踏腳石 - 退化性膝關節炎患者的棲息地

這個題目有趣，值得挑戰！

Very interesting question..... Does it depend on how often they bend their knees? I can understand why Japanese women have higher prevalence rate. I think they bend their knees too often because of their culture and life style. But why Taiwanese women's prevalence is almost as high as Japanese women's? I don't get it. Please educate us. Give me some hints. The prevalence rate differences between men and women are also quite shocking to me. Is it because women are more likely to carry/hold their children than men in Asian culture?

其實，若了解膝關節內側摩擦症候群的相關知識，就很容易解釋了
說穿了，就是重複彎曲膝蓋的次數愈多、角度愈大，軟骨就愈容易受損
請比較東西方以及男女間最貼近生活的各種動作有哪些不同，就可豁然開朗了！
而，體重及負重的影響是第三期之後才比較重要

Thanks for not telling me the answers. 1) To explain women's higher prevalence rate: Women have to sit on the toilets many times more than men. 2) To explain Turkish high prevalence rate: Islam is the main religion of the Turkish people. So both men and women have to kneel down and pray many times a day. 3) To explain Asian's women's higher prevalence rate: I think it has to do with squat toilet. Am I right?

How smart you are!
I do wish I could have such a fellow doctor like you.
Actually, my theory could be applied to many equivocal issues in current knowledge about OA knee.
Try it!

I can't take the full credit. You are truly a great professor/doctor/researcher. Without your hints, I wouldn't have guessed it. As a public health graduate, I really appreciate your generosity in sharing your knowledge. I have so much fun browsing your blog.

Appreciate your encouragement!
I do wish I could write more .....

May be related to the woman child birth which enlarges the
pelvic cavity forcing the top femur bone outward accordingly
changing 彎曲膝蓋的角度 to be 愈大.

Wayne

May be your thought will change after go through my book chapter about KHPO:
http://www.intechopen.com/books/osteoarthritis-diagnosis-treatment-and-surgery/knee-health-promotion-option-for-osteoarthritic-knee-cartilage-regeneration-is-possible

It is very enjoyable reading your excellent published paper
about KHPO. you mentioned about the catabolic mechanism from
proinflammatory cytokines IL-1B to MMP-3 which breakdowns the
cartilage, but you said the regeneration by natural character,
It seems to me after reading through some of your attached
references, anabolic pathway only happen to the weight-bearing
portion of the medial femoral condyle with "exposed subchondral
bone", therefore only in stage III and IV of knee OA will gain
noticeable cartilage regeneration because the blood supply from
inside the bone is sometimes enough to start some healing to the
damaged hyaline cartilage and may be a good time to take
Glucosamine/chondroitin. Is this possible to remove the medial
plica in certain risky person to prevent from future damage just
like I have done 包皮切割 without telling my parent when I was
in high school.

If we look into the metabolism of cartilage tissue, chondrocytes play the key role. In normal condition, catabolic and anabolic mechanisms are balanced and keep the cartilage healthy. If some damaging factors dominant (like chronic abrasion and inflammation in the case of medial plica impingement), the catabolic mechasism dominates and therefore the whole cartilage tissue "degenerates". So, according to my theory, the partial thickness cartilage injury still has the hope to "regenerate", since the chondrocytes are still there! Talking about the "preventive operation" for medial plica, just like appendix, will be an issue of debate in the future. But, from my point of view, only bothering plica needs to be removed.

I am not quite convinced by your theory of "cartilage injury
still has the hope to "regenerate", if the
chondrocytes are
there " without the direct or indirect involvement of nutrition
rich source either from blood supply or synovial fluid. Toady I
like to share with you this article of " Lab-grown cartilage
fixes damaged knees".
http://www.newscientist.com/article/dn9483-labgrown-cartilage-fixes-damaged-knees.html.
Lab-grown cartilage seems a very exiting project for your
future research. If you are interested you can team with 國立中
正大學生物醫學研究所副教授 呂昱瑋
http://admbio.ccu.edu.tw/new/teacher_lyw.html

1. "To see is to believe", I really don't know how to convince someone if he didn't know or see the "hidden lesions". So, I have no comment about this statement. By the way, in this May I will have a chance to attend a summit hosted by Prof. Hollander who is the president of ICRS and is the key person in your link. May be we could have a good communication during this meeting (http://www.cartilage.org/index.php?pid=235).
2. I've browsed your link about Prof. Lu. Unfortunately, I could not find any information regarding cartilage or osteoarthritis related research in his profile. So ........?

Thanks for your comments and time. It is my selfish to suggest
to team with professor 呂昱瑋 in 國立中正大學生物醫學研究所 I am
the one to convince him to change from pure academic research in
UC SF to practical cancer research with professor Hung then was
the head of Ellis Fischel Cancer Center, Columbia. I foresee the
potential of tissue engineering such as lab-grown cartilage to
fix not only the damaged knee cartilage but hopefully be used to
fix or replace the damaged vertebral facet joint cartilage or
even the cervical, lumbar intervertebal discs instead of
notorious bone fusion.I sincerely hope 呂昱瑋-MY NEPHEW- is
interested in this emerging field and have chance to work with
the best orthopedic knee surgeon and world well known
researcher.

Thanks for your recommendation. But I am afraid that a well established research team should be very difficult to change their research tract. Don't mention that tissue engineering for cartilage is already the hottest issue in the world. Various techniques have been far-advanced. Nevertheless, it still could not solve the OA problem. If the cause of knee OA could not be found, it's impossible to cure this disease even by tissue engineering. This situation give hope to my concept of KHPO. I do hope some researcher could see the future of KHPO and join my team. Thanks again!