Introduction: Temporomandibular joint osteoarthritis (TMJ OA) is a degenerative disease characterized by deterioration of articular tissue with concomitant osseous changes in the condyle and/or articular eminence, joint positive for TMJ noise with jaw movement or function, crepitus detected on palpation on opening, closing, right/left lateral, or protrusive movement. Hyaluronic acid (HA) is a polysaccharide of the family of glycosaminoglycans. HA has been shown to improve and restore normal lubrication in joint, provide nutrition to the avascular articulating disc, and stabilize the joint. Materials and Methods: Twenty patients with OA of TMJ with age limit between 18 and 60 years of age were enrolled in this study. Patients were randomly divided into two groups, in which one group received arthrocentesis only, and another group received arthrocentesis plus intra-articular injection of sodium HA (0.5 ml) in superior joint space in a cycle of 5 weekly arthrocentesis (one per week). Patients were followed at regular interval of 1st day, 5th day, 7th day, 4 weeks, 6 weeks, and 12 weeks. Assessment of clinical outcome was done in terms of reduction in pain (visual analog scale score), maximum mouth opening (MMO) in millimeters, painful/pain-free lateral or protrusive jaw movement, and clicking/crepitus in joint. Results: Significant reduction in pain was observed in both the groups. MMO, lateral and protrusive movements improved significantly in both groups; however, arthrocentesis with sodium HA was superior to arthrocentesis alone. Conclusion: Combination of arthrocentesis with HA injection showed much better outcome than arthrocentesis alone.

Efficacy of arthrocentesis versus arthrocentesis with sodium hyaluronic acid in temporomandibular joint osteoarthritis: A comparison.

Repairing damaged articular cartilage is particularly challenging because of the limited ability of cartilage to perform self-repair. Intra-articular injections of N-acetylglucosamine (GlcNAc) comprise a method of repairing full-thickness articular cartilage defects in the rabbit knee joint model. To date, the effects of administration of GlcNAc and hyaluronic acid (HA) have been investigated only in the context of osteoarthritis treatment. Therefore, we evaluated the therapeutic effects of using cell-free porous poly lactic-co-glycolic acid (PLGA) graft implants and intra-articular injections of GlcNAc or HA in a rabbit model of osteochondral regeneration to investigate whether they have the potential for inducing osteochondral regeneration when used alone or simultaneously. Twenty-four rabbits were randomized into one of four groups: the scaffold-only group (PLGA), the scaffold with intra-articular injections of GlcNAc (PLGA+G) group, twice per week for four weeks; the scaffold with intra-articular injections of HA group (PLGA+HA) group, once per week for three weeks; and the scaffold with intra-articular injections of GlcNAc and HA (PLGA+G+HA) group, once per week for three weeks. Knees were evaluated at 4 and 12 weeks after surgery. At the end of testing, only the PLGA+G+HA group exhibited significant bone reconstruction, chondrocyte clustering, and good interactions with adjacent surfaces at 4 weeks. Additionally, the PLGA+G+HA group demonstrated essentially original hyaline cartilage structures that appeared to have sound chondrocyte orientation, considerable glycosaminoglycan levels, and reconstruction of the bone structure at 12 weeks. Moreover, the PLGA+G+HA group showed organized osteochondral integration and significantly higher bone volume per tissue volume and trabecular thickness. However, there were no significant differences between the PLGA+G and PLGA+HA groups except for gap formation on subchondral bone in the PLGA+G group. This study demonstrated that PLGA implantation combined with intra-articular injections of GlcNAc and HA allowed for cartilage and bone regeneration and significantly promoted osteochondral regeneration in rabbits without supplementation of exogenous growth factors. And the combination of this two supplements with PLGA scaffold could also prolong injection interval and better performance than either of them alone for the reconstruction of osteochondral tissue in the knee joints of rabbits.

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Intra-articular injection of N-acetylglucosamine and hyaluronic acid combined with PLGA scaffolds for osteochondral repair in rabbits

Introduction The COVID-19 pandemic has huge influences on daily life and is not only associated with physical but also with major psychological impacts. Mental health problems and disorders are frequently present in elite paralympic athletes. Due to the pandemic situation, new stressors (e.g., loss of routine, financial insecurity) might act upon the athletes. Therefore, the assessment of mental health in athletes during the COVID-19 pandemic is important to identify prevalence of psychological problems and propose countermeasures. Methods The mental health of German paralympic athletes was longitudinally monitored (starting in May 2019). The athletes completed the Patient Health Questionnaire 4 (PHQ-4) on a weekly basis and reported a stress level, training hours, and training load. During the pandemic, 8 measurement time points (March 2020 to April 2021) were used to reflect the psychological health course of the athletes. In parallel, a convenience sample of the general population was questioned about their psychological distress, including the PHQ-4. To be included in the analysis, participants of both groups had to complete at least 4 measurement time points. Matching of the para-athletes and the general population sample was prioritized upon completion of the same measurement time points, gender, and age. Results Seventy-eight paralympic athletes (40 women, 38 men, age: 29.8 ± 11.4 years) met the inclusion criteria. Seventy-eight matched pairs of the general population (40 women; 38 men; age: 30.5 ± 10.9 years) were identified. The para-athletes had a significantly (p <0.0001; 0.39 < r <0.48) lower PHQ-4 value at each measurement time point compared to the matched control group. No significant age or sex differences were evident regarding the symptom burden. In para-athletes, no significant and a weak positive correlation was found between decreased training load and PHQ-4 values and a stress level, respectively. Reduced physical activity was significantly (p <0.0001) associated with higher PHQ-4 values in the general population sample. Discussion Lower PHQ-4 values were reported by the para-athletes compared to the general population sample. However, small sample sizes must be considered while interpreting the data. Nevertheless, adequate support for individuals suffering from severe psychopathological symptoms should be provided for para-athletes as well as for the general population.

