1
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Tran NT, Jeon SH, Moon YJ, Lee KB. Continuous detrimental activity of intra-articular fibrous scar tissue in correlation with posttraumatic ankle osteoarthritis. Sci Rep 2023; 13:20058. [PMID: 37973826 PMCID: PMC10654697 DOI: 10.1038/s41598-023-47498-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 11/14/2023] [Indexed: 11/19/2023] Open
Abstract
Posttraumatic osteoarthritis is primarily characterized by articular cartilage destruction secondary to trauma or fracture events. Even while intra-articular scar tissue can be observed following ankle fractures, little is known about its nature and molecular events linking its biological activity and cartilage deterioration. Here, we investigated scar tissue's histological and molecular characteristics, and its relationship with localized articular cartilage alterations consistent with early osteoarthritic degeneration. Intra-articular scar tissues from sixty-two patients who underwent open reduction internal fixation for ankle fracture were obtained at hardware removal time (6-44 months after fracture). Histological analysis demonstrated that scar tissue has the nature of fibrosis with fibrous tissue hyperplasia, fibroblast proliferation, and chondrometaplasia. These fibrous scar tissues showed overexpressed pro-inflammatory cytokines and high mRNA expression levels of osteoarthritis-related markers (cytokines, chemokines, and enzymes) compared to the normal synovium. Furthermore, those transcriptional levels were significantly correlated with the grade of talar chondral degeneration. Our findings suggest that following an ankle fracture, the intra-articular fibrous scar tissue exhibits high catabolic and inflammatory activity, which has a long-lasting negative impact correlated to cartilage deterioration in the development of posttraumatic osteoarthritis.
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Affiliation(s)
- Nhat Tien Tran
- Department of Surgery, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Sang-Hyeon Jeon
- Department of Orthopaedic Surgery, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School, 634-18, Keumam-Dong, Jeonju-Shi, Chonbuk, Republic of Korea
| | - Young Jae Moon
- Department of Orthopaedic Surgery and Biochemistry, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital and Research Institute for Endocrine Sciences, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Kwang-Bok Lee
- Department of Orthopaedic Surgery, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School, 634-18, Keumam-Dong, Jeonju-Shi, Chonbuk, Republic of Korea.
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2
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Ahn JY, Park CH, Jung JW, Lee WC. Plain Radiographs Underestimate Varus Deformity of the Tibial Plafond. J Foot Ankle Surg 2022; 61:836-840. [PMID: 34974979 DOI: 10.1053/j.jfas.2021.12.001] [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: 04/20/2020] [Revised: 04/01/2021] [Accepted: 12/01/2021] [Indexed: 02/08/2023]
Abstract
Understanding plain radiograph in association with 3-dimensional (3D) morphology of the ankle is essential for treatment about varus ankle osteoarthritis (OA). The aims of this study were to investigate whether the alignment of the tibial plafond as determined on plain radiograph reflected the alignment of the tibial plafond on computed tomography (CT) in varus ankle OA and whether the alignment of the tibial plafond changed as the OA progressed. The 3D CT and plain radiographs from 101 ankles with varus ankle OA were analyzed and compared with 40 ankles in control group. The tibial plafond was assessed in the coronal and sagittal planes using 3D CT. The medial angle between the vertical line and the tibial plafond was measured on 3 different coronal plane CT images which was anterior, middle and posterior area of the tibial plafond. The medial distal tibial angle on plain radiograph reflected the posterior area of the tibial plafond on CT. The amount of varus angulation on CT was larger in anterior and middle area of the tibial plafond than the posterior area. There was a difference in the degree of varus of the tibial plafond between control group and OA patients; however, there was no difference among patients in different stages of varus ankle OA. Weightbearing plain radiographs underestimate the varus deformity in anterior and middle area of the tibial plafond and there is no significant difference in deformity of the tibial plafond among patients in different stages of varus ankle OA.
