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Leite CBG, Merkely G, Charles JF, Lattermann C. From Inflammation to Resolution: Specialized Pro-resolving Mediators in Posttraumatic Osteoarthritis. Curr Osteoporos Rep 2023; 21:758-770. [PMID: 37615856 DOI: 10.1007/s11914-023-00817-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 08/25/2023]
Abstract
PURPOSE OF REVIEW To provide a comprehensive overview of the inflammatory response following anterior cruciate ligament (ACL) injury and to highlight the relationship between specialized pro-resolving mediators (SPMs) and inflammatory joint conditions, emphasizing the therapeutic potential of modulating the post-injury resolution of inflammation to prevent posttraumatic osteoarthritis (PTOA). RECENT FINDINGS The inflammatory response triggered after joint injuries such as ACL tear plays a critical role in posttraumatic osteoarthritis development. Inflammation is a necessary process for tissue healing, but unresolved or overactivated inflammation can lead to chronic diseases. SPMs, a family of lipid molecules derived from essential fatty acids, have emerged as active players in the resolution of inflammation and tissue repair. While their role in other inflammatory conditions has been studied, their relationship with PTOA remains underexplored. Proinflammatory mediators contribute to cartilage degradation and PTOA pathogenesis, while anti-inflammatory and pro-resolving mediators may have chondroprotective effects. Therapies aimed at suppressing inflammation in PTOA have limitations, as inflammation is crucial for tissue healing. SPMs offer a pro-resolving response without causing immunosuppression, making them a promising therapeutic option. The known onset date of PTOA makes it amenable to early interventions, and activating pro-resolving pathways may provide new possibilities for preventing PTOA progression. Harnessing the pro-resolving potential of SPMs may hold promise for preventing PTOA and restoring tissue homeostasis and function after joint injuries.
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Affiliation(s)
- Chilan B G Leite
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 20 Patriot Place Foxboro, Boston, MA, 02035, USA
| | - Gergo Merkely
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 20 Patriot Place Foxboro, Boston, MA, 02035, USA
| | - Julia F Charles
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 20 Patriot Place Foxboro, Boston, MA, 02035, USA
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Christian Lattermann
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 20 Patriot Place Foxboro, Boston, MA, 02035, USA.
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Li JT, Zeng N, Yan ZP, Liao T, Chen X, Ni GX. Nuclear magnetic resonance-based metabolomic study of rat serum after anterior cruciate ligament injury. Sci Rep 2023; 13:19321. [PMID: 37935794 PMCID: PMC10630467 DOI: 10.1038/s41598-023-46540-y] [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: 07/09/2023] [Accepted: 11/02/2023] [Indexed: 11/09/2023] Open
Abstract
Anterior cruciate ligament (ACL) injury, a common sports injury, is associated with a high risk of subsequent osteoarthritis (OA), which can cause serious pain and disability. Understanding the detailed mechanism underlying the predisposition of knee with ACL injury to secondary OA at an early stage is key to preventing future degradation and progression to a clinically significant disease. A total of 56 male Sprague Dawley rats (age, 8 weeks; weight, 180-220 g) were randomly divided into three experimental groups: control, ACL transection (ACLT; where surgical procedure was performed with ACLT), and sham (where surgical procedure was performed without ACLT). The ACLT and sham groups were further divided into three subgroups based on when the rats were sacrificed: 4, 8, and 12 weeks after the surgical procedure. The control group and the aforementioned subgroups contained 8 rats each. We used nuclear magnetic resonance (NMR)-based metabolomic analysis to analyze rat serum samples for the metabolic characteristics and the underlying mechanisms. In total, 28 metabolites were identified in the NMR spectra of the rat sera. At 4 and 8 weeks postoperatively, the sham group demonstrated metabolic profiles different from those of the ACLT group. However, this difference was not observed 12 weeks postoperatively. In total, five metabolites (acetate, succinate, sn-glycero-3-phosphocholine, glucose, and phenylalanine) and five metabolic pathways (phenylalanine, tyrosine, and tryptophan biosynthesis; phenylalanine metabolism; pyruvate metabolism; starch and sucrose metabolism; and histidine metabolism) demonstrated significant differences between the ACLT and sham groups. ACL injury was noted to considerably affect biochemical homeostasis and metabolism; however, these metabolic changes persisted briefly. Moreover, glucose was a characteristic metabolite, and several energy-related metabolic pathways were significantly disturbed. Therefore, an ACL injury may lead to considerable impairments in energy metabolism. Abnormal glucose levels facilitate chondrocyte function impairment and thereby lead to OA progression. Furthermore, lactate may aid in identifying metabolic changes specific to knee trauma not related to an ACL injury. Overall, the metabolic changes in rat serum after an ACL injury were closely related to disturbances in energy metabolism and amino acid metabolism. The current results may aid in understanding the pathogenesis of posttraumatic osteoarthritis.
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Affiliation(s)
- Jie-Ting Li
- Department of Rehabilitation Medicine, Fuzhou Second Hospital, Fuzhou, China
| | - Ni Zeng
- Department of Rehabilitation Medicine, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Zhi-Peng Yan
- Department of Rehabilitation Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Tao Liao
- Department of Rehabilitation Medicine, Chengdu Second People's Hospital, Chengdu, China
| | - Xin Chen
- Department of Rehabilitation Medicine, Fuzhou Second Hospital, Fuzhou, China
| | - Guo-Xin Ni
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Xiamen University, Xiamen, China.
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Waltz RA, Whitney KE, Duke VR, Kloser H, Huard C, Provencher MT, Philippon MJ, Bahney C, Godin JA, Huard J. A Systemic and Local Comparison of Senescence in an Acute Anterior Cruciate Ligament Injury-A Pilot Case Series. Life (Basel) 2023; 13:1567. [PMID: 37511942 PMCID: PMC10381817 DOI: 10.3390/life13071567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/03/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Senescence, a characteristic of cellular aging and inflammation, has been linked to the acceleration of osteoarthritis. The purpose of this study is to prospectively identify, measure, and compare senescent profiles in synovial fluid and peripheral blood in patients with an acute knee injury within 48 h. METHODS Seven subjects, aged 18-60 years, with an acute ACL tear with effusion were prospectively enrolled. Synovial fluid and peripheral blood samples were collected and analyzed by flow cytometry, using senescent markers C12FDG and CD87. The senescent versus pro-regenerative phenotype was probed at a gene and protein level using qRT-PCR and multiplex immunoassays. RESULTS C12FDG and CD87 positive senescent cells were detected in the synovial fluid and peripheral blood of all patients. Pro-inflammatory IL-1β gene expression measured in synovial fluid was significantly higher (p = 0.0156) than systemic/blood expression. Senescent-associated factor MMP-3 and regenerative factor TIMP-2 were significantly higher in synovial fluid compared to blood serum. Senescent-associated factor MMP-9 and regenerative factor TGFβ-2 were significantly elevated in serum compared to synovial fluid. Correlation analysis revealed that C12FDG++/CD87++ senescent cells in synovial fluid positively correlated with age-related growth-regulated-oncogene (ρ = 1.00, p < 0.001), IFNγ (ρ = 1.00, p < 0.001), IL-8 (ρ = 0.90, p = 0.0374), and gene marker p16 (ρ = 0.83, p = 0.0416). CONCLUSIONS There is an abundance of senescent cells locally and systemically after an acute ACL tear without a significant difference between those present in peripheral blood compared to synovial fluid. This preliminary data may have a role in identifying strategies to modify the acute environment within the synovial fluid, either at the time of acute ligament injury or reconstruction surgery.
