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Weishorn J, Koch KA, Zietzschmann S, Trefzer R, Walker T, Renkawitz T, Bangert Y. Neutral to slightly undercorrected mechanical leg alignment provides superior long-term results in patients undergoing matrix-associated autologous chondrocyte implantation. Knee Surg Sports Traumatol Arthrosc 2024; 32:2040-2051. [PMID: 38738859 DOI: 10.1002/ksa.12226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE The aim of this study was to evaluate the role of leg alignment on long-term clinical outcome after matrix-associated autologous chondrocyte implantation (M-ACI) and to define an individualized target range to optimize clinical outcome. METHODS The present study examined patients who underwent M-ACI of the femoral condyle. The Knee Injury and Osteoarthritis Outcome Score (KOOS) and Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) were used to assess the results. Clinical outcomes were related to Patient Acceptable Symptomatic State (PASS). For intra- and interobserver reliability of mechanical tibiofemoral angle, mechanical medial proximal tibial angle and mechanical lateral distal femoral angle, we calculated intraclass correlation coefficients using a two-way mixed model with absolute agreement. A regression model and receiver-operating characteristics curve were used to identify an individual range of alignment where a favourable clinical outcome could be expected in the long term. RESULTS Additional osteotomy was performed in 50% of patients with similar clinical outcomes as physiologically aligned patients (p > 0.05). The curve-fitting regression model identified a target range of -2.5° valgus to 4.5° varus for ideal postoperative alignment (R2 = 0.12, p = 0.01). Patients within this range were more likely to achieve PASS (70% vs. 27%, p = 0.001). In medially treated defects, a refined range of -2.5° valgus to 4° varus alignment was found (R2 = 0.15, p = 0.01). These patients were more likely to achieve PASS (67% vs. 30%, p = 0.01) and showed favourable postoperative KOOS and MOCART scores (p = 0.02). Patients with lateral defects were more likely to achieve PASS within a range of -2° valgus and 0.5° varus (90% vs. 45%, p = 0.03) and showed favourable postoperative KOOS and MOCART scores (p = not significant). CONCLUSIONS An individual range of leg alignment-whether achieved by osteotomy or physiologic alignment-should be respected in M-ACI treatment. A neutral to slightly undercorrected alignment favours the postoperative outcome after M-ACI. When planning surgery for patients with focal cartilage defects of the femoral condyle, these ranges should be recognized as critical factors. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Johannes Weishorn
- Department of Orthopaedics, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Kevin-Arno Koch
- Department of Orthopaedics, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Severin Zietzschmann
- Department of Orthopaedics, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Raphael Trefzer
- Department of Orthopaedics, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Tilman Walker
- Department of Orthopaedics, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Tobias Renkawitz
- Department of Orthopaedics, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Yannic Bangert
- Department of Orthopaedics, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
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Dejea H, Pierantoni M, Orozco GA, B Wrammerfors ET, Gstöhl SJ, Schlepütz CM, Isaksson H. In Situ Loading and Time-Resolved Synchrotron-Based Phase Contrast Tomography for the Mechanical Investigation of Connective Knee Tissues: A Proof-of-Concept Study. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2308811. [PMID: 38520713 DOI: 10.1002/advs.202308811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/26/2024] [Indexed: 03/25/2024]
Abstract
Articular cartilage and meniscus transfer and distribute mechanical loads in the knee joint. Degeneration of these connective tissues occurs during the progression of knee osteoarthritis, which affects their composition, microstructure, and mechanical properties. A deeper understanding of disease progression can be obtained by studying them simultaneously. Time-resolved synchrotron-based X-ray phase-contrast tomography (SR-PhC-µCT) allows to capture the tissue dynamics. This proof-of-concept study presents a rheometer setup for simultaneous in situ unconfined compression and SR-PhC-µCT of connective knee tissues. The microstructural response of bovine cartilage (n = 16) and meniscus (n = 4) samples under axial continuously increased strain, or two steps of 15% strain (stress-relaxation) is studied. The chondrocyte distribution in cartilage and the collagen fiber orientation in the meniscus are assessed. Variations in chondrocyte density reveal an increase in the top 40% of the sample during loading, compared to the lower half. Meniscus collagen fibers reorient perpendicular to the loading direction during compression and partially redisperse during relaxation. Radiation damage, image repeatability, and image quality assessments show little to no effects on the results. In conclusion, this approach is highly promising for future studies of human knee tissues to understand their microstructure, mechanical response, and progression in degenerative diseases.
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Affiliation(s)
- Hector Dejea
- Department of Biomedical Engineering, Lund University, Box 118, Lund, 221 00, Sweden
- MAX IV Laboratory, Lund University, Lund, 224 84, Sweden
| | - Maria Pierantoni
- Department of Biomedical Engineering, Lund University, Box 118, Lund, 221 00, Sweden
| | - Gustavo A Orozco
- Department of Biomedical Engineering, Lund University, Box 118, Lund, 221 00, Sweden
| | | | - Stefan J Gstöhl
- Swiss Light Source, Paul Scherrer Institute, Villigen PSI, 5232, Switzerland
| | | | - Hanna Isaksson
- Department of Biomedical Engineering, Lund University, Box 118, Lund, 221 00, Sweden
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Solaro L, Andriolo L, Di Martino A, Grassi A, Zaffagnini S, Filardo G. Unicompartmental osteoarthritis: High survival rate with a combined mechanical and biological salvage approach as alternative to metal resurfacing: Results at minimum 10 years of follow-up. Knee Surg Sports Traumatol Arthrosc 2024. [PMID: 38769777 DOI: 10.1002/ksa.12268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE The aim of this study was to prospectively evaluate the long-term clinical results and failure rate of patients treated with complex salvage procedures using a combined mechanical and biological approach to address unicompartmental knee osteoarthritis (OA) and postpone the need for joint replacement. METHODS Thirty-nine patients (40.3 ± 10.9 years old) affected by unicompartmental OA (Kellgren-Lawrence 3) in stable joints underwent a personalized surgical treatment depending on the specific requirements of the affected compartment, including high tibial osteotomy, osteochondral scaffold, meniscal scaffold and meniscal allograft transplantation. Patients were evaluated with the International Knee Documentation Committee (IKDC), Visual Analogue Scale (VAS) and Tegner scores before surgery, at 3 years and a minimum of 10 years of follow-up. RESULTS A significant improvement was observed over time in all scores but worsened at the final follow-up. The IKDC subjective score improved from 46.9 ± 16.2 to 79.8 ± 16.4 at 3 years (p < 0.0005) and then decreased to 64.5 ± 21.4 (p = 0.001) at 12 years. A similar trend was confirmed for VAS and Tegner scores. Only two patients subsequently underwent knee arthroplasty, and nine more patients were considered clinical failure, for a cumulative surgical and clinical failure rate of 28.2% at the final follow-up. CONCLUSION A personalized, joint-preserving, combined mechanical and biological approach, addressing alignment as well as meniscal and cartilage lesions, is safe and effective, providing a clinical benefit and delaying the need for arthroplasty in young patients affected by unicompartmental knee OA. At the final evaluation, the clinical improvement decreased, but more than two-thirds of the patients still benefited from this treatment at a long-term follow-up. LEVEL OF EVIDENCE Level IV case series.
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Affiliation(s)
- Luca Solaro
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Luca Andriolo
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Alessandro Di Martino
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Alberto Grassi
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Stefano Zaffagnini
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Giuseppe Filardo
- Applied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Department of Surgery, EOC, Service of Orthopaedics and Traumatology, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
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Hu X, Jin M, Sun K, Zhang Z, Wu Z, Shi J, Liu P, Yao H, Wang DA. Type II collagen scaffolds repair critical-sized osteochondral defects under induced conditions of osteoarthritis in rat knee joints via inhibiting TGF-β-Smad1/5/8 signaling pathway. Bioact Mater 2024; 35:416-428. [PMID: 38384986 PMCID: PMC10879694 DOI: 10.1016/j.bioactmat.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/13/2024] [Accepted: 02/07/2024] [Indexed: 02/23/2024] Open
Abstract
The bidirectional relationship between osteochondral defects (OCD) and osteoarthritis (OA), with each condition exacerbating the other, makes OCD regeneration in the presence of OA challenging. Type II collagen (Col2) is important in OCD regeneration and the management of OA, but its potential applications in cartilage tissue engineering are significantly limited. This study investigated the regeneration capacity of Col2 scaffolds in critical-sized OCDs under surgically induced OA conditions and explored the underlying mechanisms that promoted OCD regeneration. Furthermore, the repair potential of Col2 scaffolds was validated in over critical-sized OCD models. After 90 days or 150 days since scaffold implantation, complete healing was observed histologically in critical-sized OCD, evidenced by the excellent integration with surrounding native tissues. The newly formed tissue biochemically resembled adjacent natural tissue and exhibited comparable biomechanical properties. The regenerated OA tissue demonstrated lower expression of genes associated with cartilage degradation than native OA tissue but comparable expression of genes related to osteochondral anabolism compared with normal tissue. Additionally, transcriptome and proteome analysis revealed the hindrance of TGF-β-Smad1/5/8 in regenerated OA tissue. In conclusion, the engrafting of Col2 scaffolds led to the successful regeneration of critical-sized OCDs under surgically induced OA conditions by inhibiting the TGF-β-Smad1/5/8 signaling pathway.
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Affiliation(s)
- Xu Hu
- Department of Biomedical Engineering, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong
| | - Min Jin
- Department of Biomedical Engineering, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong
- Karolinska Institutet Ming Wai Lau Centre for Reparative Medicine, HKSTP, Sha Tin, Hong Kong
| | - Kang Sun
- Department of Biomedical Engineering, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong
| | - Zhen Zhang
- Department of Biomedical Engineering, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong
| | - Zhonglian Wu
- School of Chemistry and Chemical Engineering, Yangzhou University, Yangzhou, PR China
| | - Junli Shi
- School of Chemistry and Chemical Engineering, Yangzhou University, Yangzhou, PR China
| | - Peilai Liu
- Department of Orthopedics, Qilu Hospital of Shandong University, 107 Wenhua Xilu, Jinan, PR China
| | - Hang Yao
- School of Chemistry and Chemical Engineering, Yangzhou University, Yangzhou, PR China
| | - Dong-An Wang
- Department of Biomedical Engineering, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong
- Karolinska Institutet Ming Wai Lau Centre for Reparative Medicine, HKSTP, Sha Tin, Hong Kong
- Shenzhen Research Institute, City University of Hong Kong, Shenzhen, PR China
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Li B, Yang Z, Li Y, Zhang J, Li C, Lv N. Exploration beyond osteoarthritis: the association and mechanism of its related comorbidities. Front Endocrinol (Lausanne) 2024; 15:1352671. [PMID: 38779455 PMCID: PMC11110169 DOI: 10.3389/fendo.2024.1352671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/12/2024] [Indexed: 05/25/2024] Open
Abstract
Osteoarthritis is the most prevalent age-related degenerative joint disease and a leading cause of pain and disability in aged people. Its etiology is multifaceted, involving factors such as biomechanics, pro-inflammatory mediators, genetics, and metabolism. Beyond its evident impact on joint functionality and the erosion of patients' quality of life, OA exhibits symbiotic relationships with various systemic diseases, giving rise to various complications. This review reveals OA's extensive impact, encompassing osteoporosis, sarcopenia, cardiovascular diseases, diabetes mellitus, neurological disorders, mental health, and even cancer. Shared inflammatory processes, genetic factors, and lifestyle elements link OA to these systemic conditions. Consequently, recognizing these connections and addressing them offers opportunities to enhance patient care and reduce the burden of associated diseases, emphasizing the need for a holistic approach to managing OA and its complications.
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Affiliation(s)
| | | | | | | | | | - Naishan Lv
- The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine (Shandong Hospital of integrated traditional Chinese and Western medicine), Jinan, China
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Lv H, Liu P, Hu H, Li X, Li P. MiR-98-5p plays suppressive effects on IL-1β-induced chondrocyte injury associated with osteoarthritis by targeting CASP3. J Orthop Surg Res 2024; 19:239. [PMID: 38615043 PMCID: PMC11015643 DOI: 10.1186/s13018-024-04628-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 02/14/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND This study aims to explore how miR-98-5p affects osteoarthritis, focusing on its role in chondrocyte inflammation, apoptosis, and extracellular matrix (ECM) degradation. METHODS Quantitative real-time PCR was used to measure miR-98-5p and CASP3 mRNA levels in OA cartilage tissues and IL-1β-treated CHON-001 cells. We predicted miR-98-5p and CASP3 binding sites using TargetScan and confirmed them via luciferase reporter assays. Chondrocyte viability was analyzed using CCK-8 assays, while pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) were quantified via ELISA. Caspase-3 activity was examined to assess apoptosis, and Western blotting was conducted for protein marker quantification. RESULTS Our results showed lower miR-98-5p levels in both OA cartilage and IL-1β-stimulated cells. Increasing miR-98-5p resulted in reduced pro-inflammatory cytokines, decreased caspase-3 activity, and improved cell viability. Furthermore, miR-98-5p overexpression hindered IL-1β-induced ECM degradation, evident from the decline in MMP-13 and β-catenin levels, and an increase in COL2A1 expression. MiR-98-5p's impact on CASP3 mRNA directly influenced its expression. Mimicking miR-98-5p's effects, CASP3 knockdown also inhibited IL-1β-induced inflammation, apoptosis, and ECM degradation. In contrast, CASP3 overexpression negated the suppressive effects of miR-98-5p. CONCLUSIONS In conclusion, our data collectively suggest that miR-98-5p plays a protective role against IL-1β-induced damage in chondrocytes by targeting CASP3, highlighting its potential as a therapeutic target for OA.
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Affiliation(s)
- Hang Lv
- Department of Orthopedics, Hanan Branch, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 411, Guogeli Street, Nangang District, Harbin City, 150060, Heilongjiang Province, China
| | - Peiran Liu
- Department of Orthopedics, Hanan Branch, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 411, Guogeli Street, Nangang District, Harbin City, 150060, Heilongjiang Province, China
| | - Hai Hu
- Department of Orthopedics, Hanan Branch, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 411, Guogeli Street, Nangang District, Harbin City, 150060, Heilongjiang Province, China
| | - Xiaodong Li
- Orthopedic ward, The Third Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 2 Xiangjiang Road, Xiangfang District, Harbin City, 150000, Heilongjiang Province, China
| | - Pengfei Li
- Department of Orthopedics, Hanan Branch, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 411, Guogeli Street, Nangang District, Harbin City, 150060, Heilongjiang Province, China.
