase (MMP) expression in bovine and human cartilage explants were evaluated. Three weekly intra-articular hylan G-F 20 or control injections were administered 4 weeks post-operatively to rabbits with surgically induced osteoarthritis (OA). Cartilage histopathologic scores and osteophyte size were evaluated at 1, 4, and 8 weeks post-injections. Histomorphometry and immunostaining were used to quantify cartilage area and type II collagen (Col II) intensity, and real-time polymerase chain reaction (PCR) was used to examine the mRNA levels of Col2A1, MMP-13, -16 and IL-1β at 1 week.
RESULTS
Hylan G-F 20 retained GAG in IL-1β-exposed bovine and human cartilage explants and abrogated IL-1β-mediated increases in MMP-1, -3, and -13 in human explant culture. Hylan G-F 20‒treated OA joints had significantly better cartilage integrity at 1 and 4 weeks post-treatment and significantly smaller osteophytes at 4 weeks compared with control. Col2A1 mRNA increased with hylan G-F 20 treatment, which correlated with a trend toward increased Col II immunostaining. MMP-13 and -16 mRNAs increased in OA cartilage, but were not significantly altered by hylan G-F 20. IL-1β mRNA was undetectable in cartilage and unaltered in the synovium.
CONCLUSIONS
Hylan G-F 20 improved cartilage integrity and decreased osteophyte formation in the rabbit model of OA. Our results suggest that hylan G-F 20 may stimulate cartilage repair by increasing Col II, and inhibit IL-1β-mediated matrix degradation by decreasing MMPs.
Topics: Aged; Animals; Biocompatible Materials; Cartilage, Articular; Cattle; Cells, Cultured; Chondrocytes; Disease Models, Animal; Humans; Hyaluronic Acid; Injections, Intra-Articular; Male; Osteoarthritis; Osteophyte; Rabbits
PubMed: 22809835
DOI: 10.1016/j.joca.2012.07.004 -
Journal of Orthopaedic Research :... Mar 2020The severity of osteoarthritis (OA) has been related to osteophyte size. However, the effects on osteophyte size of repeated and increased loading associated with joint...
The severity of osteoarthritis (OA) has been related to osteophyte size. However, the effects on osteophyte size of repeated and increased loading associated with joint laxity and varus misalignment remain unclear. We investigated these relationships in patients with medial knee OA and compared the performances of computed tomography (CT) and radiography for assessing osteophyte parameters. We examined knee joint alignment on radiographs and knee laxity using arthrometry in 191 patients with medial knee OA who were undergoing total knee arthroplasty. We also measured femur and tibia osteophyte distance (largest perpendicular distance from the cortical line to outer margin of the osteophyte) using radiography and CT, osteophyte areas (largest area surrounded by the outer margin of an osteophyte) by CT and determined the locations of the osteophytes in the femur and tibia by CT. We then analyzed the correlations between the variables using Spearman's rank correlation tests. Osteophyte sizes in the femur and tibia as determined by radiography (distance) or CT (distance and area) were positively correlated with the degree of varus alignment but not with medial or lateral laxity. There was also a significant correlation between maximum osteophyte distances measured by radiography and CT. The greatest number and the largest osteophytes were located in the posterior third of the femur and middle third of the tibia, respectively. Osteophyte size was correlated with preoperative knee alignment but not with knee laxity in patients with medial knee OA. Osteophyte size can be evaluated using conventional radiography, without the need for CT. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:639-644, 2020.
Topics: Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Knee; Female; Humans; Joint Instability; Knee; Male; Middle Aged; Osteoarthritis, Knee; Osteophyte; Prospective Studies; Tomography, X-Ray Computed
PubMed: 31709593
DOI: 10.1002/jor.24501 -
The American Journal of Sports Medicine Mar 2024Posttraumatic osteoarthritis (OA) is a common disorder associated with a high socioeconomic burden, particularly in young, physically active, and working patients....
BACKGROUND
Posttraumatic osteoarthritis (OA) is a common disorder associated with a high socioeconomic burden, particularly in young, physically active, and working patients. Tranexamic acid (TXA) is commonly used in orthopaedic trauma surgery as an antifibrinolytic agent to control excessive bleeding. Previous studies have reported that TXA modulates inflammation and bone cell function, both of which are dysregulated during posttraumatic OA disease progression.
PURPOSE
To evaluate the therapeutic effects of systemic and topical TXA treatment on the progression of posttraumatic OA in the knee of mice.
STUDY DESIGN
Controlled laboratory study.
