Search

Összefoglaló. Az arthrosis az ízületeket alkotó porc, csont és a környező lágy részek leépülésével járó betegség. A betegség jelentős fájdalommal jár, progresszív, az ízület strukturális átalakulását és ennek következtében jelentős funkcióvesztést és életminőség-romlást okoz. Kialakulásában immunológiai gyulladásos folyamatok is szerepet játszanak, amelyek befolyásolása lehetőséget ad nemcsak tüneti kezelésre, hanem betegségmódosító terápia kialakítására is. A nem denaturált 2-es típusú kollagén oralis alkalmazása szisztémás toleranciát hoz létre, ami a proinflammatoricus folyamatok gátlása és az antiinflammatoricus hatások erősítése révén új lehetőség az immunmodulációra. A klinikai vizsgálatok a betegeknél a fájdalom jelentős csökkenéséről, a mozgásszervek funkciójának javulásáról számolnak be, és a kezelés egészséges ízületben is nyújthat védelmet a mechanikus stressz okozta ízületi károsodással szemben. Orv Hetil. 2021; 162(37): 1481–1484. Summary. Osteoarthritis is a disease of the cartilage, bone and surrounding soft tissues that make up the joints. The disease is associated with significant pain, it is progressive, causing structural transformation of the joint and, as a result, significant loss of function and deterioration in the quality of life. Immunological inflammatory processes also play a role in its development, the influence of which allows not only symptomatic treatment, but also the development of disease-modifying therapy. Oral administration of undenatured type II collagen creates systemic tolerance, which is a new opportunity for immunomodulation by inhibiting proinflammatory processes and enhancing anti-inflammatory effects. Clinical trials have reported significant reduction in pain, improved musculoskeletal function in patients, and the therapy may provide protection against joint damage caused by mechanical stress in healthy joints. Orv Hetil. 2021; 162(37): 1481–1484.

The literature was reviewed for reports on the pathogenesis, diagnosis and treatment of injuries to the posterior cruciate ligament (PCL). PCL is the largest intra-articular ligament in the knee joint and has good tensile mechanical properties. Optimal diagnosis and appropriate treatment strategies for PCL injury are discussed. Nonoperative treatment of isolated PCL injuries is associated with a significant risk of degeneration of the knee structures and impaired function. A comprehensive line of PCL reconstruction options are offered for the surgical approach to PCL reconstruction to restore functional joint stability in the knee. Literature data on protective effect of glucosamine, chondroitin sulfate in the prevention of secondary knee osteoarthritis caused by PCL ruptures were reviewed.

ObjectivesAlthough treatment development in osteoarthritis (OA) focuses on chondroprotection, it is unclear how much preventing cartilage loss reduces joint pain. It is also unclear how nociceptive tissues may be involved.MethodsUsing data from the Osteoarthritis Initiative, we quantified the relation between cartilage loss and worsening knee pain after adjusting for bone marrow lesions (BMLs) and synovitis, and examined how much these factors mediated this association. 600 knee MRIs were scored at baseline, 12 months and 24 months for quantitative and semiquantitative measures of OA structural features. We focused on change in medial cartilage thickness using an amount similar to that seen in recent trials. Linear models calculated mean change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score with cartilage loss, adjusted for baseline BMLs, synovitis and covariates. Mediation analysis tested whether change in synovitis or BMLs mediated the cartilage loss–pain association. We carried out a subanalysis for knees with non-zero baseline WOMAC pain scores and another for non-valgus knees.ResultsCartilage thickness loss was significantly associated with a small degree of worsening in pain over 24 months. For example, a loss of 0.1 mm of cartilage thickness over 2 years was associated with a 0.32 increase in WOMAC pain (scale 0–20). The association of cartilage thickness loss with pain was mediated by synovitis change but not by BML change. Subanalysis results were similar.ConclusionsCartilage thickness loss is associated with only a small amount of worsening knee pain, an association mediated in part by worsening synovitis. Demonstrating that chondroprotection reduces knee pain will be extremely challenging and is perhaps unachievable.

Background: Osteoarthritis is a chronic progressive disease commonly affecting the hip and knee joints. Although many drugs are available and afford symptomatic relief, their side effects pose limitations to their continuous use. Introduction: Myostaal Forte (MF) is a poly-herbal Ayurvedic formulation that has shown protection against damage to the chondrocyte layer on histopathological examination in previous studies. But biomarkers which are indicative of chondroprotection have not been assessed. So, the present study was planned to reconfirm the protective effect of MF in osteoarthritic rats by histopathology and create a more substantial evidence by assessing the levels of Cartilage oligomeric matrix protein (COMP) and matrix metalloproteinase-13 (MMP-13). Methods: 32 rats were divided into four groups (n = 8 each group); sham control (SC), disease control (DC), positive control (PC) and a MF group. Behavioural tests were compared from baseline to 7th day, 14th day, 21st day and on 28th day. Histopathology and bone markers were compared on the 28th day. p

This chapter describes chronic and acute chondral damage. Clinical history, etiology, and associated pathologies are discussed. Indications and contraindications for nonoperative management are reviewed. Nonoperative management is discussed in detail and operative treatment is described briefly, highlighting the most up-to-date level one evidence. Treatment algorithms are provided with a focus on nonoperative techniques. Outcomes are discussed. Future directions are presented and the author’s algorithm is presented. This chapter is based on the framework of chondroprotection, chondrofacilitation, and resurfacing.

Meniscal allograft transplantation yields good and excellent results but is limited by donor availability. The purpose of the study was to evaluate the effectiveness of radiated deep-frozen xenogenic meniscal tissue (RDF-X) as an alternative graft choice in meniscal transplantation. The xenogenic meniscal tissues were harvested from the inner 1/3 part of the porcine meniscus and then irradiated and deeply frozen. The medial menisci of rabbits were replaced by the RDF-X. Meniscal allograft transplantation, meniscectomy and sham operation served as controls. Only a particular kind of rabbit-anti-pig antibody (molecular ranging 60–80 kD) was detected in the blood serum at week 2. The menisci of the group RDF-X grossly resembled the native tissue and the allograft meniscus with fibrocartilage regeneration at postoperative 1 year. Cell incorporation and the extracellular matrix were mostly observed at the surface and the inner 1/3 part of the newly regenerated RDF-X, which was different from the allograft. The biomechanical properties of the group RDF-X were also approximate to those of the native meniscus except for the compressive creep. In addition, chondroprotection was achieved after the RDF-X transplantation although the joint degeneration was not completely prevented. To conclude, the RDF-X could be a promising alternative for meniscal transplantation with similar tissue regeneration capacity to allograft transplantation and superior chondroprotection. The potential minor immunological rejection should be further studied before its clinical application.

