People with osteoarthritis (OA) suffer from joint degeneration and pain as well as difficulty performing daily activities. Joint contact forces (JCF) are important for understanding individual joint loading, however, these contact force cannot be directly measured without instrumented implants. Musculoskeletal modeling is a tool for estimating JCF without the need for surgery. The results from these models can be very different due to different approaches used in the development of a model that was used for simulation. Therefore, the first purpose of this study was to develop and validate a musculoskeletal model in which lower extremity JCF were calculated at the hip, knee, and ankle in 10 participants with hip OA (H-OA) and 10 healthy control participants using OpenSim 4.0 [simtk.org, 23]. The generic gait2392 model was scaled to participant demographics, then the inverse kinematics (IK) solution and kinetic data were input into the Residual Reduction Algorithm (RRA) to reduce modeling errors. Kinematic solutions from RRA were used in the Computed Muscle Control (CMC) tool to compute muscle forces, then JCF were estimated using the Joint Reaction Analysis tool. Validation included JCF comparisons to published data of similar participant samples during level walking, and movement simulation quality was assessed with residual forces and moments applied at the pelvis, joint reserve actuators, and kinematic tracking errors. The computed JCFs were similar to the overall trends of published JCF results from similar participant samples, however the values of the computed JCFs were anywhere from 0.5 times body weight (BW) to 3BW larger than those in published studies. Simulation quality assessment resulted in low residual forces and moments, and low tracking errors. Most of the reserve actuators were small as well, besides pelvis rotation and hip rotation. The computed JCF were then used in the second portion of this study to determine the effect of group and side on JCF during both the weight acceptance and push-off phases of level walking. It was determined that there was a significant difference in the knee and ankle JCF during the weight acceptance portion of stance phase and at all joints during the push-off phase when comparing the H-OA and control groups on the affected limb. A significant interaction between group and limb was found for the peak hip JCF timing (% stance) during the push-off portion of the stance phase (p=0.009). These results demonstrate that H-OA participants experience an earlier peak hip JCF during propulsion on their affected limb. Based on previous research in OA that has examined spatiotemporal measures, this finding suggests that H-OA participants may use step or stride length changes as a strategy to decrease or limit pain and loading on the affected limb. Knowledge of potential JCF differences in H-OA participants, such as timing of the peaks in either portion of the stance phase, could provide useful insight to clinicians and therapists to make decisions on how to proceed with treatment or rehabilitation programs. / Master of Science / People with osteoarthritis suffer from joint degeneration and pain as well as difficulty performing daily activities, like walking. It is important to understand the forces and loading within individual joints. Musculoskeletal modeling is one way that researchers can estimate these joint contact forces (JCF) without needing a joint replacement implant that can measure these forces. When it comes to modeling simulations, there is a wide variety of results. Therefore, the first purpose of this study was to develop and validate a musculoskeletal model in which JCFs were calculated at the hip, knee, and ankle in 10 participants with hip osteoarthritis and 10 healthy adults. Validation of the model was completed through a comparison between computed results and published data of similar participant samples during level walking. The computed results were similar to the overall trends of published JCF results, however the numerical values themselves were larger than those in published studies. The computed JCFs were then used in the second portion of this study to determine how the two groups and limbs differ during level walking. There was a significant difference in the knee and ankle JCF during the first half of the stance phase and in all joints during the second half of stance when comparing the two groups. The hip osteoarthritis participants also experience an earlier peak hip JCF during the second half of stance phase on their affected limb. This finding suggests that hip osteoarthritis participants may change the way they take a step as a strategy to decrease or limit pain and loading on the affected limb. Knowledge of potential JCF differences, such as timing of the peaks in either portion of the stance phase, could provide useful insight to clinicians and therapists to make decisions on how to proceed with treatment or rehabilitation programs.

