IntechOpen Book Series Osteoarthritis Biomarkers and Treatments

### Volume 2

Hechmi Toumi is the director of the Translational Medicine Research Platform and Vice President of the Institute of Treatment & Prevention of Osteoporosis. Hechmi has an international background and vast experience. He graduated from the University Blaise Pascal France, was a researcher assistant at the Wisconsin University USA, and was awarded professor at the University of Wales. Currently he is the Dean of the Faculty of

Sciences Engineering, Orleans France. He is the inventor of the international patent filing on the use of algorithmic analyses to identify and quantify soft tissues in standard radiographs. He founded Demasq Limited and served as its Chief Scientific Officer. Hechmi is a member of the editorial boards of several journals, notably the American College of Sports Medicine. His research focuses on bone, cartilage and soft tissue injuries.

**Editor of Volume 2: Hechmi Toumi** University of Orléans,Orléans, France

Marija Mazor graduated from the University of Orleans France and has been a teacher assistant at Orleans University and a researcher at I3MTO (Imagerie Multimodale Multiéchelle et Modélisation du Tissu Osseux et articulaire). Currently, she is a researcher at the Histology and Embryology Center for Proteomics in Croatia. Marija's general scientific expertise is in the field of cellular and molecular biology. Marija's research focuses

on tissue pathologies and repair. A main part of Marija's research activities focuses on osteoarthritis and immunology. She has published several peer-reviewed papers in international journals and co-edited scientific books. Marija has participated in many research international congresses.

**Editor of Volume 2: Marija Mazor** University of Orléans,Orléans, France

**Book Series Editor: Maria Maślińska** National Institute of Geriatric, Rheumatology and Rehabilitation, Poland

### Scope of the Series

This book series presents new concepts of pathogenesis, including genetic, epigenetic determinants and epidemiology of rheumatic diseases. It focuses on current classification criteria, recommendations for the diagnosis and treatment of rheumatic diseases. The goal of the series is to explain various aspects of disorders associated with impaired immune response and autoimmunity processes. It also discusses risk factors associated with the development of autoimmune diseases, as well as latest discoveries and future perspectives of this extremely dynamic field of internal medicine - rheumatology.

**Preface III**

OA Biomarkers and Treatments **1**

**Chapter 1 3**

OA Treatments Options **21**

**Chapter 2 23**

**Chapter 3 39**

Natural Treatments for Osteoarthritis **55**

**Chapter 4 57**

**Chapter 5 75** Cardiovascular and Functional Capacity of Patients with Knee Osteoarthritis

Bone Changes in OA **87**

**Chapter 6 89**

Evaluating the Relation between Bone Marrow Lesions and Synovitis

with Pain and Structural Damage in Hand Osteoarthritis

Osteoarthritis as a Chronic Inflammatory Disease: A Review of the

Fat Tissue's Graft in Osteoarthritis Treatment: Indications, Preparations,

*by Edoardo De Fenu, Berardino Di Paola, Marco Ruggiero, Bruno Carlesimo,* 

*by José Fábio dos Santos Duarte Lana and Bruno Lima Rodrigues*

Herbal Medicinal Products in the Treatment of Osteoarthritis

**Section 1**

Contents

**Section 2**

and Results

**Section 3**

**Section 4**

Value of Biomarkers in Osteoarthritis

*by Yaşar Mahsut Dinçel*

Inflammatory Markers

*Andrea Conversi and Ezio Adriani*

*by Zoran Maksimović and Stevan Samardžić*

*by Zuhal Kunduracilar and Kartal Selici*

*by Nidhi Sofat and Soraya Koushesh*

## Contents


Preface

Because the regenerative ability of cartilage is limited due to its avascular nature and low replenishment rate of colla- gen type-II, osteoarthritis (OA) is one of the top five most disabling conditions that affects more than one-third of the population older than 65 years of age. Recently, ORSI recommended that the optimal OA treatment regimen should consist of both medications and non-drug treatments. Currently, painkillers and anti-inflammatory drugs are often prescribed in association with weight loss and/or physiotherapy. When these options are no longer able to control symptoms, intra-articular injections of corticosteroids, hyaluronic acid or Platelet-Rich Plasma are alternatives. Non-pharmaceutical treatments start with bracing, weight loss and muscle strengthening through different types of physical activity. Recently, physical exercise became the cornerstone of osteoarthritis therapy and several natural medicines have been examined in clinical trials. Foods for treating arthritis include Omega-3 foods, high-antioxidant and fibre foods etc. The first part of this book examines the changes in bone and OA biomarkers in response to OA-diseased joints. The second part is a description of both OA clinical

**Prof. Hechmi Toumi**

**Dr. Marija Mazor**

University of Orléans,Orléans, France

University of Orléans,Orléans, France

treatment approaches and natural supplements.
