Finnish researchers may have come up with a quantitative tool that could estimate risks for the onset and progression of osteoarthritis before it begins.
New Algorithm for Modeling Osteoarthritis Progression
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#osteoarthritisSecondary#knee#tissuedegeneration
“New algorithm for simulation of proteoglycan loss and collagen degeneration in the knee joint: Data from the osteoarthritis initiative,” appears in the June 2018 edition of the Journal of Orthopaedic Research.
Mika Mononen, Ph.D., with the department of applied physics at the University of Eastern Finland and co-author on the study, told OTW, “We wanted to evaluate influences of different parameters (tissue strains and stresses) to initiate and control tissue degeneration in cartilage in terms of mechanical overloading.”
The authors wrote, “Currently, there is only one modeling framework which can be applied to predict the progression of knee osteoarthritis, but it only considers degenerative changes in the collagen fibril network.”
“Here, we have developed the framework further by considering all of the major tissue changes (proteoglycan content, fluid flow, and collagen fibril network) occurring in osteoarthritis. While excessive levels of tissue stresses controlled degeneration of the collagen fibril network, excessive levels of tissue strains controlled the decrease in proteoglycan content and the increase in permeability.”
“We created four knee joint models with increasing degrees of complexity based on the depth‐wise composition. Models were tested for normal and abnormal, physiologically relevant, loading conditions in the knee.”
Dr. Mononen told OTW, “The most important result was that we were able to simulate collagen fibril network degradation and proteoglycan depletion simultaneously with two different mechanisms (exceeded levels of accumulated tissue strains and stresses) behind development of osteoarthritis.”
“In the future, these results can be beneficial to developing a quantitative tool to estimate risks for the onset and progression of osteoarthritis before it initiates. This enables prevention by recommend personalized conservative treatments such as weight loss or physical exercise for those subjects who have high risk for the onset and development of osteoarthritis. Furthermore, this tool could be utilized to evaluate different joint injuries and cartilage lesions in terms of initiation and development of osteoarthritis.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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