Osteoarthritis, an old wine in a new bottle!

Muthu, Sathish

doi:10.5312/wjo.v14.i1.1

Cited by 9 publications

(5 citation statements)

References 14 publications

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“…These observations still hold true; and the avascular as well as aneural nature of cartilage substantially limits its ability to self-regenerate[ 84 ]. If left untreated, a transgressed cartilage gradually results in severe osteoarthritis of the joint and ensuing long-standing disability[ 85 ].…”

Section: Discussionmentioning

confidence: 99%

Does progress in microfracture techniques necessarily translate into clinical effectiveness?

Muthu,

Viswanathan,

Sakthivel

et al. 2024

World J Orthop

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BACKGROUND Multitudinous advancements have been made to the traditional microfracture (MFx) technique, which have involved delivery of various acellular 2nd generation MFx and cellular MFx-III components to the area of cartilage defect. The relative benefits and pitfalls of these diverse modifications of MFx technique are still not widely understood. AIM To comparatively analyze the functional, radiological, and histological outcomes, and complications of various generations of MFx available for the treatment of cartilage defects. METHODS A systematic review was performed using PubMed, EMBASE, Web of Science, Cochrane, and Scopus. Patients of any age and sex with cartilage defects undergoing any form of MFx were considered for analysis. We included only randomized controlled trials (RCTs) reporting functional, radiological, histological outcomes or complications of various generations of MFx for the management of cartilage defects. Network meta-analysis (NMA) was conducted in Stata and Cochrane’s Confidence in NMA approach was utilized for appraisal of evidence. RESULTS Forty-four RCTs were included in the analysis with patients of mean age of 39.40 (± 9.46) years. Upon comparing the results of the other generations with MFX-I as a constant comparator, we noted a trend towards better pain control and functional outcome (KOOS, IKDC, and Cincinnati scores) at the end of 1-, 2-, and 5-year time points with MFx-III, although the differences were not statistically significant (P > 0.05). We also noted statistically significant Magnetic resonance observation of cartilage repair tissue score in the higher generations of microfracture (weighted mean difference: 17.44, 95% confidence interval: 0.72, 34.16, P = 0.025; without significant heterogeneity) at 1 year. However, the difference was not maintained at 2 years. There was a trend towards better defect filling on MRI with the second and third generation MFx, although the difference was not statistically significant (P > 0.05). CONCLUSION The higher generations of traditional MFx technique utilizing acellular and cellular components to augment its potential in the management of cartilage defects has shown only marginal improvement in the clinical and radiological outcomes.

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Section: Discussionmentioning

confidence: 99%

Does progress in microfracture techniques necessarily translate into clinical effectiveness?

Muthu,

Viswanathan,

Sakthivel

et al. 2024

World J Orthop

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“…[ 15 , 48 ]. However, the impact of the individual components on the therapeutic efficiency of the BMAC needs further exploration [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing the Yield of Progenitor Cells in Bone Marrow Aspiration Concentrate—A Retrospective Analysis of 58 Patients

