Unveiling the Pathophysiology of Osteoarthritis in Joint Anatomy
DOI:
https://doi.org/10.61919/jhrr.v4i2.1150Keywords:
cartilage degradation, synovial inflammation, subchondral bone changes, OsteoarthritisAbstract
Background: Osteoarthritis (OA) is a prevalent and debilitating joint disorder characterized by the degeneration of articular cartilage and underlying bone. Understanding the pathophysiology of OA is essential for developing targeted therapies and improving patient outcomes.
Objective: To explore the underlying pathophysiological mechanisms of osteoarthritis within the context of joint anatomy, focusing on cartilage degradation, synovial inflammation, and subchondral bone changes.
Methods: This prospective study was conducted at private hospitals in Karachi from June 2022 to December 2022. Eighty patients aged 45 to 70 years, diagnosed with OA, were included. Detailed clinical evaluations were performed, including pain assessment using the Visual Analog Scale (VAS) and functional status assessment using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Radiographic analysis was conducted using the Kellgren-Lawrence grading scale. Biochemical analysis of serum and synovial fluid was performed to measure levels of collagen type II cleavage products (C2C), cartilage oligomeric matrix protein (COMP), and inflammatory cytokines such as interleukin-1β (IL-1β), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6). Synovial fluid and tissue samples were collected during arthroscopy or joint replacement surgery for molecular pathway analysis. Data were analyzed using SPSS version 25, with correlations and regression analyses performed to identify predictors of disease progression.
Results: OA was associated with significant pain and functional impairment, with a mean pain score of 7.2 ± 1.3 on the VAS and WOMAC scores averaging 55 ± 10 for physical function and 30 ± 5 for stiffness. Radiographic analysis showed 25% of patients classified as grade II, 50% as grade III, and 25% as grade IV. Biochemical markers indicated elevated levels of C2C (serum: 150 ± 20 ng/mL; synovial fluid: 200 ± 25 ng/mL) and COMP (serum: 10 ± 2 µg/mL; synovial fluid: 15 ± 3 µg/mL). Inflammatory cytokines were also elevated (IL-1β: 50 ± 5 pg/mL; TNF-α: 75 ± 10 pg/mL; IL-6: 100 ± 12 pg/mL). A strong positive correlation (r = 0.85, p < 0.01) was observed between VAS pain scores and synovial IL-1β levels.
Conclusion: The pathophysiology of osteoarthritis involves a complex interplay of biomechanical, biochemical, and cellular factors. The findings from this study enhance the understanding of OA mechanisms and provide a foundation for developing more effective therapeutic strategies aimed at halting or reversing the progression of OA.
Downloads
References
Yunus MHM, Nordin A, Kamal H. Pathophysiological Perspective of Osteoarthritis. Medicina (Kaunas). 2020 Nov 16;56(11):614. doi: 10.3390/medicina56110614. PMID: 33207632; PMCID: PMC7696673.
De Sire A, De Sire R, Petito V, Masi L, Cisari C, Gasbarrini A, et al. Gut–Joint Axis: The Role of Physical Exercise on Gut Microbiota Modulation in Older People with Osteoarthritis. Nutrients. 2020;12(574). doi: 10.3390/nu12020574.
Abhishek A, Doherty M. Diagnosis and Clinical Presentation of Osteoarthritis. Rheum Dis Clin N Am. 2013;39(45–66). doi: 10.1016/j.rdc.2012.10.007.
Heikal MYM, Nazrun SA, Chua KH, Norzana AG. Stichopus Chloronotus Aqueous Extract as a Chondroprotective Agent for Human Chondrocytes Isolated from Osteoarthitis Articular Cartilage in Vitro. Cytotechnology. 2019;71(521–537). doi: 10.1007/s10616-019-00298-2.
Delco ML, Kennedy JG, Bonassar LJ, Fortier LA. Post-Traumatic Osteoarthritis of the Ankle: A Distinct Clinical Entity Requiring New Research Approaches. J Orthop Res. 2017;35(440–453). doi: 10.1002/jor.23462.