In our aging population, arthritis is becoming an increasingly common problem. Pain, loss of joint function and other negative affects make arthritis a major health problem. The most common form of arthritis, osteoarthritis, is caused by the "wear and tear" of articular cartilage on the surface of bones in synovial joints. It is a chronic problem that is slowed with different types of therapies, including pharmaceutical, nutritional and surgical, but to date the wearing down of the cartilage cannot be stopped or reversed. Normal, mature, articular cartilage does not spontaneously repair itself after an injury. In light of this, several surgical techniques are being developed to repair degenerate and/or osteoarthritic cartilage. One such approach uses Autologous Chondrocyte Implantation (ACI). Dr. Mats Brittberg, and associates at Goteborg University in Sweden began using this cartilage repair procedure in 1987. Other techniques attempt to stimulate the subchondral bone to generate cartilage, such as Abrasion Arthroplasty. Still others use tissue grafts to attempt to repair lesions in cartilage. The surface biomechanics of these repaired tissues have not yet been studied. How well does the repaired cartilage resist wear? How long will it last? How does the repaired cartilage compare to "normal" cartilage in terms of wear-resistance? It is the goal of this research to gain initial knowledge to help answer these questions. Dr. Brittberg has provided 17 sample of cartilage, from 9 Swedish patients, including repaired and normal pairs using the aforementioned repair techniques and others, as well as a degenerate and normal cartilage pair. The intention of this paper is to report the findings of experiments performed using these samples, and compare the wear-resistance of repaired and degenerate cartilage to that of normal cartilage. Wear and friction tests were carried out on 2 mm diameter specimens using a biotribology device and a new, modified technique developed specifically for these small samples. The cartilage samples were mounted, using specially designed adapters, in our biotribology device for oscillating contact against polished stainless steel disks at a constant applied normal load, oscillating frequency, and test time. A buffered saline solution was used as the lubricant. Cartilage wear was determined from hydroxyproline analysis of the test fluid and washings from the wear test. Thin layers of transferred cartilage-like films to the stainless steel disks were also analyzed. Also, friction data was recorded throughout the tests. The results of these experiments show that: 1) For the two pairs of ACI repaired cartilage, the repaired cartilage gave substantially less wear than that of normal cartilage. 2) For all other repair techniques tested, the repaired cartilage produced more wear than normal cartilage. 3) The single osteoarthritic cartilage tested produced similar wear to that of normal cartilage. This is surprising since the current thought is osteoarthritic cartilage is more susceptible to wear. 4) The hydroxyproline concentration, by weight, of cartilage increases after the wear test. 5) Friction levels were in the boundary lubrication regime, and had no correlation with the amount of wear. To our knowledge, this research represents the first controlled "in vitro" study of an important unknown in cartilage repair, i.e., the wear-resistance of the repaired cartilage. It shows that ACI produces a cartilage with very good wear-resistance, better than that of other repair techniques, and possibly better than normal, healthy cartilage. ACI and its applications to the treatment of degenerate and osteoarthritic joints are promising, and studies will continue to investigate this and other types of cartilage repair. / Master of Science

The objective was to compare the effects of three corticosteroids at various equimolar concentrations on equine articular explant co-cultures in an inflammatory environment. Synovial and osteochondral explant co-cultures from 6 equine cadavers were exposed to IL-1β (10 ng/mL) and various concentrations (10-4, 10-7, or 10-10 M) of MPA, TA, IPA. Concentrations of PGE2, MMP-13, LDH, and GAG in media were determined at 48 and 96 hours. Results indicated wells with low concentrations of MPA (10-7 and 10-10 M at 48 and 96 hours), TA (10-7 M at 48 hours and 10-7 and 10-10 M at 48 and 96 hours), and IPA (10-10 M at 48 hours) had significantly less PGE2 than positive control samples. Groups with low concentrations (10-7 and 10-10 M) of MPA and TA had significantly less PGE2 than the highest concentration (10-4 M) at 48 hours. Significantly less MMP-13 was detected for all concentrations of MPA, TA, and IPA at 96 hours. The LDH assay results indicated cytotoxicity only for samples treated with IPA at 10-4 M at 48 and 96 hours. GAG was significantly lower for samples treated with TA 10-7 M at 48 hours and MPA 10-10 M at 96 hours versus positive controls. These findings suggest corticosteroids at low concentrations mitigated the inflammatory and catabolic effects of IL-1β to a greater extent than high concentrations. Effects of IPA and MPA were similar to TA at clinically relevant low equimolar concentrations. / Master of Science

