Arthrofibrosis Research Being Done Anywhere????

[starpolisher]

I would love to know if any medical facility is doing research on arthrofibrosis.....the cause of it.  Has anyone heard of this research being done?
Thank you.   We desperately need it! 

[starpolisher]

http://www.orthosupersite.com/view.aspx?rid=3885
link re research on arthrofibrosis?  Opinions?  Very short but hopeful?

[Suzinthecity1]

Yes - K. Donald Shelbourne (doc who fixed my arthrofibrosis when no one could) has research since 1982 on every patient, it's a huge part of his work.

http://www.aclmd.com/Research/research2011.html

[missmyknee]

Hi Patty

I think the  AF docs on the list, the more prominent ones, do research on AF.  There's probably more done, it"s just hard to find the articles, esp ones available to laypeople.

Pam

[Decruz]

Hi starpolisher,
I read the article you posted, it's a HUGE thing.
It's the first time I read about specific data, not only about TGF-ß1 as the key to fibrosis, but above all the fact that the researchers identified decorin, suramin, gamma-interferon and relaxin as TGF-ß1 blockers.
I'm seriously thinking to contact University of Pitssburgh to get infos about that, if they have test/exam to check TGF-ß1 level and if these above indicated element are just used on animals or if they know what can be done in humans to block or inhibit TGF-ß1 planning another surgery, this time with a controlled inflammatory response and above all without the massive production of scat tissues/fibrosis...

Thank u

[missmyknee]

Hey All

Here are some articles I found

Clinical Benefits of Intra-articular Anakinra For Arthrofibrosis
http://www.orthosupersite.com/view.aspx?rid=77608

Gene Delivery of TGF-Beta1 Induces Arthrofibrosis And Chondrometaplasia In Synovium In Vivo
http://www.bioportfolio.com/resources/pmarticle/41343/Gene-Delivery-Of-Tgf-beta1-Induces-Arthrofibrosis-And-Chondrometaplasia-Of-Synovium-In.html
                                                 and full article
http://www.nature.com/labinvest/journal/v90/n11/full/labinvest2010145a.html

Halofuginone:A Novel Antifibrotic Therapy
http://www.ncbi.nlm.nih.gov/pubmed/9522159

The next 2 articles have an interesting discussion even though it is about spinal surgery

Scar Tissues Role In The Stages of Healing
http://www.scar-tissue.biz/scar-tissues-role-in-the-stages-of-healing/

Scar Tissue- Radiation and Enzyme Studies To Prevent Spinal Scar Tissue
http://www.scar-tissue.biz/scar-tissue-%E2%80%93-radiation-and-enzyme-studies-to-prevent-spinal-scar-tissue/

Others

Collagen Fibril Formation. A New Target To Limit Fibrosis
http://ukpmc.ac.uk/articles/PMC2533774   full article

Autologous platelet gel and fibrin sealant enhance the efficacy of total knee arthroplasty: improved range of motion, decreased length of stay and a reduced incidence of arthrofibrosis.
http://ukpmc.ac.uk/abstract/MED/17323096

Novel use of botulinum toxin to ameliorate arthrofibrosis: an experimental study in rabbits.
http://ukpmc.ac.uk/abstract/MED/17763285

Alpha-smooth muscle actin containing contractile fibroblastic cells in human knee arthrofibrosis tissue. Winner of the AGA-DonJoy Award 2003.
http://ukpmc.ac.uk/abstract/MED/15378321

Immunohistochemical localization of collagen VI in arthrofibrosis.
http://ukpmc.ac.uk/abstract/MED/10447630

Focus on collagen: in vitro systems to study fibrogenesis and antifibrosis state of the art.
http://ukpmc.ac.uk/articles/PMC2805599   full article

Reactive oxygen and nitrogen species induce protein and DNA modifications driving arthrofibrosis following total knee arthroplasty.
http://ukpmc.ac.uk/articles/PMC2785750   full article

[prech]

If there are specific articles from Pubmed or Google Scholar that folks are interested in, I would be glad to provide a copy as I, fortunately, have access to almost all journals/textbooks/lecture notes....basically anything published publicly

[Decruz]

I've read all the article listed and posted by missmyknee.

What came out are the various biological changes connected with arthrofibrosis, specifically identifing elements such as proteins, transforming growth factors, collagene, fibroblast, etc. that are highly alterated if compared with tissues took (and biopsed/tested) from knee of normal ACL patients.
Some (not too many, and that's someway positive) specific element that become uncontrolled in AF are well identified, the thing is if tests exists to find out, in each AF patient what elements became highly uncontrolled (too high/low) causing his/her AF, then if a treatment/cure exist to keep them back under control, then see the situation and eventually arrive to the point in which the patient is ready to undergo a final surgery (this time with a controlled reaction of these elements so without a coming back of fibrosis or at least much much less) to free their knee from as much scar tissues/fibrosis as possible.

