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Nakagawa Y, Koga H, Nakamura T, Horie M, Katagiri H, Ozeki N, Ohara T, Sekiya I, Muneta T, Watanabe T. Mid-term clinical outcomes of a posterior stabilized total knee prosthesis for Japanese patients: A minimum follow-up of 5 years. J Orthop Sci 2023; 28:1325-1330. [PMID: 36462994 DOI: 10.1016/j.jos.2022.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 08/24/2022] [Accepted: 09/21/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND A high-flexion posterior-stabilized total knee prosthesis has been developed for the Asian population. The component design was based on computed tomography images of Japanese osteoarthritic knees. The femoral component is composed of zirconia ceramics, which exhibit low friction and high durability. The present study aimed to evaluate the mid-term clinical outcomes of this implant. METHODS This study included 334 knees of 210 patients who underwent primary total knee arthroplasty with this implant at our hospital between October 2010 and December 2014. The patients comprised 28 men and 172 women with an average age of 73 years. The average follow-up period was 5.9 years, and the follow-up rate was 71.1%. Clinical outcomes were assessed using the Knee Society scoring system, 2011 Knee Society questionnaire, and Knee Injury and Osteoarthritis Outcome Score. Kaplan-Meier survivorship analysis was performed to determine the cumulative prosthesis survival rate. RESULTS In terms of clinical outcomes at the final follow-up, the average ranges of motion were -2.0 in extension and 126.7 in flexion. The Knee Society knee and function scores were 94.2% and 72.6%, respectively. With revision surgery or radiographic failure for any reason as the endpoint, the survival rates at 5 and 9 years were 98.2% and 95.5%, respectively. The most common reason for revision surgery or radiological failure was aseptic loosening. CONCLUSIONS Despite several revision cases mainly due to aseptic loosening, the present study found that this new high-flexion posterior-stabilized total knee arthroplasty prosthesis design showed comparable results for Asian populations with other PS prosthesis. LEVELS OF EVIDENCE Level Ⅱ (Prospective cohort study).
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Affiliation(s)
- Yusuke Nakagawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Hideyuki Koga
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Tomomasa Nakamura
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Masafumi Horie
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Hiroki Katagiri
- Second Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minami-Koshigaya, Koshigaya-shi, 343-8555 Saitama, Japan
| | - Nobutake Ozeki
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Toshiyuki Ohara
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Ichiro Sekiya
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Takeshi Muneta
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Toshifumi Watanabe
- Second Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minami-Koshigaya, Koshigaya-shi, 343-8555 Saitama, Japan.
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Hisashi K, Muneta T, Kohno Y, Sasaki M, Yamazaki J, Hayashi H, Koga H, Morito T. MRI study of medial meniscus degeneration of osteoarthritic knees with or without posterior root tear. J Exp Orthop 2022; 9:38. [PMID: 35486331 PMCID: PMC9054988 DOI: 10.1186/s40634-022-00474-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/07/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose The purpose of this study was to compare the medial meniscus (MM) degeneration, meniscus extrusion, and tibial joint inclination by using MRI to consider the pathogenesis of posterior root tear (PRT) in medial-type knee osteoarthritis (KOA) both with and without medial meniscus posterior root tear (MMPRT). Methods This study used open MRI with flexion sagittal view and included 324 medial-type osteoarthritic knees with a Kellegren–Lawrence grade of 2 or less. Following the exclusion process, 151 knees were selected for MRI analysis. MM degeneration grading was performed according to Jerosch by 5 degrees of 0–4 in four different portions from anterior to posterior. MM medial extrusion (MMME), MM posterior extrusion (MMPE), medial tibial medial slope (MTMS), and medial tibial posterior slope (MTPS) were measured according to previous studies. Results MM degeneration in the anterior portion to MCL averaged 1.72 ± 0.67 in the PRT group (n = 48) and 1.40 ± 0.78 in the non-PRT group (n = 103). The degeneration grade was statistically higher in the PRT group than in the non-PRT group (p = 0.050). There was no difference in MM degeneration in the other three portions. MMME averaged 4.02 ± 1.12 mm in the PRT group and 3.11 ± 1.11 mm in the non-PRT group. MMPE averaged 4.22 ± 0.87 mm in the PRT group and 2.83 ± 1.12 mm in the non-PRT group. Both MMME and MMPE in the PRT group were statistically larger than those in the non-PRT group (p < 0.001). There was no difference in MTMS between the two groups. MTPS averaged 6.34 ± 2.25° in the PRT group and 5.28 ± 2.23° in the non-PRT group. The MTPS of the PRT group was statistically larger than that of the non-PRT group (p = 0.007). Conclusion The severity of MM degeneration, extrusion of MM, and degree of tibial slope were compared between medial-type KOA with and without PRT using an open MRI. MM degeneration was more severe anteriorly in the PRT group. The PRT group showed larger MMME and MMPE with greater MTPS. Level of evidence III. Retrospective cohort study.
