Metabolic syndrome increases osteoarthritis risk: findings from the UK Biobank prospective cohort study.

OBJECTIVE: The association between Metabolic Syndrome (MetS), its components, and the risk of osteoarthritis (OA) has been a topic of conflicting evidence in different studies. The aim of this present study is to investigate the association between MetS, its components, and the risk of OA using data from the UK Biobank. METHODS: A prospective cohort study was conducted in the UK Biobank to assess the risk of osteoarthritis (OA) related to MetS. MetS was defined according to the criteria set by the International Diabetes Federation (IDF). Additionally, lifestyle factors, medications, and the inflammatory marker C-reactive protein (CRP) were included in the model. Cox proportional hazards regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI). The cumulative risk of OA was analyzed using Kaplan-Meier curves and log-rank tests. To explore potential nonlinear associations between MetS components and OA risk, a restricted cubic splines (RCS) model was employed. In addition, the polygenic risk score (PRS) of OA was calculated to characterize individual genetic risk. RESULTS: A total of 45,581 cases of OA were identified among 370,311 participants, with a median follow-up time of 12.48 years. The study found that individuals with MetS had a 15% higher risk of developing OA (HR = 1.15, 95%CI:1.12-1.19). Additionally, central obesity was associated with a 58% increased risk of OA (HR = 1.58, 95%CI:1.5-1.66), while hyperglycemia was linked to a 13% higher risk (HR = 1.13, 95%CI:1.1-1.15). Dyslipidemia, specifically in triglycerides (HR = 1.07, 95%CI:1.05-1.09) and high-density lipoprotein (HR = 1.05, 95%CI:1.02-1.07), was also found to be slightly associated with OA risk. When stratified by PRS, those in the high PRS group had a significantly higher risk of OA compared to those with a low PRS, whereas no interaction was found between MetS and PRS on OA risks. Furthermore, the presence of MetS significantly increased the risk of OA by up to 35% in individuals with elevated CRP levels (HR = 1.35, 95% CI:1.3-1.4). CONCLUSION: MetS and its components have been found to be associated with an increased risk of OA, particularly in individuals with elevated levels of CRP. These findings highlight the significance of managing MetS as a preventive and intervention measure for OA.

Histone deacetylase 1 is increased in rheumatoid arthritis synovium and promotes synovial cell hyperplasia and synovial inflammation in the collagen-induced arthritis mouse model via the microRNA-124-dependent MARCKS-JAK/STAT axis.

OBJECTIVES: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease featured by synovial joint inflammation. Increasing evidence has highlighted microRNAs (miRNAs) and histone deacetylase 1 (HDAC1) as active participants in RA progression. Hence, the present study aims to explore the functions of HDAC1 and miR-124 on synovial cell hyperplasia and synovial inflammation in RA. METHODS: The expression of HDAC1, miR-124 and MARCKS was determined in the synovial tissues collected from 25 RA patients by RT-qPCR and Western blot analysis. Next, a mouse model with collagen-induced arthritis (CIA) was established, from which fibroblast-like synovial cells (FLSs) were isolated. Then the effect of HDAC1, miR-124 and MARCKS on synovial cell hyperplasia and synovial inflammation in CIA mice was evaluated by HE staining, ELISA, and EdU assays. Afterwards, the interaction among HDAC1, miR-124, MARCKS and the JAK/STAT signalling pathway was assessed by ChIP and dual luciferase reporter assay. Finally, the effect of HDAC1 on RA was further verified by establishing a CIA mouse model. RESULTS: HDAC1 was highly expressed and miR-124 and MARCKS were poorly expressed in synovial tissues of CIA. Silencing HDAC1 inhibited synovial cell hyperplasia and synovial inflammation by elevating MARCKS and miR-124 both in vitro and in vivo. Deficiency of HDAC1 promoted H3 and H4 acetylation of miR-124 and MARCKS promoter region. miR-124 alleviated synovial cell hyperplasia and synovial inflammation by repressing the JAK/STAT signalling pathway in CIA. CONCLUSIONS: To sum up, silencing HDAC1 mitigates synovial cell hyperplasia and synovial inflammation in mice with CIA by elevating miR-124 and MARCKS expression, thus highlighting a promising competitive new target for RA treatment.

