Anti-Inflammatory Therapeutic Approaches to Prevent or Delay Post-Traumatic Osteoarthritis (PTOA) of the Knee Joint with a Focus on Sustained Delivery Approaches

Int J Mol Sci. 2021 Jul 27;22(15):8005. doi: 10.3390/ijms22158005.

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: IL-1 receptor antagonist; IL-10; IL-13; IL-1β; IL-4; IL-6; TNF-α; anti-apoptotic; anti-inflammatory cytokines; antibody; articular cartilage; cartilage; cartilage repair; chondrocyte; clinical; complement inhibitors; complement system; degeneration; dexamethasone; drug delivery; early PTOA; early disease; fat pad; hyaluronic acid; immunomodulation; inflammation; knee joint; knee trauma; osteoarthritis; post-traumatic osteoarthritis; prevention; regeneration; synovium; tranexamic acid; triamcinolone acetonide.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / therapeutic use*
  • Cartilage, Articular / metabolism
  • Cartilage, Articular / pathology
  • Humans
  • Knee Injuries* / complications
  • Knee Injuries* / drug therapy
  • Knee Injuries* / metabolism
  • Knee Injuries* / pathology
  • Knee Joint / metabolism
  • Knee Joint / pathology
  • Osteoarthritis, Knee* / drug therapy
  • Osteoarthritis, Knee* / etiology
  • Osteoarthritis, Knee* / metabolism
  • Osteoarthritis, Knee* / pathology

Substances

  • Anti-Inflammatory Agents