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Rimkunas A, Gudas R, Mickevicius T, Maciulaitis J, Malinauskas M, Smailys A, Staskunas M, Usas A. Arthroscopic Electromechanical Assessment of Human Articular Cartilage Injury Correlates with ICRS Scores. Cartilage 2024; 15:250-258. [PMID: 38054444 DOI: 10.1177/19476035231216439] [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: 12/07/2023] Open
Abstract
PURPOSE This study aimed to conduct arthroscopic evaluation of cartilage electromechanical properties and establish their correlation with International Cartilage Repair Society (ICRS) grading scores. METHODS In 18 patients, quantitative parameter (QP) measurements were taken on the weight-bearing surface of the medial femoral condyle. Adjacently, the same site was graded using ICRS scores (0-4). Electromechanical QPs for ICRS grades 0 to 3 were obtained during arthroscopy, while complete grade 4 injuries were assessed using femur cartilage-bone blocks from knee arthroplasty. The QP values for ICRS grades 0 to 2 were compared with grades 3 and 4 using Welch t test. The corresponding QP values were assigned to ICRS grades 0 to 4 and compared using Welch ANOVA (analysis of variance). Pearson's coefficient evaluated QP-ICRS grade relationship. RESULTS Healthy grade 0 cartilage displayed a mean QP value of 10.5 (±2.8 SD, n = 4). The ICRS grade 1 and grade 2 injuries were associated with QP values of 12 (±0.7, n = 2) and 13.25 (±1.77, n = 2), respectively. The grade 3 defects had QP values of 20.43 (±4.84, n = 4), whereas complete grade 4 defects showed electromechanical values of 30.17 (±2.19, n = 6). Significant differences in QP values were observed between ICRS grades 0 to 2 (mean QP 11.56 ± 2.3, n = 8) and grades 3 and 4 (26.27 ± 6, n = 10; P < 0.0001). Pearson's correlation coefficient of 0.9 indicated a strong association between higher ICRS cartilage injury grades and elevated QP values (P < 0.0001). CONCLUSION Arthroscopic electromechanical QP assessment robustly correlates with ICRS scores. The QP values for ICRS grades 0 to 2 are significantly lower, compared with grades 3 and 4.
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Affiliation(s)
- Augustinas Rimkunas
- Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine, Department of Orthopaedics and Traumatology, Kaunas, Lithuania
| | - Rimtautas Gudas
- Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine, Department of Orthopaedics and Traumatology, Kaunas, Lithuania
| | - Tomas Mickevicius
- Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine, Department of Orthopaedics and Traumatology, Kaunas, Lithuania
| | - Justinas Maciulaitis
- Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine, Institute of Physiology and Pharmacology, Kaunas, Lithuania
| | - Mantas Malinauskas
- Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine, Institute of Physiology and Pharmacology, Kaunas, Lithuania
| | - Alfredas Smailys
- Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine, Department of Orthopaedics and Traumatology, Kaunas, Lithuania
| | - Mantas Staskunas
- Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine, Department of Orthopaedics and Traumatology, Kaunas, Lithuania
| | - Arvydas Usas
- Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine, Institute of Physiology and Pharmacology, Kaunas, Lithuania
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Polydactyly-derived allogeneic chondrocyte cell-sheet transplantation with high tibial osteotomy as regenerative therapy for knee osteoarthritis. NPJ Regen Med 2022; 7:71. [PMID: 36522336 PMCID: PMC9755241 DOI: 10.1038/s41536-022-00272-1] [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: 11/04/2021] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
Allogeneic cell therapies are not fully effective in treating osteoarthritis of the knee (OAK). We recently reported that transplantation of autologous chondrocyte cell-sheets along with open-wedge high tibial osteotomy promoted hyaline cartilage repair in humans. Here we describe our regenerative therapy for OAK using polydactyly-derived allogeneic chondrocyte cell-sheets (PD sheets) and temperature-responsive culture inserts. Ten patients with OAK and cartilage defects categorized arthroscopically as Outerbridge grade III or IV received the therapy. Cartilage viscoelasticity and thickness were assessed before and after transplantation. Arthroscopic biopsies obtained 12 months after transplantation were analyzed histologically. Gene expression was analyzed to evaluate the PD sheets. In this small initial longitudinal series, PD sheet transplantation was effective in treating OAK, as indicated by changes in cartilage properties. Gene marker sets in PD sheets may predict outcomes after therapy and provide markers for the selection of donor cells. This combined surgery may be an ideal regenerative therapy with disease-modifying effects in OAK patients.