Limited value of serum neutrophil-to-lymphocyte ratio in the diagnosis of chronic periprosthetic joint infection.

BACKGROUND: Diagnosing chronic periprosthetic joint infection (PJI) is challenging. No single biomarker can accurately recognize PJI preoperatively in a timely manner. Therefore, the aim of the present study was to investigate the usefulness of the serum neutrophil-to-lymphocyte ratio (NLR) in aiding the diagnosis of chronic PJI. MATERIALS AND METHODS: We retrospectively evaluated the medical records of 158 patients who had undergone revision arthroplasty (104 with aseptic mechanic failure and 54 with chronic PJI) from July 2011 to July 2020. Univariate analysis followed by multivariate logistic regression was applied to compare NLR, C-reactive protein (CRP), and erythrocyte sedimentation ratio (ESR) between the two groups. The receiver operating characteristic (ROC) curve was used to assess the diagnostic performance of NLR alone and in combination with CRP and ESR. RESULTS: NLR, CRP, and ESR were significantly higher in patients with chronic PJI than in the aseptic revision group (p < 0.05). ROC curve analysis revealed that NLR had a sensitivity of 57.41% and a specificity of 77.88% with an optimal threshold of 2.56. The optimal threshold for CRP and ESR was 7.00 mg/L (sensitivity 62.50% and specificity 83.12%) and 43 mm/h (sensitivity 59.38% and specificity 80.52%), respectively. The combined diagnostic value of NLR with CRP and ESR was shown to have no additional diagnostic value in predicting chronic PJI. CONCLUSION: Compared with traditional inflammatory biomarkers (ESR and CRP), the value of serum NLR alone or combined with CRP and ESR for diagnosing chronic PJI is limited. LEVEL OF EVIDENCE: Level 3.

MicroRNA-455-3p modulates cartilage development and degeneration through modification of histone H3 acetylation.

Histone acetylation regulated by class I histone deacetylases (HDACs) plays a pivotal role in matrix-specific gene transcription and cartilage development. While we previously demonstrated that microRNA (miR)-455-3p is upregulated during chondrogenesis and can enhance early chondrogenesis, the mechanism underlying this process remains largely unclear. In this study, we characterized the effect of miR-455-3p on histone H3 acetylation and its role during cartilage development and degeneration. We observed that miR-455-3p was highly expressed in proliferating and pre-hypertrophic chondrocytes, while HDAC2 and HDAC8 were primarily expressed in hypertrophic chondrocytes. Meanwhile, miR-455-3p suppressed the activity of reporter constructs containing the 3'-untranslated regions of HDAC2/8, inhibited HDAC2/8 expression and promoted histone H3 acetylation at the collagen 2 (COL2A1) promoter in human SW1353 chondrocyte-like cells. Treatment with the HDAC inhibitor trichostatin A (TSA) resulted in increased expression of cartilage-specific genes and promoted glycosaminoglycan deposition. Moreover, TSA inhibited matrix metalloproteinase 13 (Mmp13) expression and promoted nuclear translocation of SOX9 in interleukin-1-treated primary mouse chondrocytes. Lastly, knockdown of HDAC2/3/8 increased SRY (sex-determining region Y)-box 9 (SOX9) and decreased Runt-related transcription factor 2 (RUNX2) expression. Taken together, these findings suggest that miR-455-3p plays a critical role during chondrogenesis by directly targeting HDAC2/8 and promoting histone H3 acetylation, which raises possibilities of using miR-455-3p to influence chondrogenesis and cartilage degeneration.

Advanced glycation end products biphasically modulate bone resorption in osteoclast-like cells.

