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PubMed2004

Experimental colitis does not increase the prevalence of ANKENT, a spontaneous joint disease in mice.

A possible relationship between intestinal inflammation and joint disease development was investigated. Clinical symptoms of colitis--diarrhea and rectal bleeding--were confirmed by findings of inflammatory processes in the colon in dextran sodium sulfate-treated mice and joint ankylosing enthesopathy (ANKENT) developed in 12.8 % mice with chronic colitis and 13.6 % mice in the control group. Consequently no significant difference in ANKENT frequency was found between mice with and without chronic colitis and the occurrence of ANKENT in both groups was typical for conventional conditions. ANKENT cannot be triggered solely a generalized inflammatory process in the gut.

Animals↗
PubMedDate not supplied

Correlates with comfort and function after total shoulder arthroplasty for degenerative joint disease.

Although most patients are improved after shoulder arthroplasty, the degree of improvement is variable. The factors contributing to this variability are not well understood. In particular, little information is available regarding the preoperative characteristics of the patient that may influence the quality of the result. This study correlated patient demographics, preoperative health status, and preoperative shoulder function with 3 outcome metrics: comfort, physical role function, and shoulder-specific function. One hundred thirty-four shoulders having total shoulder arthroplasty for degenerative glenohumeral joint disease had an average follow-up of 3.4 +/- 1.8 years. The SF-36 Comfort score improved from 39 to 61 (P < .0001). The SF-36 Physical Role Function score improved from 30 to 52 (P < .0001). The average number of Simple Shoulder Test functions performable (out of 12) improved from 4 to 9 (P < .0001). The strongest correlates with postoperative comfort included preoperative physical function (P < .0001), general health (P < .0001), and social function (P < .001). The strongest correlates with postoperative physical role function included preoperative physical function (P < .0001) and general health (P < .001). The strongest correlates with postoperative shoulder function included male gender (P < .0001), and preoperative physical function (P < .0001), social function (P < .0001), mental health (P < .0001) and shoulder function (P < .0001). These data indicate that the overall well-being of the patient before surgery is strongly correlated with the quality of the outcome from total shoulder arthroplasty for degenerative glenohumeral joint disease.

Adult↗
PubMed1977

Degenerative joint disease in the mouse knee; radiological and morphological observations.

Gross anatomical and radioligical techniques have been used to investigate the form and incidence of degenerative joint disease in the knee joint of an inbred strain of mouse (STR/ORT). The disease was seen radiographically as a thickening of the subchondral bone in the medial tibial and femoral condyles predominantly in the males. In fresh and macerated joints only advanced lesions could be seen with light microscopy and these appeared as concave (tibial) or flattened (femoral) erosions with hard shiny eburnated surfaces. Medial patella dislocation was a common feature of the arthrotic joints and there was associated widespread periarticular heterotopic calcification. These growths started as peripheral exostoses from the patella and as small loci of mineralisation within the synovial tissue but later enlarged into plaques of calcified tissue. Ossific centres within the menisci were present in all knees but became greatly enlarged in the osteoarthrotic joints. Calcification of the collateral ligaments occurred in non-arthrotic joints, especially laterally, but progressed to thick ossification in the medial ligament of arthrotic knees. Eventually all these enlarging sites of calcification and ossification began to fuse together, thus limiting the degree of movement of the joint. There was a statistically significant positive relationship between the severe arthropathy and (a) marked patella dislocation and (b) the presence of calcification in the medial collateral ligament.

Aging↗
PubMed1975

Tarsal degenerative joint disease in cattle: blood and synovial fluid changes.

Tarsal degenerative joint disease (DJD) in 27 cattle was classified as primary or secondary based on age, joint conformation defects, faulty hindlimb alignment, or history of trauma to the affected joint(s). Results of blood and synovial fluid analysis for cattle affected with primary or secondary tarsal DJD were grouped in compilation of data. Cattle with tarsal DJD had significantly (P smaller than 0.01) reduced hemoglobin (Hb) content in comparison to that in control cattle. There was highly significant (P smaller than 0.001) reduction in packed cell volume (PCV). A significant difference was not determined for mean corpuscular hemoglobin concentration (MCHC) values of the 2 groups of cattle. Total white blood cell (WBC) counts closely paralleled each other, although mean proportion of neutrophils was significantly (P smaller than 0.05) greater in cattle affected with tarsal DJD, as were mean proportion of lymphocytes (P smaller than 0.02). Synovial fluid samples were analyzed for physical, biochemical, and cytologic properties. Statistical comparisons were made between values determined for arthritic cattle and control cattle. All samples from cattle with tarsal DJD were transudative. Opacity and flocculation were attributed to the presence of cartilaginous fragments and fibrils. There was significant correlation between increased relative viscosity (RV) and higher grades of mucinous precipitate quality (MPQ; r = +0.294, P smaller than 0.05) for all cattle. Mean alkaline phosphatase (ALP) activity for arthritic cattle was significantly (P smaller than 0.001) reduced, as was the mean activity for lactic dehydrogenase (LDH; P smaller than 0.05). The mean aldolase (ALD) activity for arthritic cattle was increased, whereas mean activity values for glutamic oxalacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT) were reduced. Samples from arthritic cattle had reduced total leukocyte counts and significantly (P smaller than 0.05) increased proportion of macrophages in comparison to the values in control cattle.