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Tischer T, Andriolo L, Beaufils P, Ahmad SS, Bait C, Bonomo M, Cavaignac E, Cristiani R, Feucht MJ, Fiodorovas M, Grassi A, Helmerhorst G, Hoser C, Karahan M, Komnos G, Lagae KC, Madonna V, Monaco E, Monllau JC, Ollivier M, Ovaska M, Petersen W, Piontek T, Robinson J, Samuelsson K, Scheffler S, Sonnery-Cottet B, Filardo G, Condello V. Management of anterior cruciate ligament revision in adults: the 2022 ESSKA consensus part III-indications for different clinical scenarios using the RAND/UCLA appropriateness method. Knee Surg Sports Traumatol Arthrosc 2023; 31:4662-4672. [PMID: 37133742 PMCID: PMC10598192 DOI: 10.1007/s00167-023-07401-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/20/2023] [Indexed: 05/04/2023]
Abstract
PURPOSE The aim of the ESSKA 2022 consensus Part III was to develop patient-focused, contemporary, evidence-based, guidelines on the indications for revision anterior cruciate ligament surgery (ACLRev). METHODS The RAND/UCLA Appropriateness Method (RAM) was used to provide recommendations on the appropriateness of surgical treatment versus conservative treatment in different clinical scenarios based on current scientific evidence in conjunction with expert opinion. A core panel defined the clinical scenarios with a moderator and then guided a panel of 17 voting experts through the RAM tasks. Through a two-step voting process, the panel established a consensus as to the appropriateness of ACLRev for each scenario based on a nine-point Likert scale (in which a score in the range 1-3 was considered 'inappropriate', 4-6 'uncertain', and 7-9 'appropriate'). RESULTS The criteria used to define the scenarios were: age (18-35 years vs 36-50 years vs 51-60 years), sports activity and expectation (Tegner 0-3 vs 4-6 vs 7-10), instability symptoms (yes vs no), meniscus status (functional vs repairable vs non-functional meniscus), and osteoarthritis (OA) (Kellgren-Lawrence [KL] grade 0-I-II vs grade III). Based on these variables, a set of 108 clinical scenarios was developed. ACLRev was considered appropriate in 58%, inappropriate in 12% (meaning conservative treatment is indicated), and uncertain in 30%. Experts considered ACLRev appropriate for patients with instability symptoms, aged ≤ 50 years, regardless of sports activity level, meniscus status, and OA grade. Results were much more controversial in patients without instability symptoms, while higher inappropriateness was related to scenarios with older age (51-60 years), low sporting expectation, non-functional meniscus, and knee OA (KL III). CONCLUSION This expert consensus establishes guidelines as to the appropriateness of ACLRev based on defined criteria and provides a useful reference for clinical practice in determining treatment indications. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Thomas Tischer
- Department of Orthopaedic and Trauma Surgery, Waldkrankenhaus, Erlangen, Germany
- Department of Orthopaedic Surgery, University Medicine Rostock, Rostock, Germany
| | - Luca Andriolo
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy
| | | | - Sufian S. Ahmad
- Department of Orthopaedic Surgery, Medical School of Hannover MHH, Annastift Hospital, Hannover, Germany
| | - Corrado Bait
- Joint Preservation Surgery and Sport Medicine Unit, Villa Aprica Clinical Institute, Como, Italy
| | - Marco Bonomo
- Dipartimento di Ortopedia e Traumatologia, IRCCS Ospedale Sacro Cuore don Calabria, Negrar, VR Italy
| | - Etienne Cavaignac
- Musculoskeletal Institute, Hôpital Pierre Paul Riquet, CHU Toulouse, Toulouse, France
| | - Riccardo Cristiani
- Capio Artro Clinic, FIFA Medical Centre of Excellence, Valhallavägen 91, 11486 Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden
| | - Matthias J. Feucht
- Department of Orthopaedic Surgery Paulinenhilfe, Diakonie Klinikum, Stuttgart, Germany
- Department of Orthopaedics and Trauma Surgery, Medical Center, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | | | - Alberto Grassi
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy
| | - Gijs Helmerhorst
- Department of Orthopaedic Surgery, Amsterdam University Medical Centre (AUMC) and Flevoziekenhuis, Amsterdam, The Netherlands
| | | | | | - George Komnos
- Orthopaedic Department, University Hospital of Larisa, Larisa, Greece
| | - Koen Carl Lagae
- Knee and Sports Surgery, Knee Department, Monica Hospitals, Antwerp, Belgium
- Hopital Delta, Brussels, Belgium
- Physioclinic, Milan, Italy
| | - Vincenzo Madonna
- Joint Preservation and Reconstructive Surgery and Sports Medicine Unit, Humanitas Castelli Clinic, Bergamo, Italy
| | - Edoardo Monaco
- Orthopaedic Unit, University of Rome La Sapienza, Sant’Andrea Hospital, Rome, Italy
| | - Juan Carlos Monllau
- Department of Orthopaedics and Traumatology, Parc de Salut Mar, ICATME-Hospital Universitari Dexeus, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Matthieu Ollivier
- Institut for Movement and Locomotion, Hôpital Sainte Marguerite, UMR 7287, Aix-Marseille Université et CNRS, Marseille, France
| | - Mikko Ovaska
- Lower Extremity Unit, Pihlajalinna Pikkuhuopalahti, Helsinki, Finland
| | | | - Tomasz Piontek
- Rehasport, Spine Disorders and Pediatric Orthopaedic Department, University of Medical Sciences, Poznań, Poland
| | | | - Kristian Samuelsson
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden
| | | | - Bertrand Sonnery-Cottet
- Centre Orthopédique Santy, FIFA medical centre of Excellence, Hôpital Privé Jean Mermoz, Ramsay, Lyon, France
| | - Giuseppe Filardo
- Applied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland
| | - Vincenzo Condello
- Joint Preservation and Reconstructive Surgery and Sports Medicine Unit, Humanitas Castelli Clinic, Bergamo, Italy
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Kacprzak B, Rosińska K. Rehabilitation of Soccer Players' Knee Injuries: Cartilage Reconstruction, Anterior Cruciate Ligament Surgery, and Intensive Recovery-A Pilot Study. J Clin Med 2023; 12:6893. [PMID: 37959358 PMCID: PMC10650160 DOI: 10.3390/jcm12216893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/09/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
Knee injuries, particularly anterior cruciate ligament (ACL) damage and cartilage defects, are highly prevalent among athletes and affect their sports performance and long-term joint function. The purpose of this research was to evaluate the effectiveness of a comprehensive combination therapy approach for individuals with ACL and cartilage injuries. Twelve professional soccer players aged 18 to 30 years underwent bone-tendon-bone ACL reconstruction, microfracture cartilage repair surgery, and hyaluronic acid scaffold treatment. Early postoperative rehabilitation included immediate supervised physiotherapy and complete weight bearing. Follow-up assessments involved clinical evaluations, functional joint assessments, and magnetic resonance imaging (MRI) scans to measure cartilage defect repair and symptom alleviation. The results showed that patients resumed pain-free activities within 3-4 weeks and returned to their pre-injury level within 4.5 months. MRI demonstrated the absence of inflammatory reactions, repair of marrow edema, and the emergence of new cartilage. Six months and one year after surgery, the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Short Form (36) Health Survey (SF-36) questionnaire results demonstrated considerable improvement in patients' health condition and quality of life. Overall, the study suggests that the combination of Hyalofast membranes, microfracture surgery, tissue adhesive, and intensive postoperative physical therapy may be a potential alternative to commonly used treatments for patients with ACL rupture, allowing them to recover efficiently and return to sports activities.
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Affiliation(s)
- Bartłomiej Kacprzak
- Orto Med Sport Łódź, 28 Pułku Strzelców Kaniowskich 45, 90-640 Łódź, Poland;
| | - Karolina Rosińska
- Wolf Project Studio Krzysztof Król, ul. Gdańska 79/D01, 90-613 Łódź, Poland
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9
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Liu H, Gong H, Chen P, Zhang L, Cen H, Fan Y. Biomechanical effects of typical lower limb movements of Chen-style Tai Chi on knee joint. Med Biol Eng Comput 2023; 61:3087-3101. [PMID: 37624535 DOI: 10.1007/s11517-023-02906-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023]
Abstract
The load and stress distribution on cartilage and meniscus of the knee joint in typical lower limb movements of Chen-style Tai Chi (TC) and deep squat (DS) were analyzed using finite element (FE) analysis. The loadings for this analysis consisted of muscle forces and ground reaction force (GRF), which were calculated through the inverse dynamic approach based on kinematics and force plate measurements obtained from motion capture experiments. Thirteen experienced practitioners performed four typical TC movements, namely, single whip (SW), brush knee and twist step (BKTS), stretch down (SD), and part the wild horse's mane (PWHM), which exhibit lower posture and greater lower limb force compared to other TC styles. The results indicated that TC required greater lower limb muscle strength than DS, resulting in greater knee joint forces. The stress on the medial cartilage in SW and BKTS fell within a range conductive to maintaining the balance between anabolism and catabolism of cartilage matrix. This was due to the fact that SW and BKTS reduce the medial to total tibiofemoral contact force ratios through knee abduction, which may effectively alleviate mild medial knee osteoarthritis (KOA). However, the greater medial contact force ratios observed in SD and PWHM resulted in great contact stresses that may aggravate the pain of patients with KOA. To mitigate these effects, practitioners should consider elevating their postures appropriately to reduce knee flexion angles, especially during the single-leg support phase. This adjustment can decrease the required muscle strength, load and stress on the knee joint.
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Affiliation(s)
- Haibo Liu
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - He Gong
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China.
| | - Peng Chen
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - Le Zhang
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - Haipeng Cen
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
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10
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Golovach I, Rekalov D, Akimov OY, Kostenko H, Kostenko V, Mishchenko A, Solovyova N, Kostenko V. Molecular mechanisms and potential applications of chondroitin sulphate in managing post-traumatic osteoarthritis. Reumatologia 2023; 61:395-407. [PMID: 37970120 PMCID: PMC10634410 DOI: 10.5114/reum/172211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/06/2023] [Indexed: 11/17/2023] Open
Abstract
Post-traumatic osteoarthritis (PTOA), a disorder of the synovium, subchondral bone, and cartilage that affects the entire joint, constitutes approximately 12% of all cases of symptomatic osteoarthritis. This review summarizes the pathogenetic mechanisms that underlie the positive influence of chondroitin sulphates (CSs) on PTOA as means of preventive and therapeutic treatment. Mechanisms of PTOA development involve chondrocytes undergoing various forms of cell death (apoptosis, pyroptosis, necroptosis, ferroptosis and/or necrosis). Chondroitin sulphates are a class of glycosaminoglycans that improve the structure and function of cartilage and subchondral bone, which is associated with their ability to decrease the activation of NF-κB and p38 MAPK, and up-regulate Nrf2. Standardized small fish extract (SSFE) is an example of the drugs that can attenuate NF-κB-mediated systemic inflammation, potentially helping to reduce joint inflammation and cartilage degradation, improve joint function, and alleviate pain and disability in patients with these conditions.
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Affiliation(s)
- Iryna Golovach
- Centre for Rheumatology, Osteoporosis and Immunobiological Therapy, Feofania Clinical Hospital of the State Affairs Administration, Kyiv, Ukraine
| | - Dmytro Rekalov
- Department of Internal Diseases No 3, Zaporizhzhia State Medical and Pharmaceutical University, Ukraine
| | - Oleh Ye Akimov
- Department of Pathophysiology, Poltava State Medical University, Ukraine
| | - Heorhii Kostenko
- Department of Pathophysiology, Poltava State Medical University, Ukraine
| | - Viktoriia Kostenko
- Department of Foreign Languages with Latin and Medical Terminology, Poltava State Medical University, Ukraine
| | - Artur Mishchenko
- Department of Pathophysiology, Poltava State Medical University, Ukraine
| | - Natalia Solovyova
- Department of Pathophysiology, Poltava State Medical University, Ukraine
| | - Vitalii Kostenko
- Department of Pathophysiology, Poltava State Medical University, Ukraine
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11
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Reale D, Feltri P, Franceschini M, de Girolamo L, Laver L, Magalon J, Sanchez M, Tischer T, Filardo G. Biological intra-articular augmentation for osteotomy in knee osteoarthritis: strategies and results : A systematic review of the literature from the ESSKA Orthobiologics Initiative. Knee Surg Sports Traumatol Arthrosc 2023; 31:4327-4346. [PMID: 37330935 DOI: 10.1007/s00167-023-07469-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/23/2023] [Indexed: 06/20/2023]
Abstract
PURPOSE To assess whether there is evidence supporting the use of augmentation strategies, either cartilage surgical procedures or injective orthobiologic options, to improve the results of osteotomies in knees with osteoarthritis (OA). METHODS A systematic review of the literature was performed on the PubMed, Web of Science and the Cochrane databases in January 2023 on osteotomies around the knee associated with augmentation strategies (either cartilage surgical procedures or injective orthobiologic options), reporting clinical, radiological, or second-look/histological outcomes at any follow-up. The methodological quality of the included studies was assessed with the Coleman Methodology Score (CMS). RESULTS Out of the 7650 records identified from the databases, 42 articles were included for a total of 3580 patients and 3609 knees treated; 33 articles focused on surgical treatments and 9 on injective treatments performed in association with knee osteotomy. Out of the 17 comparative studies with surgical augmentation, only 1 showed a significant clinical benefit of an augmentation procedure with a regenerative approach. Overall, other studies showed no differences with reparative techniques and even detrimental outcomes with microfractures. Regarding injective procedures, viscosupplementation showed no improvement, while the use of platelet-rich plasma or cell-based products derived from both bone marrow and adipose tissue showed overall positive tissue changes which translated into a clinical benefit. The mean modified CMS score was 60.0 ± 12.1. CONCLUSION There is no evidence to support the effectiveness of cartilage surgical treatments combined with osteotomies in terms of pain relief and functional recovery of patients affected by OA in misaligned joints. Orthobiologic injective treatments targeting the whole joint environment showed promising findings. However, overall the available literature presents a limited quality with only few heterogeneous studies investigating each treatment option. This ORBIT systematic analysis will help surgeons to choose their therapeutic strategy according to the available evidence, and to plan further and better studies to optimize biologic intra-articular osteotomy augmentation. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Davide Reale
- Ortopedia e Traumatologia, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Pietro Feltri
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, 6900, Lugano, Switzerland
| | - Marco Franceschini
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli-1, 40136, Bologna, Italy.
| | - Laura de Girolamo
- Orthopaedic Biotechnology Laboratory, IRCCS Istituto Ortopedico Galeazzi, 20161, Milan, Italy
| | - Lior Laver
- Department of Orthopaedics, Hillel Yaffe Medical Center (HYMC), 38100, Hadera, Israel
- Arthrosport Clinic, Tel-Aviv, Israel
- Rappaport Faculty of Medicine, Technion University Hospital, Israel Institute of Technology, 32000, Haifa, Israel
| | - Jeremy Magalon
- Cell Therapy Department, Hôpital de la Conception, Assistance Publique des Hôpitaux de Marseille (AP-HM), INSERM CIC BT 1409, 13005, Marseille, France
- INSERM, INRA, C2VN, Aix Marseille Univ, 13005, Marseille, France
- SAS Remedex, 13008, Marseille, France
| | - Mikel Sanchez
- Arthroscopic Surgery Unit, Hospital Vithas Vitoria, 01008, Vitoria-Gasteiz, Spain
- Advanced Biological Therapy Unit, Hospital Vithas Vitoria, 01008, Vitoria-Gasteiz, Spain
| | - Thomas Tischer
- Department of Orthopaedic Surgery, University of Rostock, 18051, Rostock, Germany
| | - Giuseppe Filardo
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, 6900, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900, Lugano, Switzerland
- Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, 40136, Bologna, Italy
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12
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Zaffagnini S, Romandini I, Filardo G, Dal Fabbro G, Grassi A. Meniscal allograft transplantation, anterior cruciate ligament reconstruction, and valgus high tibial osteotomy for meniscal-deficient, unstable, and varus knees: surgical technique and clinical outcomes. INTERNATIONAL ORTHOPAEDICS 2023; 47:2523-2535. [PMID: 37316682 DOI: 10.1007/s00264-023-05846-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 05/17/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE The aim of this study was to determine the clinical and functional outcome of a salvage surgical approach with the combined procedures meniscal allograft transplantation (MAT), anterior cruciate ligament reconstruction (ACLR), and high tibial osteotomy (HTO), in a cohort of patients treated for complex knee lesions evaluated up to a mid-term follow-up. METHODS Eight patients (38.8 ± 4.6 years, 88% males) were treated arthroscopically with MAT without bone plugs combined with primary or revision ACLR and HTO and evaluated at basal, at a minimum of two years (short follow-up), and at a mean follow-up of 5.1 years (mid-term follow-up) with the VAS score for pain, Lysholm score, IKDC subjective score, WOMAC Osteoarthritis index, and Tegner score. Physical examination (Lachman and pivot-shift tests, arthrometer assessment) and radiographic evaluation (pre- and post-operative x-rays) were obtained. Complications and failures were also recorded. RESULTS A statistically significant improvement was observed from baseline to five years in all clinical scores. In particular, the IKDC subjective score improved from 33.3 ± 20.7 to 73.1 ± 18.4 at short follow-up (p < 0.05), up to 78.3 ± 9.8 at the final follow-up (p < 0.05). A similar trend was demonstrated with the Lysholm, VAS, WOMAC, and Tegner score, even though only one patient reached the pre-injury activity level. Two patients had a worsening of the Kellgren-Lawrence (KL) grade from preoperative (grade 1) to final follow-up (grade 2). No major complications and surgical failures were documented. CONCLUSION The combined procedure of MAT, ACLR, and HTO presents few complications and failures and showed to be a valid option to reduce pain, recover knee function, and slow down the osteoarthritis process even in complex patients, with good and stable results up to a mid-term follow-up.