Advanced glycation end products (AGEs) disturb bone remodeling during aging, and this process is accelerated in diabetes. However, their role in modulation of osteoclast-induced bone resorption is controversial, with some studies indicating that AGEs enhance bone resorption and others showing the opposite effect. We determined whether AGEs present at different stages of osteoclast differentiation affect bone resorption differently. Based on increased levels of tartrate-resistant acid phosphatase (TRAP) and cathepsin K (CTSK), we identified day 4 of induction as the dividing time of cell fusion stage and mature stage in RAW264.7 cell-derived osteoclast-like cells (OCLs). AGE-modified BSA (50-400 µg/ml) or control BSA (100 µg/ml) was then added at the beginning of each stage. Results showed that the presence of AGEs at the cell fusion stage reduced pit numbers, resorption area, and CTSK expression. Moreover, expression of receptor activator of nuclear factor-κB (RANK) as well as the number of TRAP-positive cells, nuclei per OCL, actin rings, and podosomes also decreased. However, the presence of AGEs at the mature stage enlarged the resorption area markedly and increased pit numbers slightly. Intriguingly, only the number of nuclei per OCL and podosomes increased. These data indicate that AGEs biphasically modulate bone resorption activity of OCLs in a differentiation stage-dependent manner. AGEs at the cell fusion stage reduce bone resorption dramatically, mainly via suppression of RANK expression in osteoclast precursors, whereas AGEs at the mature stage enhance bone resorption slightly, most likely by increasing the number of podosomes in mature OCLs.

MicroRNA-381 Regulates Chondrocyte Hypertrophy by Inhibiting Histone Deacetylase 4 Expression.

Chondrocyte hypertrophy, regulated by Runt-related transcription factor 2 (RUNX2) and matrix metalloproteinase 13 (MMP13), is a crucial step in cartilage degeneration and osteoarthritis (OA) pathogenesis. We previously demonstrated that microRNA-381 (miR-381) promotes MMP13 expression during chondrogenesis and contributes to cartilage degeneration; however, the mechanism underlying this process remained unclear. In this study, we observed divergent expression of miR-381 and histone deacetylase 4 (HDAC4), an enzyme that directly inhibits RUNX2 and MMP13 expression, during late-stage chondrogenesis of ATDC5 cells, as well as in prehypertrophic and hypertrophic chondrocytes during long bone development in E16.5 mouse embryos. We therefore investigated whether this miRNA regulates HDAC4 expression during chondrogenesis. Notably, overexpression of miR-381 inhibited HDAC4 expression but promoted RUNX2 expression. Moreover, transfection of SW1353 cells with an miR-381 mimic suppressed the activity of a reporter construct containing the 3'-untranslated region (3'-UTR) of HDAC4. Conversely, treatment with a miR-381 inhibitor yielded increased HDAC4 expression and decreased RUNX2 expression. Lastly, knockdown of HDAC4 expression resulted in increased RUNX2 and MMP13 expression in SW1353 cells. Collectively, our results indicate that miR-381 epigenetically regulates MMP13 and RUNX2 expression via targeting of HDAC4, thereby suggesting the possibilities of inhibiting miR-381 to control chondrocyte hypertrophy and cartilage degeneration.

The Role of MicroRNA-381 in Chondrogenesis and Interleukin-1-ß Induced Chondrocyte Responses.

AIM: The molecular pathways regulating cartilage degradation are unclear. miR-381 was identified as a putative regulator of chondrogenesis related genes. Here, we examined its role in chondrogenesis and osteoarthritic cartilage degeneration. METHODS: miR-381 expression was assessed in vitro in response to IL-1ß stimulation in primary human (PHC) and mouse (PMC) chondrocytes, and ATDC5 derived chondrocytes; and in vivo in mouse embryos and human osteoarthritic cartilage. The effects of miR-381 on chondrogenesis and NF-kB signaling were assessed using a synthetic RNA mimic or inhibitor and luciferase assay, respectively. Upstream regulators of miR381 were probed using siRNA or overexpression plasmids for Sox9 and Runx2. RESULTS: miR-381 expression was elevated in chondrogenic and hypertrophic ATDC5 cells. miR-381 was induced in vitro by IL-1ß in ATDC5 cells, PMCs, and PHCs, and was expressed in areas of cartilage degradation or absorption in vivo. Overexpression of Runx2 or Sox9 increased miR-381 expression in ATDC5 cells. miR-381 suppressed expression of collagen, type II, alpha 1, and enhanced expression of metalloproteinase-13 (MMP-13), but did not regulate NFKBIA and NKRF activity. CONCLUSION: miR-381 was highly expressed during chondrogenesis and in arthritic cartilage. It may contribute to absorption of the cartilage matrix by repressing type II collagen and inducing MMP-13.

Wear particles promote reactive oxygen species-mediated inflammation via the nicotinamide adenine dinucleotide phosphate oxidase pathway in macrophages surrounding loosened implants.