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Affiliation(s)
- Kosuke Hisashi
- Hachioji-Higashi Orthopedic Clinic and Akishima Orthopedic Clinic, Joint Surgery Institute, 36-1 Takakura-machi, Hachioji-shi, Tokyo, 192-0033, Japan
| | - Takeshi Muneta
- Hachioji-Higashi Orthopedic Clinic and Akishima Orthopedic Clinic, Joint Surgery Institute, 36-1 Takakura-machi, Hachioji-shi, Tokyo, 192-0033, Japan.
| | - Yuji Kohno
- Hachioji-Higashi Orthopedic Clinic and Akishima Orthopedic Clinic, Joint Surgery Institute, 36-1 Takakura-machi, Hachioji-shi, Tokyo, 192-0033, Japan
| | - Mana Sasaki
- Hachioji-Higashi Orthopedic Clinic and Akishima Orthopedic Clinic, Joint Surgery Institute, 36-1 Takakura-machi, Hachioji-shi, Tokyo, 192-0033, Japan
| | - Junya Yamazaki
- Hachioji-Higashi Orthopedic Clinic and Akishima Orthopedic Clinic, Joint Surgery Institute, 36-1 Takakura-machi, Hachioji-shi, Tokyo, 192-0033, Japan
| | - Haruhisa Hayashi
- Hachioji-Higashi Orthopedic Clinic and Akishima Orthopedic Clinic, Joint Surgery Institute, 36-1 Takakura-machi, Hachioji-shi, Tokyo, 192-0033, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshiyuki Morito
- Hachioji-Higashi Orthopedic Clinic and Akishima Orthopedic Clinic, Joint Surgery Institute, 36-1 Takakura-machi, Hachioji-shi, Tokyo, 192-0033, Japan
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Hoshino T, Nakagawa Y, Inomata K, Ohara T, Katagiri H, Otabe K, Hiyama K, Katagiri K, Katakura M, Ueki H, Hayashi M, Nagase T, Sekiya I, Ogiuchi T, Muneta T, Koga H. Effects of different surgical procedures for meniscus injury on two-year clinical and radiological outcomes after anterior cruciate ligament reconstructions. -TMDU MAKS study. J Orthop Sci 2022; 27:199-206. [PMID: 33612347 DOI: 10.1016/j.jos.2020.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 09/28/2020] [Accepted: 12/02/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND The treatment of meniscus injuries combined with anterior cruciate ligament (ACL) reconstruction would be important to improve outcomes after ACL reconstruction. However, the effects of treatment methods for meniscus after ACL reconstruction have not been thoroughly investigated. The objective of this study was to investigate the effects of treatment methods for meniscus on clinical and radiological outcomes at 2 years after ACL reconstruction. METHODS Three-hundred and eighteen patients with primary ACL reconstruction using autologous hamstring tendon registered in our multicenter study database and who were followed up for 2 years were included. They were then divided into 3 groups, the no meniscal lesion/untreated group (n = 149), the meniscal repair group (n = 139), and the meniscal resection group (n = 30). Patient-based subjective evaluations (Lysholm score, Knee injury and Osteoarthritis Outcome score and International Knee Documentation Committee subjective score), objective evaluations (Lachman test, pivot shift test and KT measurement), and radiological measurements (medial and lateral joint space width) were compared among the 3 groups preoperatively and at 2 years follow-up. RESULTS All subjective scores and objective evaluations significantly improved in all groups without significant differences among the groups postoperatively. Regarding radiological findings, the medial joint space width significantly decreased only in the resection group during the 2-year period, and the medial joint space width in the resection group was significantly smaller than that of the other groups at the 2-year follow-up. Moreover, the medial joint space width significantly decreased during the 2-year period when MM was resected. CONCLUSIONS In radiological findings, medial meniscus resection decreased medial joint space width two years after ACL reconstruction. On the other hand, treatment methods for meniscus neither significantly affected subjective nor objective findings until the 2-year follow-up. LEVEL OF EVIDENCE Ⅱ, Cohort study.