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Affiliation(s)
- Ji-Yong Ahn
- Department of Orthopaedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Chul-Hyun Park
- Department of Orthopaedic Surgery, Yeungnam University Hospital, Daegu, South Korea
| | - Jae Woong Jung
- Department of Orthopaedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Woo-Chun Lee
- Seoul Foot and Ankle Center, Dubalo Orthopaedic Clinic, Seoul, South Korea.
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3
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Buchhorn T, Polzer H. [Osteoarthritis of the ankle joint]. Unfallchirurg 2022; 125:173-174. [PMID: 35212791 DOI: 10.1007/s00113-021-01132-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2021] [Indexed: 10/19/2022]
Affiliation(s)
- T Buchhorn
- Sporthopaedicum Regensburg-Straubing, Bahnhofsplatz 27, 93415, Straubing, Deutschland.
| | - H Polzer
- Sektion Fuß- und Sprunggelenkchirurgie, Klinik für Orthopädie und Unfallchirurgie, Muskuloskelettales Universitätszentrum München (MUM), Klinikum der Universität München, LMU München, Ziemssenstr. 5, 80336, München, Deutschland.
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4
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Liu X, Yin M, Liu X, Da J, Zhang K, Zhang X, Liu L, Wang J, Jin H, Liu Z, Zhang B, Li Y. Analysis of Hub Genes Involved in Distinction Between Aged and Fetal Bone Marrow Mesenchymal Stem Cells by Robust Rank Aggregation and Multiple Functional Annotation Methods. Front Genet 2020; 11:573877. [PMID: 33424919 PMCID: PMC7793715 DOI: 10.3389/fgene.2020.573877] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 11/24/2020] [Indexed: 12/25/2022] Open
Abstract
Stem cells from fetal tissue protect against aging and possess greater proliferative capacity than their adult counterparts. These cells can more readily expand in vitro and senesce later in culture. However, the underlying molecular mechanisms for these differences are still not fully understood. In this study, we used a robust rank aggregation (RRA) method to discover robust differentially expressed genes (DEGs) between fetal bone marrow mesenchymal stem cells (fMSCs) and aged adult bone marrow mesenchymal stem cells (aMSCs). Multiple methods, including gene set enrichment analysis (GSEA), Gene Ontology (GO) analysis, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed for functional annotation of the robust DEGs, and the results were visualized using the R software. The hub genes and other genes with which they interacted directly were detected by protein–protein interaction (PPI) network analysis. Correlation of gene expression was measured by Pearson correlation coefficient. A total of 388 up-regulated and 289 down-regulated DEGs were identified between aMSCs and fMSCs. We found that the down-regulated genes were mainly involved in the cell cycle, telomerase activity, and stem cell proliferation. The up-regulated DEGs were associated with cell adhesion molecules, extracellular matrix (ECM)–receptor interactions, and the immune response. We screened out four hub genes, MYC, KIF20A, HLA-DRA, and HLA-DPA1, through PPI-network analysis. The MYC gene was negatively correlated with TXNIP, an age-related gene, and KIF20A was extensively involved in the cell cycle. The results suggested that MSCs derived from the bone marrow of an elderly donor present a pro-inflammatory phenotype compared with that of fMSCs, and the HLA-DRA and HLA-DPA1 genes are related to the immune response. These findings provide new insights into the differences between aMSCs and fMSCs and may suggest novel strategies for ex vivo expansion and application of adult MSCs.
