Ray Marks*

Department of Health and Behavior Studies, Teachers College, Columbia University, New York, United States

*Corresponding Author: Ray Marks, Department of Health and Behavior Studies, Teachers College, Columbia University, New York, United States.

Received: October 31, 2022; Published: November 12, 2022

Abstract

Knee joint osteoarthritis, a widespread disabling disease with no known cause continues to produce considerable bouts of intractable pain as a result of multiple disease associated problems despite years of research. This paper examines some probable neural influences that may be involved or implicated in inducing and perpetuating knee joint osteoarthritis, a major chronically painful, disabling and debilitating health condition. Presented are data retrieved from several sources that discuss the nature of the knee joint nerves and their ramifications in various knee joint tissue, their proposed functional importance, and connections with the spinal cord, central nervous system and motor control pathways, as this affects joint biomechanics, pain production, joint instability at the knee, and possible knee joint pathology. As such, it is concluded that to reduce the risk of joint injury, as well as to improve the effectiveness of treatments designed to avert knee joint damage and ensuing osteoarthritis pain, a better understanding of the probable neural origin[s] of knee joint pathology and pain may permit the development of more precise as well as targeted noninvasive nerve sparing preventive and intervention strategies for mitigating disabling knee osteoarthritis.

Keywords: Cartilage Degeneration; Neural Pathways; Knee Joint; Osteoarthritis; Pain

