Osteoarthritis (OA) is a common degenerative disease; however, its exact pathophysiology and early diagnosis are still a challenge. Growing attention to the exosomes may inspire innovations that would make the current management of OA more effective. The exosomes in synovial fluid are relatively stable, and they can be easily isolated by the relatively noninvasive procedure of liquid biopsy to provide diagnostic and monitoring value. Some miRNAs (miR-504, miR-146a, miR-26a, miR-200c, and miR-210) have been known to be secreted in exosomes of OA patients. On the other hand, intraarticular injection of platelet-rich plasma (PRP) is becoming a popular therapy for OA patients. PRP is also a source of exosomes and their numerous contents. It is evident from the literature that PRP-derived exosomes can induce chondrogenic gene expression in OA chondrocytes. Here, we review the latest findings on the roles of exosomes in OA with the emphasis on PRP-derived exosomes and their potential applications for treating OA.
Electrotherapy or electrical stimulation (ES) is a part of clinical intervention in the rehabilitation field. With rehabilitation intervention, electrotherapy may be provided as a treatment for pain relief, strengthening, muscle education, wound recovery, or functional training. Although these interventions may not be considered as the primary therapy for patients, the advantages of the ease of operation, lower costs, and lower risks render ES to be applied frequently in clinics. There have also been emerging ES tools for brain modulation in the past decade. ES interventions are not only considered analgesics but also as an important assistive therapy for motor improvement in orthopedic and neurological rehabilitation. In addition, during the coronavirus disease pandemic, lockdowns and self-quarantine policies have led to the discontinuation of orthopedic and neurological rehabilitation interventions. Therefore, the feasibility and effectiveness of home-based electrotherapy may provide opportunities for the prevention of deterioration or extension of the original therapy. The most common at-home applications in previous studies showed positive effects on pain relief, functional ES, muscle establishment, and motor training. Currently, there is a lack of certain products for at-home brain modulation; however, transcranial direct current stimulation has shown the potential of future home-based rehabilitation due to its relatively small and simple design. We have organized the features and applications of ES tools and expect the future potential of remote therapy during the viral pandemic.
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