Muthu

Jeyaraman

Narula³

et al. 2023

Biomedicines

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This study aims to identify the role of subjective factors (age, sex, and comorbidities) and procedure-specific factors (aspiration volume) in influencing the yield of progenitor cells in bone marrow aspiration concentrate (BMAC) harvested from the iliac crest. A retrospective analysis was conducted on 58 patients (male:female = 31:27; mean age: 52.56 ± 18.14 years) who underwent BMAC therapy between January 2020 and June 2021. The factors analyzed include individual factors such as age, sex, and comorbid conditions, and procedural factors such as aspirate volume. The mononuclear cell (MNC) count and colony-forming unit (CFU) assay were used to assess the yield of progenitors in the aspirate. Pearson’s correlation test was performed for the age, aspirate volume, and outcome parameters, such as MNC and CFU. We used the chi-square test to analyze the role of sex and comorbidities on cellular yield. The mean volume of aspirate used for BMAC therapy was 66.65 (±17.82) mL. The mean MNC count of the BMAC was 19.94 (±16.34) × 106 cells, which formed 11 (±12) CFUs. Evidence of statistically significant positive associations was noted between the CFUs developed from the BMAC and the MNC count within them (r = 0.95, p < 0.001). The sex of the individual did not play any significant role in MNC count (p = 0.092) or CFUs formed (p = 0.448). The age of the individual showed evidence of a statistically significant negative association with the MNC count (r = −0.681, p < 0.001) and CFUs (r = −0.693, p < 0.001), as did the aspiration volume with the MNC count (r = −0.740, p < 0.001) and CFUs (r = −0.629, p < 0.001). We also noted a significant reduction in the MNC count (p = 0.002) and CFUs formed (p = 0.004) when the patients presented comorbidities. Individual factors such as age, comorbid conditions, and procedure factors such as aspirate volume significantly affected the yield of progenitor cells in the BMAC. The sex of the individual did not influence the yield of progenitor cells in BMAC.

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“…In fact, these clinical manifestations reflect various phenotypes of OA, including chronic pain phenotype, inflammatory phenotype, mechanical overload phenotype, minimal arthropathy phenotype, etc. [ 2 ]. The prevalence of OA is increasing year-over-year, with over 500 million people affected worldwide [ 3 ], and it ranks as the 11th most disabling disease in the world.…”

Section: Development and Characterization Of Osteoarthritismentioning

confidence: 99%

“…MSCs regulate local inflammation, apoptosis, and cell proliferation by secreting soluble factors and extracellular vesicles into the surrounding environment [ 55 ]. In summary, the mechanisms by which MSCs act on OA mainly rely on [ 1 ] homing to the site of cartilage defects, [ 2 ] chondrogenic differentiation to repair cartilage defects, and [ 3 ] paracrine secretion of tissue repair factors. Among the factors secreted by MSCs, the exosomes are involved in many physiological and pathological processes of OA.…”

Section: Landscape Of Mscs-mediated Therapies In Osteoarthritismentioning

confidence: 99%

Enhancement of the therapeutic efficacy of mesenchymal stem cell-derived exosomes in osteoarthritis

Zhang,

Zhao,

Sun

et al. 2023

Cell Mol Biol Lett

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Osteoarthritis (OA), a common joint disorder with articular cartilage degradation as the main pathological change, is the major source of pain and disability worldwide. Despite current treatments, the overall treatment outcome is unsatisfactory. Thus, patients with severe OA often require joint replacement surgery. In recent years, mesenchymal stem cells (MSCs) have emerged as a promising therapeutic option for preclinical and clinical palliation of OA. MSC-derived exosomes (MSC-Exos) carrying bioactive molecules of the parental cells, including non-coding RNAs (ncRNAs) and proteins, have demonstrated a significant impact on the modulation of various physiological behaviors of cells in the joint cavity, making them promising candidates for cell-free therapy for OA. This review provides a comprehensive overview of the biosynthesis and composition of MSC-Exos and their mechanisms of action in OA. We also discussed the potential of MSC-Exos as a therapeutic tool for modulating intercellular communication in OA. Additionally, we explored bioengineering approaches to enhance MSC-Exos’ therapeutic potential, which may help to overcome challenges and achieve clinically meaningful OA therapies.

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Osteoarthritis, an old wine in a new bottle!

Cited by 9 publications

References 14 publications

Does progress in microfracture techniques necessarily translate into clinical effectiveness?

Does progress in microfracture techniques necessarily translate into clinical effectiveness?

Factors Influencing the Yield of Progenitor Cells in Bone Marrow Aspiration Concentrate—A Retrospective Analysis of 58 Patients

Enhancement of the therapeutic efficacy of mesenchymal stem cell-derived exosomes in osteoarthritis

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