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Lim J, Lee J, Park S, Lee J, Kim J, Park J. Change in Femoral Cartilage Cross-Sectional Area After Aerobic and Resistance Exercise. Int J Sports Med 2024; 45:705-711. [PMID: 38631375 DOI: 10.1055/a-2308-3148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
We compared the immediate response and recovery of femoral cartilage morphology following aerobic or resistance exercise to a control condition. Fifteen healthy young males (23.9 years; 170.1 cm; 69.7 kg) visited the laboratory three separate days and randomly performed one of the 30-min exercise aerobic exercises (treadmill running), resistance exercises (leg presses, back squats, and knee extensions), or seated rest as the control, each followed by the 50-min recovery. Ultrasonographic images of the femoral cartilage cross-sectional area (CSA) were obtained before and after exercise and every 5 min thereafter. To test exercise effects over time, a mixed model analysis of variance and Tukey-Kramer post-hoc tests were performed (p<0.05). The femoral cartilage CSA was different (condition×time: F34,742=4.30, p<0.0001) and the femoral cartilage CSA was decreased after the aerobic (-5.8%, p<0.0001) and the resistance (-3.4%, p=0.04) exercises compared to the pre-exercise levels. Deformed femoral cartilage CSA took 35 and 10 min to return to the pre-exercise levels after aerobic and resistance exercises (p+>+0.09), respectively. Thirty minutes of moderate exertion performing aerobic or resistance exercises immediately reduced the femoral cartilage CSA. A rest period ranging from 10 to 35 min was required for cartilage recovery after weight-bearing exercises.
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Affiliation(s)
- Junhyeong Lim
- Sports Medicine, Kyung Hee University - Global Campus, Yongin, Korea (the Republic of)
| | - Jaewook Lee
- Sports Medicine, Kyung Hee University - Global Campus, Yongin, Korea (the Republic of)
| | - Sanghyup Park
- Sports Medicine, Kyung Hee University - Global Campus, Yongin, Korea (the Republic of)
| | - Jinwoo Lee
- Sports Medicine, Kyung Hee University - Global Campus, Yongin, Korea (the Republic of)
| | - Jaewon Kim
- Sports Medicine, Kyung Hee University - Global Campus, Yongin, Korea (the Republic of)
| | - Jihong Park
- Sports Medicine, Kyung Hee University, Yongin, Korea (the Republic of)
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Battersby HS, Evans RJ, Eghobamien IJ, Pamukoff DN. Measurement Position Influences Sex Comparisons of Distal Femoral Cartilage Thickness With Ultrasound Imaging. J Appl Biomech 2024; 40:333-345. [PMID: 39013453 DOI: 10.1123/jab.2024-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/01/2024] [Accepted: 04/30/2024] [Indexed: 07/18/2024]
Abstract
The purpose was to examine (1) the effect of measurement position and sex on femoral cartilage outcomes, and (2) the association between gait biomechanics and cartilage outcomes. Fifty individuals participated (25 males and 25 females; age = 20.62 [1.80] y). Ultrasound measured femoral cartilage thickness and echo-intensity at 90°, 115°, and 140° of knee flexion. Gait outcomes included the external knee adduction and knee flexion moments. Cartilage outcomes were compared using 2 (sex) × 3 (position) repeated-measures analysis of variance. Gait and cartilage associations were assessed using stepwise regression. Medial cartilage was thicker when measured at 90° compared with 115° (P = .02) and 140° (P < .01), and 115° compared with 140°, (P < .01) in males but not in females. Cartilage was thicker at 90° compared with 140° across both sexes within all regions (P < .01). Males had thicker cartilage than females in all positions (P < .01). Echo-intensity was lower at 90° than 115° (P < .01) and 140° (P = .01) in the central and lower at 90° than at 115° (P < .01) and 140° (P = .03) in lateral regions. No association was found between gait and cartilage outcomes. Ultrasound imaging position effects cartilage features more in males compared with females. Imaging position and sex influence cartilage outcomes and should be considered in study designs and clinical evaluation.
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Affiliation(s)
| | - Ryan J Evans
- School of Kinesiology, Western University, London, ON, Canada
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Battersby HS, Holmes SC, Shumski EJ, Heredia CE, Garcia SA, Pamukoff DN. The Influence of Knee Position on Ultrasound Imaging of Femoral Cartilage in Individuals with Anterior Cruciate Ligament Reconstruction. Cartilage 2024; 15:84-93. [PMID: 37846037 DOI: 10.1177/19476035231205682] [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] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Articular cartilage is important for knee function and can be imaged using ultrasound. The purpose was to compare femoral cartilage thickness and echo intensity (EI) measured at 90° and 140° of knee flexion and between limbs in a cohort with unilateral anterior cruciate ligament reconstruction (ACLR). We also examined associations between gait biomechanics and cartilage outcomes. METHODS Twenty-seven individuals with primary unilateral ACLR participated (12 men, 15 women; age = 22.3 ± 3.8 years; time since ACLR = 71.2 ± 47.2 months). Ultrasound was used to obtain femoral cartilage measurements. Gait outcomes included peak KFA (knee flexion angle) and peak external knee flexion moment (KFM). Cartilage outcomes were compared using a 2 (position) × 2 (limb) repeated measures ANOVA (analysis of variance). Gait and cartilage associations were assessed using linear regression. FINDINGS There were no position × limb interactions for any cartilage outcome (all P > 0.05). Medial (P = 0.038) and central cartilage (P < 0.001) were thicker, whereas central (P = 0.029) and lateral cartilage EI (P = 0.003) were lower when measured at 90° than those at 140° of knee flexion. Medial cartilage was thicker in the ACLR than that in the contralateral limb (P = 0.016). A larger KFM was associated with thicker medial cartilage (ΔR2 = 0.146, P = 0.021) and central cartilage (ΔR2 = 0.159, P = 0.039) measured at 140° of knee flexion in the ACLR limb but not at 90°. INTERPRETATION Findings suggest that imaging position influences cartilage thickness and EI measurements in individuals with ACLR and should be considered in study designs and clinical evaluation. A greater KFM was associated with thicker cartilage within specific portions of the distal femur.
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Affiliation(s)
| | - Skylar C Holmes
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - Eric J Shumski
- Department of Kinesiology, University of Georgia, Athens, GA, USA
| | | | - Steven A Garcia
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
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Azami P, Ashraf A, Yousefi O, Hosseinpour A, Nasiri A. Impact of treadmill running on distal femoral cartilage thickness: a cross-sectional study of professional athletes and healthy controls. BMC Sports Sci Med Rehabil 2024; 16:104. [PMID: 38711058 DOI: 10.1186/s13102-024-00896-4] [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: 08/28/2023] [Accepted: 05/02/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE This present study aimed to assess the impact of treadmill running on distal femoral cartilage thickness. METHODS Professional athletes aged 20 to 40 years with a history of treadmill running (minimum 75 min per week for the past three months or more) and age-, sex-, and body mass index (BMI)-matched healthy controls were recruited. Demographics and clinical features of participants were recorded. Athletes were divided into subgroup 1 with less than 12 months of treadmill running and subgroup 2 with 12 months or more of treadmill running. Distal femoral cartilage thicknesses were measured at the midpoints of the right medial condyle (RMC), right intercondylar area (RIA), right lateral condyle (RLC), left medial condyle (LMC), left intercondylar area (LIA), and left lateral condyle (LLC) via ultrasonography. RESULT A total of 72 athletes (mean age: 29.6 ± 6.6 years) and 72 controls (mean age: 31.9 ± 6.7 years) were enrolled. Athletes had significantly thinner cartilages in the RLC (2.21 ± 0.38 vs. 2.39 ± 0.31 cm, p = 0.002), LLC (2.28 ± 0.37 vs. 2.46 ± 0.35 cm, p = 0.004), and LMC (2.28 ± 0.42 vs. 2.42 ± 0.36 cm, p = 0.039) compared with the control group. Furthermore, cartilage thickness was significantly thinner in subgroup 2 athletes compared with the control group in the RLC (2.13 ± 0.34 vs. 2.39 ± 0.31 cm, p = 0.001), LLC (2.22 ± 0.31 vs. 2.46 ± 0.35 cm, p = 0.005), and LMC (2.21 ± 0.46 vs. 2.42 ± 0.36 cm, p = 0.027); however, subgroup 1 athletes did not have such differences. There was a weak negative correlation between total months of treadmill running and cartilage thickness in the RLC (r = - 0.0236, p = 0.046) and LLC (r = - 0.0233, p = 0.049). No significant correlation was found between the distal femoral cartilage thickness at different sites and the patients' demographic features, including age, BMI, speed and incline of treadmill running, and minutes of running per session and week (p > 0.05). CONCLUSION Compared with healthy controls, professional athletes with a history of long-term high-intensity treadmill running had thinner femoral cartilages. The duration (months) of treadmill running was weakly negatively correlated with distal femoral cartilage thickness. Longitudinal studies with prolonged follow-ups are needed to clarify how treadmill running affects femoral cartilage thickness in athletes.
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Affiliation(s)
- Pouria Azami
- Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Ashraf
- Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Omid Yousefi
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Aref Nasiri
- Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran.
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Harkey MS, Michel N, Grozier C, Slade JM, Collins K, Pietrosimone B, Lalush D, Lisee C, Hacihaliloglu I, Fajardo R. Femoral cartilage ultrasound echo-intensity is a valid measure of cartilage composition. J Orthop Res 2024; 42:729-736. [PMID: 37874323 PMCID: PMC10978297 DOI: 10.1002/jor.25722] [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: 05/30/2023] [Revised: 08/17/2023] [Accepted: 10/17/2023] [Indexed: 10/25/2023]
Abstract
This study aimed to create a conversion equation that accurately predicts cartilage magnetic resonance imaging (MRI) T2 relaxation times using ultrasound echo-intensity and common participant demographics. We recruited 15 participants with a primary anterior cruciate ligament reconstruction between the ages of 18 and 35 years at 1-5 years after surgery. A single investigator completed a transverse suprapatellar scan with the ACLR limb in max knee flexion to image the femoral trochlea cartilage. A single reader manually segmented the femoral cartilage cross-sectional area to assess the echo-intensity (i.e., mean gray-scale pixel value). At a separate visit, a T2 mapping sequence with the MRI beam set to an oblique angle was used to image the femoral trochlea cartilage. A single reader manually segmented the cartilage cross-sectional area on a single MRI slice to assess the T2 relaxation time. A stepwise, multiple linear regression was used to predict T2 relaxation time from cartilage echo-intensity and common demographic variables. We created a conversion equation using the regression betas and then used an ICC and Bland-Altman plot to assess agreement between the estimated and true T2 relaxation time. Cartilage ultrasound echo-intensity and age significantly predicted T2 relaxation time (F = 7.33, p = 0.008, R2 = 0.55). When using the new conversion equation to estimate T2 relaxation time from cartilage echo-intensity and age, there was strong agreement between the estimated and true T2 relaxation time (ICC2,k = 0.84). This study provides promising preliminary data that cartilage echo-intensity combined with age can be used as a clinically accessible tool for evaluating cartilage composition.
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Affiliation(s)
- Matthew S Harkey
- Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA
| | - Nicholas Michel
- College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Corey Grozier
- Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA
| | - Jill M Slade
- Department of Radiology, Michigan State University, East Lansing, Michigan, USA
| | - Katherine Collins
- Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA
| | - Brian Pietrosimone
- Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - David Lalush
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Caroline Lisee
- Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ilker Hacihaliloglu
- Department of Radiology, Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Ryan Fajardo
- Department of Radiology, Michigan State University, East Lansing, Michigan, USA
- Lansing Radiology Associates, Lansing, Michigan, USA
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Hori M, Terada M, Suga T, Isaka T. The effect of attending rehabilitation after traumatic knee joint injury on femoral articular cartilage morphology in collegiate rugby players with a history of intracapsular knee joint injury during two-year consecutive rugby seasons. Front Sports Act Living 2024; 5:1309938. [PMID: 38274032 PMCID: PMC10808301 DOI: 10.3389/fspor.2023.1309938] [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: 10/09/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction This present study aimed to compare ultrasonographic measures of femoral articular cartilage during two-year seasons between collegiate rugby players who have attended supervised rehabilitation following intracapsular knee joint injury and those without a history of knee injury. Methods Using a prospective observational study design, 12 male collegiate rugby players with a previous history of intracapsular knee joint injury who have received and completed supervised rehabilitation following their injury and 44 players without knee joint injury participated in this study. Ultrasonographic images were used to verify changes in femoral articular cartilage thickness and cross-sectional area (CSA) with or without a previous history of knee joint injury over two consecutive rugby seasons. Results Significant time main effects were observed for the lateral condylar thickness (p < 0.001), the intercondylar thickness (p = 0.001), the medial condylar thickness (p < 0.001), and CSA (p < 0.001). No significant interactions nor group main effects were identified for all femoral articular cartilage (p < 0.05). Conclusions Collegiate rugby players demonstrated a decrease in femoral articular cartilage thickness and CSA over two-year consecutive rugby seasons. These findings indicate that engaging in collegiate rugby induces alterations in femoral articular cartilage structure. Furthermore, there were no differences in all femoral cartilage outcome measures between rugby players with and without a previous history of traumatic knee joint injury. Therefore, attending supervised rehabilitation at the time of their knee joint injury appeared to reduce the impact of a previous history of intracapsular knee joint injury on the change in femoral articular cartilage thickness and CSA among active rugby players.
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Affiliation(s)
- Miyuki Hori
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Masafumi Terada
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Tadashi Suga
- Research Organization of Science and Technology, Ritsumeikan University, Kusatsu, Japan
| | - Tadao Isaka
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
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Margenfeld F, Zendehdel A, Tamborrini G, Müller-Gerbl M. The advantages of utilizing different ultrasound imaging techniques on joints of human cadavers in the teaching of anatomy - A scoping review. Ann Anat 2024; 251:152179. [PMID: 37879500 DOI: 10.1016/j.aanat.2023.152179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/05/2023] [Accepted: 10/17/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND A common approach to define sonoanatomy is a reciprocal exchange of macroscopic and microscopic information in ultrasound imaging. High-resolution ultrasound has been long established and is crucial as an inexpensive and adaptable tool, not just in clinical settings but also while teaching anatomy. Early application of ultrasonography provides medical students with a couple of benefits: they acquire an improved understanding of anatomy and learn how to use it. METHODS A comprehensive literature review has been carried out, with relevant studies discovered in the following databases: MEDLINE, EMBASE, CENTRAL, BIOSIS Previews and Web of Science Core Collection. Gray literature was also considered in two different ways: (1) Regarding grey literature databases: National Gray Literature Collection. (2) For PhD theses and dissertations, the databases EThOS and Open Access Theses and Dissertations were screened for relevant studies by combining the keywords used in the search string. The reference lists of all relevant papers were scanned. Search process was performed on January 3rd, 2023. The search string was developed with the aid of and finally checked by a professional librarian. Only ultrasound studies on human cadavers were included, not animals or phantoms. If the studied subject was a joint, the article was included. Only B-Mode ultrasound was included, whereas Elastosonography, Doppler sonography and quantitative approaches including among others sound speed, backscatter attenuation were excluded. Intravascular, intraosseous, intraarticular, and three-dimensional or four-dimensional ultrasonography were also eliminated from the analysis. All appropriate information comprising articles, PhD theses, dissertations and chapters in textbooks were considered. There were solely English and German studies covered. There was no additional restriction on the publishing year. The included studies' general characteristics and ultrasound techniques were taken from them and examined. Using VOS viewer, a keyword analysis was also carried out. RESULTS 142 of the 8899 results that were returned by the search satisfied the requirements. With a quarter of the included studies, the knee joint was the most extensively studied joint, followed by the elbow joint (10.6%) and the shoulder joint (9.2%). The methodological analysis includes 125 studies. Both the sample size and the ultrasonographer's qualifications were diverse. The probe position and the ultrasound method were precisely documented so that a reader could duplicate them in about three-quarters of the included studies (72.8%). CONCLUSION The current study, in our perspective, is the first scoping review to screen ultrasound studies on human cadaver joints. A heterogeneous field was shown by the methodological investigation. We suggest using a uniform method for conducting and presenting ultrasound examinations in future studies.