BACKGROUND/AIMS: Prosthesis loosening is closely associated with chronic inflammatory cytokine secretion by macrophages, which are activated by wear particles or inflammatory stimulants such as lipopolysaccharide (LPS). Reactive oxygen species (ROS) are critical regulators of inflammation, but their enzymatic sources in response to wear particles and their effects on peri-implant LPS-tolerance remain unclear. METHODS: Three ROS-related enzymes-nicotinamide adenine dinucleotide phosphate oxidase (NOX)-1 and -2 and catalase-were investigated in interface membrane tissues and in titanium (Ti) particle-stimulated macrophages in vitro. The generation of ROS and downstream inflammatory effects were measured with or without pre-incubation with apocynin, an NOX inhibitor. RESULTS: Pre-exposure to Ti particles attenuated NF-κB activation in LPS-stimulated macrophages, indicating that wear particles suppress immune response, which may lead to chronic inflammation. NOX-1 and -2 were highly expressed in aseptically loosened interface membranes and in macrophages stimulated with Ti particles; the particles induced a moderate amount of ROS generation, NF-κB activation, and TNF-α secretion in macrophages, and these effects were suppressed by apocynin. CONCLUSION: Wear particles induce ROS generation through the NOX signaling pathway, resulting in persistent inflammation and delayed loosening. Thus, the suppression of NOX activity may be a useful strategy for preventing prosthesis loosening.

Roles of Sagittal Anatomical Parameters of the Pelvis in Primary Total Hip Replacement for Patients with Ankylosing Spondylitis.

We examined the correlation between acetabular prostheses and sagittal anatomical parameters of the pelvis for the preoperative evaluation of total hip arthroplasty in 29 patients with ankylosing spondylitis between April 2004 and November 2011. No implant dislocation or subsidence was observed at 4.18 years. The relationship between sagittal parameters conformed to the equation Pelvic incidence (PI)=Pelvic tilt (PT)+Sacral slope (SS). Better outcomes were achieved in the SS>PT group, postoperative function was positively correlated with SS/PI. Functional abduction and anteversion were positively correlated with PT but negatively correlated with SS. Due to the compensatory changes in the pelvis and spine of patients with AS, the preoperative assessment of sagittal parameters plays pivotal roles in placing acetabular prostheses in optimal positions and preventing postoperative impingement and dislocation.

Resistin stimulates expression of chemokine genes in chondrocytes via combinatorial regulation of C/EBPß and NF-κB.

To further investigate the regulation role of two chemokine genes CCL3 and CCL4 in chondrocytes in response to resistin, human primary chondrocytes and T/C-28a2 cells were cultured. The function of resistin on the chemokine genes, and the expression of C/EBPß, NF-κB isoforms were tested using qPCR. The methods used to investigate timed co-regulation of C/EBPß and NF-κB were NF-κB inhibitor (IKK-NBD) and C/EBPß inhibitor (SB303580) treatments, and subcellular localization, with or without resistin stimulation. Results showed that resistin could increase the up-regulation of chemokine genes independently. Resistin increased the expression of C/EBPß and NF-κB isoforms. C/EBPß regulated basal activity and steadily increased over time up to 24h with resistin. NF-κB was up-regulated upon induction with resistin, peaking at 4 h. C/EBPß and NF-κB co-enhanced the chemokines expression; inhibition of their activity was additive. The timing of activation in chondrocytes was confirmed by subcellular localization of C/EBPß and c-rel. Chondrocytes react to resistin in a non-restricted cell-specific manner, utilizing C/EBPß and NF-κB in a combinatorial regulation of chemokine gene expression. The activity of C/EBPß is augmented by a transient increase in activity of NF-κB, and both transcription factors act independently on the chemokine genes, CCL3 and CCL4. Thus, resistin stimulates CCL3 and CCL4 through combinatorial regulation of C/EBPß and NF-κB in chondrocytes.

A comparison of biomechanical changes on femoral head following rotational acetabular osteotomy and eccentric rotational acetabular osteotomy in normal cadaveric hip.