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Affiliation(s)
- Takashi Hoshino
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Yusuke Nakagawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Kei Inomata
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan; Kawaguchikogyo General Hospital, 1-18-15 Aoki, Kawaguchi, Saitama 332-0031, Japan
| | - Toshiyuki Ohara
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Hiroki Katagiri
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Koji Otabe
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Kanehiro Hiyama
- Kawaguchikogyo General Hospital, 1-18-15 Aoki, Kawaguchi, Saitama 332-0031, Japan
| | - Kenta Katagiri
- Doai Memorial Hospital, 2-1-11 Yokoami, Sumida-ku, Tokyo 130-8587, Japan
| | - Mai Katakura
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Hiroko Ueki
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Masaya Hayashi
- Kawaguchikogyo General Hospital, 1-18-15 Aoki, Kawaguchi, Saitama 332-0031, Japan
| | - Tsuyoshi Nagase
- Doai Memorial Hospital, 2-1-11 Yokoami, Sumida-ku, Tokyo 130-8587, Japan
| | - Ichiro Sekiya
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Takashi Ogiuchi
- Kawaguchikogyo General Hospital, 1-18-15 Aoki, Kawaguchi, Saitama 332-0031, Japan
| | - Takeshi Muneta
- National Hospital Organization Disaster Medical Center, 3256 Midori, Tachikawa, Tokyo 190-0014, Japan
| | - Hideyuki Koga
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
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Yanagisawa K, Watanabe T, Koga H, Sekiya I, Muneta T, Jinno T. Do the distal femur and the proximal tibia have narrower aspect ratios in smaller knees? : A morphological analysis of osteoarthritic knees in the Japanese population using computed tomography. Knee 2021; 33:84-92. [PMID: 34600225 DOI: 10.1016/j.knee.2021.08.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 06/08/2021] [Accepted: 08/25/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Whether the distal femur and the proximal tibia have narrower aspect ratios in smaller knees has not been clarified. The purpose of this study was to confirm the dimensional characteristics of the distal femur and the proximal tibia using a novel method for consistently determining knee size. METHODS A total of 220 Japanese osteoarthritic knees (160 female and 60 male knees) were analyzed using computed tomography. The mediolateral (ML) and the anteroposterior (AP) dimensions of the distal femur (fML, fAP) and the proximal tibia (tML, tAP) were measured. The aspect ratios (ML/AP) of the distal femur (fML/fAP) and the proximal tibia (tML/tAP) were assessed against the product of AP × ML as a consistent determination of knee size. RESULTS The fML/fAP ratios positively correlated with knee size (fAP × fML) (r = 0.420, p < 0.001), only in the combined cohort, attributable to the narrower aspect ratios of female knees. No correlations were found between the tML/tAP ratios and knee size (tAP × tML) among females, males, nor all subjects (p = 0.299, 0.994, and 0.996, respectively). Aspect ratio correlations to knee size diverged between the three knee size indices, AP, ML, and AP × ML. CONCLUSIONS AP × ML was the meaningful option for knee size indexing in our morphological analyses. The distal femur, but not the proximal tibia, was found to have a narrower aspect ratio in female knees in the Japanese population.
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Affiliation(s)
- Katsuaki Yanagisawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
| | - Toshifumi Watanabe
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan; Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minami-Koshigaya, Koshigaya, Saitama 343-8555, Japan.
| | - Hideyuki Koga
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
| | - Ichiro Sekiya
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
| | - Takeshi Muneta
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Tetsuya Jinno
- Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minami-Koshigaya, Koshigaya, Saitama 343-8555, Japan.
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Ueki H, Katagiri H, Tsuji K, Miyatake K, Watanabe T, Sekiya I, Muneta T, Koga H. Effect of transplanted mesenchymal stem cell number on the prevention of cartilage degeneration and pain reduction in a posttraumatic osteoarthritis rat model. J Orthop Sci 2021; 26:690-697. [PMID: 32859470 DOI: 10.1016/j.jos.2020.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/02/2020] [Accepted: 06/30/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Mesenchymal stem cells (MSCs) transplantation therapy is considered an alternative therapy to prevent posttraumatic osteoarthritis (PTOA). However, consensus as to the sufficient number of MSCs for the prevention of PTOA is lacking. The purpose of this study was to determine the sufficient number of MSCs to achieve PTOA prevention and the reduction in pain after anterior cruciate ligament transection (ACLT). METHODS Eight-week-old male Wistar rats were used. ACLT was conducted in the knee joint as a PTOA model. According to the species-specific knee joint volume, 104 MSCs in rats are equivalent to 3 × 107 MSCs in humans, which was clinically prepared. MSCs (104, 105, or 106 cells) or phosphate-buffered saline were injected into the knee joint at 1, 2, and 3 weeks after ACLT. Histological examinations were performed at 12 weeks after ACLT. The weight-bearing distribution improvement ratio was calculated as an assessment of pain until 12 weeks after ACLT. RESULTS Histological evaluations showed that all the MSCs groups except for 104 MSCs group in femur were significantly improved compared to the control group at 12 weeks after ACLT. The weight-bearing distribution in the 104 and 105 MSCs groups at 12 weeks after ACLT and in the 106 MSCs group at 6, 8, 10, and 12 weeks after ACLT were significantly higher than those of the control group. CONCLUSION A clinically feasible number of MSCs was found to reduce the articular cartilage degeneration and to decrease pain in the PTOA model. Increasing numbers of the cells further protected the articular cartilage against degeneration.