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Zhang H, Fang W, Zhao T, Zhang H, Gao L, Li J, Wang R, Xu W. Real-Time MRI Monitoring of GelMA-Based Hydrogel-Loaded Kartogenin for In Situ Cartilage Regeneration. Front Bioeng Biotechnol 2022; 10:940735. [PMID: 35935481 PMCID: PMC9354815 DOI: 10.3389/fbioe.2022.940735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
The cartilage has poor ability to mount a sufficient healing response. Herein, kartogenin (KGN), an emerging stable non-protein compound with the ability to recruit bone marrow mesenchyme stem cells (BMSCs) to promote chondrogenic differentiation, was grafted onto dopamine-Fe(III) chelating nanoparticles, followed by involving a gelatin- and dextran-based injectable hydrogel to mimic the extracellular matrix to promote cartilage repair. The in vitro results demonstrated that KGN underwent long-term sustained release behavior and availably promoted the deep migration of BMSC cells in yielding hydrogels. Furthermore, in vivo New Zealand white rabbits’ cartilage defect model repairing results showed that cartilage defect obtained significant regeneration post operation in the 12th week, and the defect edge almost disappeared compared to adjacent normal cartilage tissue. Meanwhile, the T2-weighted magnetic resonance imaging (MRI) property resulting from dissociative Fe (III) can significantly monitor the degradation degree of the implanted hydrogels in the defect site. This integrated diagnosis and treatment system gives insight into cartilage regeneration.
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Affiliation(s)
- Hanyuan Zhang
- Institute of Intelligent Machines, Chinese Academy of Sciences, Hefei, China
- Department of Biological Physics, University of Science and Technology of China, Hefei, China
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Weijun Fang
- School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Tingting Zhao
- School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Huabing Zhang
- School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Liang Gao
- Hua Tuo Institute of Medical Innovation (HTIMI), Wuhan, China
- Sino Euro Orthopaedics Network, Berlin, Germany
| | - Jingya Li
- Institute of Intelligent Machines, Chinese Academy of Sciences, Hefei, China
- Department of Biological Physics, University of Science and Technology of China, Hefei, China
| | - Rujing Wang
- Institute of Intelligent Machines, Chinese Academy of Sciences, Hefei, China
| | - Weiping Xu
- Institute of Intelligent Machines, Chinese Academy of Sciences, Hefei, China
- Department of Biological Physics, University of Science and Technology of China, Hefei, China
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- *Correspondence: Weiping Xu,
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Zhou Y, Ni J, Wen C, Lai P. Light on osteoarthritic joint: from bench to bed. Theranostics 2022; 12:542-557. [PMID: 34976200 PMCID: PMC8692899 DOI: 10.7150/thno.64340] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 11/08/2021] [Indexed: 12/19/2022] Open
Abstract
Osteoarthritis (OA) is one of the rapidly growing disability-associated conditions with population aging worldwide. There is a pressing need for precise diagnosis and timely intervention for OA in the early stage. Current clinical imaging modalities, including pain radiography, magnetic resonance imaging, ultrasound, and optical coherent tomography, are limited to provide structural changes when the damage has been established or advanced. It prompts further endeavors in search of novel functional and molecular imaging, which potentially enables early diagnosis and intervention of OA. A hybrid imaging modality based on photothermal effects, photoacoustic imaging, has drawn wide attention in recent years and has seen a variety of biomedical applications, due to its great performance in yielding high-contrast and high-resolution images from structure to function, from tissue down to molecular levels, from animals to human subjects. Photoacoustic imaging has witnessed gratifying potentials and preliminary effects in OA diagnosis. Regarding the treatment of OA, photothermal-triggered therapy has exhibited its attractions for enhanced therapeutic outcomes. In this narrative review, we will discuss photoacoustic imaging for the diagnosis and monitoring of OA at different stages. Structural, functional, and molecular parameter changes associated with OA joints captured by photoacoustics will be summarized, forming the diagnosis perspective of the review. Photothermal therapy applications related to OA will also be discussed herein. Lastly, relevant clinical applications and its potential solutions to extend photoacoustic imaging to deeper OA situations have been proposed. Although some aspects may not be covered, this mini review provides a better understanding of the diagnosis and treatment of OA with exciting innovations based on tissue photothermal effects. It may also inspire more explorations in the field towards earlier and better theranostics of OA.