Alanine Transaminase↗
PubMed2001

Risk factors associated with hindlimb lameness and degenerative joint disease in the distal tarsus of Icelandic horses.

The aim of this study was to evaluate potential risk factors associated with hindlimb lameness and radiographic signs of degenerative joint disease (DJD) in the distal tarsus in Icelandic horses. The material consisted of riding horses (n = 420) age 6-12 years sired by 17 selected sires representing all major breeding lines, and of riding horses (n = 194) in the same age range sired by other sires. The examination protocol included the following: interview with owners/trainers, assessment of conformation, motion evaluation and radiographic examination. At the interview, data related to factors outside the horse (environmental variables) and data associated directly with the horse (intrinsic variables) were obtained. Data analysis was performed in 2 steps: screening using bivariate analysis, followed by testing with a multivariate logistic regression model. In the multivariate analysis, the factors of sire, age when broken to saddle and stud show participation were strongly associated with the prevalence of lameness. Height at the croup and ability to perform different gaits were also associated with the prevalence of lameness, but to a lesser degree. The risk factors of age, tarsal angle and birthplace were significantly associated with radiographic signs of DJD in the distal tarsus. Neither the variation in applied training intensity, the use of a professional or amateur trainer nor the temperament or front limb action of the individual horse was significantly associated with the prevalence of hindlimb lameness and/or radiographic signs of DJD in the distal tarsus in the Icelandic horse.

Age Factors↗
PubMed1987

Cartilage proteoglycans in synovial fluid and serum in patients with inflammatory joint disease. Relation to systemic treatment.

Proteoglycan concentrations in knee joint synovial fluid and in serum from patients with various inflammatory arthritides were studied using an enzyme-linked immunosorbent assay. Patients with reactive arthritis, calcium pyrophosphate arthropathy, and juvenile rheumatoid arthritis (age less than or equal to 20 years) had the highest synovial fluid concentrations. These values differed significantly (P less than 0.001) from those in patients with rheumatoid arthritis, psoriatic arthropathy, and chronic HLA-B27-associated arthropathy. Rheumatoid arthritis patients receiving low-dose prednisolone treatment had higher synovial fluid (P = 0.006) and serum (P less than 0.001) proteoglycan concentrations than did those taking nonsteroidal antiinflammatory drugs or slow-acting antirheumatic drugs. Serum proteoglycan concentrations were near the detection limits, and did not correlate with levels found in paired samples of knee joint synovial fluid. Patients with calcium pyrophosphate arthropathy had the highest mean serum level of proteoglycan. This assay of proteoglycan antigens is a useful tool in the study of proteoglycan metabolism in patients with joint disease. With its use, differences between disease groups and effects of therapy can be distinguished.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1999

Expression of adhesion molecules on synovial fluid and peripheral blood monocytes in patients with inflammatory joint disease and osteoarthritis.

OBJECTIVE: To determine the presence of adhesion molecules on monocytes/macrophages (Mphi) from peripheral blood (PB) and synovial fluid (SF) in patients with osteoarthritis (OA) and inflammatory joint diseases (rheumatoid (RA) and reactive arthritis (ReA)) in order to improve our understanding of the possible mechanisms underlying the inflammatory process. METHODS: Whole blood and SF cells were stained with monoclonal antibodies against CD11a (LFA-1), CD15 s (sialyl-Lewis X), CD44, CD54, VLA-4, and HLA-DR counterstained with anti-CD14 antibodies as a Mphi marker for dual fluorescence analysis by flowcytometry. RESULTS: On PB-Mphi, CD15s was markedly increased in both RA as well as ReA compared with OA. Furthermore, in the PB LFA-1, CD44, and HLA-DR showed a higher surface density on Mphi in ReA than in OA. Comparison between SF and PB showed significantly higher CD44 and CD54 expression on SF-Mphi. These molecules play an important part in lymphocyte-Mphi interaction. CONCLUSION: In PB from patients with inflammatory joint diseases, Mphi are activated, allowing recruitment into the synovial compartment. These disorders, in contrast with OA seem to be "systemic" in nature. Within the SF, different adhesion molecules are expressed on CD14(+) Mphi as compared with PB.