PURPOSE: Both rotational acetabular osteotomy (RAO) and eccentric rotational acetabular osteotomy (ERAO) are effective procedures for young patients with developmental dysplasia of the hip. However, no comparative study of biomechanical changes has been reported following these two procedures. We therefore explored the stress changes on femoral head after RAO and ERAO under different load conditions. MATERIALS AND METHODS: Twelve female cadaveric hips without deformity were divided into RAO group and ERAO group. Stress value on femoral head was measured preoperatively and postoperatively after the vertical force was loaded on the cadaveric spine from 0 to 500 N. Stress change value was then calculated base on the measurements. RESULTS: In the RAO group, preoperative stress increased when loading on spine became larger, but postoperative stress changed its increasing trend into decreasing when the load was greater than 200 N (turning point). Same phenomenon was found in the ERAO group (turning point was 300 N). However, the difference between preoperative and postoperative stress was not statistically significant in both RAO and ERAO groups. Stress change value from each procedure showed similar trends. With the load growth, stress change increased firstly and then decreased, but the difference between RAO and ERAO was not statistically significant. CONCLUSIONS: Both RAO and ERAO could correct the abnormal biomechanical effect of dysplastic hip; moreover, they may have similar biomechanical effects on femoral head, obtaining the same clinical outcomes. Non-biomechanical factors (surgical trauma, technical complexity, etc.) also play important roles in procedure selection.

Association of peripheral inflammatory indicators with osteoarthritis risk.

Objectives: Numerous studies have established the role of inflammation in osteoarthritis (OA) progression, yet limited research explores the association between systemic inflammatory indicators and pre-diagnosis OA risk. This study aimed to investigate the association between peripheral inflammatory indicators and the risk of OA using data from the UK Biobank. Methods: The study analyzed data from 417,507 participants in the UK Biobank, including neutrophil count, lymphocyte count, monocyte count, platelet count, and C-reactive protein meter. Additionally, derived ratios such as NLR(neutrophils-lymphocytes ratio), PLR(Platelets-lymphocytes ratio), SII(systemic immune-inflammation index), and LMR (lymphocytes-monocytes ratio) were examined. Cox proportional hazards models and restricted cubic spline models were used to assess both linear and nonlinear associations. Results: Over a mean follow-up period of 12.7 years, a total of 49,509 OA events were identified. The findings revealed that CRP (HR:1.06, 95%CI:1.05-1.07), NLR (HR:1.02, 95%CI:1.01-1.03), PLR (HR:1.02, 95%CI:1.01-1.03), and SII (HR:1.03, 95%CI:1.01-1.04) were associated with an increased risk of OA, while LMR (HR:0.97, 95%CI:0.96-0.99) showed a significant negative correlation with OA risk. Subgroup analyses further emphasized that these associations were significant across most of the population. Although neutrophils, lymphocytes, monocytes, and platelets showed a nominal association with the risk of OA, the results were unreliable, especially for specific joint OA. Conclusion: The study provides evidence of a significant association between elevated peripheral inflammatory indicators and OA risk. These findings underscore the importance of low-grade chronic inflammation in OA development. The potential clinical utility of these indicators as early predictors of OA is suggested, warranting further exploration.

A machine learning-based model for "In-time" prediction of periprosthetic joint infection.

Background: Previous criteria had limited value in early diagnosis of periprosthetic joint infection (PJI). Here, we constructed a novel machine learning (ML)-derived, "in-time" diagnostic system for PJI and proved its validity. Methods: We filtered "in-time" diagnostic indicators reported in the literature based on our continuous retrospective cohort of PJI and aseptic prosthetic loosening patients. With the indicators, we developed a two-level ML model with six base learners including Elastic Net, Linear Support Vector Machine, Kernel Support Vector Machine, Extra Trees, Light Gradient Boosting Machine and Multilayer Perceptron), and one meta-learner, Ensemble Learning of Weighted Voting. The prediction performance of this model was compared with those of previous diagnostic criteria (International Consensus Meeting in 2018 (ICM 2018), etc.). Another prospective cohort was used for internal validation. Based on our ML model, a user-friendly web tool was developed for swift PJI diagnosis in clinical practice. Results: A total of 254 patients (199 for development and 55 for validation cohort) were included in this study with 38.2% of them diagnosed as PJI. We included 21 widely accessible features including imaging indicators (X-ray and CT) in the model. The sensitivity and accuracy of our ML model were significantly higher than ICM 2018 in development cohort (90.6% vs. 76.1%, P = 0.032; 94.5% vs. 86.7%, P = 0.020), which was supported by internal validation cohort (84.2% vs. 78.6%; 94.6% vs. 81.8%). Conclusions: Our novel ML-derived PJI "in-time" diagnostic system demonstrated significantly improved diagnostic potency for surgical decision-making compared with the commonly used criteria. Moreover, our web-based tool greatly assisted surgeons in distinguishing PJI patients comprehensively. Level of evidence: Diagnostic Level III.