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Affiliation(s)
- Hiroko Ueki
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Hiroki Katagiri
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan; Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
| | - Kunikazu Tsuji
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Kazumasa Miyatake
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan; Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Toshifumi Watanabe
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University (TMDU), Tokyo, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Takeshi Muneta
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan; Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
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Katagiri H, Nakamura K, Muneta T, Watanabe T, Miyatake K, Sekiya I, Koga H, Tsuji K. Inflammatory and healing environment in synovial fluid after anterior cruciate ligament reconstruction: Granulocytes and endogenous opioids as new targets of postoperative pain. Biochem Biophys Rep 2021; 26:100981. [PMID: 33997313 PMCID: PMC8093890 DOI: 10.1016/j.bbrep.2021.100981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 12/30/2020] [Accepted: 03/08/2021] [Indexed: 11/18/2022] Open
Abstract
Background Biological processes after anterior cruciate ligament reconstruction (ACLR) is crucial for recovery. However, alterations in the of synovial fluid cell population during the acute phase following ACLR and the relationship between these cells and postoperative pain is unclear. The goal of this study was to reveal alterations in synovial fluid cell population during the acute phase following ACLR and relationship between postoperative pain and proportion of synovial fluid cells. Methods Synovial fluids were obtained from all patients (n = 50) before surgery and from patients who showed hydrarthrosis at days 4 (n = 25), and 21 (n = 42) post-surgery. The cell population was analyzed by flow cytometry. IL1β, IL8, and met-enkephalin in synovial fluid were quantitated by enzyme-linked immunosorbent assay. Patients answered numerical rating scale (NRS) questionnaire at 4 days and approximately 4 weeks postoperatively. Results The granulocyte population was significantly higher at 4 days after surgery than at any other time points. The population of macrophages was 3.2 times and 7.7 times as high as at surgery on days 4 and 21, respectively. T cell population was significantly higher 21 days after surgery compared to 4 days after surgery. All NRS 4 weeks after surgery showed a significant negative correlation with the granulocyte population in synovial fluid 4 days after surgery. Granulocyte population in synovial fluid significantly correlated with the levels of IL1β and IL8. Postoperative pain at rest tended to decrease with an increase in met-enkephalin concentration 4 days after ACLR. Conclusions Synovial fluid after ACLR had an inflammatory environment at early time points and a healing environment in the subsequent phase about concerning to the cellular composition. A proportion of synovial fluid cells and endogenous opioids affected postoperative pain. Granulocyte population was higher at 4 days after ACLR than at other time points. Postoperative pain negatively correlated with the granulocyte in synovial fluid. Granulocyte population in synovial fluid correlate with IL1β and IL8 concentration. Postoperative pain tended to decrease with an increase in met-enkephalin.
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Affiliation(s)
- Hiroki Katagiri
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Japan
| | - Kaori Nakamura
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Japan
| | - Toshifumi Watanabe
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Japan
| | - Kazumasa Miyatake
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Japan
| | - Kunikazu Tsuji
- Department of Cartilage Regeneration, Tokyo Medical and Dental University, Japan
- Corresponding author. Tokyo Medical and Dental University, Department of Cartilage Regeneration, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
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An JS, Tsuji K, Onuma H, Araya N, Isono M, Hoshino T, Inomata K, Hino J, Miyazato M, Hosoda H, Kangawa K, Nakagawa Y, Katagiri H, Miyatake K, Sekiya I, Muneta T, Koga H. Inhibition of fibrotic changes in infrapatellar fat pad alleviates persistent pain and articular cartilage degeneration in monoiodoacetic acid-induced rat arthritis model. Osteoarthritis Cartilage 2021; 29:380-388. [PMID: 33388431 DOI: 10.1016/j.joca.2020.12.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 12/05/2020] [Accepted: 12/15/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE We have reported that fibrotic changes in infrapatellar fat pad (IFP) after acute joint inflammation are closely associated with persistent pain in rats. In this study, to examine the effects of anti-fibrotic treatment on persistent pain, we used C-type natriuretic peptides (CNP) at the recovery phase after acute joint inflammation. DESIGN Thirty-two male Wistar rats were used in this study. Monoiodoacetic acid (MIA) was injected intra-articularly to induce IFP fibrosis and persistent pain. CNP was injected after acute inflammatory phase in the same knee joint. Time-course pain-avoidance behavior tests and histological analyses were performed to examine the effects of CNP. RESULTS Histological evaluations indicated that intra-articular injection of CNP inhibited fibrotic changes in IFP after acute inflammation. Incapacitance tests indicated that MIA injection into rat knee joint quickly decreased the percent weight on ipsilateral limb. In the vehicle group, the decrease was maintained up to day 28, suggesting that pain persistence occurred after acute inflammation (Day 0/Day 28, Est Dif -8.15, CI -10.78∼-5.53, Linear mixed-effect model). In contrast, the pain was alleviated in the CNP group after day 14 (Day0/Day 14, -0.51, -2.62-1.59). In addition, we observed significant improvement in the degree of articular cartilage degeneration at day 14 in the CNP group (OARSI score: vehicle 16.14 ± 4.37 vs CNP 6.87 ± 3.44, P < 0.01; Wilcoxon rank sum test). CONCLUSION Fibrotic changes in IFP may play important roles in both persistent pain and articular cartilage degeneration.
