Autologous protein solution prepared from the blood of osteoarthritic patients contains an enhanced profile of anti-inflammatory cytokines and anabolic growth factors.

The objective of this clinical study was to test if blood from osteoarthritis (OA) patients (n = 105) could be processed by a device system to form an autologous protein solution (APS) with preferentially increased concentrations of anti-inflammatory cytokines compared to inflammatory cytokines. To address this objective, APS was prepared from patients exhibiting radiographic evidence of knee OA. Patient metrics were collected including: demographic information, medical history, medication records, and Knee Injury and Osteoarthritis Outcome Score (KOOS) surveys. Cytokine and growth factor concentrations in whole blood and APS were measured using enzyme-linked immunosorbent assays. Statistical analyses were used to identify relationships between OA patient metrics and cytokines. The results of this study indicated that anti-inflammatory cytokines were preferentially increased compared to inflammatory cytokines in APS from 98% of OA patients. APS contained high concentrations of anti-inflammatory proteins including 39,000 ± 20,000 pg/ml IL-1ra, 21,000 ± 5,000 pg/ml sIL-1RII, 2,100 ± 570 pg/ml sTNF-RI, and 4,200 ± 1,500 pg/ml sTNF-RII. Analysis of the 82 patient metrics indicated that no single patient metric was strongly correlated (R(2) > 0.7) with the key cytokine concentrations in APS. Therefore, APS can be prepared from a broad range of OA patients.

The use of NSAIDs and nutritional supplements in athletes with osteoarthritis: prevalence, benefits, and consequences.

The use of nonsteroidal antiinflammatory medications (NSAIDs) and nutraceuticals, such as glucosamine and chondroitin, is common among athletes at all ages and levels of participation. The use of these drugs has significant effects on pain and swelling associated with injury; however, this use does have significant risks to the gastrointestinal, hepatic, and renal organ systems. In the athlete with degenerative changes in the joints, the use of these medications can become chronic and lead to an increased risk of adverse effects. The purpose of this article is to examine the incidence of injury in sports, the prevalence of osteoarthritis in athletes, and the use of common over-the-counter medications and supplements. In addition, the mechanism of action, adverse side effects, and behavioral patterns for use of these medications will be analyzed.

The effects of radiofrequency energy treatment on chondrocytes and matrix of fibrillated articular cartilage.

BACKGROUND: There is no consensus regarding the safety of radiofrequency energy treatment for chondroplasty. HYPOTHESIS: Use of a radiofrequency thermal probe will produce a dose-dependent detrimental effect on chondrocytes in a setting mimicking the arthroscopic procedure. STUDY DESIGN: Controlled laboratory study. METHODS: Paired patellae from 11 horses were fibrillated; one served as the control while the contralateral patella was treated with 20, 40, and 60 watts of radiofrequency energy for 4 minutes. Proteoglycan synthesis, proteoglycan degradation, and cell viability were measured. Explant histologic sections were scored for cellular characteristics, metachromatic matrix staining intensity, and tissue architecture and were quantitatively analyzed for cell death. RESULTS: Mean peak surface articular cartilage temperatures were 35.47 degrees C (20 watts), 40.76 degrees C (40 watts), and 44.81 degrees C (60 watts). Treatment at all three settings significantly decreased proteoglycan synthesis of the chondrocytes. Proteoglycan degradation increased with increased power setting. Treatment at 40 and 60 watts significantly decreased cell viability to 81% and 73%, respectively. Significant histologic changes occurred in the superficial cartilage zone with 60-watt application. CONCLUSION: Use of radiofrequency energy on mechanically fibrillated articular cartilage induced a dose-dependent detrimental effect on chondrocytes and matrix metabolism. CLINICAL RELEVANCE: Cautious use of radiofrequency energy for treatment of articular cartilage is recommended until long-term effects are evaluated.