Journal of Clinical Medicine

Research

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9 pages, 404 KiB

Open AccessArticle

Clinical Efficacy of Melon GliSODin^® for the Treatment of Aging-Related Dysfunction in Motor Organs—A Double Blind, Randomized Placebo-Controlled Study

by Masato Koike, Masashi Nagao, Yoshiyuki Iwase, Kazuo Kaneko, Muneaki Ishijima and Hidetoshi Nojiri

J. Clin. Med. 2022, 11(10), 2747; https://doi.org/10.3390/jcm11102747 - 12 May 2022

Cited by 1 | Viewed by 1920

Abstract

Background: Locomotive syndrome is a concept proposed in Japan involving decreased mobility due to osteoarthritis, osteoporosis, and sarcopenia. This double-blind, randomized study aimed to investigate the effects of superoxide dismutase (SOD)-rich melon extract (Melon GliSODin^®) on locomotive syndrome. Methods: For 6 [...] Read more.

Background: Locomotive syndrome is a concept proposed in Japan involving decreased mobility due to osteoarthritis, osteoporosis, and sarcopenia. This double-blind, randomized study aimed to investigate the effects of superoxide dismutase (SOD)-rich melon extract (Melon GliSODin^®) on locomotive syndrome. Methods: For 6 months, we administered oral Melon GliSODin^® (500.4 mg/day) or a placebo to 24 and 22 women, respectively (aged 50–80 years), with knee or lower back discomfort or pain. Using baseline and 6-month data, changes in the Verbal Rating Scale and in subjective symptoms (determined using the Japanese Knee Osteoarthritis Measure, Locomo 25, the Roland–Morris Disability questionnaire, and the Chalder Fatigue Scale) were assessed, along with various oxidative markers, antioxidants, inflammatory markers, renal and liver function biochemical markers, bone metabolism markers, body composition, and motor function. Results: Oral Melon GliSODin^® administration tended to be associated with a larger improvement in subjective symptom scores, a reduction in oxidative markers (malondialdehyde and diacron reactive oxygen metabolites) and tumor necrosis factor-α, and a significant increase in non-fat mass between baseline and 6 months. However, no statistically significant differences were observed between the groups for outcomes at 6 months. Conclusions: Melon GliSODin^® tended to improve the subjective symptoms of participants who had knee or lower back pain or discomfort. Melon GliSODin^® administration may help to prevent the progression of locomotive syndrome. Future studies involving larger sample sizes and more stringent randomization protocols are needed to determine differences between the placebo and Melon GliSODin^® groups. Full article

(This article belongs to the Special Issue Strategies for the Prevention of Knee Osteoarthritis)

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10 pages, 1666 KiB

Open AccessEditor’s ChoiceArticle

Platelet Rich Plasma Injections for Knee Osteoarthritis Treatment: A Prospective Clinical Study

by Lorenzo Moretti, Giuseppe Maccagnano, Michele Coviello, Giuseppe D. Cassano, Andrea Franchini, Andrea Laneve and Biagio Moretti

J. Clin. Med. 2022, 11(9), 2640; https://doi.org/10.3390/jcm11092640 - 08 May 2022

Cited by 15 | Viewed by 3498

Abstract

Background: The aim of this prospective study was to evaluate the efficacy and safety of Platelet Rich Plasma (PRP) injections in patients affected by knee osteoarthritis (KOA). An autologous blood product containing a high percentage of various growth factors (GFs), cytokines and modulating [...] Read more.

Background: The aim of this prospective study was to evaluate the efficacy and safety of Platelet Rich Plasma (PRP) injections in patients affected by knee osteoarthritis (KOA). An autologous blood product containing a high percentage of various growth factors (GFs), cytokines and modulating factors as PRP has shown promising results in achieving this goal. Methods: One hundred and fifty-three patients (72 males, mean age 59.06 ± 8.78, range 40–81 years old) from January 2018 to January 2020 received three consecutive PRP injections and completed the follow ups. Western Ontario and McMaster University Osteoarthritis index (WOMAC), Knee society score (KSS) and Visual Analogic Scale (VAS) were evaluated before PRP injection (T0), one month (T1), three months (T2) and six months (T3) after the treatment. All patients underwent baseline and at 6 months MRI and X-ray evaluation. Results: A statistically significant VAS, KSS and WOMAC reduction emerged in the comparison between evaluations (p < 0.05), MRI demonstrated non-statistically significant improvement in cartilage thickness for both tibial plate and femoral plate (p = 0.46 and p = 0.33 respectively), and no radiographic changes could be seen in any patients. Conclusions: PRP injection represents a valid conservative treatment to reduce pain, improve quality of life and functional scores even at midterm of 6 months follow-up. Full article

(This article belongs to the Special Issue Strategies for the Prevention of Knee Osteoarthritis)