Yes / Objective: this research seeks to investigate the impact the Industrial Revolution had on the population of England. Materials: Pre-existing skeletal data from 1154 pre-Industrial (1066–1700AD) and 4157 industrial (1700–1905) skeletons from 21 cemeteries (N = 5411). Methods: Context number, sex, age-at-death, stature and presence/absence of selected pathological conditions were collated. The data were compared using chi square, Kolmogorov-Smirnov, t-tests and logistic regression (α = 0.01). Results: There was a statistically significant increase in cribra orbitalia, periosteal reactions, rib lesions, fractures, rickets, osteoporosis, osteoarthritis, enamel hypoplasia, dental caries and periapical lesions in the industrial period. Osteomyelitis decreased from the pre-industrial to industrial period. Conclusion: Our results confirm the Industrial Revolution had a significant negative impact on human health, however the prevalence of TB, treponemal disease, maxillary sinusitis, osteomalacia, scurvy, gout and DISH did not change, suggesting these diseases were not impacted by the change in environmental conditions. Significance: This is the largest study of health in the Industrial Revolution that includes non-adults and adults and considers age-at-death alongside disease status to date. This data supports the hypothesis that the Rise of Industry was associated with a significant decline in general health, but not an increase in all pathologies. Limitations: This meta-analysis relies upon previously gathered data and diagnosis from a large number of researchers. Incomplete skeletons were often excluded from analyses. Few rural cemeteries were available for inclusion. Suggestions for further research: Data from unpublished and ongoing excavations should be investigated. Comparison with historical data is encouraged. / Funded by the Royal Society (IES\R1\180138)

Introduktion: Artros är en folksjukdom. I Sverige har var fjärde person äldre än 45 år läkardiagnostiserad artros och förekomsten ökar med ökande antal överviktiga och äldre. Genom att upptäcka och behandla tidiga stadier av artros ger vi artros patienterna en bättre förutsättning gällande funktion och symtom.                                               Syfte: Syftet var att undersöka om Functional Moves® är en verkningsfull behandlingsmetod avseende Quadriceps styrka, balans, knästabilitet, gångförmåga samt självskattad upplevelse av symtom som smärta, funktion och livskvalitet jämfört med konventionell individuell styrke- och rörlighetsträning för patienter med höft- och knäsmärta i åldern 30-65 år.                                                                       Metod: Interventionsgruppen (n=21) testades med fysiska tester samt självskattningsformulär KOOS (Knee osteoarthritis outcome score) HOOS (Hip osteoarthritis outcome score) före åtta veckors träning med Functional Moves®. Referensgruppen (n=13) testades på samma sätt och tränade i åtta veckor, med konventionell rehab träning för höft- och knäartros. Båda grupperna utvärderades inom en vecka efter avslutad träning med samma tester. Artrosskolan ingick i både interventions- och referensgruppen.                                                                                            Resultat: Interventionsgruppen hade signifikant bättre resultat på alla fysiska tester förutom enbensuppresning höger. Referensgruppen hade signifikant förbättring på enbentlängdhopp bilateralt, SOLEC vänster samt sidledshopp höger. Alla testvärden förbättrades signifikant i självskattning av frågeformulären KOOS/HOOS i både interventions- och referensgruppen.                                                               Konklusion: I denna studie har Functional Moves® visat en signifikant förbättring avseende Quadriceps styrka vänster, balans, knästabilitet, gångförmåga samt mindre skattad smärta och ansträngning vid gångtest. Functional Moves® borde erbjudas patienter i primärvården framförallt för de som har en vardag som ställer större krav på höft- och knäled. / Introduction: Osteoarthritis is a common disease. In Sweden, every fourth person older than 45 physician-diagnosed arthritis, and the incidence increases with increasing number of obese and the elderly by preventing, detecting and treating early stages of osteoarthritis, we osteoarthritis patients a better condition. Objective: The objective was to investigate whether the Functional Moves® is an effective treatment method in respect Quadriceps strength, balance, knee stability, walking capability and self-rated experience symptoms such as pain, function and quality of life compared with conventional individual strength and flexibility training for patients with hip and knee pain in age of 30-65 years. Method: The intervention group (n = 21) were tested with physical tests and self-assessment forms KOOS (Knee osteoarthritis outcome score) HOOS (Hip osteoarthritis outcome score) HOOS before eight weeks of training, with Functional moves®. The control group (n = 13) tested the same way and trained for eight weeks, with conventional rehabilitation training of hip and knee osteoarthritis. Both groups were evaluated within one week after training with the same tests. Osteoarthritis School was included in both the intervention and control group. Results: The intervention group had significantly better results on all the physical tests except one leg uprising right. The control group had significant improvement in one leg jump on both legs. SOLEC left and right side jump. All test values ​​were significantly improved in the self-evaluation of the questionnaires KOOS / HOOS in both the intervention and control group. Conclusion: In this study, Functional moves® shown a significant improvement in  Quadriceps strength left, balance, knee stability, walking capability and lower-rated pain and effort during a walking test. Functional Moves® should be offered to patients in primary care especially for those who have a living that put´s great demands on the hip and knee.

