The Experts below are selected from a list of 10893 Experts worldwide ranked by ideXlab platform
Joseph A Buckwalter - One of the best experts on this subject based on the ideXlab platform.
-
Osteoarthritis.
Advanced drug delivery reviews, 2006Co-Authors: Joseph A Buckwalter, James A MartinAbstract:Osteoarthritis (OA), the syndrome of Joint pain and dysfunction caused by Joint Degeneration, affects more people than any other Joint disease. In most instances Joint Degeneration develops in the absence of an identifiable cause, but increasing age, excessive Joint loading, and Joint abnormalities and insults increase the risk of OA. Articular surface contact stress that causes tissue damage and compromises that ability of chondrocytes to maintain and restore the tissue has an important role in the development of Joint Degeneration Current methods of attempting to restore an articular surface in osteoarthritic Joints include penetrating subchondral bone, altering Joint loading, osteotomies and insertion of soft tissue grafts. Dramatic advances in the prevention and treatment of OA are likely to stem from better understanding of the role of mechanical forces in the initiation and progression of Joint Degeneration.
-
Perspectives on chondrocyte mechanobiology and osteoarthritis.
Biorheology, 2006Co-Authors: Joseph A Buckwalter, James A Martin, Thomas D. BrownAbstract:Osteoarthritis, the clinical syndrome of Joint pain and dysfunction due to Joint Degeneration, is among the most frequent and symptomatic medical problems for middle aged and older people, and it is the most common cause of long term disability in most populations of people over 65. Currently there are no effective methods of preventing or curing osteoarthritis. Post-traumatic OA, the Joint Degeneration, pain and dysfunction that develop following Joint injury, is the form of OA that is most directly related to elevated articular surface contact stress. However, mechanical stress that exceeds the tolerance of the articular surface can cause or accelerate the progression of Joint Degeneration in all individuals and in all synovial Joints. In some patients, decreasing mechanical forces on degenerated Joint surfaces stimulates formation of a new biologic articular surface. The advances in understanding of the effects of mechanical forces on chondrocytes and cartilage presented and discussed at the 4th Symposium on Mechanobiology: Cartilage and Chondrocyte will help in the efforts to develop new methods of preventing and treating osteoarthritis.
-
Sports and osteoarthritis.
Current opinion in rheumatology, 2004Co-Authors: Joseph A Buckwalter, James A MartinAbstract:Purpose of review Participation in sports improves general health but increases the risk of osteoarthritis. This review analyzes the relationships among increased Joint use, Joint injuries, and injury-induced Joint Degeneration that causes posttraumatic osteoarthritis. The purpose is to help people who participate in sports minimize their risk of Joint Degeneration. Recent findings Participation in sports that cause minimal Joint impact and torsional loading by people with normal Joints and neuromuscular function may cause osteophyte formation, but it has minimal, if any, effect on the risk of osteoarthritis. In contrast, participation in sports that subject Joints to high levels of impact and torsional loading increases the risk of injury-induced Joint Degeneration. People with abnormal Joint anatomy or alignment, previous Joint injury or surgery, osteoarthritis, Joint instability, articular surface incongruity or dysplasia, disturbances of Joint or muscle innervation, or inadequate muscle strength have increased risk of Joint damage during participation in athletics. Summary Gaining the benefits of participation in athletics while minimizing the risk of osteoarthritis requires understanding of the relationships between sports participation and Joint injury and the relationships between Joint injury and Joint Degeneration. People who wish to participate in sports should have an evaluation of their Joint structure and function, muscle strength, and neuromuscular function, and people with a history of Joint injury or mild osteoarthritis should select sports that have limited risk of accelerating Joint Degeneration.
-
Post-traumatic osteoarthritis: the role of accelerated chondrocyte senescence.
