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Etiopathogenesis, Prevention, Modern Diagnostics and Conservative Treatment of Osteoarthritis
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Etiopathogenesis, Prevention, Modern Diagnostics and Conservative Treatment of Osteoarthritis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 31 January 2025 | Viewed by 2683

Special Issue Editors

Dr. Wiesław Tomaszewski

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Guest Editor
1. ARS MEDICA Foundation for Medical Education and Promotion of Health, Art and Culture, 04-036 Warsaw, Poland
2. College of Physiotherapy in Wrocław, Wrocław, Poland
Interests: orthopaedic surgery; minimal invasive techniques; osteoarthritis; sports medicine (physical activity in the prevention and treatment of lifestyle diseases)
Dr. Wojciech Glinkowski

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Guest Editor
1. Polish Telemedicine and eHealth Society, Targowa 39A-5, PL-03728 Warsaw, Poland
2. Center of Excellence "TeleOrto" for Telediagnostics and Treatment of Disorders and Injuries of the Locomotor System, Department of Medical Informatics and Telemedicine, Medical University of Warsaw, PL-00581 Warsaw, Poland
Interests: orthopaedic surgery; spine surgery; telemedicine; eHealth; telerehabilitation; telediagnostics; patient-oriented outcomes; PROMIS® (Patient-Reported Outcomes Measurement Information System); quantitative methods; joint preservation; osteoarthritis; osteoporosis; minimally invasive techniques
Special Issues, Collections and Topics in MDPI journals
Dr. Grzegorz Szczȩsny

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Guest Editor
Department of Orthopedic Surgery and Traumatology, Medical University, 02-005 Warsaw, Poland
Interests: orthopaedic surgery; osteoarthritis; osteoporosis; joint surgery
Dr. Przemysław Paradowski

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Guest Editor
1. Department of Surgical and Perioperative Sciences, Division of Orthopedics, Sunderby Research Unit, Umea University, Sunderby Central Hospital of Norrbotten, SE-971 80 Lulea, Sweden
2. Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, SE-221 85 Lund, Sweden
Interests: osteoarthritis (osteoarthritis in clinical and radiographic assessment, diagnosis criteria, and assessment of progression of changes); orthopedic surgery

Special Issue Information

Dear Colleagues,

Osteoarthritis (OA) is a common chronic joint disease causing pain, disability, and loss of function. It is currently the fourth most common cause of disability in women and the eighth in men, and shows a global over 100% trend of an increase in the number of years lived with disability over the last three decades. It is among the ten diseases generating the highest social costs. As many as 5% of the world's population requires constant treatment due to pain and related disorders of the musculoskeletal system caused by this disease. It causes debilitating multi-joint changes, causes pain that impairs motor skills, limits the ability to move freely and perform everyday as well as professional activities, and significantly worsens quality of life. OA's etiology includes mechanical and biological events that lead to an imbalance between the interconnected processes of the breakdown and formation of articular cartilage as well as the subchondral bone layer. This process can be initiated by many factors: genetic, developmental, metabolic, and traumatic. OA is manifested by morphological, biochemical, molecular, and biomechanical changes both within cells and the matrix, leading to softening, fibrosis, the formation of cartilage erosions and defects, the “densification” of subchondral bone tissue, and the formation of osteophytes as well as subchondral cysts. Does osteoarthritis have to be the incurable epidemic of our times? Does the complete replacement of the joint with an artificial one remain the primary form of treatment? What can and should be used in the treatment procedure before arthroplasty, or are there practical ways to prevent the need for surgery? Such questions remain open. Many scientific studies bring us closer to understanding osteoarthritis’s etiology, pathogenesis, and natural course. However, we still need to know more to assess joint failure risk, and it is not enough to prevent and treat the disease in its early stages. Further scientific research will allow us to understand the nature of the disease better and find more effective ways to treat it.

The Special Issue of the Journal of Clinical Medicine is devoted to OA etiology and pathogenesis as well as modern methods of diagnosis, conservative treatment, and joint preservation. We accept original research, clinical papers, and review papers based on the latest literature reports.