Deconvolution of synovial myeloid cell subsets across pathotypes and role of COL3A1+ macrophages in rheumatoid arthritis remission.

Background: Monocyte/macrophage (Mo/Mp) is a critical cell population involved in immune modulation of rheumatoid synovitis (RA) across different pathotypes. This study aims to investigate the contribution of Mo/Mp clusters to RA activity, and the biological function of particular subtypes in RA remission. Methods: We integrated single-cell RNA sequencing datasets from 4 published and 1 in-house studies using Liger selected by comparison. We estimated the abundance of Mo/Mp subtypes in bulk RNA-seq data from the 81 patients of the Pathobiology of Early Arthritis Cohort (PEAC) using deconvolution analysis. Correlations between Mo/Mp subtypes and RA clinical metrics were assessed. A particular cell type was identified using multicolor immunofluorescence and flow cytometry in vivo and successfully induced from a cell line in vitro. Potential immune modulation function of it was performed using immunohistochemical staining, adhesion assay, and RT-qPCR. Results: We identified 8 Mo/Mp clusters. As a particular subtype among them, COL3A1+ Mp (CD68+, COL3A1+, ACTA2-) enriched in myeloid pathotype and negatively correlated with RA severity metrics in all pathotypes. Flow cytometry and multicolor immunofluorescence evidenced the enrichment and M2-like phenotype of COL3A1+ Mp in the myeloid pathotype. Further assays suggested that COL3A1+ Mp potentially attenuates RA severity via expressing anti-inflammatory cytokines, enhancing Mp adhesion, and forming a physical barrier at the synovial lining. Conclusion: This study reported unexplored associations between different pathologies and myeloid cell subtypes. We also identified a fibroblast-and-M2-like cluster named COL3A1+ Mp, which potentially contributes to synovial immune homeostasis. Targeting the development of COL3A1+ Mp may hold promise for inducing RA remission.

Association of thyroid hormone with osteoarthritis: from mendelian randomization and RNA sequencing analysis.

BACKGROUND: The relationship between thyroid hormone (TH) levels in vivo and osteoarthritis (OA) remains inconclusive. This study aims to investigate the association between TH levels and OA, analyze the effect of triiodothyronine on hypertrophic chondrocyte differentiation and OA progression, and identify potential target genes of triiodothyronine in OA to evaluate its diagnostic value. METHODS: Two-sample mendelian randomization method was used to probe the causal links between hyperthyroidism and OA. Differentially expressed genes (DEGs) from two RNA-sequencing data in Gene Expression Omnibus (GSE199847 and GSE114007) and enrichment analysis of DEGs (166 commonly upregulated genes and 71 commonly downregulated genes of GSE199847 and GSE114007) was performed to analyze the effect of triiodothyronine (T3) on hypertrophic chondrocyte differentiation and OA. C28/I2 cells treated with T3 and reverse transcription and quantitative real-time polymerase chain reaction were used to validate T3 targeted genes. The diagnostic performance of target genes was assessed by the receiver operating characteristic (ROC) curve and area under the curve (AUC). RESULTS: There was a positive causal association between hyperthyroidism and OA (IVW result, OR = 1.330, 95% CI 1.136-1.557, P = 0.0004). Weighted median and Weighted mode analysis also demonstrated that hyperthyroidism had a positive causal association with OA (p < 0.05, OR > 1). Bioinformatics analysis indicated T3 can partially induce the emergence of late hypertrophic chondrocyte and promote OA through extracellular matrix organization, blood vessel development, skeletal system development and ossification. Post-T3 treatment, MAFB, C1QTNF1, COL3A1 and ANGPTL2 were significantly elevated in C28/I2 cells. ROC curves in GSE114007 showed that AUC of all above genes were ≥ 0.7. CONCLUSIONS: This study identified that hyperthyroidism has a positive causal association with OA by MR analysis. T3 induced hypertrophic chondrocytes promote OA progression by upregulating genes such as MAFB, C1QTNF1, COL3A1 and ANGPTL2, which can also serve as OA diagnosis.

