Arthritis http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. Productivity Improvements in Hip and Knee Surgery Thu, 20 Feb 2014 07:48:11 +0000 http://www.hindawi.com/journals/arthritis/2014/615784/ Productivity improvements that occur as technologies become widely used are not well documented. This study measured secular trends over 1998–2010 in productivity of hip and knee procedures gauged in terms of changes in physical function and pain after versus before surgery. We used data from the Health and Retirement Study. Health outcomes from surgery were measured by 6 physical functioning scales and 2 pain indicators. We used propensity score matching to obtain nonsurgery control groups. Not only were there substantial improvements in physical functioning and pain reduction after receipt of these procedures in all years, but also we documented improvements in health outcomes over time. Largest improvements were for reductions in numbers of Activity and Instrumental Activity of Daily Living limitations for knee procedures. Frank A. Sloan, Linda K. George, and Linyan Hu Copyright © 2014 Frank A. Sloan et al. All rights reserved. A Technique of Predicting Radiographic Joint Line and Posterior Femoral Condylar Offset of the Knee Tue, 11 Feb 2014 09:17:58 +0000 http://www.hindawi.com/journals/arthritis/2014/121069/ Purpose. To describe a reliable method of predicting native joint line and posterior condylar offset (PCO) using true lateral digital radiographs of the distal femur. Methods. PCO was measured relative to a line drawn parallel to the posterior cortex of the distal femur and the joint line was measured from the posterior condylar flare to the articular surface. A ratio was then calculated for these measurements relative to the width of the femur at the level of the flare. Two independent observers measured PCO and joint line ratio for 105 radiographs of the different knees and one repeated these measurements after one week. Results. There was a significant correlation between the width of the femoral diaphysis at the level of the posterior condylar flare with joint line () and PCO (). Joint line and PCO could be predicted within 4 mm and 2 mm, respectively, using the identified ratio between the width of the femoral diaphysis at the level of the posterior condylar flare with measured joint line and PCO. The inter- () and intra- () observer reliability for these ratios were high. Conclusion. These ratios could be used to predict the native joint line and PCO. Nicholas D. Clement, David F. Hamilton, and Richard Burnett Copyright © 2014 Nicholas D. Clement et al. All rights reserved. Glucosamine for Osteoarthritis: Biological Effects, Clinical Efficacy, and Safety on Glucose Metabolism Tue, 11 Feb 2014 00:00:00 +0000 http://www.hindawi.com/journals/arthritis/2014/432463/ Osteoarthritis is a chronic degenerative disorder that currently represents one of the main causes of disability within the elderly population and an important presenting complaint overall. The pathophysiologic basis of osteoarthritis entails a complex group of interactions among biochemical and mechanical factors that have been better characterized in light of a recent spike in research on the subject. This has led to an ongoing search for ideal therapeutic management schemes for these patients, where glucosamine is one of the most frequently used alternatives worldwide due to their chondroprotective properties and their long-term effects. Its use in the treatment of osteoarthritis is well established; yet despite being considered effective by many research groups, controversy surrounds their true effectiveness. This situation stems from several methodological aspects which hinder appropriate data analysis and comparison in this context, particularly regarding objectives and target variables. Similar difficulties surround the assessment of the potential ability of glucosamine formulations to alter glucose metabolism. Nevertheless, evidence supporting diabetogenesis by glucosamine remains scarce in humans, and to date, this association should be considered only a theoretical possibility. Juan Salazar, Luis Bello, Mervin Chávez, Roberto Añez, Joselyn Rojas, and Valmore Bermúdez Copyright © 2014 Juan Salazar et al. All rights reserved. The Good Life: Assessing the Relative Importance of Physical, Psychological, and Self-Efficacy Statuses on Quality of Well-Being in Osteoarthritis Patients Wed, 25 Dec 2013 16:01:13 +0000 http://www.hindawi.com/journals/arthritis/2013/914216/ Background and Purpose. The purpose of the present study was to examine the interrelationships among physical dysfunction, self-efficacy, psychological distress, exercise, and quality of well-being for people with osteoarthritis. It was predicted that exercise would mediate the relationships between physical dysfunction, self-efficacy, psychological distress, and quality of well-being. Methods. Participants were 363 individuals with osteoarthritis who were 60 years of age or older. Data were collected from the baseline assessment period prior to participating in a social support and education intervention. A series of structural equation models was used to test the predicted relationships among the variables. Results. Exercise did not predict quality of well-being and was not related to self-efficacy or psychological distress; it was significantly related to physical dysfunction. When exercise was removed from the model, quality of life was significantly related to self-efficacy, physical dysfunction, and psychological distress. Conclusions. Engagement in exercise was directly related to physical functioning, but none of the other latent variables. Alternatively, treatment focused on self-efficacy and psychological distress