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Affiliation(s)
- Xiaoyao Liu
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Mingjing Yin
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xinpeng Liu
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Junlong Da
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Kai Zhang
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xinjian Zhang
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Lixue Liu
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jianqun Wang
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Han Jin
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zhongshuang Liu
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Bin Zhang
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Heilongjiang Academy of Medical Sciences, Harbin, China
| | - Ying Li
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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Li W, Alahdal M, Deng Z, Liu J, Zhao Z, Cheng X, Chen X, Li J, Yin J, Li Y, Wang G, Wang D, Tang K, Zhang J. Molecular functions of FSTL1 in the osteoarthritis. Int Immunopharmacol 2020; 83:106465. [DOI: 10.1016/j.intimp.2020.106465] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/11/2020] [Accepted: 03/29/2020] [Indexed: 12/18/2022]
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6
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Buchhorn T, Weber J, Lampert C. Arthrose des oberen Sprunggelenks. ARTHROSKOPIE 2020. [DOI: 10.1007/s00142-019-00333-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Younger ASE, Penner M, Wing K, Veljkovic A, Nacht J, Wang Z, Wester T, Harrison A. Nonanimal Hyaluronic Acid for the Treatment of Ankle Osteoarthritis: AProspective, Single-Arm Cohort Study. J Foot Ankle Surg 2019; 58:514-518. [PMID: 30910489 DOI: 10.1053/j.jfas.2018.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Indexed: 02/03/2023]
Abstract
Ankle osteoarthritis (OA) can cause disabling symptoms, and some patients prefer to be treated with minimally invasive procedures. Nonanimal hyaluronic acid (NASHA) is a cross-linked hyaluronic acid product that has a prolonged intra-articular residence time. The authors report the first study of NASHA for the treatment of ankle OA. Thirty-seven patients with Kellgren-Lawrence grade II or III ankle OA received an intra-articular injection of NASHA (1 mL). Outcomes included visual analogue scale (VAS) scores for pain and disability. At baseline, the mean VAS pain score was 50.1 ± 14.5mm. During the 26-week follow-up period, the least squares (LS) mean change from baseline in the ankle OA VAS pain score was -20.5mm (95% confidence interval [CI] -25.5 to -15.6 mm), an LS mean percentage reduction of 40.0% (95% CI 30.2% to 49.9%). The LS mean change from baseline in the VAS disability score during 26 weeks was -19.2mm (95% CI -24.8 to -13.6 mm), a percentage reduction of 34% (95% CI 22.3% to 45.7%). Five participants experienced a total of 7 adverse events considered to be related to study treatment (injection site pain, n = 3; injection site joint pain, n = 3; plantar fasciitis, n = 1). This study shows promise for viscosupplementation with NASHA in the treatment of ankle OA. A single injection was associated with clinically meaningful reductions in pain and disability during a 26-week period and, in general, was well tolerated.
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Affiliation(s)
- Alastair S E Younger
- Professor, Department of Orthopaedics, University of British Columbia, Vancouver, Canada
| | - Murray Penner
- Clinical Professor, Department of Orthopaedics, University of British Columbia, Vancouver, Canada
| | - Kevin Wing
- Clinical Professor, Department of Orthopaedics, University of British Columbia, Vancouver, Canada
| | - Andrea Veljkovic
- Associate Clinical Professor, Department of Orthopaedics, University of British Columbia, Vancouver, Canada
| | - Jeff Nacht
- Clinical Associate Professor, Department of Orthopaedics, University of British Columbia, Vancouver, Canada
| | - Zhe Wang
- Statistical Analyst, Bioventus LLC, Durham, NC
| | - Tawana Wester
- Manager for Clinical Affairs, Bioventus LLC, Durham, NC
| | - Andrew Harrison
- Director of Research, Research & Development, Bioventus Cooperatief UA, Hoofddorp, The Netherlands.