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Affiliation(s)
- Yingying Zhou
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Junguo Ni
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR
| | - Chunyi Wen
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, HKSAR
| | - Puxiang Lai
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
- Photonics Research Institute, The Hong Kong Polytechnic University, HKSAR
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Ukai T, Sato M, Wasai S, Takahashi T, Omura H, Watanabe M. Comparison of properties determined using electromechanical assessment (Arthro-BST™) with macroscopic and histological properties in symptomatic human articular cartilage of the hip. Arthritis Res Ther 2021; 23:227. [PMID: 34465392 PMCID: PMC8406846 DOI: 10.1186/s13075-021-02611-x] [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: 02/18/2021] [Accepted: 08/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cartilage degeneration is assessed using various methods. Although macroscopic evaluation can directly measure cartilage degeneration, it cannot accurately assess cartilage properties. Histological examination is one of the most accurate methods for evaluating cartilage degeneration. However, it is invasive and requires collection of cartilage tissue. In contrast, the Arthro-BST™ probe can assess cartilage properties noninvasively. This study aimed to evaluate the effectiveness of the Arthro-BST in assessing cartilage degeneration by comparing macroscopic (International Cartilage Repair Society [ICRS] classification) and histological evaluations (modified Mankin score and Osteoarthritis Research Society International [OARSI] histological grade). METHODS Fourteen femoral heads were excised from 13 patients during surgery to treat hip osteoarthritis or femoral fracture. The ICRS score was used for macroscopic evaluation of cartilage degeneration. The Arthro-BST was applied at sites matching the areas of cartilage damage. The sites assessed using the ICRS classification and Arthro-BST were evaluated histologically (modified Mankin score and OARSI histological grade), and these were compared with the Arthro-BST results. RESULTS The ICRS classification identified significant differences between grades 1 and 3 (p < 0.01), between grades 1 and 4 (p < 0.01), between grades 2 and 3 (p < 0.01), and between grades 2 and 4 (p < 0.01). Significant correlations were observed between the Arthro-BST results and the ICRS score, modified Mankin score (structure, cellularity, matrix staining, total score), and OARSI histological grade. CONCLUSIONS In the assessment of hip osteoarthritis, the Arthro-BST results correlated with those of macroscopic and histological evaluations. The Arthro-BST is useful for assessing hip osteoarthritis and may be helpful for noninvasive assessment of cartilage degeneration.