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8 pages, 246 KiB

Open AccessArticle

Osteoarthritis Progression after ACL Reconstruction Was Significantly Higher Than That of the Healthy Contralateral Knees: Long-Term Follow Up Study of Mean 16.4 Years

by Ali Zadehmohammad, Johannes Grillari, Vlado Stevanovic, Georg Brandl, Lukas Ernstbrunner and Thomas Hoffelner

J. Clin. Med. 2022, 11(3), 775; https://doi.org/10.3390/jcm11030775 - 31 Jan 2022

Cited by 3 | Viewed by 2130

Abstract

Background: This study aimed to assess long-term progression of osteoarthritis (OA) after isolated anterior cruciate ligament (ACL) reconstruction in athletes compared to the healthy contralateral side. Methods: The study included 15 patients and 30 knees with a mean age of 40 years (range, [...] Read more.

Background: This study aimed to assess long-term progression of osteoarthritis (OA) after isolated anterior cruciate ligament (ACL) reconstruction in athletes compared to the healthy contralateral side. Methods: The study included 15 patients and 30 knees with a mean age of 40 years (range, 35–46) years, none of whom had had revision surgery or an injury to the contralateral side. The mean follow-up period was 16.4 years (range, 13–22). Clinical and radiographic assessment included the Tegner activity scale (TAS), International Knee Documentation Committee (IKDC) score, Knee injury and Osteoarthritis Outcome Score (KOOS), and Kellgren and Lawrence (KL) grade. The long-term results of the injured knees were compared with the status of the healthy contralateral side and compared with previously published mid-term results of the same cohort of patients. Results: Patients generally remained clinically asymptomatic or mildly symptomatic at final follow-up, which is reflected by a KOOS pain score of 33 points (maximum 36 points) and an IKDC total subjective score of 87% (maximum 100%). There was a significant difference between mid-term and final follow-up in terms of the function score of the IKDC subjective questionnaire (p = 0.031), compartment findings and donor site morbidity of the IKDC functional examination (both p = 0.034), and the total KOOS score (p = 0.047). The KL score indicated significant progression of OA from mid-term to final follow-up in the injured knees (p = 0.004) and healthy contralateral knees (p = 0.014). Mean OA grades of the injured knees were significantly higher compared with the healthy contralateral side (p = 0.006) at final follow-up, and two patients showed moderate to severe signs of OA in the injured knee. Conclusions: Although most patients remained clinically asymptomatic or mildly symptomatic, long-term progression of OA after isolated ACL reconstruction in athletes was significantly higher compared with the healthy contralateral knee. Full article

(This article belongs to the Special Issue Strategies for the Prevention of Knee Osteoarthritis)

9 pages, 790 KiB

Open AccessArticle

Predictors of Effectiveness of Platelet-Rich Plasma Therapy for Knee Osteoarthritis: A Retrospective Cohort Study

by Yoshitomo Saita, Yohei Kobayashi, Hirofumi Nishio, Takanori Wakayama, Shin Fukusato, Sayuri Uchino, Yasumasa Momoi, Hiroshi Ikeda and Kazuo Kaneko

J. Clin. Med. 2021, 10(19), 4514; https://doi.org/10.3390/jcm10194514 - 29 Sep 2021

Cited by 22 | Viewed by 3524

Abstract

There has recently been growing interest worldwide in biological therapies such as platelet-rich plasma injection for the treatment of knee osteoarthritis. However, predicting the effectiveness of platelet-rich plasma therapy remains uncertain. Therefore, this retrospective cohort study was performed to assess a range of [...] Read more.

There has recently been growing interest worldwide in biological therapies such as platelet-rich plasma injection for the treatment of knee osteoarthritis. However, predicting the effectiveness of platelet-rich plasma therapy remains uncertain. Therefore, this retrospective cohort study was performed to assess a range of predictors for the effectiveness of platelet-rich plasma therapy in treating knee osteoarthritis. The study included 517 consecutive patients who underwent three injections of leucocyte-poor platelet-rich plasma therapy from 2016 to 2019 at a single institution. The treatment outcomes, including patient-oriented outcomes (visual analogue scale score and Knee Injury and Osteoarthritis Outcome Score), were analyzed and compared according to the severity of knee osteoarthritis based on Kellgren–Lawrence (KL) grading using standing plain radiographs. Fisher’s exact test, univariate regression, and multivariate regression were used for data analysis. Patient-oriented outcomes were significantly improved 6 and 12 months after platelet-rich plasma therapy. The overall responder rate in patients who met the Outcome Measures in Rheumatology (OMERACT)–Osteoarthritis Research Society International (OARSI) responder criteria was 62.1%. The responder rate was significantly lower in patients with severe knee osteoarthritis (KL4, 50.9%) than in those with mild (KL2, 75.2%) and moderate (KL3, 66.5%) knee osteoarthritis. The multivariate logistic regression analysis revealed that deterioration of the knee osteoarthritis grade (increased KL grade) was a significant predictor of a worse clinical outcome (odds ratio, 0.58; 95% confidence interval, 0.45–0.75; p < 0.001). The relative risk for non-responders in severe (KL4) KOA was 2.1 (95% CI, 1.5–3.0) at 6 months and 2.3 (1.6–3.2) at 12 months compared with mild-to-moderate (KL2-3) KOA. The efficacy of platelet-rich plasma therapy was not affected by age, sex, body weight, or platelet count. This study revealed that the effectiveness of platelet-rich plasma therapy for the treatment of knee osteoarthritis is approximately 60% and that the effectiveness depends on the severity of knee osteoarthritis. This observation is useful not only for physicians but also for patients with knee osteoarthritis. Full article

