The protective effects of Olmesartan against interleukin-29 (IL-29)-induced type 2 collagen degradation in human chondrocytes.

Osteoarthritis (OA) is a cartilage degenerative disease commonly observed in the elderly population and is pathologically characterized by the degradation of the cartilage extracellular matrix (ECM). Matrix metalloproteinases (MMPs) and a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTSs) are critical enzymes involved in the degradation of ECM. Olmesartan is an inhibitor of the angiotensin II receptor developed for the treatment of hypertension, and recent studies show that it exerts anti-inflammatory effects in arthritis. The present study aimed to investigate the mechanism of the protective effect of Olmesartan on cartilage ECM degradation. Interleukin-29 (IL-29) is a novel inflammatory mediator involved in the inflammation and degradation of cartilage in OA, and human T/C-28a2 cells treated with it were the inflammatory model in vitro. We found that the degradation of type 2 collagens and aggrecans was induced by IL-29, accompanied by the upregulation of MMPs and ADAMTSs, but the presence of Olmesartan significantly ameliorated these increases. In addition, Olmesartan abolished IL-29- induced oxidative stress and elevated the expression level of TNF receptor-associated factor 6 (TRAF-6). Mechanistically, we showed that Olmesartan suppressed IL-29- caused inhibitor kappa B α (IκBα) expression and nuclear translocation of nuclear factor kappa-B (NF-κB) p65, indicating it suppressed the activation of the NF-κB pathway. Collectively, our data reveal that Olmesartan exerted a protective function on IL-29- induced type 2 collagen degradation in human chondrocytes.

[Combined operation in treatment of osteoarthritis of knee with genu varum].

OBJECTIVE: To make the young patients with osteoarthritis and genu varum of knee delay total knee arthroplasty, to observe the clinical effect of mosaicplasty of femoral medial condyle, patellar-plasty and high tibial osteotomy in the treatment of osteoarthritis of knee with varum. METHODS: From June 2004 to February 2006, 8 patients with osteoarthritis of knee with varum (10 knees) were treated with combined operation such as mosaicplasty of femoral medial condyle, patellar-plasty and hightibial osteotomy. There were 2 males with3 knees, and 6 females with7 knees,withan average age of 50 years (42-56 years). The left knees and right knees were involved in 3 cases respectively and bilateral knees in 2 cases. All patients had knee ache after walk or long-time standing. The X-ray showed hyperosteogeny at peri-patella and circum ferential femur-tibial joint, especially in the medial. The gap between patella and femur narrowed or disappeared, especially in the medial femurtibial joint. The femoral tibial angel (FTA) was 185-200 degrees (mean 190 degrees). The HSS score of knee was 55-75 (mean 60). The history of knee ache was 1-12 years (mean 5 years). RESULTS: All patients were followed up for 7-24 months (mean 15 months). All the incisions healed by first intention,no early complication occurred. The clinical bone healing time was 8-11 weeks (mean 9 weeks). Rectification of FTA was 15-30 degrees (mean 20 degrees). Normal weight-loading alignment was recovered. The valgus angle of knee was 10 degrees. The range of motion of knee was 100-120 degrees after operation, increasing by 5-20 degrees (mean 10 degrees) when compared with preoperation. The X-ray of postoperation showed that genu varum was corrected obviously and that no displacement, loosening and breakage occurred. The mean score of HSS was 80 (75-88), increasing by 20 when compared with preoperation. CONCLUSION: Mosaic-plasty of femoral medial condyle can make articular cartilage repair in certain degrees, patellar-plasty can relieve ache of fore region of knee effectively, and high tibial osteotomy can recover normal weight-loading alignment. The curative effect is good with the combined methods.

[Balance of soft tissues in total knee arthroplasty for patients with knee of varus deformity and flexion contracture].

OBJECTIVE: To explore the technique of the soft tissue balancing in the total knee arthroplasty (TKA) for the patients with the knees of varus deformity and flexion contracture. METHODS: From January 2001 to December 2005, 86 patients (19 males, 67 females; age, 57-78 years; average, 66 years) with the knees of varus deformity and flexion contracture underwent primary TKA and the balancing of the soft tissues. All the patients had suffered from osteoarthritis. The unibilateral affection was found in 68 patients and the bilateral affection in 18. The varus deformity angle was averaged 12.3 degrees (range, 6-34 degrees). The soft tissue varus accounted for 56.7% and the bony varus accounted for 43.3%. The flexion contracture < 10 degrees was found in 21 knees, 10-19 degrees in 45 knees, 20-29 degrees in 22 knees, and > 30 degrees in 16 knees, with an average angle of 18.9 degrees. RESULTS: The flexion contractures were improved. Before operation the average angle of the flexion contracture was 18.9 degrees but after operation only 4 patients had a residual flexion contracture of 5 degrees and the remaining patients had a complete correction. The follow-up for 37 months (range, 6-72 months) in all the patients revealed that only 6 patients had a residual flexion contracture of 5-10 degrees and the others had a full extension. Before operation the average varus angle was 12.3 degrees (range, 6-34 degrees) and the average tibiofemoral angle was 174.7 degrees (range, 170.3-175.6 degrees), but after operation the residual varus angle > 3 degrees was only found in 2 patients. The complications occurring during operation and after operation were found in 6 patients, injuries to the attachment of the medial collateral ligaments in 2, patellar clunk syndromes in 2, cerebral embolism in 1, and lacunar infarction in 1, with no nerve disorders left after the medical treatment. No skin necrosis, the cut edge infection or deep infection occurred. CONCLUSION: The balancing of the soft tissues is a major management for correction of the varus deformity and the flexion contracture. The proper balancing of the soft tissues can achieve an obvious recovery of the function and correction of the varus deformity after TKA.