might be the most effective way to improve quality of well-being. Charles Van Liew, Maya S. Santoro, Arielle K. Chalfant, Soujanya Gade, Danielle L. Casteel, Mitsuo Tomita, and Terry A. Cronan Copyright © 2013 Charles Van Liew et al. All rights reserved. Application of a Simple In-House PCR-SSP Technique for HLA-B* 27 Typing in Spondyloarthritis Patients Thu, 19 Dec 2013 13:42:28 +0000 http://www.hindawi.com/journals/arthritis/2013/504109/ Background. Microlymphocytotoxicity (MLCT) and flowcytometry (FC) are the conventional serological methods to detect HLA-B* 27. Due to some disadvantages in these methods, most of the HLA laboratories have now switched over to molecular methods. Molecular techniques based on commercial kits are expensive; as such many laboratories with limited funds in developing countries cannot afford these techniques. Aims. Our main aim was to standardize a simple inexpensive in-house PCR-SSP technique for HLA-B* 27 typing. Materials and Methods. Sequence Specific primers were designed to amplify all the subtypes of B* 27 using IMGT-HLA sequence database. Accuracy was checked by retyping of 90 PCR-SSOP typed controls. Results. The presence of 149 bp specific band with control band on 2% agarose gel showed B* 27 positivity. No discrepancies were found when compared with PCR-SSOP results. The frequency of HLA-B* 27 was found to be significantly increased (68.75% versus 4.40%, O.R 46.909: value ) among 700 SpA patients as compared to controls. Clinically, 54% of patients had polyarticular arthritis with SI joints involvement (68%) and restricted spine flexion (60%). Conclusion. In-house PCR-SSP technique is very simple and inexpensive technique to detect B* 27 allele, which was strongly associated with SpA patients from Western India. Devraj J. Parasannanavar, Anjali Rajadhyaksha, and Kanjaksha Ghosh Copyright © 2013 Devraj J. Parasannanavar et al. All rights reserved. Association of Body Mass Index with Physical Function and Health-Related Quality of Life in Adults with Arthritis Thu, 12 Dec 2013 11:49:12 +0000 http://www.hindawi.com/journals/arthritis/2013/190868/ Arthritis and obesity, both highly prevalent, contribute greatly to the burden of disability in US adults. We examined whether body mass index (BMI) was associated with physical function and health-related quality of life (HRQOL) measures among adults with arthritis and other rheumatic conditions. We assessed objectively measured BMI and physical functioning (six-minute walk, chair stand, seated reach, walking velocity, hand grip) and self-reported HRQOL (depression, stiffness, pain, fatigue, disability, quality of life-mental, and quality of life, physical) were assessed. Self-reported age, gender, race, physical activity, and arthritis medication use (covariates) were also assessed. Unadjusted and adjusted linear regression models examined the association between BMI and objective measures of functioning and self-reported measures of HRQOL. BMI was significantly associated with all functional () and HRQOL measures () in the unadjusted models. Associations between BMI and all functional measures () and most HRQOL measures remained significant in the adjusted models (); depression and quality of life, physical, were not significant. The present analysis of a range of HRQOL and objective measures of physical function demonstrates the debilitating effects of the combination of overweight and arthritis and other rheumatic conditions. Future research should focus on developing effective group and self-management programs for weight loss for people with arthritis and other rheumatic conditions (registered on clinicaltrials.gov: NCT01172327). Danielle E. Schoffman, Sara Wilcox, and Meghan Baruth Copyright © 2013 Danielle E. Schoffman et al. All rights reserved. Capillaroscopy in Psoriatic and Rheumatoid Arthritis: A Useful Tool for Differential Diagnosis Thu, 12 Dec 2013 11:22:43 +0000 http://www.hindawi.com/journals/arthritis/2013/957480/ Impairment of capillaries permeability and changes of microcirculation are associated with inflammatory arthritis. In order to demonstrate microvascular differences between psoriatic arthritis (PsA) and rheumatoid arthritis (RA) we analyzed capillaroscopic abnormalities such as megacapillaries, haemorrhages, ramifications, and avascular areas in patients affected by these two rheumatic disorders. Moreover to identify specific capillaroscopy patterns we analyzed the following parameters: venous limb diameter, arterial limb diameter, capillary loop diameter, amplitude of the capillary loop, linear density of capillaries (on 2 mm), and number of twisted capillaries (on 4 mm). Through a comparative morphometric analysis of capillaroscopy, our study demonstrated the presence of specific microvascular differences between PsA and RA providing an additional diagnostic tool for the differential diagnosis. We also suggest that capillaries structural abnormalities might reflect endothelial injury due to systemic inflammation during chronic arthritis. Dario Graceffa, Beatrice Amorosi, Elisa Maiani, Claudio Bonifati, Maria Sole Chimenti, Roberto Perricone, and Aldo Di Carlo Copyright © 2013 Dario Graceffa et al. All rights reserved. Defects in Tendon, Ligament, and Enthesis in Response to Genetic Alterations in Key Proteoglycans and Glycoproteins: A Review Sun, 10 Nov 2013 13:31:19 +0000 http://www.hindawi.com/journals/arthritis/2013/154812/ This review summarizes the genetic alterations and knockdown approaches published in the literature to assess the role of key proteoglycans and glycoproteins in the structural development, function, and repair of tendon, ligament, and enthesis. The information was collected from (i) genetically altered mice, (ii) in vitro knockdown