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Affiliation(s)
- Stefano Zaffagnini
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli, 1, 40136, Bologna, Italy
| | - Iacopo Romandini
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli, 1, 40136, Bologna, Italy.
| | - Giuseppe Filardo
- Applied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli, Via Di Barbiano, 1/10, 40136, Bologna, Italy
| | - Giacomo Dal Fabbro
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli, 1, 40136, Bologna, Italy
| | - Alberto Grassi
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli, 1, 40136, Bologna, Italy
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Lana JF, Purita J, Everts PA, De Mendonça Neto PAT, de Moraes Ferreira Jorge D, Mosaner T, Huber SC, Azzini GOM, da Fonseca LF, Jeyaraman M, Dallo I, Santos GS. Platelet-Rich Plasma Power-Mix Gel (ppm)-An Orthobiologic Optimization Protocol Rich in Growth Factors and Fibrin. Gels 2023; 9:553. [PMID: 37504432 PMCID: PMC10379106 DOI: 10.3390/gels9070553] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/29/2023] Open
Abstract
Platelet- and fibrin-rich orthobiologic products, such as autologous platelet concentrates, have been extensively studied and appreciated for their beneficial effects on multiple conditions. Platelet-rich plasma (PRP) and its derivatives, including platelet-rich fibrin (PRF), have demonstrated encouraging outcomes in clinical and laboratory settings, particularly in the treatment of musculoskeletal disorders such as osteoarthritis (OA). Although PRP and PRF have distinct characteristics, they share similar properties. The relative abundance of platelets, peripheral blood cells, and molecular components in these orthobiologic products stimulates numerous biological pathways. These include inflammatory modulation, augmented neovascularization, and the delivery of pro-anabolic stimuli that regulate cell recruitment, proliferation, and differentiation. Furthermore, the fibrinolytic system, which is sometimes overlooked, plays a crucial role in musculoskeletal regenerative medicine by regulating proteolytic activity and promoting the recruitment of inflammatory cells and mesenchymal stem cells (MSCs) in areas of tissue regeneration, such as bone, cartilage, and muscle. PRP acts as a potent signaling agent; however, it diffuses easily, while the fibrin from PRF offers a durable scaffolding effect that promotes cell activity. The combination of fibrin with hyaluronic acid (HA), another well-studied orthobiologic product, has been shown to improve its scaffolding properties, leading to more robust fibrin polymerization. This supports cell survival, attachment, migration, and proliferation. Therefore, the administration of the "power mix" containing HA and autologous PRP + PRF may prove to be a safe and cost-effective approach in regenerative medicine.
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Affiliation(s)
- José Fábio Lana
- OrthoRegen Group, Max-Planck University, Indaiatuba 13343-060, Brazil
| | | | | | | | | | - Tomas Mosaner
- Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil
| | - Stephany Cares Huber
- Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil
| | | | | | - Madhan Jeyaraman
- Department of Orthopaedics, Faculty of Medicine, Sri Lalithambigai Medical College and Hospital, Tamil Nadu 600095, India
| | - Ignacio Dallo
- SportMe Medical Center, Department of Orthopaedic Surgery and Sports Medicine, Unit of Biological Therapies and MSK Interventionism, 41013 Seville, Spain
| | - Gabriel Silva Santos
- Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil
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14
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Wilson RL, Emery NC, Pierce DM, Neu CP. Spatial Gradients of Quantitative MRI as Biomarkers for Early Detection of Osteoarthritis: Data From Human Explants and the Osteoarthritis Initiative. J Magn Reson Imaging 2023; 58:189-197. [PMID: 36285338 PMCID: PMC10126208 DOI: 10.1002/jmri.28471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Healthy articular cartilage presents structural gradients defined by distinct zonal patterns through the thickness, which may be disrupted in the pathogenesis of several disorders. Analysis of textural patterns using quantitative MRI data may identify structural gradients of healthy or degenerating tissue that correlate with early osteoarthritis (OA). PURPOSE To quantify spatial gradients and patterns in MRI data, and to probe new candidate biomarkers for early severity of OA. STUDY TYPE Retrospective study. SUBJECTS Fourteen volunteers receiving total knee replacement surgery (eight males/two females/four unknown, average age ± standard deviation: 68.1 ± 9.6 years) and 10 patients from the OA Initiative (OAI) with radiographic OA onset (two males/eight females, average age ± standard deviation: 57.7 ± 9.4 years; initial Kellgren-Lawrence [KL] grade: 0; final KL grade: 3 over the 10-year study). FIELD STRENGTH/SEQUENCE 3.0-T and 14.1-T, biomechanics-based displacement-encoded imaging, fast spin echo, multi-slice multi-echo T2 mapping. ASSESSMENT We studied structure and strain in cartilage explants from volunteers receiving total knee replacement, or structure in cartilage of OAI patients with progressive OA. We calculated spatial gradients of quantitative MRI measures (eg, T2) normal to the cartilage surface to enhance zonal variations. We compared gradient values against histologically OA severity, conventional relaxometry, and/or KL grades. STATISTICAL TESTS Multiparametric linear regression for evaluation of the relationship between residuals of the mixed effects models and histologically determined OA severity scoring, with a significance threshold at α = 0.05. RESULTS Gradients of individual relaxometry and biomechanics measures significantly correlated with OA severity, outperforming conventional relaxometry and strain metrics. In human explants, analysis of spatial gradients provided the strongest relationship to OA severity (R2 = 0.627). Spatial gradients of T2 from OAI data identified variations in radiographic (KL Grade 2) OA severity in single subjects, while conventional T2 alone did not. DATA CONCLUSION Spatial gradients of quantitative MRI data may improve the predictive power of noninvasive imaging for early-stage degeneration. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Robert L. Wilson
- Paul M. Rady Department of Mechanical Engineering, University of Colorado Boulder, 1111 Engineering Drive, 427 UCB, Boulder, CO 80309
| | - Nancy C. Emery
- Department of Ecology and Evolutionary Biology, University of Colorado Boulder, 1900 Pleasant Street, 334 UCB, Boulder, CO 80309
| | - David M. Pierce
- Department of Mechanical Engineering, University of Connecticut, 191 Auditorium Road, Unit 3139, Storrs, CT 06269
- Department of Biomedical Engineering, University of Connecticut, 260 Glenbrook Road, Unit 3247, Storrs, CT 06269
| | - Corey P. Neu
- Paul M. Rady Department of Mechanical Engineering, University of Colorado Boulder, 1111 Engineering Drive, 427 UCB, Boulder, CO 80309
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15
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Kaneguchi A, Yamaoka K, Ozawa J. Changes in passive stiffness and length of the semitendinosus muscles in rats with arthritis-induced knee flexion contracture. Clin Biomech (Bristol, Avon) 2023; 107:106026. [PMID: 37301182 DOI: 10.1016/j.clinbiomech.2023.106026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Arthritis-induced joint contracture is caused by arthrogenic and myogenic factors. The arthrogenic factor, localized within the joint, is naturally accepted as the cause of contracture. However, the detailed mechanisms underlying arthritis-induced myogenic contracture are largely unknown. We aimed to elucidate the mechanisms of arthritis-induced myogenic contracture by examining the muscle mechanical properties. METHODS Knee arthritis was induced in rats by injecting complete Freund's adjuvant into the right knees, while the untreated contralateral knees were used as controls. After one or four weeks of injection, passive stiffness, length, and collagen content of the semitendinosus muscles were assessed, along with passive knee extension range of motion. FINDINGS After one week of injection, flexion contracture formation was confirmed by a decreased range of motion. Range of motion restriction was partially relieved by myotomy, but still remained even after myotomy, indicating the contribution of both myogenic and arthrogenic factors to contracture formation. After one week of injection, the stiffness of the semitendinosus muscle was significantly higher in the injected side than in the contralateral side. After four weeks of injection, the stiffness of the semitendinosus muscle in the injected side returned to levels comparable to the contralateral side, parallel to partial improvement of flexion contracture. Muscle length and collagen content did not change due to arthritis at both time points. INTERPRETATION Our results suggest that increased muscle stiffness, rather than muscle shortening, contributes to myogenic contracture detected during the early stage of arthritis. The increased muscle stiffness cannot be explained by excess collagen.
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Affiliation(s)
- Akinori Kaneguchi
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Kurose-Gakuendai 555-36, Higashi-Hiroshima, Hiroshima, Japan.
| | - Kaoru Yamaoka
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Kurose-Gakuendai 555-36, Higashi-Hiroshima, Hiroshima, Japan
| | - Junya Ozawa
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Kurose-Gakuendai 555-36, Higashi-Hiroshima, Hiroshima, Japan
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16
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Poudel SB, Ruff RR, Yildirim G, Dixit M, Michot B, Gibbs JL, Ortiz SD, Kopchick JJ, Kirsch T, Yakar S. Excess Growth Hormone Triggers Inflammation-Associated Arthropathy, Subchondral Bone Loss, and Arthralgia. THE AMERICAN JOURNAL OF PATHOLOGY 2023; 193:829-842. [PMID: 36870529 PMCID: PMC10284029 DOI: 10.1016/j.ajpath.2023.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/29/2023] [Accepted: 02/10/2023] [Indexed: 03/06/2023]
Abstract
Growth hormone (GH) is a key mediator of skeletal growth. In humans, excess GH secretion due to pituitary adenoma, seen in patients with acromegaly, results in severe arthropathies. This study investigated the effects of long-term excess GH on the knee joint tissues. One year-old wild-type (WT) and bovine GH (bGH) transgenic mice were used as a model for excess GH. bGH mice showed increased sensitivity to mechanical and thermal stimuli, compared with WT mice. Micro-computed tomography analyses of the distal femur subchondral bone revealed significant reductions in trabecular thickness and significantly reduced bone mineral density of the tibial subchondral bone-plate associated with increased osteoclast activity in both male and female bGH compared with WT mice. bGH mice showed severe loss of matrix from the articular cartilage, osteophytosis, synovitis, and ectopic chondrogenesis. Articular cartilage loss in the bGH mice was associated with elevated markers of inflammation and chondrocyte hypertrophy. Finally, hyperplasia of synovial cells was associated with increased expression of Ki-67 and diminished p53 levels in the synovium of bGH mice. Unlike the low-grade inflammation seen in primary osteoarthritis, arthropathy caused by excess GH affects all joint tissues and triggers severe inflammatory response. Data from this study suggest that treatment of acromegalic arthropathy should involve inhibition of ectopic chondrogenesis and chondrocyte hypertrophy.
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Affiliation(s)
- Sher B Poudel
- Department of Molecular Pathobiology, David B. Kriser Dental Center, New York University College of Dentistry, New York, New York
| | - Ryan R Ruff
- Department of Epidemiology and Health Promotion, David B. Kriser Dental Center, New York University College of Dentistry, New York, New York
| | - Gozde Yildirim
- Department of Molecular Pathobiology, David B. Kriser Dental Center, New York University College of Dentistry, New York, New York
| | - Manisha Dixit
- Department of Molecular Pathobiology, David B. Kriser Dental Center, New York University College of Dentistry, New York, New York
| | - Benoit Michot
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Jennifer L Gibbs
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Silvana D Ortiz
- Department of Biomedical Sciences, Edison Biotechnology Institute, Ohio University, Athens, Ohio
| | - John J Kopchick
- Department of Biomedical Sciences, Edison Biotechnology Institute, Ohio University, Athens, Ohio
| | - Thorsten Kirsch
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, New York; Department of Biomedical Engineering, New York University Tandon School of Engineering, New York, New York
| | - Shoshana Yakar
- Department of Molecular Pathobiology, David B. Kriser Dental Center, New York University College of Dentistry, New York, New York.
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17
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Marques Azzini GO, Marques Azzini VO, Santos GS, Visoni S, Fusco MA, Beker NS, Mahmood A, Bizinotto Lana JV, Jeyaraman M, Nallakumarasamy A, Jeyaraman N, da Fonseca LF, Luz Arab MG, Vicente R, Rajendran RL, Gangadaran P, Ahn BC, Duarte Lana JFS. Cannabidiol for musculoskeletal regenerative medicine. Exp Biol Med (Maywood) 2023; 248:445-455. [PMID: 37158062 PMCID: PMC10281618 DOI: 10.1177/15353702231162086] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
Chronic musculoskeletal (MSK) pain is one of the most prevalent causes, which lead patients to a physician's office. The most common disorders affecting MSK structures are osteoarthritis, rheumatoid arthritis, back pain, and myofascial pain syndrome, which are all responsible for major pain and physical disability. Although there are many known management strategies currently in practice, phytotherapeutic compounds have recently begun to rise in the medical community, especially cannabidiol (CBD). This natural, non-intoxicating molecule derived from the cannabis plant has shown interesting results in many preclinical studies and some clinical settings. CBD plays vital roles in human health that go well beyond the classic immunomodulatory, anti-inflammatory, and antinociceptive properties. Recent studies demonstrated that CBD also improves cell proliferation and migration, especially in mesenchymal stem cells (MSCs). The foremost objective of this review article is to discuss the therapeutic potential of CBD in the context of MSK regenerative medicine. Numerous studies listed in the literature indicate that CBD possesses a significant capacity to modulate mammalian tissue to attenuate and reverse the notorious hallmarks of chronic musculoskeletal disorders (MSDs). The most of the research included in this review report common findings like immunomodulation and stimulation of cell activity associated with tissue regeneration, especially in human MSCs. CBD is considered safe and well tolerated as no serious adverse effects were reported. CBD promotes many positive effects which can manage detrimental alterations brought on by chronic MSDs. Since the application of CBD for MSK health is still undergoing expansion, additional randomized clinical trials are warranted to further clarify its efficacy and to understand its cellular mechanisms.
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Affiliation(s)
| | | | - Gabriel Silva Santos
- Brazilian Institute of Regenerative
Medicine (BIRM), Indaiatuba 13334-170, Brazil
| | - Silvia Visoni
- Brazilian Institute of Regenerative
Medicine (BIRM), Indaiatuba 13334-170, Brazil
| | | | | | - Ansar Mahmood
- University Hospitals Birmingham,
Birmingham B15 2PR, UK
| | - João Vitor Bizinotto Lana
- Brazilian Institute of Regenerative
Medicine (BIRM), Indaiatuba 13334-170, Brazil
- Medical Specialties School Centre,
Centro Universitário Max Planck, Indaiatuba, 13343-060, Brazil
| | - Madhan Jeyaraman
- Department of Orthopaedics, A.C.S.