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Affiliation(s)
- Taku Ukai
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Bohseidai, Isehara, Kanagawa, 259-1193, Japan.,Center for Musculoskeletal Innovative Research and Advancement (C-MiRA), Tokai University Graduate School, Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Masato Sato
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Bohseidai, Isehara, Kanagawa, 259-1193, Japan. .,Center for Musculoskeletal Innovative Research and Advancement (C-MiRA), Tokai University Graduate School, Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
| | - Shiho Wasai
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Bohseidai, Isehara, Kanagawa, 259-1193, Japan.,Center for Musculoskeletal Innovative Research and Advancement (C-MiRA), Tokai University Graduate School, Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Takumi Takahashi
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Bohseidai, Isehara, Kanagawa, 259-1193, Japan.,Center for Musculoskeletal Innovative Research and Advancement (C-MiRA), Tokai University Graduate School, Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Haruka Omura
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Bohseidai, Isehara, Kanagawa, 259-1193, Japan.,Center for Musculoskeletal Innovative Research and Advancement (C-MiRA), Tokai University Graduate School, Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Masahiko Watanabe
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Bohseidai, Isehara, Kanagawa, 259-1193, Japan.,Center for Musculoskeletal Innovative Research and Advancement (C-MiRA), Tokai University Graduate School, Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
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Sato M, Yamato M, Mitani G, Takagaki T, Hamahashi K, Nakamura Y, Ishihara M, Matoba R, Kobayashi H, Okano T, Mochida J, Watanabe M. Combined surgery and chondrocyte cell-sheet transplantation improves clinical and structural outcomes in knee osteoarthritis. NPJ Regen Med 2019; 4:4. [PMID: 30820353 PMCID: PMC6384900 DOI: 10.1038/s41536-019-0069-4] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 01/17/2019] [Indexed: 01/08/2023] Open
Abstract
Current cartilage regenerative therapies are not fully effective in treating osteoarthritis of the knee (OAK). We have developed chondrocyte sheets for autologous transplantation and tested these in in vitro and in vivo preclinical studies, and have reported that the transplantation of chondrocyte sheets promoted hyaline cartilage repair in rat, rabbit, and minipig models. However, autologous transplantation of chondrocyte sheets has yet to be reported in humans. Here, we report our combination therapy in which conventional surgical treatment for OAK, is followed by autologous chondrocyte sheet transplantation for cartilage repair. Eight patients with OAK and cartilage defects categorized arthroscopically as Outerbridge grade III or IV receive the therapy. Patients are thoroughly assessed by preoperative and postoperative X-rays, magnetic resonance imaging (MRI), arthroscopy, Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm Knee Score (LKS), and a laser-induced photoacoustic method to assess cartilage viscoelasticity. Arthroscopic biopsies of all patients are performed 12 months after transplantation for histological evaluation. The properties of the chondrocyte sheets are evaluated using gene expression analysis to investigate the ability to predict the clinical and structural outcomes of the therapy. For this small initial longitudinal series, combination therapy is effective, as assessed by MRI, arthroscopy, viscoelasticity, histology, and the clinical outcomes of KOOS and LKS. Gene marker sets identified in autologous chondrocyte sheets may be predictive of the overall KOOS, LKS, and histological scores after therapy. These predictive gene sets may be potential alternative markers for evaluating OAK treatment.
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Affiliation(s)
- Masato Sato
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193 Japan
| | - Masayuki Yamato
- Institute of Advanced Biomedical Engineering and Science, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku, Tokyo, 162-8666 Japan
| | - Genya Mitani
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193 Japan
| | - Tomonori Takagaki
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193 Japan
| | - Kosuke Hamahashi
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193 Japan
| | - Yoshihiko Nakamura
- Cell Processing Center, Tokai University Hospital, 143 Shimokasuya, Isehara, Kanagawa 259-1193 Japan
| | - Miya Ishihara
- Department of Medical Engineering, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513 Japan
| | - Ryo Matoba
- DNA Chip Research Inc., 1-15-1 Kaigan, Suzue Baydium 5F Minato-ku, Tokyo, 105-0022 Japan
| | - Hiroyuki Kobayashi
- Department of Clinical Pharmacology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193 Japan
| | - Teruo Okano
- Institute of Advanced Biomedical Engineering and Science, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku, Tokyo, 162-8666 Japan
| | - Joji Mochida
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193 Japan
| | - Masahiko Watanabe
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193 Japan
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