Heberden-Arthrose

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Osteoarthritis is a degenerative disease that affects multiple joints. Typical clinical manifestations are joint pain and limitation of movement, which can eventually lead to joint deformity and seriously affect the patient's daily life. Risk factors for osteoarthritis include advanced age, history of trauma, obesity, and prolonged weight-bearing activities. Age is the main risk factor. As the population ages, the prevalence of osteoarthritis is increasing[1]. However, the pathogenesis of osteoarthritis has not been fully clarified. The current study shows that chondrocyte reactive oxygen species (ROS) accumulation is closely related to the pathogenesis of osteoarthritis and is also a potential therapeutic target [2]. Under the stimulation of hypoxia, stress load and chronic inflammation, chondrocyte mitochondria produce a large amount of ROS causing oxidative stress, leading to the destruction of nucleic acids, proteins and lipids, which can cause mitochondrial dysfunction, chondrocyte metabolic disorders and even apoptosis. In addition, the accumulation of ROS can lead to elevated expression of inflammatory factors, chemokines and matrix metalloproteinases, thus promoting the degradation of cartilage matrix and destroying cartilage homeostasis[3].

Physical rehabilitation for osteoarthritis is a common approach to the rehabilitation of osteoarthritis. Photobiomodulation (PBM) therapy is a non-invasive and safer physical rehabilitation method that uses visible or near-infrared light. The spectral range is usually 470~1200 nm and the light source device includes lasers and light emitting diodes. Depending on the power, it can be categorized into low-intensity laser therapy and high-intensity laser therapy. In recent years, it has been found that PBM has been used in the rehabilitation of osteoarthritis patients by reducing ROS production and lowering the level of inflammatory factors to attenuate local tissue inflammatory response and pain[4] .

PBM therapy is an emerging rehabilitation treatment for osteoarthritis. It can be categorized into low intensity laser therapy and high intensity laser therapy according to the power level. The power of low-intensity laser therapy is mostly below 500 mW, and the wavelength is mostly 470 ~ 1200 nm. The light source commonly used in high-intensity laser therapy is a pulsed laser, and the peak power of the laser used is mostly 3~3000 W. Low-intensity laser therapy has been widely used in osteoarthritis rehabilitation research. Zhao et al [5] conducted a multicenter double-blind randomized controlled trial, which included 392 patients with osteoarthritis, and selected two acupoints for 4 weeks of laser therapy using 10.6 μm wavelength laser at 160~180 mW. It was found that low intensity laser treatment could reduce the level of cartilage oligomeric matrix protein in the serum of the patients, and the patients' pain was reduced and their functions were improved. High-intensity laser therapy is more penetrating than low-intensity laser therapy. It can be applied to deeper tissues without causing damage to the tissue. Recent studies have shown that high-intensity laser therapy is better than low-intensity laser therapy in reducing pain in patients with osteoarthritis. Angelova et al[6] randomly divided 72 cases of osteoarthritis patients into experimental and control groups. The experimental group was treated with a 1064 nm laser with a peak power of 12 W. It was found that high-intensity laser therapy could effectively reduce pain and improve motor function of the patients, and it was found that the effect of pain reduction was maintained for 3 months after the end of the treatment.

Reference

  1. Zhang L, Lin C, Liu Q, Gao J, Hou Y, Lin J. Incidence and related risk factors of radiographic knee osteoarthritis: a population-based longitudinal study in China. J Orthop Surg Res. 2021 Jul 31;16(1):474.

  2. Arra M, Swarnkar G, Ke K, Otero JE, Ying J, Duan X, Maruyama T, Rai MF, O'Keefe RJ, Mbalaviele G, Shen J, Abu-Amer Y. LDHA-mediated ROS generation in chondrocytes is a potential therapeutic target for osteoarthritis. Nat Commun. 2020 Jul 9;11(1):3427.

  3. Zhao X, Yang L, Zhang L, Ji L, Ma S, Zhou F. Novel biomimetic macromolecules system for highly efficient lubrication, ROS scavenging and osteoarthritis treatment. Colloids Surf B Biointerfaces. 2024 May 8;239:113956.

  4. Sakata S, Kunimatsu R, Tsuka Y, Nakatani A, Gunji H, Yanoshita M, Kado I, Ito S, Putranti NAR, Prasetya RC, Hirose N, Tanimoto K. High-frequency near-infrared diode laser irradiation suppresses IL-1β-induced inflammatory cytokine expression and NF-κB signaling pathways in human primary chondrocytes. Lasers Med Sci. 2022 Mar;37(2):1193-1201.

  5. Zhao L, Cheng K, Wu F, Du J, Chen Y, Tan MT, Lao L, Shen X. Effect of Laser Moxibustion for Knee Osteoarthritis: A Multisite, Double-blind Randomized Controlled Trial. J Rheumatol. 2021 Jun;48(6):924-932.

  6. Angelova A, Ilieva EM. Effectiveness of High Intensity Laser Therapy for Reduction of Pain in Knee Osteoarthritis. Pain Res Manag. 2016;2016:9163618.