Biver E, Berenbaum F, Valdes AM, De Carvalho IA, Bindels LB, Brandi ML, et al. Gut Microbiota and Osteoarthritis Management: An Expert Consensus of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Ageing Res Rev. 2019;55(100946). doi: 10.1016/j.arr.2019.100946.
Wang X, Hunter DJ, Jin X, Ding C. The Importance of Synovial Inflammation in Osteoarthritis: Current Evidence from Imaging Assessments and Clinical Trials. Osteoarthritis Cartil. 2018;26(165–174). doi: 10.1016/j.joca.2017.11.015.
Chow YY, Chin KY. The Role of Inflammation in the Pathogenesis of Osteoarthritis. Mediat Inflamm. 2020;2020(8293921). doi: 10.1155/2020/8293921.
Hwang HS, Kim HA. Chondrocyte Apoptosis in the Pathogenesis of Osteoarthritis. Int J Mol Sci. 2015;16(26035–26054). doi: 10.3390/ijms161125943.
Ruszymah BHI, Shamsul B, Chowdhury SR, Hamdan M. Effect of Cell Density on Formation of Three-Dimensional Cartilaginous Constructs Using Fibrin & Human Osteoarthritic Chondrocytes. Indian J Med Res. 2019;149(641–649). doi: 10.4103/ijmr.IJMR_45_17.
Jang S, Lee K, Ju JH. Recent Updates of Diagnosis, Pathophysiology, and Treatment on Osteoarthritis of the Knee. Int J Mol Sci. 2021;22(5):2619.
Coaccioli S, Sarzi-Puttini P, Zis P, Rinonapoli G, Varrassi G. Osteoarthritis: New Insight on Its Pathophysiology. J Clin Med. 2022;11(20):6013.
Ali A. Pathophysiology of Osteoarthritis and Current Treatment. Zagazig Vet J. 2021;49(1):13–26.
Hall M, van der Esch M, Hinman RS, Peat G, de Zwart A, Quicke JG, et al. How Does Hip Osteoarthritis Differ from Knee Osteoarthritis?. Osteoarthritis Cartil. 2022;30(1):32–41.
Samvelyan HJ, Hughes D, Stevens C, Staines KA. Models of Osteoarthritis: Relevance and New Insights. Calcif Tissue Int. 2021;109(3):243–256.
Prathap Kumar J, Arun Kumar M, Venkatesh D. Healthy Gait: Review of Anatomy and Physiology of Knee Joint. Int J Curr Res Rev. 2020;12(6):1–8.
Dudaric L, Dumic-Cule I, Divjak E, Cengic T, Brkljacic B, Ivanac G. Bone Remodeling in Osteoarthritis—Biological and Radiological Aspects. Medicina. 2023;59(9):1613.
Kudashev D, Kotelnikov G, Lartsev Y, Zuev-Ratnikov S, Asatryan V, Shcherbatov N. Pathogenetic and clinical aspects of osteoarthritis and osteoarthritis-associated defects of the cartilage of the knee joint from the standpoint of understanding the role of the subchondral bone. NN Priorov Journal of Traumatology and Orthopedics. 2023 Jul 4.
Yang J, Jiang T, Xu G, Wang S, Liu W. Exploring molecular mechanisms underlying the pathophysiological association between knee osteoarthritis and sarcopenia. Osteoporosis and Sarcopenia. 2023 Sep 1;9(3):99-111.
Sharif MU, Aslam HM, Iftakhar T, Abdullah M. Pathophysiology of cartilage damage in knee osteoarthritis and regenerative approaches toward recovery. Journal of Bone and Joint Diseases. 2024 Jan 1;39(1):32-44.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Irfan Ashraf, Qurat Ul Khan, Farah Malik, Sarah Sughra Asghar, Afsheen Mansoor, Emaan Mansoor
This work is licensed under a Creative Commons Attribution 4.0 International License.