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8
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Rohlfing FI, Wiebking U, O'Loughlin PF, Krettek C, Gaulke R. Clinical and Radiological Mid-to-Long-term Outcomes Following Ankle Arthrolysis. In Vivo 2019; 33:535-542. [PMID: 30804138 PMCID: PMC6506290 DOI: 10.21873/invivo.11507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 12/20/2018] [Accepted: 12/26/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the clinical and radiographic success of arthrolysis surgery and the risk of progression of osteoarthrosis at the ankle joint. MATERIALS AND METHODS In a retrospective clinical and radiological study, with a minimum follow-up of 24 months, the pain level and quality of living were evaluated. RESULTS Following arthrolysis of the ankle joint, 16% of patients required ankle fusion within 2 years. Women had a higher quality-of-life in terms of Foot Function Index. Younger patients scored higher in both quality-of-life and function scores. Radiographic osteoarthrotic changes and the specific follow-up interval did not correlate with clinical outcome. CONCLUSION Fewer than 20% of patients required ankle fusion. Female gender and young age had a positive impact. Preoperative radiography and the postsurgical interval are poorly predictive for the progression of osteoarthrosis.
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Affiliation(s)
- Freya-Isabelle Rohlfing
- Section of Upper Extremity, Foot and Rheuma Surgery, Trauma Department, Medical School Hannover (MHH), Hannover, Germany
- Trauma Department, Medical School Hannover (MHH), Hannover, Germany
| | - Ulrich Wiebking
- Section of Upper Extremity, Foot and Rheuma Surgery, Trauma Department, Medical School Hannover (MHH), Hannover, Germany
- Trauma Department, Medical School Hannover (MHH), Hannover, Germany
| | | | | | - Ralph Gaulke
- Section of Upper Extremity, Foot and Rheuma Surgery, Trauma Department, Medical School Hannover (MHH), Hannover, Germany
- Trauma Department, Medical School Hannover (MHH), Hannover, Germany
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9
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Hasan O, Fahad S, Sattar S, Umer M, Rashid H. Ankle Arthrodesis using Ilizarov Ring Fixator: A Primary or Salvage Procedure? An Analysis of Twenty Cases. Malays Orthop J 2018; 12:24-30. [PMID: 30555643 PMCID: PMC6287131 DOI: 10.5704/moj.1811.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Ankle arthrodesis using the Ilizarov technique provides high union rate with the added benefits of early weight-bearing, and the unique advantage of its ability to promote regeneration of soft tissue around the bone, including skin, muscle and neuro-vascular structures, and its versatility to allow correction of the position of the foot by adjusting the frame post-operatively as needed. We describe our experience with this technique and the functional outcomes in our patients. Materials and Methods: This retrospective study was conducted in 20 ankle fusion cases using the Ilizarov method between the years 2007 and 2017. We defined success in treatment by loss of preoperative symptoms and radiological union on plain radiographs of the ankle. Results: Fusion was achieved in all patients (100%). Immediate post-operative ambulation was with full weight bearing (FWB) in 16 (83%) of the participants and non-weight bearing (NWB) in 3 patients (17%). Post-procedure 11 patients (67%) of the participants who were full weight bearing required some form of support for walking for 2-3 weeks. Post-operatively three patients had pin tract infection requiring intravenous antibiotics. Radiological union took range of 6-12 weeks, mean union time was 8 weeks. Only one patient required bone grafting due to bone loss. Average follow-up period was 10-45 months. Conclusion: The Ilizarov technique has a high union rate and leads to general favourable clinical outcome and may be considered for any ankle arthrodesis but is especially useful in complex cases such as for revisions, soft-tissue compromise, infection and in patients with risk for non-union. Early weight bearing is an extra benefit.
