Cartilage repair activity during joint-preserving treatment may be accompanied by osteophyte formation
Jansen, Mylène P.; Mastbergen, Simon C.; Watt, Fiona E.; Willemse, Elske J.; Vincent, Tonia L.; Spruijt, Sander; Emans, Pieter J.; Custers, Roel J.H.; van Heerwaarden, Ronald J.; Lafeber, Floris P.J.G.
(2021) Applied Sciences (Switzerland), volume 11, issue 15, pp. 1 - 13
(Article)
Abstract
Knee joint distraction (KJD) treatment has shown cartilage repair and clinical improvement in patients with osteoarthritis, as has high tibial osteotomy (HTO). Following KJD, TGFβ-1 and IL-6 were increased in synovial fluid (SF), factors related to cartilage regeneration, but also to osteophyte formation. As such, osteophyte formation after both joint-preserving
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treatments was studied. Radiographic osteophyte size was measured before, one year, and two years after treatment. Changes were compared with natural progression in patients from the CHECK cohort before un-dergoing total knee arthroplasty. An additional KJD cohort underwent SF aspiration, and one-year Altman osteophyte score changes were compared to SF-marker changes during treatment. After two years, both KJD (n = 58) and HTO (n = 38) patients showed an increase in osteophyte size (+6.2 mm2 and +7.0 mm2 resp.; both p < 0.004), with no significant differences between treatments (p = 0.592). Untreated CHECK patients (n = 44) did not show significant two-year changes (+2.1 mm2; p = 0.207) and showed significant differences with KJD and HTO (both p < 0.044). In SF aspiration patients (n = 17), there were significant differences in TGFβ-1 changes (p = 0.044), but not IL-6 (p = 0.898), between patients with a decrease, no change, or increase in osteophyte Altman score. Since KJD and HTO showed joint space widening and clinical improvement accompanied by osteophyte formation, increased osteophytosis after joint-preserving treatments may be a bystander effect of cartilage repair activity related to intra-articular factors like TGFβ-1 and raises questions regarding osteophyte formation as solely characteristic of the joint degenerative process.
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Keywords: High tibial osteotomy, Joint-preserving, Knee joint distraction, Osteoarthritis, Osteophyte, TGFβ-1, General Materials Science, Instrumentation, General Engineering, Process Chemistry and Technology, Computer Science Applications, Fluid Flow and Transfer Processes
ISSN: 2076-3417
Publisher: Multidisciplinary Digital Publishing Institute
Note: Funding Information: Funding: Parts of this work were supported by the Dutch Arthritis Association (ReumaNederland, grant numbers LLP-9/ISP14-3-301/16-1-404), ZonMw (The Netherlands Organisation for Health Research and Development, grant number 95110008), Versus Arthritis project (grant number 7837), Centre for OA Pathogenesis Versus Arthritis (grant numbers 20205/21621) and the Kennedy Trust for Rheumatology Research. The funders had no role in the study design, data collection, analysis or interpretation of the data, or in the writing of, or decision to submit the manuscript. Funding Information: Acknowledgments: The authors wish to thank Benjamin Hamid for his contribution to the synovial fluid biomarker analyses. The CHECK-cohort study is funded by the Dutch Arthritis Foundation. Involved are: Erasmus Medical Center Rotterdam; Kennemer Gasthuis Haarlem; Leiden University Medical Center; Maastricht University Medical Center; Martini Hospital Groningen/Allied Health Care Center for Rheumatology and Rehabilitation Groningen; Medical Spectrum Twente Enschede/Ziekenhuisgroep Twente Almelo; Reade Center for Rehabilitation and Rheumatology; St.Maartens-kliniek Nijmegen; University Medical Center Utrecht and Wilhelmina Hospital Assen. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
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