Adult↗
PubMed1992

Arthroplasty of the first metatarsophalangeal joint with a double-stem silicone implant. Results in patients who have degenerative joint disease failure of previous operations, or rheumatoid arthritis.

Sixty-six patients who had a total of eighty-six double-stem silicone implants in the first metatarsophalangeal joint were followed prospectively for an average of 5.8 years (range, two to fifteen years). There were two groups of patients: thirty-four patients (thirty-seven implants) who had degenerative joint disease (including those who had hallux rigidus or in whom a previous operation on a bunion had failed) and thirty-two patients (forty-nine implants) who had rheumatoid arthritis. The implants were used only if the patient was a candidate for an excisional arthroplasty or an arthrodesis; they were not used in patients who wished to maintain or adopt very active use of the foot (such as in running, jogging, and tennis) or to wear very high heels. Twenty-eight (82 per cent) of the thirty-four patients in the first group were completely satisfied and three (9 per cent) were somewhat satisfied. However, three patients (9 per cent), all of whom had had a failed bunionectomy, were dissatisfied; the ages of these three patients were less than the average age of all patients in the first group. Radiographs showed a fracture in three implants, but the patients had a good clinical result and an additional operation was not warranted. Twenty-seven (84 per cent) of the thirty-two patients in the second group were completely satisfied, four (13 per cent) were somewhat satisfied, and one (3 per cent) was dissatisfied. Radiographs showed a fracture in five implants. Four of the implants caused no symptoms, and the result was good; the fifth one was fragmented and was removed because of symptoms. Radiographs showed radiolucent areas around the implant and hypertrophic changes in many patients. There was no evidence of synovitis, such as that caused by silicone, either clinically or radiographically. We found that the double-stem silicone implant was effective in reconstructing the first metatarsophalangeal joint but emphasize our belief that it should be used only in carefully selected patients.

Adult↗
PubMed2005

Doppler sonography of the medial arterial blood supply to the coxofemoral joints of 36 medium to large breed dogs and its relationship with radiographic signs of joint disease.

The medial arterial supply to 68 of the 72 coxofemoral joints of 36 medium to large breed dogs was examined ultrasonographically. The medial circumflex femoral artery and three branches were identified; the artery and its transverse branch were identified in all 68 joints, and the deep branch was identified in 61 joints, and the ascending branch was identified in 63. However, the acetabular and obturator branches were not identified. The pulsatility index, the mean velocity and the peak systolic velocity of the medial circumflex femoral artery were determined and associated with a radiographic score of degenerative coxofemoral joint disease and a lath distraction index (LDI). In joints with a LDI greater than 0.35, the pulsatility index was significantly lower (P=0.023) and its mean velocity was higher (P=0.005). However, no significant associations were observed in individual dogs when the measurements in both joints were taken into account.

Animals↗
PubMedDate not supplied

Boundary lubricating ability of synovial fluid in degenerative joint disease.

The boundary lubricating ability of eleven synovial fluids was measured in a miniaturized latex--glass test system. The specimens were obtained at necropsy from knees in which the degree of degenerative joint disease varied from none to very severe. The lubricating ability of the fluid was independent of the viscosity over a wide range of shear rates. It was not diminished even in advanced lesions. In two additional fluids, the mucin clot was poor; the lubricating ability of one of these was compromised. Thus, although degenerative joint disease, during its quiescent stages, is not associated with defective synovial lubrication, the possibility that transient defects might lead to cartilage wear during life has not been excluded. The measurements are believed to be valid indicators of boundary lubricating ability under physiological conditions despite the fact that the test surfaces were not cartilaginous and the loading was relatively low (up to 47 pounds per square inch).

Adult↗
PubMed1998

The role of glucosamine sulfate and chondroitin sulfates in the treatment of degenerative joint disease.