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Affiliation(s)
- O Hasan
- Section of Orthopaedics, Aga Khan University Hospital, Karachi, Pakistan
| | - S Fahad
- Section of Orthopaedics, Aga Khan University Hospital, Karachi, Pakistan
| | - S Sattar
- Section of Orthopaedics, Aga Khan University Hospital, Karachi, Pakistan
| | - M Umer
- Section of Orthopaedics, Aga Khan University Hospital, Karachi, Pakistan
| | - H Rashid
- Section of Orthopaedics, Aga Khan University Hospital, Karachi, Pakistan
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10
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El-Jawhari JJ, Brockett CL, Ktistakis I, Jones E, Giannoudis PV. The regenerative therapies of the ankle degeneration: a focus on multipotential mesenchymal stromal cells. Regen Med 2018; 13:175-188. [PMID: 29553890 DOI: 10.2217/rme-2017-0104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The ankle degeneration ranging from focal osteochondral lesions to osteoarthritis can cause a total joint function loss. With rising life expectancy and activity of the patients, various regenerative therapies were introduced aiming to preserve the joint function via the induction of cartilage and bone repair. Here, biological events and mechanical changes of the ankle degeneration were discussed. The regenerative therapies were reviewed versus the standard surgical treatment. We especially focused on the use of mesenchymal (multipotential) stromal cells (MSCs) highlighting their dual functions of regeneration and cell modulation with an emphasis on the emerging MSC-based clinical studies. Being at an early step, more basic and clinical research is needed to optimize the applications of all ankle regenerative therapies including MSC-based methods.
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Affiliation(s)
- Jehan J El-Jawhari
- Leeds Institute of Rheumatic & Musculoskeletal Medicine, University of Leeds, Leeds, UK
- Clinical pathology department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Claire L Brockett
- Institute of Medical & Biological Engineering, University of Leeds, Leeds, UK
| | - Ioannis Ktistakis
- Leeds Institute of Rheumatic & Musculoskeletal Medicine, University of Leeds, Leeds, UK
- Academic Unit of Trauma and Orthopaedic Surgery, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Elena Jones
- Leeds Institute of Rheumatic & Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Peter V Giannoudis
- Leeds Institute of Rheumatic & Musculoskeletal Medicine, University of Leeds, Leeds, UK
- Academic Unit of Trauma and Orthopaedic Surgery, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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11
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Li J, Li B, Zhang Z, Wang S, Liu L. Ilizarov external fixation versus plate internal fixation in the treatment of end-stage ankle arthritis: decision analysis of clinical parameters. Sci Rep 2017; 7:16155. [PMID: 29170505 PMCID: PMC5701001 DOI: 10.1038/s41598-017-16473-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 11/13/2017] [Indexed: 02/05/2023] Open
Abstract
The purpose of this study was to evaluate the effect of Ilizarov external fixation (IEF) and plate internal fixation (PIF) in the treatment of end-stage ankle arthritis on pain relieving and function improvement. The study cohort consisted of 59 patients with end-stage ankle arthritis underwent ankle arthrodesis with IEF or PIF between June 2011 and June 2015. Standard radiographs and computed tomography (CT) scans were obtained before surgery and during the follow-up. Functional assessments were performed using Foot and Ankle pain score of American Orthopedics Foot and Ankle Society (AOFAS) and Visual Analogue Scale (VAS). The average AOFAS scores in both IEF group and PIF groups increased significantly after operation, from 45.5 ± 6.3 to 84.8 ± 4.9 and from 45.9 ± 6.6 to 86.6 ± 5.4, respectively. The average VAS scores in both groups decreased significantly after operation, from 8.4 ± 1.9 to 2.5 ± 0.6 and from 8.2 ± 1.5 to 2.3 ± 0.7, respectively. Nevertheless, there was no significant difference for preoperative or postoperative AOFAS and VAS scores between the two groups. The IEF would result in comparable postoperative functional recovery and pain relieving to PIF and may be an effective substitute to PIF in the treatment of end-stage ankle arthritis.
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Affiliation(s)
- Jun Li
- Department of Orthopedics, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu, 610041, People's Republic of China
| | - Bohua Li
- Department of Orthopedics, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu, 610041, People's Republic of China
| | - Zhengdong Zhang
- Department of Orthopedics, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu, 610041, People's Republic of China
| | - Shanxi Wang
- Department of Orthopedics, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu, 610041, People's Republic of China
| | - Lei Liu
- Department of Orthopedics, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu, 610041, People's Republic of China.