Background Osteoarthritis (OA) is a prevalent musculoskeletal disease resulting in progressive degeneration of the hyaline articular cartilage within synovial joints. Current repair treatments for OA often result in poor quality tissue that is functionally ineffective compared to the hyaline cartilage and demonstrates increased failure rates post-treatment. Complicating efforts to improve clinical outcomes, animal models used in pre-clinical research show significant heterogeneity in their regenerative and degenerative responses associated with their species, age, genetic/epigenetic traits, and context of cartilage injury or disease. These can lead to variable outcomes when testing and validating novel therapeutic approaches for OA. Furthermore, it remains unclear whether protection against OA among different model systems is driven by inhibition of cartilage degeneration, enhancement of cartilage regeneration, or any combination thereof. Main text Understanding the mechanistic basis underlying this context-dependent duality is essential for the rational design of targeted cartilage repair and OA therapies. Here, we discuss some of the critical variables related to the cross-species paradigm of degenerative and regenerative abilities found in pre-clinical animal models, to highlight that a gradient of regenerative competence within cartilage may exist across species and even in the greater human population, and likely influences clinical outcomes. Conclusions A more complete understanding of the endogenous regenerative potential of cartilage in a species specific context may facilitate the development of effective therapeutic approaches for cartilage injury and/or OA.

Extracorporeal shockwave therapy (ESWT) is a popular non-invasive therapeutic modality in the medical field for the treatment of numerous musculoskeletal disorders. This technique first emerged around the 1980s as extracorporeal shockwave lithotripsy and has been studied since then for its application towards orthopedics and traumatology. ESWT works by the emission of acoustic waves (shockwaves) that carry energy and can propagate through tissues. Shockwaves can generate interstitial and extracellular responses, producing many beneficial effects such as: pain relief, vascularization, protein biosynthesis, cell proliferation, neuro and chondroprotection, and destruction of calcium deposits in musculoskeletal structures. The combination of these effects can lead to tissue regeneration and significant alleviation of pain, improving functional outcomes in injured tissue. Considering these facts, ESWT shows great potential as a useful regenerative medicine technique for the treatment of numerous musculoskeletal injuries.

Background: Knee osteoarthritis (OA) is a common and often disabling joint disorder among adults that may result in impaired activity and daily function. A variety of treatment options are currently available and prescribed for knee OA depending on the severity of the disorder and physician preference. Intra-articular hyaluronic acid (IA-HA) injection is a treatment for knee OA that reportedly provides numerous biochemical and biological benefits, including shock absorption, chondroprotection, and anti-inflammatory effects within the knee. Clarity is needed as to whether the available IA-HA products should be considered for therapy as a group or whether there are significant differences in the products that need to be considered in treatment of OA of the knee. Purpose: To determine whether there are differences in efficacy and safety with respect to intrinsic properties of available IA-HA injections for knee OA. Study Design: Meta-analysis. Methods: A comprehensive literature search of the Medline, EMBASE, and PubMed databases was conducted for all existing randomized trials of IA-HA. The primary outcome measure analyzed was the mean pain score at the reported follow-up nearest to 26 weeks after injection. Pooled efficacy and safety results were recorded for subgroupings of HA product characteristics. Results: A total of 68 studies were included for analysis. Products with an average molecular weight ≥3000 kDa provided favorable efficacy results when compared with products of an average molecular weight Conclusion: Despite similarities, IA-HA products should not be treated as a group, as there are differences in IA-HA products that influence both efficacy and safety. In the available literature, IA-HA products with a molecular weight ≥3000 kDa and those derived from biological fermentation relate to superior efficacy and safety—factors that may influence selection an IA-HA product for OA of the knee.

We read with interest the recent article by Bacon et al 1 that used mediation analysis2 to understand the process by which cartilage loss changes joint pain. Given considerable investment in treatments that focus on chondroprotection, this is an important topic and the findings from this study have potential to inform patient management. The authors concluded that a small, non-clinically important effect of cartilage loss on joint pain was mediated by synovitis. To ensure this study accurately informs future research and practice, we ask the authors to clarify the reporting and interpretation of their results. The results presented in tables 3 and 4 do not support the authors conclusion that synovitis mediated the effect of cartilage loss on joint pain. The 95% …

The reasonability of using nonsteroidal anti-inflammatory drugs (NSAIDs) in osteoarthritis (OA) is due mainly to persistent articular tissue inflammation that contributes to the progression of structural changes in the hyaline cartilage, as well as its leading clinical manifestation – pain syndrome caused by damage to different articular structures. NSAIDs are basic rapid-acting symptom-modifying drugs in the treatment of OA. Meloxicam has high anti-inflammatory and analgesic activities. The effect of meloxicam on hyaline cartilage metabolism permits one to consider it as a potential chondroprotective agent. Short- and long-term investigations have demonstrated its good tolerability, including that in patients with polymorbidity. The use of meloxicam does not increase the risk of cardiac and renal complications. The high therapeutic activity of meloxicam along with the low level of adverse reactions determines the pharmacoeconomic expediency of its use.

The anatomy and microstructure of the menisci allow the effective distribution of load across the knee. Meniscectomy alters the biomechanical environment and is a potent risk factor for osteoarthritis. Despite a trend towards meniscus-preserving surgery, many tears are irreparable, and many repairs fail.Meniscal allograft transplantation has principally been carried out for pain in patients who have had a meniscectomy. Numerous case series have reported a significant improvement in patient-reported outcomes after surgery, but randomised controlled trials have not been undertaken.It is scientifically plausible that meniscal allograft transplantation is protective of cartilage, but this has not been established clinically to date.Cite this article: Bone Joint J 2015; 97-B:590–4.