Successful treatment of osteoarthritis must effectively control pain, and should slow down or reverse progression of the disease. Biochemical and pharmacological data combined with animal and human studies demonstrate glucosamine sulfate is capable of satisfying these criteria. Glucosamine sulfate's primary biological role in halting or reversing joint degeneration appears to be directly due to its ability to act as an essential substrate for, and to stimulate the biosynthesis of, the glycosaminoglycans and the hyaluronic acid backbone needed for the formation of proteoglycans found in the structural matrix of joints. Chondroitin sulfates, whether they are absorbed intact or broken into their constituent components, similarly provide additional substrates for the formation of a healthy joint matrix. Evidence also supports the oral administration of chondroitin sulfates for joint disease, both as an agent to slowly reduce symptoms and to reduce the need for non-steroidal anti-inflammatory drugs. The combined use of glucosamine sulfate and chondroitin sulfates in the treatment of degenerative joint disease has become an extremely popular supplementation protocol in arthritic conditions of the joints. Although glucosamine sulfate and chondroitin sulfates are often administered together, there is no information available to demonstrate the combination produces better results than glucosamine sulfate alone.

Chondroitin Sulfates↗
PubMed1989

Temporomandibular degenerative joint disease in children and adolescents: report of eight cases.

The prevalence of degenerative joint disease (DJD), of the temporomandibular joint (TMJ) in adolescents and its clinical and radiographic presentation has not been widely described. During a 2-year period, 174 patients with TMJ pain or dysfunction were referred to the Division of Oral Radiology, College of Dentistry, University of Saskatchewan, for radiographic evaluation. Twenty-one patients were 18 years or younger and, of these, eight were diagnosed as having DJD of one or both joints on the basis of the radiographic appearances. The clinical and radiographic features of these eight adolescent patients are described and the factors potentially associated with the development of the condition discussed. The prevalence in this study appeared to be higher than previously reported.

Adolescent↗
PubMed2000

High concentration of soluble HLA-DR in the synovial fluid: generation and significance in "rheumatoid-like" inflammatory joint diseases.

In the search for its role in inflammatory joint diseases, soluble HLA-DR (sHLA-DR) was quantitated in 72 synovial fluids (SF) by a newly established immunoenzyme assay. Unlike other soluble receptors which accumulated only moderately (sCD25, sCD4) or negligibly (sHLA class I, sCD8) in the SF, SF sHLA-DR levels exceeded serum levels by up to 3 orders of magnitude and varied disease dependently from "control" values (traumatic synovitis and osteoarthritis: 9.9 +/- 6.1 ng/ml). Clear-cut different SF sHLA-DR values in HLA-DR-associated "rheumatoid-like" (136.5 +/- 130.0 ng/ml) vs HLA-B27-associated "spondylarthropathy-like" arthritic forms (28.4 +/- 29.1 ng/ml) were most significant comparing oligoarticular juvenile chronic arthritis type I (147.6 +/- 112.6 ng/ml) and type II (3.3 +/- 1.1 ng/ml), thus offering a new classification marker. Also ex vivo, large amounts of sHLA-DR were released spontaneously by SF mononuclear cells and found to be related to the T-cell activation state. SF sHLA-DR may be shed in large complexes or micelles, as it eluted mainly at >450 kDa on gel filtration. Western blotting revealed that the majority of SF sHLA-DR consisted of full-length alpha- and beta-chains. Minor fractions of smaller sized antigens seemed to be generated by proteolytic cleavage rather than by alternative splicing, since only minute amounts of HLA-DRB mRNA lacking the transmembrane exon could be amplified by RT-PCR. Distinct forms of high-dose sHLA-DR, able to provoke rather than to suppress T-cell responses, are discussed as contributing to some HLA-DR disease association.

Adolescent↗
PubMed1978

Somatomedin activity in synovial fluid from patients with joint diseases.

The somatomedin activity in synovial fluids from 50 patients with a variety of joint diseases has been studied and compared with the activity in each of the patient's own serum and a standard reference serum (SRS). The porcine costal cartilage bioassay of Van den Brande and Du Caju (1974a) has been used with the isotopes 3H-thymidine and 35S-sulphate. Synovial fluids from most patients with post-traumatic and post-operative effusions, osteoarthritis and arthritis associated with psoriasis, Reiter's disease, and ankylosing spondylitis stimulated the synthesis of DNA and proteoglycans in cartilage. Synovial fluids from patients with rheumatoid arthritis either had impaired capacity to stimulate DNA synthesis, or they inhibited it; a similar, but less evident pattern was observed for proteoglycan synthesis. Some synovial fluids from patients with miscellaneous synovitides stimulated, while others inhibited cartilage metabolism. It is concluded that the synovial fluid from patients with rheumatoid arthritis and from some patients with miscellaneous synovitides contained an inhibitor(s) to DNA and possibly proteoglycan synthesis. The sera from nearly all the patients stimulated both DNA and proteoglycan synthesis, but the somatomedin potency ratios for serum in terms of SRS were generally less than 1.0. There was a significant inverse correlation between the serum somatomedin potency ratio and the age of the patient.

