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Shakya BR, Karjalainen VP, Hellberg I, Finnilä MAJ, Elkhouly K, Sjögren A, Turkiewicz A, Önnerfjord P, Hughes V, Tjörnstrand J, Englund M, Saarakkala S. Prevalence and classification of meniscal calcifications in the human knee. Osteoarthritis Cartilage 2024:S1063-4584(24)01319-0. [PMID: 39116991 DOI: 10.1016/j.joca.2024.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 07/19/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVE To investigate the occurrence of meniscal calcifications in individuals with and without knee osteoarthritis (OA). Additionally, we aim to identify the specific types of calcifications: basic calcium phosphate (BCP) and calcium pyrophosphate dihydrate (CPP). METHOD We analyzed 82 meniscal posterior horn samples (medial and lateral) collected from 41 human subjects. Among them, 20 individuals underwent total knee replacement due to medial compartment OA, while 21 deceased donors had no known knee OA. The assessment of meniscal calcifications and Pauli's histopathological scoring was conducted using histological sections. Furthermore, adjacent sections underwent measurement using Raman spectroscopy to characterize BCP and CPP calcifications based on their distinct spectral fingerprints. RESULTS All OA individuals exhibited calcifications in at least one meniscus, compared to 9.5% (95%CI 1%, 30%) of donors. Among 35 OA menisci with calcifications, 28(80%) had BCP, 5(14%) had CPP and 2(6%) had both types. In 4 donor menisci, 3(75%) had CPP while 1(25%) had both types. We estimated the association between Pauli score and presence of BCP in OA individuals, yielding an odds ratio of 2.1 (95%CI 0.8, 5.3) per 1 Pauli score. The association between Pauli score and presence of CPP (in whole study sample) seemed weaker, with odds ratio of 1.3 (95%CI 1.1, 1.7). CONCLUSION The presence of BCP was predominant in menisci of OA individuals, whereas CPP exhibited similar prevalence in individuals with and without OA. The formation of BCP crystals in menisci may represent an important and specific characteristic of OA disease process that warrants further attention.
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Affiliation(s)
- Bijay Ratna Shakya
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - Ville-Pauli Karjalainen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - Iida Hellberg
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - Mikko A J Finnilä
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Biocenter Oulu, University of Oulu, Oulu, Finland.
| | - Khaled Elkhouly
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - Amanda Sjögren
- Clinical Epidemiology Unit, Orthopaedics, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
| | - Aleksandra Turkiewicz
- Clinical Epidemiology Unit, Orthopaedics, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
| | - Patrik Önnerfjord
- Rheumatology and Molecular Skeletal Biology, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
| | - Velocity Hughes
- Clinical Epidemiology Unit, Orthopaedics, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
| | - Jon Tjörnstrand
- Department of Clinical Sciences, Orthopaedics, Skåne University Hospital, Lund University, Lund, Sweden.
| | - Martin Englund
- Clinical Epidemiology Unit, Orthopaedics, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
| | - Simo Saarakkala
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Biocenter Oulu, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
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Kosik-Bogacka DI, Lanocha-Arendarczyk N, Kot K, Zietek P, Karaczun M, Prokopowicz A, Kupnicka P, Ciosek Z. Calcium, magnesium, zinc and lead concentrations in the structures forming knee joint in patients with osteoarthritis. J Trace Elem Med Biol 2018; 50:409-414. [PMID: 30262313 DOI: 10.1016/j.jtemb.2018.08.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 07/10/2018] [Accepted: 08/28/2018] [Indexed: 12/29/2022]
Abstract
The aim of the study was to investigate the relationships between the concentrations of calcium (Ca), magnesium (Mg), zinc (Zn), and lead (Pb) in cartilage, anterior cruciate ligament, and meniscus samples obtained following knee joint surgery in patients with osteoarthritis in northwestern Poland. Furthermore, we examined the relationships between the concentrations of these metals in the studied parts of the knee joint and the influences of gender, age, BMI and hypertension. We found significantly higher concentrations of Ca, Mg, and Zn in the cartilage of men than in women and a significantly higher Pb concentration in the meniscus of the men. We also found a higher concentration of Pb in the cartilage of patients over 65 years of age. There were no differences in the concentrations of the studied metals between patients with and without hypertension. There was no relationship between Ca, Mg, Zn, and Pb levels in analyzed materials and BMI. Furthermore, we noted some new interactions between metals in the studied structures of the knee joint. The results reported in the study shows the influence of age, gender and BMI on the Ca, Mg, Zn and Pb in the studied structures of the knee joint.