(This article belongs to the Special Issue Strategies for the Prevention of Knee Osteoarthritis)

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14 pages, 4111 KiB

Open AccessArticle

Attenuation of Knee Osteoarthritis Progression in Mice through Polarization of M2 Macrophages by Intra-Articular Transplantation of Non-Cultured Human Adipose-Derived Regenerative Cells

by Kohei Kamada, Takehiko Matsushita, Takahiro Yamashita, Tomoyuki Matsumoto, Hideki Iwaguro, Satoshi Sobajima and Ryosuke Kuroda

J. Clin. Med. 2021, 10(19), 4309; https://doi.org/10.3390/jcm10194309 - 22 Sep 2021

Cited by 3 | Viewed by 1689

Abstract

Adipose-derived regenerative cells (ADRCs) are non-cultured heterogeneous or mixed populations of cells obtained from adipose tissue by collagenase digestion. The injection of ADRCs have been tried clinically for the treatment of osteoarthritis (OA). The purpose of this study was to evaluate the effect [...] Read more.

Adipose-derived regenerative cells (ADRCs) are non-cultured heterogeneous or mixed populations of cells obtained from adipose tissue by collagenase digestion. The injection of ADRCs have been tried clinically for the treatment of osteoarthritis (OA). The purpose of this study was to evaluate the effect of intra-articular transplantation of human ADRCs on OA progression in mice and the effect of ADRCs on macrophage polarization. In in vivo experiments, BALB/c-nu mice with knee OA received intra-articular transplantation of either phosphate buffered-saline or human ADRCs. OA progression was evaluated histologically and significantly attenuated in the ADRC group at both four and eight weeks postoperatively. The expression of OA-related proteins in the cartilage and macrophage-associated markers in the synovium were examined by immunohistochemistry. The numbers of MMP-13-, ADAMTS-5-, IL-1β-, IL-6- and iNOS-positive cells significantly decreased, and type II collagen- and CD206-positive cells were more frequently detected in the ADRC group compared with that in the control group. In vitro co-culture experiments showed that ADRCs induced macrophage polarization toward M2. The results of this study suggest that the intra-articular transplantation of human ADRCs could attenuate OA progression possibly by reducing catabolic factors in chondrocytes and modulating macrophage polarization. Full article

(This article belongs to the Special Issue Strategies for the Prevention of Knee Osteoarthritis)

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11 pages, 2485 KiB

Open AccessArticle

Collagen XII Deficiency Increases the Risk of Anterior Cruciate Ligament Injury in Mice

by Shin Fukusato, Masashi Nagao, Kei Fujihara, Taiju Yoneda, Kiyotaka Arai, Manuel Koch, Kazuo Kaneko, Muneaki Ishijima and Yayoi Izu

J. Clin. Med. 2021, 10(18), 4051; https://doi.org/10.3390/jcm10184051 - 07 Sep 2021

Cited by 4 | Viewed by 2938

Abstract

Anterior cruciate ligament (ACL) rupture is a common knee injury for athletes. Although surgical reconstruction is recommended for the treatment of ACL ruptures, 100% functional recovery is unlikely. Therefore, the discovery of risk factors for ACL ruptures may prevent injury. Several studies have [...] Read more.

Anterior cruciate ligament (ACL) rupture is a common knee injury for athletes. Although surgical reconstruction is recommended for the treatment of ACL ruptures, 100% functional recovery is unlikely. Therefore, the discovery of risk factors for ACL ruptures may prevent injury. Several studies have reported an association between polymorphisms of the collagen XII gene COL12A1 and ACL rupture. Collagen XII is highly expressed in tendons and ligaments and regulates tissue structure and mechanical property. Therefore, we hypothesized that collagen XII deficiency may cause ACL injury. To elucidate the influence of collagen XII deficiency on ACL, we analyzed a mouse model deficient for Col12a1. Four- to 19-week-old male Col12a1^-/- and wild-type control mice were used for gait analysis; histological and immunofluorescent analysis of collagen XII, and real-time RT-PCR evaluation of Col12a1 mRNA expression. The Col12a1^-/- mice showed an abnormal gait with an approximately 2.7-fold increase in step angle, suggesting altered step alignment. Col12a1^-/- mice displayed 20–60% ACL discontinuities, but 0% discontinuity in the posterior cruciate ligament. No discontinuities in knee ligaments were found in wild-type mice. Collagen XII mRNA expression in the ACL tended to decrease with aging. Our study demonstrates for the first time that collagen XII deficiency increases the risk of ACL injury. Full article