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Affiliation(s)
- Robert A Waltz
- Naval Health Clinic Annapolis, U.S. Naval Academy, Annapolis, MD 21402, USA
- Linda and Mitch Hart Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO 81657, USA
| | - Kaitlyn E Whitney
- Linda and Mitch Hart Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO 81657, USA
| | - Victoria R Duke
- Linda and Mitch Hart Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO 81657, USA
| | - Heidi Kloser
- Linda and Mitch Hart Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO 81657, USA
| | - Charles Huard
- Linda and Mitch Hart Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO 81657, USA
| | - Matthew T Provencher
- Linda and Mitch Hart Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO 81657, USA
- The Steadman Clinic, Vail, CO 81657, USA
| | - Marc J Philippon
- Linda and Mitch Hart Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO 81657, USA
- The Steadman Clinic, Vail, CO 81657, USA
| | - Chelsea Bahney
- Linda and Mitch Hart Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO 81657, USA
| | - Jonathan A Godin
- Linda and Mitch Hart Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO 81657, USA
- The Steadman Clinic, Vail, CO 81657, USA
| | - Johnny Huard
- Linda and Mitch Hart Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO 81657, USA
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Yuan S, Li G, Zhang J, Chen X, Su J, Zhou F. Mesenchymal Stromal Cells-Derived Extracellular Vesicles as Potential Treatments for Osteoarthritis. Pharmaceutics 2023; 15:1814. [PMID: 37514001 PMCID: PMC10385170 DOI: 10.3390/pharmaceutics15071814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/20/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023] Open
Abstract
Osteoarthritis (OA) is a degenerative disease of the joints characterized by cartilage damage and severe pain. Despite various pharmacological and surgical interventions, current therapies fail to halt OA progression, leading to high morbidity and an economic burden. Thus, there is an urgent need for alternative therapeutic approaches that can effectively address the underlying pathophysiology of OA. Extracellular Vesicles (EVs) derived from mesenchymal stromal cells (MSCs) represent a new paradigm in OA treatment. MSC-EVs are small membranous particles released by MSCs during culture, both in vitro and in vivo. They possess regenerative properties and can attenuate inflammation, thereby promoting cartilage healing. Importantly, MSC-EVs have several advantages over MSCs as cell-based therapies, including lower risks of immune reactions and ethical issues. Researchers have recently explored different strategies, such as modifying EVs to enhance their delivery, targeting efficiency, and security, with promising results. This article reviews how MSC-EVs can help treat OA and how they might work. It also briefly discusses the benefits and challenges of using MSC-EVs and talks about the possibility of allogeneic and autologous MSC-EVs for medical use.
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Affiliation(s)
- Shunling Yuan
- School of Pharmacy, Naval Medical University, Shanghai 200433, China
| | - Guangfeng Li
- Department of Orthopedics Trauma, Shanghai Zhongye Hospital, Shanghai 200941, China
| | - Jinbo Zhang
- School of Pharmacy, Naval Medical University, Shanghai 200433, China
- Department of Pharmacy, Tianjin Rehabilitation Center of Joint Logistics Support Force, Tianjin 300110, China
| | - Xiao Chen
- Department of Orthopedics Trauma, Shanghai Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Jiacan Su
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, China
- Institute of Advanced Interdisciplinary Materials Science, Shanghai University, Shanghai 200444, China
- Organoid Research Center, Shanghai University, Shanghai 200444, China
| | - Fengjin Zhou
- Department of Orthopaedics, Honghui Hospital, Xi'an Jiao Tong University, Xi'an 710000, China
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Nieboer MF, Reijman M, Wesdorp MA, Bastiaansen-Jenniskens YM, Meuffels DE. Improved Understanding of the Inflammatory Response in Synovial Fluid and Serum after Traumatic Knee Injury, Excluding Fractures of the Knee: A Systematic Review. Cartilage 2023; 14:198-209. [PMID: 36661182 PMCID: PMC10416200 DOI: 10.1177/19476035221141417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Traumatic knee injury results in a 4- to 10-fold increased risk of post-traumatic osteoarthritis (PTOA). Currently, there are no successful interventions for preventing PTOA after knee injury. The aim of this study is to identify inflammatory proteins that are increased in serum and synovial fluid after acute knee injury, excluding intra-articular fractures. METHODS A literature search was done according to the PRISMA guidelines. Articles reporting about inflammatory proteins after knee injury, except fractures, up to December 8, 2021 were collected. Inclusion criteria were as follows: patients younger than 45 years, no radiographic signs of knee osteoarthritis at baseline, and inflammatory protein measurement within 1 year after trauma. Risk of bias was assessed of the included studies. The level of evidence was determined by the Strength of Recommendation Taxonomy. RESULTS Ten studies were included. All included studies used a healthy control group or the contralateral knee as healthy control. Strong evidence for interleukin 6 (IL-6) and limited evidence for CCL4 show elevated concentrations of these proteins in synovial fluid (SF) after acute knee injury; no upregulation in SF for IL-2, IL-10, CCL3, CCL5, CCL11, granulocyte colony-stimulating factor (G-CSF), and granulocyte-macrophage colony-stimulating factor (GM-CSF) was found. Limited evidence was found for no difference in serum concentration of IL-1β, IL-6, IL-10, CCL2, and tumor necrosis factor alpha (TNF-α) after knee injury. CONCLUSION Interleukin 6 and CCL4 are elevated in SF after acute knee injury. Included studies failed to demonstrate increased concentration of inflammatory proteins in SF samples taken 6 weeks after trauma. Future research should focus on SF inflammatory protein measurements taken less than 6 weeks after injury.
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Affiliation(s)
- Michael F. Nieboer
- Department of Orthopaedics and Sports Medicine, Erasmus MC—University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Max Reijman
- Department of Orthopaedics and Sports Medicine, Erasmus MC—University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marinus A. Wesdorp
- Department of Orthopaedics and Sports Medicine, Erasmus MC—University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Duncan E. Meuffels
- Department of Orthopaedics and Sports Medicine, Erasmus MC—University Medical Center Rotterdam, Rotterdam, The Netherlands
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Kaneguchi A, Yamaoka K, Ozawa J. The effects of the amount of weight bearing on articular cartilage early after ACL reconstruction in rats. Connect Tissue Res 2023; 64:186-204. [PMID: 36334016 DOI: 10.1080/03008207.2022.2141627] [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] [Indexed: 11/06/2022]
Abstract
PURPOSE Osteoarthritis that develops after anterior cruciate ligament (ACL) reconstruction is a critical issue. We examined the effects of the amount of weight bearing early after ACL reconstruction on articular cartilage. MATERIALS AND METHODS Rats were divided into groups according to the treatment received: untreated control, ACL reconstruction (ACLR), ACL reconstruction plus hindlimb unloading (ACLR + HU), and ACL reconstruction plus morphine administration (ACLR + M). ACL reconstruction was performed on the right knee throughout the groups. To assess the amount of weight bearing, one-hindlimb standing time ratio (STR; operated side/contralateral side) during treadmill locomotion was evaluated during the experimental period. At day 7 or 14 post-surgery, cartilage degeneration of the medial tibial plateau was histologically assessed. RESULTS In the ACLR group, reduction in weight bearing characterized by significantly reduced STR was observed between day 1 and 7. Reduction in weight bearing was partially attenuated by morphine administration. Compared with the control group, the ACLR group exhibited an increased Mankin score that was accompanied by increased cyclooxygenase-2 expression in the anterior region. In the ACLR + HU group, Mankin scores were significantly higher in the middle and posterior regions, and cartilage thickness in these regions was significantly thinner than those in the ACLR group. In the ACLR + M group, although chondrocyte density in the anterior region was increased, all other parameters were not significantly different from those in the ACLR group. CONCLUSIONS Our results suggest that early weight bearing after ACL reconstruction is important to reduce cartilage degeneration.
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Affiliation(s)
- Akinori Kaneguchi
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Higashi-Hiroshima, Japan
| | - Kaoru Yamaoka
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Higashi-Hiroshima, Japan
| | - Junya Ozawa
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Higashi-Hiroshima, Japan
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Vachhani K, Prodeus A, Nakamura S, Rockel JS, Hopfgartner A, Kapoor M, Gariépy J, Whyne C, Nam D. Can CD200R1 Agonists Slow the Progression of Osteoarthritis Secondary to Injury? Front Immunol 2022; 13:836837. [PMID: 35359946 PMCID: PMC8964055 DOI: 10.3389/fimmu.2022.836837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
Post-traumatic knee osteoarthritis is characterized by cartilage degeneration, subchondral bone remodeling, osteophyte formation, and synovial changes. Therapeutic targeting of inflammatory activity in the knee immediately post injury may alter the course of osteoarthritis development. This study aimed to determine whether CD200R1 agonists, namely the protein therapeutic CD200Fc or the synthetic DNA aptamer CCS13, both known to act as anti-inflammatory agents, are able to delay the pathogenesis of injury-associated knee osteoarthritis in a murine model. Ten week old male C57BL/6 mice were randomized and surgical destabilization of the medial meniscus (DMM) to induce knee arthritis or sham surgery as a control were performed. CCS13 was evaluated as a therapeutic treatment along with CD200Fc and a phosphate-buffered saline vehicle control. Oligonucleotides were injected intra-articularly beginning one week after surgery, with a total of six injections administered prior to sacrifice at 12 weeks post-surgery. Histopathological assessment was used as the primary outcome measure to assess cartilage and synovial changes, while µCT imaging was used to compare the changes to the subchondral bone between untreated and treated arthritic groups. We did not find any attenuation of cartilage degeneration or synovitis in DMM mice with CD200Fc or CCS13 at 12 weeks post-surgery, nor stereological differences in the properties of subchondral bone. The use of CD200R1 agonists to blunt the inflammatory response in the knee are insufficient to prevent disease progression in the mouse DMM model of OA without anatomical restoration of the normal joint biomechanics.