Introduction: Myostaal Forte, a proprietary poly-herbal formulation, is mixture of nine herbal plant extracts which possess analgesic, anti-inflammatory and chondroprotective properties. Aim: A prospective, randomised, active controlled, 2-arm, parallel group, assessor blind study was planned to evaluate clinical efficacy and safety of Myostaal Forte in patients of knee osteoarthritis. Materials and Methods: Idiopathic knee osteoarthritis cases as per American College of Rheumatology (ACR) clinical criteria were screened and recruited. A total of sixty patients were assigned to receive Myostaal Forte TDS (n=30) or Paracetamol 650 mg TDS (n=30) for six weeks. Naproxen was rescue analgesia. Modified Western Ontario and McMaster Universities Arthritis Index (WOMAC), Visual Analogue Scale (VAS), global assessment scores determined by orthopaedic physician at baseline, two, four, six weeks and telephonically at eight weeks. Safety was assessed through laboratory investigations at baseline and six weeks, adverse events and tolerability. Data were expressed as Mean±SD and analysed by Chi-square and unpaired t-test. p0.05). No significant adverse events, changes in the laboratory parameters and excellent compliance to treatment were seen in both the groups. Conclusion: Earlier onset analgesic effect with sustained chondroprotection after treatment cessation makes Myostaal Forte, a safe and effective alternative for treatment of knee osteoarthritis.

Drilling into cartilage/bone is often required for orthopaedic surgery. While drilling into bone has been studied, the response of cartilage has received little attention. We have measured cartilage and drill bit temperatures during drilling and quantified the zone of chondrocyte death (ZCD) around the hole in the presence/absence of irrigation solutions.Drilling was performed using a 1.5-mm orthopaedic drill bit applied to bovine metatarsophalangeal joints and temperatures recorded by infrared camera. Osteochondral explants were then incubated with 5-chloromethylfluorescein diacetate (CMFDA) and propidium iodide (PI) to label living/dead chondrocytes respectively. The width of the ZCD was quantified by confocal laser scanning microscopy (CLSM) and image analysis.Without irrigation, the ZCD following drilling for two seconds was 135 ± 15 μm and this increased (fourfold, P 0.001) with five seconds of drilling. Irrigation reduced the ZCD following drilling for both two and five seconds (P 0.05, P 0.001 respectively) to the same level (approx. 60 μm). Without irrigation, drill bit and cartilage temperature increased rapidly to265 and 119 °C respectively, whereas the camera saturated at282 °C during drilling for five seconds. With irrigation, the drill bit temperature was significantly reduced during drilling for two and five seconds (approx. 90 °C) with negligible change in cartilage temperature. Drilling while irrigating with hyperosmotic saline (600 mOsm) reduced (P 0.01) the ZCD compared to saline, whereas chondrocyte death was increased (P 0.01) by Ca(2+) saline (5 mM).Reducing temperature during drilling by irrigation markedly suppressed, but did not abolish chondrocyte death. Optimising the irrigation solution by raising osmolarity and reducing Ca(2+) content significantly reduced chondrocyte death during drilling and may be clinically beneficial.

➤ Novel (i.e., quantitative and semiquantitative) cartilage imaging techniques can evaluate cartilage composition to augment information obtained from traditional magnetic resonance imaging sequences that detail morphology.➤ A well-defined role for drugs leading to chondroprotection has not yet been determined.➤ Shortcomings of bone marrow stimulation include limited production of hyaline repair tissue, unpredictable repair cartilage volume, and a negative impact on later cellular transplantation if required.➤ The role of biological augments, such as cellular concentrates or platelet-rich plasma, remains undefined. When their use is reported in the literature, it is important that their process of production and characterization be detailed.➤ Rehabilitation programs, incorporating controlled exercise and progressive partial weight-bearing, are an important part of cartilage repair surgery and should be detailed in reports on operative techniques applied.➤ Malalignment, meniscal injury, and ligament deficiency should be corrected in a staged or concomitant fashion to reduce the overall likelihood of mechanical failure in cartilage repair surgery.

Cartilage injuries of the knee are common and can be managed in a variety of ways. Choice of management must take into account the demands and expectations of the patient as well as the size, depth and location of the defect, how chronic it is and any concomitant intra-articular, extra-articular or general conditions. Previous treatments and injuries should be addressed before starting the treatment. Defect size is one of the most important parameters to take into account for pre-operative planning. All symptomatic cartilage defects of type III or IV using the International Cartilage Repair Society grading system should be managed surgically. No more than three localized cartilage defects can be treated successfully at the same time. Cartilage lesions can be managed with a wide spectrum of different techniques that can be used isolated or in combination according to surgeon’s choice. These techniques can be classified into five main groups: (1) cartilage reparative techniques (microfracture, drilling, cartilage shaving), (2) cartilage restoration techniques (fresh allograft transplantation or autograft transplantation – mosaicplasty), (3) autologous chondrocyte implantation (ACI) or matrix-induced autologous chondrocyte implantation (MACI), (4) other biologic approaches, including repair with gene-activated matrices (GAMs), scaffolds, mesenchymal stem cell (MSCs), platelet-rich plasma (PRP), growing factors (GRs), magnetically labelled synovium-derived cells (M-SDCs), bone morphogenetic proteins (BMPs) and elastic-like polypeptide gels, and (5) other therapies such as osteotomies, stem cell-coated titanium implants and chondroprotection with pulsed electromagnetic fields (PEMFs).

Summary Objective To perform a molecular mechanism-based investigation of the chondroprotective potential of hylan G-F 20. Method The effects of hylan G-F 20 on IL-1β-induced glycosaminoglycan (GAG) depletion and matrix metalloproteinase (MMP) expression in bovine and human cartilage explants were evaluated. Three weekly intra-articular hylan G-F 20 or control injections were administered 4 weeks post-operatively to rabbits with surgically induced osteoarthritis (OA). Cartilage histopathologic scores and osteophyte size were evaluated at 1, 4, and 8 weeks post-injections. Histomorphometry and immunostaining were used to quantify cartilage area and type II collagen (Col II) intensity, and real-time polymerase chain reaction (PCR) was used to examine the mRNA levels of Col2A1 , MMP-13 , - 16 and IL-1β at 1 week. Results Hylan G-F 20 retained GAG in IL-1β-exposed bovine and human cartilage explants and abrogated IL-1β-mediated increases in MMP-1, -3, and -13 in human explant culture. Hylan G-F 20‒treated OA joints had significantly better cartilage integrity at 1 and 4 weeks post-treatment and significantly smaller osteophytes at 4 weeks compared with control. Col2A1 mRNA increased with hylan G-F 20 treatment, which correlated with a trend toward increased Col II immunostaining. MMP - 13 and - 16 mRNAs increased in OA cartilage, but were not significantly altered by hylan G-F 20. IL-1β mRNA was undetectable in cartilage and unaltered in the synovium. Conclusions Hylan G-F 20 improved cartilage integrity and decreased osteophyte formation in the rabbit model of OA. Our results suggest that hylan G-F 20 may stimulate cartilage repair by increasing Col II, and inhibit IL-1β-mediated matrix degradation by decreasing MMPs.

