Outcomes after Total Knee Arthroplasty for post-traumatic arthritis

Bala, Abiram; Penrose, Colin T.; Seyler, Thorsten M.; Mather, Richard C.; Wellman, Samuel S.; Bolognesi, Michael P.

doi:10.1016/j.knee.2015.10.004

Cited by 70 publications

(64 citation statements)

References 33 publications

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“…Knee pain, stiffness and muscular movement dysfunction are the main clinical manifestations of PTKO (17). Among them, myodynamia reduction of quadriceps femoris muscles is a characteristic manifestation of PTKO muscle dysfunction (18). In the present study, myrtol treatment significantly improved knee osteoarthritis, inhibited the osteoarthritis score, and reversed the PTKO-induced changes in subchondral bone thickness, subchondral bone density, BV/TV and trabecular bone spacing.…”

Section: Discussionsupporting

confidence: 57%

Myrtol improves post‑traumatic knee osteoarthritis by regulation of reactive oxygen species, transforming growth factor β1 and apoptosis in a mouse model

Duan

Zhang

et al. 2017

Exp Ther Med

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Abstract. The present study tested whether myrtol improves post-traumatic knee osteoarthritis (PTKO) by regulating the reactive oxygen species (ROS), transforming growth factor β1 (TGF-β1) and apoptosis in a mouse model. PTKO model mice were administered with 150, 300 or 450 mg/kg myrtol for 8 weeks. ELISA analysis was used to measure tumor necrosis factor-α, interleukin-6, malondialdehyde, superoxide dismutase, reactive oxygen species and TGF-β1 levels. Caspase-3 and Bax protein expressions were analyzed using western blot analysis. In the current study, treatment with myrtol improved the tissue damage and osteoarthritis score, while it also reversed the subchondral bone thickness, subchondral bone density, trabecular bone volume/relative trabecular bone volume ratio and trabecular bone spacing in PTKO mice. The activity of tumor necrosis factor α, interleukin-6, TGF-β1, malondialdehyde, superoxide dismutase and ROS were effectively inhibited, and the protein expression of caspase-3 and Bax were clearly suppressed by treatment with myrtol in a mouse model of PTKO. In conclusion, the results demonstrated that myrtol treatment improved PTKO through the suppression of inflammation, oxidative stress, ROS, TGF-β1 and Bax/caspase-3 in mice, and myrtol may be a potential agent for clinical therapy. IntroductionPost-traumatic knee osteoarthritis (PTKO) is a common disease presenting joint degenerative changes (1). PTKO is most frequently detected on the elderly population, with an estimated 15 million cases in China (2). Survey data in the United States also demonstrated that PTKO is the second most common cause of disability in males >50 years old, after cardiovascular disease (3). Thus, prevention and treatment of PTKO have become one of the most difficult issues in clinical practice at present (3).Transforming growth factor β1 (TGF-β1) is a member of the TGF-β superfamily and a type of multifunctional polypeptide growth factor (4). It participates in the proliferation and differentiation processes of diversified cell types, such as chondrocytes, epithelial cells and fibroblasts, and has essential regulating effects in the developing process of embryo, organs and cartilage. Studies have demonstrated that, in the chondrocytes of rabbits and cattle, TGF-β1 can regulate the synthesis of proteoglycan (4,5). In addition, TGF-β1 has the ability to promote synthesis of type II collagen by reducing consumption of proteoglycan in order to repair the cartilage (6). Therefore, it can be seen that TGF-β1 serves an important regulatory role in the process of maintaining chondrocytes and cartilage (7).PTKO is a chronic autoimmune disease characterized by joint synovitis, and its early lesion mainly presents on the synovial membrane (8). Synovial cells are subject to rapid proliferation due to autoimmune response resulting from an external stimulus, such as infection or trauma (9); thus, the infiltration of diversified inflammatory cells on the synovial membrane is enhanced (9). In addition, a large number of cytokines, inflammator...

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Section: Discussionsupporting

confidence: 57%

Myrtol improves post‑traumatic knee osteoarthritis by regulation of reactive oxygen species, transforming growth factor β1 and apoptosis in a mouse model

Duan

Zhang

et al. 2017

Exp Ther Med

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“…Bala et al. (2015) published a large retrospective database study involving 3,509 patients (with an average follow-up of 5 years) and reported an odds ratio of 1.2 for revision and an increased risk of some postoperative complications, such as infections and wound complications. Furthermore, 2 recent studies based on data from the Finnish Arthroplasty Register concluded that there was a similar increased risk of revision—either due to infection or for any reason—in knees with posttraumatic osteoarthritis when compared to OA (Jamsen et al.…”

