Dexamethasone: chondroprotective corticosteroid or catabolic killer?

Dexamethasone: chondroprotective corticosteroid or catabolic killer? Eur Cell Mater. 2019 Nov 22;38:246-263 Authors: Black R, Grodzinsky AJ Abstract While glucocorticoids have been used for over 50 years to treat rheumatoid and osteoarthritis pain, the prescription of glucocorticoids remains controversial because of potentially harmful side effects at the molecular, cellular and tissue levels. One member of the glucocorticoid family, dexamethasone (DEX) has recently been demonstrated to rescue cartilage matrix loss and chondrocyte viability in animal studies and cartilage explant models of tissue injury and post-traumatic osteoarthritis, suggesting the possibility of DEX as a disease-modifying drug if used appropriately. However, the literature on the effects of DEX on cartilage reveals conflicting results on the drug's safety, depending on the dose and duration of DEX exposure as well as the model system used. Overall, DEX has been shown to protect against arthritis-related changes in cartilage structure and function, including matrix loss, inflammation and cartilage viability. These beneficial effects are not always observed in model systems using initially healthy cartilage or isolated chondrocytes, where many studies have reported significant increases in chondrocyte apoptosis. It is crucially important to understand under what conditions DEX may be beneficial or harmful to cartilage and other joint tissues and to determine potential for safe use of t...
Source: European Cells and Materials - Category: Cytology Tags: Eur Cell Mater Source Type: research

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Conclusions This scoping review confirmed that patients with malunited scaphoids seem to have higher likelihood of post traumatic arthritis. However, clinical implications remain uncertain and better methods for assessing and defining scaphoid deformity are required. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: Journal of Wrist Surgery - Category: Orthopaedics Authors: Tags: Survey or Meta-analysis Source Type: research
CONCLUSIONS: Ankle arthrodesis could allow painless gait, improving patients life quality, even after long-term follow-up, and is, therefore, a solution to be considered in patients affected by septic arthritis. PMID: 30977880 [PubMed - in process]
Source: Pharmacological Reviews - Category: Drugs & Pharmacology Authors: Tags: Eur Rev Med Pharmacol Sci Source Type: research
CONCLUSION: Despite the difficulties associated with performing THA in patients with PTA from previous acetabular fracture (including soft tissue scarring, existing hardware, and acetabular bone loss) and the relatively high complication rates, THA in patients with PTA following prior acetabular fracture leads to significant improvement in pain and function at 10-year follow-up. Further high quality randomized controlled studies are needed to confirm the outcomes after delayed THA in these patients. PMID: 29773451 [PubMed - as supplied by publisher]
Source: Chinese Journal of Traumatology - Category: Orthopaedics Authors: Tags: Chin J Traumatol Source Type: research
Tibiotalocalcaneal (TTC) and tibiocalcaneal (TC) arthrodesis are salvage procedures for end-stage pathologies of the hindfoot such as ankle arthritis (rheumatoid, osteoarthritis or post-traumatic), Charcot arthropathy, advanced flatfoot deformities, talar avascular necrosis and even failed total ankle arthroplasty [1]. The procedure alleviates pain and joint instability by eliminating motion at the fused joints. Thus, it sacrifices joint motion for significantly reduced pain, allowing comfortable ambulation for the patient.
Source: Foot and Ankle Surgery - Category: Orthopaedics Authors: Source Type: research
In this study, we evaluate long-term implant survival and patient-reported outcomes after primary total hip arthroplasty (THA) in patients aged 35 or younger with post-traumatic arthritis of the hip. METHODS: We conducted a retrospective study with follow-up. A chart review was performed to identify young patients with post-traumatic arthritis of the hip treated with primary THA. Follow-up surveys were conducted to determine implant survival and patient-reported outcomes. Implant survival was assessed using Kaplan-Meier survival analysis, and patient outcomes were determined using the hip disability and osteoarthritis...
Source: Hip International - Category: Orthopaedics Authors: Tags: Hip Int Source Type: research
In this study we demonstrate the use of clustered regularly interspaced short palindromic repeats (CRISPR)-based epigenome editing to alter cell response to inflammatory environments by repressing inflammatory cytokine cell receptors, specifically TNFR1 and IL1R1. This has applications for many inflammatory-driven diseases. It could be applied for arthritis or to therapeutic cells that are being delivered to inflammatory environments that need to be protected from inflammation." In chronic back pain, for example, slipped or herniated discs are a result of damaged tissue when inflammation causes cells to create ...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
SPECIAL FROM Next Avenue Whether it came on suddenly when you were playing tennis or more gradually over many years, knee pain can keep you from doing even the most basic of activities. At the very least, it can limit your ability to move as easily or quickly, or sit in one place for an extended time.   Arthritis is the most common cause of knee pain for older adults, said Dr. Julie Switzer, an orthopedic surgeon at Regions Hospital in St. Paul, Minn. Arthritis comes in three main forms, she said: osteoarthritis, inflammatory arthritis and post-traumatic arthritis. We’ll examine these types, as well as other ...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
There are many conditions that can be associated with elbow pain. Elbow pain is not usually a serious condition. Tennis Elbow Tennis elbow can also be referred to as lateral epicondylitis. Tennis elbow is an inflammation, soreness or pain on the outside (lateral) area near the elbow (Figure 1). The condition is usually seen in patients who perform manual labor or sports that require twisting and extension of the wrist against resistance. Tennis elbow is often associated with degeneration, irritation, tears and pain of the extensor tendons. Treatment: Treatment of tennis elbow includes ice, wearing an elbow pad, a decrea...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
CONCLUSION: Although associated with higher complication rates, TKA is an effective treatment for PTA, as it improves ROM, pain and functional outcomes. PMID: 27672572 [PubMed]
Source: World Journal of Orthopaedics - Category: Orthopaedics Tags: World J Orthop Source Type: research
Abstract BACKGROUND: In the young patient, treatment of post-traumatic elbow arthritis remains difficult. Total elbow arthroplasty must be delayed for as long as possible. Therapy starts with nonoperative treatment. If this fails, operative options can be discussed. TREATMENT AIM: The aim of surgery is to provide a functional range of motion with acceptable pain without obstructing future treatment options. THERAPY: Patients with pain at terminal extension and/or flexion may benefit from arthroscopic or open debridement. Patients with advanced osteoarthritis and pain throughout the complete range of...
Source: Der Orthopade - Category: Orthopaedics Authors: Tags: Orthopade Source Type: research
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