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Affiliation(s)
- J-S An
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
| | - K Tsuji
- Department of Cartilage Regeneration, Tokyo Medical and Dental University, Tokyo, Japan.
| | - H Onuma
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
| | - N Araya
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
| | - M Isono
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
| | - T Hoshino
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
| | - K Inomata
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
| | - J Hino
- Department of Biochemistry, Japan; National Cerebral and Cardiovascular Center Research Institute, Japan.
| | - M Miyazato
- Department of Biochemistry, Japan; National Cerebral and Cardiovascular Center Research Institute, Japan.
| | - H Hosoda
- Department of Regenerative Medicine and Tissue Engineering, Japan; National Cerebral and Cardiovascular Center Research Institute, Japan.
| | - K Kangawa
- National Cerebral and Cardiovascular Center Research Institute, Japan.
| | - Y Nakagawa
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan; Department of Cartilage Regeneration, Tokyo Medical and Dental University, Tokyo, Japan.
| | - H Katagiri
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
| | - K Miyatake
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
| | - I Sekiya
- Center for Stem Cells and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
| | - T Muneta
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
| | - H Koga
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
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Watanabe T, Gamada K, Koga H, Sekiya I, Muneta T, Jinno T. Characteristic kinematics of floor-sitting activities after posterior-stabilized total knee arthroplasty determined using model-based shape-matching techniques. Knee 2021; 29:571-579. [PMID: 33602618 DOI: 10.1016/j.knee.2020.12.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 08/12/2020] [Accepted: 12/22/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Detailed kinematics of floor-sitting activities after total knee arthroplasty (TKA) have not been well explored. Knee kinematics of cross-legged sitting, seiza-sitting, and side-sitting after TKA were examined to clarify the differences in tibiofemoral kinematics of each activity. METHODS Subjects were 40 knees in 20 osteoarthritic patients who underwent bilateral TKA with a high-flexion fixed-bearing posterior-stabilized prosthesis. Dynamic radiographs of floor-sitting activities were taken, and the knee kinematics were compared among the three activities. The patients were also divided into two groups (possible/easy group and impossible/no-try group) for each activity, and group comparisons were conducted. RESULTS The maximum implant flexion angle was significantly greater in seiza-sitting. In valgus/varus rotation, seiza-sitting demonstrated neutral rotation, while cross-legged sitting showed varus of about 10°, and side-sitting exhibited valgus. In tibial internal/external rotation, seiza-sitting demonstrated a constant rotational angle, while cross-legged sitting showed tibial internal rotation with flexion, and side-sitting exhibited tibial external rotation with flexion. The kinematic pathway during deep flexion illustrated the medial pivot pattern in cross-legged sitting, a small amount of bicondylar rollback in seiza-sitting, and the weak lateral pivot pattern in side-sitting. A greater flexion angle was the important factor for the performance of each floor-sitting activity followed by varus laxity at 10° knee flexion. CONCLUSIONS This study successfully revealed characteristic kinematic patterns of TKA knees in three floor-sitting activities. Obtaining a greater knee flexion with adequate lateral laxity is the key to enhancing postoperative floor-sitting activities.
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Affiliation(s)
- Toshifumi Watanabe
- Second Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan; Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan.