Association of coffee and tea consumption with osteoporosis risk: A prospective study from the UK biobank.

OBJECTIVE: The association of coffee and tea consumption with osteoporosis is highly controversial, and few studies have focused on the combined effects of the two beverages. This study aimed to investigate the independent and combined associations of coffee and tea consumption with osteoporosis risk. METHODS: A prospective cohort study involving 487,594 participants aged 38-73 years from the UK Biobank was conducted. Participants with reported coffee and tea consumption and without osteoporosis at baseline were included. Coffee and tea consumption were assessed via a touch-screen questionnaire at baseline. Newly diagnosed osteoporosis during the follow-up period, defined based on ICD-10 codes (M80-M82), was the primary outcome. Cox regression analyses were utilized to calculate hazard ratios (HRs) and 95 % confidence intervals (CIs). Dose-effect associations were assessed using restricted cubic spline analysis. RESULTS: During a median follow-up of 12.8 years, 15,211 cases of osteoporosis were identified. Compared to individuals without coffee or tea consumption, drinking coffee was associated with an HR of 0.93 (95 % CI: 0.89-0.96), and tea consumption with an HR of 0.86 (95 % CI: 0.83-0.90). Continuous trends were significant for both coffee and tea consumption, showing non-linear associations with osteoporosis incidence. Moderate consumption, such as 1-2 cups of coffee or 3-4 cups of tea per day, was associated with a lower incidence of osteoporosis, with HRs of 0.9 (95 % CI: 0.86-0.94) and 0.85 (95 % CI: 0.81-0.90), respectively. Additionally, combined coffee and tea consumption displayed a U-shaped association with osteoporosis risk, with the lowest risk observed in individuals who consumed 1-2 cups of both beverages daily, with an HR of 0.68 (95 % CI: 0.61-0.75). CONCLUSION: Our findings highlight the potential benefits of moderate coffee and tea consumption in reducing the risk of osteoporosis.

Application of the New Irrigation Protocol to Reduce Recurrence Rate in the Management Of Periprosthetic Joint Infection.

OBJECTIVE: Irrigation is a conventional treatment for acute and chronic periprosthetic joint infections (PJI). However, there has been no unified standard for irrigation during surgery for PJI in the past, and the efficacy is uncertain. The purpose of this study is to create a new irrigation protocol to enhance the infection control rate and reduce the postoperative recurrence rate of PJI patients. METHODS: We conducted a single-institution retrospective review with a total of 56 patients who underwent revision total hip or knee arthroplasties due to PJI from January 2011 to January 2022. Conventional irrigation (CI) was used in 32 cases, and standard operating procedure of irrigation (SOPI) was used in 24. The CI protocol carries out an empirical irrigation after debridement, which is quite random. Our SOPI protocol clearly stipulates the soaking concentration and time of hydrogen peroxide and povidone-iodine. The irrigation is carried out three times, and tissue samples are taken from multiple parts before and after irrigation, which are sent for microbial culture. The important statistical indicators were the rate of positive microbiological culture and postoperative recurrence rate with an average follow-up of 24 average months. RESULTS: The drainage volume was lower in the SOPI group than in the CI group on postoperative day 3 (p < 0.01) and 7 (p = 0.016). In addition, the percentage of positive microbiological cultures after the third irrigation was less than that before (p < 0.01) and after (p < 0.01) the first irrigation. The most common causative organism was Staphylococcus aureus, which was detected in 25.0% and 12.5% of the SOPI and CI groups, respectively. The failure rate at the final follow-up was 8.3% and 31.3% (p = 0.039) for the SOPI and CI groups, respectively. CONCLUSION: Compared with the traditional CI method, SOPI standardized the soaking time of hydrogen peroxide and povidone-iodine, increased the frequency of and irrigation, and proved that microorganisms were almost completely removed through the microbial culture of multiple tissues. SOPI has the potential to become a standardized irrigation process worthy of promotion, effectively reducing the postoperative recurrence rate of PJI patients.

Presence of interleukin-17C in the tissue around aseptic loosened implants.