studies, (iii) genetic variants predisposition to injury, and (iv) human genetic diseases. The genes reviewed are for small leucine-rich proteoglycans (lumican, fibromodulin, biglycan, decorin, and asporin); dermatan sulfate epimerase (Dse) that alters structure of glycosaminoglycan and hence the function of small leucine-rich proteoglycans by converting glucuronic to iduronic acid; matricellular proteins (thrombospondin 2, secreted phosphoprotein 1 (Spp1), secreted protein acidic and rich in cysteine (Sparc), periostin, and tenascin X) including human tenascin C variants; and others, such as tenomodulin, leukocyte cell derived chemotaxin 1 (chondromodulin-I, ChM-I), CD44 antigen (Cd44), lubricin (Prg4), and aggrecan degrading gene, a disintegrin-like and metallopeptidase (reprolysin type) with thrombospondin type 1 motif, 5 (Adamts5). Understanding these genes represents drug targets for disrupting pathological mechanisms that lead to tendinopathy, ligamentopathy, enthesopathy, enthesitis and tendon/ligament injury, that is, osteoarthritis and ankylosing spondylitis. Subhash C. Juneja and Christian Veillette Copyright © 2013 Subhash C. Juneja and Christian Veillette. All rights reserved. Association of Self-Efficacy and Outcome Expectations with Physical Activity in Adults with Arthritis Thu, 24 Oct 2013 11:14:11 +0000 http://www.hindawi.com/journals/arthritis/2013/621396/ Background and Purpose. The purpose of this study is to determine whether higher baseline levels of (a) self-efficacy for physical activity, (b) self-efficacy for arthritis self-management, and (c) outcome expectations for exercise are associated with higher physical activity levels following an exercise intervention for adults with arthritis. Methods. A secondary analysis of the intervention cohort () within a randomized controlled trial of the People with Arthritis Can Exercise program was performed. Multiple linear regression evaluated the relationship between physical activity at a time point three months after the completion of an exercise intervention and three main explanatory variables. Results. After controlling for baseline physical activity, neither self-efficacy for arthritis self-management nor outcome expectations for exercise related to three-month physical activity levels. There was a relationship between three-month physical activity and self-efficacy for physical activity. Conclusions. Future research is needed to evaluate the ability of self-efficacy-enhancing programs to increase physical activity in adults with arthritis. Thelma J. Mielenz, Kathryn L. Kubiak-Rizzone, Kimberly J. Alvarez, Patrick R. Hlavacek, Janet K. Freburger, Carol Giuliani, Vicki S. Mercer, and Leigh F. Callahan Copyright © 2013 Thelma J. Mielenz et al. All rights reserved. Physical Functioning, Perceived Disability, and Depressive Symptoms in Adults with Arthritis Thu, 05 Sep 2013 08:41:01 +0000 http://www.hindawi.com/journals/arthritis/2013/525761/ This study investigated how physical functioning and perceived disability are related to depressive symptoms in adults with arthritis (). Participants self-reported depressive symptoms and disability. Objective measures of physical functioning included the 30-second chair stand test, 6-minute walk test, gait speed, balance, grip strength, and the seated reach test. Separate quantile regression models tested associations between each functional measure and depressive symptoms, controlling for age, gender, race, BMI, self-reported health status, and arthritis medication use. The association between perceived disability and depressive symptoms was also tested. Participants averaged years; 85.8% were women; 64.3% were white. Lower distance in the 6-minute walk test, fewer chair stands, slower gait speed, and greater perceived disability were associated with greater depressive symptoms in unadjusted models (). Fewer chair stands and greater perceived disability were associated with more depressive symptoms in adjusted models (). Balance, grip strength, and seated reach were not related to depressive symptoms. The perception of being disabled was more strongly associated with depressive symptoms than reduced physical functioning. To reduce the risk of depression in arthritic populations, it may be critical to not only address physical symptoms but also to emphasize coping skills and arthritis self-efficacy. Katie Becofsky, Meghan Baruth, and Sara Wilcox Copyright © 2013 Katie Becofsky et al. All rights reserved. Diagnosis and Progression of Sacroiliitis in Repeated Sacroiliac Joint Computed Tomography Tue, 03 Sep 2013 09:12:19 +0000 http://www.hindawi.com/journals/arthritis/2013/659487/ Objective. To assess the clinical utility of repeat sacroiliac joint computed tomography (CT) in sacroiliitis by assessing the proportion of patients changing from normal to pathologic at CT and to which degree there is progression of established sacroiliitis at repeat CT. Methods. In a retrospective analysis of 334 patients (median age 34 years) with symptoms suggestive of inflammatory back pain, CT had been performed twice, in 47 of these thrice, and in eight patients four times. The studies were scored as normal, equivocal, unilateral sacroiliitis, or bilateral sacroiliitis. Results. There was no change in 331 of 389 repeat examinations. Ten patients (3.0%) had progressed from normal or equivocal to unilateral or bilateral sacroiliitis. Of 43 cases with sacroiliitis on the first study, 36 (83.7%) progressed markedly. Two normal cases had changed to equivocal. Eight equivocal cases were classified as normal on the repeat study. In further two patients, only small changes within the scoring grade equivocal were detected. Conclusions. CT is a valuable examination for diagnosis of sacroiliitis, but