Adolescent↗
PubMed1983

Degenerative joint disease of the trapezium: a comparative radiographic and anatomic study.

The accuracy of radiographic evaluation of the pantrapezial joints and the anatomic incidence of pantrapezial arthrosis, were studied by comparing radiographs with anatomic dissections of 68 cadaver hands. When the trapezium-thumb metacarpal joint demonstrated degenerative changes, multitrapezial joint changes were noted in 73% radiographically, but in only 46% anatomically. The major reason for this discrepancy was a radiographic misinterpretation of the nature of osteophytes near the trapezium-index metacarpal joint. Anatomic changes of degenerative joint disease were noted in 60% of the trapezium-thumb metacarpal joints and 34% of the trapezium-scaphoid joints. Degenerative joint changes were rare in the trapezium-index metacarpal and trapezium-trapezoid joints. Routine anteroposterior, lateral, and oblique radiographs of the hand cannot be depended upon to provide adequate visualization of all the trapezial joints.

Aged↗
PubMed2002

[Arthroscopy for the diagnosis and treatment of hip joint disease].

OBJECTIVE: To evaluate the value of arthroscopy for the diagnosis and treatment of hip joint disease. METHODS: Arthroscopy was performed in 54 patients (68 hips) from July 1998 to September 2001. Of the 54 patients, 36 were male and 18 female, aged from 17 to 64 years. The disease was located on the left side in 18 patients, the right side in 22, and both sides in 14. In this group, osteoarthritis was noted in 21 patients, avascular necrosis of the femoral head in 16, infection of the hip joint in 3, chondrosarcoma in 2, synovial-chondromatosis in 7, acetabular labral tears in 2, and spondylitis in 3. The procedures of arthroscopy consisted of removal of loose bodies, debridement, and biopsy. RESULTS: The operation made accurate diagnosis possible for chondrosarcoma, acetabular labral tears, and infection of the hip joint. After debridement of the hip joint for avascular necrosis of the femoral head, osteoarthritis and spondylitis, most patients in this group were free from pain, function and range of the motion were restored and the pathological process was delayed. The Harris hip scores increased by 27 on average. CONCLUSION: Arthroscopy plays an important role in accurate diagnosis and treatment of hip joint.

Adolescent↗
PubMed2006

Total ankle arthroplasty in inflammatory joint disease with use of two mobile-bearing designs.

BACKGROUND: Interest in mobile-bearing total ankle arthroplasty has increased in recent years. However, to our knowledge, no study has focused exclusively on patients with the diagnosis of inflammatory joint disease or has provided a detailed analysis of the risk factors for failure. METHODS: A prospective observational study of the results of cementless mobile-bearing total ankle arthroplasty in patients with inflammatory joint disease (mainly rheumatoid arthritis) was conducted at two centers. Ninety-three total ankle arthroplasties were performed. The LCS (low contact stress) prosthesis was used initially, in nineteen ankles, between 1988 and 1992, and a modification of the LCS prosthesis, the Buechel-Pappas design, was used in seventy-four ankles between 1993 and 1999. Clinical and radiographic follow-up was performed at yearly intervals. Three clinical scoring systems were used, and any complication was recorded throughout follow-up. Actuarial survival (with revision as the end point), multivariate analysis, and a competing risk approach were used to describe the long-term outcome. RESULTS: The clinical result at one year after surgery showed a significant improvement in the scores on all three scoring systems (p < 0.05). Ankle dorsiflexion (mean, 7 degrees ) also improved significantly (p < 0.05) compared with the preoperative state. The most frequent complication was a malleolar fracture, which occurred in twenty ankles. Only when it occurred in combination with a deformity in the frontal plane did this complication have an adverse effect on the end result. At a mean follow-up of eight years, seventeen patients (twenty-one ankles) had died and fifteen ankles had been revised because of aseptic loosening (six ankles), primary or secondary axial deformity with edge-loading (six ankles), deep infection (two ankles), and a severe wound-healing problem (one ankle), leaving fifty-seven ankles (61%) that were evaluated. The mean overall survival rate at eight years was 84%. An increased failure rate was encountered in ankles with a preoperative deformity in the frontal plane of >10 degrees (p = 0.03) and in ankles in which an undersized tibial component had been implanted (p = 0.02). CONCLUSIONS: Mobile-bearing total ankle arthroplasty is a valid treatment option for the rheumatoid ankle if proper indications are used. Aseptic loosening and persistent deformity are the most important modes of failure.

Adult↗