Biorheology, 2004Co-Authors: James A Martin, Thomas G. Brown, Anneliese D. Heiner, Joseph A BuckwalterAbstract:Joint injuries frequently lead to progressive Joint Degeneration that causes the clinical syndrome of post-traumatic osteoarthritis. The pathogenesis of osteoarthritis remains poorly understood, but patient age is a significant risk factor for progressive Joint Degeneration. We have found that articular cartilage chondrocytes show strong evidence of senescence with increasing age, including synthesis of smaller more irregular aggrecans; increased expression of lysosomal beta-galactosidase and telomere erosion; and decreased proteoglycan synthesis, response to the anabolic cytokine IGF-I, proliferative capacity, and mitochondrial function. These observations help explain the strong association between age and Joint Degeneration, but they do not explain how Joint injury increases the risk of Joint Degeneration in younger individuals. We hypothesized that excessive loading of articular surfaces due to acute Joint trauma or post-traumatic Joint instability, incongruity or mal-alignment increases release of reactive oxygen species, and that the increased oxidative stress on chondrocytes accelerates chondrocyte senescence thereby decreasing the ability of the cells to maintain or restore the tissue. To test this hypothesis, we exposed human articular cartilage chondrocytes from young adults to mechanical and oxidative stress. We found that shear stress applied to cartilage explants in a triaxial pressure vessel increased release of reactive oxygen species and oxidative stress induced chondrocyte senescence (as measured by expression of lysosomal beta-galactosidase, nuclear and mitochondrial DNA damage and decreased mitochondrial function). These observations support the hypothesis that Joint injury accelerates chondrocyte senescence and that this acceleration plays a role in the Joint Degeneration responsible for post-traumatic osteoarthritis.
-
Joint injury, repair, and remodeling: Roles in post-traumatic osteoarthritis : Symposium
Clinical Orthopaedics and Related Research, 2004Co-Authors: Joseph A Buckwalter, Thomas D. BrownAbstract:Joint injuries, especially intraarticular fractures, frequently lead to progressive Joint Degeneration that causes the clinical syndrome of posttraumatic osteoarthritis. Orthopaedists try to prevent this disease by attempting to restore Joint congruity, alignment, and stability; however, many patients have crippling Joint pain and dysfunction develop despite optimal current treatment. The pathophysiology of posttraumatic osteoarthritis has not been explained. It is not simply the magnitude and type of injury that determines whether an injured articular surface will repair and remodel or undergo progressive Degeneration. For these reasons, clinically significant progress in preventing posttraumatic osteoarthritis depends on advances in understanding of the pathogenesis of this disease that will make it possible to decrease the risk of articular surface Degeneration and facilitate articular surface repair and remodeling. We examine the relationships between Joint injury, repair and remodeling, and Joint Degeneration; the factors that increase the risk of posttraumatic Joint Degeneration; and, the questions that need additional investigation to develop treatments of Joint injuries that will decrease the risk or severity of posttraumatic osteoarthritis.
Thomas D. Brown - One of the best experts on this subject based on the ideXlab platform.
-
Perspectives on chondrocyte mechanobiology and osteoarthritis.
Biorheology, 2006Co-Authors: Joseph A Buckwalter, James A Martin, Thomas D. BrownAbstract:Osteoarthritis, the clinical syndrome of Joint pain and dysfunction due to Joint Degeneration, is among the most frequent and symptomatic medical problems for middle aged and older people, and it is the most common cause of long term disability in most populations of people over 65. Currently there are no effective methods of preventing or curing osteoarthritis. Post-traumatic OA, the Joint Degeneration, pain and dysfunction that develop following Joint injury, is the form of OA that is most directly related to elevated articular surface contact stress. However, mechanical stress that exceeds the tolerance of the articular surface can cause or accelerate the progression of Joint Degeneration in all individuals and in all synovial Joints. In some patients, decreasing mechanical forces on degenerated Joint surfaces stimulates formation of a new biologic articular surface. The advances in understanding of the effects of mechanical forces on chondrocytes and cartilage presented and discussed at the 4th Symposium on Mechanobiology: Cartilage and Chondrocyte will help in the efforts to develop new methods of preventing and treating osteoarthritis.