| | - Kazuyoshi Gamada
- Graduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, Hiroshima, Japan
| | - Hideyuki Koga
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Ichiro Sekiya
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Takeshi Muneta
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Tetsuya Jinno
- Second Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
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Onuma H, Tsuji K, Hoshino T, Inomata K, Udo M, Nakagawa Y, Katagiri H, Miyatake K, Watanabe T, Sekiya I, Muneta T, Koga H. Fibrotic changes in the infrapatellar fat pad induce new vessel formation and sensory nerve fiber endings that associate prolonged pain. J Orthop Res 2020; 38:1296-1306. [PMID: 31903621 DOI: 10.1002/jor.24580] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 12/05/2019] [Accepted: 12/28/2019] [Indexed: 02/04/2023]
Abstract
The infrapatellar fat pad (IFP) contains nerve fiber endings and is considered to play an important role in the perception of knee pain. However, it is unclear whether and to what degree prolonged pain influences the nociceptive role of the IFP. To answer this question, we established a novel rat model of knee pain in which inflammation is restricted to the IFP. Rats received a single intra-IFP injection of monoiodoacetic acid (MIA) (0.2 mg/10 µL or 1.0 mg/10 µL) in the left knee and a phosphate-buffered saline (10 µL) injection in the right knee as a control. Pain-avoidance behavior and histological changes of the knee joint were measured at multiple time points up to 28 days after MIA injection. Histological analysis showed a transient inflammatory response in the IFP body in the 0.2-mg model, whereas prolonged inflammation followed by fibrotic changes was observed in the 1.0-mg model. Subtle histological alterations were observed in the articular cartilage and IFP surface regardless of the dose. The pain-avoidance behavior test indicated the development of prolonged knee pain throughout the experimental period in the 1.0-mg group. Histological assessments showed a significant increase in calcitonin gene-related peptide (CGRP)-positive nerve fiber endings inside IFPs with fibrosis in newly vascularized surrounding regions. These data suggest that irreversible fibrotic changes in the IFP induce the formation of new vessels and CGRP-positive nerve fiber endings that associate prolonged pain in the joint.
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Affiliation(s)
- Hiroaki Onuma
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kunikazu Tsuji
- Department of Cartilage Regeneration, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Hoshino
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kei Inomata
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mio Udo
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yusuke Nakagawa
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroki Katagiri
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazumasa Miyatake
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshifumi Watanabe
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ichiro Sekiya
- Section of Applied Regenerative Medicine, Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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10
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Nakagawa Y, Muneta T, Watanabe T, Horie M, Nakamura T, Otabe K, Katakura M, Sumi Y, Sekiya I, Koga H. Arthroscopic centralization achieved good clinical improvements and radiographic outcomes in a rugby player with osteoarthritis after subtotal lateral meniscectomy: A case report. J Orthop Sci 2020; 25:537-543. [PMID: 28969953 DOI: 10.1016/j.jos.2017.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 09/03/2017] [Accepted: 09/13/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Yusuke Nakagawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Takeshi Muneta
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Toshifumi Watanabe
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Masafumi Horie
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Tomomasa Nakamura
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Koji Otabe
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Mai Katakura
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Yusuke Sumi
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Ichiro Sekiya
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Hideyuki Koga
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
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11
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Nakamura K, Nakamura T, Horie M, Katagiri H, Otabe K, Nakagawa Y, Amemiya M, Sekiya I, Muneta T, Koga H. Anatomic femoral tunnel placement is difficult by the transtibial technique: comparison of three different femoral tunnel drilling techniques in double-bundle anterior cruciate ligament reconstructions. Knee Surg Sports Traumatol Arthrosc 2020; 28:584-593. [PMID: 31612263 DOI: 10.1007/s00167-019-05740-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 09/30/2019] [Indexed: 01/18/2023]
Abstract
PURPOSE To compare the position and direction of femoral and tibial tunnels for both the anteromedial bundle (AMB) and posterolateral bundle (PLB) among three different femoral tunnel drilling techniques, transtibial (TT), transportal (TP), and outside-in (OI) techniques, in anatomic double-bundle ACL reconstruction to clarify advantages and disadvantages of each technique. METHODS One-hundred and thirty-nine patients underwent primary ACL reconstruction with an autologous semitendinosus tendon in our institution between 2014 and 2016. Thirteen patients were excluded according to the exclusion criteria. Of the 126 patients, 98 patients agreed to be included in this study. Patients were then randomized into three groups according to the femoral tunnel drilling technique; the TT, TP, and OI groups. Femoral and tibial tunnel angles and positions were measured using three-dimensional computed tomography. RESULTS Of patients who agreed to be included in this study, eight patients (seven in TT and one in OI) were excluded since the femoral tunnel could not be created at the intended position. Eighty-six patients (29 in TT, 29 in TP, and 28 in OI) were included for the analyses. Tunnel angles, as well as tunnel lengths, had significant differences among different techniques depending on each technique's characteristics. In terms of tunnel position, femoral tunnel positions of both the AMB and PLB in the TT group were significantly higher than those in the TP group (AMB: p = 0.003, PLB: p = 0.001), and the PLB tunnel position in the TP group had significantly smaller vaciance than that in the TT group (p = 0.004) and OI group (0.002). CONCLUSIONS The femoral tunnel positions created by the TT technique were significantly higher, with larger variance, than the TP technique in double-bundle ACL reconstruction, although the positions seemed to be within anatomical footprint. In addition, there were several cases in which femoral tunnels could not be created at the intended position by the TT technique. LEVEL OF EVIDENCE I.