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12
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Fernandez-Pernas P, Rodríguez-Lesende I, de la Fuente A, Mateos J, Fuentes I, De Toro J, Blanco FJ, Arufe MC. CD105+-mesenchymal stem cells migrate into osteoarthritis joint: An animal model. PLoS One 2017; 12:e0188072. [PMID: 29190645 PMCID: PMC5708708 DOI: 10.1371/journal.pone.0188072] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 10/31/2017] [Indexed: 02/05/2023] Open
Abstract
Mesenchymal stem cells are being the focus of connective tissue technology and regenerative medicine, presenting a good choice cell source for improving old and well recognized techniques of cartilage defect repair. For instance, the autologous chondrocyte transplantation using new concepts of regenerative medicine. The present study investigated the risk of xenogenicity of human synovial membrane-derived MSCs, injected into the monkeys using intravenous and intra-articular administration. The animal models used were adult monkeys Rhesus which had been injured into the left knee to create an Osteoarthritis (OA) animal model. CD105+-MSCs were injected twice into the OA monkeys with an interval of one week between them. The animals were euthanized one month after treatment. Immunohistochemistry analysis of different organs: spleen, heart, fat, liver, gut, pancreas, lung, skeletal muscle and kidney from the animals revealed that CD105+-MSCs migrated towards the injured knee joint. MSCs naive were found statistically significant increased in the injured knee in front of healthy one. CD105+-MSCs were negatives for CD68 and the area where CD105+-MSCs were found presented SDF-1 increased levels in front of healthy knee. We concluded that a characterized MSCs subset could be a safe alternative for cell therapy in clearly localized pathologies.
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Affiliation(s)
- Pablo Fernandez-Pernas
- Grupo de Terapia Celular y Medicina Regenerativa (TCMR-CHUAC), CIBER BBN/ISCIII, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Departamento de Ciencias Biomédicas, Medicina y Fisioterapia, Facultade de Oza, Universidade da Coruña (UDC), As Xubias, A Coruña, Spain
| | - Iván Rodríguez-Lesende
- Grupo de Terapia Celular y Medicina Regenerativa (TCMR-CHUAC), CIBER BBN/ISCIII, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Departamento de Ciencias Biomédicas, Medicina y Fisioterapia, Facultade de Oza, Universidade da Coruña (UDC), As Xubias, A Coruña, Spain
| | - Alexandre de la Fuente
- Grupo de Terapia Celular y Medicina Regenerativa (TCMR-CHUAC), CIBER BBN/ISCIII, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Departamento de Ciencias Biomédicas, Medicina y Fisioterapia, Facultade de Oza, Universidade da Coruña (UDC), As Xubias, A Coruña, Spain
| | - Jesús Mateos
- Grupo de Investigación de Proteómica-PBR2-ProteoRed/ISCIII-Servicio de Reumatologia, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña (UDC), As Xubias, A Coruña, España
| | - Isaac Fuentes
- Grupo de Terapia Celular y Medicina Regenerativa (TCMR-CHUAC), CIBER BBN/ISCIII, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Departamento de Ciencias Biomédicas, Medicina y Fisioterapia, Facultade de Oza, Universidade da Coruña (UDC), As Xubias, A Coruña, Spain
| | - Javier De Toro
- Grupo de Terapia Celular y Medicina Regenerativa (TCMR-CHUAC), CIBER BBN/ISCIII, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Departamento de Ciencias Biomédicas, Medicina y Fisioterapia, Facultade de Oza, Universidade da Coruña (UDC), As Xubias, A Coruña, Spain
| | - Fco J. Blanco
- Grupo de Investigación de Proteómica-PBR2-ProteoRed/ISCIII-Servicio de Reumatologia, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña (UDC), As Xubias, A Coruña, España
- * E-mail: (FJB); (MCA)
| | - M. C. Arufe