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Affiliation(s)
- Kathak Vachhani
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Sunnybrook Research Institute, Toronto, ON, Canada
| | - Aaron Prodeus
- Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Sayaka Nakamura
- Division of Orthopaedics, Osteoarthritis Research Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Jason S. Rockel
- Division of Orthopaedics, Osteoarthritis Research Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | | | - Mohit Kapoor
- Division of Orthopaedics, Osteoarthritis Research Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
- Division of Orthopedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Jean Gariépy
- Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Cari Whyne
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Sunnybrook Research Institute, Toronto, ON, Canada
- Division of Orthopedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Diane Nam
- Sunnybrook Research Institute, Toronto, ON, Canada
- Division of Orthopedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
- *Correspondence: Diane Nam,
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Barton KI, Heard BJ, Kroker A, Sevick JL, Raymond DA, Chung M, Achari Y, Martin CR, Frank CB, Boyd SK, Shrive NG, Hart DA. Structural Consequences of a Partial Anterior Cruciate Ligament Injury on Remaining Joint Integrity: Evidence for Ligament and Bone Changes Over Time in an Ovine Model. Am J Sports Med 2021; 49:637-648. [PMID: 33523721 DOI: 10.1177/0363546520985279] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Severe injury to the knee joint often results in accelerated posttraumatic osteoarthritis (PTOA). In an ovine knee injury model, altered kinematics and degradation of the cartilage have been observed at 20 and 40 weeks after partial anterior cruciate ligament (ACL) transection (p-ACL Tx) surgery. However, changes to the integrity of the remaining intact intra-articular ligaments (posterolateral [PL] band and posterior cruciate ligament [PCL]) as well as the subchondral bone after anteromedial (AM) band Tx remain to be characterized. PURPOSE (1) To investigate histological alterations to the remaining intact intra-articular ligaments, the synovium, and the infrapatellar fat pad (IPFP) and (2) to quantify subchondral bone changes at the contact surfaces of the proximal tibia at 20 and 40 weeks after AM band Tx. STUDY DESIGN Descriptive laboratory study. METHODS Mature female Suffolk cross sheep were allocated into 3 groups: nonoperative controls (n = 6), 20 weeks after partial ACL transection (p-ACL Tx; n = 5), and 40 weeks after p-ACL Tx (n = 6). Ligament, synovium, and IPFP sections were stained and graded. Tibial subchondral bone microarchitecture was assessed using high-resolution peripheral quantitative computed tomography. RESULTS p-ACL Tx of the AM band led to significant change in histological scores of the PL band and the PCL at 20 weeks after p-ACL Tx (P = .031 and P = .033, respectively) and 40 weeks after p-ACL Tx (P = .011 and P = .029) as compared with nonoperative controls. Alterations in inflammatory cells and collagen fiber orientation contributed to the greatest extent of the combined histological score in the PL band and PCL. p-ACL Tx did not lead to chronic activation of the synovium or IPFP. Trabecular bone mineral density was strongly inversely correlated with combined gross morphological damage in the top and middle layers of the subchondral bone in the lateral tibial plateau for animals at 40 weeks after p-ACL Tx. CONCLUSION p-ACL Tx influences the integrity (biology and structure) of remaining intact intra-articular ligaments and bone microarchitecture in a partial knee injury ovine model. CLINICAL RELEVANCE p-ACL Tx leads to alterations in structural integrity of the remaining intact ligaments and degenerative changes in the trabecular bone mineral density, which may be detrimental to the injured athlete's knee joint in the long term.
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Affiliation(s)
- Kristen I Barton
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Bryan J Heard
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Andres Kroker
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Schulich School of Engineering, University of Calgary, Calgary, Canada
| | - Johnathan L Sevick
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Schulich School of Engineering, University of Calgary, Calgary, Canada
| | - Duncan A Raymond
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - May Chung
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Yamini Achari
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - C Ryan Martin
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Section of Orthopaedics, Foothills Hospital, Calgary, Canada
| | | | - Steven K Boyd
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Schulich School of Engineering, University of Calgary, Calgary, Canada
| | - Nigel G Shrive
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Schulich School of Engineering, University of Calgary, Calgary, Canada
| | - David A Hart
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Faculty of Kinesiology, University of Calgary, Calgary, Canada.,Bone and Joint Health Strategic Clinical Network, Alberta Health Services, Edmonton, Canada
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9
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Wimmer MA, Pacione C, Yuh C, Chan YM, Kunze J, Laurent MP, Chubinskaya S. Articulation of an alumina-zirconia composite ceramic against living cartilage – An in vitro wear test. J Mech Behav Biomed Mater 2020; 103:103531. [DOI: 10.1016/j.jmbbm.2019.103531] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 11/04/2019] [Accepted: 11/11/2019] [Indexed: 11/24/2022]
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10
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van der List JP, Mintz DN, DiFelice GS. The Locations of Anterior Cruciate Ligament Tears in Pediatric and Adolescent Patients: A Magnetic Resonance Study. J Pediatr Orthop 2019; 39:441-448. [PMID: 31503221 DOI: 10.1097/bpo.0000000000001041] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Recently, a resurgence of interest has been noted in anterior cruciate ligament (ACL) preservation in pediatric and adolescent patients. Different tear types, defined by their tear location, require different preservation techniques: proximal and distal avulsion tears can be treated with arthroscopic primary repair, whereas primary repair with biological scaffold has been proposed for midsubstance tears. The goal of this study was to assess the distribution of different tear types in pediatric and adolescent patients, as these are currently unknown. METHODS A retrospective search in an institutional radiographic database was performed for patients under 18.0 years undergoing knee magnetic resonance imaging (MRI) for ACL tears between June 2005 and June 2016. Patients with reports of chronic tears, partial tears, and multiligamentous injuries were excluded.Tear locations were graded using MRI as: proximal avulsion (distal remnant length >90% of total length; type I), proximal (75% to 90%; type II), midsubstance (25% to 75%; type III), distal (10% to 25%; type IV), and distal avulsion (<10%; type V). RESULTS A total of 274 patients (59% girls; mean±SD age, 15.1±2.1 y; range, 6.9 to 18.0 y) were included. Frequency of type I tears was 15%, type II 23%, type III 52%, type IV 1%, and type V 8% (of which 7% had bony avulsion).Prevalence of tear types varied with age. At age 6 to 10 years, 93% were type V (bony) avulsion tears. At age 11 to 13 years, 32% were type I, 16% type II, 32% type III, and 16% type V. At age 14 to 17 years, type III tears were more common (57%) than type I (14%), type II (25%) and type V (2%) tears. CONCLUSIONS It was noted that the ACL was torn at different locations depending on the patients' age. These data provide more information on the potential application for ACL preservation in pediatric and adolescent patients. Future studies correlating these findings with arthroscopy are needed before using MRI for preoperative planning of ACL preservation surgery. LEVEL OF EVIDENCE Diagnostic level III.
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Affiliation(s)
| | - Douglas N Mintz
- Radiology and Imaging, Hospital for Special Surgery, New York, NY
| | - Gregory S DiFelice
- Departments of Orthopedic Surgery, Orthopaedic Trauma and Sports Medicine
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11
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Deckers C, Stephan P, Wever KE, Hooijmans CR, Hannink G. The protective effect of anterior cruciate ligament reconstruction on articular cartilage: a systematic review of animal studies. Osteoarthritis Cartilage 2019; 27:219-229. [PMID: 30317001 DOI: 10.1016/j.joca.2018.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 09/27/2018] [Accepted: 10/01/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE It is unclear if anterior cruciate ligament (ACL) reconstruction can prevent the onset of degenerative changes in the knee. Previous studies were inconclusive on this subject. The aim of this study was to systematically review all studies on the effect of ACL reconstruction on articular cartilage in animals. DESIGN Pubmed and Embase were searched to identify all original articles concerning the effect of ACL reconstruction on articular cartilage compared with both its positive (ACL transection) and negative (sham and/or non-operated) control in animals. Subsequently a Risk of bias and meta analysis was conducted based on five outcomes (gross macroscopic assessment, medical imaging, histological histochemical grading, histomophometrics and biomechanical characterization) related to articular cartilage. RESULTS From the 19 included studies, 29 independent comparisons could be identified which underwent ACL reconstruction with an average timing of data collection of 23 weeks (range 1-104 weeks). Due to limited data availability meta-analysis could only be conducted for gross macroscopic damage. ACL reconstruction caused significant gross macroscopic damage compared with intact controls (SMD 2.0 [0.88; 3.13]). These findings were supported by individual studies reporting on histomorphometrics, histology and imaging. No significant gross macroscopic damage was found when ACL reconstruction was compared with ACL transection (SMD -0.64 [-1.85; 0.57]). CONCLUSION This systematic review with an average follow up of included studies of 23 weeks (range 1-104 weeks) demonstrates that, in animals, ACL reconstruction does not protect articular cartilage from degenerative changes. The consistency of the direction of effect, provides some reassurance that the direction of effect in humans might be the same.