Osteoarthritis (OA) of the knee is a disease that deteriorates the bones and surrounding soft tissue of the affected joint. Categorisation of the disease into grades of severity is subject to errors of measurement and poor observer agreement. There is an urgent need for automated methods to measure radiographic features and remove, as far as possible, the element of subjectivity in assessment. This project creates a fully automated system to analyse all aspects of the knee in radiographs. The methods evaluate explicit and implicit features of: overall shape, trabecular structure, osteophytes, tibial spines and intercondylar notch, and joint space shape. The project develops the first fully automated osteophyte detection algorithms, improved trabeculae features using raw pixel intensities, and a better analysis of joint space using shape models. This project is the first to combine explicit and implicit features across the whole of the knee, and applies these features to classify radiographs using four main outcomes: current OA, current pain, later onset OA, and later onset pain. The results find a strong current OA classification rate, with an Area Under the ROC Curve (AUC) of 0.904 and weighted kappa of 0.49 (0.48-0.51). The remaining later onset and pain experiments report weaker results; these results suggest that radiographic features in Posterior-Anterior (PA) view radiographs have a weak association with clinical and later onset OA.

Playing professional football is a high risk occupation. Injury rates among professional footballers are higher than those commonly found in other industries. Several Scandinavian studies have begun to document the long-term physical health problems, such as osteoarthritis (OA), that can beset ex-professional footballers. However, the experiences of ex-professional footballers playing and living in the United Kingdom (UK) have not received similar academic attention. Furthermore, no studies have investigated the impact that OA has on the quality of life of former players anywhere in the world. This thesis aimed to rectify a widespread and serious health problem among a cohort that has largely been neglected to date. In Phase I, 284 ex-professional footballers responded to a postal survey which aimed to establish the prevalence of injury and OA. In Phase II, 12 semi-structured interviews were conducted with ex-professional footballers from Phase I who had developed OA. The aim was to gain an in-depth understanding of how the condition impacted on their lives and how they coped. In Phase II, 101 ex-professional footballers, who were not involved in Phases I and II, responded to a cross-sectional postal survey, which investigated the relationships between pain, pain coping and psychological distress within the context of a stress and coping model. Career injury and surgery were common among respondents in Phase I and nearly half (49%) had subsequently developed OA in at least one joint. Pain was the most common problem for all respondents irrespective of OA diagnosis. Lack of mobility and work disability were other problems reported by respondents. Interviewees in Phase II described how they were encouraged to 'play hurt' during their career and to accept, minimise or ignore the threat of pain, injury and OA. It was some of these attributes which enabled respondents to 'live hurt' in the presence of chronic pain and disability in later life. In Phase II it was shown that psychological distress was not a serious problem for many respondents. However, several coping strategies (denial, emotional venting and upward comparison) were positively associated with pain and psychological distress, particularly for those participants in greater pain. Although OA and chronic pain are prevalent among ex-professional footballers in the UK, its