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1.
Sci Rep ; 10(1): 14388, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32873877

RESUMO

To describe the 5 years' trajectories in functionality and pain of patients with hip or knee osteoarthritis and arthroplasty and analyze the association of these with long-term patients survival. Patients with OA receiving total hip or knee arthroplasty were recruited and completed two sets of standardized questionnaires for functionality and pain 6, 12, and 60 months postoperatively. Multivariate mixed models were conducted to assess trajectories over time and the resulting improvement per month during the last time period was included in a landmark-model to estimate adjusted hazard ratios for mortality. In total 809 patients with joint replacement were included (mean age 65.0 years, 62.2% female), 407 patients died (median follow-up 18.4 years). Both instruments of functionality and pain showed extensive improvement during the first 6 months. Baseline and change in functionality (both p < 0.001) and pain (p = 0.02) during the first 6 months were associated with mortality. Better values in functionality corresponded with improved survival whereas the association with the pain scores was inverse. In patients with hip and knee OA, an explicit improvement in function is seen within the first 6 months after arthroplasty. In addition, especially the functionality scores at baseline as well as their improvement showed an association with long-term patient survival.


Assuntos
Artroplastia de Quadril/efeitos adversos , Artroplastia de Quadril/mortalidade , Artroplastia do Joelho/efeitos adversos , Artroplastia do Joelho/mortalidade , Osteoartrite do Quadril/cirurgia , Osteoartrite do Joelho/cirurgia , Dor Pós-Operatória/etiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Estudos Prospectivos , Inquéritos e Questionários , Resultado do Tratamento , Escala Visual Analógica
2.
Arch Orthop Trauma Surg ; 134(4): 537-41, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24509940

RESUMO

INTRODUCTION: Restoring the joint line (JL) in primary as well as revision total knee arthroplasty (TKA) influences clinical results as well as long-term survival rates. Whereas studies agree about the negative effect of JL alteration, the reference system of choice is unclear. The purpose of the present study was to evaluate the effect of JL allocation comparing a ratio to a distance method on clinical outcome following revision TKA. MATERIALS: After a miminum follow-up of 2 years JL reconstruction was evaluated in 69 consecutive patients after revision TKA. Clinical results were obtained using the Knee Society Score (KSS). We used the Figgie distance method in comparison to the epicondylar ratio method. RESULTS: The mean postoperative KSS significantly improved in all 69 revision TKAs compared to the preoperative value. Patients with a positive JL reconstruction in reference to the epicondylar ratio showed significantly better KSS results compared to knees without restoration of the JL. The degree of JL reconstruction depending on the distance method showed no effect on postoperative KSS results. CONCLUSION: We recommend the epicondylar ratio to calculate the physiological JL rather than JL allocation by a distance.


Assuntos
Artroplastia do Joelho/métodos , Articulação do Joelho/cirurgia , Idoso , Feminino , Humanos , Articulação do Joelho/anatomia & histologia , Articulação do Joelho/diagnóstico por imagem , Masculino , Radiografia , Estudos Retrospectivos , Resultado do Tratamento
3.
Spine (Phila Pa 1976) ; 39(2): E97-E103, 2014 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-24108284

RESUMO

STUDY DESIGN: Retrospective case series. OBJECTIVE: (1) To analyze clinical and radiographical characteristics, treatment, and outcome in patients with sacral osteoblastoma, (2) to evaluate progression-free survival and local recurrence rate, and (3) to identify prognostic factors. SUMMARY OF BACKGROUND DATA: Osteoblastoma is a rare tumor that has been reported to affect the sacrum from 7% to 17%. Symptoms are various and the diagnosis is often delayed. METHODS: From 1980 to 2010, 18 patients with sacral osteoblastoma (16 males and 2 females) were treated at Rizzoli Institute. Lesion involved S1 (2 cases), S1-S2 (3 cases), S2 (1 case), S2-S3 (1 case), S2-S4 (1 case), S3 (2 cases), S3-S4 (5 cases), S4 (1 case), and almost the entire sacrum in 2 cases. According to Enneking classification for benign bone tumors, 13 (72%) were diagnosed at stage 2 and 5 (28%) at stage 3. Mean tumor volume was 64 cm (range, 2-441 cm). Nine patients had preoperative magnetic resonance imaging. Five patients had a previous inadequate intralesional surgery elsewhere. Treatment consisted in intralesional surgery (16 cases), intralesional surgery and radiotherapy (1 case), and wide resection (1 case). Local adjuvants used were phenol (7 patients), cryocoagulation with "iceball" technique (1 case). Embolizations were performed in 7 patients. RESULTS: At a mean of 8.4 years (range, 1-28 yr), 15 patients (83%) remained continuously disease free, whereas 3 patients had local recurrence (17%). Progression-free survival was 87% at 5 years and 74% at 10 years. No statistical difference was found between patients who received or not local adjuvants (P = 1.254), older or younger than 20 years (P = 0.970), at stage 2 or 3 (P = 0.826), evaluated preoperatively with or without magnetic resonance imaging (P = 0.160), primarily treated versus patients with previous intralesional surgery elsewhere (P = 0.131). CONCLUSION: In our series, curettage was successful in most of the patients. Local adjuvants did not seem to reduce the risk of local recurrence when combined with intralesional surgery. LEVEL OF EVIDENCE: 4.