Medical College and Hospital, Dr.M.G.R. Educational and Research Institute, Chennai
600056, India
- Department of Biotechnology, School of
Engineering and Technology, Sharda University, Greater Noida 201310, India
- South Texas Orthopaedic Research
Institute (STORI Inc.), Laredo, TX 78045, USA
- Indian Stem Cell Study Group (ISCSG)
Association, Lucknow 226010, India
| | - Arulkumar Nallakumarasamy
- Indian Stem Cell Study Group (ISCSG)
Association, Lucknow 226010, India
- Department of Orthopaedics, All India
Institute of Medical Sciences, Bhubaneswar 751019, India
| | - Naveen Jeyaraman
- Indian Stem Cell Study Group (ISCSG)
Association, Lucknow 226010, India
- Department of Orthopaedics, Atlas
Hospitals, Tiruchirappalli 620002, India
| | - Lucas Furtado da Fonseca
- Brazilian Institute of Regenerative
Medicine (BIRM), Indaiatuba 13334-170, Brazil
- Universidade Federal de São Paulo
(UNIFESP), São Paulo, 04021-001, Brazil
| | - Miguel Gustavo Luz Arab
- Brazilian Institute of Regenerative
Medicine (BIRM), Indaiatuba 13334-170, Brazil
- Saúde Máxima (SAMAX), São Paulo,
01239-040, Brazil
| | - Rodrigo Vicente
- Brazilian Institute of Regenerative
Medicine (BIRM), Indaiatuba 13334-170, Brazil
- Ultra Sports Science, São Paulo,
Brazil
| | - Ramya Lakshmi Rajendran
- Department of Nuclear Medicine,
School of Medicine, Kyungpook National University Hospital, Kyungpook National
University, Daegu 41944, Republic of Korea
| | - Prakash Gangadaran
- Department of Nuclear Medicine,
School of Medicine, Kyungpook National University Hospital, Kyungpook National
University, Daegu 41944, Republic of Korea
- BK21 FOUR KNU Convergence Educational
Program of Biomedical Sciences for Creative Future Talents, Department of Biomedical
Science, School of Medicine, Kyungpook National University, Daegu 41944, Republic of
Korea
| | - Byeong-Cheol Ahn
- Department of Nuclear Medicine,
School of Medicine, Kyungpook National University Hospital, Kyungpook National
University, Daegu 41944, Republic of Korea
- BK21 FOUR KNU Convergence Educational
Program of Biomedical Sciences for Creative Future Talents, Department of Biomedical
Science, School of Medicine, Kyungpook National University, Daegu 41944, Republic of
Korea
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Sahin E, Orhan C, Erten F, Saiyed Z, Azari EK, Durkee S, Sahin K. The effect of oral administration of undenatured type II collagen on monosodium iodoacetate-induced osteoarthritis in young and old rats. Sci Rep 2023; 13:6499. [PMID: 37081089 PMCID: PMC10119188 DOI: 10.1038/s41598-023-33763-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/18/2023] [Indexed: 04/22/2023] Open
Abstract
We investigated whether different doses of undenatured type II collagen (undenatured collagen, UC-II) help improve monosodium iodoacetate (MIA)-induced (osteoarthritis) OA in young and old rats. A total of 70 rats were divided into five groups: (1) control; (2) MIA (a single intra-articular injection of MIA); (3)-(5) MIA+ Undenatured Collagen with various oral doses (0.66, 1.33, and 2 mg/kg). The results showed that all doses of undenatured collagen in both age groups reduced knee diameter, while the two higher doses (1.33 mg/kg and 2 mg/kg) reduced the Mankin score and increased most gait measurements as early as day 14 compared to the MIA rats. However, the 2 mg/kg dose showed the best efficacy in improving Mankin score and gait measurements by 28 days post-OA induction. In young but not old rats, all doses of undenatured collagen reduced the Kellgren-Lawrence score compared to the MIA group. Undenatured collagen reduced the levels of most inflammatory and cartilage breakdown markers in serum and knee joint cartilage in both age groups. In conclusion, this data suggests that while all doses of undenatured collagen supplementation may ameliorate MIA-induced OA symptoms, the higher doses showed faster improvement in gait measurements and were more efficacious for overall joint health in rats.
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Affiliation(s)
- Emre Sahin
- Department of Animal Nutrition, Faculty of Veterinary Medicine, Bingol University, Bingol, 12100, Turkey
| | - Cemal Orhan
- Department of Animal Nutrition, Faculty of Veterinary Medicine, Firat University, Elazig, 23119, Turkey
| | - Fusun Erten
- Department of Veterinary Science, Pertek Sakine Genc Vocational School, Munzur University, Tunceli, 62500, Turkey
| | | | | | | | - Kazim Sahin
- Department of Animal Nutrition, Faculty of Veterinary Medicine, Firat University, Elazig, 23119, Turkey.
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Costa FR, Costa Marques MR, Costa VC, Santos GS, Martins RA, Santos MDS, Santana MHA, Nallakumarasamy A, Jeyaraman M, Lana JVB, Lana JFSD. Intra-Articular Hyaluronic Acid in Osteoarthritis and Tendinopathies: Molecular and Clinical Approaches. Biomedicines 2023; 11:biomedicines11041061. [PMID: 37189679 DOI: 10.3390/biomedicines11041061] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/10/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
Musculoskeletal diseases continue to rise on a global scale, causing significant socioeconomic impact and decreased quality of life. The most common disorders affecting musculoskeletal structures are osteoarthritis and tendinopathies, complicated orthopedic conditions responsible for major pain and debilitation. Intra-articular hyaluronic acid (HA) has been a safe, effective, and minimally invasive therapeutic tool for treating these diseases. Several studies from bedside to clinical practice reveal the multiple benefits of HA such as lubrication, anti-inflammation, and stimulation of cellular activity associated with proliferation, differentiation, migration, and secretion of additional molecules. Collectively, these effects have demonstrated positive outcomes that assist in the regeneration of chondral and tendinous tissues which are otherwise destroyed by the predominant catabolic and inflammatory conditions seen in tissue injury. The literature describes the physicochemical, mechanical, and biological properties of HA, their commercial product types, and clinical applications individually, while their interfaces are seldom reported. Our review addresses the frontiers of basic sciences, products, and clinical approaches. It provides physicians with a better understanding of the boundaries between the processes that lead to diseases, the molecular mechanisms that contribute to tissue repair, and the benefits of the HA types for a conscientious choice. In addition, it points out the current needs for the treatments.
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Nelwan BN, Lubis AMT, Dilogo IH, Hanitya AL. Single bundle vs double bundle for anterior cruciate ligament reconstruction evaluated with T2 mapping: A case series. Int J Surg Case Rep 2023; 104:107922. [PMID: 36801763 PMCID: PMC9958415 DOI: 10.1016/j.ijscr.2023.107922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 01/08/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023] Open
Abstract
INTRODUCTION ACL reconstruction is needed to restore the stability and biomechanics properties of the injured knee joints in order to reproduce the function of the native ACL. The single-bundle (SB) and double-bundle (DB) techniques are most commonly used to reconstruct the injured ACL. However, its superiority upon each other is still controversial. PRESENTATION OF CASE This study presented a case series of six patients underwent ACL reconstruction, consisted of three patients with SB ACL reconstruction and three patients with DB ACL reconstruction with further T2 mapping for joint instability evaluation. Only two DB patients showed consistent decreased value in every follow-up. DISCUSSION ACL tear can generate joint instability. Joint instability is resulted from two mechanisms of relative cartilage overloading. First, there is an abnormal load distribution due to shifting of the center of pressure of the tibiofemoral force, resulting in increased stresses on the articular cartilage of the knee joint. There is also an increase of translation between articular surfaces, resulting in increased shear stresses on the articular cartilage. A trauma of knee joint causes cartilage damage and increased oxidative and metabolic stress of chondrocytes, resulting in chondrocyte senescence acceleration. CONCLUSION This case series showed inconsistent results to determine either SB or DB has a better outcome in joint instability, thus further larger studies are needed.
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Affiliation(s)
- Bobby N Nelwan
- Orthopaedics and Traumatology Division, Department of Surgery, Gatot Soebroto Army Central Hospital, Jakarta, Indonesia.
| | - Andri M T Lubis
- Department of Orthopaedics and Traumatology, dr. Cipto Mangunkusumo General Hospital - Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Ismail H Dilogo
- Department of Orthopaedics and Traumatology, dr. Cipto Mangunkusumo General Hospital - Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Alberto L Hanitya
- Department of Orthopaedics and Traumatology, dr. Cipto Mangunkusumo General Hospital - Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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21
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He R, Xiong R, Sun ML, Yang JJ, Chen H, Yang PF, Yang L. Study on the correlation between early three-dimensional gait analysis and clinical efficacy after robot-assisted total knee arthroplasty. Chin J Traumatol 2023; 26:83-93. [PMID: 35798637 PMCID: PMC10071330 DOI: 10.1016/j.cjtee.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 03/23/2022] [Accepted: 04/28/2022] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Robot-assisted technology is a forefront of surgical innovation that improves the accuracy of total knee arthroplasty (TKA). But whether the accuracy of surgery can improve the clinical efficacy still needs further research. The purpose of this study is to perform three-dimensional (3D) analysis in the early postoperative period of patients who received robot-assisted total knee arthroplasty (RATKA), and to study the trend of changes in gait parameters after RATKA and the correlation with the early clinical efficacy. METHODS Patients who received RATKA in the Center of Joint Surgery, the First Hospital Affiliated to Army Military Medical University from October 2020 to January 2021 were included. The imaging parameters, i.e., hip-knee-ankle angle, lateral distal femoral angle, medial proximal tibial angle, posterior condylar angle were measured 3 months post-TKA. The 3D gait analysis and clinical efficacy by Western Ontario Mac Master University Index (WOMAC) score were performed pre-TKA, 3 and 6 months post-TKA. The differences in spatiotemporal parameters of gait, kinetic parameters, and kinematic parameters of the operated limb and the contralateral limb were compared. The correlation between gait parameters and WOMAC scores was analyzed. Paired sample t-test and Wilcoxon rank-sum test were used to analyze the difference between groups, and Spearman correlation coefficient was used to analyze the correlation. RESULTS There were 31 patients included in this study, and the imaging indexes showed that all of them returned to normal post-TKA. The WOMAC score at 3 months post-TKA was significantly lower than that pre-TKA, and there was no significant difference between at 3 and 6 months. The 3D gait analysis results showed that the double support time of the operated limb reduced at 3 and 6 months (all p < 0.05), the maximum extension and maximum external rotation of the knee joint increased at stance phase, and the maximum flexion angle, the range of motion and the maximum external rotation increased at swing phase. Compared with the preoperative data, there were significant improvements (all p < 0.05). Compared with the contralateral knee joint, the maximum external rotation of the knee joint at swing phase was smaller than that of the contralateral side, and the maximum flexion and extension moment was greater than that of the contralateral knee. The maximum external rotation moment of the joint was greater than that of the contralateral knee joint (p < 0.05). There was a negative correlation between the single support time pre-TKA and the WOMAC score at 3 months (p = 0.017), and the single support time at 3 months was negatively correlated with the WOMAC score at 6 months (p = 0.043). The cadence at 6 months was negatively correlated with the WOMAC score at 6 months (p = 0.031). The maximum knee extension at stance phase at 6 months was negatively correlated with the WOMAC score at 6 month (p = 0.048). The maximum external rotation at stance phase at 6 months was negatively correlated with the WOMAC score at 6 months (p = 0.024). CONCLUSION The 3D gait analysis of RATKA patients is more sensitive than WOMAC score in evaluating the clinical efficacy. Trend of changes in gait parameters shows that the knee joint support, flexion and extension function, range of motion, external rotation and varus deformity moment of the patient were significantly improved at 3 months after surgery, and continued to 6 months after surgery. Compared with the contralateral knee, the gait parameters of the operated limb still has significant gaps in functionality, such as the external rotation and flexion and extension. The single support time, cadence, knee extension, and knee external rotation of the operated limb have a greater correlation with the postoperative WOMAC score. Postoperative rehabilitation exercises should be emphasized, which is of great value for improving the early efficacy of RATKA.
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Affiliation(s)
- Rui He
- Center for Joint Surgery, Southwest Hospital, Third Military University (Amy Medical University), Chongqing, 400038, China
| | - Ran Xiong
- Center for Joint Surgery, Southwest Hospital, Third Military University (Amy Medical University), Chongqing, 400038, China
| | - Mao-Lin Sun
- Center for Joint Surgery, Southwest Hospital, Third Military University (Amy Medical University), Chongqing, 400038, China
| | - Jun-Jun Yang
- Center for Joint Surgery, Southwest Hospital, Third Military University (Amy Medical University), Chongqing, 400038, China
| | - Hao Chen
- Center for Joint Surgery, Southwest Hospital, Third Military University (Amy Medical University), Chongqing, 400038, China
| | - Peng-Fei Yang
- Center for Joint Surgery, Southwest Hospital, Third Military University (Amy Medical University), Chongqing, 400038, China
| | - Liu Yang
- Center for Joint Surgery, Southwest Hospital, Third Military University (Amy Medical University), Chongqing, 400038, China.
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22
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Chen H, Tu M, Liu S, Wen Y, Chen L. Dendrobine Alleviates Cellular Senescence and Osteoarthritis via the ROS/NF-κB Axis. Int J Mol Sci 2023; 24:ijms24032365. [PMID: 36768689 PMCID: PMC9916903 DOI: 10.3390/ijms24032365] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/12/2023] [Accepted: 01/19/2023] [Indexed: 01/27/2023] Open
Abstract
Osteoarthritis (OA) is a degenerative joint disease characterized by low-grade inflammation and cartilage degradation. Dendrobine (DEN) is reported to inhibit inflammation and oxidative stress in some diseases, but its role in chondrocyte senescence and OA progress has not yet been elucidated. Our study aimed to explore the protective effects of DEN on OA both in vitro and in vivo. We found that DEN inhibited extracellular matrix (ECM) degradation and promoted ECM synthesis. Meanwhile, DEN inhibited senescence-associated secretory phenotype (SASP) factors expression and senescence phenotype in IL-1β-treated chondrocytes. Furthermore, DEN improved mitochondrial function and reduced the production of intracellular reactive oxygen species (ROS). Also, DEN suppressed IL-1β-induced activation of the NF-κB pathway. Further, using NAC (ROS inhibitor), we found that DEN might inhibit NF-κB cascades by reducing ROS. Additionally, X-ray, micro-CT, and histological analyses in vivo demonstrated that DEN significantly alleviated cartilage inflammation, ECM degradation, and subchondral alterations in OA progression. In conclusion, DEN inhibits SASP factors expression and senescence phenotype in chondrocytes and alleviated the progression of OA via the ROS/NF-κB axis, which provides innovative strategies for the treatment of OA.
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23
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Toropitsyn E, Pravda M, Rebenda D, Ščigalková I, Vrbka M, Velebný V. A composite device for viscosupplementation treatment resistant to degradation by reactive oxygen species and hyaluronidase. J Biomed Mater Res B Appl Biomater 2022; 110:2595-2611. [PMID: 35727166 DOI: 10.1002/jbm.b.35114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 05/02/2022] [Accepted: 06/08/2022] [Indexed: 12/15/2022]
Abstract
Osteoarthritis (OA) is one of the most common musculoskeletal disorders in the world. OA is often associated with the loss of viscoelastic and tribological properties of synovial fluid (SF) due to degradation of hyaluronic acid (HA) by reactive oxygen species (ROS) and hyaluronidases. Viscosupplementation is one of the ways how to effectively restore SF functions. However, current viscosupplementation products provide only temporal therapeutic effect because of short biological half-life. In this article we describe a novel device for viscosupplementation (NV) based on the cross-linked tyramine derivative of HA, chondroitin sulfate (CS), and high molecular weight HA by online determination of viscoelastic properties loss during degradation by ROS and hyaluronidase. Rheological and tribological properties of developed viscosupplement were compared with HA solutions with different molecular weights in the range 500-2000 kDa, which are currently commonly used as medical devices for viscosupplementation treatment. Moreover, based on clinical practice and scientific literature all samples were also diluted by model OA SF in the ratio 1:1 (vol/vol) to better predict final properties after injection to the joint. The observed results confirmed that NV exhibits appropriate rheological properties (viscosity, elastic, and viscous moduli) comparable with healthy SF and maintain them during degradation for a significantly longer time than HA solutions with molecular weight in the range 500-2000 kDa and cross-linked material without CS.
