Yet more evidence that osteoarthritis is not a cartilage disease.
Annals of the Rheumatic Diseases (impact factor: 8.73). 11/2006; 65(10):1261-4. DOI:10.1136/ard.2006.058347 pp.1261-4
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ABSTRACT: Recent research in the field of joint osteoarthritis (OA) indicates that osteoarthritis is in fact not a disease of joint cartilage. Rather, the cartilage wear seen in OA should be regarded as the end-stage of a disease that originates in the tissues supporting the joint. Therefore, it has been suggested that the joint should be viewed as a "synovial organ", where any part of that organ, be it the cartilage, subchondral bone, synovium, ligament, nerve or periarticular muscle, may be in-volved in the development of joint OA. Proprioception and neuromuscular control of a joint are dependent on intact func-tions in ligaments, preserved joint innervation and adequate reflex control of periarticular muscles to stabilize the joint. One of the described potential contributors to joint OA is thus a failure of joint proprioception. The aim of this article is to review our current knowledge of proprioception and functional joint stability, how this relates to the development of OA in the hand and wrist, and how clinical interventions may protect against progressive OA following ligament injury.Current Rheumatology Reviews 12/2012; 8(4):278-284.
Article: Is radiology a determinant of pain, stiffness, and functional disability in knee osteoarthritis? A cross-sectional study.[show abstract] [hide abstract]
ABSTRACT: Discordance between clinical and radiological profiles in knee osteoarthritis has been reported. We hypothesized that the discordance could be due to limited radiological variables studied. This study essentially analyzed many more radiological features than previous studies in order to seek an association between clinical and radiographic features. One hundred and eighty patients with knee osteoarthritis were enrolled as per the American College of Rheumatology (ACR) guidelines. Visual analog scale (VAS) for knee pain and the knee-specific Western Ontario Mac University (WOMAC) index for pain, stiffness, and disability were recorded. Five additional radiological features apart from those in the Kellgren-Lawrence (KL) classification grading system were recorded by two authors who were blinded to the clinical diagnosis. The variables significantly associated were analyzed by linear regression model. Pain was significantly associated with increasing KL grades; physical function was nearly significant and stiffness was not. On analysis of individual radiological features, WOMAC pain was significant with subchondral sclerosis, joint space width, and tibiofemoral alignment although the correlation was week. VAS pain was significant with the latter two and with articular incongruity. Functional disability was associated with medial joint-space narrowing, tibiofemoral alignment, loose bodies, and juxta-articular osteopenia. However, in the linear regression model, pain and stiffness were significantly associated with articular incongruity and functional disability and total clinical scores with juxta-articular osteopenia. When the radiological features were extended beyond those included in KL grades, pain, stiffness, and disability correlated well with radiography; articular incongruity with pain and stiffness; and juxta-articular osteopenia with physical disability and clinical severity.Journal of Orthopaedic Science 08/2011; 16(6):719-25. · 0.84 Impact Factor
Article: Phenotypic characterization of osteoarthritic osteocytes from the sclerotic zones: a possible pathological role in subchondral bone sclerosis.[show abstract] [hide abstract]
ABSTRACT: Subchondral bone sclerosis is a well-recognised manifestation of osteoarthritis (OA). The osteocyte cell network is now considered to be central to the regulation of bone homeostasis; however, it is not known whether the integrity of the osteocyte cell network is altered in OA patients. The aim of this study was to investigate OA osteocyte phenotypic changes and its potential role in OA subchondral bone pathogenesis. The morphological and phenotypic changes of osteocytes in OA samples were investigated by micro-CT, SEM, histology, immunohistochemistry, TRAP staining, apoptosis assay and real-time PCR studies. We demonstrated that in OA subchondral bone, the osteocyte morphology was altered showing rough and rounded cell body with fewer and disorganized dendrites compared with the osteocytes in control samples. OA osteocyte also showed dysregulated expression of osteocyte markers, apoptosis, and degradative enzymes, indicating that the phenotypical changes in OA osteocytes were accompanied with OA subchondral bone remodelling (increased osteoblast and osteoclast activity) and increased bone volume with altered mineral content. Significant alteration of osteocytes identified in OA samples indicates a potential regulatory role of osteocytes in subchondral bone remodelling and mineral metabolism during OA pathogenesis.International journal of biological sciences 01/2012; 8(3):406-17. · 2.70 Impact Factor
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