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Affiliation(s)
- Felix Margenfeld
- Institute of Anatomy, Department of Biomedicine, Musculoskeletal Research, University of Basel, Pestalozzistrasse 20, Basel 4056, Switzerland.
| | - Adib Zendehdel
- Institute of Anatomy, Department of Biomedicine, Musculoskeletal Research, University of Basel, Pestalozzistrasse 20, Basel 4056, Switzerland
| | - Giorgio Tamborrini
- Swiss Ultrasound Center UZR and Institute for Rheumatology, Aeschenvorstadt 68, Basel 4051, Switzerland; Rheumatology Clinic, University Hospital of Basel, Basel 4001 Switzerland
| | - Magdalena Müller-Gerbl
- Institute of Anatomy, Department of Biomedicine, Musculoskeletal Research, University of Basel, Pestalozzistrasse 20, Basel 4056, Switzerland
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Lunser MK, Hurdle MF, Taylor WC, Bertasi RAO, Bertasi TGO, Kurklinsky S, Cooper GM, Garner HW, Helmi H, Pujalte GGA. Ultrasound Measurement of Femoral Articular Cartilage Thickness Before and After Marathon Running. Cureus 2024; 16:e52870. [PMID: 38406107 PMCID: PMC10894013 DOI: 10.7759/cureus.52870] [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] [Accepted: 01/23/2024] [Indexed: 02/27/2024] Open
Abstract
OBJECTIVE The purpose of this study was to use ultrasonography to measure femoral articular cartilage thickness changes during marathon running, which could support MRI studies showing that deformation of knee cartilage during long-distance running is no greater than that for other weight-bearing activities. MATERIALS AND METHODS Participants included 38 marathon runners with no knee pain or history of knee injury, aged 18-39. Ultrasound images of the femoral articular cartilage were taken two hours before and immediately after the race. Femoral articular cartilage thickness was measured at both the medial and lateral femoral condyles. RESULTS The maximum change in femoral articular cartilage thickness, measured at the left outer lateral femoral condyle, was 6.94% (P=.006). All other femoral articular cartilage thickness changes were not significant. CONCLUSION A change in femoral articular cartilage thickness of 6.94% supports our hypothesis that long-distance running does not induce deformational changes greater than that of regular daily activities. This study using ultrasonography supports MRI evidence that knee cartilage tolerates marathon running well.
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Affiliation(s)
| | | | - Walter C Taylor
- Department of Family Medicine, Mayo Clinic, Jacksonville, USA
| | - Raphael A O Bertasi
- Department of Internal Medicine, Mount Sinai Morningside West, New York, USA
| | - Tais G O Bertasi
- Department of Internal Medicine, Mount Sinai Morningside West, New York, USA
| | | | - George M Cooper
- Department of Family Medicine, Mayo Clinic, Jacksonville, USA
| | | | - Haytham Helmi
- Department of Critical Care Medicine, Mayo Clinic, Jacksonville, USA
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Veličković1† Z, Pavlov Dolijanović S, Stojanović N, Janjić S, Kovačević L, Soldatović I, Radunović G. The short-term effect of glucosamine-sulfate, nonanimal chondroitin-sulfate, and S-adenosylmethionine combination on ultrasonography findings, inflammation, pain, and functionality in patients with knee osteoarthritis: A pilot, double-blind, randomized, placebo-controlled clinical trial. Arch Rheumatol 2023; 38:521-541. [PMID: 38125054 PMCID: PMC10728741 DOI: 10.46497/archrheumatol.2023.9994] [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: 03/01/2023] [Accepted: 03/14/2023] [Indexed: 12/23/2023] Open
Abstract
Objectives This study aimed to investigate the efficacy of glucosamine-sulfate (GS), nonanimal chondroitin-sulfate (naCS), and S-adenosylmethionine (SAMe) combination on ultrasound findings, inflammation, pain, and functionality in knee osteoarthritis. Patients and methods In the prospective, randomized, double-blind, placebo-controlled pilot study conducted between August 2019 and November 2019, 120 participants (28 males, 92 females; mean age: 66.4±7.9 years; range, 42.4 to 74.5 years) were randomized at a 1:1:1 ratio to the placebo group, the first experimental group (a combination of GS, naCS, and SAMe was administered to the experimental groups. The first experimental group received 375 mg of GS, 300 mg of naCS, and 100 mg of SAMe, whereas the second experimental group received 750 mg of GS, 600 mg of naCS, and 200 mg of SAMe). Laboratory (erythrocyte sedimentation rate, C-reactive protein, tumor necrosis factor alpha, interleukin [IL]-1β, IL-6, IL-17), clinical (Visual Analog Scale [VAS], short form health survey [SF-36], the Western Ontario and McMaster Universities Arthritis Index [WOMAC], and the Tegner Lysholm Knee Scoring Scale [TLKS]), and musculoskeletal ultrasound (MSUS) assessments were performed at baseline and after three and six months. Results A minor increase was observed in the second experimental group after six months using ultrasonography to evaluate articular cartilage thickness (p<0.05). The investigational product's superiority in reducing osteoarthritis ultrasonographic findings was not proven. A moderately negative association was found between cartilage thickness and VAS scores at baseline (ρ=-0.36, p<0.01), while the presence of massive osteophytes on MSUS showed a low to moderate association with all clinical outcomes. There was no difference in the delta changes between groups for the VAS, TLKS, WOMAC, and SF-36. The only serum inflammatory marker outside the reference range was IL-1β, but no significant changes were observed after six months. Conclusion According to the results of our investigation, treatment for knee osteoarthritis should be evaluated using more objective outcomes. The most important conclusion of our study is that IP may result in a slight increase in articular cartilage thickness, which was associated with a decrease in pain intensity at baseline. Clarification of the potential influence of this combination on radiographic progression and laboratory markers of inflammation requires further exploration.
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Affiliation(s)
| | | | | | | | | | - Ivan Soldatović
- School of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Medical Statistics and Informatics, Belgrade, Serbia
| | - Goran Radunović
- Institute of Rheumatology, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
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Ogura T, Katagiri T, Kameda H. Cartilage evaluation by ultrasonography in patients with rheumatoid arthritis: a scoping review. Inflamm Regen 2023; 43:34. [PMID: 37403142 DOI: 10.1186/s41232-023-00286-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/20/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND This study aimed to provide an overview of ultrasonographic cartilage evaluation in patients with rheumatoid arthritis (RA) and identify research gaps in the utilization of cartilage evaluation. METHODS The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. A systematic literature search of the PubMed, Embase, and Cochrane Library databases was conducted for articles published up to July 2022 using the search term variations of "cartilage," "ultrasonography," and "rheumatoid arthritis." Studies that included patients with RA who underwent cartilage evaluation by ultrasonography were selected. Articles published in languages other than English and about juvenile idiopathic arthritis were excluded. RESULTS Twenty-nine articles were identified. Most were cross-sectional studies (86%), mainly involving the metacarpophalangeal (55%) and knee (34%) joints. Assessments were performed using quantitative, binary, and semi-quantitative methods in 15, 10, and 15 studies, respectively. Reliability assessments were conducted in 10 studies, which showed feasible reliability but were limited to the finger joints. The validity assessment was validated in one study each that compared cartilage thickness measurements with cadaveric specimens and histological and semi-quantitative methods with surgical specimens, respectively. Comparisons with conventional radiography were also performed in six studies, which showed significant correlations. However, there was heterogeneity in the examination and assessment methods, and no adequate longitudinal evaluation was conducted. CONCLUSION This review highlights the need for further research and validation of ultrasonographic cartilage assessment in patients with RA.
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Affiliation(s)
- Takehisa Ogura
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Toho University, 2-22-36, Ohashi, Meguro-Ku, Tokyo, 153-8515, Japan.
| | - Takaharu Katagiri
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Toho University, 2-22-36, Ohashi, Meguro-Ku, Tokyo, 153-8515, Japan
| | - Hideto Kameda
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Toho University, 2-22-36, Ohashi, Meguro-Ku, Tokyo, 153-8515, Japan
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Bjornsen E, Davis-Wilson H, Evans-Picket A, Horton WZ, Lisee C, Munsch AE, Nissman D, Blackburn JT, Franz JR, Pietrosimone B. Knee kinetics and the medial femoral cartilage cross-sectional area response to loading in indviduals with anterior cruciate ligament reconstruction. Clin Biomech (Bristol, Avon) 2023; 105:105979. [PMID: 37148613 PMCID: PMC10278237 DOI: 10.1016/j.clinbiomech.2023.105979] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 04/24/2023] [Accepted: 04/27/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Ultrasonography is capable of detecting morphological changes in femoral articular cartilage cross-sectional area in response to an acute bout of walking; yet, the response of femoral cartilage cross-sectional area varies between individuals. It is hypothesized that differences in joint kinetics may influence the response of cartilage to a standardized walking protocol. Therefore, the study purpose was to compare internal knee abduction and extension moments between individuals with anterior cruciate ligament reconstruction who demonstrate an acute increase, decrease, or unchanged medial femoral cross-sectional area response following 3000 steps. METHODS The medial femoral cartilage in the anterior cruciate ligament reconstructed limb was assessed with ultrasonography before and immediately following 3000 steps of treadmill walking. Knee joint moments were calculated in the anterior cruciate ligament reconstructed limb and compared between groups throughout the stance phase of gait using linear regression and functional, mixed effects waveform analyses. FINDINGS No associations between peak knee joint moments and the cross-sectional area response were observed. The group that demonstrated an acute cross-sectional area increase exhibited 1) lower knee abduction moments in early stance in comparison to the group that exhibited a decreased cross-sectional area response; and 2) greater knee extension moments in early stance in comparison to the group with an unchanged cross-sectional area response. INTERPRETATION The propensity of femoral cartilage to acutely increase cross-sectional area in response to walking is consistent with less-dynamic knee abduction and knee extension moment profiles.
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Affiliation(s)
- Elizabeth Bjornsen
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - Hope Davis-Wilson
- University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
| | - Alyssa Evans-Picket
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - W Zachary Horton
- Department of Statistics, University of California, Santa Cruz, CA, United States.
| | - Caroline Lisee
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - Amanda E Munsch
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill and Raleigh, NC, United States.
| | - Daniel Nissman
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - J Troy Blackburn
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - Jason R Franz
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill and Raleigh, NC, United States.
| | - Brian Pietrosimone
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
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12
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Armitage AJ, Miller JM, Sparks TH, Georgiou AE, Reid J. Efficacy of autologous mesenchymal stromal cell treatment for chronic degenerative musculoskeletal conditions in dogs: A retrospective study. Front Vet Sci 2023; 9:1014687. [PMID: 36713862 PMCID: PMC9880336 DOI: 10.3389/fvets.2022.1014687] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/27/2022] [Indexed: 01/15/2023] Open
Abstract
Introduction The objective of this study was to retrospectively analyze clinical data from a referral regenerative medicine practice, to investigate the efficacy of autologous mesenchymal stromal cells (MSC) in 245 dogs deemed unresponsive to conventional treatment by their referring vet. Methods Diagnostic imaging [radiology and musculoskeletal ultrasound (MSK-US)] identified musculoskeletal pathology holistically. MSCs, produced according to current guidelines, were initially administered with PRP by targeted injection to joints and/or tendons, with a second MSC monotherapy administered 12 weeks later to dogs with severe pathology and/or previous elbow arthroscopic interventions. Dogs with lumbosacral disease received epidural MSCs with additional intravenous MSCs administered to dogs with spondylosis of the cervical, thoracic and lumbar spine. All dogs received laser therapy at 10 J/cm2 at the time of treatment and for 5 sessions thereafter. Objective outcome measures (stance analysis, range of joint motion, pressure algometry) and validated subjective outcome measures (owner reported VetMetrica HRQL™ and veterinary pain and quality of life impact scores) were used to investigate short and long-term (6-104 weeks) efficacy. Outcome data were collected at predetermined time windows (0-6, 7-12, 13-18, 19-24, 25-48, 49-78, 79-104) weeks after initial treatment. Results There were statistically significant improvements in post compared with pre-treatment measures at all time windows in stance analysis, shoulder and hip range of motion, lumbosacral pressure algometry, and to 49-78 weeks in carpus and elbow range of motion. Improvements in 4 domains of quality of life as measured by VetMetricaTM were statistically significant, as were scores in vet-assessed pain and quality of life impact. In dogs receiving one initial treatment the mean time before a second treatment was required to maintain improvements in objective measures was 451 days. Diagnostic imaging confirmed the regenerative effects of MSCs in tendinopathies by demonstrating resolution of abnormal mineralization and restoration of normal fiber patterns. Discussion This represents the first study using "real-world" data to show that cell-based therapies, injected into multiple areas of musculoskeletal pathology in a targeted holistic approach, resulted in rapid and profound positive effects on the patient's pain state and quality of life which was maintained with repeat treatment for up to 2 years.