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Affiliation(s)
- Evgeniy Toropitsyn
- Contipro a.s., Dolní Dobrouč, Czech Republic.,Biocev, First Faculty of Medicine Charles University, Vestec, Czech Republic
| | | | - David Rebenda
- Faculty of Mechanical Engineering, Brno University of Technology, Brno, Czech Republic
| | | | - Martin Vrbka
- Faculty of Mechanical Engineering, Brno University of Technology, Brno, Czech Republic
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24
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Gillis S, Deltoff MN. Capitellar osteochondritis dissecans in an elite pre-adolescent gymnast: a case report and overview. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2022; 66:282-292. [PMID: 36818357 PMCID: PMC9914824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Objective Following sports injury, a timely and accurate diagnosis is important, so as to initiate appropriate care as soon as possible. This is perhaps even more paramount in pediatric athletic trauma, particularly during the pre-puberty through adolescent years of rapid skeletal growth. This paper presents the diagnosis and management of osteochondritis dissecans in its third most common location, the elbow, a presentation of which chiropractors should be aware, including the importance of timely diagnosis and appropriate treatment. Clinical features A 9-year-old elite gymnast presented at a chiropractic clinic with elbow pain and restricted range of motion after a fall during training. Following multidisciplinary involvement, the diagnosis was eventually made as osteochondritis dissecans. Intervention and outcomes The patient underwent successful arthroscopic surgery in order to remove the osteochondral fragment, followed by a specific regimen of rehabilitation exercises, which helped to enhance and accelerate optimal healing for her return to athletic activity. Summary This case reminds the practicing chiropractor of the valuable role he/she can play in a multidisciplinary management of pediatric sports trauma, particularly in diagnosis and post-surgical care. A literature review presents a synopsis of the reported clinical presentations, diagnostic assessment and therapeutic options for capitellar osteochondritis dissecans.
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25
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Saornil JV, Sánchez Milá Z, Campón Chekroun AM, Baraja Vegas L, Vicente Mampel J, Frutos Llanes R, Barragán Casas JM, Rodríguez-Sanz D. Comparative Study of the Efficacy of Hyaluronic Acid, Dry Needling and Combined Treatment in Patellar Osteoarthritis-Single-Blind Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10912. [PMID: 36078628 PMCID: PMC9517789 DOI: 10.3390/ijerph191710912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/21/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
Background: Osteoarthritis of the knee is one of the most common ailments worldwide, and pain management of this condition is critical. Methods: A multicentre randomized controlled trial RCT with three months of follow-up, conducted in parallel groups: hyaluronic acid (HA), dry needling (DN) and ultrasound (US) and isometrics of quadriceps. 60 participants took part in the RCT who were diagnosed with osteoarthritis (Grade 3) of the knee by MRI and active adults (age: 23.41 ± 1.68 years; height: 1.79 ± 0.08 m; body mass: 78.33 ± 9.03 kg; body mass index (BMI): 24.14 ± 1.45 kg/m2). After the assigned intervention, VAS, WOMAC, IPAQ and the Star Excursion Balance test were measured at baseline. At 24 h, 15 days, 30 days, 90 days and 180 days follow-up, all variables were measured again. Results: Comparing statistically significant differences between groups, VAS scores were significant at post-test measurement (HA vs. US + isometric and DN vs. US + isometric) at 24 h (HA vs. DN), at 15 days (HA vs. US + isometric and DN vs. US + isometric) and at 1 month (US + isometric vs. HA and US + isometric vs. DN). Conclusions: There is an improvement in pain intensity in knee osteoarthritis in the short term in patients undergoing DN and conventional US + isometric treatment, but in the long term the HA group shows an improvement in pain intensity. There is also a significant difference in the improvement of knee function at different phases of the study in the various intervention groups. The combination of DN and HA in clinical practice is the best option for the treatment of osteoarthritis.
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Affiliation(s)
- Jorge Velázquez Saornil
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad Católica de Ávila, C/Canteros s/n, 05005 Ávila, Spain
| | - Zacarías Sánchez Milá
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad Católica de Ávila, C/Canteros s/n, 05005 Ávila, Spain
| | | | - Luis Baraja Vegas
- Departamento de Fisioterapia, Facultad de Medicina y Ciencias de la Salud, Universidad Católica de Valencia, C/Quevedo, 2, 46001 Valencia, Spain
| | - Juan Vicente Mampel
- Departamento de Fisioterapia, Facultad de Medicina y Ciencias de la Salud, Universidad Católica de Valencia, C/Quevedo, 2, 46001 Valencia, Spain
| | - Raúl Frutos Llanes
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad Católica de Ávila, C/Canteros s/n, 05005 Ávila, Spain
| | - José Manuel Barragán Casas
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad Católica de Ávila, C/Canteros s/n, 05005 Ávila, Spain
| | - David Rodríguez-Sanz
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Avenida Séneca, 2, 28040 Madrid, Spain
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26
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Evers BJ, Van Den Bosch MHJ, Blom AB, van der Kraan PM, Koëter S, Thurlings RM. Post-traumatic knee osteoarthritis; the role of inflammation and hemarthrosis on disease progression. Front Med (Lausanne) 2022; 9:973870. [PMID: 36072956 PMCID: PMC9441748 DOI: 10.3389/fmed.2022.973870] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
Knee injuries such as anterior cruciate ligament ruptures and meniscal injury are common and are most frequently sustained by young and active individuals. Knee injuries will lead to post-traumatic osteoarthritis (PTOA) in 25–50% of patients. Mechanical processes where historically believed to cause cartilage breakdown in PTOA patients. But there is increasing evidence suggesting a key role for inflammation in PTOA development. Inflammation in PTOA might be aggravated by hemarthrosis which frequently occurs in injured knees. Whereas mechanical symptoms (joint instability and locking of the knee) can be successfully treated by surgery, there still is an unmet need for anti-inflammatory therapies that prevent PTOA progression. In order to develop anti-inflammatory therapies for PTOA, more knowledge about the exact pathophysiological mechanisms and exact course of post-traumatic inflammation is needed to determine possible targets and timing of future therapies.
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Affiliation(s)
- Bob J. Evers
- Department of Experimental Rheumatology, Radboud Institute for Molecular Life Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
- Canisius Wilhelmina Hospital, Nijmegen, Netherlands
- *Correspondence: Bob J. Evers
| | - Martijn H. J. Van Den Bosch
- Department of Experimental Rheumatology, Radboud Institute for Molecular Life Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - Arjen B. Blom
- Department of Experimental Rheumatology, Radboud Institute for Molecular Life Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - Peter M. van der Kraan
- Department of Experimental Rheumatology, Radboud Institute for Molecular Life Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | | | - Rogier M. Thurlings
- Department of Experimental Rheumatology, Radboud Institute for Molecular Life Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
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27
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Yang Y, Huang JJ, Zhu GS, Hu W. Hyperoside attenuates osteoarthritis progression by targeting PI3K/Akt/NF-κB signaling pathway: In vitro and in vivo studies. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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28
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Farouk H, Ben-Ziad T. Bone plug fixation in anterior cruciate ligament reconstruction: A clinical and radiological assessment of graft-tunnel integration. Knee 2022; 37:153-161. [PMID: 35779433 DOI: 10.1016/j.knee.2022.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/07/2022] [Accepted: 05/31/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The decision regarding graft choice and fixation in anterior cruciate ligament (ACL) reconstruction remains controversial. Free cylindrical bone plugs have been used successfully as graft fixation method. However, some concerns continue to exist regarding how well these plugs integrate with the bony walls of the tunnel. The aim of this study was to assess osteo-integration of free cylindrical bone plugs and to evaluate its effect on the clinical outcomes of the procedure. METHODS From January 2015 to December 2017, 30 patients (21-40 years old) with torn ACL were operated on and followed up for 24 months after surgery. All patients were assessed clinically (International Knee Documentation Committee score (IKDC) and Tegner-Lysholm knee scoring system), instrumentally (KT 1000 and Rolimeter), and radiologically (X-ray, computed tomography and magnetic resonance imaging). Young active patients with torn ACL were included while those with previous ligamentous injury and/or surgery were excluded. RESULTS All bone grafts showed solid bone healing after 6 months of surgery; incorporation was 'good to excellent' (tibial side: 66.6%; femoral side: 86.6%). There was no correlation between age or time interval and graft incorporation. Positive correlation was shown between tibial and femoral graft incorporation within the same patient. Only one patient was abnormal in our final objective IKDC scores (graded C). The mean side-to-side difference with KT 1000 and Rolimeter was 1.9 and 1.8, respectively. CONCLUSION Free cylindrical bone plugs could be used safely for hamstring tendon graft fixation; it enhances graft tunnel integration within the first 6 months and yields comparable clinical outcomes whilst avoiding the potential hazards of foreign hardware implants.
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Affiliation(s)
- Hazem Farouk
- Orthopedic & Trauma Department, Cairo University, Cairo, Egypt.
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29
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Su W, Liu G, Mohajer B, Wang J, Shen A, Zhang W, Liu B, Guermazi A, Gao P, Cao X, Demehri S, Wan M. Senescent preosteoclast secretome promotes metabolic syndrome associated osteoarthritis through cyclooxygenase 2. eLife 2022; 11:e79773. [PMID: 35881544 PMCID: PMC9365389 DOI: 10.7554/elife.79773] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 05/06/2022] [Indexed: 01/10/2023] Open
Abstract
Background Metabolic syndrome-associated osteoarthritis (MetS-OA) is a distinct osteoarthritis phenotype defined by the coexistence of MetS or its individual components. Despite the high prevalence of MetS-OA, its pathogenic mechanisms are unclear. The aim of this study was to determine the role of cellular senescence in the development of MetS-OA. Methods Analysis of the human osteoarthritis initiative (OAI) dataset was conducted to investigate the MRI subchondral bone features of MetS-human OA participants. Joint phenotype and senescent cells were evaluated in two MetS-OA mouse models: high-fat diet (HFD)-challenged mice and STR/Ort mice. In addition, the molecular mechanisms by which preosteoclasts become senescent as well as how the senescent preosteoclasts impair subchondral bone microenvironment were characterized using in vitro preosteoclast culture system. Results Humans and mice with MetS are more likely to develop osteoarthritis-related subchondral bone alterations than those without MetS. MetS-OA mice exhibited a rapid increase in joint subchondral bone plate and trabecular thickness before articular cartilage degeneration. Subchondral preosteoclasts undergo senescence at the pre- or early-osteoarthritis stage and acquire a unique secretome to stimulate osteoblast differentiation and inhibit osteoclast differentiation. Antagonizing preosteoclast senescence markedly mitigates pathological subchondral alterations and osteoarthritis progression in MetS-OA mice. At the molecular level, preosteoclast secretome activates COX2-PGE2, resulting in stimulated differentiation of osteoblast progenitors for subchondral bone formation. Administration of a selective COX2 inhibitor attenuated subchondral bone alteration and osteoarthritis progression in MetS-OA mice. Longitudinal analyses of the human Osteoarthritis Initiative (OAI) cohort dataset also revealed that COX2 inhibitor use, relative to non-selective nonsteroidal antiinflammatory drug use, is associated with less progression of osteoarthritis and subchondral bone marrow lesion worsening in participants with MetS-OA. Conclusions Our findings suggest a central role of a senescent preosteoclast secretome-COX2/PGE2 axis in the pathogenesis of MetS-OA, in which selective COX2 inhibitors may have disease-modifying potential. Funding This work was supported by the National Institutes of Health grant R01AG068226 and R01AG072090 to MW, R01AR079620 to SD, and P01AG066603 to XC.
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Affiliation(s)
- Weiping Su
- Department of Orthopaedic Surgery, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of MedicineBaltimoreUnited States
- Department of Orthopaedic Surgery, The Third Xiangya Hospital of Central South UniversityChangshaChina
| | - Guanqiao Liu
- Department of Orthopaedic Surgery, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of MedicineBaltimoreUnited States
- Division of Orthopaedics & Traumatology, Department of Orthopaedics, Southern Medical University Nanfang HospitalGuangzhouChina
| | - Bahram Mohajer
- Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Jiekang Wang
- Department of Orthopaedic Surgery, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Alena Shen
- University of Southern California, Dornsife College of Letters, Arts and SciencesLos AngelesUnited States
| | - Weixin Zhang
- Department of Orthopaedic Surgery, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Bin Liu
- Department of Orthopaedic Surgery, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Ali Guermazi
- Department of Radiology, Boston University School of MedicineBostonUnited States
| | - Peisong Gao
- Johns Hopkins Asthma & Allergy Center, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Xu Cao
- Department of Orthopaedic Surgery, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Shadpour Demehri
- Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Mei Wan
- Department of Orthopaedic Surgery, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of MedicineBaltimoreUnited States
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30
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Lewis E, Merghani K, Robertson I, Mulford J, Prentice B, Mathew R, Van Winden P, Ogden K. The effectiveness of leucocyte-poor platelet-rich plasma injections on symptomatic early osteoarthritis of the knee: the PEAK randomized controlled trial. Bone Joint J 2022; 104-B:663-671. [PMID: 35638203 DOI: 10.1302/0301-620x.104b6.bjj-2021-1109.r2] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AIMS Platelet-rich plasma (PRP) intra-articular injections may provide a simple and minimally invasive treatment for early-stage knee osteoarthritis (OA). This has led to an increase in its adoption as a treatment for knee OA, although there is uncertainty about its efficacy and benefit. We hypothesized that patients with early-stage symptomatic knee OA who receive multiple PRP injections will have better clinical outcomes than those receiving single PRP or placebo injections. METHODS A double-blinded, randomized placebo-controlled trial was performed with three groups receiving either placebo injections (Normal Saline), one PRP injection followed by two placebo injections, or three PRP injections. Each injection was given one week apart. Outcomes were prospectively collected prior to intervention and then at six weeks, three months, six months, and 12 months post-intervention. Primary outcome measures were Knee Injury and Osteoarthritis Outcome Score (KOOS) and EuroQol five-dimension five-level index (EQ-5D-5L). Secondary outcomes included visual analogue scale for pain and patient subjective assessment of the injections. RESULTS A total of 102 patients were recruited. The follow-up period was 12 months, at intervals of six weeks, 12 weeks, six months, and 12 months. KOOS-Total significantly improved in all groups at these time intervals compared to pre-injection. There was an improvement in EQ-5D-5L index scores in saline and single injection groups, but not in the multiple injection group. Comparison of treatment groups showed no additional beneficial effect of single or multiple PRP injections above that displayed in the saline injection group. Subjective patient satisfaction and recommendation of treatment received demonstrated a similar pattern in all the groups. There was no indication of superiority of either single or multiple PRP injections compared to saline injections. CONCLUSION There is no evidence that single or multiple PRP had any additional beneficial effect compared to saline injection up to 12 months, follow-up after treatment of early stage symptomatic OA of the knee. Cite this article: Bone Joint J 2022;104-B(6):663-671.
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Affiliation(s)
- Emma Lewis
- Launceston General Hospital, Launceston, Australia
| | | | - Iain Robertson
- College of Health and Medicine, University of Tasmania, Launceston, Australia.,Clifford Craig Foundation, Launceston General Hospital, Launceston, Australia
| | | | - Ben Prentice
- Launceston General Hospital, Launceston, Australia
| | | | | | - Kathryn Ogden
- College of Health and Medicine, University of Tasmania, Launceston, Australia.,Clifford Craig Foundation, Launceston General Hospital, Launceston, Australia
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Apoptosis Activation and Autophagy Inhibition of Chondrocytes by Leptin by the Upregulation of LOXL3 in Osteoarthritis Pathogenesis. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:4026128. [PMID: 35035830 PMCID: PMC8759858 DOI: 10.1155/2022/4026128] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 11/25/2022]
Abstract
Background Osteoarthritis is one of the usual chronic musculoskeletal dysfunctions. It is one of the primary leading causes which leads to limitation of movement and absenteeism in the working adult population. Chondrocytes are the singlecellular-based component found in the cartilage which has an important role in the degradation of the cartilage. In recent studies, autophagy is observed to protect the human chondrocytes from stress.Leptin an adipokine managing food consumption and energy outlay. Chondrocytes indicate prolonged isoform of the leptin receptor where inside these cells theleptin signals individually or combine with the remaining molecules and promptthe indication of the pro-inflammatory molecules and cartilage disintegration enzymes. Materials and Methods mRNA expressions of Lysyl oxidase-like 3 in tissues of cartilage and concentration of leptin from synovial fluidwere measured from all samples from disease-induced groups, sham group, and RAPA-treated groups via RT-PCR and immunoassays. Histopathological analysis was also performed post-induction of the rat osteoarthritis model by the anterior cruciate ligament transection method. Western blot analysis was done, and expressions were analyzed by autophagy and apoptosis regulatory markers. Cell apoptosis and cell survival were evaluated with the help of flow cytometry, respectively, in all groups. Result mRNA of LOXL3 was increased in osteoarthritis models which were directly related to leptin concentration in SF. ACLT surgery caused an increase in cleaved caspase 3 protein levels, while a significant reduction in Bcl-2, Beclin1, and LC3 I was noted (figure 4,5). When LOXL3 was silenced in the ACLT group and leptin-treated group apoptosis was inhibited and autophagy, cell proliferation was promoted in primary chondrocytes. A significant increase in LOXL3 caused inhibition of autophagy in chondrocytes. Conclusion LOXL3 has stimulated apoptosis while inhibited autophagy in chondrocytes; hence LOXL3 is a prominent target for treating osteoarthritis. Keywords:chondrocytes, LOXL3, Leptin, osteoarthritis, qRT-PCR, ACLT, mRNA.