-
Joint injury, repair, and remodeling: Roles in post-traumatic osteoarthritis : Symposium
Clinical Orthopaedics and Related Research, 2004Co-Authors: Joseph A Buckwalter, Thomas D. BrownAbstract:Joint injuries, especially intraarticular fractures, frequently lead to progressive Joint Degeneration that causes the clinical syndrome of posttraumatic osteoarthritis. Orthopaedists try to prevent this disease by attempting to restore Joint congruity, alignment, and stability; however, many patients have crippling Joint pain and dysfunction develop despite optimal current treatment. The pathophysiology of posttraumatic osteoarthritis has not been explained. It is not simply the magnitude and type of injury that determines whether an injured articular surface will repair and remodel or undergo progressive Degeneration. For these reasons, clinically significant progress in preventing posttraumatic osteoarthritis depends on advances in understanding of the pathogenesis of this disease that will make it possible to decrease the risk of articular surface Degeneration and facilitate articular surface repair and remodeling. We examine the relationships between Joint injury, repair and remodeling, and Joint Degeneration; the factors that increase the risk of posttraumatic Joint Degeneration; and, the questions that need additional investigation to develop treatments of Joint injuries that will decrease the risk or severity of posttraumatic osteoarthritis.
-
Joint injury, repair, and remodeling: roles in post-traumatic osteoarthritis
Clinical orthopaedics and related research, 2004Co-Authors: Joseph A Buckwalter, Thomas D. BrownAbstract:Joint injuries, especially intraarticular fractures, frequently lead to progressive Joint Degeneration that causes the clinical syndrome of posttraumatic osteoarthritis. Orthopaedists try to prevent this disease by attempting to restore Joint congruity, alignment, and stability; however, many patients have crippling Joint pain and dysfunction develop despite optimal current treatment. The pathophysiology of posttraumatic osteoarthritis has not been explained. It is not simply the magnitude and type of injury that determines whether an injured articular surface will repair and remodel or undergo progressive Degeneration. For these reasons, clinically significant progress in preventing posttraumatic osteoarthritis depends on advances in understanding of the pathogenesis of this disease that will make it possible to decrease the risk of articular surface Degeneration and facilitate articular surface repair and remodeling. We examine the relationships between Joint injury, repair and remodeling, and Joint Degeneration; the factors that increase the risk of posttraumatic Joint Degeneration; and, the questions that need additional investigation to develop treatments of Joint injuries that will decrease the risk or severity of posttraumatic osteoarthritis.
Maurizio Marcacci - One of the best experts on this subject based on the ideXlab platform.
-
platelet rich plasma why intra articular a systematic review of preclinical studies and clinical evidence on prp for Joint Degeneration
Knee Surgery Sports Traumatology Arthroscopy, 2015Co-Authors: Giuseppe Filardo, A. Roffi, M. L. Merli, Berardo Di Matteo, Elizaveta Kon, Maurizio MarcacciAbstract:Purpose The aim of this review was to analyze the available evidence on the clinical application of this biological approach for the injective treatment of cartilage lesions and Joint Degeneration, together with preclinical studies to support the rationale for the use of platelet concentrates, to shed some light and give indications on what to treat and what to expect from intra-articular injections of platelet-rich plasma (PRP).
-
Platelet-rich plasma: why intra-articular? A systematic review of preclinical studies and clinical evidence on PRP for Joint Degeneration
Knee Surgery Sports Traumatology Arthroscopy, 2015Co-Authors: Giuseppe Filardo, E. Kon, A. Roffi, M. L. Merli, Berardo Di Matteo, Maurizio MarcacciAbstract:PURPOSE: The aim of this review was to analyze the available evidence on the clinical application of this biological approach for the injective treatment of cartilage lesions and Joint Degeneration, together with preclinical studies to support the rationale for the use of platelet concentrates, to shed some light and give indications on what to treat and what to expect from intra-articular injections of platelet-rich plasma (PRP).\n\nMETHODS: All in vitro, in vivo preclinical and clinical studies on PRP injective treatment in the English language concerning the effect of PRP on cartilage, synovial tissue, menisci, and mesenchymal stem cells were considered. A systematic review on the PubMed database was performed using the following words: (platelet-rich plasma or PRP or platelet concentrate or platelet lysate or platelet supernatant) and (cartilage or chondrocytes or synoviocytes or menisci or mesenchymal stem cells).\n\nRESULTS: Fifty-nine articles met the inclusion criteria: 26 were in vitro, 9 were in vivo, 2 were both in vivo and in vitro, and 22 were clinical studies. The analysis showed an increasing number of published studies over time. Preclinical evidence supports the use of PRP injections that might promote a favourable environment for Joint tissues healing. Only a few high-quality clinical trials have been published, which showed a clinical improvement limited over time and mainly documented in younger patients not affected by advanced knee Degeneration.\n\nCONCLUSIONS: Besides the limits and sometimes controversial findings, the preclinical literature shows an overall support toward this PRP application. An intra-articular injection does not just target cartilage; instead, PRP might influence the entire Joint environment, leading to a short-term clinical improvement. Many biological variables might influence the clinical outcome and have to be studied to optimize PRP injective treatment of cartilage Degeneration and osteoarthritis. LEVEL OF EVIDENCE: IV.