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Affiliation(s)
- C Deckers
- Department of Orthopedics, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - P Stephan
- Department of Orthopedics, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - K E Wever
- Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - C R Hooijmans
- Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - G Hannink
- Department of Orthopedics, Radboud University Medical Center, Nijmegen, The Netherlands.
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12
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Maerz T, Sherman E, Newton M, Yilmaz A, Kumar P, Graham SF, Baker KC. Metabolomic serum profiling after ACL injury in rats: A pilot study implicating inflammation and immune dysregulation in post-traumatic osteoarthritis. J Orthop Res 2018; 36:1969-1979. [PMID: 29315787 DOI: 10.1002/jor.23854] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 12/24/2017] [Indexed: 02/04/2023]
Abstract
ACL rupture is a major risk factor for post-traumatic osteoarthritis (PTOA) development. Little information exists on acute systemic metabolic indicators of disease development. Thirty-six female Lewis rats were randomized to Control or noninvasive anterior cruciate ligament rupture (ACLR) and to three post-injury time points: 72 h, 4 weeks, 10 weeks (n = 6). Serum was collected and analyzed by 1 H nuclear magnetic resonance (NMR) spectroscopy and combined direct injection and liquid chromatography (LC)-mass spectrometry (MS)/MS (DI-MS). Univariate and multivariate statistics were used to analyze metabolomic data, and predictive biomarker models were analyzed by receiver operating characteristic (ROC) analysis. Topological pathway analysis was used to identify perturbed pathways. Two hundred twenty-two metabolites were identified by 1 H NMR and DI-MS. Differences in the serum metabolome between ACLR and Control were dominated by medium- and long-chain acylcarnitine species. Further, decreases in several tryptophan metabolites were either found to be significantly different in univariate analysis or to play important contributory roles to multivariate model separation. In addition to acylcarnitines and tryptophan metabolites, glycine, carnosine, and D-mannose were found to differentiate ACLR from Control. Glycine, 9-hexadecenoylcarnitine, trans-2-Dodecenoylcarnitine, linoelaidyl carnitine, hydroxypropionylcarnitine, and D-Mannose were identified as biomarkers with high area under ROC curve values and high predictive accuracies. Our analysis provides new information regarding the potential contribution of inflammatory processes and immune dysregulation to the onset and progression of PTOA following ACL injury. As these processes have most commonly been associated with inflammatory arthropathies, larger-scale studies elucidating their involvement in PTOA development and progression are necessary. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1969-1979, 2018.
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Affiliation(s)
- Tristan Maerz
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan.,Beaumont Research Institute, Orthopaedic Research Laboratories, Royal Oak, Michigan
| | - Eric Sherman
- Beaumont Research Institute, Metabolomics Division, OB/GYN, Royal Oak, Michigan
| | - Michael Newton
- Beaumont Research Institute, Orthopaedic Research Laboratories, Royal Oak, Michigan
| | - Ali Yilmaz
- Beaumont Research Institute, Metabolomics Division, OB/GYN, Royal Oak, Michigan
| | - Praveen Kumar
- Beaumont Research Institute, Metabolomics Division, OB/GYN, Royal Oak, Michigan
| | - Stewart F Graham
- Beaumont Research Institute, Metabolomics Division, OB/GYN, Royal Oak, Michigan
| | - Kevin C Baker
- Beaumont Research Institute, Orthopaedic Research Laboratories, Royal Oak, Michigan
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13
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Blood Flow Restriction Training in Rehabilitation Following Anterior Cruciate Ligament Reconstructive Surgery: A Review. Tech Orthop 2018. [DOI: 10.1097/bto.0000000000000265] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Sieker JT, Proffen BL, Waller KA, Chin KE, Karamchedu NP, Akelman MR, Perrone GS, Kiapour AM, Konrad J, Fleming BC, Murray MM. Transcriptional profiling of synovium in a porcine model of early post-traumatic osteoarthritis. J Orthop Res 2018; 36:10.1002/jor.23876. [PMID: 29460983 PMCID: PMC6102098 DOI: 10.1002/jor.23876] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 02/15/2018] [Indexed: 02/04/2023]
Abstract
To determine the transcriptional profile of synovium during the molecular phase of post-traumatic osteoarthritis, anterior cruciate ligament transections (ACL) were performed in 36 Yucatan minipigs. Equal numbers were randomly assigned to no further treatment, ACL reconstruction or repair. Perimeniscal synovium for histopathology and RNA-sequencing was harvested at 1 and 4 weeks post-operatively and from six healthy control animals. Microscopic synovitis scores significantly worsened at 1 (p < 0.001) and 4 weeks (p = 0.003) post-surgery relative to controls, and were driven by intimal hyperplasia and increased stromal cellularity without inflammatory infiltrates. Synovitis scores were similar between no treatment, reconstruction, and repair groups (p ≥ 0.668). Relative to no treatment at 1 week, 88 and 367 genes were differentially expressed in the reconstruction and repair groups, respectively (227 and 277 at 4 weeks). Relative to controls and with the treatment groups pooled, 1,683 transcripts were concordantly differentially expressed throughout the post-surgery time-course. Affected pathways included, proteolysis_connective tissue degradation (including upregulations of protease-encoding MMP1, MMP13, and ADAMTS4), and development_cartilage development (including upregulations of ACAN, SOX9, and RUNX2), among others. Using linear regression, significant associations of post-surgery synovial expression levels of 20 genes with the articular cartilage glycosaminoglycan loss were identified. These genes were predominantly related to embryonic skeletal system development and included RUNX2. In conclusion, this study confirmed an increased synovial expression of genes that may serve as targets to prevent cartilage degradation, including MMP1, MMP13, and ADAMTS4, in knees with microscopic synovitis and cartilage proteoglycan loss. Attractive novel targets include regulators of embryonic developmental processes in synovium. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
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Affiliation(s)
- Jakob T. Sieker
- Boston Children's Hospital, Harvard Medical School, Boston, MA
| | | | - Kimberly A. Waller
- Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI
| | - Kaitlyn E. Chin
- Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI
| | | | - Matthew R. Akelman
- Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI
| | | | - Ata M. Kiapour
- Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Johannes Konrad
- Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Braden C. Fleming
- Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI
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15
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Qu R, Chen X, Wang W, Qiu C, Ban M, Guo L, Vasilev K, Chen J, Li W, Zhao Y. Ghrelin protects against osteoarthritis through interplay with Akt and NF‐κB signaling pathways. FASEB J 2018; 32:1044-1058. [DOI: 10.1096/fj.201700265r] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Ruize Qu
- Department of PathologyShandong UniversityJinanChina
- Medical School of Shandong UniversityShandong UniversityJinanChina
| | - Xiaomin Chen
- Department of PathologyShandong UniversityJinanChina
- Medical School of Shandong UniversityShandong UniversityJinanChina
| | - Wenhan Wang
- Department of OrthopedicsQilu HospitalShandong UniversityJinanChina
- Medical School of Shandong UniversityShandong UniversityJinanChina
| | - Cheng Qiu
- Medical School of Shandong UniversityShandong UniversityJinanChina
| | - Miaomiao Ban
- Medical School of Shandong UniversityShandong UniversityJinanChina
| | - Linlin Guo
- Medical School of Shandong UniversityShandong UniversityJinanChina
| | - Krasimir Vasilev
- School of EngineeringUniversity of South AustraliaMawson LakesSouth AustraliaAustralia
| | - Jianying Chen
- Institute of Biopharmaceuticals of Shandong ProvinceJinanChina
| | - Weiwei Li
- Department of PathologyShandong UniversityJinanChina
| | - Yunpeng Zhao
- Department of OrthopedicsQilu HospitalShandong UniversityJinanChina
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16
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Duan L, Zhang W, Zhang F, Cai H. Myrtol improves post-traumatic knee osteoarthritis by regulation of reactive oxygen species, transforming growth factor β1 and apoptosis in a mouse model. Exp Ther Med 2017; 15:393-399. [PMID: 29250157 DOI: 10.3892/etm.2017.5367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Accepted: 02/10/2017] [Indexed: 12/21/2022] Open
Abstract
The present study tested whether myrtol improves post-traumatic knee osteoarthritis (PTKO) by regulating the reactive oxygen species (ROS), transforming growth factor β1 (TGF-β1) and apoptosis in a mouse model. PTKO model mice were administered with 150, 300 or 450 mg/kg myrtol for 8 weeks. ELISA analysis was used to measure tumor necrosis factor-α, interleukin-6, malondialdehyde, superoxide dismutase, reactive oxygen species and TGF-β1 levels. Caspase-3 and Bax protein expressions were analyzed using western blot analysis. In the current study, treatment with myrtol improved the tissue damage and osteoarthritis score, while it also reversed the subchondral bone thickness, subchondral bone density, trabecular bone volume/relative trabecular bone volume ratio and trabecular bone spacing in PTKO mice. The activity of tumor necrosis factor α, interleukin-6, TGF-β1, malondialdehyde, superoxide dismutase and ROS were effectively inhibited, and the protein expression of caspase-3 and Bax were clearly suppressed by treatment with myrtol in a mouse model of PTKO. In conclusion, the results demonstrated that myrtol treatment improved PTKO through the suppression of inflammation, oxidative stress, ROS, TGF-β1 and Bax/caspase-3 in mice, and myrtol may be a potential agent for clinical therapy.