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Hu W, Mao C, Sheng W. The protective effect of kirenol in osteoarthritis: an in vitro and in vivo study. J Orthop Surg Res 2022; 17:195. [PMID: 35365162 PMCID: PMC8974005 DOI: 10.1186/s13018-022-03063-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 03/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Osteoarthritis (OA) is a chronic degenerative disease, its main characteristic involves articular cartilage destruction and inflammation response, absent of effective medical treatment. Our current research aimed to explore anti-inflammatory effect of kirenol, a diterpenoid natural product compound, in the development of OA and its potential molecular mechanism through in vitro and in vivo study. METHODS In vitro, chondrocytes were pretreated with kirenol for 2 h before IL-1β stimulation. Production of NO, PGE2, TNF-α, IL-6, aggrecan, collagen-II, MMP13and ADAMTS5 were evaluated by the Griess reaction and ELISAs. The mRNA (aggrecan and collagen-II) and protein expression (COX-2, iNOS, P65, IκB, PI3K, AKT) were measured by qRT-PCR and Western blot respectively. Immunofluorescence was used to assess the expression of collagen-II and P65. The in vivo effect of kirenol was evaluated in mice OA models induced by destabilization of the medial meniscus (DMM). RESULTS We found that kirenol inhibited IL-1β-induced expression of NO, PGE2, TNF-α, IL-6, COX-2, iNOS, ADAMTS-5. Besides, kirenol remarkably decreased IL-1β-induced degradation of aggrecan and collagen-II. Furthermore, kirenol significantly inhibited IL-1β-induced phosphorylation of PI3K/Akt and NF-κB signaling. In vivo, the cartilage in kirenol-treated mice exhibited less cartilage degradation and lower OARSI scores. CONCLUSIONS Taken together, the results of this study provide potent evidence that kirenol could be utilized as a potentially therapeutic agent in prevention and treatment of OA.
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Affiliation(s)
- Wei Hu
- Department of Spine Surgery, Xinjiang Medical University Affiliated First Hospital, Urumqi, Xinjiang, China
| | - Chao Mao
- Department of Spine Surgery, Xinjiang Medical University Affiliated First Hospital, Urumqi, Xinjiang, China
| | - Weibin Sheng
- Department of Spine Surgery, Xinjiang Medical University Affiliated First Hospital, Urumqi, Xinjiang, China.
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33
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Rapid X-Ray-Based 3-D Finite Element Modeling of Medial Knee Joint Cartilage Biomechanics During Walking. Ann Biomed Eng 2022; 50:666-679. [PMID: 35262835 PMCID: PMC9079039 DOI: 10.1007/s10439-022-02941-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 02/23/2022] [Indexed: 11/30/2022]
Abstract
Finite element (FE) modeling is becoming an increasingly popular method for analyzing knee joint mechanics and biomechanical mechanisms leading to osteoarthritis (OA). The most common and widely available imaging method for knee OA diagnostics is planar X-ray imaging, while more sophisticated imaging methods, e.g., magnetic resonance imaging (MRI) and computed tomography (CT), are seldom used. Hence, the capability to produce accurate biomechanical knee joint models directly from X-ray imaging would bring FE modeling closer to clinical use. Here, we extend our atlas-based framework by generating FE knee models from X-ray images (N = 28). Based on measured anatomical landmarks from X-ray and MRI, knee joint templates were selected from the atlas library. The cartilage stresses and strains of the X-ray-based model were then compared with the MRI-based model during the stance phase of the gait. The biomechanical responses were statistically not different between MRI- vs. X-ray-based models when the template obtained from X-ray imaging was the same as the MRI template. However, if this was not the case, the peak values of biomechanical responses were statistically different between X-ray and MRI models. The developed X-ray-based framework may pave the way for a clinically feasible approach for knee joint FE modeling.
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Yuan L, He W, Degefu DM, Kong Y, Wu X, Xu S, Wan Z, Ramsey TS. Elucidating competing strategic behaviors using prospect theory, system dynamics, and evolutionary game: a case of transjurisdictional water pollution problem in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:20829-20843. [PMID: 34743306 DOI: 10.1007/s11356-021-17034-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/11/2021] [Indexed: 06/13/2023]
Abstract
Water is a critical natural resource for socio-economic and environmental systems. In transjurisdictional river basins, when basin-wide water pollution management scheme is absent, stakeholders tend to adopt utility-maximizing behavior based on incomplete information. Such a scenario could lead to a free-riding problem. This paper attempts to elucidate the strategic behavior of riparian regions using prospect theory, evolutionary game, and system dynamics. The evolution of riparian regions' strategic behaviors is explained, and the impacts of different factors on their strategic selections are simulated. The results showed that the prospective value of factors and stakeholders' attitude to risk are a key for resolving transjurisdictional river water pollution problems. Improving the subjective judgment of the probability of water pollution, raising awareness, strengthening the penalties in "polluter pays" schemes, abandoning segmented river basin management, and building a basin-wide water management system are vital for maintaining the ecological integrity of any transjurisdictional river basin and accelerate the sustainable development of its riparian regions.
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Affiliation(s)
- Liang Yuan
- College of Economics and Management, China Three Gorges University, Yichang, 443002, China
| | - Weijun He
- College of Economics and Management, China Three Gorges University, Yichang, 443002, China
| | - Dagmawi Mulugeta Degefu
- College of Economics and Management, China Three Gorges University, Yichang, 443002, China
- Department of Architecture Science, Ryerson University, Toronto, ON, M5B 2K3, Canada
| | - Yang Kong
- School of Business, Hohai University, Nanjing, 210098, China.
| | - Xia Wu
- College of Economics and Management, China Three Gorges University, Yichang, 443002, China
- School of Law and Public Administration, China Three Gorges University, Yichang, 443002, China
| | - Shasha Xu
- School of Business, Hohai University, Nanjing, 210098, China
| | - Zhongchi Wan
- College of Economics and Management, China Three Gorges University, Yichang, 443002, China
| | - Thomas Stephen Ramsey
- College of Economics and Management, China Three Gorges University, Yichang, 443002, China
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Mehl J, Feucht M, Achtnich A, Imhoff AB, Niemeyer P, Angele P, Zinser W, Spahn G, Loer I, Kniffler H, Schauf G, Schmitt A. Autologous chondrocyte implantation combined with anterior cruciate ligament reconstruction: similar short-term results in comparison with isolated cartilage repair in ligament intact joints. Knee Surg Sports Traumatol Arthrosc 2022; 30:3249-3257. [PMID: 34626229 PMCID: PMC9464143 DOI: 10.1007/s00167-021-06764-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/28/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE Both acute ruptures of the anterior cruciate ligament (ACL) as well as chronic ACL insufficiency show a high association with focal cartilage defects of the knee. However, the results after combined ACL reconstruction and cartilage repair are not well investigated. The aim of the present study was to investigate the short-term outcomes after autologous chondrocyte implantation (ACI) in combination with ACL reconstruction and to compare the results with patients who underwent isolated ACI in ligament intact knees. METHODS All patients who were registered in the German Cartilage Registry with ACI for focal cartilage defects in the knee joint in combination with ACL reconstruction and who completed the 24 month follow-up were included in the study group. A matched-pair procedure according to gender, defect location, defect size, and age was used to create a control group of patients with isolated ACI in ACL intact joints. The Knee Injury and Osteoarthritis Outcome Score (KOOS) and the numeric analog scale for pain (NAS) were used to assess the preoperative state as well as the clinical outcomes 12 and 24 months after surgery. RESULTS A total of 34 patients were included in both the study group (age mean 33.3 ± SD 8.8 years) and the control group (33.6 ± 8.4 years) with a median defect size of 466 (25%-75% IQR 375-600) mm2 and 425 (IQR 375-600) mm2, respectively. In comparison with the preoperative state (median 67, IQR 52-75), the study group showed a significant increase of the total KOOS after 12 months (78, IQR 70-86; p = 0.014) and after 24 months (81, IQR 70-84; p = 0.001). The NAS for pain did not change significantly in the postoperative course. In comparison with the control group there was no significant difference for the total KOOS neither preoperative (control group median 67, IQR 52-73) nor at any postoperative time point (12 months: 82, IQR 67-93; 24 months: 81, IQR 71-91). CONCLUSION The clinical short-term outcomes after ACI at the knee joint in combination with ACL reconstruction are good and similar to the results after isolated ACI in ligament intact knees. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Julian Mehl
- Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technical University, Ismaninger Strasse 22, 81675, Munich, Germany.
| | - Matthias Feucht
- Department of Orthopaedic Surgery, Paulinenhilfe, Diakonieklinikum, Stuttgart, Germany
| | - Andrea Achtnich
- grid.6936.a0000000123222966Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technical University, Ismaninger Strasse 22, 81675 Munich, Germany
| | - Andreas B. Imhoff
- grid.6936.a0000000123222966Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technical University, Ismaninger Strasse 22, 81675 Munich, Germany
| | | | - Peter Angele
- grid.411941.80000 0000 9194 7179Department for Traumatology, University Hospital Regensburg, Regensburg, Germany
| | - Wolfgang Zinser
- Department of Orthopaedic Surgery and Traumatology, St. Vinzenz Hospital, Dinslaken, Germany
| | - Gunter Spahn
- grid.275559.90000 0000 8517 6224Center of Trauma and Orthopaedic Surgery Eisenach, Jena University Hospital, Eisenach, Germany
| | - Ingo Loer
- Orthopaedie in Essen, Essen, Germany
| | | | | | - Andreas Schmitt
- grid.6936.a0000000123222966Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technical University, Ismaninger Strasse 22, 81675 Munich, Germany
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Maqbool M, Fekadu G, Jiang X, Bekele F, Tolossa T, Turi E, Fetensa G, Fanta K. An up to date on clinical prospects and management of osteoarthritis. Ann Med Surg (Lond) 2021; 72:103077. [PMID: 34868573 PMCID: PMC8626656 DOI: 10.1016/j.amsu.2021.103077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/14/2021] [Accepted: 11/16/2021] [Indexed: 12/19/2022] Open
Abstract
The rising prevalence of osteoarthritis (OA) in the general population has necessitated the development of novel treatment options. It is critical to recognize the joint as a separate entity participating in degenerative processes, as well as the multifaceted nature of OA. OA is incurable because there is currently no medication that can stop or reverse cartilage or bone loss. As this point of view has attracted attention, more research is being directed toward determining how the various joint components are impacted and how they contribute to OA pathogenesis. Over the next few years, several prospective therapies focusing on inflammation, cartilage metabolism, subchondral bone remodelling, cellular senescence, and the peripheral nociceptive pathway are predicted to transform the OA therapy landscape. Stem cell therapies and the use of various biomaterials to target articular cartilage (AC) and osteochondral tissues are now being investigated in considerable detail. Currently, laboratory-made cartilage tissues are on the verge of being used in clinical settings. This review focuses on the update of clinical prospects and management of osteoarthritis, as well as future possibilities for the treatment of OA. Osteoarthritis (OA) is a general term that incorporates several different joint diseases. The exact pathophysiology of OA remains unclear. OA is incurable because there is currently no medication that can stop or reverse cartilage or bone loss. Nonsteroidal anti-inflammatory drugs are the most frequently prescribed medications to alleviate arthritic discomfort. Stem cell therapies to target articular cartilage and osteochondral tissues are now under investigation.
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Affiliation(s)
- Mudasir Maqbool
- Department of Pharmaceutical Sciences, University of Kashmir, Hazratbal Srinagar, 190006, Jammu and Kashmir, India
| | - Ginenus Fekadu
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong.,School of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Xinchan Jiang
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong
| | - Firomsa Bekele
- Department of Pharmacy, College of Health Science, Mettu University, Mettu, Ethiopia
| | - Tadesse Tolossa
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Ebisa Turi
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Getahun Fetensa
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Korinan Fanta
- School of Pharmacy, Institute of Health Science, Jimma University, Jimma, Ethiopia
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Filardo G, Andriolo L, Angele P, Berruto M, Brittberg M, Condello V, Chubinskaya S, de Girolamo L, Di Martino A, Di Matteo B, Gille J, Gobbi A, Lattermann C, Nakamura N, Nehrer S, Peretti GM, Shabshin N, Verdonk P, Zaslav K, Kon E. Scaffolds for Knee Chondral and Osteochondral Defects: Indications for Different Clinical Scenarios. A Consensus Statement. Cartilage 2021; 13:1036S-1046S. [PMID: 31941355 PMCID: PMC8808892 DOI: 10.1177/1947603519894729] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To develop patient-focused consensus guidelines on the indications for the use of scaffolds to address chondral and osteochondral femoral condyle lesions. DESIGN The RAND/UCLA Appropriateness Method (RAM) was used to develop patient-specific recommendations by combining the best available scientific evidence with the collective judgement of a panel of experts guided by a core panel and multidisciplinary discussers. A list of specific clinical scenarios was produced regarding adult patients with symptomatic lesions without instability, malalignment, or meniscal deficiency. Each scenario underwent discussion and a 2-round vote on a 9-point Likert-type scale (range 1-3 "inappropriate," 4-6 "uncertain," 7-9 "appropriate"). Scores were pooled to generate expert recommendations. RESULTS Scaffold (chondral vs. osteochondral), patient characteristics (age and sport activity level), and lesion characteristics (etiology, size, and the presence of osteoarthritis [OA]) were considered to define 144 scenarios. The use of scaffold-based procedures was considered appropriate in all cases of chondral or osteochondral lesions when joints are not affected by OA, while OA joints presented more controversial results. The analysis of the evaluated factors showed a different weight in influencing treatment appropriateness: the presence of OA influenced 58.3% of the indications, while etiology, size, and age were discriminating factors in 54.2%, 29.2%, and 16.7% of recommendations, respectively. CONCLUSIONS The consensus identified indications still requiring investigation, but also the convergence of the experts in several scenarios defined appropriate or inappropriate, which could support decision making in the daily clinical practice, guiding the use of scaffold-based procedures for the treatment of chondral and osteochondral knee defects.
