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Anti-Inflammatory Therapeutic Approaches to Prevent or Delay Post-Traumatic Osteoarthritis (PTOA) of the Knee Joint with a Focus on Sustained Delivery Approaches
Authors:Christine M Khella  Judith M Horvath  Rojiar Asgarian  Bernd Rolauffs  Melanie L Hart
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.)
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.
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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