Assuntos
Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/cirurgia , Osteoblastoma/diagnóstico , Osteoblastoma/cirurgia , Sacro/patologia , Adolescente , Adulto , Criança , Feminino , Seguimentos , Humanos , Masculino , Sacro/cirurgia , Adulto Jovem
4.
Epilepsy Res ; 84(2-3): 273-5, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19269790

RESUMO

Cranial MRI has been shown to be a safe procedure in patients with a vagus nerve stimulator (VNS), but body MRI may cause overheating of the stimulator lead. Here we report a case of a patient with an implanted vagus nerve stimulator who required a cervical spinal MRI due to a rapidly progressive paraparesis. The spinal MRI was performed in a 1.5T scanner without complications showing a nearly complete compression of the spinal cord.


Assuntos
Vértebras Cervicais/patologia , Epilepsia/patologia , Epilepsia/terapia , Compressão da Medula Espinal/etiologia , Estimulação do Nervo Vago/efeitos adversos , Idoso , Descompressão Cirúrgica/métodos , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Compressão da Medula Espinal/terapia
5.
Onkologie ; 30(8-9): 414-8, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17848812

RESUMO

BACKGROUND: The Tomita prognosis score consists of the following 3 parameters: growth behavior, evidence of visceral metastases, and/or evidence of bony metastases. METHODS: 217 consecutive patients, surgically treated for vertebral metastases of different entities, were studied retrospectively. The score according to Tomita was determined. RESULTS: In the study group, the Tomita score showed significant results for the estimation of life expectancy of the different prognostic groups (p < 0.0001), but the analysis showed a low reliability, i.e. correlation between predicted prognosis and real survival. A modified division of the patients based on the total sum of points allowed a significant separation (p < 0.0001) of patients into 2 prognostic groups with a real survival of more or less than 12 months. CONCLUSION: In our study, the original Tomita score was not reliable to predict the life expectancy of cancer patients with spinal metastases. Our modification allows a significant differentiation of patients with spinal metastases with a prognosis of more or less than 12 months.


Assuntos
Avaliação de Resultados em Cuidados de Saúde/métodos , Medição de Risco/métodos , Índice de Gravidade de Doença , Neoplasias da Coluna Vertebral/diagnóstico , Neoplasias da Coluna Vertebral/secundário , Análise de Sobrevida , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Risco , Sensibilidade e Especificidade , Neoplasias da Coluna Vertebral/mortalidade , Neoplasias da Coluna Vertebral/cirurgia , Taxa de Sobrevida
6.
Arch Orthop Trauma Surg ; 127(8): 677-83, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17653733

RESUMO

PURPOSE: In this study we present our experience with CT-guided interventions for musculoskeletal diseases. Technical details, advantages and disadvantages and the accuracy of the method are described. MATERIALS AND METHODS: Between 2002 and 2005 we performed 77 CT-guided interventions on 72 patients (42 men, mean age 43.9 +/- 24.4 years, and 30 women, mean age 54.2 +/- 20.3) with (suspected) fracture, tumor or infection. RESULTS: Forty-one tumors, metastases or bone cysts, 17 infections, 12 bone alterations (e.g. osteoporosis, fracture) and 4 joints were diagnosed or treated. In three patients a tumor or an infection could be excluded. The duration of the procedure was 29.1 +/- 16.8 min. We did not see any intraoperative complication. However, the intervention had to be repeated in two patients, as the collected specimen was insufficient for histopathological evaluation in one patient, and in the other the nidus of osteoid osteoma persisted. The effective accuracy was 90.5%. Two patients were diagnosed first and then treated by screw osteosynthesis or corticoid steroid infiltration. One patient with an osteoid osteoma of the tibia fell and sustained a fracture of the tibial shaft. CONCLUSION: CT-guidance can substantially support diagnostic and therapeutic procedures in bone and soft tissues, especially if located in deep areas of the body, which are difficult to reach using open approaches.