METHODS
OA was induced via anterior cruciate ligament (ACL) transection on the right knee of female mice. Mice were treated with TXA or vehicle intraperitoneally daily or intra-articularly weekly for 4 weeks, starting on the day of surgery. Articular cartilage degeneration, synovitis, bone erosion, and osteophyte formation were scored histologically. Micro-computed tomography evaluation was conducted to measure the subchondral bone microstructure and osteophyte volume. Cartilage thickness and bone remodeling were assessed histomorphometrically.
RESULTS
Both systemic and topical TXA treatment significantly reduced cartilage degeneration, synovitis, and bone erosion scores and increased the ratio of hyaline to calcified cartilage thickness in posttraumatic OA. Systemic TXA reversed ACL transection-induced subchondral bone loss and osteophyte formation, whereas topical treatment had no effect. Systemic TXA decreased the number and surface area of osteoclasts, whereas those of osteoblasts were not affected. No effect of topical TXA on osteoblast or osteoclast parameters was observed.
CONCLUSION
Both systemic and topical TXA exerted protective effects on the progression of posttraumatic OA. Drug repurposing of TXA may, therefore, be useful for the prevention or treatment of posttraumatic OA, particularly after ACL surgery.
CLINICAL RELEVANCE
TXA might be beneficial in patients with posttraumatic OA of the knee.
Topics: Humans; Female; Animals; Mice; Tranexamic Acid; Osteophyte; X-Ray Microtomography; Osteoarthritis; Synovitis
PubMed: 38305280
DOI: 10.1177/03635465231220855 -
Osteoarthritis and Cartilage Aug 2020To describe the value of radiographic- and magnetic resonance imaging (MRI)-defined tibiofemoral osteoarthritis (ROA and MRI-OA, respectively) and in combination for... (Comparative Study)
Comparative Study
Comparison of radiographic and MRI osteoarthritis definitions and their combination for prediction of tibial cartilage loss, knee symptoms and total knee replacement: a longitudinal study.
OBJECTIVE
To describe the value of radiographic- and magnetic resonance imaging (MRI)-defined tibiofemoral osteoarthritis (ROA and MRI-OA, respectively) and in combination for predicting tibial cartilage loss, knee pain and disability and total knee replacement (TKR) in a population-based cohort.
DESIGN
A radiograph and 1.5T MRI of the right knee was performed. ROA and MRI-OA at baseline were defined according to the Osteoarthritis Research Society International atlas and a published Delphi exercise, respectively. Tibial cartilage volume was measured over 2.6 and 10.7 years. Knee pain and disability were assessed at baseline, 2.6, 5.1 and 10.7 years. Right-sided TKRs were assessed over 13.5 years.
RESULTS
Of 574 participants (mean 62 years, 49% female), 8% had ROA alone, 15% had MRI-OA alone, 13% had both ROA and MRI-OA. Having ROA (vs. no ROA) and MRI-OA (vs. no MRI-OA) predicted greater tibial cartilage loss over 2.6 years (-75.9 and -86.4 mm/year) and higher risk of TKR over 13.5 years (Risk Ratio [RR]: 15.0 and 10.9). Only MRI-OA predicted tibial cartilage loss over 10.7 years (-7.1 mm/year) and only ROA predicted onset and progression of knee symptoms (RR: 1.32-1.88). In participants with both MRI-OA and ROA, tibial cartilage loss was the greatest (over 2.6 years: -116.1 mm/year; over 10.7 years: -11.2 mm/year), and the onset and progression of knee symptoms (RR: 1.75-2.89) and risk of TKR (RR: 50.9) were the highest.
CONCLUSIONS
The Delphi definition of MRI-OA is not superior to ROA for predicting structural or symptomatic OA progression but, combining MRI-OA and ROA has much stronger predictive validity.
Topics: Activities of Daily Living; Aged; Arthroplasty, Replacement, Knee; Bone Marrow; Cartilage, Articular; Disease Progression; Female; Humans; Knee Joint; Longitudinal Studies; Magnetic Resonance Imaging; Male; Middle Aged; Osteoarthritis, Knee; Osteophyte; Pain; Radiography; Tibial Meniscus Injuries
PubMed: 32413465
DOI: 10.1016/j.joca.2020.04.017 -
Osteoarthritis and Cartilage Nov 2021To examine whether acetabular dysplasia (AD), cam and/or pincer morphology are associated with radiographic hip osteoarthritis (rHOA) and hip pain in UK Biobank (UKB)...