References

1. Øiestad Britt Elin., et al. “Knee extensor muscle weakness is a risk factor for the development of knee osteoarthritis: an updated systematic review and meta-analysis including 46 819 men and women”. British Journal of Sports Medicine6 (2022): 349-355.
2. Coaccioli Stefano., et al. “Osteoarthritis: new Insight on Its pathophysiology”. Journal of Clinical Medicine20 (2022): 6013.
3. Yu Huan., et al. “Osteoarthritis pain”. International Journal of Molecular Sciences9 (2022): 4642.
4. Ashraf Sadaf., et al. “Increased vascular penetration and nerve growth in the meniscus: a potential source of pain in osteoarthritis”. Annals of the Rheumatic Diseases3 (2011): 523-529.
5. Duarte Felipe CK., et al. “Association between naturally occurring spine osteoarthritis in geriatric rats and neurogenic inflammation within neurosegmentally linked skeletal muscle”. Experimental Gerontology118 (2019): 31-38.
6. Philpott Holly T., et al. “Attenuation of early phase inflammation by cannabidiol prevents pain and nerve damage in rat osteoarthritis”. Pain12 (2017): 2442.
7. Ohtori Seiji., et al. “Efficacy of combination of meloxicam and pregabalin for pain in knee osteoarthritis”. Yonsei Medical Journal5 (2013): 1253-1258.
8. Damarey B., et al. “Imaging of the nerves of the knee region”. European Journal of Radiology1 (2013): 27-37.
9. Zhang Li., et al. “Knee joint biomechanics in physiological conditions and how pathologies can affect it: a systematic review”. Applied Bionics and Biomechanics2020 (2020).
10. Ghazwan Aseel., et al. “Knee osteoarthritis alters peri-articular knee muscle strategies during gait”. Plos One1 (2022): e0262798.
11. Çabuk Haluk and Fatmagül Kuşku Çabuk. "Mechanoreceptors of the ligaments and tendons around the knee”. Clinical Anatomy6 (2016): 789-795.
12. Adatia Aleem., et al. “Osteoarthritis of the knee and hip. Part I: aetiology and pathogenesis as a basis for pharmacotherapy”. Journal of Pharmacy and Pharmacology5 (2012): 617-625.
13. Roberts Shannon L., et al. “Review of knee joint innervation: implications for diagnostic blocks and radiofrequency ablation”. Pain Medicine5 (2020): 922-938.
14. Laurant David Burckett-St., et al. “The nerves of the adductor canal and the innervation of the knee: an anatomic study”. Regional Anesthesia and Pain Medicine3 (2016): 321-327.
15. Kwon Susie S., et al. “Investigation of genicular neurotomy of the knee: MRI characterization of anatomy and implications for intervention”. Clinical Imaging1 (2020): 78-83.
16. Esrafilian A., et al. “EMG-assisted muscle force driven finite element model of the knee joint with fibril-reinforced poroelastic cartilages and menisci”. Scientific Reports1 (2020): 1-16.
17. Dye Scott F., et al. “Conscious neurosensory mapping of the internal structures of the human knee without intraarticular anesthesia”. The American Journal of Sports Medicine6 (1998): 773-777.
18. Saeed Alshahrani Mastour., et al. “Correlation and comparison of quadriceps endurance and knee joint position sense in individuals with and without unilateral knee osteoarthritis”. BMC Musculoskeletal Disorders1 (2022): 1-7.
19. Huang Dong., et al. “The Diagnosis and therapy of degenerative knee joint disease: expert consensus from the Chinese pain medicine panel”. Pain Research and Management2018 (2018).
20. Freeman MA and B Wyke. "The innervation of the knee joint. An anatomical and histological study in the cat”. Journal of AnatomyPt 3 (1967): 505.
21. Kennedy John C., et al. “Nerve supply of the human knee and its functional importance”. The American Journal of Sports Medicine6 (1982): 329-335.
22. Gardner Ernest. "The innervation of the knee joint”. The Anatomical Record1 (1948): 109-130.
23. Tran John., et al. “Overview of innervation of knee joint”. Physical Medicine and Rehabilitation Clinics4 (2021): 767-778.
24. Franco Carlo D., et al. “Innervation of the anterior capsule of the human knee: implications for radiofrequency ablation”. Regional Anesthesia and Pain Medicine4 (2015): 363-368.
25. Fonkoué Loïc., et al. “Distribution of sensory nerves supplying the knee joint capsule and implications for genicular blockade and radiofrequency ablation: an anatomical study”. Surgical and Radiologic Anatomy12 (2019): 1461-1471.
26. Dimitriou Michael. "Human muscle spindles are wired to function as controllable signal-processing devices”. Elife11 (2022): e78091.
27. Zimny Marilyn L and Carole S Wink. "Neuroreceptors in the tissues of the knee joint”. Journal of Electromyography and Kinesiology3 (1991): 148-157.
28. Biedert Roland M., et al. “Occurrence of free nerve endings in the soft tissue of the knee joint: a histologic investigation”. The American Journal of Sports Medicine4 (1992): 430-433.
29. Logerstedt David S., et al. “Effects of and response to mechanical loading on the knee”. Sports Medicine (2021): 1-35.
30. Diracoglu Demirhan., et al. “The effect of visco supplementation on neuromuscular control of the knee in patients with osteoarthritis”. Journal of Back and Musculoskeletal Rehabilitation1 (2009): 1-9.
31. Wyke, Barry. "Articular neurology: a review”. Physiotherapy3 (1972): 94-99.
32. Hogervorst TOM and Richard A Brand. "Current concepts review-mechanoreceptors in joint function”. JBJS9 (1998): 1365-1378.
33. de Lima Diego Ariel., et al. “Study of the nerve endings and mechanoreceptors of the anterolateral ligament of the knee”. Arthroscopy: The Journal of Arthroscopic and Related Surgery10 (2019): 2918-2927.
