Abstract:
With its main features of cartilage degeneration, subchondral bone sclerosis and osteophyte formation, osteoarthritis represents a multifactorial disease with no effective treatment options. As biomechanical shift in the trabecular network may be a driver for further cartilage degeneration, bone enhancement could possibly delay OA progression. Magnesium is known to be osteoconductive and already showed positive effects in OA models. We aimed to use magnesium cylinders to enhance subchondral bone quality, condition of cartilage and pain sensation compared to sole drilling in vivo. After eight weeks of implantation in rabbits, significant increase in subchondral bone volume and trabecular thickness with constant bone mineral density was found indicating favored biomechanics. As representative for pain, a higher number of CD271+ vessels were present in control samples without magnesium. However, this result could not be confirmed by sensitive, objective lameness evaluation using a pressure sensing mat and no positive effect could be shown on either cartilage degeneration evaluated by OARSI score nor the presence of regenerative cells in CD271-stained samples. The presented results show a relevant impact of implanted magnesium on key structures in OA pain with missing clinical relevance regarding pain. Further studies with shifted focus should examine additional structures as joint capsule or osteophytes.
摘要:
以软骨退变为主要特征,软骨下骨硬化和骨赘形成,骨关节炎是一种多因素疾病,没有有效的治疗选择。由于骨小梁网络的生物力学移位可能是进一步软骨退化的驱动因素,骨增强可能会延迟OA的进展。已知镁是骨传导性的,并且在OA模型中已经显示出积极作用。我们的目标是使用镁圆柱体来增强软骨下骨质量,与体内唯一钻孔相比,软骨和疼痛感觉的状况。植入兔子八周后,软骨下骨体积和骨小梁厚度的显着增加与恒定的骨矿物质密度被发现表明有利的生物力学。作为疼痛的代表,在不含镁的对照样品中存在较高数量的CD271+血管。然而,这个结果无法得到敏感的证实,使用压力感测垫进行客观跛行评估,对于OARSI评分评估的软骨退变和CD271染色样本中再生细胞的存在均未显示出积极作用.所呈现的结果表明,植入镁对OA疼痛的关键结构有相关影响,但与疼痛相关的临床相关性缺失。焦点转移的进一步研究应检查其他结构,如关节囊或骨赘。