- Grupo de Terapia Celular y Medicina Regenerativa (TCMR-CHUAC), CIBER BBN/ISCIII, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Departamento de Ciencias Biomédicas, Medicina y Fisioterapia, Facultade de Oza, Universidade da Coruña (UDC), As Xubias, A Coruña, Spain
- * E-mail: (FJB); (MCA)
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13
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Kim YS, Lee M, Koh YG. Additional mesenchymal stem cell injection improves the outcomes of marrow stimulation combined with supramalleolar osteotomy in varus ankle osteoarthritis: short-term clinical results with second-look arthroscopic evaluation. J Exp Orthop 2016; 3:12. [PMID: 27206975 PMCID: PMC4875581 DOI: 10.1186/s40634-016-0048-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 05/17/2016] [Indexed: 01/08/2023] Open
Abstract
Background Supramalleolar osteotomy (SMO) is reported to be an effective treatment for varus ankle osteoarthritis by redistributing the load line within the ankle joint. Mesenchymal stem cells (MSCs) have been proposed as a new treatment option for osteoarthritis on the basis of their cartilage regeneration ability. The purpose of this study was to compare the clinical, radiological, and second-look arthroscopic outcomes between MSC injection with marrow stimulation and marrow stimulation alone in patients with varus ankle osteoarthritis who have undergone SMO. Methods In this retrospective study, 62 patients (64 ankles) with varus ankle osteoarthritis underwent second-look arthroscopy at a mean of 12.8 months after arthroscopic marrow stimulation combined with SMO; 33 ankles were subjected to marrow stimulation alone (group I), and 31 were subjected to marrow stimulation with MSC injection (group II). Clinical outcome measures included a visual analog scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) score. Radiological outcome variables included the tibial–ankle surface (TAS), talar tilt (TT), and tibial–lateral surface (TLS) angles. In second-look arthroscopy, cartilage regeneration was evaluated using the International Cartilage Repair Society (ICRS) grade. Results The mean VAS score improved significantly from 7.2 ± 1.0 to 4.7 ± 1.4 in group I and from 7.3 ± 0.8 to 3.7 ± 1.5 in group II at the final follow-up (P < 0.001 for both groups). The mean AOFAS score also improved significantly from 61.7 ± 5.8 to 80.9 ± 6.7 in group I and from 60.6 ± 6.1 to 85.2 ± 5.1 in group II at the final follow-up (P < 0.001 for both groups). There were significant differences in the mean VAS and AOFAS scores between groups at the final follow-up (P = 0.002 and 0.010, respectively). At second-look arthroscopy, there were significant differences in ICRS grades between groups(P = 0.015 for medial aspect of the talar dome, P = 0.044 for medial aspect of the tibial plafond, and P = 0.005 for articular surface of the medial malleolus). ICRS grades were significantly correlated with clinical outcomes in both groups (all P < 0.05). Mean TAS, TT, and TLS angles improved significantly after SMO in both groups but were not significantly correlated with clinical outcomes or ICRS grade (all n.s.). Conclusions The clinical and second-look arthroscopic outcomes of MSC injection with marrow stimulation were better compared to those of marrow stimulation alone in patients with varus ankle osteoarthritis who have undergone SMO. Furthermore, the ICRS grade is significantly correlated with clinical outcome.
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Affiliation(s)
- Yong Sang Kim
- Department of Orthopaedic Surgery, Center for Stem Cell & Arthritis Research, Yonsei Sarang Hospital, 478-3, Bangbae-dong, Seocho-gu, Seoul, Korea.
| | - Moses Lee
- Department of Orthopaedic Surgery, Center for Stem Cell & Arthritis Research, Yonsei Sarang Hospital, 478-3, Bangbae-dong, Seocho-gu, Seoul, Korea
| | - Yong Gon Koh
- Department of Orthopaedic Surgery, Center for Stem Cell & Arthritis Research, Yonsei Sarang Hospital, 478-3, Bangbae-dong, Seocho-gu, Seoul, Korea
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