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Affiliation(s)
- Liqun Duan
- Department of Orthopedics, Anhui Provincial Hospital, Hefei, Anhui 230001, P.R. China
| | - Wenzhi Zhang
- Department of Orthopedics, Anhui Provincial Hospital, Hefei, Anhui 230001, P.R. China
| | - Feng Zhang
- Department of Orthopedics, Anhui Provincial Hospital, Hefei, Anhui 230001, P.R. China
| | - Haiping Cai
- Department of Orthopedics, Anhui Provincial Hospital, Hefei, Anhui 230001, P.R. China
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17
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Abstract
PURPOSE OF REVIEW Because of the epidemiological incidence of anterior cruciate ligament (ACL) injuries, the high reinjury rates that occur when returning back to sports, the actual number of patients that return to the same premorbid level of competition, the high incidence of osteoarthritis at 5-10-year follow-ups, and the effects on the long-term health of the knee and the quality of life for the patient, individualizing the return to sports after ACL reconstruction (ACL-R) is critical. However, one of the challenging but unsolved dilemmas is what criteria and clinical decision making should be used to return an athlete back to sports following an ACL-R. This article describes an example of a functional testing algorithm (FTA) as one method for clinical decision making based on quantitative and qualitative testing and assessment utilized to make informed decisions to return an athlete to their sports safely and without compromised performance. The methods were a review of the best current evidence to support a FTA. RECENT FINDINGS In order to evaluate all the complicated domains of the clinical decision making for individualizing the return to sports after ACL-R, numerous assessments need to be performed including the biopsychosocial concepts, impairment testing, strength and power testing, functional testing, and patient-reported outcomes (PROs). The optimum criteria to use for individualizing the return to sports after ACL-R remain elusive. However, since this decision needs to be made on a regular basis with the safety and performance factors of the patient involved, this FTA provides one method of quantitatively and qualitatively making the decisions. Admittedly, there is no predictive validity of this system, but it does provide practical guidelines to facilitate the clinical decision making process for return to sports. The clinical decision to return an athlete back into competition has significant implications ranging from the safety of the athlete, to performance factors and actual litigation issues. By using a multifactorial FTA, such as the one described, provides quantitative and qualitatively criteria to make an informed decision in the best interests of the athlete.
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Affiliation(s)
- George J Davies
- Physical Therapy Program, Armstrong State University, Savannah, GA, USA.
- Coastal Therapy, Savannah, GA, USA.
- Gundersen Health System, LaCrosse, WI, USA.
| | - Eric McCarty
- Sports Medicine and Performance Center, Colorado University, Boulder, CO, USA
| | - Matthew Provencher
- Steadman Clinic and Steadman Philippon Research Institute, Vail, CO, USA
| | - Robert C Manske
- Department of Physical Therapy, Wichita State University, Via Christi Health, Wichita, KS, USA
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18
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19
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Heard BJ, Beveridge JE, Atarod M, O'Brien EJ, Rolian C, Frank CB, Hart DA, Shrive NG. Analysis of change in gait in the ovine stifle: normal, injured, and anterior cruciate ligament reconstructed. BMC Musculoskelet Disord 2017; 18:212. [PMID: 28535749 PMCID: PMC5442660 DOI: 10.1186/s12891-017-1576-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 05/12/2017] [Indexed: 01/13/2023] Open
Abstract
Background Many patients who undergo anterior cruciate ligament (ACL) reconstructive surgery develop post-traumatic osteoarthritis (PTOA). ACL reconstructive surgery may not fully restore pre-injury joint biomechanics, thereby resulting in further joint damage and contributing to the development of PTOA. In an ovine model of idealized ACL reconstruction (ACL-R), it has been shown that signs of PTOA develop within surgical joints by 20 weeks post-surgery. The aim of the present study was to investigate whether altered kinematics contribute to early PTOA development within ACL-R joints of the ovine injury model by comparing the gait of these surgical animals to the gait of a stable normal control group, and an unstable injury group in which the ACL and medial collateral ligament (MCL) had been transected. Methods Fifteen skeletally mature female sheep were allocated evenly into 3 treatment groups: normal control, ACL-R, and ACL/MCL Tx (each group n = 5). Each animal’s gait was recorded at baseline, 4 weeks post injury, and 20 weeks post injury. Principal component analysis (PCA) was used to identify the kinematic patterns that may be discriminant between treatment groups. Results from previous studies were referenced to present the amount of gross PTOA-like changes that occurred in the joints. Results ACL-R and ACL/MCL transected (Tx) animals developed a similar amount of early PTOA-like changes within the surgical joints, but differed significantly in the amount of kinematic change present at 20 weeks post-surgery. We showed that the stifle joint kinematics of ACL/MCL Tx differed significantly from those of CTRL and the majority of ACL-R animals, while no significant differences in joint kinematic changes were found between ACL-R and CTRL animals. Conclusions These results suggest that the early PTOA-like changes reported in the ACL-R model cannot be attributed exclusively to post-surgical kinematic changes, and therefore biologic components in the post-injury environment must be contributing significantly to PTOA development. Electronic supplementary material The online version of this article (doi:10.1186/s12891-017-1576-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- B J Heard
- The McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
| | - J E Beveridge
- The McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
| | - M Atarod
- The McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
| | - E J O'Brien
- The McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
| | - C Rolian
- The McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada.,Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - C B Frank
- The McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
| | - D A Hart
- The McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
| | - N G Shrive
- The McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada. .,Department of Civil Engineering, University of Calgary, Calgary, AB, Canada.
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20
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Barton KI, Shekarforoush M, Heard BJ, Sevick JL, Vakil P, Atarod M, Martin R, Achari Y, Hart DA, Frank CB, Shrive NG. Use of pre-clinical surgically induced models to understand biomechanical and biological consequences of PTOA development. J Orthop Res 2017; 35:454-465. [PMID: 27256202 DOI: 10.1002/jor.23322] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 05/27/2016] [Indexed: 02/04/2023]
Abstract
Post-traumatic osteoarthritis (PTOA) development is often observed following traumatic knee injuries involving key stabilising structures such as the cruciate ligaments or the menisci. Both biomechanical and biological alterations that follow knee injuries have been implicated in PTOA development, although it has not been possible to differentiate clearly between the two causal factors. This review critically examines the outcomes from pre-clinical lapine and ovine injury models arising in the authors' laboratories and differing in severity of PTOA development and progression. Specifically, we focus on how varying severity of knee injuries influence the subsequent alterations in kinematics, kinetics, and biological outcomes. The immediate impact of injury on the lubrication capacity of the joint is examined in the context of its influence on biomechanical alterations, thus linking the biological changes to abnormal kinematics, leading to a focus on the potential areas for interventions to inhibit or prevent development of the disease. We believe that PTOA results from altered cartilage surface interactions where biological and biomechanical factors intersect, and mitigating acute joint inflammation may be critical to prolonging PTOA development. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:454-465, 2017.
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Affiliation(s)
- Kristen I Barton
- McCaig Institute for Bone & Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Mehdi Shekarforoush
- McCaig Institute for Bone & Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
| | - Bryan J Heard
- McCaig Institute for Bone & Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - John L Sevick
- McCaig Institute for Bone & Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
| | - Paria Vakil
- McCaig Institute for Bone & Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
| | - Mohammad Atarod
- McCaig Institute for Bone & Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
| | - Ryan Martin
- McCaig Institute for Bone & Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Section of Orthopaedics, University of Calgary, Foothills Hospital, Calgary, Alberta, Canada
| | - Yamini Achari
- McCaig Institute for Bone & Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - David A Hart
- McCaig Institute for Bone & Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Cyril B Frank
- McCaig Institute for Bone & Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Nigel G Shrive
- McCaig Institute for Bone & Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
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Hindle P, Baily J, Khan N, Biant LC, Simpson AHR, Péault B. Perivascular Mesenchymal Stem Cells in Sheep: Characterization and Autologous Transplantation in a Model of Articular Cartilage Repair. Stem Cells Dev 2016; 25:1659-1669. [PMID: 27554322 DOI: 10.1089/scd.2016.0165] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Previous research has indicated that purified perivascular stem cells (PSCs) have increased chondrogenic potential compared to conventional mesenchymal stem cells (MSCs) derived in culture. This study aimed to develop an autologous large animal model for PSC transplantation and to specifically determine if implanted cells are retained in articular cartilage defects. Immunohistochemistry and fluorescence-activated cell sorting were used to ascertain the reactivity of anti-human and anti-ovine antibodies, which were combined and used to identify and isolate pericytes (CD34-CD45-CD146+) and adventitial cells (CD34+CD45-CD146-). The purified cells demonstrated osteogenic, adipogenic, and chondrogenic potential in culture. Autologous ovine PSCs (oPSCs) were isolated, cultured, and efficiently transfected using a green fluorescence protein (GFP) encoding lentivirus. The cells were implanted into articular cartilage defects on the medial femoral condyle using hydrogel and collagen membranes. Four weeks following implantation, the condyle was explanted and confocal laser scanning microscopy demonstrated the presence of oPSCs in the defect repaired with the hydrogel. These data suggest the testability in a large animal of native MSC autologous grafting, thus avoiding possible biases associated with xenotransplantation. Such a setting will be used in priority for indications in orthopedics, at first to model articular cartilage repair.