Cure to prevent or reverse the hyper-fibrotic reaction process were mostly tested on animals but some of them are already available on humans: I'll contact the authors of these researches/articles, where supported by objective and succesfull data, all over the world to find out if the above described path is possible (test-cure-eventual surgery with controlled reaction).
This is, IMHO, the way to follow when an AF patient, after multiples unsuccesful surgeries for AF, still needs to be freed from scar tissues/fibrosis but can't do it because they keep coming back even worse.
Maybe isn't possible on humans, but I'll try and I'll let you guys know.

PS: I strongly believe others should do the same in order to get the most possible infos, resources, etc., eventually to arrive to doctors name all over the globe (those articles report researches made in Europe, Asia, USA...) to be visited and tested by (again, if this path is a possible one - only researching we'll find out it)

Bye

[missmyknee]

Here is another full article

Fibrillin assemblies: extracellular determinants of tissue formation and fibrosis
http://www.fibrogenesis.com/content/3/1/24

Explore around this Fibrogenesis Website in the articles. It is interesting to see all the articles on some form of fibrosis process in the body. They all seem to have the same cellular beginnings

Factors influencing myofibroblast differentiation during wound healing and fibrosis.
http://ukpmc.ac.uk/abstract/MED/7640660

Clinical benefits of intra-articular anakinra for arthrofibrosis.
http://orthopedics.researchtoday.net/archive/6/12/3121.htm

http://books.google.com/books?id=nxiCfmXPkzYC&pg=PA129&lpg=PA129&dq=anti+arthrofibrosis+research&source=bl&ots=jOdEE_Pb7i&sig=FjtvG89cBpfLtMcfRKmwEMLMImI&hl=en&ei=Q4tVTdyeMIfAsAPTg6iCBg&sa=X&oi=book_result&ct=result&resnum=5&ved=0CDYQ6AEwBA#v=onepage&q=anti%20arthrofibrosis%20research&f=false    read thru on Hyaluronan  chapter

Mast cells and hypoxia drive tissue metaplasia and heterotopic ossification in idiopathic arthrofibrosis after total knee arthroplasty
http://www.fibrogenesis.com/content/3/1/17

This next website is excellent. Even though the title has TKR in it, it is all about AF. I will provide 2 links. The second link is the webcast presentation by Marla Steinbeck M.T., Phd, from Thomas Jefferson University. It discusses the whole cell process of AF. It is about an hour long. I listened to it and even though it is very technical , you can understand just how complicated this process is. The question and answer period after the presentation is excellent. Dr Javad Pavizi of the Rothman Insitiute is listed as a stiff knee expert.

Seminar - Arthrofibrosis Following Total Knee Arthroplasty: Insight into Molecular Mechanisms
http://www.biomed.drexel.edu/new04/Content/news_events/display_event.cfm?EVENT_ID=442

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Arthrofibrosis Following Total Knee Arthroplasty: Insight into Molecular Mechanisms
Webcast

http://media.irt.drexel.edu/mediasite/viewer/?peid=eb324431-8728-4e55-9a3e-d74faface9bc[/b]    and companion article

Reactive oxygen and nitrogen species induce protein and DNA modifications driving arthrofibrosis following total knee arthroplasty
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785750/

http://docs.google.com/viewer?a=v&q=cache:wg2kGr7FjtUJ:www.craneclinic.com/Article_PPM_JanFeb08_12-27_Crane.pdf

Don't be fooled by the next title. It is about AF

New developments in osteoarthritis. Posttraumatic osteoarthritis: pathogenesis and pharmacological treatment options
http://arthritis-research.com/content/12/3/211

http://www.biobridge-event.com/site/index.php/2008unog2008europe/2008-speakers-directory/165-everts-peter-prof-.html?lang=

The effect of mitomycin C in reducing intraarticular adhesion after knee surgery in rabbits
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T1J-50BJNSK-1&_user=10&_coverDate=09%2F15%2F2010&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1638635505&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=f792047b81a9e1d996faef28fb2cb446&searchtype=a      Abstract

Gene delivery of TGF-β1 induces arthrofibrosis and chondrometaplasia of synovium in vivo
http://www.nature.com/labinvest/journal/v90/n11/full/labinvest2010145a.html     abstract

That's all for now unless I find more. Sorry if there are any duplicates

Pam

[Clarkey]

I have seen on Mr Martyn Snow Profile he has a major interest in soft tissue injuries of the knee, he work for the NHS as well as private. I am thinking about seeing him about my right knee if it does not improve and will be 15 months post op next week and almost certain I have scar tissue and possible AF. Have classic signs, swelling and pain around the portal areas and cannot think what else it could be.

