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Ambrosio L, Vadalà G, Castaldo R, Gentile G, Nibid L, Rabitti C, Ambrosio L, Franceschetti E, Samuelsson K, Senorski EH, Papalia R, Denaro V. Massive foreign body reaction and osteolysis following primary anterior cruciate ligament reconstruction with the ligament augmentation and reconstruction system (LARS): a case report with histopathological and physicochemical analysis. BMC Musculoskelet Disord 2022; 23:1140. [PMID: 36581922 PMCID: PMC9801556 DOI: 10.1186/s12891-022-05984-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 11/14/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Autologous hamstrings and patellar tendon have historically been considered the gold standard grafts for anterior cruciate ligament reconstruction (ACLR). In the last decades, the utilization of synthetic grafts has re-emerged due to advantageous lack of donor site morbidity and more rapid return to sport. The Ligament Augmentation and Reconstruction System (LARS) has demonstrated to be a valid and safe option for ACLR in the short term. However, recent studies have pointed out the notable frequency of associated complications, including synovitis, mechanical failure, and even chondrolysis requiring joint replacement. CASE PRESENTATION We report the case of a 23-year-old male who developed a serious foreign body reaction with wide osteolysis of both femoral and tibial tunnels following ACLR with LARS. During first-stage arthroscopy, we performed a debridement of the pseudocystic mass incorporating the anterior cruciate ligament (ACL) and extending towards the tunnels, which were filled with autologous anterior iliac crest bone graft chips. Histological analysis revealed the presence of chronic inflammation, fibrosis, and foreign body giant cells with synthetic fiber inclusions. Furthermore, physicochemical analysis showed signs of fiber depolymerization, increased crystallinity and formation of lipid peroxidation-derived aldehydes, which indicate mechanical aging and instability of the graft. After 8 months, revision surgery was performed and ACL revision surgery with autologous hamstrings was successfully carried out. CONCLUSIONS The use of the LARS grafts for ACLR should be cautiously contemplated considering the high risk of complications and early failure.
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Affiliation(s)
- Luca Ambrosio
- grid.488514.40000000417684285Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy ,grid.9657.d0000 0004 1757 5329Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Gianluca Vadalà
- grid.488514.40000000417684285Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy ,grid.9657.d0000 0004 1757 5329Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Rachele Castaldo
- grid.5326.20000 0001 1940 4177Institute of Polymers, Composites and Biomaterials, National Research Council, Naples, Italy
| | - Gennaro Gentile
- grid.5326.20000 0001 1940 4177Institute of Polymers, Composites and Biomaterials, National Research Council, Naples, Italy
| | - Lorenzo Nibid
- grid.488514.40000000417684285Department of Human Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Carla Rabitti
- grid.488514.40000000417684285Department of Human Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Luigi Ambrosio
- grid.5326.20000 0001 1940 4177Institute of Polymers, Composites and Biomaterials, National Research Council, Naples, Italy
| | - Edoardo Franceschetti
- grid.488514.40000000417684285Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy ,grid.9657.d0000 0004 1757 5329Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Kristian Samuelsson
- grid.8761.80000 0000 9919 9582Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg, Gothenburg, Sweden ,Sahlgrenska Sports Medicine Center, Gothenburg, Sweden ,grid.1649.a000000009445082XDepartment of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Eric Hamrin Senorski
- Sahlgrenska Sports Medicine Center, Gothenburg, Sweden ,grid.8761.80000 0000 9919 9582Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Rocco Papalia
- grid.488514.40000000417684285Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy ,grid.9657.d0000 0004 1757 5329Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Vincenzo Denaro
- grid.488514.40000000417684285Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
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Li B, Zhan H, Luo J, Wang X, Cao T, Wei B. A novel serological biomarker are associated with disease severity in patients with osteoarthritis. J Bone Miner Metab 2022; 40:1007-1013. [PMID: 36036835 DOI: 10.1007/s00774-022-01364-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/31/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND AND AIM Apolipoprotein D (ApoD) is a 25-30 kDa glycoprotein, as a distinct component of the human plasma lipoprotein system. Its known biological functions are mainly related to lipid metabolism. The purpose of this study was to explore the potential role of ApoD concentration in knee osteoarthritis (KOA). METHODS This study was performed in a population of 113 KOA subjects and 97 healthy controls. Serum ApoD was detected using the commercial ELISA kit (Cusabio, Wu Han, China, Cat No. CSB-EL001935HU). Radiographic progression was evaluated using Kellgren-Lawrence (KL) classification. The clinical severity of KOA was assessed by visual analog score (VAS), Hospital for special surgery (HSS) knee score disease duration and TNF-α. Receiver-operating characteristic (ROC) curve was performed to test the potential diagnostic value of ApoD in radiographic progression. RESULTS The serum ApoD level of patients with KOA was significantly lower than that of healthy controls. The serum ApoD level was negatively correlated with KL grades, VAS score, disease duration, TNF-α concentrations. On the contrary, it was positively correlated with HSS score. However, there was no correlation between this serological indicator and which side was affected. ROC curve analysis indicated that attenuated serum ApoD could serve as an appropriate biomarker concerning the diagnosis of KOA. CONCLUSIONS Serum ApoD concentration was correlated with the presence and severity of KOA.