Cam morphology but neither acetabular dysplasia nor pincer morphology is associated with osteophytosis throughout the hip: findings from a cross-sectional study in UK Biobank.
OBJECTIVES
To examine whether acetabular dysplasia (AD), cam and/or pincer morphology are associated with radiographic hip osteoarthritis (rHOA) and hip pain in UK Biobank (UKB) and, if so, what distribution of osteophytes is observed.
DESIGN
Participants from UKB with a left hip dual-energy X-ray absorptiometry (DXA) scan had alpha angle (AA), lateral centre-edge angle (LCEA) and joint space narrowing (JSN) derived automatically. Cam and pincer morphology, and AD were defined using AA and LCEA. Osteophytes were measured manually and rHOA grades were calculated from JSN and osteophyte measures. Logistic regression was used to examine the relationships between these hip morphologies and rHOA, osteophytes, JSN, and hip pain.
RESULTS
6,807 individuals were selected (mean age: 62.7; 3382/3425 males/females). Cam morphology was more prevalent in males than females (15.4% and 1.8% respectively). In males, cam morphology was associated with rHOA [OR 3.20 (95% CI 2.41-4.25)], JSN [1.53 (1.24-1.88)], and acetabular [1.87 (1.48-2.36)], superior [1.94 (1.45-2.57)] and inferior [4.75 (3.44-6.57)] femoral osteophytes, and hip pain [1.48 (1.05-2.09)]. Broadly similar associations were seen in females, but with weaker statistical evidence. Neither pincer morphology nor AD showed any associations with rHOA or hip pain.
CONCLUSIONS
Cam morphology was predominantly seen in males in whom it was associated with rHOA and hip pain. In males and females, cam morphology was associated with inferior femoral head osteophytes more strongly than those at the superior femoral head and acetabulum. Further studies are justified to characterise the biomechanical disturbances associated with cam morphology, underlying the observed osteophyte distribution.
Topics: Absorptiometry, Photon; Arthralgia; Cohort Studies; Cross-Sectional Studies; Female; Hip Dislocation; Hip Joint; Humans; Male; Middle Aged; Osteoarthritis, Hip; Osteophyte; Risk Factors
PubMed: 34419604
DOI: 10.1016/j.joca.2021.08.002 -
Journal of Anatomy Jan 2012Previous research on lumbar spine osteophyte formation has focused on patterned development and the relation of age and sex to degeneration within the vertebral bodies....
Previous research on lumbar spine osteophyte formation has focused on patterned development and the relation of age and sex to degeneration within the vertebral bodies. The inclusion of osteophytes originating on the laminae and body mass index (BMI) may result in a more complete evaluation. This study investigates lumbar osteophyte development on the laminae and vertebral bodies to determine whether osteophyte development: (i) is related bilaterally, at different lumbar levels, and superior and inferior margins; (ii) on the laminae and vertebral bodies are reciprocally dependent responses; (iii) is correlated with sex, age and/or BMI. Seventy-six individuals (39 females, 37 males) were randomly selected from a modern skeletal collection (Bass Donated Collection). Osteophyte development was scored in eight regions on each vertebra at all five lumbar levels. A factor analysis considered all 40 scoring regions and Pearson's correlation analyses assessed the relatedness of age and BMI with the consequent factors. The factor analysis separated the variables into two similar factors for males and females defined as: (i) superior and inferior vertebral body scores and (ii) superior laminar scores at higher lumbar levels. The factor analysis also determined a third factor for females defined as: (iii) inferior laminar scores at lower lumbar levels. The severity of vertebral body osteophytes increased with age for both sexes. Additionally for females, as BMI increased, osteophyte severity increased for both the superior laminar margins higher in the column and the vertebral bodies. Dissimilarities between the factors in males and females and the correlation of BMI to osteophyte severity exclusively in females provide evidence for different biomechanical processes influencing osteophyte development.
Topics: Adult; Age Factors; Aged; Aged, 80 and over; Biomechanical Phenomena; Body Mass Index; Factor Analysis, Statistical; Female; Humans; Lumbar Vertebrae; Male; Middle Aged; Risk Factors; Sex Factors; Spinal Osteophytosis; Young Adult
PubMed: 22050626
DOI: 10.1111/j.1469-7580.2011.01444.x -
American Journal of Physiology.... Dec 2019Insulin-like growth factor-I (IGF-I) is anabolic for cartilage and important for cartilage integrity, which might suggest a connection between IGF-I and osteoarthritis...