a repeated examination detects only a few additional cases of sacroiliitis. Most cases with already established sacroiliitis showed progression of disease. Mats Geijer, Gro Gadeholt Göthlin, and Jan H. Göthlin Copyright © 2013 Mats Geijer et al. All rights reserved. No Association between FCγR3B Copy Number Variation and Susceptibility to Biopsy-Proven Giant Cell Arteritis Tue, 20 Aug 2013 10:47:27 +0000 http://www.hindawi.com/journals/arthritis/2013/514914/ Objective. To determine the relationship between FCGR3B gene copy number variation (CNV) and biopsy proven giant cell arteritis (GCA). Methods. FCGR3B CNV was determined in 139 Australian biopsy proven GCA patients and 162 population matched controls, using a duplex qPCR assay and RNase P as the reference gene. Copy number was determined using Copy Caller software (v.1.0, Applied Biosystems, USA). CNV genotypes were classified into 3 groups (<2, 2, 3+) for analysis purposes, and analysis was performed using logistic regression. Results. All GCA patients had a positive temporal artery biopsy, and the most common presenting symptoms were visual disturbance and temporal headache. The mean age of patients at biopsy was 74 years (range 51–94) and 88/139 (63%) were female. The frequency of low (<2) FCGR3B copy number was comparable between GCA patients (%) and controls (%), as was the frequency of high (3+) FCGR3B copy number (15/130 (10.8%) in GCA patients versus 13/162 (8.0%) in controls). Overall there was no evidence that FCGR3B CNV frequencies differed between GCA patients and controls (, , ). Conclusion. FCGR3B CNV is not associated with GCA; however, replicate studies are required. Emma Dunstan, Sue Lester, Rachel Black, Maureen Rischmueller, Helen Chan, Alex W. Hewitt, and Catherine L. Hill Copyright © 2013 Emma Dunstan et al. All rights reserved. Differences in Mammalian Target of Rapamycin Gene Expression in the Peripheral Blood and Articular Cartilages of Osteoarthritic Patients and Disease Activity Tue, 25 Jun 2013 10:40:05 +0000 http://www.hindawi.com/journals/arthritis/2013/461486/ The gene expression of mTOR, autophagy-related ULK1, caspase 3, CDK-inhibitor p21, and TNFα was measured in the peripheral blood of osteoarthritic (OA) patients at different stages of the disease aiming to establish a gene expression profile that might indicate the activity of the disease and joint destruction. Whole blood of 65 OA outpatients, 27 end-stage OA patients, 27 healthy volunteers, and knee articular cartilages of 28 end-stage OA patients and 26 healthy subjects were examined. OA outpatients were subjected to clinical testing, ultrasonography, and radiographic and WOMAC scoring. Protein levels of p70-S6K, p21, and caspase 3 were quantified by ELISA. Gene expression was measured using real-time RT-PCR. Upregulation of mTOR gene expression was observed in PBMCs of 42 OA outpatients (“High mTOR expression subset”) and in PBMCs and articular cartilages of all end-stage OA patients. A positive correlation between mTOR gene expression in PBMCs and cartilage was observed in the end-stage OA patients. 23 OA outpatients in the “Low mTOR expression subset” exhibited significantly lower mTOR gene expression in PBMCs compared to healthy controls. These “Low mTOR” subset subjects experienced significantly more pain upon walking, and standing and increased total joint stiffness versus “High mTOR” subset, while the latter more often exhibited synovitis. The protein concentrations of p70-S6K, p21, and caspase 3 in PBMCs were significantly lower in the “Low” subset versus “High” subset and end-stage subjects. Increases in the expression of mTOR in PBMCs of OA patients are related to disease activity, being associated with synovitis more than with pain. Elena V. Tchetina, A. Robin Poole, Elena M. Zaitseva, Eugeniya P. Sharapova, Natalya G. Kashevarova, Elena A. Taskina, Liudmila I. Alekseeva, Liudmila A. Semyonova, Svetlana I. Glukhova, Alexandr N. Kuzin, Maxim A. Makarov, and Sergey A. Makarov Copyright © 2013 Elena V. Tchetina et al. All rights reserved. Retrospective Cohort Study of the Prevalence of Lumbosacral Transitional Vertebra in a Wide and Well-Represented Population Mon, 24 Jun 2013 11:37:02 +0000 http://www.hindawi.com/journals/arthritis/2013/461425/ Purpose. The aim of this study is to determine the prevalence of lumbosacral transitional vertebra (LSTV) in a well-represented general population. Methods. For a retrospective cohort study, abdominal radiographs of adult subjects were queried with clear visibility of the vertebral body articulation of the last rib, all lumbar transverse processes, and complete sacral wings. Exclusion criteria included any radiologic evidence of previous lumbosacral surgery that would block our view. A total of 6200 abdominal films were reviewed, and 3607 were identified as being suitable for the measurement of the desired parameters. Results. A total of 3607 subjects were identified as eligible for the study, and 683 (18.9%) were classified as positive for a lumbosacral transitional vertebra. The prevalence of sacralization and lumbarization was found as 17.2% and 1.7%, respectively. The average age at the time of the study was years (18–86 years). Conclusions. As a result of different opinions, LSTV retains its controversial status. Our prevalence study of the general population will provide assistance for resolution of the controversy. Prevalence studies of the general population with a wide participation will shed light on comparative studies. Demet Uçar, Bekir Yavuz Uçar, Yahya Coşar, Kurtuluş Emrem, Gürkan Gümüşsuyu, Serhat Mutlu, Burcu Mutlu, Mehmet Akif Çaçan, Yılmaz Mertsoy, and Hatice Gümüş Copyright © 2013 Demet Uçar et al. All rights reserved. Primary and Posttraumatic Arthritis