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Affiliation(s)
- Andrew J. Armitage
- Greenside Veterinary Practice, Part of Linnaeus Veterinary Limited, Melrose, United Kingdom,*Correspondence: Andrew J. Armitage ✉
| | | | - Tim H. Sparks
- Waltham Petcare Science Institute, Melton Mowbray, United Kingdom
| | - Alex E. Georgiou
- Cell Therapy Sciences Ltd., Coventry, United Kingdom,Coventry University, Coventry, United Kingdom
| | - Jacqueline Reid
- University of Glasgow, Glasgow, United Kingdom,NewMetrica Research Ltd., Glasgow, United Kingdom
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13
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Uysal A, Oktay G, Ural C, Kalkan NB. The effect of ferritin levels on distal femoral cartilage thickness in patients with beta thalassaemia major. J Bone Miner Metab 2023; 41:95-104. [PMID: 36422676 DOI: 10.1007/s00774-022-01384-w] [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: 06/07/2022] [Accepted: 10/21/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION To the best of our knowledge, the present study is the first in the literature to assess distal femoral cartilage thickness and its relationship with ferritin levels in adult patients with beta thalassaemia major (BTM). MATERIALS AND METHODS 45 patients with BTM and 45 healthy controls were included in the study. Ferritin and haemoglobin levels of the patient and healthy groups were determined by blood analysis and distal femoral cartilage thicknesses were measured via ultrasound. Then, the patient group was divided into subgroups according to whether their ferritin levels were below or above 2500 µg/L. They were then compared among themselves and with the healthy control group using the available data. RESULTS Distal femoral cartilage thickness values were statistically significantly lower in the BTM group compared to the healthy control group (p values < 0.001). Patients with a ferritin level below 2500 µg/L had statistically significantly higher right and left average distal femoral cartilage thickness values than the patients with a ferritin level above 2500 µg/L (p = 0.029 and p = 0.019, respectively). The right and left average distal femoral cartilage thickness values of the patient subgroup with low ferritin levels were statistically similar to the control group (p = 0.146 and p = 0.164, respectively). CONCLUSION Our study showed that thalassaemia patients are more likely to develop osteoarthritis (OA) than the normal population and possible OA development can be prevented by keeping the ferritin levels of these patients in the optimum range.
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Affiliation(s)
- Alper Uysal
- Physical Medicine and Rehabilitation Clinic, Hatay Training and Research Hospital, Güzelburç, 31001, Antakya, Hatay, Turkey.
| | - Gönül Oktay
- Thalassemia Center, Hatay Training and Research Hospital, Hatay, Turkey
| | - Cihan Ural
- Hematology Clinic, Hatay Training and Research Hospital, Hatay, Turkey
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14
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Peiffer M, Burssens A, Duquesne K, Last M, De Mits S, Victor J, Audenaert EA. Personalised statistical modelling of soft tissue structures in the ankle. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 218:106701. [PMID: 35259673 DOI: 10.1016/j.cmpb.2022.106701] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 01/20/2022] [Accepted: 02/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Revealing the complexity behind subject-specific ankle joint mechanics requires simultaneous analysis of three-dimensional bony and soft-tissue structures. 3D musculoskeletal models have become pivotal in orthopedic treatment planning and biomechanical research. Since manual segmentation of these models is time-consuming and subject to manual errors, (semi-) automatic methods could improve the accuracy and enlarge the sample size of personalised 'in silico' biomechanical experiments and computer-assisted treatment planning. Therefore, our aim was to automatically predict ligament paths, cartilage topography and thickness in the ankle joint based on statistical shape modelling. METHODS A personalised cartilage and ligamentous prediction algorithm was established using geometric morphometrics, based on an 'in-house' generated lower limb skeletal model (N = 542), tibiotalar cartilage (N = 60) and ankle ligament segmentations (N = 10). For cartilage, a population-averaged thickness map was determined by use of partial least-squares regression. Ligaments were wrapped around bony contours based on iterative shortest path calculation. Accuracy of ligament path and cartilage thickness prediction was quantified using leave-one-out experiments. The novel personalised thickness prediction was compared with a constant cartilage thickness of 1.50 mm by use of a paired sample T-test. RESULTS Mean distance error of cartilage and ligament prediction was 0.12 mm (SD 0.04 mm) and 0.54 mm (SD 0.05 mm), respectively. No significant differences were found between the personalised thickness cartilage and segmented cartilage of the tibia (p = 0.73, CI [-1.60 .10-17, 1.13 .10-17]) and talus (p = 0.95, CI[ -1.35 .10-17, 1.28 .10-17]). For the constant thickness cartilage, a statistically significant difference was found in 89% and 92% of the tibial (p < 0.001, CI [0.51, 0.58]) and talar (p < 0.001, CI [0.33, 0.40]) cartilage area. CONCLUSIONS In this study, we described a personalised prediction algorithm of cartilage and ligaments in the ankle joint. We were able to predict cartilage and main ankle ligaments with submillimeter accuracy. The proposed method has a high potential for generating large (virtual) sample sizes in biomechanical research and mitigates technological advances in computer-assisted orthopaedic surgery.
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Affiliation(s)
- M Peiffer
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent 9000, Belgium; Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, Ghent 9000, Belgium.
| | - A Burssens
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent 9000, Belgium; Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, Ghent 9000, Belgium
| | - K Duquesne
- Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, Ghent 9000, Belgium
| | - M Last
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent 9000, Belgium
| | - S De Mits
- Department of Reumatology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent 9000, Belgium; Department of Podiatry, Artevelde University of Applied Sciences, Voetweg 66, Ghent 9000, Belgium
| | - J Victor
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent 9000, Belgium; Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, Ghent 9000, Belgium
| | - E A Audenaert
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent 9000, Belgium; Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, Ghent 9000, Belgium; Department of Trauma and Orthopedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK; Department of Electromechanics, Op3Mech research group, University of Antwerp, Groenenborgerlaan 171, 2020, Antwerp, Belgium
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15
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Harkey MS, Michel N, Kuenze C, Fajardo R, Salzler M, Driban JB, Hacihaliloglu I. Validating a Semi-Automated Technique for Segmenting Femoral Articular Cartilage on Ultrasound Images. Cartilage 2022; 13:19476035221093069. [PMID: 35438030 PMCID: PMC9251823 DOI: 10.1177/19476035221093069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To validate a semi-automated technique to segment ultrasound-assessed femoral cartilage without compromising segmentation accuracy to a traditional manual segmentation technique in participants with an anterior cruciate ligament injury (ACL). DESIGN We recruited 27 participants with a primary unilateral ACL injury at a pre-operative clinic visit. One investigator performed a transverse suprapatellar ultrasound scan with the participant's ACL injured knee in maximum flexion. Three femoral cartilage ultrasound images were recorded. A single expert reader manually segmented the femoral cartilage cross-sectional area in each image. In addition, we created a semi-automatic program to segment the cartilage using a random walker-based method. We quantified the average cartilage thickness and echo-intensity for the manual and semi-automated segmentations. Intraclass correlation coefficients (ICC2,k) and Bland-Altman plots were used to validate the semi-automated technique to the manual segmentation for assessing average cartilage thickness and echo-intensity. A dice correlation coefficient was used to quantify the overlap between the segmentations created with the semi-automated and manual techniques. RESULTS For average cartilage thickness, there was excellent reliability (ICC2,k = 0.99) and a small mean difference (+0.8%) between the manual and semi-automated segmentations. For average echo-intensity, there was excellent reliability (ICC2,k = 0.97) and a small mean difference (-2.5%) between the manual and semi-automated segmentations. The average dice correlation coefficient between the manual segmentation and semi-automated segmentation was 0.90, indicating high overlap between techniques. CONCLUSIONS Our novel semi-automated segmentation technique is a valid method that requires less technical expertise and time than manual segmentation in patients after ACL injury.
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Affiliation(s)
- Matthew S. Harkey
- Department of Kinesiology, Michigan
State University, East Lansing, MI, USA,Matthew S. Harkey, Department of
Kinesiology, Michigan State University, 308 W. Circle Drive #112, East Lansing,
MI 48824, USA.
| | - Nicholas Michel
- College of Osteopathic Medicine,
Michigan State University, East Lansing, MI, USA
| | - Christopher Kuenze
- Department of Kinesiology, Michigan
State University, East Lansing, MI, USA
| | - Ryan Fajardo
- Department of Radiology, Michigan State
University, East Lansing, MI, USA
| | - Matt Salzler
- Department of Orthopaedics, Tufts
Medical Center, Boston, MA, USA
| | - Jeffrey B. Driban
- Division of Rheumatology, Allergy, and
Immunology, Tufts Medical Center, Boston, MA, USA
| | - Ilker Hacihaliloglu
- Department of Radiology, Department of
Medicine, The University of British Columbia, Vancouver, BC, Canada
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16
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Andersen C, Griffin JF, Jacobsen S, Østergaard S, Walters M, Mori Y, Lindegaard C. Validation of ultrasonography for measurement of cartilage thickness in the equine carpus. Vet Radiol Ultrasound 2022; 63:478-489. [PMID: 35347811 PMCID: PMC9545370 DOI: 10.1111/vru.13085] [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: 08/09/2021] [Revised: 01/05/2022] [Accepted: 01/16/2022] [Indexed: 12/04/2022] Open
Abstract
Articular cartilage thinning is an important hallmark of osteoarthritis (OA), and ultrasonography (US) is a clinically accessible tool potentially suitable for repeated evaluation. The aim of the present prospective methods comparison study was to validate US as a tool for measuring cartilage thickness in the carpus of the horse. Eight Standardbred trotters underwent US examination with 9 and 15 MHz linear transducers. Six anatomical locations in the radiocarpal joint (RCJ) and middle carpal joint (MCJ) were examined. The same joints were assessed by ultrahigh field (9.4 Tesla) magnetic resonance imaging (MRI) and histology. Associations between measurements obtained by the different modalities were assessed by ANOVA, Deming regression, Pearson correlation and Bland–Altman plots. Histologically assessed total cartilage thickness (the noncalcified cartilage (NCC) plus the calcified cartilage zone (CCZ)) overestimated thickness compared to MRI (P < 0.01) and US (P < 0.01). US 15 MHz had substantial agreement with MRI and NCC histology, and repeatability was acceptable (coefficient of variation = 8.6–17.9%) when used for assessment of cartilage thickness in the RCJ. In contrast, 9 MHz US showed poorer agreement with MRI and NCC histology, as it overestimated the thickness of thin cartilage and underestimated the thickness of thicker cartilage in the RCJ and MCJ. Moreover, repeatability was suboptimal (coefficient of variation = 10.4–26.3%). A 15 MHz transducer US is recommended for detecting changes in RCJ cartilage thickness or monitoring development over time, and it has the potential for noninvasive assessment of cartilage health in horses.
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Affiliation(s)
- Camilla Andersen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark
| | - John F Griffin
- Department of Large Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Stine Jacobsen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark
| | - Stine Østergaard
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark
| | - Marie Walters
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark
| | - Yuki Mori
- Center for Translational Neuromedicine, Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
| | - Casper Lindegaard
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark
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17
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Yildirim A, Önder ME, Özkan D. Ultrasonographic evaluation of distal femoral and talar cartilage thicknesses in patients with early rheumatoid arthritis and their relationship with disease activity. Clin Rheumatol 2022; 41:2001-2007. [DOI: 10.1007/s10067-022-06132-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/09/2022] [Accepted: 03/13/2022] [Indexed: 11/03/2022]
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18
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Saito M, Ito H, Okahata A, Furu M, Nishitani K, Kuriyama S, Nakamura S, Kawata T, Ikezoe T, Tsuboyama T, Ichihashi N, Tabara Y, Matsuda F, Matsuda S. Ultrasonographic Changes of the Knee Joint Reflect Symptoms of Early Knee Osteoarthritis in General Population; The Nagahama Study. Cartilage 2022; 13:19476035221077403. [PMID: 35225002 PMCID: PMC9137311 DOI: 10.1177/19476035221077403] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Radiographic changes in knee osteoarthritis (OA) are not always associated with symptoms, especially in its early stages. Ultrasonography (US) can detect early changes in the knee joint, but the changes that reflect symptoms have not been fully elucidated. This study aimed to identify US-detectable changes in the knee that are often associated with knee symptoms and demonstrate the feasibility of early diagnosis in symptomatic knee OA using US. DESIGN In this cross-sectional community-based study, 1,667 participants aged ≥60 years (1,103 women [66%]) were included. All participants concurrently underwent US and radiography of the knee and completed the Knee Society Knee Scoring System (KSS) questionnaire. Simple and multiple regression analyses were used to examine the associations between US findings and KSS symptom subscales. RESULTS Among all participants, medial meniscus protrusion and medial osteophytes, age, and body mass index showed significant associations with KSS symptom scores. Among 894 participants with Kellgren-Lawrence (KL) grade ≤1, medial osteophytes and age were significantly associated with KSS symptom score. US measures were more related to KSS symptoms than KL grades. CONCLUSIONS Among the knee US-detectable changes, medial osteophytes were strongly associated with knee symptoms. Osteophytes are reliable predictors of symptomatic early knee OA, even in participants with few radiographic OA changes.
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Affiliation(s)
- Motoo Saito
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiromu Ito
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan,Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan,Hiromu Ito, Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo, Kyoto 606-8507, Japan.
| | - Akinori Okahata
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Moritoshi Furu
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kohei Nishitani
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinichi Kuriyama
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinichiro Nakamura
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomotoshi Kawata
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tome Ikezoe
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tadao Tsuboyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan,Department of Physical Therapy, School of Health Sciences, Bukkyo University, Kyoto, Japan
| | - Noriaki Ichihashi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan,Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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19
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Quantifying Region-Specific Elastic Properties of Distal Femoral Articular Cartilage: A Shear-Wave Elastography Study. Appl Bionics Biomech 2022; 2022:9406863. [PMID: 35178122 PMCID: PMC8844102 DOI: 10.1155/2022/9406863] [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] [Received: 11/24/2021] [Accepted: 12/30/2021] [Indexed: 11/22/2022] Open
Abstract
Knee osteoarthritis is a disease with the degeneration of articular cartilage as its main feature. Cartilage thickness cannot become a single index to evaluate cartilage degeneration, so it is essential to also evaluate the stiffness. The purposes were as follows: (1) to examine test-retest reliabilities of the elastic modulus measurement in distal femoral articular cartilage (FAC) and compare the changes in specific-regional of distal FAC, (2) to explore the difference in distal FAC stiffness and thickness between the dominant and nondominant sides, and (3) to examine the correlation between the elastic properties of cartilage and the thickness of cartilage. Twenty healthy participants were recruited. The stiffness of distal FAC at the lateral femoral condyle (LFC), medial femoral condyle (MFC), and intercondylar notch (IN) was quantified using shear-wave elastography (SWE). Intra- and interrater reliabilities were excellent for measuring the stiffness of distal FAC (ICC: 0.83-0.98). About a 50% increase in the stiffness of LFC (40.78 kPa) was found when compared with IN (21.82 kPa) and MFC (18.34 kPa). No significant difference was found between the dominant and nondominant sides in distal FAC stiffness and thickness. There was no correlation between the stiffness and thickness of the distal FAC. In conclusion, SWE can quantify the stiffness of the distal FAC.