Insulin-like growth factor-I (IGF-I) is anabolic for cartilage and important for cartilage integrity, which might suggest a connection between IGF-I and osteoarthritis (OA) development. However, the results of studies performed so far are conflicting, and we aimed to clarify the role of endocrine IGF-I in rodent OA. Male mice with inducible inactivation of circulating, liver-derived IGF-I (LI-IGF-I mice, serum IGF-I reduced by ~80%) were used. Experimental OA was induced in young adult LI-IGF-I and control mice by destabilization of the medial meniscus (DMM); age-related OA was also evaluated in 1-yr-old mice. DMM-operated LI-IGF-I mice had thinner lateral subchondral bone plate in tibia compared with control mice, whereas osteophyte volume and articular cartilage damage were unaffected at the medial side of the DMM knee. However, the control mice but not the LI-IGF-I mice also developed mild OA on the lateral side of the DMM knee compared with the unoperated knee. One-year-old LI-IGF-I mice had lower mid-diaphyseal cortical bone area than the 1-yr-old control mice, whereas analyses of joint tissues displayed smaller osteophyte volume and thicker calcified cartilage than the control mice. There was no difference in OA severity in the articular cartilage between old LI-IGF-I and control mice. Our study is the first to investigate whether there is an association between circulating IGF-I and OA in mice. We conclude that, although there is an ~80% reduction of circulating IGF-I and a decrease in cortical bone in male LI-IGF-I mice, cartilage damage is clearly not intensified and may instead be slightly reduced.
Topics: Animals; Cartilage, Articular; Cortical Bone; Gene Knockdown Techniques; Insulin-Like Growth Factor I; Liver; Male; Mice; Osteoarthritis; Osteophyte; Stifle; Tibia; Tibial Meniscus Injuries
PubMed: 31638855
DOI: 10.1152/ajpendo.00330.2019 -
Osteoarthritis and Cartilage Jul 2020To determine if osteoarthritis (OA) progression and joint tissue-pathology associations link specific animal models to different human OA phenotypes.
OBJECTIVE
To determine if osteoarthritis (OA) progression and joint tissue-pathology associations link specific animal models to different human OA phenotypes.
DESIGN
Male 11-week-old C57BL6 mice had unilateral medial-meniscal-destabilization (DMM) or antigen-induced-arthritis (AIA). Joint tissue histopathology was scored day-3 to week-16. Tissue-pathology associations (corrected for time and at week-16) were determined by partial correlation coefficients, and odds ratios (OR) calculated for likelihood of cartilage damage and joint inflammation by ordinal-logistic-regression.
RESULTS
Despite distinct temporal patterns of progression, by week-16 joint-wide OA pathology in DMM and AIA was equivalent. Significant pathology associations common to both models included: osteophyte size and maturity (r > 0.4); subchondral bone (SCB) sclerosis and osteophyte maturity (r > 0.25); cartilage erosion and chondrocyte hypertrophy/apoptosis (r > 0.4), SCB sclerosis (r > 0.26), osteophyte size (r > 0.3), and maturity (r > 0.32). DMM-specific associations were between cartilage proteoglycan loss and structural damage (r = 0.56), osteophyte maturity (r = 0.49), size (r = 0.45), and SCB sclerosis (r = 0.28). AIA-specific associations were between SCB sclerosis and chondrocyte hypertrophy/apoptosis (r = 0.40) and osteophyte size (r = 0.37); and synovitis with cartilage structural damage (r = 0.18). No tissue-pathology associations were common to both models at week-16. Increased likelihood of cartilage structural damage was associated with: chondrocyte hypertrophy/apoptosis (OR>1.7), and osteophyte size (OR>2.3) in both models; SCB sclerosis (OR = 2.0) and proteoglycan loss (OR = 2.4) in DMM; and synovitis (OR = 1.2) in AIA. Joint inflammation was associated positively with cartilage proteoglycan loss (OR = 1.4) and inversely with osteophyte size (OR = 0.21) in AIA only.
CONCLUSION
This study highlights the importance of defining OA-models by initiating mechanisms and progression, not just end-stage joint-tissue pathology.
Topics: Adjuvants, Immunologic; Animals; Arthritis, Experimental; Cartilage, Articular; Chondrocytes; Disease Models, Animal; Femur; Freund's Adjuvant; Hypertrophy; Inflammation; Logistic Models; Male; Menisci, Tibial; Mice; Mice, Inbred C57BL; Osteoarthritis; Osteophyte; Phenotype; Sclerosis; Serum Albumin, Bovine; Synovitis; Tibia
PubMed: 32360537
DOI: 10.1016/j.joca.2020.04.009