of the Elbow Mon, 27 May 2013 14:16:07 +0000 http://www.hindawi.com/journals/arthritis/2013/473259/ Whether degenerative joint disease of the elbow may be the result of primary or posttraumatic etiologies, arthritis of the elbow commonly leads to pain, loss of motion, and functional disability. A detailed history and focused physical examination, in combination with imaging modalities, can help localize the origin of symptoms and help direct treatment. Although nonoperative treatment is the initial therapy for arthritis of the elbow, surgical interventions may provide substantial relief to the appropriately selected patient. Debdut Biswas, Robert W. Wysocki, and Mark S. Cohen Copyright © 2013 Debdut Biswas et al. All rights reserved. Determination of the Diagnostic Values of Asymmetric Dimethylarginine as an Indicator for Evaluation of the Endothelial Dysfunction in Patients with Rheumatoid Arthritis Wed, 15 May 2013 13:51:51 +0000 http://www.hindawi.com/journals/arthritis/2013/818037/ Introduction. To compare the diagnostic values of laboratory variables, to present evaluations of the diagnostic test for asymmetric dimethyl arginine (ADMA), rheumatoid factor (RF), C-reactive protein (CRP), and DAS28 index, and to define the effect of untreated rheumatoid arthritis on endothelial function. In order to determine whether ADMA changes depending on the disease evolution, ADMA was used as an indicator for endothelial dysfunction. Methods. Using an ELISA technology of DLD-Diagnostika-GMBH for the detection of ADMA, the samples of serum and urine have been examined in 70 participants (35 RA who were not treated, 35 healthy controls). RF was defined with the test for agglutination (Latex RF test) in the same participants. Results. Out of 35 examined patients with RA, RF appeared in 17 patients (sensitivity of the test, 51.42%). In 20 of the 35 examined patients with RA, we found the presence of ADMA (sensitivity of the test, 57.14%). Anti-CCP antibody was present in 24 examined patients with RA (sensitivity of the test, 68.57%). Conclusion. ADMA has equal or very similar sensitivity and specificity to RF in untreated RA (sensitivity of 57.14% versus 48.57%, specificity of 88.57% versus 91.42%) in the detection of asymptomatic endothelial dysfunction in untreated RA. Dejan Spasovski, Arif Latifi, Bashkim Osmani, Svetlana Krstevska-Balkanov, Irena Kafedizska, Maja Slaninka-Micevska, Beti Dejanova, Sonja Alabakovska, and Trajan Balkanov Copyright © 2013 Dejan Spasovski et al. All rights reserved. Rheumatoid Arthritis in Minorities Tue, 14 May 2013 11:18:53 +0000 http://www.hindawi.com/journals/arthritis/2013/256493/ Juan-Manuel Anaya, Adriana Rojas-Villarraga, Rubén Darío Mantilla, and Claudio Galarza-Maldonado Copyright © 2013 Juan-Manuel Anaya et al. All rights reserved. Comment on “The Effects of Bariatric Surgery Weight Loss on Knee Pain in Patients with Osteoarthritis of the Knee” Wed, 24 Apr 2013 16:12:18 +0000 http://www.hindawi.com/journals/arthritis/2013/517803/ Janice Lin, Manish Parikh, and Jonathan Samuels Copyright © 2013 Janice Lin et al. All rights reserved. Two Single-Nucleotide Polymorphisms in ADAM12 Gene Are Associated with Early and Late Radiographic Knee Osteoarthritis in Estonian Population Thu, 28 Mar 2013 13:56:40 +0000 http://www.hindawi.com/journals/arthritis/2013/878126/ Objectives. To investigate associations of selected single-nucleotide polymorphisms (SNPs) in ADAM12 gene with radiographic knee osteoarthritis (rKOA) in Estonian population. Methods. The rs3740199, rs1871054, rs1278279, and rs1044122 SNPs in ADAM12 gene were genotyped in 438 subjects (303 women) from population-based cohort, aged 32 to 57 (mean 45.4). The rKOA features were evaluated in the tibiofemoral joint (TFJ) and patellofemoral joint. Results. The early rKOA was found in 51.4% of investigated subjects (72% women) and 12.3% of participants (63% women) had advanced stage of diseases. The A allele of synonymous SNP rs1044122 was associated with early rKOA in TFJ, predominantly with the presence of osteophytes in females (OR 1.57; 95% CI 1.08–2.29, ). The C allele of intron polymorphism rs1871054 carried risk for advanced rKOA, mostly to osteophyte formation in TFJ in males (OR 3.03; 95% CI 1.11–7.53, ). Also the CCAA haplotype of ADAM12 was associated with osteophytosis, again mostly in TFJ in males (). For rs3740199 and rs1278279, no statistically significant associations were observed. Conclusion.  ADAM12 gene variants are related to rKOA risk during the early and late stages of diseases. The genetic risk seems to be predominantly associated with the appearance of osteophytes—a marker of bone remodelling and neochondrogenesis. Irina Kerna, Kalle Kisand, Ann E. Tamm, Jaanika Kumm, and Agu O. Tamm Copyright © 2013 Irina Kerna et al. All rights reserved. Imaging Appearances in Gout Mon, 25 Mar 2013 13:34:55 +0000 http://www.hindawi.com/journals/arthritis/2013/673401/ Gout is an ancient disease. Last decade has brought about significant advancement in imaging technology and real scientific growth in the understanding of the pathophysiology of gout, leading to the availability of multiple effective noninvasive diagnostic imaging options for gout and treatment options fighting inflammation and controlling urate levels. Despite this, gout is still being sub-optimally treated, often by nonspecialists. Increased awareness of optimal treatment options and an increasing role of ultrasound and dual energy computed tomography (DECT) in the diagnosis and management of gout are expected to transform the management of gout and limit its morbidity. DECT gives an accurate assessment of the distribution of the deposited monosodium urate (MSU) crystals in gout and quantifies them. The presence of