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Affiliation(s)
- Danuta I Kosik-Bogacka
- Departament of Biology and Medical Parasitology, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland.
| | - Natalia Lanocha-Arendarczyk
- Departament of Biology and Medical Parasitology, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
| | - Karolina Kot
- Departament of Biology and Medical Parasitology, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
| | - Pawel Zietek
- Chair and Clinic of Orthopaedics, Traumatology and Oncology, Pomeranian Medical University, Unii Lubelskiej 1, 71-252, Szczecin, Poland
| | - Maciej Karaczun
- Chair and Clinic of Orthopaedics, Traumatology and Oncology, Pomeranian Medical University, Unii Lubelskiej 1, 71-252, Szczecin, Poland
| | - Adam Prokopowicz
- Departmet of Chemical Hazards and Genetic Toxicology, Institute of Occupational Medicina and Environmental Health, Koscielna 13, 71-200, Sosnowiec, Poland
| | - Patrycja Kupnicka
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
| | - Zaneta Ciosek
- Departament of Biology and Medical Parasitology, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
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Matsumoto N, Kumai T, Isomoto S, Shinohara Y, Tanaka Y, Azuma C, Minami T, Tohno Y. Regional differences in elements of human peroneus longus tendons. Biol Trace Elem Res 2013; 154:185-9. [PMID: 23812651 DOI: 10.1007/s12011-013-9735-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 06/12/2013] [Indexed: 10/26/2022]
Abstract
Many studies have been performed on the structure, molecular composition, and biochemical properties of tendons. However, comparatively little research has been conducted on the content of various trace elements within tendons. Six elements were analyzed in four regions of the peroneus longus tendon: the tensional part of the tendon immediately proximal to the lateral malleolus (region A), the compressive region of the tendon in contact with the lateral malleolus (region B), the compressive region of the tendon in contact with the deep surface of the cuboid (region C), and the tensional part of the tendon between the cuboid and first metatarsal, to which the tendon is attached (region D). Regions B and C are wraparound regions. The calcium content was higher in region C (2.10 ± 0.93 mg/g) than in both regions A (1.25 ± 0.51 mg/g) and D (1.43 ± 0.41 mg/g) (p < 0.05), indicating that it is likely related to regional differences in cartilage degeneration. The phosphorus content was also higher in region C, possibly because of low alkaline phosphatase activity in this region. The sulfur content was higher in the wraparound regions (region B: 0.98 ± 0.09 mg/g, region C: 1.24 ± 0.19 mg/g) than in both regions A (0.83 ± 0.11 mg/g) and D (0.83 ± 0.1 mg/g) (p < 0.01); sulfur content is thought to be influenced by tendon-bone compression. Finally, the magnesium content in the wraparound regions was also higher, which is probably related to a higher level of fibrocartilage. No significant relationships were found with regard to zinc or iron. Overall, the findings of the present study indicate that element contents are related to function and anatomical differences in tendons, and that they may even vary within the same tendon.
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Affiliation(s)
- Norikazu Matsumoto
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, Japan.
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Longo UG, Loppini M, Romeo G, Maffulli N, Denaro V. Histological scoring systems for tissue-engineered, ex vivo and degenerative meniscus. Knee Surg Sports Traumatol Arthrosc 2013; 21:1569-76. [PMID: 22829330 DOI: 10.1007/s00167-012-2142-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 07/09/2012] [Indexed: 02/05/2023]
Abstract
PURPOSE Because its function is strictly related to the quality of meniscal tissue, one of the most important outcome measures for the evaluation of meniscal repair effectiveness is the assessment of histological features. Data on the validation and application of the histological scoring systems in research settings and specific fields of meniscal disorders are lacking. The available histological scoring systems to assess meniscal tissue were systematically evaluated. METHODS Histological scoring systems for the analysis of degenerative meniscal changes, ex vivo and tissue-engineered meniscal repair were reviewed. Furthermore, the validity and applicability of the scoring systems were assessed. RESULTS The Copenhaver classification and Mankin score have been modified to classify the degeneration of collagen bundles in the meniscal structure. The Pauli score seems to be a comprehensive and simple scoring system for the evaluation of both macroscopic and histologic meniscal changes related to ageing and osteoarthritic degeneration. The Zhang score may be used for ex vivo gene therapy in meniscus healing. The Ishida score seems to be the most adequate for the evaluation of tissue-engineered meniscal repair. CONCLUSION Although several histological scoring systems are available to assess meniscal structure, only few of them have been validated for specific application in research settings. Validated scores are required to provide a standardized data collection to allow the comparison of results of different research groups. Further experimental and clinical studies are needed to find a comprehensive and validated histological scoring system in the field of meniscus repair. LEVEL OF EVIDENCE Systematic review of Level III studies, Level III.