Objetivo Evaluar la eficacia y seguridad de una unica inyeccion intraarticular de acido hialuronico (AH)+manitol en artrosis de rodilla (AR). Material y metodo Estudio prospectivo, abierto, no-comparativo con 80 pacientes diagnosticados de AR, de los cuales 79 finalizaron el estudio. Recibieron una inyeccion intraarticular de 2ml de AH al 2%+manitol al 0,5% (dia 0) y fueron monitorizados durante 6 meses. Los dias 0, 15, 30, 60, 90, 120, 150 y 180 se evaluaron dolor y funcionalidad articular mediante una escala analogica visual (EAV) y el indice WOMAC, eficacia y seguridad segun medico y paciente, y medicacion de rescate como medida indirecta del dolor. Resultados Disminucion significativa del dolor articular, rigidez e incapacidad funcional en comparacion con el valor inicial en todas las visitas (p

At the beginning of the new millennium, there was a breakthrough in platelet-rich plasma (PRP) therapy for tissue repair. The mechanisms governing the effects of this therapy in joint pathology remain largely unexplored.This review is primarily based on PubMed and Web of Knowledge searches with the terms osteoarthritis in combination with PRP, treatment, cartilage, synovium, platelets, inflammation and/or angiogenesis. This search was completed by a manual search for relevant studies. We mainly include papers from the last 5 years. The concept of dynamic reciprocity is used to shape understanding of the spatial relationship between cells and their microenvironments as well as between tissues within the joint. We describe the processes of joint injury and pathology relevant to the mechanism of action of PRP, and elaborate insights into how PRP components may influence inflammation, angiogenesis, cell death and cartilage chondroprotection.PRP therapies are more complicated than previously acknowledged, and an understanding of the fundamental processes and pivotal molecules involved will hopefully be elucidated soon. This challenge is to provide a comprehensive description of the relationship between PRP components, healing mechanisms and clinical outcomes. Although PRP therapies in clinical trials await assessment, they have shed light on new avenues of management because of their effects on repair functions.

Objective: Articular cartilage injury is common after athletic injury and remains a difficult treatment conundrum both for the surgeon and athlete. Although recent treatments for damage to articular cartilage have been successful in alleviating symptoms, more durable and complete, long-term articular surface restoration remains the unattained goal. In this article, we look at both new ways to prevent damage to articular surfaces as well as new techniques to recreate biomechanically sound and biochemically true articular surfaces once an athlete injures this surface. This goal should include reproducing hyaline cartilage with a well-integrated and flexible subchondral base and the normal zonal variability in the articular matrix. Results: A number of nonoperative interventions have shown early promise in mitigating cartilage symptoms and in preclinical studies have shown evidence of chondroprotection. These include the use of glucosamine, chondroitin, and other neutraceuticals, viscosupplementation with hyaluronic acid, platelet-rich plasma, and pulsed electromagnetic fields. Newer surgical techniques, some already in clinical study, and others on the horizon offer opportunities to improve the surgical restoration of the hyaline matrix often disrupted in athletic injury. These include new scaffolds, single-stage cell techniques, the use of mesenchymal stem cells, and gene therapy. Conclusion: Although many of these treatments are in the preclinical and early clinical study phase, they offer the promise of better options to mitigate the sequelae of athletically induced cartilage.

Large meniscal defects are a common problem for which treatment options are limited. Successful meniscal regeneration has been achieved by using grafts of small intestinal submucosa in posterior, vascular meniscal defects in a dog model. This study investigates the long-term effects of a tibial tunnel fixation technique and a clinically based meniscectomy defect on meniscal regeneration using this model. Eight mongrel dogs underwent medial arthrotomy and partial meniscectomy. The dogs were divided into groups based on defect treatment: small intestinal submucosa (n = 4) or meniscectomy (n = 4). Dogs were scored for lameness by subjective scoring postoperatively, sacrificed at 6 months, and assessed for articular cartilage damage, gross and histologic appearance of the operated meniscus, amount of new tissue in the defect, and relative compressive stiffness of articular cartilage. Dogs in the meniscectomy group were significantly (P = .002) more lame than dogs treated with small intestinal submucosa. Small intestinal submucosa-treated joints had significantly (P = .01) less articular cartilage damage than meniscectomy joints. Small intestinal submucosa meniscal implants resulted in production of meniscal-like replacement tissue, which was consistently superior to meniscectomy in amount, type, and integration of new tissue, chondroprotection, and limb function during the study period. Small intestinal submucosa implants may be useful for treatment of large posterior vascular meniscal defects in humans. The tibial tunnel technique used for fixation may have clinical advantages and therefore warrants further investigation.

Meniscal scaffolds represent an attractive surgical option for irreparable meniscal lesions in appropriately symptomatic patients. Although a wide range of conditions could be potentially treated, good results are strictly dependent upon adherence to proper surgical indications. Scaffold implant could be performed only in case of partial medial or lateral meniscal defect with intact meniscal horns. The arthroscopic implantation is technically challenging where traditional surgical risks are present; however, good to excellent results have been reported ranging from 70 to 90 %. Both CMI® and Actifit® have been reported to undergo reabsorption and substitution over time, with a meniscus-like tissue with the potential of chondroprotection, good integration with the native meniscus, and no cartilage damage.

Joint injuries are common, especially among young adults aged 18 to 44 years. They are accompanied by a cascade of events that increase the risk of posttraumatic osteoarthritis (PTOA). Therefore, understanding of biological responses that predispose to PTOA should help in determining treatment modalities to delay and/or prevent the onset and progression of the disease. The vast majority of the literature pointed to chondrocyte death and apoptosis, inflammation and matrix damage/fragmentation being the earliest events that follow joint trauma. Together these events lead to the development of osteoarthritis-like focal cartilage lesions that if untreated have a tendency to expand and progress to fully developed disease. Currently, the only treatments available for joint trauma are surgical interventions. Experimental biologic approaches involve engineering of cartilage with the use of cells (stem cells or chondrocytes), juvenile or adult cartilage pieces, scaffolds, and various polymeric matrices. The major challenge for all of them is regeneration of normal functional mature hyaline cartilage that can sustain the load, resist compression, and most important, integrate with the host tissue. If the tissue is spontaneously repaired it fails to reproduce original structure and function and thus, may be more susceptible to re-injury. Thus, there is a critical need to develop novel molecular mechanism-based therapeutic approaches to biologic chondral and/or osteochondral repair. The focus of this review is on the earliest molecular and cellular manifestations of injury that can be grouped based on the following therapeutic options for PTOA: chondroprotection, anti-inflammatory, matrix protection, and matrix remodeling/matrix synthesis.