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Affiliation(s)
- Paul Hindle
- 1 MRC Centre for Regenerative Medicine, The University of Edinburgh , Edinburgh, United Kingdom
- 2 Department of Trauma and Orthopaedic Surgery, The Royal Infirmary of Edinburgh , Edinburgh, United Kingdom
| | - James Baily
- 1 MRC Centre for Regenerative Medicine, The University of Edinburgh , Edinburgh, United Kingdom
| | - Nusrat Khan
- 1 MRC Centre for Regenerative Medicine, The University of Edinburgh , Edinburgh, United Kingdom
| | - Leela C Biant
- 2 Department of Trauma and Orthopaedic Surgery, The Royal Infirmary of Edinburgh , Edinburgh, United Kingdom
| | - A Hamish R Simpson
- 2 Department of Trauma and Orthopaedic Surgery, The Royal Infirmary of Edinburgh , Edinburgh, United Kingdom
| | - Bruno Péault
- 1 MRC Centre for Regenerative Medicine, The University of Edinburgh , Edinburgh, United Kingdom
- 3 The University of California , Los Angeles, Los Angeles, California
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22
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Koizumi K, Ebina K, Hart DA, Hirao M, Noguchi T, Sugita N, Yasui Y, Chijimatsu R, Yoshikawa H, Nakamura N. Synovial mesenchymal stem cells from osteo- or rheumatoid arthritis joints exhibit good potential for cartilage repair using a scaffold-free tissue engineering approach. Osteoarthritis Cartilage 2016; 24:1413-22. [PMID: 26973329 DOI: 10.1016/j.joca.2016.03.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 03/03/2016] [Accepted: 03/04/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess whether synovial mesenchymal stem cells (SMSCs) from patients with osteoarthritis (OA) or rheumatoid arthritis (RA) can be used as an alternative cell source for cartilage repair using allogenic tissue engineered construct (TEC). METHODS Twenty-five patients (17 female, average age 61.8 years) were divided according to their pathology (control trauma group; N = 6, OA group; N = 6) and RA patients were subdivided into two groups to evaluate the impact of biologics in accordance with whether treated with biologics [Bio(+)RA; N = 7] or not [Bio(-)RA; N = 6]. We compared the following characteristics among these groups: (1) The cell proliferation capacity of SMSCs; (2) The influence of passage number on features of SMSCs; (3) The weight and volume of TEC from the same number of SMSCs; (4) Inflammatory cytokine gene expressions levels of TEC; (5) The chondrogenic potential of TEC; and (6) Osteochondral repair using TEC in athymic nude rats. RESULTS SMSCs from the four groups exhibited equivalent features in the above evaluation items. In in vivo studies, the TEC-treated repair tissues for all groups exhibited significantly better outcomes than those for the untreated group and no significant differences among the four TEC groups. CONCLUSION SMSCs from OA or RA patients are no less appropriate for repairing cartilage than those from trauma patients and thus, may be an effective source for allogenic cell-based cartilage repair.
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Affiliation(s)
- K Koizumi
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - K Ebina
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - D A Hart
- McCaig Institute for Bone and Joint Health, University of Calgary, Canada
| | - M Hirao
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - T Noguchi
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - N Sugita
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Y Yasui
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - R Chijimatsu
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - H Yoshikawa
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - N Nakamura
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan; Institute for Medical Science in Sports, Osaka Health Science University, 1-9-27, Tennma, Kita-ku, Osaka 530-0043, Japan.
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Akelman MR, Fadale PD, Hulstyn MJ, Shalvoy RM, Garcia A, Chin KE, Duryea J, Badger GJ, Tung GA, Fleming BC. Effect of Matching or Overconstraining Knee Laxity During Anterior Cruciate Ligament Reconstruction on Knee Osteoarthritis and Clinical Outcomes: A Randomized Controlled Trial With 84-Month Follow-up. Am J Sports Med 2016; 44:1660-70. [PMID: 27159308 PMCID: PMC4930731 DOI: 10.1177/0363546516638387] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The "initial graft tension" applied at the time of graft fixation during anterior cruciate ligament (ACL) reconstruction surgery modulates joint contact mechanics, which in turn may promote posttraumatic osteoarthritis (OA). PURPOSE/HYPOTHESES The study objectives were to compare clinical, functional, patient-reported, and OA imaging outcomes between 2 different initial laxity-based graft tension cohorts and a matched uninjured control group as well as to evaluate the effects of laxity-based graft tension on OA development at 84-month follow-up. The 2 laxity-based tension protocols were (1) to restore normal anteroposterior (AP) laxity at the time of surgery relative to the contralateral uninjured knee (low-tension group) or (2) to overconstrain AP laxity by 2 mm relative to the contralateral uninjured knee (high-tension group). The hypotheses were that (1) the high-tension group would have improved outcomes and decreased OA compared with the low-tension group after 84 months, and (2) the outcomes for the high-tension group would be equivalent to those for an age-, sex-, race-, and activity-matched group of control participants with uninjured knees. STUDY DESIGN Randomized controlled trial; Level of evidence, 1. METHODS Patients had their ACLs reconstructed with either a bone-patellar tendon-bone or 4-stranded hamstring autograft, and outcomes were compared with a matched control group. Outcomes were evaluated preoperatively and at 60 and 84 months postoperatively and included clinical (KT-1000 arthrometer AP laxity measurement and International Knee Documentation Committee [IKDC] examination score), functional (1-legged hop for distance and knee extensor torque), patient-reported (Knee injury and Osteoarthritis Outcome Score [KOOS], Short Form-36 [SF-36], and patient satisfaction survey), and OA imaging (measurement of joint space width [JSW], Osteoarthritis Research Society International [OARSI] radiographic score, and Whole-Organ Magnetic Resonance Imaging Score [WORMS]) components. Repeated-measures analyses of variance were used to evaluate differences in outcomes between the treatment groups and the control group. RESULTS There were significant differences between the 2 tension groups in 1 of 5 KOOS subscales (sports and recreation; P = .04) and 2 of 8 SF-36 subscales (vitality, mental health; P < .04) at 84 and 60 months, respectively. Both tension groups scored significantly worse than the control group in the IKDC examination (P < .001), 1-legged hop (P ≤ .017), KOOS quality of life and symptoms subscales (P < .03), and OARSI radiographic score (P ≤ .02) at 84 months. The low-tension group performed significantly worse than the control group on the KOOS pain subscale (P = .03), SF-36 general health and social functioning (P < .04), OARSI radiographic score (P < .001), and WORMS (P = .001), while the high-tension group had statistically different results than the control group in AP knee laxity (P < .001), radiographic JSW (P = .003), and OARSI radiographic score (P = .02) as well as significantly more subsequent knee injuries (P = .02) at 84 months. CONCLUSION The results do not support the hypotheses that the high-tension group would have improved outcomes when compared with the low-tension group after 84 months of healing or that the outcomes for the high-tension group would be equivalent to those for the matched control group. While there were minor differences in patient-reported outcomes between the 2 laxity-based tension groups, all other outcomes were similar. REGISTRATION NCT00434837.