a combination of the ultrasound findings of an effusion, tophus, erosion and the double contour sign in conjunction with clinical presentation may be able to obviate the need for intervention and joint aspiration in a certain case population for the diagnosis of gout. The purpose of this paper is to review imaging appearances of gout and its clinical applications. Gandikota Girish, David M. Melville, Gurjit S. Kaeley, Catherine J. Brandon, Janak R. Goyal, Jon A. Jacobson, and David A. Jamadar Copyright © 2013 Gandikota Girish et al. All rights reserved. Long-Term Effects of AposTherapy in Patients with Osteoarthritis of the Knee: A Two-Year Followup Sun, 03 Mar 2013 17:15:20 +0000 http://www.hindawi.com/journals/arthritis/2013/689236/ Several biomechanics treatments for knee osteoarthritis (OA) have emerged with the goal of reducing pain and improving function. Through this, researchers have hoped to achieve a transition from the pathological gait patterns to coordinated motor responses. The purpose of the study was to determine the long-term effects of a therapy using a biomechanical device in patients with knee OA. Patients with knee OA were enrolled to active and control groups. The biomechanical device used in therapy (AposTherapy) was individually calibrated to each patient in the active group. Patients in the control group received standard treatment. Outcomes were the Western Ontario and McMaster Osteoarthritis Index (WOMAC), Aggregated Locomotor Function (ALF), Short Form 36 (SF-36), and Knee Society Score assessments. The active and control groups were similar at the baseline (group difference in all scores ). The active group showed a larger improvement over time between groups in all three WOMAC categories (, 21.7, and 18.1 for pain, stiffness, and function; all ), SF-36 Physical Scale (; ), Knee Society Knee Score (; ), and Knee Society Function Score (; ). At the two-year endpoint, the active group showed significantly better results (all ). The groups showed a difference of 4.9, 5.6, and 4.7 for the WOMAC pain, stiffness, and function scores, respectively, 10.8 s in ALF score, 30.5 in SF-36 Physical Scale, 16.9 in SF-36 Mental Scale, 17.8 in Knee Society Knee Score, and 25.2 in Knee Society Function Score. The biomechanical therapy examined was shown to significantly reduce pain and improve function and quality of life of patients with knee OA over the long term. Yaron Bar-Ziv, Eytan M. Debbi, Yuval Ran, Shaike Benedict, Nahum Halperin, and Yiftah Beer Copyright © 2013 Yaron Bar-Ziv et al. All rights reserved. How Different Methodologies of Harvesting and Analysing the Samples Affect the Test Results in Determining Joint Mediators Wed, 20 Feb 2013 11:03:08 +0000 http://www.hindawi.com/journals/arthritis/2013/631959/ Purpose. This study has researched the affect of different methodologies of harvesting and analysing the samples in determining the mediators emerging after the rat articular cartilage injury. Materials and Methods. One hundred and forty-four male wistar rats were divided into 2 groups. Synovial fluid samples were taken from all of the rats. We entered into the right knees of the rats in group I under anaesthesia and took cartilage tissue samples from their distal femur. Samples were taken as reference values for enzyme linked immunosorbent assay (ELISA) and histopathological evaluations. We entered into the right knees of the rats in group II and formed complete layer of cartilage injury in their medial femoral condyles. At the end of the 15th day, the rats were sacrificed after taking synovial fluid samples from their right knees creating defect in the rats in group II. The molecular markers in the synovial fluid and cartilage tissue samples which were taken from the experimental and control groups (MMP-9, MMP-13, TIMP-1, TNF-α, and NO) were analysed by direct or indirect methodologies. SPSS 18.0 Package program was used in the statistical evaluation. Students t-test where the measurement variables between the experimental and control groups were compared was applied. Receiver Operating Characteristics (ROC) curves were used in the determination of the diagnostic sufficiency from the tissue. Results. No difference was found between TIMP-1 and MMP-9 levels in synovial fluid and cartilage tissue. From the molecular markers, when MMP-9, MMP-13, NO, TIMP-1, TNF-α′, the area under ROC curve, and P values were examined, MMP-13 (, 95% CI: 0.70–0.85), NO (, 95% CI: 0.72–0.86), and TNF-α (, 95% CI: 0.91–0.98) results were found to be statistically significant. Inferences. The indirect ELISA protocol which we apply for the cartilage tissue as an alternative to synovial lavage fluid is a reliable method which can be used in the determination of articular cartilage injury markers. Ibrahim Yilmaz, Nevzat Selim Gokay, Rifat Bircan, Gamze V. Saracoglu, Sergulen Dervisoglu, and Alper Gokce Copyright © 2013 Ibrahim Yilmaz et al. All rights reserved. High Frequency of Fibromyalgia in Patients with Psoriatic Arthritis: A Pilot Study Thu, 14 Feb 2013 18:02:24 +0000 http://www.hindawi.com/journals/arthritis/2013/762921/ Background. Widespread pain from fibromyalgia syndrome (FMS) is observed in patients with psoriatic arthritis (PsA). We hypothesized that there is increased frequency of FMS in patients with PsA that contributes to fatigue and pain. Method. We prospectively enrolled patients with PsA based on the Classification criteria for Psoriatic Arthritis and healthy subjects were used as controls. The frequency of FMS was determined using London Fibromyalgia Epidemiologic Study Screening Questionnaire (LFESSQ) and Symptoms Intensity scale (SIs). Results. 