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Affiliation(s)
- Giuseppe Filardo
- Applied and Translational Research (ATR)
Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Luca Andriolo
- Clinica Ortopedica e Traumatologica 2,
IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy,Luca Andriolo, Clinica Ortopedica e
Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Di Barbiano, 1/10,
Bologna 40136, Italy.
| | - Peter Angele
- Clinic for Trauma and Reconstructive
Surgery, University Hospital Regensburg, Regensburg, Bayern, Germany,Sporthopaedicum Regensburg, Regensburg,
Germany
| | - Massimo Berruto
- UOS Knee SURGERY-1st University Clinic
of Orthopaedics, ASST Pini-CTO, Milan, Italy
| | - Mats Brittberg
- Cartilage Research Unit, University of
Gothenburg, Gothenburg, Sweden,Region Halland Orthopaedics, Kungsbacka
Hospital, Kungsbacka, Sweden
| | - Vincenzo Condello
- Joint Preservation and Reconstructive
Surgery and Sports Medicine Unit, Humanitas Castelli Clinic, Bergamo, Lombardy,
Italy
| | - Susan Chubinskaya
- Department of Pediatrics, Orthopedic
Surgery & Medicine (Section of Rheumatology), Rush University Medical Center,
Chicago, IL, USA
| | - Laura de Girolamo
- Orthopaedic Biotechnology Laboratory,
IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
| | - Alessandro Di Martino
- Clinica Ortopedica e Traumatologica 2,
IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Berardo Di Matteo
- Department of Biomedical Sciences,
Humanitas University, Rozzano, Milan, Italy,Humanitas Clinical and Research
Center- IRCCS, Via Manzoni 56, 20089, Rozzano - Milan, Italy
| | - Justus Gille
- Department of Trauma and Orthopaedic
Surgery, University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck,
Germany
| | - Alberto Gobbi
- Orthopaedic Arthroscopic Surgery
International (OASI) Bioresearch Foundation, Milan, Italy
| | - Christian Lattermann
- Department of Orthopaedic Surgery,
Division of Sports Medicine, Center for Cartilage Repair, Brigham and Women’s
Hospital, Harvard Medical School, Boston, MA, USA
| | - Norimasa Nakamura
- Institute for Medical Science in
Sports, Osaka Health Science University, Osaka, Japan
| | - Stefan Nehrer
- Center for Regenerative Medicine,
Danube University, Krems an der Donau, Austria
| | - Giuseppe M. Peretti
- IRCCS Istituto Ortopedico Galeazzi,
Milan, Italy,Department of Biomedical Sciences for
Health, University of Milan, Milan, Italy
| | - Nogah Shabshin
- Department of Radiology, Emek Medical
Center, Clalit Healthcare Services, Afula, Israel,Department of Radiology, PennMedicine,
Philadelphia, PA, USA
| | - Peter Verdonk
- ORTHOCA, AZ Monica Hospitals, Antwerp,
Belgium,Aspetar Hospital, Doha, Qatar
| | - Kenneth Zaslav
- Ortho Virginia, Virginia Commonwealth
University, Richmond, VA, USA
| | - Elizaveta Kon
- Department of Biomedical Sciences,
Humanitas University, Rozzano, Milan, Italy,Humanitas Clinical and Research
Center- IRCCS, Via Manzoni 56, 20089, Rozzano - Milan, Italy,Department of Traumatology,
Orthopedics and Disaster Surgery, First Moscow State Medical University of the
Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian
Federation
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Lee HS, Oh KJ, Moon YW, In Y, Lee HJ, Kwon SY. Intra-articular Injection of Type I Atelocollagen to Alleviate Knee Pain: A Double-Blind, Randomized Controlled Trial. Cartilage 2021; 13:342S-350S. [PMID: 31370668 PMCID: PMC8808911 DOI: 10.1177/1947603519865304] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE Collagen disruption is one of the underlying causes of knee pain in patients with osteoarthritis and/or diverse cartilage defects. Atelocollagen is a type of collagen that lacks telopeptides and thus has reduced antigenicity. The intra-articular injection of type I atelocollagen supplements collagen levels in the disrupted articular cartilage. This randomized controlled trial evaluated the effects of the intra-articular injection of atelocollagen for the management of knee pain. DESIGN Two hundred patients with osteoarthritis, chondromalacia, or other cartilage defects were randomly assigned to receive a 3-mL intra-articular injection of atelocollagen (BioCollagen group) or saline (Placebo group). Clinical improvement was evaluated over a 24-week period using the 100-mm visual analogue scale (VAS), the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and the 36-item Short-Form Health Survey (SF-36). RESULTS VAS scores were significantly better in the BioCollagen group as compared with the Placebo group at 24 weeks. More patients in the BioCollagen group reported exceeding 20% and 40% VAS improvements. The WOMAC and SF-36 scores were also significantly improved from baseline after the intra-articular injection of atelocollagen; although, the differences between the BioCollagen and Placebo groups were not significant. There were no unexpected or severe adverse events reported for either group. CONCLUSIONS The results show that an intra-articular injection of atelocollagen effectively alleviates knee pain, as intended. Therefore, the intra-articular injection of atelocollagen can be considered an alternative solution to controlling knee pain due to osteoarthritis and diverse cartilage defects.
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Affiliation(s)
- Hwa Sung Lee
- Department of Orthopedic Surgery,
Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea,
Seoul, Republic of Korea
| | - Kwang Jun Oh
- Department of Orthopedic Surgery, Konkuk
University Medical Center, School of Medicine, Konkuk University, Seoul, Republic of
Korea
| | - Young Wan Moon
- Department of Orthopedic Surgery,
Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Republic
of Korea
| | - Yong In
- Department of Orthopedic Surgery, Seoul
St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Republic of Korea
| | - Han Jun Lee
- Department of Orthopedic Surgery,
Chung-Ang University Hospital, School of Medicine, Chung-Ang University, Seoul,
Republic of Korea
| | - Soon Yong Kwon
- Department of Orthopedic Surgery,
Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea,
Seoul, Republic of Korea,Soon Yong Kwon, Department of Orthopedic
Surgery, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic
University of Korea, 10, 63-ro Yeongdeungpo-gu, Seoul, 07345, Republic of Korea.
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Wang K, Esbensen Q, Karlsen T, Eftang C, Owesen C, Aroen A, Jakobsen R. Low-Input RNA-Sequencing in Patients with Cartilage Lesions, Osteoarthritis, and Healthy Cartilage. Cartilage 2021; 13:550S-562S. [PMID: 34775802 PMCID: PMC8808811 DOI: 10.1177/19476035211057245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To analyze and compare cartilage samples from 3 groups of patients utilizing low-input RNA-sequencing. DESIGN Cartilage biopsies were collected from patients in 3 groups (n = 48): Cartilage lesion (CL) patients had at least ICRS grade 2, osteoarthritis (OA) samples were taken from patients undergoing knee replacement, and healthy cartilage (HC) was taken from ACL-reconstruction patients without CLs. RNA was isolated using an optimized protocol. RNA samples were assessed for quality and sequenced with a low-input SmartSeq2 protocol. RESULTS RNA isolation yielded 48 samples with sufficient quality for sequencing. After quality control, 13 samples in the OA group, 9 in the HC group, and 9 in the CL group were included in the analysis. There was a high degree of co-clustering between the HC and CL groups with only 6 genes significantly up- or downregulated. OA and the combined HC/CL group clustered significantly separate from each other, yielding 659 significantly upregulated and 1,369 downregulated genes. GO-term analysis revealed that genes matched to cartilage and connective tissue development terms. CONCLUSION The gene expression profiles from the 3 groups suggest that there are no major differences in gene expression between cartilage from knees with a cartilage injury and knees without an apparent cartilage injury. OA cartilage, as expected, showed markedly different gene expression from the other 2 groups. The gene expression profiles resulting from this low-input RNA-sequencing study offer opportunities to discover new pathways not previously recognized that may be explored in future studies.
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Affiliation(s)
- Katherine Wang
- Faculty of Medicine, University of
Oslo, Oslo, Norway,Oslo Sports Trauma Research Center,
Norwegian School of Sports Sciences, Oslo, Norway,Department of Orthopaedic Surgery,
Akershus University Hospital, Lørenskog, Norway,Katherine Wang, Faculty of Medicine,
University of Oslo, P.O. Box 1072 Blindern, 0316 Oslo, Norway.
| | - Q.Y. Esbensen
- Department of Clinical Molecular
Biology (EpiGen), Akershus University Hospital, Lørenskog, Norway,Department of Clinical Molecular
Biology, University of Oslo, Oslo, Norway
| | - T.A. Karlsen
- Norwegian Center for Stem Cell
Research, Department of Immunology and Transfusion Medicine, Oslo University
Hospital, Rikshospitalet, Oslo, Norway
| | - C.N. Eftang
- Department of Pathology, Akershus
University Hospital, Lørenskog, Norway
| | - C. Owesen
- Department of Orthopaedic Surgery,
Akershus University Hospital, Lørenskog, Norway
| | - A. Aroen
- Oslo Sports Trauma Research Center,
Norwegian School of Sports Sciences, Oslo, Norway,Department of Orthopaedic Surgery,
Akershus University Hospital, Lørenskog, Norway,Institute of Clinical Medicine, Faculty
of Medicine, University of Oslo, Oslo, Norway
| | - R.B. Jakobsen
- Department of Orthopaedic Surgery,
Akershus University Hospital, Lørenskog, Norway,Department of Health Management and
Health Economics, Institute of Health and Society, Faculty of Medicine, University
of Oslo, Oslo, Norway
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40
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Prabhath S, Alappatt K, Shetty A, Sumalatha S. An exploratory study of the histomorphogenesis and zonal vascular changes in the human fetal medial meniscus. TRANSLATIONAL RESEARCH IN ANATOMY 2021. [DOI: 10.1016/j.tria.2021.100148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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41
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Crowder HA, Mazzoli V, Black MS, Watkins LE, Kogan F, Hargreaves BA, Levenston ME, Gold GE. Characterizing the transient response of knee cartilage to running: Decreases in cartilage T 2 of female recreational runners. J Orthop Res 2021; 39:2340-2352. [PMID: 33483997 PMCID: PMC8295402 DOI: 10.1002/jor.24994] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/20/2020] [Accepted: 01/19/2021] [Indexed: 02/04/2023]
Abstract
Cartilage transmits and redistributes biomechanical loads in the knee joint during exercise. Exercise-induced loading alters cartilage hydration and is detectable using quantitative magnetic resonance imaging (MRI), where T2 relaxation time (T2 ) is influenced by cartilage collagen composition, fiber orientation, and changes in the extracellular matrix. This study characterized short-term transient responses of healthy knee cartilage to running-induced loading using bilateral scans and image registration. Eleven healthy female recreational runners (33.73 ± 4.22 years) and four healthy female controls (27.25 ± 1.38 years) were scanned on a 3T GE MRI scanner with quantitative 3D double-echo in steady-state before running over-ground (runner group) or resting (control group) for 40 min. Subjects were scanned immediately post-activity at 5-min intervals for 60 min. T2 times were calculated for femoral, tibial, and patellar cartilage at each time point and analyzed using a mixed-effects model and Bonferroni post hoc. There were immediate decreases in T2 (mean ± SEM) post-run in superficial femoral cartilage of at least 3.3% ± 0.3% (p = .002) between baseline and Time 0 that remained for 25 min, a decrease in superficial tibial cartilage T2 of 2.9% ± 0.4% (p = .041) between baseline and Time 0, and a decrease in superficial patellar cartilage T2 of 3.6% ± 0.3% (p = .020) 15 min post-run. There were decreases in the medial posterior region of superficial femoral cartilage T2 of at least 5.3 ± 0.2% (p = .022) within 5 min post-run that remained at 60 min post-run. These results increase understanding of transient responses of healthy cartilage to repetitive, exercise-induced loading and establish preliminary recommendations for future definitive studies of cartilage response to running.
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Affiliation(s)
- Hollis A. Crowder
- Department of Mechanical Engineering, Stanford University, Stanford, California, USA,Department of Radiology, Stanford University, Stanford, California, USA
| | - Valentina Mazzoli
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Marianne S. Black
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Lauren E. Watkins
- Department of Radiology, Stanford University, Stanford, California, USA,Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Feliks Kogan
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Brian A. Hargreaves
- Department of Radiology, Stanford University, Stanford, California, USA,Department of Bioengineering, Stanford University, Stanford, California, USA,Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Marc E. Levenston
- Department of Mechanical Engineering, Stanford University, Stanford, California, USA,Department of Radiology, Stanford University, Stanford, California, USA
| | - Garry E. Gold
- Department of Radiology, Stanford University, Stanford, California, USA
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Logerstedt DS, Ebert JR, MacLeod TD, Heiderscheit BC, Gabbett TJ, Eckenrode BJ. Effects of and Response to Mechanical Loading on the Knee. Sports Med 2021; 52:201-235. [PMID: 34669175 DOI: 10.1007/s40279-021-01579-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2021] [Indexed: 11/30/2022]
Abstract
Mechanical loading to the knee joint results in a differential response based on the local capacity of the tissues (ligament, tendon, meniscus, cartilage, and bone) and how those tissues subsequently adapt to that load at the molecular and cellular level. Participation in cutting, pivoting, and jumping sports predisposes the knee to the risk of injury. In this narrative review, we describe different mechanisms of loading that can result in excessive loads to the knee, leading to ligamentous, musculotendinous, meniscal, and chondral injuries or maladaptations. Following injury (or surgery) to structures around the knee, the primary goal of rehabilitation is to maximize the patient's response to exercise at the current level of function, while minimizing the risk of re-injury to the healing tissue. Clinicians should have a clear understanding of the specific injured tissue(s), and rehabilitation should be driven by knowledge of tissue-healing constraints, knee complex and lower extremity biomechanics, neuromuscular physiology, task-specific activities involving weight-bearing and non-weight-bearing conditions, and training principles. We provide a practical application for prescribing loading progressions of exercises, functional activities, and mobility tasks based on their mechanical load profile to knee-specific structures during the rehabilitation process. Various loading interventions can be used by clinicians to produce physical stress to address body function, physical impairments, activity limitations, and participation restrictions. By modifying the mechanical load elements, clinicians can alter the tissue adaptations, facilitate motor learning, and resolve corresponding physical impairments. Providing different loads that create variable tensile, compressive, and shear deformation on the tissue through mechanotransduction and specificity can promote the appropriate stress adaptations to increase tissue capacity and injury tolerance. Tools for monitoring rehabilitation training loads to the knee are proposed to assess the reactivity of the knee joint to mechanical loading to monitor excessive mechanical loads and facilitate optimal rehabilitation.
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Affiliation(s)
- David S Logerstedt
- Department of Physical Therapy, University of the Sciences in Philadelphia, Philadelphia, PA, USA.
| | - Jay R Ebert
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, WA, Australia.,Orthopaedic Research Foundation of Western Australia, Perth, WA, Australia.,Perth Orthopaedic and Sports Medicine Research Institute, Perth, WA, Australia
| | - Toran D MacLeod
- Department of Physical Therapy, Sacramento State University, Sacramento, CA, USA
| | - Bryan C Heiderscheit
- Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, USA
| | - Tim J Gabbett
- Gabbett Performance Solutions, Brisbane, QLD, Australia.,Centre for Health Research, University of Southern Queensland, Ipswich, QLD, Australia
| | - Brian J Eckenrode
- Department of Physical Therapy, Arcadia University, Glenside, PA, USA
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Singh YP, Moses JC, Bhardwaj N, Mandal BB. Overcoming the Dependence on Animal Models for Osteoarthritis Therapeutics - The Promises and Prospects of In Vitro Models. Adv Healthc Mater 2021; 10:e2100961. [PMID: 34302436 DOI: 10.1002/adhm.202100961] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/10/2021] [Indexed: 12/19/2022]
Abstract
Osteoarthritis (OA) is a musculoskeletal disease characterized by progressive degeneration of osteochondral tissues. Current treatment is restricted to the reduction of pain and loss of function of the joint. To better comprehend the OA pathophysiological conditions, several models are employed, however; there is no consensus on a suitable model. In this review, different in vitro models being developed for possible therapeutic intervention of OA are outlined. Herein, various in vitro OA models starting from 2D model, co-culture model, 3D models, dynamic culture model to advanced technologies-based models such as 3D bioprinting, bioassembly, organoids, and organ-on-chip-based models are discussed with their advantages and disadvantages. Besides, different growth factors, cytokines, and chemicals being utilized for induction of OA condition are reviewed in detail. Furthermore, there is focus on scrutinizing different molecular and possible therapeutic targets for better understanding the mechanisms and OA therapeutics. Finally, the underlying challenges associated with in vitro models are discussed followed by future prospective. Taken together, a comprehensive overview of in vitro OA models, factors to induce OA-like conditions, and intricate molecular targets with the potential to develop personalized osteoarthritis therapeutics in the future with clinical translation is provided.