Assuntos
Doenças Ósseas/diagnóstico , Fraturas Ósseas/diagnóstico , Artropatias/diagnóstico , Radiografia Intervencionista , Tomografia Computadorizada por Raios X , Adulto , Biópsia por Agulha/métodos , Doenças Ósseas/terapia , Osso e Ossos/patologia , Feminino , Fraturas Ósseas/terapia , Humanos , Artropatias/terapia , Masculino , Pessoa de Meia-Idade
7.
Ann Surg Oncol ; 14(2): 998-1004, 2007 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17083006

RESUMO

BACKGROUND: Retrospective evaluation of the prognosis scores of Tokuhashi and Tomita for life expectancy in 37 consecutive patients with spinal metastases secondary to renal cancer who underwent surgery. The score of Tokuhashi, composed of six parameters, each rated from zero to two, has been proposed in 1990 for the prognostic assessment of patients with spinal metastases. In 2001, Tomita et al. created another prognostic score, composed of three parameters, growth behaviour of the primary tumor (slow, moderate and rapid) and the evidence of visceral and bony metastases. METHODS: Thirty-seven patients, surgically treated for vertebral metastases secondary to renal cancer were studied. The scores according to Tokuhashi and Tomita were calculated for each patient. RESULTS: Applying the Tokuhashi Score for the estimation of life expectancy of renal cancer patients with vertebral metastases was found to provide very reliable results with a statistically high significance. The analysis according to Tomita showed no correlation between predicted and real survival. The statistical analysis did not show any significance. CONCLUSION: For surgical decisions in renal cancer patients with spinal metastases, the prognostic score of Tokuhashi appears to be much more valuable than the Tomita score.


Assuntos
Carcinoma de Células Renais/cirurgia , Neoplasias Renais/patologia , Índice de Gravidade de Doença , Neoplasias da Coluna Vertebral/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Renais/secundário , Feminino , Humanos , Expectativa de Vida , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Neoplasias da Coluna Vertebral/secundário
8.
Orthopedics ; 29(8): 716-22, 2006 08.
Artigo em Inglês | MEDLINE | ID: mdl-16924866

RESUMO

This study analyzed the outcome of patients treated with total disk replacement and posterior dynamic stabilization. For pathologies of different origin, dynamic stabilization of the lumbar spine is a novel alternative to fusion surgery. Although a physiological reconstruction of the sagittal profile was not always achieved, improvement was seen in all subscales of the clinical outcome measures in both treatment groups. Posterior dynamic stabilization and total disk replacement are promising alternatives to fusion with acceptable morbidity for strictly defined indications.


Assuntos
Placas Ósseas , Parafusos Ósseos , Vértebras Lombares/cirurgia , Procedimentos Ortopédicos/métodos , Próteses e Implantes , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade
9.
Onkologie ; 29(6): 276-8, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16783903

RESUMO

BACKGROUND: Adamantinomas are rare low-grade primary bone tumors of unknown histological origin. They typically develop in the diaphyses and metaphyses of long bones, prevalently the tibia. CASE REPORTS: The cases of 2 female patients, one with localized swelling of the lateral metatarsals and one with pain of the tibia are being reported. The diagnostic work-up including biopsy verified an adamantinoma in both cases. In the younger patient, the tumor was located in the metatarsals 4 and 5, in the older patient in the left tibial diaphyses. In both patients, an en-bloc resection of the tumor with wide surgical margins was performed. Further follow-ups 73 and 36 months after surgery showed no local recurrence or metastatic spread. CONCLUSION: Adamantinomas of the short bones are rarely reported. In accordance to the literature, an en-bloc resection with wide surgical margins seems to reduce the risk of local recurrence and metastatic spread.