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Affiliation(s)
- Umile Giuseppe Longo
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy
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Phosphocitrate is potentially a disease-modifying drug for noncrystal-associated osteoarthritis. BIOMED RESEARCH INTERNATIONAL 2013; 2013:326267. [PMID: 23555081 PMCID: PMC3595112 DOI: 10.1155/2013/326267] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 01/10/2013] [Indexed: 01/13/2023]
Abstract
Phosphocitrate (PC), a calcification inhibitor, inhibits the development of crystal-associated osteoarthritis (OA) in Hartley guinea pigs. However, the molecular mechanisms underlying its disease-modifying effect remain elusive. This study sought to test the hypothesis that PC has calcium crystal-independent biological activities which are, at least in part, responsible for its disease-modifying activity. We found that PC inhibited the proliferation of OA fibroblast-like synoviocytes in the absence of calcium crystals. Consistent with its effect on cell proliferation, PC downregulated the expression of numerous genes classified in cell proliferation. PC also downregulated the expression of many genes classified in angiogenesis and inflammatory response including prostaglandin-endoperoxide synthase 2, interleukin-1 receptor, type I, and chemokine (C-C motif) ligand 2. In contrast, PC upregulated the expression of many genes classified in musculoskeletal tissue development, including aggrecan, type I collagen, and insulin-like growth factor binding protein 5. These findings suggest that PC is not only a promising disease-modifying drug for crystal-associated OA but also for noncrystal-associated OA.
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Sun Y, Mauerhan DR, Honeycutt PR, Kneisl JS, Norton JH, Hanley EN, Gruber HE. Analysis of meniscal degeneration and meniscal gene expression. BMC Musculoskelet Disord 2010; 11:19. [PMID: 20109188 PMCID: PMC2828422 DOI: 10.1186/1471-2474-11-19] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Accepted: 01/28/2010] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Menisci play a vital role in load transmission, shock absorption and joint stability. There is increasing evidence suggesting that OA menisci may not merely be bystanders in the disease process of OA. This study sought: 1) to determine the prevalence of meniscal degeneration in OA patients, and 2) to examine gene expression in OA meniscal cells compared to normal meniscal cells. METHODS Studies were approved by our human subjects Institutional Review Board. Menisci and articular cartilage were collected during joint replacement surgery for OA patients and lower limb amputation surgery for osteosarcoma patients (normal control specimens), and graded. Meniscal cells were prepared from these meniscal tissues and expanded in monolayer culture. Differential gene expression in OA meniscal cells and normal meniscal cells was examined using Affymetrix microarray and real time RT-PCR. RESULTS The grades of meniscal degeneration correlated with the grades of articular cartilage degeneration (r = 0.672; P < 0.0001). Many of the genes classified in the biological processes of immune response, inflammatory response, biomineral formation and cell proliferation, including major histocompatibility complex, class II, DP alpha 1 (HLA-DPA1), integrin, beta 2 (ITGB2), ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1), ankylosis, progressive homolog (ANKH) and fibroblast growth factor 7 (FGF7), were expressed at significantly higher levels in OA meniscal cells compared to normal meniscal cells. Importantly, many of the genes that have been shown to be differentially expressed in other OA cell types/tissues, including ADAM metallopeptidase with thrombospondin type 1 motif 5 (ADAMTS5) and prostaglandin E synthase (PTGES), were found to be expressed at significantly higher levels in OA meniscal cells. This consistency suggests that many of the genes detected in our study are disease-specific. CONCLUSION Our findings suggest that OA is a whole joint disease. Meniscal cells may play an active role in the development of OA. Investigation of the gene expression profiles of OA meniscal cells may reveal new therapeutic targets for OA therapy and also may uncover novel disease markers for early diagnosis of OA.
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Affiliation(s)
- Yubo Sun
- Department of Orthopaedic Surgery, Carolinas Medical Center, PO Box 32861, Charlotte, NC 28232, USA
| | - David R Mauerhan
- Department of Orthopaedic Surgery, Carolinas Medical Center, PO Box 32861, Charlotte, NC 28232, USA
| | - Patrick R Honeycutt
- Department of Orthopaedic Surgery, Carolinas Medical Center, PO Box 32861, Charlotte, NC 28232, USA
| | - Jeffrey S Kneisl
- Department of Orthopaedic Surgery, Carolinas Medical Center, PO Box 32861, Charlotte, NC 28232, USA
| | - James H Norton
- Department of Biostatistics, Carolinas Medical Center, PO Box 32861, Charlotte, NC 28232, USA
| | - Edward N Hanley
- Department of Orthopaedic Surgery, Carolinas Medical Center, PO Box 32861, Charlotte, NC 28232, USA
| | - Helen E Gruber
- Department of Orthopaedic Surgery, Carolinas Medical Center, PO Box 32861, Charlotte, NC 28232, USA
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