34 PsA patients and 44 controls fulfilled the inclusion criteria. Median age of PsA patients was 52 years with 53.33% females. Median age of controls was 50.5 years with 59% females. FMS was present in 53.33% of PsA patients compared to 4.54% of the controls (), based on LFESSQ. 37.50% of PsA had FMS compared to 6.66% of controls () based on SIs. There was a significant correlation between LFESSQ and SIs in the psoriatic group (). 76.66% of PsA patients complained of fatigue compared to 40.90% of controls, but the mean fatigue score between the two groups was comparable (5.03 versus 5.18). Conclusion. FMS-associated pain and fatigue are significantly more frequent in patients with PsA compared to controls. Marina N. Magrey, Maria Antonelli, Neena James, and Muhammad Asim Khan Copyright © 2013 Marina N. Magrey et al. All rights reserved. A Literature Synthesis Indicates Very Low Quality, but Consistent Evidence of Improvements in Function after Surgical Interventions for Primary Osteoarthritis of the Elbow Thu, 31 Jan 2013 08:28:33 +0000 http://www.hindawi.com/journals/arthritis/2013/487615/ Background. Primary osteoarthritis of the elbow is a debilitating disease with an overall incidence of about 2%. Pain and reduced motion (ROM) lead to disability and loss of functional independence. Purpose. To critically review the literature on patient-related important functional outcomes (pain, ROMs and functional recovery) after surgery for primary OA of the elbow, utilizing the 2011 OCEBM levels of evidence. Design. A literature synthesis. Results. Twenty-six articles satisfied the inclusion and exclusion criteria; 25 of the studies were at level IV evidence, and 1 at level III. All three surgical techniques led to improvement in pain, ROM, and functional recovery in the short- and medium-term follow-up. Long-term follow-up results, available only for open joint debridement, showed recurrence of osteoarthritic signs on X-ray with minimal loss of motion. Recently, there seems to be an increased focus on arthroscopic debridement. Conclusion. The quality of research addressing surgical interventions is very low, including total elbow arthroplasty (TEA). However, the evidence concurs that open and arthroscopic joint debridement can improve function in patients with moderate-to-severe OA of the elbow. TEA is reserved for treating severe joint destruction, mostly for elderly individuals with low physical demands when other intervention options have failed. Joshua I. Vincent, Anthony A. Vandervoort, and Joy C. MacDermid Copyright © 2013 Joshua I. Vincent et al. All rights reserved. The Application of Optical Coherence Tomography in Musculoskeletal Disease Tue, 15 Jan 2013 10:05:46 +0000 http://www.hindawi.com/journals/arthritis/2013/563268/ Many musculoskeletal disorders (MDs) are associated with irreversible bone and cartilage damage; this is particularly true for osteoarthritis (OA). Therefore, a clinical need exists for modalities which can detect OA and other MDs at early stages. Optical coherence tomography (OCT) is an infrared-based imaging, currently FDA approved in cardiology and ophthalmology, which has a resolution greater than 10 microns and acquisition rate of 120 frames/second. It has shown feasibility for imaging early OA, identifying changes prior to cartilage thinning both in vitro and in vivo in patients and in OA animal models. In addition, OCT has shown an ability to identify early rheumatoid arthritis (RA) and guide tendon repair, but has the potential for an even greater impact. Clinical trials in OA are currently underway, as well as in several other MDs. Christopher Rashidifard, Christopher Vercollone, Scott Martin, Bin Liu, and Mark E. Brezinski Copyright © 2013 Christopher Rashidifard et al. All rights reserved. Shoulder Osteoarthritis Thu, 10 Jan 2013 13:21:00 +0000 http://www.hindawi.com/journals/arthritis/2013/370231/ Osteoarthritis (OA) is the most frequent cause of disability in the USA, affecting up to 32.8% of patients over the age of sixty. Treatment of shoulder OA is often controversial and includes both nonoperative and surgical modalities. Nonoperative modalities should be utilized before operative treatment is considered, particularly for patients with mild-to-moderate OA or when pain and functional limitations are modest despite more advanced radiographic changes. If conservative options fail, surgical treatment should be considered. Although different surgical procedures are available, as in other joints affected by severe OA, the most effective treatment is joint arthroplasty. The aim of this work is to give an overview of the currently available treatments of shoulder OA. Claudio Chillemi and Vincenzo Franceschini Copyright © 2013 Claudio Chillemi and Vincenzo Franceschini. All rights reserved. Prescribing Optimal Nutrition and Physical Activity as “First-Line” Interventions for Best Practice Management of Chronic Low-Grade Inflammation Associated with Osteoarthritis: Evidence Synthesis Mon, 31 Dec 2012 20:02:33 +0000 http://www.hindawi.com/journals/arthritis/2012/560634/ Low-grade inflammation and oxidative stress underlie chronic osteoarthritis. Although best-practice guidelines for osteoarthritis emphasize self-management including weight control and exercise, the role of lifestyle behavior change to address chronic low-grade inflammation has not been a focus of first-line management. This paper synthesizes the literature that supports the idea in which the Western diet and inactivity are proinflammatory, whereas a plant-based diet and activity are anti-inflammatory, and that low-grade inflammation and oxidative stress underlying osteoarthritis often coexist with lifestyle-related risk factors and conditions. We provide evidence-informed recommendations on how lifestyle behavior change can be integrated into “first-line” osteoarthritis management