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Affiliation(s)
- Matthew R. Akelman
- College of Medicine, Medical University of South Carolina, Charleston, SC
| | - Paul D. Fadale
- Dept of Orthopaedics, Brown University/Rhode Island Hospital, Providence, RI
| | - Michael J. Hulstyn
- Dept of Orthopaedics, Brown University/Rhode Island Hospital, Providence, RI
| | - Robert M. Shalvoy
- Dept of Orthopaedics, Brown University/Memorial Hospital, Providence RI
| | - Arlene Garcia
- Dept of Orthopaedics, Brown University/Rhode Island Hospital, Providence, RI
| | - Kaitlyn E. Chin
- Dept of Orthopaedics, Brown University/Rhode Island Hospital, Providence, RI
| | - Jeffrey Duryea
- Dept of Radiology, Brigham and Women’s Hospital/Harvard, Boston MA
| | - Gary J. Badger
- Dept of Medical Biostatistics, University of Vermont, Burlington, VM
| | - Glenn A. Tung
- Dept of Diagnostic Imaging, Brown University/Rhode Island Hospital, Providence, RI
| | - Braden C. Fleming
- Dept of Orthopaedics, Brown University/Rhode Island Hospital, Providence, RI
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24
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Deledda D, Rosso F, Cottino U, Bonasia DE, Rossi R. Results of meniscectomy and meniscal repair in anterior cruciate ligament reconstruction. JOINTS 2016; 3:151-7. [PMID: 26889472 DOI: 10.11138/jts/2015.3.3.151] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Meniscal tears are commonly associated with anterior cruciate ligament (ACL) injuries. A deficient medial meniscus results in knee instability and could lead to higher stress forces on the ACL reconstruction. Comparison of results in meniscectomy and meniscal repairs revealed worse clinical outcomes in meniscectomy, but higher re-operation rates in meniscal repairs. Our aim was to review the results of ACL reconstruction associated with meniscectomy or meniscal repair.
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Affiliation(s)
- Davide Deledda
- Department of Orthopedic and Traumatology, H. Umberto I, Torino, Italy
| | - Federica Rosso
- Department of Orthopedic and Traumatology, H. Umberto I, Torino, Italy
| | - Umberto Cottino
- Department of Orthopedic and Traumatology, H. Umberto I, Torino, Italy
| | | | - Roberto Rossi
- Department of Orthopedic and Traumatology, H. Umberto I, Torino, Italy
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25
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Heard BJ, Barton KI, Chung M, Achari Y, Shrive NG, Frank CB, Hart DA. Single intra-articular dexamethasone injection immediately post-surgery in a rabbit model mitigates early inflammatory responses and post-traumatic osteoarthritis-like alterations. J Orthop Res 2015; 33:1826-34. [PMID: 26135713 DOI: 10.1002/jor.22972] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 06/24/2015] [Indexed: 02/04/2023]
Abstract
Despite surgical reconstruction of the anterior cruciate ligament, a significant number of patients will still develop post-traumatic osteoarthritis (PTOA). Our objective was to determine if mitigating aspects of the acute phase of inflammation following a defined knee surgery with a single administration of a glucocorticoid could prevent the development of PTOA-like changes within an established rabbit model of surgically induced PTOA. An early and late post-surgical time-point was investigated in this study (48 h and 9 weeks post-surgery) in which the following groups were repeated (each n=6, for a total of 24 rabbits per time-point, and 48 rabbits used in the study): control (age/sex matched), sham (arthrotomy), drill injury (arthrotomy+two drill holes to a non-cartilaginous area of the femoral notch), and drill injury+single intra-articular (IA) injection of dexamethasone (DEX). At 48 h post-surgery, DEX treatment significantly lowered the mRNA levels for a subset of pro-inflammatory mediators, and significantly lowered the histological grade. Nine weeks post surgery, DEX treatment significantly lowered the histological scores (presented as effect size) for synovium (3.8), lateral femoral condyle (3.9), and lateral tibial cartilage (5.1) samples. Thus, DEX likely acts to prevent injury induced inflammation that could contribute to subsequent joint damage.
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Affiliation(s)
- Bryan J Heard
- Department of Surgery, University of Calgary, McCaig Institute for Bone and Joint Health, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Kristen I Barton
- Department of Surgery, University of Calgary, McCaig Institute for Bone and Joint Health, Cumming School of Medicine, Calgary, Alberta, Canada
| | - May Chung
- Department of Surgery, University of Calgary, McCaig Institute for Bone and Joint Health, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Yamini Achari
- Department of Surgery, University of Calgary, McCaig Institute for Bone and Joint Health, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Nigel G Shrive
- Department of Surgery, University of Calgary, McCaig Institute for Bone and Joint Health, Cumming School of Medicine, Calgary, Alberta, Canada.,Department of Civil Engineering, University of Calgary, Calgary, Alberta, Canada
| | - Cyril B Frank
- Department of Surgery, University of Calgary, McCaig Institute for Bone and Joint Health, Cumming School of Medicine, Calgary, Alberta, Canada
| | - David A Hart
- Department of Surgery, University of Calgary, McCaig Institute for Bone and Joint Health, Cumming School of Medicine, Calgary, Alberta, Canada
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26
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Clinical Trial and In Vitro Study for the Role of Cartilage and Synovia in Acute Articular Infection. Mediators Inflamm 2015; 2015:430324. [PMID: 26640325 PMCID: PMC4657131 DOI: 10.1155/2015/430324] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 10/08/2015] [Accepted: 10/12/2015] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Osteoarthritis is a long-term complication of acute articular infections. However, the roles of cartilage and synovia in this process are not yet fully understood. METHODS Patients with acute joint infections were enrolled in a prospective clinical trial and the cytokine composition of effusions compared in patients with arthroplasty (n = 8) or with intact joints (n = 67). Cytokines and cell function were also analyzed using a human in vitro model of joint infection. RESULTS Synovial IL-1β levels were significantly higher in patients with arthroplasty (p = 0.004). Higher IL-1β concentrations were also found in the in vitro model without chondrocytes (p < 0.05). The anti-inflammatory cytokines IL-4 and IL-10 were consistently expressed in vivo and in vitro, showing no association with the presence of cartilage or chondrocytes. In contrast, FasL levels increased steadily in vitro, reaching higher levels without chondrocytes (p < 0.05). Likewise, the viability of synovial fibroblasts (SFB) during infection was higher in the presence of chondrocytes. The cartilage-metabolism markers aggrecan and bFGF were at higher concentrations in intact joints, but also synthesized by SFB. CONCLUSIONS Our data suggest an anti-inflammatory effect of cartilage associated with the SFBs' increased resistance to infections, which displayed the ability to effectively synthesize cartilage metabolites.The trial is registered with DRKS 00003536, MISSinG.
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27
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Inflammation in joint injury and post-traumatic osteoarthritis. Osteoarthritis Cartilage 2015; 23:1825-34. [PMID: 26521728 PMCID: PMC4630675 DOI: 10.1016/j.joca.2015.08.015] [Citation(s) in RCA: 293] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 08/24/2015] [Accepted: 08/28/2015] [Indexed: 02/07/2023]
Abstract
Inflammation is a variable feature of osteoarthritis (OA), associated with joint symptoms and progression of disease. Signs of inflammation can be observed in joint fluids and tissues from patients with joint injuries at risk for development of post-traumatic osteoarthritis (PTOA). Furthermore, inflammatory mechanisms are hypothesized to contribute to the risk of OA development and progression after injury. Animal models of PTOA have been instrumental in understanding factors and mechanisms involved in chronic progressive cartilage degradation observed after a predisposing injury. Specific aspects of inflammation observed in humans, including cytokine and chemokine production, synovial reaction, cellular infiltration and inflammatory pathway activation, are also observed in models of PTOA. Many of these models are now being utilized to understand the impact of post-injury inflammatory response on PTOA development and progression, including risk of progressive cartilage degeneration and development of chronic symptoms post-injury. As evidenced from these models, a vigorous inflammatory response occurs very early after joint injury but is then sustained at a lower level at the later phases. This early inflammatory response contributes to the development of PTOA features including cartilage erosion and is potentially modifiable, but specific mediators may also play a role in tissue repair. Although the optimal approach and timing of anti-inflammatory interventions after joint injury are yet to be determined, this body of work should provide hope for the future of disease modification tin PTOA.
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28
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Thomas N, Li P, Fleming BC, Chen Q, Wei X, Pan XH, Wei L, Wei L. Attenuation of cartilage pathogenesis in post-traumatic osteoarthritis (PTOA) in mice by blocking the stromal derived factor 1 receptor (CXCR4) with the specific inhibitor, AMD3100. J Orthop Res 2015; 33:1071-8. [PMID: 25732515 PMCID: PMC4557642 DOI: 10.1002/jor.22862] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 02/08/2015] [Indexed: 02/04/2023]
Abstract
SDF-1 was found to infiltrate cartilage, decrease proteoglycan content, and increase MMP-13 activity after joint trauma. In this study, we tested the hypothesis that interference of the SDF-1/CXCR4 signaling pathway via AMD3100 can attenuate pathogenesis in a mouse model of PTOA. We also tested the predictive and confirmatory power of fluorescence molecular tomography (FMT) for cartilage assessment. AMD3100 was continuously delivered via mini-osmotic pumps. The extent of cartilage damage after AMD3100 or PBS treatment was assessed by histological analysis 2 months after PTOA was induced by surgical destabilization of the medial meniscus (DMM). Biochemical markers of PTOA were assessed via immunohistochemistry and in vivo fluorescence molecular tomography (FMT). Regression analysis was used to validate the predictive power of FMT measurements. Safranin-O staining revealed significant PTOA damage in the DMM/PBS mice, while the DMM/AMD3100 treated mice showed a significantly reduced response with minimal pathology. Immunohistochemistry showed that AMD3100 treatment markedly reduced typical PTOA marker expression in chondrocytes. FMT measurements showed decreased cathepsins and MMP activity in knee joints after treatment. The results demonstrate that AMD3100 treatment attenuates PTOA. AMD3100 may provide a viable and expedient option for PTOA therapy given the drug's FDA approval and well-known safety profile.