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20
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Schadler P, Lohberger B, Thauerer B, Faschingbauer M, Kullich W, Stradner MH, Husic R, Leithner A, Steinecker-Frohnwieser B. Fatty Acid-Binding Protein 4 (FABP4) Is Associated with Cartilage Thickness in End-Stage Knee Osteoarthritis. Cartilage 2021; 13:1165S-1173S. [PMID: 34218665 PMCID: PMC8804752 DOI: 10.1177/19476035211011520] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND There is no single blood biomarker for the staging of knee osteoarthritis (KOA). The purpose of this study was to assess the relationship of obesity, serum biomarkers, the hip-knee-ankle angle (HKAA) with sonographic cartilage thickness. METHODS We conducted a cross-sectional study of n = 33 patients undergoing knee arthroplasty. Body mass index (BMI) was recorded, and patients were grouped based on BMI. Serum blood samples were collected, and the following biomarkers were measured using the ELISA technique (subgroup of n = 23): oxidized low-density lipoprotein (oxLDL), soluble receptor for advanced glycation end-products (sRAGE), fatty acid-binding protein 4 (FABP4), membrane-bound phospholipase A2 (PLA2G2A). The HKAA was analyzed on full-length limb standing x-ray images. Cartilage thickness was assessed on ultrasound images. Multivariable regression analysis was performed to account for confounding. RESULTS After adjusting for age, gender, and HKAA, obese patients had thicker medial femoral cartilage (β = 0.165, P = 0.041). Furthermore, lateral cartilage thickness was negatively correlated with FABP4 level after adjusting for of age, gender, BMI, and HKAA (β = -0.006, P = 0.001). Confirming previous studies, after adjustment, FABP4 level was associated with a higher BMI group (β = 42.99, P < 0.001). None of the other markers (oxLDL, PLA2G2A, and sRAGE) was associated with BMI or cartilage thickness. DISCUSSION Our results indicate that BMI has a weak, positive association with cartilage thickness in end-stage KOA patients. FABP4 levels were negatively associated with cartilage thickness. While our study is limited by a small sample size, these results further highlight the role of FABP4 as promising biomarkers of burden of disease in KOA.
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Affiliation(s)
- Paul Schadler
- Department of Orthopaedics and Trauma,
Medical University of Graz, Graz, Austria,Paul Schadler, Research Laboratory,
Department of Orthopaedics and Trauma, Medical University of Graz,
Auenbruggerplatz 5-7, Graz, 8036, Austria.
| | - Birgit Lohberger
- Department of Orthopaedics and Trauma,
Medical University of Graz, Graz, Austria,Ludwig Boltzmann Institute for
Arthritis and Rehabilitation, Saalfelden, Austria
| | - Bettina Thauerer
- Department for Rehabilitation, Ludwig
Boltzmann Institute for Arthritis and Rehabilitation, Saalfelden, Austria
| | | | - Werner Kullich
- Department for Rehabilitation, Ludwig
Boltzmann Institute for Arthritis and Rehabilitation, Saalfelden, Austria
| | - Martin Helmut Stradner
- Division of Rheumatology and
Immunology, Department of Internal Medicine, Medical University of Graz, Graz,
Austria
| | - Rusmir Husic
- Division of Rheumatology and
Immunology, Department of Internal Medicine, Medical University of Graz, Graz,
Austria
| | - Andreas Leithner
- Department of Orthopaedics and Trauma,
Medical University of Graz, Graz, Austria
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21
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Lisee C, Harkey M, Walker Z, Pfeiffer K, Covassin T, Kovan J, Currie KD, Kuenze C. Longitudinal Changes in Ultrasound-Assessed Femoral Cartilage Thickness in Individuals from 4 to 6 Months Following Anterior Cruciate Ligament Reconstruction. Cartilage 2021; 13:738S-746S. [PMID: 34384276 PMCID: PMC8808943 DOI: 10.1177/19476035211038749] [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: 02/02/2023] Open
Abstract
OBJECTIVE Diagnostic ultrasound provides a valid assessment of cartilage health that has been used to observe cross-sectional cartilage thickness differences post-ACLR (anterior cruciate ligament reconstruction), but has not been used longitudinally during early recovery post-ACLR. DESIGN The purpose of this study was to assess longitudinal changes in femoral cartilage thickness via ultrasound in individuals at 4 to 6 months post-ACLR and compared to healthy controls. Twenty participants (50% female, age = 21.1 ± 5.7 years) completed testing sessions 4 and 6 months post-ACLR. Thirty healthy controls (57% female, age = 20.8 ± 3.8 years) without knee injury history completed 2 testing sessions (>72 hours apart). Femoral cartilage ultrasound images were captured bilaterally in ACLR participants and in the dominant limb of healthy controls during all sessions. Average cartilage thicknesses in the medial, intercondylar, and lateral femoral regions were determined using a semi-automated processing technique. RESULTS When comparing cartilage thickness mean differences or changes over time, individuals post-ACLR did not demonstrate between limb differences (P-range = 0.50-0.92), limb differences compared to healthy controls (P-range = 0.19-0.94), or changes over time (P-range = 0.22-0.72) for any femoral cartilage thickness region. However, participants demonstrated cartilage thickening (45%) or thinning (35%) that exceeded minimal detectable change (MDC) from 4 to 6 months post-ACLR, respectively. CONCLUSIONS Using MDC scores may help better identify within-subject femoral cartilage thickness changes longitudinally post-ACLR due to bidirectional cartilage thickness changes.
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Affiliation(s)
- Caroline Lisee
- Department of Exercise and Sport
Science, University of North Carolina at Chapel Hill, NC, USA,Caroline Lisee, Department of Exercise and
Sport Science, The University of North Carolina at Chapel Hill, 209 Fetzer Hall,
CB# 8700, Chapel Hill, NC 27599, USA.
| | - Matthew Harkey
- Department of Kinesiology, Michigan
State University, East Lansing, MI, USA
| | - Zachary Walker
- Department of Orthopedics, Michigan
State University, East Lansing, MI, USA
| | - Karin Pfeiffer
- Department of Kinesiology, Michigan
State University, East Lansing, MI, USA
| | - Tracey Covassin
- Department of Kinesiology, Michigan
State University, East Lansing, MI, USA
| | - Jeffrey Kovan
- College of Osteopathic Medicine,
Michigan State University, East Lansing, MI, USA
| | | | - Christopher Kuenze
- Department of Kinesiology, Michigan
State University, East Lansing, MI, USA,College of Osteopathic Medicine,
Michigan State University, East Lansing, MI, USA
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22
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Harkey MS, Blackburn JT, Hackney AC, Lewek MD, Schmitz RJ, Pietrosimone B. Sex-Specific Associations between Cartilage Structure and Metabolism at Rest and Acutely Following Walking and Drop-Landing. Cartilage 2021; 13:1772S-1781S. [PMID: 32954820 PMCID: PMC8808927 DOI: 10.1177/1947603520959386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Cartilage health is thought to be dependent on the relationship between mechanics, structure, and metabolism, rather than these individual components in isolation. Due to sex differences in cartilage health, there is need to determine if the relationships between these cartilage components separately for males and females. Therefore, we sought to determine the sex-specific associations between cartilage structure and metabolism at rest and their acute response following walking and drop-landing in healthy individuals. DESIGN A cartilage ultrasound assessment and an ante-cubital blood draw were performed before and after walking and drop-landing conditions in 20 males and 20 females. Cartilage structure was assessed via medial and lateral femoral cartilage cross-sectional area. Cartilage metabolism was quantified with serum cartilage oligomeric matrix protein (COMP) concentration. Percent change scores from pre- to postloading were used to calculate acute alterations in cross-sectional area and COMP. Correlational analyses were used to assess the association between cartilage structure and metabolism measures separately for males and females. RESULTS In females, greater resting COMP concentration was associated with less cartilage cross-sectional area in the medial(ρ = -0.50, P = 0.03) and lateral (ρ = -0.69, P = 0.001) femur. Resting cartilage measures were not associated among males. Following walking and drop-landing, percent change scores in cartilage structure and metabolism were not associated. CONCLUSIONS This study highlights that, in females, thinner anterior femoral cartilage is associated with greater resting serum COMP concentrations, a biomarker often linked to cartilage breakdown. Future studies into the relationships between various cartilage components should consider sex-specific analyses as these relationships are sex dependent.
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Affiliation(s)
- Matthew S. Harkey
- Department of Kinesiology, Michigan
State University, East Lansing, MI, USA,Matthew S. Harkey, Department of
Kinesiology, Michigan State University, 308 W. Circle Drive #112, East Lansing,
MI 48824, USA.
| | - J. Troy Blackburn
- Department of Exercise and Sports
Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anthony C. Hackney
- Department of Exercise and Sports
Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Department of Nutrition, School of
Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC,
USA
| | - Michael D. Lewek
- Division of Physical Therapy, University
of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Randy J. Schmitz
- Department of Kinesiology, University of
North Carolina at Greensboro, Greensboro, NC, USA
| | - Brian Pietrosimone
- Department of Exercise and Sports
Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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23
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Saito M, Nishitani K, Ito H, Ikezoe T, Furu M, Okahata A, Nigoro K, Kawata T, Nakamura S, Kuriyama S, Tabara Y, Ichihashi N, Tsuboyama T, Matsuda F, Matsuda S. Tenderness of the knee is associated with thinning of the articular cartilage evaluated with ultrasonography in a community-based cohort: The Nagahama study. Mod Rheumatol 2021:roab040. [PMID: 34910204 DOI: 10.1093/mr/roab040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/02/2021] [Accepted: 07/09/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVES This study aimed to elucidate the association between joint line tenderness (JLT) of the knee and knee joint structural changes evaluated with ultrasonography (US) for the early diagnosis of knee osteoarthritis (KOA). METHODS This cross-sectional study included 121 participants (age 71.7 ± 5.8 years, 75 women) from a community-based population. Bilateral structural changes in the knee joint were evaluated with US, and the presence or absence of JLT was evaluated using a pressure algometer. Logistic regression analysis was performed to evaluate the odds ratios (ORs) of US findings for the presence of JLT. Moreover, when the analysis was limited to knees with pre-/early radiographic KOA, the ORs were also calculated using logistic regression analysis. RESULTS Among the 242 knees, 38 had medial JLT, which was significantly associated with female sex (OR 11.87) and loss of cartilage thickness of the distal medial femoral condyle (CTh-MFC) (OR 0.12). Among 96 knees with Kellgren-Lawrence grade ≤ 2, 18 knees had medial JLT, which was also significantly associated with loss of CTh-MFC (OR 0.07) and medial osteophytes (OR 2.01). CONCLUSIONS JLT is significantly associated with thinning of the femoral cartilage and larger osteophytes in elderly patients, even in those with pre-/early radiographic KOA.
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Grants
- 25293141, 26670313, 26293198, 17H04182, 17H04126, 17H04123, 18K18450 Ministry of Education, Culture, Sports, Science and Technology of Japan
- ek0109070, ek0109070, ek0109196, ek0109348 Practical Research Project for Rare/Intractable Diseases
- H26-Choju-Ippan-001, dk0207006, dk0207027 Comprehensive Research on Aging and Health Science Research Grants for Dementia R&D
- kk0205008 Integrated Database of Clinical and Genomic Information
- ek0210066, ek0210096, ek0210116 Practical Research Project for Lifestyle-related Diseases including Cardiovascular Diseases and Diabetes Mellitus
- le0110005 Japan Agency for Medical Research and Development
- Takeda Medical Research Foundation
- Mitsubishi Foundation
- Daiwa Securities Health Foundation
- Sumitomo Foundation
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Affiliation(s)
- Motoo Saito
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kohei Nishitani
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiromu Ito
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tome Ikezoe
- Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Moritoshi Furu
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akinori Okahata
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazuya Nigoro
- Department of Drug Discovery Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomotoshi Kawata
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinichiro Nakamura
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinichi Kuriyama
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasuharu Tabara
- Department of Health Informatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Noriaki Ichihashi
- Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tadao Tsuboyama
- Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
- School of Health Sciences, Bukkyo University, Kyoto, Japan
| | - Fumihiko Matsuda
- Department of Health Informatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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24
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Holowka NB, Wallace IJ, Mathiessen A, Mang'eni Ojiambo R, Okutoyi P, Worthington S, Lieberman DE. Urbanization and Knee Cartilage Growth Among Children and Adolescents in Western Kenya. ACR Open Rheumatol 2021; 3:765-770. [PMID: 34448545 PMCID: PMC8593811 DOI: 10.1002/acr2.11323] [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] [Received: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 11/10/2022] Open
Abstract
Objective Previous studies have demonstrated that low physical activity levels during youth are associated with the development of thin knee cartilage, which may increase susceptibility to osteoarthritis later in life. Here, we propose and test the hypothesis that reductions in physical activity impair knee cartilage growth among people in developing countries experiencing urbanization and increased market integration. Methods Ultrasonography was used to measure knee cartilage thickness in 168 children and adolescents (aged 8‐17 years) from two groups in western Kenya: a rural, physically active group from a small‐scale farming community and an urban, less physically active group from the nearby city of Eldoret. We used general linear models to assess the relative effects of age on cartilage thickness in these two groups, controlling for sex and leg length. Results Both groups exhibited significant reductions in knee cartilage thickness with increasing age (P < 0.0001; 95% confidence interval [CI] 0.15‐0.06 mm), yet the rate of reduction was significantly less in the rural than in the urban group (P = 0.012; 95% CI 0.01‐0.10 mm). Conclusion The results support our hypothesis by showing that individuals from the more physically active rural group exhibited less knee cartilage loss during youth than the more sedentary urban group. Our findings suggest that reduced physical activity associated with urbanization in developing nations may affect adult knee cartilage thickness and thus could be a factor that increases susceptibility to osteoarthritis.
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Affiliation(s)
- Nicholas B Holowka
- Harvard University, Cambridge, Massachusetts, and University at Buffalo, Buffalo, New York
| | - Ian J Wallace
- Harvard University, Cambridge, Massachusetts, and The University of New Mexico, Albuquerque
| | | | - Robert Mang'eni Ojiambo
- Moi University School of Medicine, Eldoret, Kenya, and University of Global Health Equity, Butaro, Rwanda
| | - Paul Okutoyi
- Moi University School of Medicine, Eldoret, Kenya
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25
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Hori M, Terada M, Suga T, Isaka T. Changes in anterior femoral articular cartilage structure in collegiate rugby athletes with and without a history of traumatic knee joint injury following a five-month competitive season. Sci Rep 2021; 11:15186. [PMID: 34312456 PMCID: PMC8313691 DOI: 10.1038/s41598-021-94462-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/12/2021] [Indexed: 11/21/2022] Open
Abstract
This study aimed to examine anterior femoral cartilage morphology before (pre-season) and after (post-season) a 5-month competitive season in collegiate ruby players with and without a previous history of traumatic injury to ligamentous, meniscus, and/or cartilage structures at the knee joint. Using a prospective cohort design, 42 male collegiate rugby players with a previous history of traumatic intracapsular knee joint injury and 124 players without knee injury history were included in this study. Ultrasonography assessments of anterior femoral cartilage were performed before (pre-season) and following a 5-month athletic season (post-season). Rugby players with a history of traumatic knee joint injury had greater lateral condylar thickness (2.37 ± 0.35 mm, p = 0.03), intercondylar thickness (2.51 ± 0.47 mm, p = 0.03), and partial area (44.67 ± 7.28mm2, p = 0.02) compared to control players (lateral = 2.23 ± 0.35 mm, intercondylar = 2.32 ± 0.47 mm, partial area = 41.60 ± 7.26 mm2), regardless of pre-and post-season assessment time points. Pre-season ultrasonography assessment of lateral condylar thickness (2.34 ± 0.47 mm, p = 0.02), medial condylar thickness (2.05 ± 0.43 mm, p = 0.03), and partial area (44.10 ± 9.23 mm2, p = 0.001) were significantly greater than the post-season ultrasonography assessment time point (lateral = 2.26 ± 0.43 mm, medial = 1.98 ± 0.43 mm, partial area = 42.17 ± 8.82 mm2), regardless of group membership. Rugby players with a history of intracapsular knee joint injury displayed altered anterior femoral cartilage size via ultrasonography assessments. Regardless of a presence of injury history, collegiate rugby players showed a decrease in cartilage thickness and partial area following a 5-month competitive season.