I live in Birmingham and had my surgery at The Birmingham Royal Orthopaedic Hospital and Mr Snow works at the Hospital and very tempted to see him about my right knee that has got worse after my surgery. (was not under Mr Snow's care when I had my knee surgery)

http://www.roh.nhs.uk/patient-information/consultants-and-clinics/consultants/mr-snow/

Nick {2011}

[Decruz]

Well,
I've thoroughly read each article here posted (it took time), to summarize these 2 pretty much resume everything:

• http://www.orthosupersite.com/view.aspx?rid=3885
• http://books.google.com/books?id=nxiCfmXPkzYC&pg=PA129&lpg=PA129&dq=anti+arthrofibrosis+research&source=bl&ots=jOdEE_Pb7i&sig=FjtvG89cBpfLtMcfRKmwEMLMImI&hl=en&ei=Q4tVTdyeMIfAsAPTg6iCBg&sa=X&oi=book_result&ct=result&resnum=5&ved=0CDYQ6AEwBA#v=onepage&q=anti%20arthrofibrosis%20research&f=false

I think I got how arthrofibrosis onset due to untreated hemarthrosis, consequent platelets degradation, biochemical changes and final alterations of the tissues, with all the involved elements that become highly alterated and controllers of these elements/blockers of the alterations of them.
I'll focus myself in finding, if possible on humans, treatments to reverse the process or to bring back a patient in having (after beeing thoroughly tested) normal levels of the involved and highly alterated elements to possibly undergo new surgical scar tissues/fibrosis removal without forming excessive scar tissues (or much less) and having a balanced immune response;  this to have a real hope of recovery, or to do extremely better, once actually having a good outcome that restore a reasonable knee status.
I'll keep you updated, any input and co-operation will be appreciated.
I'm basically contacting via e-mail researchers & doctors involved in the above listed researches to see what come out: an idea could be that other AF interested patients contact researchers & doctors when in or close to their own country (I've read about researches done in Iran, Italy, France, Germany, Holland, UK, all across USA, Korea, etc.)

Bye

[Rennschnecke]

Just found this article http://www.fibrogenesis.com/content/2/1/7 which I hope will be a review of where things are at the moment.  It's around 2 years old, but with way things go it may accurately reflect what is available to AF patients at this time.

[missmyknee]

Hi Renn

Glad you found an article from the fibrogenesis website  I said to explore. I thought the.fibrogenesis website to be an excellent source of info. I also found most of the articles and abstracts came from science sources rather than ortho sites.  You have to know the how's and why's to get to the prevention and treatments.

Pam

[Rennschnecke]

Hi Pam

I still haven't read the article, but I found it when I was doing an update to my own research  .

I have to admit that I narrowed my focus to anything that may be of practical use for me now and ignored articles looking at animal models and biochemical models.  I know it's selfish, as I can't persuade any OS to provide unapproved treatments but perhaps others are in quite different circumstance from me.

Thanks for the pointers.

[missmyknee]

Here are some more articles, most on anti-fibrosis agents

TGF-ß signaling and the fibrotic response
http://www.fasebj.org/content/18/7/816.long

Regulation of wound healing using Nitric Oxide
http://www.sumobrain.com/patents/wipo/Regulation-wound-healing-by-nitric/WO1996008966.html

Halofuginone: a novel antifibrotic therapy.
http://www.ncbi.nlm.nih.gov/pubmed/9522159

Selective inhibition of activin receptor–like kinase 5 signaling blocks profibrotic transforming growth factor β responses in skin fibroblasts
http://onlinelibrary.wiley.com/doi/10.1002/art.20658/full

Postoperative Use of Bevacizumab as an Antifibrotic Agent in Glaucoma Filtration Surgery in the Rabbit
http://www.iovs.org/content/50/7/3233.full

Pirfenidone: A Novel Potential Therapeutic Agent in the Management of Chronic Allograft Rejection
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VJ0-4PPNW70-12&_user=10&_origUdi=B6T1J-4JGGD8S-3&_fmt=high&_coverDate=09%2F30%2F2007&_rdoc=1&_orig=article&_origin=article&_zone=related_art&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=53634d13f03d9d0e53a7479ce4eae2b5

The Use of Suramin, an Antifibrotic Agent, to Improve Muscle Recovery After Strain Injury
http://ajs.sagepub.com/content/33/1/43.abstract

Criteria to select molecular targets for anti-fibrotic therapy
http://rheumatology.oxfordjournals.org/content/47/suppl_5/v12.long   full article

Using decorin, an anti-fibrosis agent, to improve muscle recovery after injury
http://www.sportsinjurybulletin.com/archive/decorin.htm

Method for preventing scar tissue formation
http://www.patentstorm.us/patents/6060474/description.html

New developments in osteoarthritis. Posttraumatic osteoarthritis: pathogenesis and pharmacological treatment options
http://preview.arthritis-research.com/content/12/3/211    be sure to page down

Focus on collagen: in vitro systems to study fibrogenesis and antifibrosis _ state of the art
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2805599/


Pam