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- Stefan Lohmander, L., et al.
(författare)
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Procollagen II C-propeptide in joint fluid : Changes in concentration with age, time after knee injury, and osteoarthritis
- 1996
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Ingår i: Journal of Rheumatology. - 0315-162X. ; 23:10, s. 1765-1769
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To determine in a cross sectional study the concentrations in joint fluid of the C-propeptide of collagen II (pCol II-C) in patients with knee injury and developing osteoarthritis (OA). Methods. Synovial fluid (SF) samples were collected from knees of healthy volunteers, from patients with injury to the knee causing lesions of the anterior cruciate ligament and/or menisci, and from patients with posttraumatic or primary OA. Concentrations of pCol II-C were determined by enzyme immunoassay with a polyclonal antiserum against the bovine propeptide. Results. The median concentration of pCol II-C in joint fluid in the reference group was 1.3 ng/ml (range 0.1-5.7 ng/ml). Median concentrations of pCol II-C in joint fluid were increased 2-4-fold in all 3 study groups over that in the reference group. Very high concentrations of propeptide were noted in samples from patients younger than about 18 years. Propeptide concentrations were increased after knee injury, with a suggested peak at about 1-4 years evident for patients with cruciate ligament injury. pCol II-C levels were increased at all stages of OA development, except in the most advanced phases. Conclusion. The increased levels of pCol II-C in SF may reflect an increased rate of synthesis of collagen II in the joint cartilage of patients with knee injury and developing OA. The increase reaches a maximum well before radiographic changes indicative of OA are apparent, and occurs during a disease phase characterized by signs of increased degradation of collagen II, aggrecan, and other matrix components. Further studies of markers of matrix metabolism of cartilage, bone, and other joint tissues in human and animal models of OA may aid in the identification of process markers, individuals at risk, and new therapeutic targets.
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| 2. |
- Wiig, Monica, et al.
(författare)
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Division of flexor tendons causes progressive degradation of tendon matrix in rabbits
- 1996
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Ingår i: Acta Orthopaedica Scandinavica. - 0001-6470. ; 67:5, s. 491-497
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Tidskriftsartikel (refereegranskat)abstract
- Deep flexor tendons of 30 rabbits were divided at the ankle level. The effects of unloading on the synthesis and content of matrix components, the synthesis of DNA, and dry weight were investigated. The reaction of the fibrocartilaginous and non-fibrocartilaginous segments were separately analyzed. The ability of the tendons to synthesize collagen during short-term culture and the contents of matrix components decreased inversely to the time of unloading. 12 weeks following division, the fibrocartilaginous segments had lost 2/5 of their dry weight, 2/3 of proteoglycan and 1/3 of collagen and non-collagen protein content. Less pronounced losses were observed in the non-fibrocartilaginous segments. A transient increase in cell proliferation in both types of segments was found. These findings indicate that divided flexor tendons undergo a progressive degradation, which may have implications for delayed suture of deep flexor tendon injuries.
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| 3. |
- Lohmander, L. Stefan, et al.
(författare)
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Increased concentrations of bone sialoprotein in joint fluid after knee injury
- 1996
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Ingår i: Annals of the Rheumatic Diseases. - 0003-4967. ; 55:9, s. 622-626
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Tidskriftsartikel (refereegranskat)abstract
- Objective - To detect evidence for localised changes in bone matrix metabolism after joint trauma and in post-traumatic osteoarthritis by quantification of bone sialoprotein in joint fluid and serum after knee injury in a cross sectional study. Methods - Samples of knee joint fluid and serum were obtained from volunteers with normal knees (n = 19), patients with rupture of the anterior cruciate ligament isolated or combined with tear of a meniscus (n = 114), and patients with isolated meniscus lesions (n = 80). Concentrations of bone sialoprotein were determined by ELISA. Concentrations of other markers of joint tissue metabolism in these samples were determined in previous investigations. Results - The median concentration of bone sialoprotein in joint fluid from healthy volunteers was 122 ng ml-1 (range 41 to 183). Concentrations of bone sialoprotein were increased in both injury groups compared with the reference group (median for cruciate ligament injury 146 ng ml-1, range 72 to 339; median for meniscus injury 166 ng ml-1, range 75 to 376). After injury, bone sialoprotein increased quickly and remained increased for six months. Bone sialoprotein in joint fluid was increased only in samples from joints with normal or nearly normal (fibrillated) cartilage, and was within reference range in joints with radiographic signs of osteoarthritis. Bone sialoprotein concentrations in joints with cruciate ligament injury were positively correlated with levels of aggrecan and cartilage oligomeric matrix protein fragments, and with levels of stromelysin-1 and tissue inhibitor of metalloproteinase-1. The ratios between the concentrations of bone sialoprotein in joint fluid and serum were >1 in the majority of the cruciate ligament injury cases. Conclusions - The release of significant amounts of bone sialoprotein into joint fluid in connection with acute joint trauma may be associated with injury to, and active remodelling of, the cartilage-bone interface and subchondral bone. The findings are consistent with dramatic shifts in cartilage, bone, and synovial metabolism following joint injury. Bone sialoprotein concentrations in synovial fluid may be a useful marker of subchondral injury and remodelling following joint injury.
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| 4. |
- Lohmander, L. Stefan, et al.
(författare)
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Intra-articular hyaluronan injections in the treatment of osteoarthritis of the knee : A randomised, double blind, placebo controlled multicentre trial
- 1996
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Ingår i: Annals of the Rheumatic Diseases. - : BMJ. - 0003-4967. ; 55:7, s. 424-431
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Tidskriftsartikel (refereegranskat)abstract
- Objective - To assess the effects of intraarticular injections of hyaluronan on symptoms of knee osteoarthritis (OA). Methods - Two hundred and forty patients with symptomatic, radiological knee OA were randomly assigned to treatment with weekly injections for five weeks with either 25 mg of high molecular weight hyaluronan or vehicle. Results were evaluated at weeks 1, 2, 3, 4, 5, 13, and 20 by visual analogue scales (pain, function, motion, activity), algofunctional index, and global evaluation by patient and investigator. Analysis was by 'intention to treat', 'per protocol), and area under the curve principles on unstratified patient groups and for patients stratified into four groups of equal size by age and baseline algofunctional index. Results - No serious side effects were reported. At 20 weeks both treatment groups were improved compared with baseline, with no difference between unstratified groups treated with placebo or hyaluronan. Comparison of treatment-groups stratified by age and baseline algofunctional index revealed a significant-difference in favour of hyaluronan over placebo (pain, activity, algofunctional index, global evaluations by patient-and investigator) for patients older than 60 years and with a baseline algofunctional index greater than 10. There was no clinically relevant difference between the two treatments for the other three stratified subgroups of younger age or fewer symptoms. Similar results were obtained by area under the curve, intention to treat, and per protocol analysis. Conclusions-Patients older than 60 years with knee osteoarthritis and with significant symptoms corresponding to an index of severity of knee disease of 10 or more, comprise the group most likely to benefit from treatment with intra-articular hyaluronan injections.
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