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Affiliation(s)
- Miyuki Hori
- Graduate School of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan
| | - Masafumi Terada
- College of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan.
| | - Tadashi Suga
- Research Organization of Science and Technology, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan
| | - Tadao Isaka
- Graduate School of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan.,College of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan
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26
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Harkey MS, Driban JB, Kuenze C, Zhang M, Salzler MJ. Pre-Operative Femoral Cartilage Ultrasound Characteristics Are Altered in People Who Report Symptoms at 1 year After Anterior Cruciate Ligament Reconstruction. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:1976-1984. [PMID: 33931287 PMCID: PMC8169620 DOI: 10.1016/j.ultrasmedbio.2021.03.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/08/2021] [Accepted: 03/19/2021] [Indexed: 06/12/2023]
Abstract
We assessed whether pre-operative femoral cartilage thickness and echo intensity on ultrasound are different between individuals who are symptomatic (n = 6) and asymptomatic (n = 7) at 1 year after a primary unilateral anterior cruciate ligament (ACL) reconstruction (age, 23 ± 4 y; 31% women, 69% men; body mass index, 24.9 ± 3.7 kg/m2). A pre-operative, bilateral ultrasound assessment was used to quantify average thickness and echo intensity in the medial, middle and lateral femoral trochlear regions. An inter-limb ratio (ACL/contralateral limb) was calculated for average thickness and echo intensity. At 1 y after ACL reconstruction, we operationally defined the presence of symptoms as scoring ≤85% on at least two Knee Injury and Osteoarthritis Outcome Score subscales. Independent-sample t-tests and Cohen's d effect sizes were used to compare ultrasound pre-operative inter-limb ratios between participants with and without symptoms at 1 y after ACL reconstruction. For medial femoral cartilage, symptomatic participants had significantly greater average cartilage thickness inter-limb ratios (p = 0.01, d = -1.65) and significantly lower echo intensity inter-limb ratios (p = 0.01, d = 1.72) compared with asymptomatic participants. Middle and lateral femoral cartilage average thickness and echo intensity were not different between symptomatic and asymptomatic participants. These findings provide preliminary evidence that a clinically feasible ultrasound assessment of the femoral trochlear cartilage may be prognostic of self-reported symptoms at 1 y after ACL reconstruction.
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Affiliation(s)
- Matthew S Harkey
- Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA.
| | - Jeffrey B Driban
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Christopher Kuenze
- Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA
| | - Ming Zhang
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, Massachusetts, USA; Department of Computer Science & Networking, Wentworth Institute of Technology, Boston, Massachusetts, USA
| | - Matthew J Salzler
- Department of Orthopaedics, Tufts Medical Center, Boston, Massachusetts, USA
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27
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Mesleh Shayeb A, Barnes RFW, Hanacek C, Aguero P, Steiner B, Bailey C, Quon D, Kruse-Jarres R, von Drygalski A. Quantitative measurements of haemophilic joint tissues by point-of-care musculoskeletal ultrasound: Associations with clinical and functional joint outcome parameters. Haemophilia 2021; 27:866-875. [PMID: 34171150 PMCID: PMC9292691 DOI: 10.1111/hae.14368] [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: 11/19/2020] [Revised: 04/16/2021] [Accepted: 06/11/2021] [Indexed: 01/06/2023]
Abstract
Background Painful arthropathy is a long‐term complication in patients with hemophilia (PWH), affecting mobility and quality of life. A major barrier for the appraisal of joint health is the absence of point‐of‐care (POC) imaging modalities to promptly identify and manage arthropathic changes. Accordingly, we developed the Joint tissue Activity and Damage Exam (JADE) POC musculoskeletal ultrasound (MSKUS) protocol. JADE is validated for haemophilic joint tissue recognition with high intra/inter‐rater and inter‐operator reliability. Aims Evaluate associations of JADE with clinical (Hemophilia Joint Health Score, [HJHS]) and functional (total arc [combined flexion and extension range of motion [ROM]]) parameters. Methodology In this multi‐centre prospective study, we recruited PWH A or B with at least one arthropathic joint. We evaluated joint health (both elbows, knees, and ankles) by comparing JADE measurements (soft tissue and cartilage thickness, and osteochondral alterations) with HJHS and total arc. Results Of 44 PWH, most had hemophilia A (35/44), were severe (36/44) and had a median age of 36 years. Increasing HJHSs and declining total arc, indicating worsening arthropathy, were associated with JADE measurements in the expected direction, including (1) increasing length of osteochondral alterations, (2) diminished cartilage thickness, and (3) greater soft tissue expansion. The ankles had the highest proportion of joints without measurable (missing) cartilage. In multivariable models MSKUS measurements explained 68% and 71% of the variation in HJHS and total arc respectively for the elbow, 55% and 29% respectively for the knee, and 50% and 73% for the ankle. Conclusions This study highlights the associations of direct intra‐articular ultrasonography measurements using the JADE protocol with clinical and functional parameters. Our findings underscore the clinical value of POC MSKUS using the JADE protocol as a complementary instrument for the diagnosis and management of haemophilic arthropathy.
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Affiliation(s)
- Akram Mesleh Shayeb
- Department of Medicine, Division of Hematology/Oncology, University of California San Diego, San Diego, California, USA
| | - Richard F W Barnes
- Department of Medicine, Division of Hematology/Oncology, University of California San Diego, San Diego, California, USA
| | - Cris Hanacek
- Department of Medicine, Division of Hematology/Oncology, University of California San Diego, San Diego, California, USA
| | - Peter Aguero
- Department of Physical Medicine and Rehabilitation, University of California San Diego, San Diego, California, USA
| | - Bruno Steiner
- Washington Center for Bleeding Disorders, Seattle, Washington, USA
| | - Cindy Bailey
- LA Orthopedic Hemophilia Treatment Center, Orthopedic Institute for Children, Los Angeles, California, USA
| | - Doris Quon
- LA Orthopedic Hemophilia Treatment Center, Orthopedic Institute for Children, Los Angeles, California, USA
| | | | - Annette von Drygalski
- Department of Medicine, Division of Hematology/Oncology, University of California San Diego, San Diego, California, USA.,The Scripps Research Institute, San Diego, California, USA
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28
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Yokuş A, Toprak M, Arslan H, Toprak N, Akdeniz H, Gündüz AM. Evaluation of distal femoral cartilage by B-mode ultrasonography and shear wave elastography in patients with knee osteoarthritis: a preliminary study. Acta Radiol 2021; 62:510-514. [PMID: 32517531 DOI: 10.1177/0284185120930642] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Degenerative change in articular cartilage is one of the most important factors in the development of osteoarthritis. Shear wave elastography can be used to identify pathologic cartilage. PURPOSE To evaluate distal femoral cartilage by shear wave elastography in patients with symptomatic knee osteoarthritis. MATERIAL AND METHODS Twenty patients with bilateral knee osteoarthritis (study group) and 20 volunteers with the same demographic characteristics but without symptomatic knee pain (control group) were included in the study. A total of 80 knee joints of 40 individuals were evaluated. At the medial, intercondylar, and lateral condylar levels distal femoral cartilage thickness was measured by B-mode ultrasonography and stiffness was measured by shear wave elastography. RESULTS The medial, intercondylar, and lateral cartilage thickness measurements were similar between the two groups and no statistically significant difference was observed (P = 0.711, P = 0.766, and P = 0.575, respectively). The shear wave velocity values in the medial and intercondylar cartilage were significantly higher in the study group (P = 0.002). Shear wave velocity values measured from lateral cartilage were higher in the study group and the difference between the groups had a borderline statistical significance (P = 0.053). CONCLUSION Shear wave elastography seems to be a reliable, non-invasive, and acceptable method for the assessment of pathologic cartilage.
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Affiliation(s)
- Adem Yokuş
- Department of Radiology, Faculty of Medicine, Van Yüzüncü Yıl University, Van, Turkey
| | - Murat Toprak
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Van Yüzüncü Yıl University, Van, Turkey
| | - Harun Arslan
- Department of Radiology, Faculty of Medicine, Van Yüzüncü Yıl University, Van, Turkey
| | - Nurşen Toprak
- Department of Radiology, Faculty of Medicine, Van Yüzüncü Yıl University, Van, Turkey
| | - Hüseyin Akdeniz
- Department of Radiology, Faculty of Medicine, Van Yüzüncü Yıl University, Van, Turkey
| | - Ali Mahir Gündüz
- Department of Radiology, Faculty of Medicine, Van Yüzüncü Yıl University, Van, Turkey
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29
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Roberts HM, Griffith-McGeever CL, Owen JA, Angell L, Moore JP, Thom JM. An exploratory study to investigate the association between age, physical activity, femoral trochlear cartilage thickness and biomarkers of tissue metabolism in adult males. Eur J Appl Physiol 2021; 121:1871-1880. [PMID: 33713200 PMCID: PMC8192398 DOI: 10.1007/s00421-021-04655-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 02/25/2021] [Indexed: 11/27/2022]
Abstract
Purpose To investigate the association between age, physical activity, femoral trochlear cartilage thickness and biomarkers of tissue metabolism in a cross-sectional sample of adult males. This study utilizes several emerging biomarkers that have been associated with early joint degenerative changes; serum COMP (cartilage oligomeric matrix protein), HA (hyaluronan) and lubricin. Methods Eighty-one males (age: mean (range): 43(18–70) years; body mass index: 25.2 (21.0–30.6) kg/m2) volunteered. Resting serum COMP, HA and lubricin concentrations were determined via commercially available enzyme-linked immunosorbent assay (ELISA) and femoral trochlear cartilage thickness via supra-patellar ultrasound imaging. Physical activity levels were assessed using questionnaires. Statistical analyses were performed using correlation and regression analyses. Results Age was correlated with lateral trochlear cartilage thickness (r = − 0.372; p < 0.01) and serum COMP (r = 0.342; p < 0.01). 7-day physical activity was correlated with serum COMP (r = 0.357, p < 0.01), and 12-month physical activity with both lateral trochlear cartilage thickness (r = 0.340, p = 0.01) and serum HA (r = 0.296, p < 0.05). Regression analyses revealed that age significantly accounted for the variability in lateral cartilage thickness and serum COMP, following the adjustment for potential cofounders. However, the association between age and lateral trochlear cartilage thickness was not moderated by physical activity levels (all p > 0.05). Conclusion This study indicates that older age may be associated with thinner lateral trochlear cartilage and higher cartilage turnover. Being physically active may also be positive for lateral trochlear cartilage thickness. However, overall, both age and physical activity level only account for a small amount of the variability in cartilage thickness and serum biomarkers.
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Affiliation(s)
- Harry M Roberts
- School of Sport, Health and Exercise Sciences, Physical Activity for Health and Well Being (PAWB) Research Group, Bangor University, Bangor, UK. .,School of Biosciences and Medicine, University of Surrey, The Leggett Building, Daphne Jackson Road, Guildford, GU2 7WG, UK.
| | - Claire L Griffith-McGeever
- School of Sport, Health and Exercise Sciences, Physical Activity for Health and Well Being (PAWB) Research Group, Bangor University, Bangor, UK
| | - Julian A Owen
- School of Sport, Health and Exercise Sciences, Physical Activity for Health and Well Being (PAWB) Research Group, Bangor University, Bangor, UK
| | - Lewis Angell
- School of Sport, Health and Exercise Sciences, Physical Activity for Health and Well Being (PAWB) Research Group, Bangor University, Bangor, UK
| | - Jonathan P Moore
- School of Sport, Health and Exercise Sciences, Physical Activity for Health and Well Being (PAWB) Research Group, Bangor University, Bangor, UK
| | - Jeanette M Thom
- School of Sport, Health and Exercise Sciences, Physical Activity for Health and Well Being (PAWB) Research Group, Bangor University, Bangor, UK.,School of Medical Sciences, University of New South Wales, Sydney, Australia
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30
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Harkey MS, Little E, Thompson M, Zhang M, Driban JB, Salzler MJ. Femoral Cartilage Ultrasound Echo Intensity Associates with Arthroscopic Cartilage Damage. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:43-50. [PMID: 33082054 PMCID: PMC7568485 DOI: 10.1016/j.ultrasmedbio.2020.09.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/03/2020] [Accepted: 09/07/2020] [Indexed: 05/21/2023]
Abstract
This study compared quantitative cartilage ultrasound metrics between people with (n = 12) and without (n = 12) arthroscopic cartilage damage after anterior cruciate ligament injury (age, 24.9 ± 3.7 y; sex, 33% female, 67% male; days since injury = 50 ± 52). A transverse suprapatellar ultrasound assessment imaged the femoral cartilage in participants' injured knees before a clinical arthroscopy. A custom program automatically separated a manual cartilage segmentation into standardized medial and lateral femoral regions and calculated mean thickness (i.e., cross-sectional area/length of cartilage-bone interface), mean echo intensity and echo-intensity heterogeneity. An orthopedic surgeon assessed arthroscopic cartilage damage in the medial and lateral femoral condyles using the Outerbridge grading system (cartilage damage = Outerbridge ≥ 1). Separate logistic regressions for medial and lateral femoral cartilage were used to determine the association between each ultrasound metric and arthroscopic cartilage damage. In medial femoral cartilage, for every 1 standard deviation decrease in echo-intensity mean and heterogeneity, there is, respectively, a 91% (adjusted odds ratio, 0.09; 95% confidence interval, 0.01-0.69) and 97% (adjusted odds ratio, 0.03; 95% confidence interval, 0.002-0.50) increase in the odds of having arthroscopic cartilage damage. Lateral cartilage ultrasound metrics are not associated with lateral arthroscopic cartilage damage. This study provides preliminary evidence that femoral cartilage ultrasound echo intensity is a non-invasive measure associated with medial femoral cartilage health after anterior cruciate ligament injury.