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Affiliation(s)
- Kaori Nakamura
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Tomomasa Nakamura
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Masafumi Horie
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Hiroki Katagiri
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Koji Otabe
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Yusuke Nakagawa
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Masaki Amemiya
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Ichiro Sekiya
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan. .,Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
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12
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Ozeki N, Koga H, Matsuda J, Kohno Y, Mizuno M, Katano H, Tsuji K, Saito T, Muneta T, Sekiya I. Biomechanical analysis of the centralization procedure for extruded lateral menisci with posterior root deficiency in a porcine model. J Orthop Sci 2020; 25:161-166. [PMID: 30902537 DOI: 10.1016/j.jos.2019.02.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 01/05/2019] [Accepted: 02/12/2019] [Indexed: 02/09/2023]
Abstract
PURPOSE The purpose of this study was to investigate the biomechanical properties of load distribution following a centralization procedure for extruded lateral menisci with posterior root deficiency in a porcine model. METHODS Six porcine knee joints were analyzed in a universal tester, as follows: 1) Intact; 2) Extrusion (meniscus extrusion was created by resecting the posterior root of the lateral meniscus, as well as the posterior synovial capsule); and 3) Centralization (two anchors were inserted at the lateral tibial plateau, and the meniscus was sutured to secure it close to the original position). Meniscus extrusion was evaluated using two markers put on the posterior cruciate ligament and the lateral meniscus, and the load distribution were assessed using a pressure mapping sensor system after applying a loading force of 200 N to the knee joint. RESULTS Distance between two markers (mm, Average; 95% CI) was larger in the extrusion group (21.9; 17.8, 25.6) than in the intact (18.1; 15.1, 22.7) or the centralization (15.3; 12.9, 18.0) groups. The contact area (mm2) in the middle of the meniscus was significantly smaller in the extrusion group (45.8; 18.5, 73.2) than in the intact (85.7; 72.1, 99.2) or the centralization (98.3; 88.8, 107.8) groups. The maximum contact pressure (MPa) in the tibial plateau was significantly higher in the extrusion group (0.37; 0.35, 0.40) than in the intact (0.29; 0.21, 0.37) or the centralization (0.29; 0.22, 0.36) groups. CONCLUSIONS The centralization procedure enabled a reduction of the meniscus extrusion in the lateral meniscus with posterior root deficiency and restored the maximum load and contact pressure to values close to those of the normal knee joint.
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Affiliation(s)
- Nobutake Ozeki
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Japan; Department of Orthopaedic Surgery, Yokohama City University, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Japan
| | - Junpei Matsuda
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Japan
| | - Yuji Kohno
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Japan
| | - Mitsuru Mizuno
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Japan
| | - Hisako Katano
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Japan
| | - Kunikazu Tsuji
- Department of Cartilage Regeneration, Tokyo Medical and Dental University, Japan
| | - Tomoyuki Saito
- Department of Orthopaedic Surgery, Yokohama City University, Japan
| | - Takeshi Muneta
- National Hospital Organization Disaster Medical Center, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Japan.
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13
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Amemiya M, Tsuji K, Katagiri H, Miyatake K, Nakagawa Y, Sekiya I, Muneta T, Koga H. Synovial fluid-derived mesenchymal cells have non-inferior chondrogenic potential and can be utilized for regenerative therapy as substitute for synovium-derived cells. Biochem Biophys Res Commun 2019; 523:465-472. [PMID: 31882120 DOI: 10.1016/j.bbrc.2019.12.068] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 12/15/2019] [Indexed: 12/26/2022]
Abstract
Recent progress in the field of mesenchymal stem cell (MSC) biology has enabled their clinical application. In the autologous cell transplantation therapy, the source of MSCs are quite important to reduce patients' physical burden. In this study, we isolated MSCs from the synovial fluid (SF) and synovial membrane (Syn) of the same patients and compared the biological characteristics of them. In vitro and in vivo experiments indicated the non-inferior chondrocytic differentiation and articular cartilage regeneration potential of SF-MSCs compared to that of Syn-MSCs; however, SF-MSCs showed less proliferative potential than Syn-MSCs in vitro. Flow cytometry-based multiplex surface antigen expression analyses indicated that SF-MSCs exhibit fewer cells positive for CD140, which is a functional growth factor receptor for MSCs. Nevertheless, we obtained enough SF-MSCs for transplantation within several passages. Since arthrocentesis is routinely performed during outpatient care in the consultation room and is less invasive than synovial biopsy, MSC derived from synovial fluid could be considered an attractive cell source for cartilage regenerative therapy as a substitute for Syn-MSC. Developing these cells for clinical application may greatly benefit patients undergoing autologous MSC transplantation therapy.