Assuntos
Adamantinoma/diagnóstico , Adamantinoma/cirurgia , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/cirurgia , Ossos do Metatarso/cirurgia , Tíbia/cirurgia , Adolescente , Feminino , Humanos , Ossos do Metatarso/patologia , Pessoa de Meia-Idade , Doenças Raras/diagnóstico , Doenças Raras/cirurgia , Tíbia/patologia
10.
Spine (Phila Pa 1976) ; 30(19): 2222-6, 2005 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-16205351

RESUMO

STUDY DESIGN: Retrospective study of 55 consecutive patients with spinal metastases secondary to breast cancer who underwent surgery. OBJECTIVE: To evaluate the predictive value of the Tokuhashi score for life expectancy in patients with breast cancer with spinal metastases. SUMMARY OF BACKGROUND DATA: The score, composed of 6 parameters each rated from 0 to 2, has been proposed by Tokuhashi and colleagues for the prognostic assessment of patients with spinal metastases. METHODS: A total of 55 patients surgically treated for vertebral metastases secondary to breast cancer were studied. The score was calculated for each patient and, according to Tokuhashi, the patients were divided into 3 groups with different life expectancy according to their total number of scoring points. In a second step, the grouping for prognosis was modified to get a better correlation of the predicted and definitive survival. RESULTS: Applying the Tokuhashi score for the estimation of life expectancy of patients with breast cancer with vertebral metastases provided very reliable results. However, the original analysis by Tokuhashi showed a limited correlation between predicted and real survival for each prognostic group. Therefore, our patients were divided into modified prognostic groups regarding their total number of scoring points, leading to a higher significance of the predicted prognosis in each group (P < 0.0001), and a better correlation of the predicted and real survival. CONCLUSION: The modified Tokuhashi score assists in decision making based on reliable estimators of life expectancy in patients with spinal metastases secondary to breast cancer.


Assuntos
Neoplasias da Mama/patologia , Expectativa de Vida , Procedimentos Ortopédicos , Índice de Gravidade de Doença , Neoplasias da Coluna Vertebral/fisiopatologia , Neoplasias da Coluna Vertebral/secundário , Feminino , Humanos , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Neoplasias da Coluna Vertebral/cirurgia , Análise de Sobrevida
11.
Acta Orthop Belg ; 71(4): 467-71, 2005 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16185003

RESUMO

We retrospectively evaluated the results after corporectomy and vertebral body replacement in 40 patients with thoracic or lumbar spine collapse due to tumour osteolysis, unstable fractures, spondylodiscitis and Paget's disease. They underwent posterior transpedicular instrumentation followed 7 to 21 days later by vertebral body replacement with a distractible device, the "Obelisc" cage, filled up with autogenous/allogeneic bone graft. The mean residual kyphosis after surgery was only 13.8 degrees. After a mean follow-up period of 16.3 months, there was a mean loss of correction of 1.1 degrees. Perioperative complications occurred in 25 patients (62.5%); one died of septic shock, and the others were treated conservatively. Postoperatively, neurological improvement was noted in 8 patients. Using this in situ distractible vertebral body replacement system to achieve intraoperative stabilisation, neurological improvement and minimal postoperative displacement were achieved with an acceptable perioperative risk.


Assuntos
Vértebras Lombares , Doenças da Coluna Vertebral/cirurgia , Vértebras Torácicas , Adulto , Idoso , Idoso de 80 Anos ou mais , Discite/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fraturas da Coluna Vertebral/cirurgia
12.
Acta Orthop Belg ; 71(3): 349-52, 2005 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16035711

RESUMO

Oesophageal cancer is frequently complicated by malignant fistulae. Necrosis of the tumour following radiotherapy or chemotherapy may lead to the development of fistulae between the oesophagus and adjacent tissues and organs. We report the expansion of an extra-luminal oesophageal cancer after resection, invading the cervico-thoracic spine, fortunately without neurological deficit, and leading to instability and formation of a malignant fistula linking the tracheo-bronchial tree to the subarachnoidal space. To prevent imminent paraplegia and to alleviate severe pain, we rigidly stabilised the spine at the cervico-thoracic junction using an angle-stable system through a single posterior approach. Further postoperative follow-up revealed no signs of neurological deterioration. Cervico-thoracic stability was preserved until the patient died nearly five months postoperatively. This case shows that posterior stabilisation and decompression may be a palliative option for patients with imminent paraplegia and severe pain due to advanced tumour infiltration of the cervico-thoracic spine.