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Affiliation(s)
- Yogendra Pratap Singh
- Department of Biosciences and Bioengineering Indian Institute of Technology Guwahati Guwahati Assam 781039 India
| | - Joseph Christakiran Moses
- Department of Biosciences and Bioengineering Indian Institute of Technology Guwahati Guwahati Assam 781039 India
| | - Nandana Bhardwaj
- Department of Science and Mathematics Indian Institute of Information Technology Guwahati Bongora Guwahati Assam 781015 India
| | - Biman B. Mandal
- Department of Biosciences and Bioengineering Indian Institute of Technology Guwahati Guwahati Assam 781039 India
- Centre for Nanotechnology Indian Institute of Technology Guwahati Guwahati Assam 781039 India
- School of Health Sciences and Technology Indian Institute of Technology Guwahati Guwahati Assam 781039 India
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Wu W, Liang D. Expression and related mechanisms of miR-330-3p and S100B in an animal model of cartilage injury. J Int Med Res 2021; 49:3000605211039471. [PMID: 34590918 PMCID: PMC8489778 DOI: 10.1177/03000605211039471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective To investigate the roles of and relationship between microRNA (miR)-330-3p and S100 calcium-binding protein B (S100B) in an animal model of cartilage injury. Methods This study included 30 New Zealand male rabbits randomly divided into three groups: an intervention group, a model group and a sham surgery control group. Modelling was performed in the intervention and model groups, but in the sham surgery group, only the skin was cut. After modelling, the intervention and model groups were injected with the miR-330-3p overexpression vector GV268-miR-330-3p or the control GV268-N-ODN vector, respectively, twice a week for 7 weeks. Results Levels of interleukin-1β and tumour necrosis factor-α in the synovial fluid were significantly higher in the model group than in the intervention and control groups. The level of miR-330-3p in the cartilage tissue was significantly higher in the control group than in the model group but it was significantly lower compared with the intervention group. Levels of S100B, fibroblast growth factor receptor 1 and fibroblast growth factor-2 in the cartilage tissue of rabbits in the model group were significantly higher compared with the control and intervention groups. Conclusion These findings demonstrate that the upregulation of miR-330-3p can inhibit the expression of S100B.
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Affiliation(s)
- Wenming Wu
- Department of Orthopaedics, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Dongming Liang
- Lirimax (Tianjin) Medical Technical Co., Ltd, Tianjin, China
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Cellular senescence in musculoskeletal homeostasis, diseases, and regeneration. Bone Res 2021; 9:41. [PMID: 34508069 PMCID: PMC8433460 DOI: 10.1038/s41413-021-00164-y] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/08/2021] [Accepted: 07/14/2021] [Indexed: 01/10/2023] Open
Abstract
Emerging insights into cellular senescence highlight the relevance of senescence in musculoskeletal disorders, which represent the leading global cause of disability. Cellular senescence was initially described by Hayflick et al. in 1961 as an irreversible nondividing state in in vitro cell culture studies. We now know that cellular senescence can occur in vivo in response to various stressors as a heterogeneous and tissue-specific cell state with a secretome phenotype acquired after the initial growth arrest. In the past two decades, compelling evidence from preclinical models and human data show an accumulation of senescent cells in many components of the musculoskeletal system. Cellular senescence is therefore a defining feature of age-related musculoskeletal disorders, and targeted elimination of these cells has emerged recently as a promising therapeutic approach to ameliorate tissue damage and promote repair and regeneration of the skeleton and skeletal muscles. In this review, we summarize evidence of the role of senescent cells in the maintenance of bone homeostasis during childhood and their contribution to the pathogenesis of chronic musculoskeletal disorders, including osteoporosis, osteoarthritis, and sarcopenia. We highlight the diversity of the senescent cells in the microenvironment of bone, joint, and skeletal muscle tissue, as well as the mechanisms by which these senescent cells are involved in musculoskeletal diseases. In addition, we discuss how identifying and targeting senescent cells might positively affect pathologic progression and musculoskeletal system regeneration.
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Grevenstein D, Schafigh D, Oikonomidis S, Eysel P, Brochhausen C, Spies CK, Oppermann J. Short-term radiological results after spheroid-based autologous chondrocyte implantation in the knee are independent of defect localisation. Technol Health Care 2021; 30:725-733. [PMID: 34397439 DOI: 10.3233/thc-213066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Lesions of articular cartilage represent a crucial risk factor for the early development of osteoarthritis. Autologous chondrocyte implantation (ACI) is a well-established procedure in therapy of those lesions in the knee. The aim of the presented study is to detect differences in short-term radiological outcome depending on defect localization (femoral condyle vs. retropatellar) after spheroid-based ACI. OBJECTIVE This study aimed to demonstrate that radiological outcome after spheroid-based ACI in the knee is independent of defect localization. METHODS MRI-scans after retropatellar ACI and ACI of the medial/lateral femoral condyle, with a preoperative Outerbridge grade of III or IV were evaluated regarding MOCART 2.0. RESULTS The mean defect-size was 5.0 ± 1.8 cm2, with a minimum size of 2 cm2 and a maximum size of 9 cm2. Scans were performed 7.7 months (± 3.1 months) postoperatively. The mean MOCART 2.0 score was 78.5 ± 15.6. No statistically significant influence neither of the localization (p= 0.159), the gender (p= 0.124) nor defect size (< 5 cm2 vs. ⩾ 5 cm2; p= 0.201) could be observed. CONCLUSIONS The presented data demonstrate good to excellent radiological short-term results after spheroid-based ACI. Data indicates, that at least radiological results are independent of gender, defect-size and defect-localization.
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Affiliation(s)
- David Grevenstein
- Department for Orthopaedic and Trauma Surgery, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany.,Cologne Center for Musculoskeletal Biomechanics, Faculty of Medicine, University Hospital of Cologne, JCologne, Germany
| | - Darius Schafigh
- Department for Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital of Cologne, Cologne, Germany
| | - Stavros Oikonomidis
- Department for Orthopaedic and Trauma Surgery, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany.,Cologne Center for Musculoskeletal Biomechanics, Faculty of Medicine, University Hospital of Cologne, JCologne, Germany
| | - Peer Eysel
- Department for Orthopaedic and Trauma Surgery, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany.,Cologne Center for Musculoskeletal Biomechanics, Faculty of Medicine, University Hospital of Cologne, JCologne, Germany
| | | | | | - Johannes Oppermann
- Department for Orthopaedic and Trauma Surgery, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany.,Cologne Center for Musculoskeletal Biomechanics, Faculty of Medicine, University Hospital of Cologne, JCologne, Germany
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Esdaille CJ, Ude CC, Laurencin CT. Regenerative Engineering Animal Models for Knee Osteoarthritis. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2021; 8:284-297. [PMID: 35958163 PMCID: PMC9365239 DOI: 10.1007/s40883-021-00225-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Abstract
Osteoarthritis (OA) of the knee is the most common synovial joint disorder worldwide, with a growing incidence due to increasing rates of obesity and an aging population. A significant amount of research is currently being conducted to further our understanding of the pathophysiology of knee osteoarthritis to design less invasive and more effective treatment options once conservative management has failed. Regenerative engineering techniques have shown promising preclinical results in treating OA due to their innovative approaches and have emerged as a popular area of study. To investigate these therapeutics, animal models of OA have been used in preclinical trials. There are various mechanisms by which OA can be induced in the knee/stifle of animals that are classified by the etiology of the OA that they are designed to recapitulate. Thus, it is essential to utilize the correct animal model in studies that are investigating regenerative engineering techniques for proper translation of efficacy into clinical trials. This review discusses the various animal models of OA that may be used in preclinical regenerative engineering trials and the corresponding classification system.
Lay Summary
Osteoarthritis (OA) of the knee is the most common synovial joint disease worldwide, with high rates of occurrence due to an increase in obesity and an aging population. A great deal of research is currently underway to further our understanding of the causes of osteoarthritis, to design more effective treatments. The emergence of regenerative engineering has provided physicians and investigators with unique opportunities to join ideas in tackling human diseases such as OA. Once the concept is proven to work, the initial procedure for the evaluation of a treatment solution begins with an animal model. Thus, it is essential to utilize a suitable animal model that reflects the particular ailment in regenerative engineering studies for proper translation to human patients as each model has associated advantages and disadvantages. There are various ways by which OA can occur in the knee joint, which are classified according to the particular cause of the OA. This review discusses the various animal models of OA that may be used in preclinical regenerative engineering investigations and the corresponding classification system.
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Huang Y, Fan H, Gong X, Yang L, Wang F. Scaffold With Natural Calcified Cartilage Zone for Osteochondral Defect Repair in Minipigs. Am J Sports Med 2021; 49:1883-1891. [PMID: 33961510 DOI: 10.1177/03635465211007139] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Long-term outcomes of current clinical interventions for osteochondral defect are less than satisfactory. One possible reason is an ignorance of the interface structure between cartilage and subchondral bone, the calcified cartilage zone (CCZ). However, the importance of natural CCZ in osteochondral defects has not been directly described. PURPOSE To explore the feasibility of fabricating trilayer scaffold containing natural CCZ for osteochondral defects and the role of CCZ in the repair process. STUDY DESIGN Controlled laboratory study. METHODS The scaffold was prepared by cross-linking lyophilized type II collagen sponge and acellular normal pig subchondral bone with or without natural CCZ. Autologous bone marrow stem cells (BMSCs) of minipig were mixed with type II collagen gel and injected into the cartilage layer of the scaffold before operation. Thirty minipigs were randomly divided into CCZ (n = 10), non-CCZ (n = 10), and blank control (n = 10) groups. An 8 mm-diameter full-thickness osteochondral defect was created on the trochlear surface, and scaffold containing BMSCs was transplanted into the defect according to grouping requirements. At 12 and 24 weeks postoperatively, specimens were assessed by macroscopic observation, magnetic resonance imaging examination, and histological observations (hematoxylin and eosin, Safranin O-fast green, type II collagen immunohistochemical, and Sirius red staining). Semiquantitative cartilage repair scoring was conducted using the MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) system and the O'Driscoll repaired cartilage value system. RESULTS The defects in the blank control and non-CCZ groups were filled with fibrous tissue, while the cartilage layer of the CCZ group was mainly repaired by hyaline cartilage at 24 weeks postoperatively. The superior repair outcome of the CCZ group was confirmed by MOCART and O'Driscoll score. CONCLUSION The trilayer scaffold containing natural CCZ obtained the best repair effect compared with the non-CCZ scaffold and the blank control, indicating the importance of the CCZ in osteochondral tissue engineering. CLINICAL RELEVANCE This study demonstrates the necessity to reconstruct CCZ in clinical osteochondral defect repair and provides a possible strategy for osteochondral tissue engineering.
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Affiliation(s)
- Yang Huang
- Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Huaquan Fan
- Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xiaoyuan Gong
- Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Liu Yang
- Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Fuyou Wang
- Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
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Zlotnick H, Locke R, Stoeckl B, Patel J, Gupta S, Browne K, Koh J, Carey J, Mauck R. Marked differences in local bone remodelling in response to different marrow stimulation techniques in a large animal. Eur Cell Mater 2021; 41:546-557. [PMID: 34008855 PMCID: PMC8569589 DOI: 10.22203/ecm.v041a35] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Marrow stimulation, including subchondral drilling and microfracture, is the most commonly performed cartilage repair strategy, whereby the subchondral bone plate is perforated to release marrow-derived cells into a cartilage defect to initiate repair. Novel scaffolds and therapeutics are being designed to enhance and extend the positive short-term outcomes of this marrow stimulation. However, the translation of these newer treatments is hindered by bony abnormalities, including bone resorption, intralesional osteophytes, and bone cysts, that can arise after marrow stimulation. In this study, three different marrow stimulation approaches - microfracture, subchondral drilling and needle-puncture - were evaluated in a translationally relevant large-animal model, the Yucatan minipig. The objective of the study was to determine which method of marrow access (malleted awl, drilled Kirschner wire or spring-loaded needle) best preserved the underlying subchondral bone. Fluorochrome labels were injected at the time of surgery and 2 weeks post-surgery to capture bone remodelling over the first 4 weeks. Comprehensive outcome measures included cartilage indentation testing, histological grading, microcomputed tomography and fluorochrome imaging. Findings indicated that needle-puncture devices best preserved the underlying subchondral bone relative to other marrow access approaches. This may relate to the degree of bony compaction occurring with marrow access, as the Kirschner wire approach, which consolidated bone the most, induced the most significant bone damage with marrow stimulation. This study provided basic scientific evidence in support of updated marrow stimulation techniques for preclinical and clinical practice.
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Affiliation(s)
- H.M. Zlotnick
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA,Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA,Translational Musculoskeletal Research Center, CMC VA Medical Center, Philadelphia, PA, USA
| | - R.C. Locke
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA,Translational Musculoskeletal Research Center, CMC VA Medical Center, Philadelphia, PA, USA
| | - B.D. Stoeckl
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA,Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA,Translational Musculoskeletal Research Center, CMC VA Medical Center, Philadelphia, PA, USA
| | - J.M. Patel
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA,Translational Musculoskeletal Research Center, CMC VA Medical Center, Philadelphia, PA, USA,Department of Orthopaedics, Emory University, Atlanta, GA, USA
| | - S. Gupta
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA,Translational Musculoskeletal Research Center, CMC VA Medical Center, Philadelphia, PA, USA
| | - K.D. Browne
- Center for Neurotrauma, Neurodegeneration and Restoration, CMC VA Medical Centre, Philadelphia, PA, USA
| | - J. Koh
- Orthopaedic and Spine Institute, NorthShore University Health System, Evanston, IL, USA
| | - J.L. Carey
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA,Translational Musculoskeletal Research Center, CMC VA Medical Center, Philadelphia, PA, USA
| | - R.L. Mauck
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA,Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA,Translational Musculoskeletal Research Center, CMC VA Medical Center, Philadelphia, PA, USA,Address for correspondence: Robert L. Mauck, 308A Stemmler Hall, 3450 Hamilton Walk, Philadelphia, PA, 19104-6081, USA. Telephone number: +1 2158988653 Fax number: +1 2155732133
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Chen H, Ni Q, Li B, Chen L. Identification of differentially expressed genes in synovial tissue of osteoarthritis based on a more robust integrative analysis method. Clin Rheumatol 2021; 40:3745-3754. [PMID: 33677723 DOI: 10.1007/s10067-021-05649-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 02/05/2021] [Accepted: 02/10/2021] [Indexed: 01/15/2023]
Abstract
OBJECTIVE This study aimed to identify osteoarthritis (OA) related genes based on microarray data in synovium with a more robust integrative analysis method. METHODS Four series GSE55457, GSE12021, GSE55235, and GSE55584 (36 OA and 29 normal samples) were downloaded from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) of GSE55457, GSE12021, and GSE55235 were identified using the LIMMA package. Overlapping DEGs from the intersection of the three series were detected. Simultaneously, samples in the four series were pooled to identify DEGs with integrated analysis using the Sva package. RESULTS In total, 74 overlapping DEGs and 242 DEGs by integrating four series were detected. Based on them, 70 common DEGs were used to construct a protein-protein interaction (PPI) network, involving 61 nodes and 206 edges. Also, three gene modules and five hub genes, named JUN, IL6, VEGFA, MYC, and EGR1, were identified. CONCLUSIONS Seventy DEGs were finally identified with a more robust integrative analysis method. JUN, IL6, VEGFA, MYC, and EGR1 were identified as hub genes in the development of OA. Key Points • 76 overlapping DEGs were detected from the intersection of DEGs in GSE55457, GSE12021, and GSE55235. • 242 DEGs were identified by integrating four series using Sva package. • 72 common DEGs were finally identified based on the overlapping DEGs and the integrated DEGs. • JUN, IL6, VEGFA, MYC, and EGR1 were identified as hub genes in the development of OA.
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Affiliation(s)
- Haitao Chen
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Qubo Ni
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Bin Li
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Liaobin Chen
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
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