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Affiliation(s)
- Nathan Thomas
- Department of Orthopaedics, Warren Alpert Medical School of Brown University/RIH, CORO West, Suite 402H, 1 Hoppin Street, Providence RI 02903
| | - Pengcui Li
- Department of Orthopaedics, Warren Alpert Medical School of Brown University/RIH, CORO West, Suite 402H, 1 Hoppin Street, Providence RI 02903.,Department of Orthopaedics, the Second Hospital of Shanxi Medical University; Shanxi Key Lab of Bone and Soft Tissue Injury Repair. Taiyuan, China
| | - Braden C. Fleming
- Department of Orthopaedics, Warren Alpert Medical School of Brown University/RIH, CORO West, Suite 402H, 1 Hoppin Street, Providence RI 02903
| | - Qian Chen
- Department of Orthopaedics, Warren Alpert Medical School of Brown University/RIH, CORO West, Suite 402H, 1 Hoppin Street, Providence RI 02903
| | - Xiaochun Wei
- Department of Orthopaedics, the Second Hospital of Shanxi Medical University; Shanxi Key Lab of Bone and Soft Tissue Injury Repair. Taiyuan, China
| | - Xiao-Hua Pan
- Department of Orthopedics, Shenzhen Second Hospital. Shenzhen, China
| | - Lei Wei
- Department of Orthopaedics, Warren Alpert Medical School of Brown University/RIH, CORO West, Suite 402H, 1 Hoppin Street, Providence RI 02903.,Department of Orthopaedics, the Second Hospital of Shanxi Medical University; Shanxi Key Lab of Bone and Soft Tissue Injury Repair. Taiyuan, China., Author to whom correspondence should be addressed; ; Tel.: +1-401-793-8384; Fax: +1-401-444-6140
| | - Lei Wei
- Department of Orthopaedics, Warren Alpert Medical School of Brown University/RIH, CORO West, Suite 402H, 1 Hoppin Street, Providence, Rhode Island, 02903.,Department of Orthopaedics, The Second Hospital of Shanxi Medical University, Shanxi Key Lab of Bone and Soft Tissue Injury Repair, Taiyuan, China
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29
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Solbak NM, Heard BJ, Achari Y, Chung M, Shrive NG, Frank CB, Hart DA. Alterations in Hoffa’s fat pad induced by an inflammatory response following idealized anterior cruciate ligament surgery. Inflamm Res 2015; 64:615-26. [DOI: 10.1007/s00011-015-0840-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 05/19/2015] [Accepted: 06/05/2015] [Indexed: 12/28/2022] Open
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30
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Elsaid KA, Zhang L, Shaman Z, Patel C, Schmidt TA, Jay GD. The impact of early intra-articular administration of interleukin-1 receptor antagonist on lubricin metabolism and cartilage degeneration in an anterior cruciate ligament transection model. Osteoarthritis Cartilage 2015; 23:114-21. [PMID: 25219670 PMCID: PMC4275352 DOI: 10.1016/j.joca.2014.09.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 08/13/2014] [Accepted: 09/02/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Study the impact of intra-articular interleukin-1 receptor antagonist (IL-1 ra) treatment on lubricin biosynthesis following anterior cruciate ligament transection (ACLT) in the rat and evaluate the effect of combined IL-1 ra and recombinant human lubricin (rhPRG4) treatments on chondrocyte apoptosis. METHODS ACLT was performed in male Lewis rats. Treatments included IL-1 ra or vehicle (n = 36 in each group). IL-1 ra intra-articular dosing was performed on days 1, 3, 5 and 7 following ACLT using Anakinra (150 mg/ml; 40 μl). At 3 and 5 weeks, animals were sacrificed and RNA was isolated. Histological analyses included Safranin O and H&E. Lubricin synovial fluid (SF) lavage concentrations were determined at 5 weeks. ACLT animals were treated with a single injection of vehicle, IL-1 ra (75 mg/ml; 40 μl), rhPRG4 (200 μg/ml; 40 μl), or IL-1 ra + rhPRG4 (75 mg/ml + 200 μg/ml; 40 μl) (n = 6 in each group) on day 7 following ACLT and cartilage was probed for cleaved caspase-3 at 5 weeks. RESULTS IL-1 ra treatment improved lubricin expression (P < 0.001) and lubricin SF lavage concentrations in the IL-1 ra group was higher (P = 0.005) than the vehicle. IL-1 ra treatment reduced cartilage and synovial scores (P < 0.001) compared to vehicle. IL-1 ra and rhPRG4 acted synergistically to reduce caspase-3 positive chondrocytes (P < 0.001) compared to individual treatments. CONCLUSION IL-1 ra treatment preserved lubricin following ACLT and a combined treatment of IL-1 ra + rhPRG4 may act synergistically to reduce cartilage catabolism.
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Affiliation(s)
- KA Elsaid
- Department of Pharmaceutical Sciences, MCPHS University, Boston, MA 02115
| | - L Zhang
- Department of Emergency Medicine, Rhode Island Hospital, Providence, RI 02903
| | - Z Shaman
- Department of Pharmaceutical Sciences, MCPHS University, Boston, MA 02115
| | - C Patel
- Department of Pharmaceutical Sciences, MCPHS University, Boston, MA 02115
| | - TA Schmidt
- Faculty of Kinesiology and Schulich School of Engineering, University of Calgary
| | - GD Jay
- Department of Emergency Medicine, Rhode Island Hospital, Providence, RI 02903
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31
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Almeida D, Barletta M, Mathews L, Graham L, Quandt J. Comparison between invasive blood pressure and a non-invasive blood pressure monitor in anesthetized sheep. Res Vet Sci 2014; 97:582-6. [DOI: 10.1016/j.rvsc.2014.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 07/24/2014] [Accepted: 10/05/2014] [Indexed: 10/24/2022]
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32
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Haslauer CM, Proffen BL, Johnson VM, Hill A, Murray MM. Gene expression of catabolic inflammatory cytokines peak before anabolic inflammatory cytokines after ACL injury in a preclinical model. JOURNAL OF INFLAMMATION-LONDON 2014; 11:34. [PMID: 25400511 PMCID: PMC4232656 DOI: 10.1186/s12950-014-0034-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 10/08/2014] [Indexed: 12/28/2022]
Abstract
Background The response of the joint to anterior cruciate ligament (ACL) injury has not been fully characterized. In particular, the characterization of both catabolic factors, including interleukin-6 (IL-6), interleukin-8 (IL-8), and markers of ongoing tissue damage (CRP), and anabolic factors, including vascular endothelial growth factor (VEGF), transforming growth factor β-induced (TGFβI), and the presence of CD163+ macrophages, have not been well defined. In this study, we hypothesized ACL injury would catalyze both catabolic and anabolic processes and that these would have different temporal profiles of expression. Methods Adolescent Yucatan minipigs were subjected to ACL transection. Within the joint, gene expression levels of IL-6, IL-8, VEGF, and TGFβI were quantified in the synovium, ligament, and provisional scaffold located between the torn ligament ends at days 1, 5, 9, and 14 post-injury. Macrophage infiltration was also assessed in the joint tissues over the two week period. Serum C-reactive protein (CRP) levels were measured at multiple time points between 1 hour to 14 days after injury. Results Increases in IL-6 and IL-8 gene expression peaked at day 1 after injury in the synovium and ligament. CRP levels were significantly increased at day 3 before returning to pre-injury levels. VEGF and TGFβI gene expression did not significantly increase until day 9 in the synovium and were unchanged in the other tissues. CD163+ macrophages increased in the ligament and synovium until day 9. Conclusion Taken together, these results suggest that the response within the joint is primarily catabolic in the first three days after injury, switching to a more anabolic phase by nine days after injury. The effect of medications which alter these processes may thus depend on the timing of administration after injury.
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Affiliation(s)
- Carla M Haslauer
- Department of Orthopaedic Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115 USA
| | - Benedikt L Proffen
- Department of Orthopaedic Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115 USA
| | - Victor M Johnson
- Department of Anesthesiology, Boston Children's Hospital, Boston, MA USA
| | - Adele Hill
- Department of Orthopaedic Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115 USA ; Department of Genetics, Harvard Medical School, Boston, MA USA
| | - Martha M Murray
- Department of Orthopaedic Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115 USA
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