Association between changes in knee load and effusion-synovitis: evidence of mechano-inflammation in knee osteoarthritis using high tibial osteotomy as a model

Atkinson, Hayden F.; Birmingham, Trevor B.; Primeau, Codie A.; Schulz, J.M.; Appleton, T.; Pritchett, Stephany; Giffin, J. Robert

doi:10.1016/j.joca.2020.11.007

Cited by 21 publications

(14 citation statements)

References 40 publications

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“…The underlying mechanism of the associations between quadriceps strength and structural abnormalities is unclear, but biomechanical and biochemical pathways have been involved [12]. As a dynamic stabilizer of knee joint, quadriceps may help to reduce intra-articular stress and maintain biomechanical environment [37,38], and indeed, there have been studies reporting that stable biomechanical environment was associated with knee structural changes [39][40][41]. It appears that quadriceps could protect joint structures through biomechanical pathways.…”

Section: Discussionmentioning

confidence: 99%

Quadriceps strength is negatively associated with knee joint structural abnormalities—data from osteoarthritis initiative

Gong

et al. 2022

BMC Musculoskelet Disord

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Objective The aim of this study was to explore the longitudinal associations between baseline quadriceps strength and knee joint structural abnormalities in knee osteoarthritis (KOA). Methods This study is a longitudinally observational study based on Osteoarthritis Initiative (OAI) cohort, including men and women aged 45–79. Quadriceps strength was measured by isometric knee extension testing at baseline. Knee joint structural abnormalities, including cartilage damage, bone marrow lesions (BMLs), effusion-synovitis and Hoffa-synovitis, were evaluated by Magnetic Resonance Imaging Osteoarthritis Knee Score (MOAKS) at baseline and 1-year follow-up. Generalized estimating equations were employed to examine the associations between quadriceps strength and knee structural abnormalities. All analyses were stratified by sex. Results One thousand three hundred thirty-eight participants (523 men and 815 women) with a mean age of 61.8 years and a mean BMI of 29.4 kg/m2 were included in this study. For men, no significantly longitudinal association of quadriceps strength with structural abnormalities was detected. In contrast, quadriceps strength was significantly and negatively associated with changes in cartilage damage and BMLs in lateral patellofemoral joint (PFJ) (cartilage damage: OR: 0.91, 95% CI 0.84 to 0.99, P = 0.023; BMLs: OR: 0.85, 95% CI 0.74 to 0.96, P = 0.011) and effusion-synovitis (OR = 0.88, 95% CI 0.78 to 0.99, P = 0.045) among females longitudinally. Higher quadriceps strength was significantly associated with less progression of lateral PFJ cartilage damage, BMLs and effusion-synovitis in females. Conclusions Higher quadriceps strength was associated with changes in cartilage damage and BMLs within the lateral PFJ and effusion-synovitis among females, suggesting the potential protective role of quadriceps strength on joint structures in women.

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Section: Discussionmentioning

confidence: 99%

Quadriceps strength is negatively associated with knee joint structural abnormalities—data from osteoarthritis initiative

Gong

et al. 2022

BMC Musculoskelet Disord

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“…Moreover, improved cartilage scores were noted in 38% of participants, and various synovial markers of inflammation were reduced by 14e49%. Another study investigating unilateral medial open wedge high tibial osteotomy with internal fixation in 36 participants showed a frontal plane correction of approximately 7 , but also reduced effusion-synovitis volume, KAM and KAM impulse, and shorter T2 relaxation times in the medial tibiofemoral joint 93,94 . Together, these studies suggest that the surgical correction of severe varus alignment may result not only in biomechanical improvements but also in improvements in inflammation and cartilage health.…”

Section: Biomechanics In Oa Treatmentmentioning

confidence: 98%

Osteoarthritis year in review 2021: mechanics

Harlaar

Macri

Wesseling

2022

Osteoarthritis and Cartilage

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“…A possible explanation is that joint malalignment contributes to synovial inflammation. Synovial inflammation decreases in patients that receive extra-articular correction of varus malalignment of the knee join ( 147 – 149 ). This shows that inflammation is induced by pathological loading of the knee cartilage and contributes to a negative feedback of inflammation and cartilage destruction.…”

Section: Other Contributing Factors In Ptoa Developmentmentioning

confidence: 99%

Post-traumatic knee osteoarthritis; the role of inflammation and hemarthrosis on disease progression

et al. 2022

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Knee injuries such as anterior cruciate ligament ruptures and meniscal injury are common and are most frequently sustained by young and active individuals. Knee injuries will lead to post-traumatic osteoarthritis (PTOA) in 25–50% of patients. Mechanical processes where historically believed to cause cartilage breakdown in PTOA patients. But there is increasing evidence suggesting a key role for inflammation in PTOA development. Inflammation in PTOA might be aggravated by hemarthrosis which frequently occurs in injured knees. Whereas mechanical symptoms (joint instability and locking of the knee) can be successfully treated by surgery, there still is an unmet need for anti-inflammatory therapies that prevent PTOA progression. In order to develop anti-inflammatory therapies for PTOA, more knowledge about the exact pathophysiological mechanisms and exact course of post-traumatic inflammation is needed to determine possible targets and timing of future therapies.

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Association between changes in knee load and effusion-synovitis: evidence of mechano-inflammation in knee osteoarthritis using high tibial osteotomy as a model

Cited by 21 publications

References 40 publications

Quadriceps strength is negatively associated with knee joint structural abnormalities—data from osteoarthritis initiative

Quadriceps strength is negatively associated with knee joint structural abnormalities—data from osteoarthritis initiative

Osteoarthritis year in review 2021: mechanics

Post-traumatic knee osteoarthritis; the role of inflammation and hemarthrosis on disease progression

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