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Affiliation(s)
- Matthew S Harkey
- Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA; Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, Massachusetts, USA; Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
| | - Erin Little
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Mikaela Thompson
- Department of Orthopaedics, Tufts Medical Center, Boston, Massachusetts, USA
| | - Ming Zhang
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, Massachusetts, USA; Department of Computer Science & Networking, Wentworth Institute of Technology, Boston, Massachusetts, USA
| | - Jeffrey B Driban
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Matthew J Salzler
- Department of Orthopaedics, Tufts Medical Center, Boston, Massachusetts, USA
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31
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Ultrasonographic Measurement of Talar Cartilage Thickness in Patients With Cerebral Palsy. Am J Phys Med Rehabil 2020; 99:1116-1120. [PMID: 32541350 DOI: 10.1097/phm.0000000000001499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Foot deformities are one of the most common musculoskeletal problems in children with cerebral palsy (CP). These deformities affect the walking ability and function of the patients. Talar cartilage is the hyaline joint cartilage of the tibiotalar joint that plantarflexes and dorsiflexes of the ankle. The aim of this study was to determine whether talar cartilage thickness was affected in children with ambulant diplegic CP. DESIGN Forty patients with diplegic CP (19 boys, 21 girls) and 40 age-, sex-, and weight-matched healthy control subjects (20 boys, 20 girls) were included in the study. The demographic and clinical characteristics of the patients, including age, sex, and body mass index, were recorded. Patients were classified using the Gross Motor Function Classification System. A 12-MHz linear probe was used for ultrasonographic cartilage measurements at the tibiotalar joint according to European Musculoskeletal Ultrasound Study Group (EURO-MUSCULUS) and the Ultrasound Study Group in Physical and Rehabilitation Medicine (USPRM) scanning protocols. RESULTS Mean talar cartilage thickness was significantly decreased in the CP group compared with the healthy control group (P < 0.001). There was a significant negative correlation between Gross Motor Function Classification System levels and talar cartilage thickness measurements (P < 0.001, Tb = -0.695). CONCLUSION This study demonstrates that patients with CP have a thinner talar cartilage compared with healthy control subjects.
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Reliability and concurrent validity of three-dimensional ultrasound for quantifying knee cartilage volume. OSTEOARTHRITIS AND CARTILAGE OPEN 2020; 2:100127. [DOI: 10.1016/j.ocarto.2020.100127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 11/18/2020] [Indexed: 11/20/2022] Open
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Effects of exercise mode in knee cartilage thickness. J Bodyw Mov Ther 2020; 24:490-495. [PMID: 33218552 DOI: 10.1016/j.jbmt.2020.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 01/07/2020] [Accepted: 05/01/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND It is unclear how cycling and running would differ in terms of changes in cartilage thickness. Also, given squats are a popular type of exercise used to strengthen lower limbs, it is critical to assess if loads used during resisted training could lead to changes in cartilage cushioning properties. Therefore, the purpose of this study was to compare the effects of exercise mode in knee cartilage thickness. METHODS This study utilized a randomized cross-over design with repeated measures. All sessions were completed between 48hrs and seven days, at the same time of the day. Fourteen (seven males and seven females) apparently healthy participants without musculoskeletal or neurological diseases volunteered for the study. Participants were assessed after squats and functional exercises (n = 18 knees) or after running and cycling (n = 10 knees). All ultrasound images were collected at participants' arrival in the laboratory (Baseline), after warm-up (Pre-exercise), after the completion of each exercise protocol (Post-exercise), and at five (5-min) and 10 minutes (10-min) after exercise. RESULTS Cartilage thickness did not change after squats performed with 60% of 1-RM or after a set of three functional exercises (i.e. sit-to-stand, lunges, and step-ups; p = 0.68). However, longer duration exercises (i.e. cycling and running) led to increases in cartilage thickness after 5-min from the completion of the exercise (p = 0.02). CONCLUSION Knee cartilage may have capacity to sustain short-term cyclical loads applied during exercise (i.e. squats and functional exercises) but not to moderate duration exercises (i.e. cycling and running).
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Üşen A, Tolu S. Factors Affecting the Femoral Cartilage Thickness After Anterior Cruciate Ligament Reconstruction. Indian J Orthop 2020; 55:352-359. [PMID: 33927813 PMCID: PMC8046890 DOI: 10.1007/s43465-020-00262-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/14/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND This study aimed to evaluate the changes in the distal femoral cartilage thickness in patients that underwent anterior cruciate ligament reconstruction (ACLR) and to analyze their association with concomitant meniscal surgery, knee muscle strength, kinesophobia, and physical activity level. METHODS The demographic characteristics and surgical data of 47 male patients that underwent unilateral ACLR (mean, 27.55 ± 5.63; range, 18-40 years) were evaluated. The patients were assessed in three groups depending on surgery: isolated ACLR (n = 15), ACLR + partial medial meniscus resection (ACLR&M) (n = 16), and ACLR + medial meniscus repair (ACLR&MR) (n = 16). The medial (MCCT), intercondylar (ICCT), and lateral (LCCT) femoral cartilage thicknesses on both limbs were measured using ultrasonography. The extensor and flexor muscles strength of the knees was assessed using an isokinetic dynamometer at 60°/s. The physical activity level was evaluated by the International Physical Activity Questionnaire (IPAQ) short form and Tegner Activity Scale (TAS). The fear of movement was assessed by the Tampa Scale for Kinesiophobia Questionnaire (TSKQ). RESULTS The postoperative mean follow-up duration was 32.24 ± 9.17 months. MCCT and LCCT were significantly decreased in the ACLR&M group (p < 0.001 and p = 0.019, respectively). MCCT, ICCT and LCCT were significantly decreased in the ACLR&MR group (p = 0.017, p = 0.011, and p = 0.004, respectively). No significant change was found in the ACLR group. Cartilage thickness changes were not significantly correlated with the knee muscle strength, IPAQ, TAS and TSKQ scores in all groups (p > 0.05). CONCLUSION The results showed partial meniscectomy and meniscus repair at the time of ACLR as important risk factors for decreased chondral thickness.
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Affiliation(s)
- Ahmet Üşen
- Department of Physical, Medicine and Rehabilitation, Faculty of Medicine, Istanbul Medipol University, TEM Avrupa Otoyolu Göztepe Çıkışı No: 1, Bagcilar, Istanbul, 34214 Turkey
| | - Sena Tolu
- Department of Physical, Medicine and Rehabilitation, Faculty of Medicine, Istanbul Medipol University, TEM Avrupa Otoyolu Göztepe Çıkışı No: 1, Bagcilar, Istanbul, 34214 Turkey
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Reliability of a Novel Semiautomated Ultrasound Segmentation Technique for Assessing Average Regional Femoral Articular Cartilage Thickness. J Sport Rehabil 2020; 29:1042-1046. [DOI: 10.1123/jsr.2019-0476] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/13/2020] [Accepted: 03/01/2020] [Indexed: 11/18/2022]
Abstract
Context: Ultrasound imaging is a clinically feasible tool to assess femoral articular cartilage and may have utility in tracking early knee osteoarthritis development. Traditional assessment techniques focus on measurements at a single location, which can be challenging to adopt for novice raters. Objective: To introduce a novel semiautomated ultrasound segmentation technique and determine the intrarater and interrater reliability of average regional femoral articular cartilage thickness and echo intensity of a novice and expert rater. Design: Descriptive observational study. Setting: Orthopedic clinic. Patients or Other Participants: Fifteen participants (mean [SD]; age 23.5 [4.6] y, height = 172.6 [9.3] cm, mass = 79.8 [15.7] kg) with a unilateral history of anterior cruciate ligament reconstruction participated. Intervention: None. Main Outcome Measures: One rater captured anterior femoral cartilage images of the participants’ contralateral knees using a transverse suprapatellar ultrasound assessment. The total femoral cartilage cross-sectional area of each image was segmented by a novice and expert rater. A novel custom program automatically separated the cartilage segmentations into medial, lateral, and intercondylar regions to determine the cross-sectional area and cartilage length. The average cartilage thickness in each region was calculated by dividing the cross-sectional area by the cartilage length. Echo intensity was calculated as the average gray-scale pixel value of each region. Two-way random effect intraclass correlations coefficient (ICC) for absolute agreement were used to determine the interrater reliability between a novice and expert rater, as well as the intrarater reliability of the novice rater. Results: The novice rater demonstrated excellent intrarater (ICC [2,k] range = .993–.997) and interrater (ICC [2,k] range = .944–.991) reliability with the expert rater of all femoral articular cartilage average thickness and echo intensity regions. Conclusions: The novel semiautomated average cartilage thickness and echo-intensity assessment is efficient, systematic, and reliable between an expert and novice rater with minimal training.
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Bedewi MA, Elsifey AA, Naguib MF, Saleh AK, Nwihadh NB, Abd-Elghany AA, Swify SM. Sonographic assessment of femoral cartilage thickness in healthy adults. J Int Med Res 2020; 48:300060520948754. [PMID: 32811271 PMCID: PMC7441287 DOI: 10.1177/0300060520948754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study was performed to obtain normative data of the distal femoral cartilage thickness in healthy adults by ultrasound. METHODS This cross-sectional study included 72 healthy adults. The demographic characteristics of the participants were recorded, and the thickness of the femoral articular cartilage was measured using a 5- to 18-MHz linear probe. RESULTS Significant statistical difference towards the male side at left medial condyle (P = 0.001) and left lateral condyle (P = 0.009). Weakly positive statistical difference was noted towards the male side at right medial condyle (P = 0.06) and right lateral condyle (P = 0.07). The femoral cartilage thickness in the study participants did not correlate with weight, body mass index, and age (P >0.05). Positive statistical correlation with height noted in right medial condyle, right lateral condyle, right intercondylar area, and left medial condyle. CONCLUSION This study increases the pool of normative data of femoral cartilage thickness measurements. Additionally, the findings of this study emphasize the fact that women have thinner cartilage than men in four of the studied parameters.
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Affiliation(s)
- Mohamed A Bedewi
- Department of Internal Medicine, Prince Sattam Bin Abdulaziz University, College of Medicine, Al-Kharj, Kingdom of Saudi Arabia
| | - Ayman A Elsifey
- Department of Internal Medicine, Prince Sattam Bin Abdulaziz University, College of Medicine, Al-Kharj, Kingdom of Saudi Arabia
| | - Moheyeldeen F Naguib
- Department of Internal Medicine, Prince Sattam Bin Abdulaziz University, College of Medicine, Al-Kharj, Kingdom of Saudi Arabia
| | - Ayman K Saleh
- Department of Surgery, Prince Sattam Bin Abdulaziz University, College of Medicine, Al-Kharj, Kingdom of Saudi Arabia.,Orthopedic Department, Faculty of Medicine for Girls, Alazhar University, Cairo, Egypt
| | - Naif Bin Nwihadh
- Department of Surgery, Prince Sattam Bin Abdulaziz University, College of Medicine, Al-Kharj, Kingdom of Saudi Arabia
| | - Amr A Abd-Elghany
- Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam Bin Abdul-Aziz University, Al-Kharj, Kingdom of Saudi Arabia.,Biophysics Department, Faculty of Science, Cairo University, Cairo University St., Giza, Egypt
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Herrera H GA, Llinás PJ, Flórez L, Blanco Montes C, Vernaza Obando D, Díaz Solorzano A, Loaiza D, Guillen Astete C. Ultrasound measurement of femoral cartilage thickness in the knee of healthy young university students. Rev Esp Cir Ortop Traumatol (Engl Ed) 2020; 64:244-250. [PMID: 32499158 DOI: 10.1016/j.recot.2020.04.001] [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] [Received: 10/28/2019] [Revised: 03/28/2020] [Accepted: 04/18/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Articular cartilage (AC) is always affected in any joint with osteoarthritis. Ultrasound can be a useful tool in monitoring changes in the AC. The purpose of the present study is to ultrasound measure the thickness of the AC in the distal femur in young students and determine its relationship with body mass index (BMI), muscle mass, body fat and sports practice. MATERIALS AND METHODS An observational cross-sectional study was conducted with healthy volunteers, between 15 and 25 years old. Anthropometric data were collected and the thickness of the femoral cartilage of the knee was measured at 5 points. In addition, the percentage of muscle and body fat was measured in a subgroup. RESULTS 100 subjects were included in the study. The average age was 20 years (± 2.5). The average BMI was 23 kg/m2 (± 3.1). AC was thicker in men and sportsmen, versus women and sedentary people, with a statistically significant difference. When comparing BMI with AC thickness no significant relationship was found; however, only 2 participants had BMI > 30. CONCLUSIONS Cartilage thickness has a direct relationship with the percentage of muscle, and inversely with the percentage of fat. BMI is not a good parameter when evaluating the dynamic behaviour of cartilage in non-obese youths.
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Affiliation(s)
- G A Herrera H
- Departamento de Ortopedia, Fundación Valle del Lili, Cali, Colombia; Universidad Icesi, Cali, Colombia
| | - P J Llinás
- Departamento de Ortopedia, Fundación Valle del Lili, Cali, Colombia; Universidad Icesi, Cali, Colombia
| | - L Flórez
- Fundación Valle del Lili. Centro de Investigaciones Clínicas, Cali, Colombia
| | | | - D Vernaza Obando
- Fundación Valle del Lili. Centro de Investigaciones Clínicas, Cali, Colombia.
| | | | - D Loaiza
- Universidad Icesi, Cali, Colombia
| | - C Guillen Astete
- Departamento de Reumatología, Hospital Universitario Ramón y Cajal, Madrid, España
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Ultrasound measurement of femoral cartilage thickness in the knee of healthy young university students. Rev Esp Cir Ortop Traumatol (Engl Ed) 2020. [DOI: 10.1016/j.recote.2020.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Pfeiffer SJ, Davis-Wilson HC, Pexa B, Szymczak J, Wistreich C, Sorensen R, Wikstrom EA, Blackburn JT, Pietrosimone B. Assessing Step Count-Dependent Changes in Femoral Articular Cartilage Using Ultrasound. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:957-965. [PMID: 31763713 DOI: 10.1002/jum.15180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/08/2019] [Accepted: 10/14/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To evaluate changes in the femoral cartilage cross-sectional area (CSA) measured with ultrasound (US) between baseline and 1000, 2000, 3000, 4000, and 5000 steps of walking on a treadmill. METHODS Forty-one healthy individuals completed a single testing session. Participants rested with their knees extended on a plinth for 45 minutes to unload the femoral cartilage. Ultrasound was used to acquire images of the femoral cartilage before the treadmill-walking protocol. After the baseline US acquisition, participants walked on a treadmill at their preferred overground walking speed for 1000 steps, after which additional US images of the femoral cartilage were acquired. This process was repeated after 2000, 3000, 4000, and 5000 steps. A 1-way repeated-measures analysis of variance compared the CSA across the 6 step counts. An analysis of variance with repeated measures on time and Bonferroni corrected planned comparisons (.05/5) were used to evaluate differences in the femoral cartilage at each step count compared to baseline. RESULTS The study included 20 male and 21 female participants (mean age ± SD, 21.5 ± 2.8 years; mean body mass index, 24.3 ± 3.4 kg/m 2 ). The CSAs were significantly greater at the 2000-step (1.27 ± 1.75 mm 2 ; P < .001), 4000-step (0.89 ± 1.17 mm2; P < .001), and 5000-step (2.10 ± 1.73 mm 2 ; P < .001) points compared to baseline. The CSA was significantly less at the 3000-step point (1.05 ± 1.29 mm 2 ; P < .001) compared to baseline. CONCLUSIONS Changes in the CSA after walking may be dependent on the number of steps. The participants had a significant decrease in the CSA after 3000 steps of normal walking and a significant increase in the CSA after 2000, 4000, and 5000 steps of normal walking.