through teamwork and targeted evidence-based interventions. Healthy living can be exploited to reduce inflammation, oxidative stress, and related pain and disability and improve patients’ overall health. This approach aligns with evidence-based best practice and holds the promise of eliminating or reducing chronic low-grade inflammation, attenuating disease progression, reducing weight, maximizing health by minimizing a patient’s risk or manifestations of other lifestyle-related conditions hallmarked by chronic low-grade inflammation, and reducing the need for medications and surgery. This approach provides an informed cost effective basis for prevention, potential reversal, and management of signs and symptoms of chronic osteoarthritis and has implications for research paradigms in osteoarthritis. Elizabeth Dean and Rasmus Gormsen Hansen Copyright © 2012 Elizabeth Dean and Rasmus Gormsen Hansen. All rights reserved. A Synoviocyte Model for Osteoarthritis and Rheumatoid Arthritis: Response to Ibuprofen, Betamethasone, and Ginger Extract—A Cross-Sectional In Vitro Study Mon, 31 Dec 2012 15:20:32 +0000 http://www.hindawi.com/journals/arthritis/2012/505842/ This study aimed at determining if synovial cell cultures from rheumatoid arthritis (RA), osteoarthritis (OA), and healthy controls (HC) differ and are suitable disease models in pharmacological studies, and tested their response to some anti-inflammatory drugs. Synovial cells were isolated from synovial membrane or joint fluid. Cells were cultivated and exposed to no or TNF-α stimulation without, or in the presence of, betamethasone, ibuprofen, or a standardized ginger extract. Concentrations of a panel of cytokines, growth factors, and chemokines were mapped for each culture and condition. Our cells secreted an increased amount of the cytokines IL-1β, IL-6, and IL-8 in response to TNF-α stimulation in all conditions. OA cells showed a higher IL-6 and IL-8 and a lower IL-1β production, when not stimulated, than RA and HC cells, which were similar. TNF-α stimulation caused similar IL-1β, IL-6, and IL-8 release in all groups. Ibuprofen showed no effect on cytokine production, while ginger extract was similar to betamethasone. Ginger extract was as effective an anti-inflammatory agent as betamethasone in this in vitro model. Cultured fibroblast-like synoviocytes from OA and RA subjects promise to be a useful pharmacological disease model, but further studies, to support results from such a model are needed. Søren Ribel-Madsen, Else Marie Bartels, Anders Stockmarr, Arne Borgwardt, Claus Cornett, Bente Danneskiold-Samsøe, and Henning Bliddal Copyright © 2012 Søren Ribel-Madsen et al. All rights reserved. Expression of Angiotensin II Receptor-1 in Human Articular Chondrocytes Sun, 30 Dec 2012 18:38:06 +0000 http://www.hindawi.com/journals/arthritis/2012/648537/ Background. Besides its involvement in the cardiovascular system, the renin-angiotensin-aldosterone (RAS) system has also been suggested to play an important role in inflammation. To explore the role of this system in cartilage damage in arthritis, we investigated the expression of angiotensin II receptors in chondrocytes. Methods. Articular cartilage was obtained from patients with osteoarthritis, rheumatoid arthritis, and traumatic fractures who were undergoing arthroplasty. Chondrocytes were isolated and cultured in vitro with or without interleukin (IL-1). The expression of angiotensin II receptor types 1 (AT1R) and 2 (AT2R) mRNA by the chondrocytes was analyzed using reverse transcription-polymerase chain reaction (RT-PCR). AT1R expression in cartilage tissue was analyzed using immunohistochemistry. The effect of IL-1 on AT1R/AT2R expression in the chondrocytes was analyzed by quantitative PCR and flow cytometry. Results. Chondrocytes from all patient types expressed AT1R/AT2R mRNA, though considerable variation was found between samples. Immunohistochemical analysis confirmed AT1R expression at the protein level. Stimulation with IL-1 enhanced the expression of AT1R/AT2R mRNA in OA and RA chondrocytes. Conclusions. Human articular chondrocytes, at least partially, express angiotensin II receptors, and IL-1 stimulation induced AT1R/AT2R mRNA expression significantly. Yuki Kawakami, Kosuke Matsuo, Minako Murata, Kazuo Yudoh, Hiroshi Nakamura, Hiroyuki Shimizu, Moroe Beppu, Yutaka Inaba, Tomoyuki Saito, Tomohiro Kato, and Kayo Masuko Copyright © 2012 Yuki Kawakami et al. All rights reserved. A Review of Translational Animal Models for Knee Osteoarthritis Thu, 27 Dec 2012 09:10:27 +0000 http://www.hindawi.com/journals/arthritis/2012/764621/ Knee osteoarthritis remains a tremendous public health concern, both in terms of health-related quality of life and financial burden of disease. Translational research is a critical step towards understanding and mitigating the long-term effects of this disease process. Animal models provide practical and clinically relevant ways to study both the natural history and response to treatment of knee osteoarthritis. Many factors including size, cost, and method of inducing osteoarthritis are important considerations for choosing an appropriate animal model. Smaller animals are useful because of their ease of use and cost, while larger animals are advantageous because of their anatomical similarity to humans. This evidence-based review will compare and contrast several different animal models for knee osteoarthritis. Our goal is to inform the clinician about current research models, in order to facilitate the transfer of knowledge from the “bench” to the “bedside.” Martin H. Gregory, Nicholas Capito, Keiichi Kuroki, Aaron M. Stoker, James L. Cook, and Seth L. Sherman Copyright © 2012 Martin H. Gregory et al. All rights reserved.