Relationships amongst osteoarthritis biomarkers, dynamic knee joint load, and exercise: results from a randomized controlled pilot study.

Hunt, Michael A

Pollock, Courtney L

Kraus, Virginia Byers

Saxne, Tore

Peters, Sue

Peters, Sue

Huebner, Janet L

Sayre, Eric C

Cibere, Jolanda

England

2015-11-10T22:34:53Z

2013-03-27

BACKGROUND: Little is known about the relationships of circulating levels of biomarkers of cartilage degradation with biomechanical outcomes relevant to knee osteoarthritis (OA) or biomarker changes following non-pharmacological interventions. The objectives of this exploratory, pilot study were to: 1) examine relationships between biomarkers of articular cartilage degradation and synthesis with measures of knee joint load during walking, and 2) examine changes in these biomarkers following 10 weeks of strengthening exercises. METHODS: Seventeen (8 male, 9 female; 66.1 +/- 11.3 years of age) individuals with radiographically-confirmed medial tibiofemoral OA participated. All participants underwent a baseline testing session where serum and urine samples were collected, followed by a three-dimensional motion analysis. Motion analysis was used to calculate the external knee adduction moment (KAM) peak value and impulse. Following baseline testing, participants were randomized to either 10 weeks of: 1) physiotherapist-supervised lower limb muscle strengthening exercises, or 2) no exercises (control). Identical follow-up testing was conducted 11 weeks after baseline. Biomarkers included: urinary C-telopeptide of type II collagen (uCTX-II) and type II collagen cleavage neoepitope (uC2C), serum cartilage oligomeric matrix protein (sCOMP), serum hyaluronic acid (sHA) and serum C-propeptide of type II procollagen (sCPII). Linear regression analysis was used to examine relationships between measures of the KAM and biomarker concentrations as baseline, as well as between-group differences following the intervention. RESULTS: KAM impulse predicted significant variation in uCTX-II levels at baseline (p = 0.04), though not when controlling for disease severity and walking speed (p = 0.33). KAM impulse explained significant variation in the ratio uCTX-II;sCPII even when controlling for additional variables (p = 0.04). Following the intervention, changes in sCOMP were significantly greater in the exercise group compared to controls (p = 0.04). On average those in the control group experienced a slight increase in sCOMP and uCTX-II, while those in the exercise group experienced a reduction. No other significant findings were observed. CONCLUSIONS: This research provides initial evidence of a potential relationship between uCTX-II and knee joint load measures in patients with medial tibiofemoral knee OA. However, this relationship became non-significant after controlling for disease severity and walking speed, suggesting further research is necessary. It also appears that sCOMP is amenable to change following a strengthening intervention, suggesting a potential beneficial role of exercise on cartilage structure. TRIAL REGISTRATION: Clinicaltrials.gov NCT01241812.

http://www.ncbi.nlm.nih.gov/pubmed/23530976

1471-2474-14-115

1471-2474

https://hdl.handle.net/10161/10869

eng

Springer Science and Business Media LLC

BMC Musculoskelet Disord

10.1186/1471-2474-14-115

Aged

Biomarkers

Exercise Therapy

Female

Follow-Up Studies

Humans

Knee Joint

Male

Middle Aged

Osteoarthritis, Knee

Pilot Projects

Single-Blind Method

Weight-Bearing

Relationships amongst osteoarthritis biomarkers, dynamic knee joint load, and exercise: results from a randomized controlled pilot study.

Journal article

Kraus, Virginia Byers|0000-0001-8173-8258

http://www.ncbi.nlm.nih.gov/pubmed/23530976

115

Clinical Science Departments

Duke

Duke Molecular Physiology Institute

Institutes and Centers

Medicine

Medicine, Rheumatology and Immunology

Orthopaedics

Pathology

School of Medicine

Published online

14