(This article belongs to the Special Issue Strategies for the Prevention of Knee Osteoarthritis)

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9 pages, 243 KiB

Open AccessArticle

Explanatory Factors for Periprosthetic Infection in Total Knee Arthroplasty

by Alberto Delgado-González, Juan José Morales-Viaji, Guillermo Criado-Albillos, Adoración del Pilar Martín-Rodríguez, Josefa González-Santos, Remedios López-Liria, Carla Collazo-Riobo, Raúl Soto-Cámara and Jerónimo J. González-Bernal

J. Clin. Med. 2021, 10(11), 2315; https://doi.org/10.3390/jcm10112315 - 26 May 2021

Cited by 1 | Viewed by 2146

Abstract

There are many studies whose results reveal possible risk factors for developing an infection after a total knee arthroplasty (TKA). The objective of this study is to analyse the risk factors that depend on the hospital and, especially, if the patellar replacement influences [...] Read more.

There are many studies whose results reveal possible risk factors for developing an infection after a total knee arthroplasty (TKA). The objective of this study is to analyse the risk factors that depend on the hospital and, especially, if the patellar replacement influences the appearance of periprosthetic infection. A retrospective study was performed, where data from the electronic registry of patients of people over 18 and who had undergone TKA, between the years 2015 and 2018, were reviewed. Dependent variables on the patients and the health care system were collected. The possible associations between the factors and the appearance of infection after TKA were studied using univariate and multivariate regression analyses. A total of 907 primary knee arthroplasties were included in the study. Those patients who had their patella replaced had a significantly higher risk of developing an infection (OR 2.07; 95% confidence interval 1.01–6.31). Likewise, patients who underwent surgery by surgeons with more than 10 years of experience were more than twice as likely to become infected than those operated on by younger surgeons (OR 2.64; 95%CI 1.01–6.97). Male patients were also found to be three times more likely to be infected than women (OR 2.99; 95%CI 1.32–5.74). Those interventions that were longer had a higher risk of infection. The same happened with patients who stayed in the hospital for a longer period of time. The rest of the variables did not show statistically significant results. In this study, it was found that the replacement of the patella may be a factor of infection, but it should be corroborated with randomized clinical trials. Furthermore, patients who underwent longer surgeries or those with prolonged hospital stays should be closely monitored to detect infection as soon as possible and establish the most appropriate treatment. Full article

(This article belongs to the Special Issue Strategies for the Prevention of Knee Osteoarthritis)

Review

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12 pages, 4582 KiB

Open AccessReview

Knee Pain from Osteoarthritis: Pathogenesis, Risk Factors, and Recent Evidence on Physical Therapy Interventions

by Jean-Philippe Berteau

J. Clin. Med. 2022, 11(12), 3252; https://doi.org/10.3390/jcm11123252 - 07 Jun 2022

Cited by 11 | Viewed by 5079

Abstract

For patients presenting knee pain coming from osteoarthritis (OA), non-pharmacological conservative treatments (e.g., physical therapy interventions) are among the first methods in orthopedics and rehabilitation to prevent OA progression and avoid knee surgery. However, the best strategy for each patient is difficult to [...] Read more.

For patients presenting knee pain coming from osteoarthritis (OA), non-pharmacological conservative treatments (e.g., physical therapy interventions) are among the first methods in orthopedics and rehabilitation to prevent OA progression and avoid knee surgery. However, the best strategy for each patient is difficult to establish, because knee OA’s exact causes of progression are not entirely understood. This narrative review presents (i) the most recent update on the pathogenesis of knee OA with the risk factors for developing OA and (ii) the most recent evidence for reducing knee pain with physical therapy intervention such as Diathermy, Exercise therapy, Ultrasounds, Knee Brace, and Electrical stimulation. In addition, we calculated the relative risk reduction in pain perception for each intervention. Our results show that only Brace interventions always reached the minimum for clinical efficiency, making the intervention significant and valuable for the patients regarding their Quality of Life. In addition, more than half of the Exercise and Diathermy interventions reached the minimum for clinical efficiency regarding pain level. This literature review helps clinicians to make evidence-based decisions for reducing knee pain and treating people living with knee OA to prevent knee replacement. Full article

(This article belongs to the Special Issue Strategies for the Prevention of Knee Osteoarthritis)

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