Assuntos
Carcinoma de Células Escamosas/secundário , Vértebras Cervicais , Neoplasias Esofágicas/patologia , Neoplasias da Coluna Vertebral/secundário , Neoplasias da Coluna Vertebral/cirurgia , Vértebras Torácicas , Parafusos Ósseos , Carcinoma de Células Escamosas/terapia , Terapia Combinada , Descompressão Cirúrgica/métodos , Progressão da Doença , Neoplasias Esofágicas/terapia , Evolução Fatal , Humanos , Fixadores Internos , Laminectomia/métodos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Cuidados Paliativos/métodos , Medição de Risco , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Falha de Tratamento
13.
Acta Orthop Belg ; 70(4): 361-4, 2004 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-15481422

RESUMO

After multiple revisions of her right hip arthroplasty, an 83-year-old woman developed deep infection with a chronic draining sinus. In August 2002 severe acute bleeding occurred through this fistula. Angiography revealed a pseudoaneurysm of the right external iliac artery. Because of the multiple pathologies affecting this ASA grade IV patient, conventional surgical treatment was considered to be contra-indicated, and a stent was placed percutaneously under fluoroscopic control to seal the vascular laceration. No haematoma and no further bleeding was observed on the control CT-scan or at angiography. However the patient died with terminal renal failure forty days later. The case reported shows a rare complication of total hip arthroplasty. The method used in this case to seal the leakage, using a covered stent, is uncommon but effective in cases where conventional surgery is contra-indicated.


Assuntos
Falso Aneurisma/terapia , Artroplastia de Quadril/efeitos adversos , Hemorragia/terapia , Artéria Ilíaca , Stents , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Falso Aneurisma/diagnóstico por imagem , Angiografia , Artroplastia de Quadril/métodos , Oclusão com Balão/métodos , Feminino , Seguimentos , Hemorragia/diagnóstico por imagem , Humanos , Falha de Prótese , Infecções Relacionadas à Prótese/diagnóstico , Infecções Relacionadas à Prótese/terapia , Reoperação , Medição de Risco , Resultado do Tratamento
14.
Histochem Cell Biol ; 119(4): 281-7, 2003 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12692671

RESUMO

To elucidate the process of endochondral ossification in human osteophytes we have studied the expression of parathyroid hormone-related protein (PTHrP), its receptor (PTHr), and fibroblast growth factor receptor 3 (FGFR3). Osteophytes from patients undergoing total knee replacement ( n=13), and fetal growth plate cartilages ( n=4) were processed for safranin O staining and immunohistochemistry. Chondrocytes and their matrix were preferentially stained for PTHrP in the middle and deep zones of the osteophytes examined. Ossified areas did not show a positive staining. In fetal joints the cartilaginous surface and the perichondrium as well as the osteoblasts in the trabecular bone were positive. PTHr was expressed at large in chondrocytes and osteoblasts of all osteophytes and fetal joints. Cells of the perichondrium were also positive. The FGFR3 antibody stained only single chondrocytes in some osteophytes, and groups of cells in others. In fetal samples, chondrocytes of the proliferating and the hypertrophic zone showed staining for FGFR3. This is the first report on the expression of PTHrP, PTHr, and FGFR3 in human osteophytes. As in fetal joints these mediators might regulate proliferation and differentiation of chondrocytes playing an important role in osteo(chondro)phyte growth.


Assuntos
Cartilagem Articular/metabolismo , Ossificação Heterotópica/metabolismo , Proteína Relacionada ao Hormônio Paratireóideo/metabolismo , Proteínas Tirosina Quinases , Receptor Tipo 1 de Hormônio Paratireóideo/metabolismo , Receptores de Fatores de Crescimento de Fibroblastos/metabolismo , Idoso , Cartilagem Articular/embriologia , Condrócitos/metabolismo , Idade Gestacional , Lâmina de Crescimento/embriologia , Lâmina de Crescimento/metabolismo , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Osteoblastos/metabolismo , Receptor Tipo 3 de Fator de Crescimento de Fibroblastos
15.
Acta Orthop Scand ; 73(5): 562-7, 2002 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12440501