Dr. Wiesław Tomaszewski
Dr. Wojciech Glinkowski
Dr. Grzegorz Szczȩsny
Dr. Przemysław Paradowski
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • osteoarthritis
  • etiopathogenesis of osteoarthritis
  • articular cartilage
  • OA treatment
  • joint preservation

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Published Papers (4 papers)

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Research

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10 pages, 1467 KiB  
Article
Short-Term Effects of Cooled Radiofrequency Ablation on Walking Ability in Japanese Patients with Knee Osteoarthritis
by Kentaro Hiromura, Hironori Kitajima, Chie Hatakenaka, Yoshiaki Shimizu, Terumasa Miyagaki, Masayuki Mori, Kazuhei Nakashima, Atsushi Fuku, Hiroaki Hirata, Yoshiyuki Tachi and Ayumi Kaneuji
J. Clin. Med. 2024, 13(23), 7049; https://doi.org/10.3390/jcm13237049 - 22 Nov 2024
Abstract
Background/Objectives: Knee osteoarthritis (KOA) is a degenerative joint disease typically managed with conservative treatments, such as anti-inflammatory medications and intra-articular hyaluronic acid injections; however, advanced cases may eventually require surgical intervention. Recently, cooled radiofrequency ablation (CRFA) has emerged as a novel treatment [...] Read more.
Background/Objectives: Knee osteoarthritis (KOA) is a degenerative joint disease typically managed with conservative treatments, such as anti-inflammatory medications and intra-articular hyaluronic acid injections; however, advanced cases may eventually require surgical intervention. Recently, cooled radiofrequency ablation (CRFA) has emerged as a novel treatment option for alleviating KOA-related pain by temporarily disabling pain-transmitting nerves. This study evaluated the short-term effects of CRFA on pain relief and walking ability in KOA patients, with a specific focus on functional improvements in walking capacity. Methods: This study included 58 patients (71 knees) with KOA who underwent CRFA after experiencing inadequate pain control with conservative treatments. The cohort consisted of 28 men and 30 women, with a mean age of 75.2 years (55–90). Under ultrasound guidance, CRFA was performed on the superior lateral geniculate nerve, superior medial geniculate nerve, and inferior medial geniculate nerve, with each targeted nerve ablated. Pre- and post-procedural evaluations (one month after CRFA) included assessments of visual analog scale (VAS) scores for pain at rest and during walking, range of motion (ROM), knee extensor strength, walking speed, and gait stability. Results: Significant improvements in the mean VAS (rest/walking) and mean walking speed (comfortable/maximum) were observed following CRFA. However, no significant changes were noted in ROM, knee extensor strength, or walking stability. Conclusions: These findings suggest that rehabilitation may be essential to further enhance walking stability. Overall, CRFA appears to be a promising short-term treatment option for reducing VAS pain scores and enhancing walking speed in patients with KOA. Full article
(This article belongs to the Special Issue Etiopathogenesis, Prevention, Modern Diagnostics and Conservative Treatment of Osteoarthritis)
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11 pages, 2870 KiB  
Article
Safety and Effectiveness of a Novel Liposomal Intra-Articular Lubricant in Symptomatic Knee Osteoarthritis: A First-in-Human Study
by Shai Shemesh, Oleg Dolkart, Ronit Goldberg, Sabrina Jahn, Amal Khoury, Yaniv Warschawski, Haggai Schermann, Moshe Salai, Gaby Agar and Michael Drexler
J. Clin. Med. 2024, 13(22), 6956; https://doi.org/10.3390/jcm13226956 - 18 Nov 2024
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Abstract
Background/Objectives: Osteoarthritis (OA) is a common disease that affects almost half the population at some point in their lives, causing pain and decreased functional capacity. New conservative treatment modalities are being proposed to provide symptomatic relief and delay surgical intervention. This study aimed [...] Read more.
Background/Objectives: Osteoarthritis (OA) is a common disease that affects almost half the population at some point in their lives, causing pain and decreased functional capacity. New conservative treatment modalities are being proposed to provide symptomatic relief and delay surgical intervention. This study aimed at evaluating the safety of the novel liposomal boundary lubricant, injected intra-articularly in patients with moderate knee OA. Additionally, the effect on the functionality and life quality was assessed. Methods: Eighteen of the twenty screened subjects met inclusion criteria and were enrolled in the study. After receiving a single IA injection of AqueousJoint, patients were prospectively evaluated at baseline and at 2, 4, 8, 12, and 26 weeks. Numeric Pain Rating Scale (NRS), Knee injury and Osteoarthritis Outcome Score (KOOS), Short Form Health Survey (SF12) and range of motion were also recorded. Results: The final analysis was conducted on 18 subjects. No adverse events related to the investigational product were observed in the study. No serious adverse events were observed at all. A significant decrease in pain was demonstrated at all time points vs. baseline (Friedman X2 = 35.08, p < 0.001). Significant improvement was demonstrated in KOOS pain, symptoms, sports, and ADL subscales (p < 0.001). Conclusions: Despite a relatively small sample, it was demonstrated that single IA AqueousJoint injection is a safe procedure, resulting in significant pain reduction, higher ADL score, and higher KOOS sport scores. The effects lasted up to 6 months. Full article
(This article belongs to the Special Issue Etiopathogenesis, Prevention, Modern Diagnostics and Conservative Treatment of Osteoarthritis)
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9 pages, 1281 KiB  
Article
In Silico Modeling of Stress Distribution in the Diseased Ankle Joint
by Jacek Lorkowski, Miroslaw W. Mrzyglod and Mieczyslaw Pokorski
J. Clin. Med. 2024, 13(18), 5453; https://doi.org/10.3390/jcm13185453 - 13 Sep 2024
Viewed by 669
Abstract
Background/Objectives: Osteoarthritis is a feature of the aging process. Here, we adopted in silico 2D finite element modeling (FEM) for the simulation of diseased ankle joints. We delved into the influence of body weight intensity on the stress distribution caused by subchondral cysts [...] Read more.
Background/Objectives: Osteoarthritis is a feature of the aging process. Here, we adopted in silico 2D finite element modeling (FEM) for the simulation of diseased ankle joints. We delved into the influence of body weight intensity on the stress distribution caused by subchondral cysts imitating degenerative age-related arthritic changes. Methods: FEM was performed using virtually generated pictorial schemes of the ankle joint skeletal contour. It included a constellation of scenarios with solitary or multiple cysts, or the lack thereof, located centrally, peripherally, or both in the talus and tibia at increased fixed levels of body weight. Results: The modeling showed that the highest stress was in the presence of a solitary central cyst in the talus and two centrally located cysts in the talus and the tibia, with the averaged values of 1.81 ± 0.52 MPa and 1.92 ± 0.55 MPa, respectively; there was a significant increase compared with the 1.24 ± 0.35 MPa in the control condition without cysts. An increase in body weight consistently increased the strain on the ankle joint. In contrast, peripherally located cysts failed to affect the stress distribution significantly. Conclusions: We conclude that subchondral central cysts substantially enhance the stress exerted on the ankle joint and its vicinity with body weight dependence. FEM’s ability to predict the location and magnitude of subchondral stress changes when confirmed in clinical trials might help to optimize the management of age-related degenerative joint changes. Full article
(This article belongs to the Special Issue Etiopathogenesis, Prevention, Modern Diagnostics and Conservative Treatment of Osteoarthritis)
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Review

