[Nutraceuticals in therapy of knee osteoarthritis: orthopaedic view]. / Nutraceutika v terapii gonartrózy: pohled ortopeda.

Knee osteoarthritis is one of the most frequent diagnoses of load-carrying joints encountered in orthopaedic surgeons offices. Depending on the clinical stage, the therapy starts with conservative treatment. Corrective osteotomy is indicated in younger patients without an extensive and serious impairment. Implantation of TKR (total knee replacement) is usually indicated in more advanced stages. One of the pillars of conservative therapy is analgesics and non-steroidal antirheumatic drugs. A specific group consists of perorally administered drugs for suppression of symptoms or even deceleration of knee osteoarthrosis. These products are popular mainly thanks to their good tolerance and minimal side effects. The clinical effect ranges between minimal and medium depending on the degree of osteoarthrosis, type of drug and study. Similar to rheumatologists, orthopaedic surgeons also find it difficult to identify candidates suitable for a particular type of therapy, except indication for TKR. By all means, nutraceuticals are still considered part of clinical practice.Key words: chondroitin sulphate - glucosamine sulphate - knee osteoarthrosis - methylsulfonylmethane - nutraceuticals - pharmaceutical intervention.

In situ measurements of thin films in bovine serum lubricated contacts using optical interferometry.

The aim of this study is to consider the relevance of in situ measurements of bovine serum film thickness in the optical test device that could be related to the function of the artificial hip joint. It is mainly focussed on the effect of the hydrophobicity or hydrophilicity of the transparent surface and the effect of its geometry. Film thickness measurements were performed using ball-on-disc and lens-on-disc configurations of optical test device as a function of time. Chromatic interferograms were recorded with a high-speed complementary metal-oxide semiconductor digital camera and evaluated with thin film colorimetric interferometry. It was clarified that a chromium layer covering the glass disc has a hydrophobic behaviour which supports the adsorption of proteins contained in the bovine serum solution, thereby a thicker lubricating film is formed. On the contrary, the protein film formation was not observed when the disc was covered with a silica layer having a hydrophilic behaviour. In this case, a very thin lubricating film was formed only due to the hydrodynamic effect. Metal and ceramic balls have no substantial effect on lubricant film formation although their contact surfaces have relatively different wettability. It was confirmed that conformity of contacting surfaces and kinematic conditions has fundamental effect on bovine serum film formation. In the ball-on-disc configuration, the lubricant film is formed predominantly due to protein aggregations, which pass through the contact zone and increase the film thickness. In the more conformal ball-on-lens configuration, the lubricant film is formed predominantly due to hydrodynamic effect, thereby the film thickness is kept constant during measurement.

Early fracture of a plasma cup ceramic liner: a case report and surface analysis.

BACKGROUND: Ceramic surfaces offer excellent tribological properties and for this reason are frequently used in younger patients with osteoarthritis of the hip. However, they may fracture easily owing to low tolerance to tensile and impact stresses in particular. We report a case of early fracture of a currently available ceramic liner in a 44-year-old woman with revision total hip arthroplasty. METHODS AND RESULTS: Scanning electron microscopy and macroscopic fractographic examination were done to elucidate the cause of failure. These showed the fracture started most probably at the inner surface of the cup. Several mechanisms of fracture initiation are discussed in the paper. CONCLUSION: This is the first report on early fracture of the Plasma cup ceramic liner in white man. The fracture occurred intraoperatively or early postoperatively while the diagnosis was determined much later despite the patient had experienced sensations of subluxations long time before.

The efficacy of glucosamine and chondroitin sulfate in the treatment of osteoarthritis: are these saccharides drugs or nutraceuticals?

This review summarizes recent knowledge on the efficacy of glucosamine (GS) and/or chondroitin sulfate (CS) in the therapy of mild to moderate osteoarthritis (OA). OA, the most common joint disease is a significant source of disability, quality of life impairment and a considerable burden to any health care system. In the Czech Republic, glucosamine sulfate (GS) and chondroitin sulfate (CS) are available both as prescription drugs and as food supplements. Based on available data both are useful in the earlier stages of OA when combined with other modalities such as weight loss and exercises. They appear to relieve pain and improve range of the joint motion. In addition, they also display mild anti-inflammatory effects. However, controversy still exists over their ability to change significantly the natural history of the osteoarthritic joint. This effect is not easy to demonstrate for any other treatment modalities apart from joint replacement. Monitoring the cure efficacy by X-ray has been recently criticised and hence future techniques are anticipated for this reason. Further, long-term oral administration is required to obtain slightly increased levels of GS and/or CS in human blood. Both reviewed saccharides are well tolerated with negligible adverse reactions. In conclusion, the authors suggest that GS and CS should be classified as food supplements only.