RESUMO

We studied the effects of dexamethasone on proteoglycan (PG) concentration and gene expression in human osteoarthrotic chondrocytes stimulated with IL-1beta. Cartilage samples were taken from 7 patients with osteoarthrosis of the knee and chondrocytes cultivated in alginate beads. Dexamethasone was added in three concentrations (10(-5), 10(-6), 10(-7) M) to IL-1beta (100 pg/nL)-stimulated chondrocytes. PG concentration was estimated by a dimethylmethylene blue assay. To assess cell proliferation, DNA content was measured fluorometrically. Quantitative Lightcycler-PCR was used to estimate the mRNA levels of stromelysin-1 (MMP-3) and aggrecan (AGG). The proliferation rate was unchanged in all treatment groups. IL-1beta increased MMP-3 expression by 44% and inhibited AGG expression by 16%, but PG-concentration was reduced by 7%. The addition of dexamethasone to IL-1beta-stimulated chondrocytes further reduced the PG concentration by 19% at 10(-5) M and by 17% at 10(-7) M. The MMP-3 expression was inhibited between 27-53% and the AGG expression between 30-46% by dexamethasone. In osteoarthrotic chondrocytes, dexamethasone in an appropriate dose range reduced the expression of MMP-3 and AGG at the same time. The resulting decrease in PG concentration should be considered when using intraarticular corticosteroids to treat an osteoarthrotic joint.


Assuntos
Anti-Inflamatórios/farmacologia , Condrócitos/efeitos dos fármacos , Dexametasona/farmacologia , Proteínas da Matriz Extracelular , Expressão Gênica/efeitos dos fármacos , Interleucina-1/farmacologia , Osteoartrite do Joelho/genética , Osteoartrite do Joelho/cirurgia , Proteoglicanas/análise , Proteoglicanas/efeitos dos fármacos , Idoso , Agrecanas , Feminino , Humanos , Técnicas In Vitro , Articulação do Joelho/efeitos dos fármacos , Articulação do Joelho/cirurgia , Lectinas Tipo C , Masculino , Metaloproteinase 3 da Matriz/análise , Metaloproteinase 3 da Matriz/efeitos dos fármacos , Pessoa de Meia-Idade , Estimulação Química
16.
J Orthop Res ; 20(3): 551-5, 2002 May.
Artigo em Inglês | MEDLINE | ID: mdl-12038630

RESUMO

PURPOSE: To investigate the effect of hyaluronic acid (HA) on proteoglycan (PG) concentration in alginate cultures of human osteoarthritic chondrocytes and to analyze whether HA exhibit anti-degradative effects in the presence of the cytokine IL-1beta. METHODS: Cartilage samples from ten patients with osteoarthritis of the knee were harvested and chondrocytes were cultivated in alginate beads. Four groups were cultured: control group with and without IL-1beta (500 pg/ml) and HA group (100 microg/ml) with and without IL-1beta (500 pg/ml). PG concentration was estimated by a dimethylmethylene blue assay. To assess cell proliferation, we measured DNA content fluorometrically. RESULTS: The proliferation rate (DNA) was unchanged in all culture groups. In the control-group PG/DNA (ng/ng) concentration was 27.1 +/- 7.2. Supplementation of the medium with HA decreased PG concentration to 25.3 +/- 6.9 (p < 0.05). After administration of IL-1beta PG/DNA concentration dropped to 23.1 +/- 6.0 (p < 0.01). By contrast HA treatment of IL-1beta stimulated chondrocytes did not further decrease PG concentration (23.9 +/- 6.1). In fact the negative effect of isolated HA application was inverted if HA was given with IL-1beta (p < 0.05). CONCLUSIONS: In osteoarthritic chondrocytes cultured phenotypically stable, HA could exhibit protective effects only in the presence of the degradative cytokine IL-1beta. Thus, the reported anti-inflammatory effects of HA to cartilage matrix seem to be more indirect by blocking degradative effects of cytokines to the matrix.


Assuntos
Condrócitos/metabolismo , Ácido Hialurônico/farmacologia , Osteoartrite/metabolismo , Proteoglicanas/metabolismo , Idoso , Divisão Celular/efeitos dos fármacos , Células Cultivadas , Condrócitos/efeitos dos fármacos , Condrócitos/patologia , Sinergismo Farmacológico , Feminino , Humanos , Interleucina-1/farmacologia , Masculino , Pessoa de Meia-Idade , Osteoartrite/patologia , Proteoglicanas/antagonistas & inibidores
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