Introduction Incidence of meniscal lesions is increasing in the pediatric population. Given the harmful impact of meniscectomy, meniscal repair is attempted whenever possible. The present study sought to assess the efficacy of FasT-Fix (Smith and Nephew) all-inside arthroscopic meniscal repair devices in childhood meniscal lesions. The study hypothesis was that functional results would be equivalent to those of other suture techniques. Material and methods Nineteen patients were assessed following arthroscopic meniscal repair, at a mean 6 years (range: 3–9 years). Mean age was 14.8 years. There was associated ACL tear in 31% of cases. Functional assessment used Lysholm, subjective IKDC, Tegner activity level and KOOS scores. Anatomic assessment of healing used MRI, arthroscopy or CT-arthrography. Results At last follow-up, the meniscal survival rate was 89.5% (n = 17/19). Functional results were good: Lysholm: 95.7/100; subjective IKDC: 90.7/100; Tegner: 7.64. Imaging found systematic healing. Discussion All-inside arthroscopic meniscal suture is increasingly used in adults, and can also be implemented in children or adolescents in pediatrics. FasT-Fix (Smith and Nephew) implants, although not always easy to use, ensure a perfectly functional knee and conserve long-term meniscal chondroprotection with a low risk of complications. Level of evidence IV, retrospective study.

Many compounds are being investigated for the control of symptoms of osteoarthritis in people and animals. Ideally, treatment should include analgesia, inflammation control, and chondroprotection. With further progress in this area, combination therapies tailored to the needs of the individual animal should enable us to maximize efficacy and minimize side effects. Only a few of the newer therapies and pharmaceutic agents have been investigated in the horse, however. With more rigorous investigation, they may be determined to be ineffective or unsafe. Meanwhile, as much information should be gathered from manufacturers as possible so as to ensure that appropriate recommendations are made.

Summary Objective Articular cartilage may experience iatrogenic injury during routine orthopaedic/arthroscopic procedures. This could cause chondrocyte death, leading to cartilage degeneration and posttraumatic osteoarthritis. In an in vitro cartilage injury model, chondrocyte death was reduced by increasing the osmolarity of normal saline (NS), the most commonly-used irrigation solution. Here, we studied the effect of hyperosmolar saline (HS) on chondrocyte viability and cartilage repair in an in vivo injury model. Design Cartilage injury was induced by a single scalpel cut along the patellar groove of 8 week old rats in the absence of irrigation or with either NS (300 mOsm) or HS (600 mOsm). The percentage of cell death (PCD) within the injured area was assessed using confocal microscopy. Repair from injury was evaluated by histology/immunostaining, and inflammatory response by histology, cytokine array analysis and ELISA (enzyme-linked immunosorbent assay). Results The PCD in saline-irrigated joints was increased compared to non-irrigated (NI) joints [PCD = 20.8% (95%CI; 14.5, 27.1); PCD = 9.14% (95%CI; 6.3, 11.9); P = 0.0017]. However, hyperosmotic saline reduced chondrocyte death compared to NS (PCD = 10.4% (95%CI; 8.5, 12.3) P = 0.0024). Repair score, type II collagen and aggrecan levels, and injury width, were significantly improved with hyperosmotic compared to NS. Mild synovitis and similar changes in serum cytokine profile occurred in all operated joints irrespective of experimental group. Conclusions Hyperosmotic saline significantly reduced the chondrocyte death associated with scalpel-induced injury and enhanced cartilage repair. This irrigation solution might be useful as a simple chondroprotective strategy and may also reduce unintentional cartilage injury during articular reconstructive surgery and promote integrative cartilage repair, thereby reducing the risk of posttraumatic osteoarthritis.

Systematic review of overlapping meta-analyses shows that platelet-rich plasma improves knee pain and function in patients with knee osteoarthritis. Ultimately, biologics hold promise for chondroprotection in addition to symptomatic relief.

The combination of anterior cruciate ligament (ACL) reconstruction and meniscal allograft transplantation (MAT) may produce a synergistic effect for chondroprotection and knee stability. The menisci have an important role in knee stability via load-sharing with the ACL. This role may be particularly relevant in the setting of revision ACL reconstruction, as meniscus loss is often present and can lead to increased strain on an ACL graft. Since the failure rates are generally higher in revision ACL surgery compared to primary reconstruction, careful consideration of meniscus status is prudent. A thorough preoperative history, physical examination, and radiographic evaluation should be performed to ascertain the contributors to ACL reconstruction failure. Careful patient selection and counseling regarding the potential long-term patient outcome including increased risk for arthrosis should be performed. Young patients with ACL and meniscal deficiency and minimal chondral injury represent a unique situation in which MAT and ACL reconstruction can be extremely beneficial. Consideration of these factors is crucial for optimizing the outcome following revision ACL reconstruction.

Cartilage therapy for focal articular lesions of the knee has been implemented for more than a decade, and it is becoming increasingly available. What do we know on the healing response of cartilage lesions? What do we know on the treatment of focal cartilage lesions of the knee and the prognostic factors involved? PubMed articles related to articular cartilage regeneration of the knee in clinical studies were searched from January 2006 to November 2012, using the following key words: articular cartilage, regeneration, clinical studies, and knee. A total of 44 reports were found. They showed the following possibilities for the treatment of focal lesions of the articular cartilage of the knee: cartilage regeneration and repair including cartilage reparation with gene-activated matrices, autologous chondrocyte implantation (ACI) and matrix-induced ACI (MACI), microfracture, osteochondral autograft transfer (mosaicplasty), biological approaches (scaffolds, mesenchymal stem cells-MSCs, platelet-rich plasma, growing factors-GF, bone morphogenetic proteins-BMPs, magnetically labeled synovium-derived cells-M-SDCs, and elastic-like polypeptide gels), osteotomies, stem-cell-coated titanium implants, and chondroprotection with pulsed electromagnetic fields. Untreated cartilage lesions on the femoral condyles had a superior healing response compared to those on the tibial plateaus, and in the patellofemoral joint. Clinical outcome regarding the treatment of medial defects is better than that of the lateral defects. Improvement from baseline was better for patientsor = 30 years compared with patientsor = 30 years. ACI, MACI, and mosaicplasty have shown similar results. The results of comparative clinical studies using ACI have shown some superiority over conventional microfracturing in medium or large defects and in long-term durability. Some biological methods such as scaffolds, MSCs, GF, M-SDCs, BMPs, and elastic-like polypeptide gels still need more research.