Section: Discussionmentioning

confidence: 99%

Increased risk of early and medium-term revision after post-fracture total knee arthroplasty

et al. 2017

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Background and purposeTotal knee arthroplasty (TKA) due to posttraumatic fracture osteoarthritis (PTFA) may be associated with inferior prosthesis survival. This study is the first registry-based study solely addressing this issue. Both indications and predictors for revision were identified.Patients and methods52,518 primary TKAs performed between 1997 and 2013 were retrieved from the Danish Knee Arthroplasty Register (DKR). 1,421 TKAs were inserted due to PTFA and 51,097 due to primary osteoarthritis (OA). Short-term (< 1 year), medium-term (1–5 years), and long-term (> 5 years) implant survival were analyzed using Kaplan-Meier analysis and Cox regression after age stratification (< 50, 50–70, and >70 years). In addition, indications for revision and characteristics of TKA patients with subsequent revision were determined.ResultsDuring the first 5 years, TKAs inserted due to PTFA had a higher risk of revision than OA (with adjusted hazard ratio ranging from 1.5 to 2.4 between age categories). After 5 years, no significant differences in the risk of revision were seen between the groups. Infection and aseptic loosening were the most common causes of revision in both groups, but TKA instability was a more frequent indication for revision in the PTFA group. In both groups, the revision rates were higher with younger age and extended duration of primary surgery.InterpretationWe found an increased risk of early and medium-term revision of TKAs inserted due to previous fractures in the distal femur and/or proximal tibia. Predictors of revision such as age <50 years and extended duration of primary surgery were identified, and revision due to instability occurred more frequently in TKAs performed due to previous fractures.

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“…Indeed, 22% of TKAs for PTOA were performed in patients aged < 65 years, compared with 9% of primary OA patients. 26 Accordingly, the ACLT + climbing model showed more severe articular degeneration and massive osteophyte formation not only through joint instability induced by ACLT but also through mechanical loading force by climbing exercise. Therefore, excessive impact to the articular cartilage and/or unstable and abnormal force to the joint might play critical roles in PTOA progression.…”

Section: Discussionmentioning

confidence: 93%

“…Additionally, among patients undergoing total knee arthroplasty (TKA), PTOA patients were younger than primary OA patients according to the analysis using the entire Medicare database in the United States. Indeed, 22% of TKAs for PTOA were performed in patients aged < 65 years, compared with 9% of primary OA patients . Accordingly, the ACLT + climbing model showed more severe articular degeneration and massive osteophyte formation not only through joint instability induced by ACLT but also through mechanical loading force by climbing exercise.…”

Section: Discussionmentioning

confidence: 99%

Attenuation of Post‐Traumatic Osteoarthritis After Anterior Cruciate Ligament Injury Via Inhibition of Hedgehog Signaling

Takada

Nakamura

Sabanai

et al. 2019

Journal Orthopaedic Research

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We aimed to investigate whether post‐traumatic osteoarthritis (PTOA) progression is appropriately represented by a PTOA mouse model using a unique climbing cage to add mechanical loading after anterior cruciate ligament (ACL) transection and to determine how Hedgehog signaling inhibition prevents PTOA progression by observing time‐dependent morphological changes. This controlled laboratory study histologically compared mice with surgically‐induced ACL transection (ACLT) and those with voluntary increased activity in a climbing cage from 1 week postoperatively (ACLT + climbing). We generated conditional knockout (cKO) mice with a deleted Smoothened (Smo) gene. Time‐dependent histopathological, immunohistochemical, and gene expression analyses were performed. The ACLT + climbing group showed more severe cartilage defects and massive osteophyte formation than the ACLT group. Smo deletion significantly suppressed PTOA progression. The time‐dependent assessment revealed cartilaginous processes of equivalent size at the posterior tibial margin in the Smo cKO and control mice at 4 weeks postoperatively. However, at 8 weeks postoperatively, mature ossifying lesions were detected in the controls but not in Smo cKO mice. In the articular cartilage, ADAMTS5 and RUNX2 expression were observed in hypertrophic chondrocytes near the defective cartilage in controls but not in Smo cKO mice. Climbing exercise after ACLT accelerated PTOA progression more severely not only through increasing joint instability induced by ACLT but also through mechanical loading force induced by climbing exercise. Hedgehog signaling inhibition attenuated PTOA progression by suppressing chondrocyte hypertrophy induced by mechanical loads, to which ACL‐deficient athletes are usually exposed. Thus, Hedgehog signaling inhibition may be a therapeutic option to prevent arthritic changes in athletes. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:609–619, 2020

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Outcomes after Total Knee Arthroplasty for post-traumatic arthritis

Cited by 70 publications

References 33 publications

Myrtol improves post‑traumatic knee osteoarthritis by regulation of reactive oxygen species, transforming growth factor β1 and apoptosis in a mouse model

Myrtol improves post‑traumatic knee osteoarthritis by regulation of reactive oxygen species, transforming growth factor β1 and apoptosis in a mouse model

Increased risk of early and medium-term revision after post-fracture total knee arthroplasty

Attenuation of Post‐Traumatic Osteoarthritis After Anterior Cruciate Ligament Injury Via Inhibition of Hedgehog Signaling

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