PURPOSE: The most common long-term complication of joint arthroplasty is aseptic loosening. The proinflammatory cytokines secreted by macrophages are involved in aseptic loosening. Recently, a novel proinflammatory cytokine IL-17C was reported to participate in inflammatory diseases by synergising with proinflammatory cytokines. However, the relationship between IL-17C and the aseptic loosening is unclear. METHODS: The tissues around aseptic loosened implants were collected during revision surgery and handled by formalin fixation and embedded in paraffin. The presence of IL-17C in the tissues around the aseptic loosened implants was investigated in 12 aseptic loosening patients using immunofluorescence. RESULTS: The presence of IL-17C protein in the tissues around aseptic loosened implants was detected by immunofluorescence. There are no statistical differences between optical density of IL-17C in aseptic loosening samples and in rheumatoid arthritis samples (positive control). CONCLUSIONS: These results suggest the presence of IL-17C in aseptic loosening. Interleukin-17C was related to the inflammation of aseptic loosening, possibly by contributing to the inflammation and osteolysis in the tissues surrounding aseptic loosened implants.

Blood transfusion and drainage catheter clamping are associated with ecchymosis formation at the surgical site after total knee arthroplasty: an analysis of 102 unilateral cases.

BACKGROUND: Many previous studies have focused on the postoperative complication of postoperative knee pain, infection, knee prosthesis loosening, periprosthetic fractures, and so on. There have been few studies focused on postoperative ecchymosis formation surrounding the wound of the TKA site. A certain degree of effect on the early functional recovery of the patients may occur due to the mental stress caused by the ecchymosis, which raises doubts regarding the success of the surgery. Therefore, it is particularly important to understand the risk factors for postsurgical ecchymosis formation after TKA, and specific measures for preventing ecchymosis should be taken. In this study, we reviewed the record of patients who received TKAs in our hospital, and a comprehensive analysis and assessment was conducted regarding 15 clinical factors causing postsurgical ecchymosis formation. METHODS: The records of 102 patients who received unilateral TKAs between January 2007 and May 2010 were retrospectively analyzed. Patients were divided into two groups based on the occurrence of ecchymosis. RESULTS: Of the 102 patients, 14 (13.7%) developed ecchymosis. Blood transfusion and drainage catheter clamping during the first few postoperative hours had a significant impact on the development of ecchymosis (p < 0.05). There was no difference in age, BMI, operation time, pre- and postoperative platelet count, and length of postoperative anticoagulant therapy between the two groups. Multivariate logistic regression revealed major risk factors for ecchymosis were postoperative blood transfusion (odds ratio (OR) = 15.624) and drainage catheter clamping (OR 14.237) (both, p < 0.05). CONCLUSION: Blood transfusion and drainage catheter clamping after TKA due to excessive blood suction were associated with higher risks for ecchymosis formation surrounding the surgical site.

Total hip arthroplasty for vascular necrosis of the femoral head in patients with systemic lupus erythematosus: a midterm follow-up study of 28 hips in 24 patients.

OBJECTIVE: Avascular necrosis of the femoral head is one of the most frequently reported complications in patients with systemic lupus erythematosus (SLE) and often requires total hip arthroplasty (THA). Our objective was to analyze the perioperative management, technical problems, clinical outcomes, and complications associated with THA in patients with SLE. METHODS: A total of 28 total hip arthroplasties performed for 24 patients with SLE, including 19 women and 5 men with a mean age of 38.8 years performed from 1998 to 2011 were retrospectively reviewed. SLE disease activity index and ASA class were evaluated preoperatively. WOMAC, HHS, and SF-36 scores were also evaluated in all cases pre- and post-operatively for functional recovery of the hip and health-related quality of life (HRQOL). RESULTS: The average SLE disease activity index was 3.5 points. Three patients were in ASA class I, 12 class II, and 9 were class III (37.5%). The average duration of follow-up was 67.5 months. None of the patients required a revision, and 3 patients died during the follow-up period. A statistically significant improvement in all scores was found comparing pre- and post-operative conditions (P < 0.001). The complication rate was 11.1% with 2 wound infections and 1 urinary tract infection. CONCLUSION: THA is an acceptable method for achieving functional recovery and increasing HRQOL in patients with SLE and ANFH who receive proper perioperative management.