-
Arthroscopic mosaicplasty: long-term outcome and Joint Degeneration progression.
The Knee, 2014Co-Authors: Giuseppe Filardo, Elizaveta Kon, Francesco Perdisa, Cecilia Tetta, Alessandro Di Martino, Maurizio MarcacciAbstract:Abstract Background This study aims to document the long-term results in a group of patients treated with arthroscopic mosaicplasty for knee cartilage lesions, both in terms of clinical outcome and Joint Degeneration progression, evaluated by radiographs. Methods 26 patients (19 men and 7 women, mean age 29years, mean BMI 23) treated arthroscopically with mosaicplasty for cartilage defects of the femoral condyles (mean/median/mode size 1.9 standard deviation, SD 0.6cm 2 ) were prospectively evaluated at 12years follow-up. The clinical outcome was analyzed with IKDC and Tegner scores. Range of motion, transpatellar and suprapatellar circumferences were also measured. Radiographs with weight-bearing antero-posterior and Rosenberg projections were used for radiological evaluation in 18 patients, applying both Kellgren–Lawrence score and a direct Joint line measurement to assess osteoarthritis. Results A significant improvement in all clinical scores was obtained from the basal evaluation to the 12-year follow-up (IKDC subjective score from 36.8 standard deviation, SD 13.0 to 77.3 standard deviation, SD 20.6, P Conclusions Mosaicplasty is an effective surgical option for small lesions of the femoral condyles. Although Joint Degeneration progression was present at 12years, this did not affect significantly the clinical outcome which was satisfactory at long-term follow-up. Level of evidence IV, case series.
James A Martin - One of the best experts on this subject based on the ideXlab platform.
-
Osteoarthritis.
Advanced drug delivery reviews, 2006Co-Authors: Joseph A Buckwalter, James A MartinAbstract:Osteoarthritis (OA), the syndrome of Joint pain and dysfunction caused by Joint Degeneration, affects more people than any other Joint disease. In most instances Joint Degeneration develops in the absence of an identifiable cause, but increasing age, excessive Joint loading, and Joint abnormalities and insults increase the risk of OA. Articular surface contact stress that causes tissue damage and compromises that ability of chondrocytes to maintain and restore the tissue has an important role in the development of Joint Degeneration Current methods of attempting to restore an articular surface in osteoarthritic Joints include penetrating subchondral bone, altering Joint loading, osteotomies and insertion of soft tissue grafts. Dramatic advances in the prevention and treatment of OA are likely to stem from better understanding of the role of mechanical forces in the initiation and progression of Joint Degeneration.
-
Perspectives on chondrocyte mechanobiology and osteoarthritis.