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Affiliation(s)
- Steven J Pfeiffer
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
- Human Movement Science Curriculum, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Hope C Davis-Wilson
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
- Human Movement Science Curriculum, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brett Pexa
- Department of Athletic Training, High Point University, High Point, NC, USA
| | - Jessica Szymczak
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Catherine Wistreich
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Rachel Sorensen
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Erik A Wikstrom
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
- Human Movement Science Curriculum, University of North Carolina, Chapel Hill, North Carolina, USA
| | - J Troy Blackburn
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
- Human Movement Science Curriculum, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Orthopedics, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brian Pietrosimone
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
- Human Movement Science Curriculum, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Orthopedics, University of North Carolina, Chapel Hill, North Carolina, USA
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Angerová Y, Mezian K, Kara M, Pudilová V, Sobotová K, Michalčinová K, Konopáčová E, Özçakar L. Ultrasonographic evaluation of the distal femoral and talar cartilage thicknesses in patients with poliomyelitis: a cross-sectional observational study. Eur J Phys Rehabil Med 2020; 56:421-426. [PMID: 32329587 DOI: 10.23736/s1973-9087.20.06127-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Sequelae of poliomyelitis, coupled with asymmetric impairment and weight-bearing, typically alter walking biomechanics which can be associated with the knee and ankle osteoarthritis. AIM We aimed to investigate whether the distal femoral and talar cartilage thicknesses were different in patients with poliomyelitis. DESIGN Cross-sectional observational study. SETTING Outpatients, tertiary care center. POPULATION Thirty-six patients (12 males, 24 females) with a history of poliomyelitis and 36 age, gender and body mass index similar healthy subjects (11 males, 25 females) were enrolled. Mean values for age, body mass index and age of the poliomyelitis onset were 70.2±4.6 years, 27.2±5.7 kg/m2, and 3.6±2.4 years. METHODS Visual Analogue Scale (VAS) was used to assess pain. Lower limb muscle strengths were measured by manual muscle testing. The more affected side was identified according to the lower limb manual muscle testing. Bilateral distal femoral cartilage from the lateral femoral condyle, intercondylar area, medial femoral condyle and talar cartilage thicknesses were measured using ultrasound imaging. RESULTS Among patients, the onset of poliomyelitis was at 3.6±2.4 years of age, and Functional Ambulation Category scores were 5 (3-5). VAS scores were similar between the sides affected more and less by poliomyelitis. All cartilage thicknesses (except the talar cartilage) of the patients were found to be thinner on the more affected side than the less affected side (all P<0.001). The thickness of talar cartilage was thinner compared to control subjects (P<0.001). Among the patients, quadriceps muscle strength was positively correlated with medial condyle (r=0.377, P=0.024), intercondylar area (r=0.399, P=0.016) and lateral condyle (r=0.363, P=0.030) thicknesses. Knee VAS scores were negatively correlated with talar cartilage thicknesses (r=-0.393, P=0.018). CONCLUSIONS We found a thinning of the distal femoral condyle in the more affected paretic sides of poliomyelitis patients as compared to both those of less affected sides and those of healthy controls. Talar cartilages on both sides of the patients were thinner compared to control subjects. CLINICAL REHABILITATION IMPACT Our preliminary findings may contribute to the long-term management of patients with long-term poliomyelitis sequelae.
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Affiliation(s)
- Yvona Angerová
- Department of Rehabilitation Medicine, First Faculty of Medicine, General University Hospital, Charles University, Prague, Czech Republic
| | - Kamal Mezian
- Department of Rehabilitation Medicine, First Faculty of Medicine, General University Hospital, Charles University, Prague, Czech Republic -
| | - Murat Kara
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Veronika Pudilová
- Department of Rehabilitation Medicine, First Faculty of Medicine, General University Hospital, Charles University, Prague, Czech Republic
| | - Karolína Sobotová
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic
| | - Klaudia Michalčinová
- Department of Rehabilitation Medicine, First Faculty of Medicine, General University Hospital, Charles University, Prague, Czech Republic.,Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic
| | - Eva Konopáčová
- Department of Rehabilitation Medicine, First Faculty of Medicine, General University Hospital, Charles University, Prague, Czech Republic
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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Bedewi MA, Elsifey AA, Naguib MF, Saleh AK, Al-Ghamdi S, Alhariqi BA, Aldossary NM, Gould ES. Ultrasonographic measurement of femoral cartilage thickness in type II diabetic patients. Medicine (Baltimore) 2020; 99:e19455. [PMID: 32243364 PMCID: PMC7220742 DOI: 10.1097/md.0000000000019455] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study is to compare the distal femoral cartilage thickness of patients with type II diabetes mellitus with those of healthy subjects using ultrasonography. The study comprised 34 patients and 36 healthy subjects. Demographic characteristics of all the participants were recorded. The thickness of the femoral articular cartilage was measured using a 5-18MHzlinearprobe.Measurements were performed bilaterally from three points (intercondylar area, medial condyle, and lateral condyle). No significant difference could be found between patients and healthy subjects. Two demographic characteristics correlated positively with diabetic patients.
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Affiliation(s)
- Mohamed A. Bedewi
- Department of Internal Medicine, Prince Sattam Bin Abdulaziz university, College of Medicine
| | - Ayman A. Elsifey
- Department of Internal Medicine, Prince Sattam Bin Abdulaziz university, College of Medicine
| | - Moheyeldeen F. Naguib
- Department of Internal Medicine, Prince Sattam Bin Abdulaziz university, College of Medicine
| | - Ayman K. Saleh
- Department of Surgery, Prince Sattam Bin Abdulaziz university, College of Medicine, Kingdom of Saudi Arabia
- Orthopedic Department, Faculty of Medicine for Girls, Alazhar University, Cairo, Egypt
| | - Sameer Al-Ghamdi
- Department of Family Medicine, Prince Sattam Bin Abdulaziz university, College of Medicine, Kingdom of Saudi Arabia
| | - Bader A. Alhariqi
- Department of Internal Medicine, Prince Sattam Bin Abdulaziz university, College of Medicine
| | - Nasser M. Aldossary
- Department of Internal Medicine, Prince Sattam Bin Abdulaziz university, College of Medicine
| | - Elaine S. Gould
- Department of Radiology, Stony Brook University, Stony Brook, New York, USA
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Lee SW, Patel J, Van Dien C, Ayutyanont N, Naguib A, Emam M, Kim S. The Transverse Infrapatellar View: A New Ultrasound Technique to Measure Distal Femoral Cartilage Thickness. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:463-470. [PMID: 31452247 DOI: 10.1002/jum.15122] [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: 03/04/2019] [Accepted: 08/03/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To examine the reliability and face validity of ultrasound (US) measurements of distal femoral cartilage thickness (CT) using the infrapatellar view (IPV) with knee extension compared to the traditional suprapatellar view (SPV) with knee hyperflexion in young asymptomatic participants and patients with painful knee osteoarthritis (KOA). METHODS The IPV was obtained in an extended knee position by placing the US transducer on the patellar tendon at a 60° angle tilted toward the distal femoral condyle in 19 young adults (control group) and 70 patients with KOA. The CT was measured at the medial femoral condyle, the intercondylar notch, and the lateral femoral condyle. RESULTS The inter-rater intraclass correlation coefficient was higher for IPV-based CT measurement (range, 0.856-0.858) compared to SPV-based CT measurement (range, 0.315-0.523) among the patients with symptomatic KOA. The IPV-based CT differed significantly between the control group and the KOA group at the intercondylar notch (P < .001) and lateral femoral condyle (P = .006). The SPV-based CT differed significantly between the control group and the KOA group only at the lateral femoral condyle region (P = .014). CONCLUSIONS An infrapatellar US evaluation of the distal femoral CT can be a reliable alternative method to a suprapatellar US evaluation for patients with KOA.
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Affiliation(s)
- Se Won Lee
- Department of Physical Medicine and Rehabilitation, Sunrise Health GME Consortium, Las Vegas, Nevada, USA
| | - Jasal Patel
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Craig Van Dien
- Department of Physical Medicine and Rehabilitation, JFK Johnson Rehabilitation Institute, Edison, New Jersey, USA
| | - Napatkamon Ayutyanont
- Department of Physical Medicine and Rehabilitation, Sunrise Health GME Consortium, Las Vegas, Nevada, USA
| | - Abir Naguib
- Department of Physical Medicine and Rehabilitation, Creighton University, Omaha, Nebraska, USA
| | - Mohammed Emam
- Department of Orthopedics and Rehabilitation Medicine, State University of New York Downstate Medical Center, Brooklyn, New York, USA
| | - Sooyeon Kim
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
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Hurnakova J, Filippucci E, Cipolletta E, Di Matteo A, Salaffi F, Carotti M, Draghessi A, Di Donato E, Di Carlo M, Lato V, Horvath R, Komarc M, Pavelka K, Grassi W. Prevalence and distribution of cartilage damage at the metacarpal head level in rheumatoid arthritis and osteoarthritis: an ultrasound study. Rheumatology (Oxford) 2020; 58:1206-1213. [PMID: 30690561 DOI: 10.1093/rheumatology/key443] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 12/03/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To determine the prevalence and distribution of US-detected qualitative cartilage damage at metacarpal heads of patients with RA and hand OA. METHODS Fifty-two RA patients and 34 patients with hand OA were enrolled. US examination of the metacarpal head cartilage from the II to V finger of both hands was performed. A total of 414 MCP joints in RA and 266 MCP joints in OA patients were scanned with a linear probe up to 22 MHz. Qualitative assessments using a previously described scoring system for cartilage damage were performed. The prevalence and distribution of cartilage damage were analysed. Multivariate regression analysis was used to determine the predictive value of age, gender, BMI, disease duration and the presence of RF and anti-CCP antibodies for US-detected cartilage damage. RESULTS The metacarpal head cartilage was positive for cartilage damage in 35.7% (148/414) of MCP joints in RA and in 43.6% (116/266) of MCP joints in OA patients. In RA, the hyaline cartilage of the II and III metacarpal heads (bilaterally) was the most frequently affected. In OA, cartilage damage was more homogeneously distributed in all MCP joints. Multivariate regression analysis showed that age and disease duration, but not gender, BMI or autoantibody status, were independent predictors of US-detected cartilage damage in RA. CONCLUSION Cartilage damage was found in more than one-third of the MCP joints in both RA and OA patients, and in RA patients, the II and III MCP joints were the most damaged.
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Affiliation(s)
- Jana Hurnakova
- Rheumatology Department, Università Politecnica delle Marche, C. Urbani Hospital, Jesi, Ancona, Italy.,Department of Rheumatology, Institute of Rheumatology, First Faculty of Medicine, Charles University.,Department of Pediatric and Adult Rheumatology, Motol University Hospital, Prague, Czech Republic
| | - Emilio Filippucci
- Rheumatology Department, Università Politecnica delle Marche, C. Urbani Hospital, Jesi, Ancona, Italy
| | - Edoardo Cipolletta
- Rheumatology Department, Università Politecnica delle Marche, C. Urbani Hospital, Jesi, Ancona, Italy
| | - Andrea Di Matteo
- Rheumatology Department, Università Politecnica delle Marche, C. Urbani Hospital, Jesi, Ancona, Italy
| | - Fausto Salaffi
- Rheumatology Department, Università Politecnica delle Marche, C. Urbani Hospital, Jesi, Ancona, Italy
| | - Marina Carotti
- Radiology Department, Università Politecnica delle Marche, Ancona, Italy
| | - Antonella Draghessi
- Rheumatology Department, Università Politecnica delle Marche, C. Urbani Hospital, Jesi, Ancona, Italy
| | - Eleonora Di Donato
- Rheumatology Department, Università Politecnica delle Marche, C. Urbani Hospital, Jesi, Ancona, Italy
| | - Marco Di Carlo
- Rheumatology Department, Università Politecnica delle Marche, C. Urbani Hospital, Jesi, Ancona, Italy
| | - Valentina Lato
- Rheumatology Department, Università Politecnica delle Marche, C. Urbani Hospital, Jesi, Ancona, Italy
| | - Rudolf Horvath
- Department of Pediatric and Adult Rheumatology, Motol University Hospital, Prague, Czech Republic
| | - Martin Komarc
- Department of Methodology, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Karel Pavelka
- Department of Rheumatology, Institute of Rheumatology, First Faculty of Medicine, Charles University
| | - Walter Grassi
- Rheumatology Department, Università Politecnica delle Marche, C. Urbani Hospital, Jesi, Ancona, Italy
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Bratke G, Bruggemann GP, Willwacher S, Mählich D, Trudeau MB, Rohr E, Weir G, Maintz D, Hamill J. Does footwear affect articular cartilage volume change after a prolonged run? Scand J Med Sci Sports 2019; 30:332-338. [PMID: 31605631 DOI: 10.1111/sms.13576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/25/2019] [Accepted: 10/08/2019] [Indexed: 11/26/2022]
Abstract
The aim of this study was to investigate knee intra-articular cartilage volume changes after a prolonged running bout in three footwear conditions. Twelve participants performed 75-minute running bouts in the three footwear conditions. Before and after each running bout, magnetic resonance imaging (MRI) scans were obtained using a high-resolution 3.0 Tesla MRI. Three-dimensional reconstruction of the cartilage plates of the patella, the femur, and the tibia was created to quantify cartilage volume change due to the 75-minute running bout. Three-dimensional biomechanical data were also collected using an integrated motion capture and force treadmill system. There were no statistically significant differences among shoe conditions for all anatomical regions. However, significant cartilage volume reductions at all anatomical sites were observed after the 75-minute running bout in each footwear condition. These data suggest that the intra-articular knee cartilage undergoes a significant reduction in cartilage volume during a prolonged run that may indicate an increase in joint loading. There was a considerable variation in cartilage volume between participants across footwear conditions indicating an individual cartilage volume response to footwear. An individualistic approach to footwear recommendations may help in minimizing this change in cartilage.