Developing therapies for chondroprotection offers the potential to prevent debilitating osteoarthritis and associated joint replacement following acute joint trauma. Although many significant challenges must be overcome, in comparison to expensive and time-consuming conventional osteoarthritis clinical trials, therapeutic chondroprotection may provide an easier path to evaluate treatments that have potential as disease-modifying therapies for osteoarthritis.

The use of biophysical stimulation, with low-frequency pulsed electromagnetic fields, to modulate osteogenetic response and favour fracture healing has been the subject of wide-ranging research. Current orthopaedics reviews the different modalities of biophysical treatment in search of solutions most adequate to the pathology, the characteristics of the fracture and those of the patient. It is up to the orthopaedist to assess whether the biomechanical conditions of stability of the fracture site are such as not to jeopardize the osteogenetic process. Moreover, experimental studies on articular cartilage have demonstrated that low-frequency pulsed electromagnetic fields control inflammation, protect extracellular matrix and favour chondrocytes metabolic activity. The results of two level I clinical study on patients underwent arthroscopic procedures demonstrated that low-frequency pulsed electromagnetic fields favour patients' recovery both in the short (90 days) and in the long term (3 years). The long term benefit results from biophysical chondroprotection of articular cartilage and from prevention of the fibrotic stimuli exerted by pro-inflammatory cytokines on wound tissue. Biophysical stimulation plays a central role also in regenerative medicine, protecting the repair of tissue from catabolic effects of the inflammatory reaction elicited by the surgical implantation procedure.

This was a preliminary study performed in vivo to evaluate the viability and the chondroprotective effects of irradiated deep-frozen xenogeneic meniscal tissue as a novel substitute for meniscus transplantation.Medial meniscectomies were performed on the right knees of 48 New Zealand white rabbits. The inner one-third of pig meniscus was harvested and then irradiated and deeply frozen. The treated xenogeneic meniscal tissues were then transplanted to 24 right knees (Xeno group), whereas 24 other knees received meniscus allograft transplantations (Allo group). The left knees of the Xeno group and Allo group received meniscectomies (Meni group) and sham operations (Sham group), respectively. The rabbits were killed at weeks 6, 12, and 24 postoperatively. The newly formed structure of the implanted tissue and cartilage of the medial compartment of each group was assessed by gross and semiquantitative histologic analysis.After 24 weeks, the implanted xenogeneic meniscal tissue completely healed to the synovium and formed meniscus-like tissue. The chondrocyte-like cell infiltrated into the tissue with extracellular matrix including type II collagen and proteoglycans. The Xeno group showed significantly less cartilage degeneration than that of the Meni group in the medial tibial plateau at week 24 (P.05). No significant difference was found between the Xeno group and the Allo group except for the meniscus-covered regions at week 24. From week 12 to week 24, almost no advanced cartilage degeneration was found in weight-bearing regions of the medial tibial plateau of the Xeno group.The treated xenogeneic meniscal tissue healed to the synovium with tissue regeneration and slowed down articular cartilage degeneration in the short-term. The chondroprotection of xenograft transplantation was similar to that of allograft transplantation.The treated xenogeneic meniscal tissue showed the potential for viability and slowed cartilage degeneration, but more studies are required for application in humans in the future.

Osteoarthritis is the most prevalent rheumatic disease. Inasmuch as osteoarthritis is predominantly idiopathic, current treatment is aimed not at a cure but palliative management. Research, however, has made considerable forward strides with respect to feasibility of new methods for diagnostic markers of early disease and disease progression, as well as methods to conserve articular damage. This article briefly describes the authors' experience with the use of one type of surgical repair and five different medicinal agents for cartilage conservation.

Aims Osteoarthritis (OA) is a common joint disorder and a major socio-economic burden. Chondroitin sulfate (CS), which has chondroprotective properties, is a promising candidate for the therapeutic treatment of OA. Here, we summarize current knowledge as well as future trends of CS for the treatment of hip and knee OA. Main methods We retrospectively reviewed pharmacokinetics, pharmacodynamics, clinical efficacy, safety and tolerability of CS for the treatment of OA. Key findings The safety and tolerability of CS are confirmed. CS is effective, at least in part, for the treatment of OA, and its therapeutic benefits occur through three main mechanisms: 1) stimulation of extracellular matrix production by chondrocytes; 2) suppression of inflammatory mediators; and 3) inhibition of cartilage degeneration. Significance CS is a safe and tolerable therapeutic agent for the management of OA. Its effects include benefits that are not achieved by current medicines and include chondroprotection and the prevention of joint space narrowing. Such positive effects of CS represent a breakthrough in the treatment of hip and knee OA.

Pre-clinical studies have shown that treatment by pulsed electromagnetic fields (PEMFs) can limit the catabolic effects of pro-inflammatory cytokines on articular cartilage and favour the anabolic activity of the chondrocytes. Anterior cruciate ligament (ACL) reconstruction is usually performed by arthroscopic procedure that, even if minimally invasive, may elicit an inflammatory joint reaction detrimental to articular cartilage. In this study the effect of I-ONE PEMFs treatment in patients undergoing ACL reconstruction was investigated. The study end-points were (1) evaluation of patients’ functional recovery by International Knee Documentation Committee (IKDC) Form; (2) use of non-steroidal anti-inflammatory drugs (NSAIDs), necessary to control joint pain and inflammation. The study design was prospective, randomized and double blind. Sixty-nine patients were included in the study at baseline. Follow-up visits were scheduled at 30, 60 and 180 days, followed by 2-year follow-up interview. Patients were evaluated by IKDC Form and were asked to report on the use of NSAIDs. Patients were randomized to active or placebo treatments; active device generated a magnetic field of 1.5 mT at 75 Hz. Patients were instructed to use the stimulator (I-ONE) for 4 h per day for 60 days. All patients underwent ACL reconstruction with use of quadruple hamstrings semitendinosus and gracilis technique. At baseline there were no differences in the IKDC scores between the two groups. At follow-up visits the SF-36 Health Survey score showed a statistically significant faster recovery in the group of patients treated with I-ONE stimulator (P