impact upon psychological distress was not as great as reported in some other studies of persons which chronic disease and pain. Increased psychological distress was linked to greater pain and the use of several coping strategies (e.g. denial, emotional venting and upward comparison). However, given the cross-sectional design, it remains to be clarified whether coping predicts psychological distress or whether an increase in psychological distress precipitates more coping. Suggestions are proposed for a psychosocial intervention which would have an impact on pain coping and psychological distress among ex-professional footballers.

[Truncated abstract] Osteoarthritis (OA) is the most common form of arthritis, characterized by progressively degeneration of articular cartilage. Chondrocyte is the only cell type in articular cartilage tissue and responsible for cartilage matrix turnover. This thesis focuses on the biological and genetic behaviors of human chondrocyte and potential therapeutic strategies that target on chondrocyte. Chondrocytes have been used for the tissue-engineered cartilage construction, especially in articular cartilage repair. The technique of chondrocyte-base tissue engineering utilizes in vitro propagated chondrocytes combined with several manufactured biomaterials to regenerate cartilage tissue. Although these technologies have been successfully applied in clinic, the biological characteristics of chondrocyte during in vitro propagation and after implantation remain unclear. This thesis reviewed the present studies of chondrocyte biology and its potential uses in tissue engineering. Particularly, chondrocytes have been shown to de-differentiate into fibroblastic-cells when they are exposed to inflammatory conditions or cultured on monolayer in vitro. This thesis investigated the gene expression profile of chondrocytes when they are cultured and serially passaged on monolayer in vitro. Human chondrocytes obtained from OA patients were cultured up to passage 6. Twenty-eight chondrocyte associated genes were measured by Real-time PCR. The results showed that a number of genes were changed in expression levels at various stages of passage as indications of chondrocyte de-differentiation. Chondrocytes derived from OA patients or normal donors exhibited a very similar gene expression pattern. Interestingly, transcription factor Sox-9, which plays a key role in chondrogenesis remained unchanged with increasing passage number, indicating that the de-differentiation process of chondrocyte is reversible. This thesis also focused on the development of novel pharmacological approaches for OA that target on articular chondrocyte. The clinical feature, etiology, pathogenesis, diagnostic approaches, conventional and potential future treatments for OA were briefly reviewed in this thesis. ... The effects of natural compounds on chondrocyte gene expression, proteoglycan degradation and nitric oxide production were measured. The results showed that parthenolide, a NF-kB inhibitor, regulated chondrocyte function by suppressing the up-regulation of gene expression of inflammatory factors and matrix proteinases induced by lipopolysaccharide, and down-regulating COX-2 expression. Parthenolide was able to reduce proteoglycan degradation in human chondrocytes, but had no effect on nitric oxide production. These results suggest that parthenolide mediates inflammatory-activated NF-kB pathway, and subsequently reduces inflammatory response, prevents cartilage destruction and relieves pain, and hence may be useful for OA treatment.

Diss. (sammanfattning) Stockholm : Karol inst., 2004. / Härtill 4 uppsatser.

Thesis (Ph. D.)--University of Missouri-Columbia, 1997. / Typescript. Vita. Includes bibliographical references (leaves 45-56). Also available on the Internet.