Radiographic patterns and associations of osteoarthritis of the knee in patients referred to hospital.

Ledingham, Joanna; Regan, Marian; Jones, Adrian; Doherty, Michael

doi:10.1136/ard.52.7.520

Cited by 255 publications

(173 citation statements)

References 27 publications

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“…In vitro, calcium-containing crystals induce the release of catabolic cytokines and proteases from synovial cells and chondrocytes (Cheung 2001). Clinically, their presence predicts increased severity of joint damage and more rapid progression of joint destruction (Ledingham et al 1993;Nalbant et al 2003). …”

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Osteopontin promotes pathologic mineralization in articular cartilage

et al. 2007

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Calcium pyrophosphate dihydrate (CPPD) crystals are commonly found in osteoarthritic joint tissues, where they predict severe disease. Unlike other types of calcium phosphate crystals, CPPD crystals form almost exclusively in the pericellular matrix of damaged articular cartilage, suggesting a key role for the extracellular matrix milieu in their development. Osteopontin is a matricellular protein found in increased quantities in the pericellular matrix of osteoarthritic cartilage. Osteopontin modulates the formation of calcium-containing crystals in many settings. We show here that osteopontin stimulates ATP-induced CPPD crystal formation by chondrocytes in vitro. This effect is augmented by osteopontin's incorporation into extracellular matrix by transglutaminase enzymes, is only modestly affected by its phosphorylation state, and is inhibited by integrin blockers. Surprisingly, osteopontin stimulates transglutaminase activity in cultured chondrocytes in a dose responsive manner. As elevated levels of transglutaminase activity promote extracellular matrix changes that permit CPPD crystal formation, this is one possible mechanism of action. We demonstrate the presence of osteopontin in the pericellular matrix of chondrocytes adjacent to CPPD deposits and near active transglutaminases. Thus, osteopontin may play an important role in facilitating CPPD crystal formation in articular cartilage. KeywordsOsteopontin; Calcium pyrophosphate dihydrate; Transglutaminase; Osteoarthritis Pathologic matrix mineralization is a common occurrence in joints affected by late stage osteoarthritis. Of synovial fluids sampled at the time of knee replacement, for example, 60% contain pathologic calcium-containing crystals (Derfus et al. 2002). Both calcium pyrophosphate dihydrate (CPPD) and hydroxyapatite-like basic calcium phosphate (BCP) crystals occur in osteoarthritic joints. Although the role that calcium-containing crystals play in osteoarthritis is not fully understood, there is ample evidence to suggest that these crystals are active participants in joint damage. In vitro, calcium-containing crystals induce the release of catabolic cytokines and proteases from synovial cells and chondrocytes (Cheung 2001). Clinically, their presence predicts increased severity of joint damage and more rapid progression of joint destruction (Ledingham et al. 1993;Nalbant et al. 2003).Corresponding Author: Ann K. Rosenthal, MD Rheumatology Section/ cc-111W Zablocki VA Medical Center 5000 W. National Ave. Milwaukee, WI 53295-1000 TEL: 414-384-2000ann.rosenthal@med.va.gov. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply ...

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Osteopontin promotes pathologic mineralization in articular cartilage

et al. 2007

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“…Out of the 98 patients (96 females) who underwent knee replacement during the study period 14 were excluded according to the exclusion criteria (7 had previous knee surgery, 4 Table 2 gives the average macroscopic scores. Pairwise comparisons showed that varus knees had higher macroscopic damage scores in the medial than the lateral compartment (p<0.0001), while the valgus knees had markedly higher scores in the lateral than the medial compartment (p<0.0001).…”

Section: Resultsmentioning

confidence: 99%

“…The medial compartment of the knee transmits 60%-70% of the body weight and this partly explains why osteoarthritis in the medial compartment is commoner than osteoarthritis in the lateral [3,4]. The weight distribution to each compartment of the knee is based on the angle between the femur and the tibia described as the alignment of the knee joint [5].…”

Section: Introductionmentioning

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Relationship between the goniometric alignment and articular cartilage damage in knee osteoarthritis

et al. 2017

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Introduction Osteoarthritis of the knee is common among the elderly. The alignment of the knee plays an important part in disease progression. Objectives The aim was to determine the relationship between goniometric measurement of malalignment and gross and histological damage to articular cartilages of osteoarthritic knees. Methods Anterior plane knee alignment was measured using a handheld metal goniometer in 84 patients awaiting knee replacement. Articular cartilages removed at surgery were stained and examined for macroscopic and microscopic damage which were quantified with macroscopic visual assessment score and Mankins histochemical score, respectively. The relationship between the type of knee angulation and macroscopic and microscopic damage to medial and lateral compartments was analyzed using analysis of variance (ANOVA), and the relationship between the degree of angulation and the degree of damage was determined using multiple linear regression models. Results Varus knees had markedly higher macroscopic damage scores in the medial than the lateral compartment (p<0.0001), while valgus knees showed the opposite (p<0.0001). The knee angulation, together with age and BMI, predicted 54% of the macroscopic (p<0.0001) and 60% of the microscopic damage (p<0.0001) in varus knees. Conclusion Anterior plane goniometric knee alignment is a significant predictor of the articular cartilage damage present in an osteoarthritic knee. Goniometric measurement is a valuable tool in assessing the disease severity as it is a simple, safe and cost-effective method.

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“…The medial compartment is more commonly affected than the lateral compartment in osteoarthritis (67% and 17%, respectively). 3 Varus alignment of the lower limbs increases the risk of incident knee osteoarthritis and also increases the risk of disease progression in patients with osteoarthritis. 4 Apart from static lower limb alignment, dynamic varus thrust during the gait cycle is also independently associated with osteoarthritis progression in the knee.…”

Section: Resultsmentioning

confidence: 99%

Prospective study on the effects of orthotic treatment for medial knee osteoarthritis in Chinese patients: clinical outcome and gait analysis

Fu¹,

Lie²,

Ng³

et al. 2015

Hong Kong Med J

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Radiographic patterns and associations of osteoarthritis of the knee in patients referred to hospital.

Cited by 255 publications

References 27 publications

Osteopontin promotes pathologic mineralization in articular cartilage

Osteopontin promotes pathologic mineralization in articular cartilage

Relationship between the goniometric alignment and articular cartilage damage in knee osteoarthritis

Prospective study on the effects of orthotic treatment for medial knee osteoarthritis in Chinese patients: clinical outcome and gait analysis

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