SummaryRupture of the cranial cruciate ligament (CCL) is one of the most frequent causes of lameness of the rear limb in the dog. Regardless of the type of treatment, CCL rupture inevitably leads to knee osteoarthritis (OA). The purpose of this study was to evaluate the efficacy of associating surgical treatment of spontaneous rupture of the CCL with a chondroprotector, that is called “supraadditive” because it is formulated to counteract not only chondrodegeneration, but also the oxidative and inflammatory processes of OA. The open-label controlled study used proton NMR spectroscopy to evaluate the synovial fluid of the stifle of 10 dogs with monolateral rupture of the CCL, selected for the study based on specific inclusive criteria. The dogs were assigned randomly into two groups. Five dogs received the supra-additive chondroprotector for 60 days, starting on the day after surgery. Five dogs only underwent surgical reconstruction of the CCL. The results were analysed with the ANOVA unstructured variance matrix-covariance test. The trend overtime of the synovial concentration of four metabolites (lactate, alanine, acetyl groups of N-acety-lated sugars on glycoproteins and alpha-anomers of glucose) was found to differ to a statistically significant extent between the two groups, suggesting that the supra-additive chondroprotector produces an intra-ar-ticular metabolic rebalance. The results support the adjuvant use of the chondroprotector in the management of CCL rupture, in view of its control of the OA changes that accompany this orthopaedic disabling condition.

Severe joint inflammation following trauma, arthroscopic surgery or infection can damage articular cartilage, thus every effort should be made to protect cartilage from the catabolic effects of pro-inflammatory cytokines and stimulate cartilage anabolic activities. Previous pre-clinical studies have shown that pulsed electromagnetic fields (PEMFs) can protect articular cartilage from the catabolic effects of pro-inflammatory cytokines, and prevent its degeneration, finally resulting in chondroprotection. These findings provide the rational to support the study of the effect of PEMFs in humans after arthroscopic surgery. The purpose of this pilot, randomized, prospective and double-blind study was to evaluate the effects of PEMFs in patients undergoing arthroscopic treatment of knee cartilage. Patients with knee pain were recruited and treated by arthroscopy with chondroabrasion and/or perforations and/or radiofrequencies. They were randomized into two groups: a control group (magnetic field at 0.05 mT) and an active group (magnetic field of 1.5 mT). All patients were instructed to use PEMFs for 90 days, 6 h per day. The patients were evaluated by the Knee injury and Osteoarthritis Outcome Score (KOOS) test before arthroscopy, and after 45 and 90 days. The use of non-steroidal anti-inflammatory drugs (NSAIDs) to control pain was also recorded. Patients were interviewed for the long-term outcome 3 years after arthroscopic surgery. Thirty-one patients completed the treatment. KOOS values at 45 and 90 days were higher in the active group and the difference was significant at 90 days (P < 0.05). The percentage of patients who used NSAIDs was 26% in the active group and 75% in the control group (P = 0.015). At 3 years follow-up, the number of patients who completely recovered was higher in the active group compared to the control group (P < 0.05). Treatment with I-ONE aided patient recovery after arthroscopic surgery, reduced the use of NSAIDs, and also had a positive long-term effect.

Osteoarthritis (OA) is a common, chronic and painful condition. It is the most common of all rheumatic disorders and is destined to become one of the most prevalent and costly diseases in our society. The conventional therapeutic options employed in the management of OA are simple analgesics and NSAIDs, but these options frequently produce sub-optimal benefit and are associated with an adverse-safety profile. Unsurprisingly patients are looking to alternative and complementary medicine. The aim of this article was to review the available literature on the effectiveness and safety of ‘natural remedies’ for the treatment of OA. Computerised literature searches were carried out for systematic reviews and randomised controlled trials examining the role of ‘natural remedies’ in the treatment of OA. There have been few randomised controlled trials of ‘natural remedies’ that have satisfied the internationally agreed standards. There was, however, evidence of efficacy for glucosamine, chondroitin sulfate and possibly avocado/soybean unsaponifiables for the symptomatic relief of OA. To date, it is not established whether any of the ‘natural remedies’ are capable of chondroprotection. Even if ‘natural remedies’ are only modestly effective, they are widely available and well tolerated, suggesting that they may play a significant role in the management of OA in the elderly.

Rationale The aim of the treatment of osteoarthritis (OA) is to improve symptoms and function; ideally, treatment would also prevent the structural progression of the disease. The targets of structure-modifying OA drugs (STMOADs) can be one of the various lesions of OA, including cartilage destruction, osteophytes, bone sclerosis, cysts, and bone attrition. However, prevention of cartilage destruction (chondroprotection) is currently accepted as the most promising target of STMOADs. The possibility of preventing progression of cartilage damage has been demonstrated in various animal models of OA. Chondroprotection is now being investigated in human OA. Several trials are in progress, and two positive studies have already been reported 1,2 . The goal of these initial trials was mainly to demonstrate that a reduction of the natural progression of OA joint space narrowing is possible in humans. Today, chondroprotection is no longer considered a myth, and the questions now are whether STMOADs provide a clinical benefit for the patient and how to evaluate that benefit. These new and relevant questions are difficult to answer. Can we expect a clinical benefit from STMOADs? Drugs evaluated for a structure-modifying effect may or may not also have symptomatic effects in the short term. STMOADs with a symptomatic effect can be expected to lead to clinical improvement in the OA patient in the long term. Evaluation of the clinical benefit of STMOADs could be possible with the tools presently used for the assessment of symptom-modifying drugs in OA. The clinical benefit that can be expected from a drug without known symptomatic effects but with a structuremodifying effect and how to measure that clinical benefit are as yet unknown. An effective STMOAD is not expected to induce a repair of the structural lesions of OA, but it is expected to stop or decrease their progression. Such a structural effect in the long term might result in symptom improvement or might only prevent a progression of symptoms. It also might have no clinical effect, since symptoms and lesions are poorly correlated in OA patients. The time required to demonstrate the clinical benefit of a STMOAD is unknown. It is possible that there may be a long delay (several years) between the beginning of STMOAD efficacy and the realization of any clinical benefit. The extent of clinical benefit could be related to the degree of effectiveness of the STMOAD. If this were true, the delay in clinical benefit could be very long for drugs able to only partially reduce the structural progression of the disease. Finally, the clinical benefit of a STMOAD might be missed by our usual tools and could require new methods of evaluation.