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15 pages, 835 KiB  
Review
Harnessing the Power of Water: A Scoping Review of Hydrokinesiotherapy as a Game-Changer in Knee Osteoarthritis Management
by Roberto Tedeschi, Federica Giorgi and Danilo Donati
J. Clin. Med. 2024, 13(19), 5811; https://doi.org/10.3390/jcm13195811 - 28 Sep 2024
Viewed by 822
Abstract
Background: Knee osteoarthritis (OA) is a prevalent condition that significantly impairs pain, mobility, and quality of life. Hydrokinesiotherapy, a water-based exercise therapy, is gaining traction as a potential alternative to traditional land-based rehabilitation for managing knee OA symptoms. Methods: This scoping review aimed [...] Read more.
Background: Knee osteoarthritis (OA) is a prevalent condition that significantly impairs pain, mobility, and quality of life. Hydrokinesiotherapy, a water-based exercise therapy, is gaining traction as a potential alternative to traditional land-based rehabilitation for managing knee OA symptoms. Methods: This scoping review aimed to evaluate the effectiveness of hydrokinesiotherapy compared to standard land-based physical therapy and self-administered exercise regimens in improving pain, joint mobility, quality of life, and physical function in patients with knee OA. Five randomized controlled trials (RCTs) were included, assessing outcomes using measures such as the WOMAC score, Visual Analog Scale (VAS), and SF-12. The studies were critically appraised using the PEDro scale and the RoB-2 tool to determine the quality and risk of bias. Results: Hydrokinesiotherapy consistently demonstrated superior outcomes in pain reduction, joint mobility, and physical function across all studies. Patients in the hydrokinesiotherapy groups reported significant improvements in pain and mobility, which were strongly associated with enhanced quality of life. The review also highlighted the potential for hydrokinesiotherapy to serve as an effective alternative or complement to land-based exercises, particularly in populations experiencing severe symptoms. Conclusions: Hydrokinesiotherapy is an effective intervention for managing knee OA, offering significant improvements in key clinical outcomes. Given its benefits, hydrokinesiotherapy should be considered a valuable addition to knee OA treatment protocols. However, further research is needed to confirm long-term effects and to explore ways to improve accessibility to this therapeutic option. Full article
(This article belongs to the Special Issue Etiopathogenesis, Prevention, Modern Diagnostics and Conservative Treatment of Osteoarthritis)
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