Biorheology, 2006Co-Authors: Joseph A Buckwalter, James A Martin, Thomas D. BrownAbstract:Osteoarthritis, the clinical syndrome of Joint pain and dysfunction due to Joint Degeneration, is among the most frequent and symptomatic medical problems for middle aged and older people, and it is the most common cause of long term disability in most populations of people over 65. Currently there are no effective methods of preventing or curing osteoarthritis. Post-traumatic OA, the Joint Degeneration, pain and dysfunction that develop following Joint injury, is the form of OA that is most directly related to elevated articular surface contact stress. However, mechanical stress that exceeds the tolerance of the articular surface can cause or accelerate the progression of Joint Degeneration in all individuals and in all synovial Joints. In some patients, decreasing mechanical forces on degenerated Joint surfaces stimulates formation of a new biologic articular surface. The advances in understanding of the effects of mechanical forces on chondrocytes and cartilage presented and discussed at the 4th Symposium on Mechanobiology: Cartilage and Chondrocyte will help in the efforts to develop new methods of preventing and treating osteoarthritis.
-
Sports and osteoarthritis.
Current opinion in rheumatology, 2004Co-Authors: Joseph A Buckwalter, James A MartinAbstract:Purpose of review Participation in sports improves general health but increases the risk of osteoarthritis. This review analyzes the relationships among increased Joint use, Joint injuries, and injury-induced Joint Degeneration that causes posttraumatic osteoarthritis. The purpose is to help people who participate in sports minimize their risk of Joint Degeneration. Recent findings Participation in sports that cause minimal Joint impact and torsional loading by people with normal Joints and neuromuscular function may cause osteophyte formation, but it has minimal, if any, effect on the risk of osteoarthritis. In contrast, participation in sports that subject Joints to high levels of impact and torsional loading increases the risk of injury-induced Joint Degeneration. People with abnormal Joint anatomy or alignment, previous Joint injury or surgery, osteoarthritis, Joint instability, articular surface incongruity or dysplasia, disturbances of Joint or muscle innervation, or inadequate muscle strength have increased risk of Joint damage during participation in athletics. Summary Gaining the benefits of participation in athletics while minimizing the risk of osteoarthritis requires understanding of the relationships between sports participation and Joint injury and the relationships between Joint injury and Joint Degeneration. People who wish to participate in sports should have an evaluation of their Joint structure and function, muscle strength, and neuromuscular function, and people with a history of Joint injury or mild osteoarthritis should select sports that have limited risk of accelerating Joint Degeneration.
-
Post-traumatic osteoarthritis: the role of accelerated chondrocyte senescence.
Biorheology, 2004Co-Authors: James A Martin, Thomas G. Brown, Anneliese D. Heiner, Joseph A BuckwalterAbstract:Joint injuries frequently lead to progressive Joint Degeneration that causes the clinical syndrome of post-traumatic osteoarthritis. The pathogenesis of osteoarthritis remains poorly understood, but patient age is a significant risk factor for progressive Joint Degeneration. We have found that articular cartilage chondrocytes show strong evidence of senescence with increasing age, including synthesis of smaller more irregular aggrecans; increased expression of lysosomal beta-galactosidase and telomere erosion; and decreased proteoglycan synthesis, response to the anabolic cytokine IGF-I, proliferative capacity, and mitochondrial function. These observations help explain the strong association between age and Joint Degeneration, but they do not explain how Joint injury increases the risk of Joint Degeneration in younger individuals. We hypothesized that excessive loading of articular surfaces due to acute Joint trauma or post-traumatic Joint instability, incongruity or mal-alignment increases release of reactive oxygen species, and that the increased oxidative stress on chondrocytes accelerates chondrocyte senescence thereby decreasing the ability of the cells to maintain or restore the tissue. To test this hypothesis, we exposed human articular cartilage chondrocytes from young adults to mechanical and oxidative stress. We found that shear stress applied to cartilage explants in a triaxial pressure vessel increased release of reactive oxygen species and oxidative stress induced chondrocyte senescence (as measured by expression of lysosomal beta-galactosidase, nuclear and mitochondrial DNA damage and decreased mitochondrial function). These observations support the hypothesis that Joint injury accelerates chondrocyte senescence and that this acceleration plays a role in the Joint Degeneration responsible for post-traumatic osteoarthritis.
Giuseppe Filardo - One of the best experts on this subject based on the ideXlab platform.
