The effect of marginal osteophytes on reduction of varus‐valgus instability in osteoarthritic knees

Abstract

The varus-valgus stability of M knees with unicompartmental osteoarthritis was studied in vivo at the time of total knee replacement. Intact osteoarthritic knees had an average of 11.0" of varus-valgus motion. Removal of osteophytes from the osteoarthritic compartment significantly increased the motion to 13.1" (P < 0.05), while subsequent removal of osteophytes from the nonosteoarthritic compartment further increased motion to 14.7" ( P < 0.025). In primarily unicompartmental osteoarthritis, marginal osteophytes appear to stabilize osteoarthritic knees, but can cause fixed deformity.

Characterisation of size and direction of osteophyte in knee osteoarthritis: a radiographic study

“…12 In experimental models of OA, osteophyte formation in an unstable joint is promoted by joint movement 13 and inhibited by immobilisation. 24 Removal of osteophytes during total arthroplasty for knee OA increases instability, 7 indicating that osteophyte can stabilise the OA joint. To best achieve this splinting function, osteophyte may need to grow laterally to widen the articular surface.…”

“…1 3 Although osteophyte is viewed as a remodelling and reparative feature of OA, the factors that determine osteophyte formation and growth are unknown. Growth factors influence both chondrocyte synthesis and osteophyte formation in experimental joint damage, 4 5 and evidence from animal 6 and human studies [7][8][9] shows that cartilage damage initiates "secondary" osteophyte growth. However, osteophyte may also develop as an isolated feature associated with age 10 and precede rather than follow cartilage loss in animal studies.…”

In vivo microfocal computed tomography and micro–magnetic resonance imaging evaluation of antiresorptive and antiinflammatory drugs as preventive treatments of osteoarthritis in the rat

“…Mediators of inflammation secreted by the synovium, such as interleukin-1, tumor necrosis factor ␣, and transforming growth factor ␤, are believed to be involved in osteophytogenesis (4,5). Osteophytes are known to cause joint stiffness by limiting the movement of the joint (6) and leading to fixed bony deformity, and thus are permanent bony changes that increase the severity of OA, and are strong predictors of OA-related pain (7). Therefore, the reduction of osteophyte incidence using drugs known to influence bone mass (such as the bisphosphonates), and/or drugs capable of blocking the potential costimulation of osteophytogenesis by mediators of inflammation (such as nonsteroidal antiinflammatory drugs [NSAIDs]), remains a viable disease-modifying goal of OA therapy.…”

Hand Osteoarthritis — Clinical Presentation, Phenotypes and Management

“…Osteophytes consist of both new bone and cartilage formation, which arise from progenitor cells, indicating that the sequelae of joint destruction induces a pluripotent cell response [32]. The exact function of osteophytes in osteoarthritis is yet be understood but can been seen as an adaptive mechanism against joint injury to stabilize the joint [33,34]. Analysis of osteophytes at different developmental stages has shown a sequential process of differentiation and the presence of the anabolic factor transforming growth factor-beta (TGF-β) [32].…”