Mental Health in German Paralympic Athletes During the 1st Year of the COVID-19 Pandemic Compared to a General Population Sample

As aging causes challenges in several countries globally, more and more people are suffering from bad health conditions. Nowadays, COVID-19 causes many problems-and one of the root causes of these problems is the isolation of people from each other. The aim of our article is to investigate the effects of COVID-19 on people's physical activity. Physical activity is strongly correlated with health status and health preservation is very important to minimize the negative effects of the pandemic. In order to investigate this topic, we prepared an extended literature review, citing the most important sources of COVID-related health-preservation issues. Our results showed that the negative economic effects of the coronavirus pandemic have caused a decrease in physical activities in several cases. A reduction in possible physical activities has a potential negative effect on the life expectancies of elderly people. In order to underline the importance of physical activities, we prepared an extended literature review, aiming to summarize the available knowledge related to COVID-19. As a conclusion we recommend to strengthen, maintain, and develop available sporting possibilities for people. The most important of these recommendations is the development of physical activities that are available for free. 

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Lockdowns and Physical Activities: Sports in the Time of COVID

(1) Background: The COVID-19 pandemic has created challenges for college athletes as they return to sport and campus life. Emerging literature highlights some of these challenges, but no studies have used a primarily qualitative approach to assess the impact of the pandemic on college athletes. The purpose of this study was to better understand factors affecting college athletes’ return to sport and campus life amidst the COVID-19 pandemic. (2) Methods: Semi-structured interviews were conducted with varsity athletes who participated in the 2020–2021 season at a single university. Qualitative analysis was performed using the Strauss and Corbin method to derive codes, categories, and themes. Additionally, Athletic Coping Skills Inventory-28 (ACSI-28) scores were recorded and analyzed using descriptive statistics. (3) Results: A total of 20 student athletes were interviewed, revealing that confidence and motivation, increased stress and anxiety, and adaptive coping strategies were common themes affecting their experiences returning to sport and campus life. Results from the ACSI-28 showed an average score of 49.5 and a range of 24–66. (4) Conclusions: Semi-structured interviews revealed factors impacting return to sport and student life. These findings can help inform how to better support college athletes throughout the remainder of the current pandemic and moving forward.

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The Collegiate Athlete Perspective on Return to Sport Amidst the COVID-19 Pandemic: A Qualitative Assessment of Confidence, Stress, and Coping Strategies

Due to the rapid rate of spread of the SARS-CoV-2 coronavirus, a number of restrictions have been introduced into public spaces, including those related to the operation of sports facilities, compounding the difficulty for athletes to conduct appropriate forms of training. The aim of this study was to review current scientific reports assessing the impact of the pandemic on the physical activity, mental state, and quality of life of professional athletes. Popular scientific databases-PubMed, Scopus, and Embase-were systematically searched from the beginning of the pandemic until 12 July 2021. According to the adopted criteria, 14 articles were included in the review. Ten of the qualified studies determined the impact of the pandemic on the physical activity of athletes. The authors of 11 papers assessed the mental state and quality of life of athletes during the pandemic. The studies showed negative effects of the pandemic: a decrease in overall physical fitness and number of days and hours of training, as well as an increase in the occurrence of negative emotions (stress, fatigue, and depression) and a decrease in sleep quality. Changes in physical activity had an impact on overall well-being ratings, which depended on the sex of the subjects. Women were more likely to experience negative emotions compared to men. The mental state of the athletes affected the quality of sleep. This review summarises the negative effects of the SARS-CoV-2 coronavirus pandemic on the physical and mental health of professional athletes.

Impact of the SARS-CoV-2 Coronavirus Pandemic on Physical Activity, Mental Health and Quality of Life in Professional Athletes-A Systematic Review.

Osteoarthritis (OA) is one of the leading causes of disability in the elderly. The changes in the lubricating properties of synovial fluid lead to significant pain and loss of function. Viscosupplemen-tation, in which hyaluronic acid (HA) is injected into the knee joint, has evolved into an important part of our current therapeutic regimen in addressing the patient with knee pain due to OA. Intra-articular HA or hylan have proven to be an effective, safe, and tolerable treatment for symptomatic knee OA. In an effort to limit cardiovascular, gastrointestinal, and renal safety concerns with COX-2 selective and nonselective NSAIDs and maximize HA efficacy, it is even proposed using HA earlier in the treatment paradigm for knee OA and also as part of a comprehensive treatment strategy. Our study reconfirmed effectiveness and safety of intra-articular use of hyaluronic acid (Suplasyn) in the treatment of knee osteoarthritis.

Alicja Jurecka

Papers

Impact of the SARS-CoV-2 Coronavirus Pandemic on Physical Activity, Mental Health and Quality of Life in Professional Athletes-A Systematic Review.

[Effectiveness and safety of intra-articular use of hyaluronic acid (Suplasyn I-Shot) in the treatment of knee osteoarthritis].