Knee Osteoarthritis: A Review of Pathogenesis and State-Of-The-Art Non-Operative Therapeutic Considerations

Dragan Primorac; Vilim Molnar; Eduard Rod; Željko Jeleč; Fabijan Čukelj; Vid Matišić; Trpimir Vrdoljak; Damir Hudetz; Hana Hajsok; Igor Borić

doi:10.3390/genes11080854

Knee Osteoarthritis: A Review of Pathogenesis and State-Of-The-Art Non-Operative Therapeutic Considerations

Genes (Basel). 2020 Jul 26;11(8):854. doi: 10.3390/genes11080854.

Authors

Dragan Primorac^{1

2

3

4

5

6

7

8

9}, Vilim Molnar^{1

6}, Eduard Rod^{1

6}, Željko Jeleč^{1

6

10}, Fabijan Čukelj^{1

4}, Vid Matišić¹, Trpimir Vrdoljak^{1

11}, Damir Hudetz^{1

6

11}, Hana Hajsok^{1

12}, Igor Borić^{1

4

7

9}

Affiliations

¹ St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia.
² Eberly College of Science, The Pennsylvania State University, University Park, State College, PA 16802, USA.
³ The Henry C. Lee College of Criminal Justice and Forensic Sciences, University of New Haven, West Haven, CT 06516, USA.
⁴ Medical School, University of Split, 21000 Split, Croatia.
⁵ School of Medicine, Faculty of Dental Medicine and Health, University "Josip Juraj Strossmayer", 31000 Osijek, Croatia.
⁶ School of Medicine, JJ Strossmayer University of Osijek, 31000 Osijek, Croatia.
⁷ Medical School, University of Rijeka, 51000 Rijeka, Croatia.
⁸ Medical School REGIOMED, 96 450 Coburg, Germany.
⁹ Medical School, University of Mostar, 88000 Mostar, Bosnia and Herzegovina.
¹⁰ Department of Nursing, University North, 48 000 Varaždin, Croatia.
¹¹ Department of Orthopedics, Clinical Hospital "Sveti Duh", 10000 Zagreb, Croatia.
¹² Medical School, University of Zagreb, 10000 Zagreb, Croatia.

Abstract

Being the most common musculoskeletal progressive condition, osteoarthritis is an interesting target for research. It is estimated that the prevalence of knee osteoarthritis (OA) among adults 60 years of age or older is approximately 10% in men and 13% in women, making knee OA one of the leading causes of disability in elderly population. Today, we know that osteoarthritis is not a disease characterized by loss of cartilage due to mechanical loading only, but a condition that affects all of the tissues in the joint, causing detectable changes in tissue architecture, its metabolism and function. All of these changes are mediated by a complex and not yet fully researched interplay of proinflammatory and anti-inflammatory cytokines, chemokines, growth factors and adipokines, all of which can be measured in the serum, synovium and histological samples, potentially serving as biomarkers of disease stage and progression. Another key aspect of disease progression is the epigenome that regulates all the genetic expression through DNA methylation, histone modifications, and mRNA interference. A lot of work has been put into developing non-surgical treatment options to slow down the natural course of osteoarthritis to postpone, or maybe even replace extensive surgeries such as total knee arthroplasty. At the moment, biological treatments such as platelet-rich plasma, bone marrow mesenchymal stem cells and autologous microfragmented adipose tissue containing stromal vascular fraction are ordinarily used. Furthermore, the latter two mentioned cell-based treatment options seem to be the only methods so far that increase the quality of cartilage in osteoarthritis patients. Yet, in the future, gene therapy could potentially become an option for orthopedic patients. In the following review, we summarized all of the latest and most important research in basic sciences, pathogenesis, and non-operative treatment.

Keywords: cytokines; epigenomics; genetic therapy; knee osteoarthritis; mesenchymal stem cells; phenotype; platelet-rich plasma.

Publication types

Review

MeSH terms

Animals
Anti-Inflammatory Agents / therapeutic use*
Humans
Osteoarthritis, Knee / pathology*
Osteoarthritis, Knee / therapy*
Platelet-Rich Plasma*

Substances

Anti-Inflammatory Agents