-
platelet rich plasma why intra articular a systematic review of preclinical studies and clinical evidence on prp for Joint Degeneration
Knee Surgery Sports Traumatology Arthroscopy, 2015Co-Authors: Giuseppe Filardo, A. Roffi, M. L. Merli, Berardo Di Matteo, Elizaveta Kon, Maurizio MarcacciAbstract:Purpose The aim of this review was to analyze the available evidence on the clinical application of this biological approach for the injective treatment of cartilage lesions and Joint Degeneration, together with preclinical studies to support the rationale for the use of platelet concentrates, to shed some light and give indications on what to treat and what to expect from intra-articular injections of platelet-rich plasma (PRP).
-
Platelet-rich plasma: why intra-articular? A systematic review of preclinical studies and clinical evidence on PRP for Joint Degeneration
Knee Surgery Sports Traumatology Arthroscopy, 2015Co-Authors: Giuseppe Filardo, E. Kon, A. Roffi, M. L. Merli, Berardo Di Matteo, Maurizio MarcacciAbstract:PURPOSE: The aim of this review was to analyze the available evidence on the clinical application of this biological approach for the injective treatment of cartilage lesions and Joint Degeneration, together with preclinical studies to support the rationale for the use of platelet concentrates, to shed some light and give indications on what to treat and what to expect from intra-articular injections of platelet-rich plasma (PRP).\n\nMETHODS: All in vitro, in vivo preclinical and clinical studies on PRP injective treatment in the English language concerning the effect of PRP on cartilage, synovial tissue, menisci, and mesenchymal stem cells were considered. A systematic review on the PubMed database was performed using the following words: (platelet-rich plasma or PRP or platelet concentrate or platelet lysate or platelet supernatant) and (cartilage or chondrocytes or synoviocytes or menisci or mesenchymal stem cells).\n\nRESULTS: Fifty-nine articles met the inclusion criteria: 26 were in vitro, 9 were in vivo, 2 were both in vivo and in vitro, and 22 were clinical studies. The analysis showed an increasing number of published studies over time. Preclinical evidence supports the use of PRP injections that might promote a favourable environment for Joint tissues healing. Only a few high-quality clinical trials have been published, which showed a clinical improvement limited over time and mainly documented in younger patients not affected by advanced knee Degeneration.\n\nCONCLUSIONS: Besides the limits and sometimes controversial findings, the preclinical literature shows an overall support toward this PRP application. An intra-articular injection does not just target cartilage; instead, PRP might influence the entire Joint environment, leading to a short-term clinical improvement. Many biological variables might influence the clinical outcome and have to be studied to optimize PRP injective treatment of cartilage Degeneration and osteoarthritis. LEVEL OF EVIDENCE: IV.
-
Arthroscopic mosaicplasty: long-term outcome and Joint Degeneration progression.
The Knee, 2014Co-Authors: Giuseppe Filardo, Elizaveta Kon, Francesco Perdisa, Cecilia Tetta, Alessandro Di Martino, Maurizio MarcacciAbstract:Abstract Background This study aims to document the long-term results in a group of patients treated with arthroscopic mosaicplasty for knee cartilage lesions, both in terms of clinical outcome and Joint Degeneration progression, evaluated by radiographs. Methods 26 patients (19 men and 7 women, mean age 29years, mean BMI 23) treated arthroscopically with mosaicplasty for cartilage defects of the femoral condyles (mean/median/mode size 1.9 standard deviation, SD 0.6cm 2 ) were prospectively evaluated at 12years follow-up. The clinical outcome was analyzed with IKDC and Tegner scores. Range of motion, transpatellar and suprapatellar circumferences were also measured. Radiographs with weight-bearing antero-posterior and Rosenberg projections were used for radiological evaluation in 18 patients, applying both Kellgren–Lawrence score and a direct Joint line measurement to assess osteoarthritis. Results A significant improvement in all clinical scores was obtained from the basal evaluation to the 12-year follow-up (IKDC subjective score from 36.8 standard deviation, SD 13.0 to 77.3 standard deviation, SD 20.6, P Conclusions Mosaicplasty is an effective surgical option for small lesions of the femoral condyles. Although Joint Degeneration progression was present at 12years, this did not affect significantly the clinical outcome which was satisfactory at long-term follow-up. Level of evidence IV, case series.