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Affiliation(s)
- Bin Li
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Department of Femoral Head, Linyi People's Hospital, The Intersection of Wuhan Road and Wohushan Road, Linyi, 276000, Shandong, China
| | - Huixian Zhan
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Department of Femoral Head, Linyi People's Hospital, The Intersection of Wuhan Road and Wohushan Road, Linyi, 276000, Shandong, China
| | - Jintao Luo
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Department of Femoral Head, Linyi People's Hospital, The Intersection of Wuhan Road and Wohushan Road, Linyi, 276000, Shandong, China
| | - Xuewen Wang
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Department of Femoral Head, Linyi People's Hospital, The Intersection of Wuhan Road and Wohushan Road, Linyi, 276000, Shandong, China
| | - Ting Cao
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Department of Femoral Head, Linyi People's Hospital, The Intersection of Wuhan Road and Wohushan Road, Linyi, 276000, Shandong, China
| | - Biaofang Wei
- Department of Femoral Head, Linyi People's Hospital, The Intersection of Wuhan Road and Wohushan Road, Linyi, 276000, Shandong, China.
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Herr SA, Gardeen SS, Low PS, Shi R. Targeted delivery of acrolein scavenger hydralazine in spinal cord injury using folate-linker-drug conjugation. Free Radic Biol Med 2022; 184:66-73. [PMID: 35398493 DOI: 10.1016/j.freeradbiomed.2022.04.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/30/2022] [Accepted: 04/03/2022] [Indexed: 11/26/2022]
Abstract
Oxidative stress has been shown to play a critical pathogenic role in functional loss after spinal cord injury (SCI). As a direct result of oxidative stress, lipid peroxidation-derived aldehydes have emerged as key culprits that sustain secondary injury and contribute significantly to pathological outcomes. Acrolein, a neurotoxin, has been shown to be elevated in SCI and can result in post-SCI neurological deficits. Reducing acrolein has therefore emerged as a novel and effective therapeutic strategy in SCI. Previous studies have revealed that hydralazine, an FDA approved blood pressure lowering medication, when administered after SCI shows strong acrolein scavenging capabilities and significantly improves cellular and behavioral outcomes. However, while effective at scavenging acrolein, hydralazine's blood pressure lowering activity can have a detrimental impact on neurotrauma patients. Here, our goal was to preserve the acrolein scavenging capability while mitigating the effect of hydralazine on blood pressure. We accomplished this using a folate-targeted delivery system to deploy hydralazine to the folate receptor positive inflammatory site of the cord injury. Using a model of rat SCI, we found that this system is effective for targeting the injury site, and that folate targeted hydralazine can scavenge acrolein without significantly impacting blood pressure.
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Affiliation(s)
- Seth A Herr
- Center for Paralysis Research & Department of Basic Medical Sciences, College of Veterinary Medicine, Purdue University. Lynn Hall, 625 N Harrison St. West Lafayette, IN, 47907, USA.
| | - Spencer S Gardeen
- Department of Chemistry, College of Science, Purdue University. Drug Discovery Building, 720 Clinic Dr. West Lafayette, IN, 47907, USA.
| | - Philip S Low
- Department of Chemistry, College of Science, Purdue University. Drug Discovery Building, 720 Clinic Dr. West Lafayette, IN, 47907, USA.
| | - Riyi Shi
- Center for Paralysis Research & Department of Basic Medical Sciences, College of Veterinary Medicine, Purdue University. Lynn Hall, 625 N Harrison St. West Lafayette, IN, 47907, USA.
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Xiong W, Zhao J, Ma X, Feng Z. Mechanisms and Molecular Targets of BuShenHuoXue Formula for Osteoarthritis. ACS OMEGA 2022; 7:4703-4713. [PMID: 35155962 PMCID: PMC8830072 DOI: 10.1021/acsomega.1c07270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 01/19/2022] [Indexed: 06/14/2023]
Abstract
The aim was to identify latent mechanism of BuShenHuoXue (BSHX) formula for the management of osteoarthritis (OA) through the network pharmacology approach and experimental validation. We obtained OA-related targets through the Gene Expression Omnibus database and bioactive ingredients with corresponding targets in the formula via the Traditional Chinese Medicine Systems Pharmacology database. Subsequently, networks of the protein-protein interaction and compound-disease target were created and enrichment analysis was implemented. Furthermore, in vitro, IL-1β was applied to rat chondrocytes to mediate apoptosis through inflammation and the Alcian blue and type II collagen staining was used to observe cell morphology. The TUNEL and DAPI staining was performed to observe chondrocyte apoptosis, and the apoptosis rates were gauged via flow cytometry. In addition, we utilized Western blot and PCR to detect the protein and mRNA expression, respectively. A total of 104 potential chemicals and 42 intersecting targets were screened out. Quercetin and luteolin from BSHX formula were principal ingredients. The experiment validated quercetin might suppress chondrocyte apoptosis mediated by IL-1β and reduce SELE, MMP2, and COL1 expression. Via the AGE-RAGE signaling pathway in diabetic complications, quercetin could aim at SELE, MMP2, and COL1 and exert antagonistic effects against OA.
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Affiliation(s)
- Wen Xiong
- Department
of Orthopedics, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical
College, Huazhong University of Science
and Technology, 473 Street, Wuhan, Hubei 430033, China
| | - Jiazheng Zhao
- Department
of Orthopedics, The Fourth Hospital of Hebei
Medical University, 12
Health Road, Shijiazhuang, Hebei 050011, China
| | - Xiaowei Ma
- Department
of Orthopedics, The Fourth Hospital of Hebei
Medical University, 12
Health Road, Shijiazhuang, Hebei 050011, China
| | - Zhangying Feng
- Department
of Clinical Pharmacology, The Fourth Hospital
of Hebei Medical University, 12 Health Road, Shijiazhuang, Hebei 050011, China
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