34. Langford Lauren A., et al. “Afferent and efferent axons in the medial and posterior articular nerves of the cat”. The Anatomical Record1 (1983): 71-78.
35. Henry Mélanie and Stéphane Baudry. "Age-related changes in leg proprioception: implications for postural control”. Journal of Neurophysiology2 (2019): 525-538.
36. Schaible HG., et al. “Responses of spinal cord neurones to stimulation of articular afferent fibres in the cat”. The Journal of Physiology1 (1986): 575-593.
37. Wojtys Edward M., et al. “Innervation of the human knee joint by substance-P fibers”. Arthroscopy: The Journal of Arthroscopic and Related Surgery4 (1990): 254-263.
38. Tracey David J. "Joint receptors and the control of movement”. Trends in Neurosciences11 (1980): 253-255.
39. Obeidat Alia M., et al. “The nociceptive innervation of the normal and osteoarthritic mouse knee”. Osteoarthritis and Cartilage11 (2019): 1669-1679.
40. Elfvin L-G., et al "The innervation of the synovium of the knee joint in the guinea pig: an immunohistochemical and ultrastructural study”. Anatomy and Embryology4 (1998): 293-303.
41. Mayer William P., et al. “Role of muscle spindle feedback in regulating muscle activity strength during walking at different speed in mice”. Journal of Neurophysiology5 (2018): 2484-2497.
42. Zhao Jie., et al. “Clinical efficacy of repeated intra‑articular pulsed radiofrequency for the treatment of knee joint pain and its effects on inflammatory cytokines in synovial fluid of patients”. Experimental and Therapeutic Medicine4 (2021): 1-8.
43. McCormick Zachary L., et al. “A prospective randomized trial of prognostic genicular nerve blocks to determine the predictive value for the outcome of cooled radiofrequency ablation for chronic knee pain due to osteoarthritis”. Pain Medicine8 (2018): 1628-1638.
44. More Semedh N., et al. “Improvement in pain and quality of life after ultrasound-guided saphenous nerve block in patients with knee osteoarthritis”. Cureus5 (2022).
45. Krupka Efficacy GL., et al. “Efficacy and safety of intra-articular injection of tropomyosin receptor kinase A inhibitor in painful knee osteoarthritis: a randomized, double-blind and placebo-controlled study”. Osteoarthritis and Cartilage11 (2019): 1599-1607.
46. Ishihara Shingo., et al. “The role of intra-articular neuronal CCR2 receptors in knee joint pain associated with experimental osteoarthritis in mice”. Arthritis Research and Therapy1 (2021): 1-12.
47. Cunha Jonathan Emanuel., et al. “Knee osteoarthritis induces atrophy and neuromuscular junction remodeling in the quadriceps and tibialis anterior muscles of rats”. Scientific Reports1 (2019): 1-11.
48. Hodgkinson Tom., et al. “Mechanosignalling in cartilage: an emerging target for the treatment of osteoarthritis”. Nature Reviews Rheumatology2 (2022): 67-84.
49. Güler Tuba., et al. “Ultrasound-guided genicular nerve block versus physical therapy for chronic knee osteoarthritis: a prospective randomised study”. Rheumatology International4 (2022): 591-600.
50. Van Tunen Joyce AC., et al. “Association of malalignment, muscular dysfunction, proprioception, laxity and abnormal joint loading with tibiofemoral knee osteoarthritis-a systematic review and meta-analysis”. BMC Musculoskeletal Disorders1 (2018): 1-15.
51. Roemer Frank W., et al. “Presence of magnetic resonance imaging–defined inflammation particularly in overweight and obese women increases risk of radiographic knee osteoarthritis: The POMA Study”. Arthritis Care and Research8 (2022): 1391-1398.
52. Ramezanpour Sara., et al. “Impact of sustained synovitis on knee joint structural degeneration: 4‐year MRI data from the Osteoarthritis Initiative”. Journal of Magnetic Resonance Imaging (2022).
53. Bennell Kim L., et al. “Effect of intra-articular platelet-rich plasma vs placebo injection on pain and medial tibial cartilage volume in patients with knee osteoarthritis: the RESTORE randomized clinical trial”. JAMA20 (2021).
54. Ohtori Seiji., et al. “Efficacy of direct injection of etanercept into knee joints for pain in moderate and severe knee osteoarthritis”. Yonsei Medical Journal5 (2015): 1379-1383.
55. Freiwald J., et al. “Die nervose Versorgung der Kniegelenke”. Wiener Medizinische Wochenschrift23-24 (1997): 531-541
56. Wang Huan and Baoan Ma. "Healthcare and Scientific Treatment of Knee Osteoarthritis”. Journal of Healthcare Engineering2022 (2022).
57. Horner Gregory and A Lee Dellon. "Innervation of the human knee joint and implications for surgery”. Clinical Orthopaedics and Related Research301 (1994): 221-226.
58. Johansson H., et al. “Receptors in the knee joint ligaments and their role in the biomechanics of the joint”. Critical Reviews in Biomedical Engineering5 (1991): 341-368.
59. Zhou Feng., et al. “Associations of osteoclastogenesis and nerve growth in subchondral bone marrow lesions with clinical symptoms in knee osteoarthritis”. Journal of Orthopaedic Translation32 (2022): 69-76.
60. Mailhot Benoit., et al. “Neuronal interleukin-1 receptors mediate pain in chronic inflammatory diseases”. Journal of Experimental Medicine9 (2020).

Citation

Citation: Ray Marks. “Knee Joint Neural Pathways and their Osteoarthritis Pathogenic Linkage Implications”. Acta Scientific Orthopaedics 5.12 (2022): 116-126.

Copyright

Copyright: © 2022 Ray Marks. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.