Anti-Inflammatory Therapeutic Approaches to Prevent or Delay Post-Traumatic Osteoarthritis (PTOA) of the Knee Joint with a Focus on Sustained Delivery Approaches |
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Authors: | Christine M Khella Judith M Horvath Rojiar Asgarian Bernd Rolauffs Melanie L Hart |
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Affiliation: | G.E.R.N. Center for Tissue Replacement, Regeneration & Neogenesis, Department of Orthopedics and Trauma Surgery, Faculty of Medicine, Medical Center—Albert-Ludwigs—University of Freiburg, 79085 Freiburg im Breisgau, Germany; (C.M.K.); (J.M.H.); (R.A.); (B.R.) |
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Abstract: | Inflammation plays a central role in the pathogenesis of knee PTOA after knee trauma. While a comprehensive therapy capable of preventing or delaying post-traumatic osteoarthritis (PTOA) progression after knee joint injury does not yet clinically exist, current literature suggests that certain aspects of early post-traumatic pathology of the knee joint may be prevented or delayed by anti-inflammatory therapeutic interventions. We discuss multifaceted therapeutic approaches that may be capable of effectively reducing the continuous cycle of inflammation and concomitant processes that lead to cartilage degradation as well as those that can simultaneously promote intrinsic repair processes. Within this context, we focus on early disease prevention, the optimal timeframe of treatment and possible long-lasting sustained delivery local modes of treatments that could prevent knee joint-associated PTOA symptoms. Specifically, we identify anti-inflammatory candidates that are not only anti-inflammatory but also anti-degenerative, anti-apoptotic and pro-regenerative. |
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Keywords: | chondrocyte articular cartilage synovium fat pad osteoarthritis post-traumatic osteoarthritis immunomodulation inflammation degeneration regeneration anti-apoptotic early PTOA cartilage repair clinical knee trauma knee joint anti-inflammatory cytokines cartilage IL-1β TNF-α IL-6 triamcinolone acetonide dexamethasone IL-1 receptor antagonist antibody hyaluronic acid IL-4 IL-10 IL-13 complement inhibitors complement system tranexamic acid drug delivery early disease prevention |
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