Summary Objective Cell-based tissue engineering strategies are currently in clinical use and continue to be developed at a rapid pace for the repair of cartilage defects. Regardless of the repair methodology, chondrocytes within newly regenerated cartilage remain susceptible to the abnormal inflammatory and mechanical environments that underlie osteoarthritic disease, likely compromising the implant's integration, function, and longevity. The present study investigates the use of parathyroid hormone-related peptide (PTHrP) overexpression for chondroprotection. Design Bovine articular chondrocytes were transfected with human PTHrP (hPTHrP) constructs (1-141 or 1-173) and subjected to injurious cyclic tensile strain (CTS; 0.5Hz and 16% elongation) for 48h. mRNA expression of matrix remodeling, inflammatory signaling, hypertrophic, and apoptotic genes were examined with real-time reverse transcription polymerase chain reaction. Nitric oxide (NO) and prostaglandin E 2 (PGE 2 ) production were measured using the Griess assay and enzyme immunoassay (EIA), respectively. Results CTS-induced an arthritic phenotype in articular chondrocytes as indicated by increased gene expression of collagenases and aggrecanases and increased production of NO and PGE 2 . Additionally, CTS increased collagen type X (Col10a1) mRNA expression, whereas overexpression of either hPTHrP isoform inhibited CTS-induced Col10a1 gene expression. However, hPTHrP 1-141 augmented CTS-induced NO and PGE 2 production, and neither hPTHrP isoform had any significant effect on apoptotic genes. Conclusions Our results suggest that chondrocytes overexpressing PTHrP resist mechanical strain-induced hypertrophic-like changes. Therapeutic PTHrP gene transfer may be considered for chondroprotection applications in newly regenerated cartilage.

SummaryObjectiveTo evaluate the impact of forced joint exercise following acute knee injury on lubricin metabolism and its relationship to cartilage degeneration and to assess chondroprotection of a single-dose purified human lubricin injection in exercised injured joints.MethodsAnterior cruciate ligament transection (ACLT) was performed in rats with six experimental groups; 3-week post-ACLT, 3-week post-ACLT + exercise, 5-week post-ACLT, 5-week post-ACLT + exercise, and 5-week post-ACLT + exercise treated with intra-articular phosphate buffered saline (PBS) or lubricin. Joint exercise was achieved using a rotating cylinder at a speed of 6 rpm for 30 min daily, 5 days a week starting 1 week following surgery. Cartilage lubricin expression in injured joints was determined. Histological analyses included Safranin O/Fast Green, activated caspase-3, and lubricin mRNA in-situ hybridization. Assessment of cartilage damage was performed by osteoarthritis research society international (OARSI) modified Mankin scoring and urinary CTXII (uCTXII) levels.ResultsAt 3 weeks, lubricin expression in exercised ACLT joints was significantly (P

Background Curcumin has been shown to have chondroprotective potential in vitro. However, its effect on disease and symptom modification in osteoarthritis (OA) is largely unknown. This study aimed to determine whether curcumin could slow progression of OA and relieve OA-related pain in a mouse model of destabilization of the medial meniscus (DMM). Methods Expression of selected cartilage degradative-associated genes was evaluated in human primary chondrocytes treated with curcumin and curcumin nanoparticles and assayed by real-time PCR. The mice subjected to DMM surgery were orally administered curcumin or topically administered curcumin nanoparticles for 8 weeks. Cartilage integrity was evaluated by Safranin O staining and Osteoarthritis Research Society International (OARSI) score, and by immunohistochemical staining of cleaved aggrecan and type II collagen, and levels of matrix metalloproteinase (MMP)-13 and ADAMTS5. Synovitis and subchondral bone thickness were scored based on histologic images. OA-associated pain and symptoms were evaluated by von Frey assay, and locomotor behavior including distance traveled and rearing. Results Both curcumin and nanoparticles encapsulating curcumin suppressed mRNA expression of pro-inflammatory mediators IL-1β and TNF-α, MMPs 1, 3, and 13, and aggrecanase ADAMTS5, and upregulated the chondroprotective transcriptional regulator CITED2, in primary cultured chondrocytes in the absence or presence of IL-1β. Oral administration of curcumin significantly reduced OA disease progression, but showed no significant effect on OA pain relief. Curcumin was detected in the infrapatellar fat pad (IPFP) following topical administration of curcumin nanoparticles on the skin of the injured mouse knee. Compared to vehicle-treated controls, topical treatment led to: (1) reduced proteoglycan loss and cartilage erosion and lower OARSI scores, (2) reduced synovitis and subchondral plate thickness, (3) reduced immunochemical staining of type II collagen and aggrecan cleavage epitopes and numbers of chondrocytes positive for MMP-13 and ADAMTS5 in the articular cartilage, and (4) reduced expression of adipokines and pro-inflammatory mediators in the IPFP. In contrast to oral curcumin, topical application of curcumin nanoparticles relieved OA-related pain as indicated by reduced tactile hypersensitivity and improved locomotor behavior. Conclusion This study provides the first evidence that curcumin significantly slows OA disease progression and exerts a palliative effect in an OA mouse model. Electronic supplementary material The online version of this article (doi:10.1186/s13075-016-1025-y) contains supplementary material, which is available to authorized users.

Background Increased production of matrix metalloproteinases (MMPs) is closely related to the progression of osteoarthritis (OA). The present study was performed to investigate the potential value of biochanin A in inhibition of MMP expression in both rabbit chondrocytes and an animal model of OA. Methods MTT assay was performed to assess chondrocyte survival in monolayers. The mRNA and protein expression of MMPs (including MMP-1, MMP-3, and MMP-13) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in interleukin-1 (IL-1β)-induced rabbit chondrocytes were determined by quantitative real-time PCR and enzyme-linked immunosorbent assay (ELISA), respectively. The involvement of the NF-kappaB (NF-κB) pathway activated by IL-1β was determined by western blotting. The in vivo effects of biochanin A were evaluated by intra-articular injection in an experimental OA rabbit model induced by anterior cruciate ligament transection (ACLT). Results Biochanin A downregulated the expression of MMPs and upregulated TIMP-1 at both the mRNA and protein levels in IL-1β-induced chondrocytes in a dose-dependent manner. In addition, IL-1β-induced activation of NF-κB was attenuated by biochanin A, as determined by western blotting. Moreover, biochanin A decreased cartilage degradation as determined by both morphological and histological analyses in vivo. Conclusions Taken together, these findings suggest that biochanin A may be a useful agent in the treatment and prevention of OA.