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Affiliation(s)
- Grischa Bratke
- Institute for Diagnostic and Interventional Radiology, University Hospital, Cologne, Germany
| | - Gert-Peter Bruggemann
- Institute of Biomechanics and Orthopedics, German Sport University, Cologne, Germany
| | - Steffen Willwacher
- Institute of Biomechanics and Orthopedics, German Sport University, Cologne, Germany
| | - Daniela Mählich
- Institute of Biomechanics and Orthopedics, German Sport University, Cologne, Germany
| | | | - Eric Rohr
- Brooks Running Inc, Seattle, WA, USA
| | - Gillian Weir
- Biomechanics Laboratory, University of Massachusetts Amherst, Amherst, MA, USA
| | - David Maintz
- Institute for Diagnostic and Interventional Radiology, University Hospital, Cologne, Germany
| | - Joseph Hamill
- Biomechanics Laboratory, University of Massachusetts Amherst, Amherst, MA, USA
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Seifeldein GS, Haseib A, Hassan HA, Ahmed G. Correlation of knee ultrasonography and Western Ontario and McMaster University (WOMAC) osteoarthritis index in primary knee osteoarthritis. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2019. [DOI: 10.1186/s43055-019-0029-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Im SC, Kim K. Comparison of medial femoral cartilage deformation in normal adults according to gait conditions. J Exerc Rehabil 2019; 15:407-413. [PMID: 31316933 PMCID: PMC6614776 DOI: 10.12965/jer.1938192.096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 06/04/2019] [Indexed: 12/04/2022] Open
Abstract
This study aimed to explore the deformation of medial femoral cartilage in normal adults according to gait conditions. Overall, 76 normal adults without degenerative arthritis or a knee injury on medical history were randomly assigned into control, flatland walk, slope walk, and stepper walk groups. The control group was rested for 30 min, the test group performed flatland walking, 16° slope walking, and stepper walking, respectively. The thickness of medial femoral cartilage before and after gait was evaluated through ultrasound test. Compared with the control group, a significant difference was noted for medial femoral cartilage deformation before and after gait in all the three groups. Comparison of the medial femoral cartilage deformation among the groups revealed a significant difference between the control group and the flatland walk, slope walk, and stepper walk groups (P<0.05). The flatland walk group had a significant difference between the slope walk group and stepper walk group (P<0.05), whereas no significant difference was noted between the slope walk and stepper walk groups (P>0.05). After a 30-min walk, the thickness of medial femoral cartilage was reduced, and a difference in deformation was noted according to gait conditions. The thickness of medial femoral cartilage was reduced more in the stepper walk and slope walk groups, wherein more load operates on the knee, than the flatland walk group.
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Affiliation(s)
- Sang-Cheol Im
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Gyeongsan, Korea
| | - Kyoung Kim
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Gyeongsan, Korea
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Martin-Alguacil JL, Arroyo-Morales M, Martin-Gómez JL, Lozano-Lozano M, Galiano-Castillo N, Cantarero-Villanueva I. Comparison of knee sonography and pressure pain threshold after anterior cruciate ligament reconstruction with quadriceps tendon versus hamstring tendon autografts in soccer players. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2019; 53:260-265. [PMID: 31201076 PMCID: PMC6738273 DOI: 10.1016/j.aott.2019.04.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 03/05/2019] [Accepted: 04/28/2019] [Indexed: 12/16/2022]
Abstract
Objective The aim of this study was to compare the pressure pain threshold and muscle architecture after an anatomic single bundle reconstruction with quadriceps tendon and hamstring tendon autografts of the anterior cruciate ligament in competitive soccer players. We hypothesized that both procedures will obtain similar outcomes. Methods Fifty-one participants were enrolled in this secondary analysis of a randomized controlled trial and were categorised into two groups: quadriceps tendon (QT) group (23 men and 3 women; mean age 18.7 ± 3.6; BMI 23.0 ± 2.2) or hamstring tendon (HT) group (16 men and 9 women; mean age 19.2 ± 3.6 BMI 23.5 ± 3.5). Both groups followed the same rehabilitation staged protocol. Pressure pain threshold (PPT), as a measure of perceived pain, was obtained in several points of quadriceps and hamstring muscles. Ultrasound imaging measurements were obtained in quadriceps tendon and knee cartilage thickness. Four measurements were taken in this study: baseline, 1, 3, 6, and 12 months after the anterior cruciate ligament (ACL) reconstruction. Results The analysis of PPT did not find significant differences in both groups × interaction time in the points evaluated: epicondyle (QT = 421.1 ± 184.1 vs HT = 384.7 ± 154.1 kPa), vastus lateralis (QT = 576.2 ± 221.3 vs HT = 560.1 ± 167.7 kPa), vastus medialis (QT = 544.7 ± 198.8 vs HT = 541.1.1 ± 181.77 kPa), patellar tendon (QT = 626.3 ± 221.1 vs HT = 665.0 ± 205.5 kPa), QT (QT = 651.1 ± 276.9 vs HT = 660.0 ± 195.2 kPa). (QT = 667.8 ± 284.7 vs HT = 648.2 ± 193.4 kPa) injured knee (all P > 0.05). The results of ultrasound imaging did not show significant differences in both groups × interaction time in the thickness of the QT (QT = 9.9 ± 2.4 vs HT = 9.4 ± 1.7 kPa) and patellar cartilage (QT = 3.2 ± 0.6 vs HT = 3.2 ± 0.4 kPa) (P > 0.05). Conclusion A QT autograft produces similar results to a HT autograft in ACL reconstructions in terms of pressure pain threshold and ultrasound muscle architecture during the 1-year follow-up. Level of Evidence Level I, Therapeutic Study.
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Efficacy and Safety of a Stimulator Using Low-Intensity Pulsed Ultrasound Combined with Transcutaneous Electrical Nerve Stimulation in Patients with Painful Knee Osteoarthritis. Pain Res Manag 2019; 2019:7964897. [PMID: 31316682 PMCID: PMC6604342 DOI: 10.1155/2019/7964897] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 04/03/2019] [Accepted: 05/22/2019] [Indexed: 01/17/2023]
Abstract
Objective Studies regarding the combination of ultrasound and transcutaneous electrical nerve stimulation (TENS) are rarely reported. In this study, we aimed to elucidate the efficacy and safety of a stimulator using low-intensity pulsed ultrasound (LIPUS) combined with TENS in patients with painful knee osteoarthritis (OA). We evaluated the effectiveness of this therapy against pain, physical function, and cartilage regeneration. Moreover, we aim to prove the superiority of the effects of LIPUS combined with TENS therapy compared with only TENS therapy. Methods Of the 40 included patients, aged 45-85 years with painful knee OA, 20 patients received only TENS therapy and 20 patients received LIPUS combined with TENS therapy for 8 weeks (a total of more than 80 treatment sessions). We evaluated visual analogue scale (VAS), Western Ontario and McMaster Universities (WOMAC) osteoarthritis index, MOS 36-Item Short-Form Health Survey (SF-36), and femoral articular cartilage (FAC) thickness. The evaluation was performed at three visits: visit 1 (V1, pretreatment, within 28 days after screening), visit 2 (V2, posttreatment period 1, ±3 days after treatment), and visit 3 (V3, posttreatment period 2, 21 ± 3 days after treatment). Results We expected that LIPUS combined with TENS therapy would be superior to only TENS therapy. However, there was no significant difference between the two therapies. In the within-group comparison, both treatments (only TENS therapy and LIPUS with TENS therapy) demonstrated statistical differences from baseline values for pain and physical function outcomes. FAC thickness showed no significant differences after treatment in both groups. Conclusion The effects of a stimulator using LIPUS with TENS on pain relief and functional improvement were not superior to the only TENS therapy. Cartilage regeneration, which was expected as an additional benefit of LIPUS, was also not significantly evident. Therefore, further investigation is warranted to determine whether the combination therapy is beneficial. This trial is registered with KCT0003883.
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Bernardo-Bueno MM, Gonzalez-Suarez CB, Malvar AK, Cua R, Feliciano D, Tan-Sales BG, Aycardo SMO, Tan-Ong M, Chan R, De Los Reyes F. Stratifying Minimal Versus Severe Pain in Knee Osteoarthritis Using a Musculoskeletal Ultrasound Protocol. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:1411-1423. [PMID: 30239017 DOI: 10.1002/jum.14819] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 08/10/2018] [Accepted: 08/14/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The aim of this cross-sectional correlational study was to determine the association of pain with morphologic and inflammatory sonographic findings in patients with knee osteoarthritis. METHODS A total of 113 participants with knee osteoarthritis were assessed using visual analog scale pain score and sonography. Ultrasound evaluation included morphologic changes (ie, articular cartilage degeneration, medial and lateral meniscal protrusion, and presence of osteophytes on the joint margins) and inflammatory changes (ie suprapatellar effusion and/or synovitis, Baker cyst, superficial and deep infrapatellar effusion, pes anserine tendinopathy, and Hoffa panniculitis). RESULTS Cluster analysis via Ward's method grouped patients with minimal pain (visual analog scale score, 0-4) and with substantial pain (visual analog scale score, 5-10). Stepwise logistic regression yielded 5 variables that significantly explained the variation in the probability of perceived substantial pain at 10% level of significance: lateral cartilage clarity (LCC; P = .025), medial cartilage clarity (MCC; P = .20), medial cartilage thickness (MCT; P = .041), medial meniscus protrusion (MMP) (P = .029), and osteophytes at medial femoral margin (P = .082), with 63% overall prediction accuracy. When age and sex were added, 4 variables remained significant at a 10% level of significance: LCC, MCC, MCT, and MMP, with 65% overall prediction accuracy. The receiver operating characteristic curve of this model was 0.667. CONCLUSION The study was able to demonstrate that morphologic abnormalities in the ultrasound parameters for LCC, MCC, MCT, and MMP were able to predict significant joint pain in knee osteoarthritis. There were no inflammatory changes that contributed to significant joint pain in this study.
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Affiliation(s)
- Mary Monica Bernardo-Bueno
- Department of Physical Medicine and Rehabilitation, University of Santo Tomas Hospital
- Department of Physical Medicine and Rehabilitation, Our Lady of Lourdes Hospital, Manila, Philippines
- East Avenue Medical Center Quezon City, Philippines College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines
| | - Consuelo B Gonzalez-Suarez
- Department of Physical Medicine and Rehabilitation, University of Santo Tomas Hospital
- Department of Physical Medicine and Rehabilitation, Our Lady of Lourdes Hospital, Manila, Philippines
| | | | - Ronald Cua
- Department of Physical Medicine and Rehabilitation, University of Santo Tomas Hospital
| | - Daniel Feliciano
- Department of Physical Medicine and Rehabilitation, University of Santo Tomas Hospital
| | - Bee Giok Tan-Sales
- Department of Physical Medicine and Rehabilitation, University of Santo Tomas Hospital
| | | | - Millicent Tan-Ong
- Faculty of Medicine and Surgery, Department of Medicine, Section of Rheumatology, Clinical Immunology and Osteoporosis, University of Santo Tomas, Manila Philippines
| | - Robert Chan
- Department of Orthopedic Surgery, University of Santo Tomas Hospital
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Volland LM, Zhou JY, Barnes RFW, Kruse-Jarres R, Steiner B, Quon DV, Bailey C, Hughes TH, Moore RE, Chang EY, von Drygalski A. Development and Reliability of the Joint Tissue Activity and Damage Examination for Quantitation of Structural Abnormalities by Musculoskeletal Ultrasound in Hemophilic Joints. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:1569-1581. [PMID: 30371941 DOI: 10.1002/jum.14846] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 09/24/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Musculoskeletal ultrasound (US) is used increasingly to examine hemophilic arthropathy. However, quantitative algorithms to document findings are lacking. We developed and sought to validate a protocol quantifying hemophilic joint abnormalities. METHODS Thirty-one patients with hemophilia were examined serially for 2 years with musculoskeletal US (≈600 joint examinations and ≈6000 images). Based on the spectrum of pathologies, a quantitative algorithm, named Joint Tissue Activity and Damage Examination (JADE), was developed for soft tissue and osteochondral measurements, including power Doppler, using nominal group techniques. To study intra- and inter-rater reliability, 8 musculoskeletal US-experienced hemophilia providers performed anatomic landmark recognition and tissue measurements on 86 images with arthropathic changes, with repetition 1 month later. Twenty-three musculoskeletal US-inexperienced providers performed similar assessments. Inter-operator reliability was established by 6 musculoskeletal US-experienced hemophilia providers, each acquiring images and JADE assessments of 3 hemophilic arthropathic joints. A radiologist and musculoskeletal sonographer functioned as adjudicators. The statistical analysis was performed with the intraclass correlation coefficient (ICC), Fleiss κ, and Cohen κ where appropriate. RESULTS The musculoskeletal US-experienced providers showed excellent intra-and inter-rater reliability for tissue measurements (ICCs, 0.94-0.96). Agreement was good to excellent for landmark recognition (Fleiss κ, 0.87-0.94). Inter-operator reliability was excellent for measurements and landmark recognition (ICC, 0.90; Fleiss κ, 1.0). Agreement with adjudicators was mostly good to excellent. Musculoskeletal US-inexperienced providers showed excellent inter-rater reliability for measurements (ICC, 0.96) and moderate agreement for landmark recognition (Fleiss κ, 0.58). CONCLUSIONS The JADE protocol appears feasible for quantifying hemophilic intra-articular abnormalities. Musculoskeletal US-trained hemophilia providers showed high intra-rater, inter-rater, and inter-operator reliability, supporting JADE as a protocol for clinical management and research.
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Affiliation(s)
- Lena M Volland
- Department of Medicine, Division of Hematology/Oncology, University of California, San Diego, California, USA
| | - Jenny Y Zhou
- Department of Medicine, Division of Hematology/Oncology, University of California, San Diego, California, USA
| | - Richard F W Barnes
- Department of Medicine, Division of Hematology/Oncology, University of California, San Diego, California, USA
| | - Rebecca Kruse-Jarres
- Washington Center for Bleeding Disorders at Bloodworks Northwest, Seattle, Washington, USA
| | - Bruno Steiner
- Washington Center for Bleeding Disorders at Bloodworks Northwest, Seattle, Washington, USA
| | - Doris V Quon
- Orthopedic Hemophilia Treatment Center, Orthopedic Institute for Children, Los Angeles, California, USA
| | - Cindy Bailey
- Orthopedic Hemophilia Treatment Center, Orthopedic Institute for Children, Los Angeles, California, USA
| | - Tudor H Hughes
- Department of Radiology, University of California, San Diego, California, USA
| | - Randy E Moore
- General Musculoskeletal Imaging, Inc, Cincinnati, Ohio, USA
| | - Eric Y Chang
- Radiology Service, VA San Diego Healthcare System, San Diego, California, USA
| | - Annette von Drygalski
- Department of Medicine, Division of Hematology/Oncology, University of California, San Diego, California, USA
- Department of Molecular Medicine, Scripps Research Institute, La Jolla, California, USA
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