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Affiliation(s)
| | | | | | | | | | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Japan
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14
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Katakura M, Koga H, Nakamura T, Araki D, Nagai K, Nishida K, Kuroda R, Muneta T. Biomechanical Effects of Additional Anterolateral Structure Reconstruction With Different Femoral Attachment Sites on Anterior Cruciate Ligament Reconstruction. Am J Sports Med 2019; 47:3373-3380. [PMID: 31657943 DOI: 10.1177/0363546519880192] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Recently reported anterolateral structure reconstructions (ALSRs) to augment intra-articular anterior cruciate ligament reconstruction (ACLR) use various femoral attachment sites, and their biomechanical effects are still unknown. HYPOTHESIS ALSR concomitant with ACLR would control anterolateral rotational instability better than ACLR alone, and if ALSR had different femoral attachment sites, there would be different effects on its control of anterolateral rotational instability. STUDY DESIGN Controlled laboratory study. METHODS Twelve fresh-frozen hemipelvis lower limbs were included. Anterior tibial translation during the Lachman test and tibial acceleration during the pivot-shift test were measured with a 3-dimensional electromagnetic measurement system in situations with the (1) ACL and ALS intact, (2) ACL and ALS cut, (3) ALSR without ACLR (ALSR alone), (4) ACLR without ALSR (ACLR alone), and (5) ALSR with ACLR. Three femoral attachment sites were used for ALSR: F1, 2 mm anterior and 2 mm distal to the lateral epicondyle; F2, 4 mm posterior and 8 mm proximal to the lateral epicondyle; and F3, over-the-top position for the lateral extra-articular tenodesis. The Steel test and Wilcoxon signed rank test were used for statistical analysis. RESULTS Anterior tibial translation during the Lachman test in the ACL and ALS-cut state was significantly larger than it was in the ACL and ALS-intact state, while its difference disappeared after ACLR. As for the pivot-shift test, additional ALSR with F2 to ACLR significantly decreased the acceleration (P = .046), although additional ALSR with F1 and F3 showed no significant effect. CONCLUSION ALSR with the femoral attachment site 4 mm posterior and 8 mm proximal to the lateral epicondyle in addition to ACLR played a role in reducing anterolateral rotational instability the most effectively among the measured attachment sites. CLINICAL RELEVANCE The present data will contribute to determine the appropriate femoral attachment site for ALSR to better control anterolateral rotational instability after ACL reconstruction.
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Affiliation(s)
- Mai Katakura
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Orthopaedic Surgery, Hospital of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Orthopaedic Surgery, Hospital of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomomasa Nakamura
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Daisuke Araki
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Kanto Nagai
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Kyohei Nishida
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Takeshi Muneta
- National Hospital Organization Disaster Medical Center, Tachikawa-shi, Japan
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15
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Araki D, Matsushita T, Hoshino Y, Nagai K, Nishida K, Koga H, Nakamura T, Katakura M, Muneta T, Kuroda R. The Anterolateral Structure of the Knee Does Not Affect Anterior and Dynamic Rotatory Stability in Anterior Cruciate Ligament Injury: Quantitative Evaluation With the Electromagnetic Measurement System. Am J Sports Med 2019; 47:3381-3388. [PMID: 31657944 DOI: 10.1177/0363546519879692] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The biomechanical function of the anterolateral structure (ALS), which includes the anterolateral joint capsule and anterolateral ligament (ALL), remains a topic of debate. HYPOTHESIS The ALS contributes to knee joint stability during the Lachman test and the pivot-shift test in anterior cruciate ligament (ACL)-deficient knees. STUDY DESIGN Controlled laboratory study. METHODS Fourteen fresh-frozen hemipelvis lower limbs were used. For 7 specimens, the anterior one-third of the ALS and the residual ALS were cut intra-articularly with a radiofrequency device. Subsequently, the ACL was cut arthroscopically. For the other 7 specimens, the ACL was cut first, followed by the anterior one-third of the ALS and the residual ALS intra-articularly. During the procedures, the iliotibial band (ITB) was kept intact. At each condition, the anterior tibial translation (ATT) during the manual Lachman test and the acceleration of posterior tibial translation (APT) and the posterior tibial translation (PTT) during the manual pivot-shift test were measured quantitatively with an electromagnetic measurement system. The mean values of those parameters were compared among 6 groups (ACL intact, one-third ALS cut, all ALS cut, ACL cut, ACL/one-third ALS cut, and ACL/all ALS cut). RESULTS The mean ATTs during the Lachman test and the mean APTs and PTTs in the ACL-cut conditions (ACL cut, ACL/one-third ALS cut, and ACL/all ALS cut) were significantly larger than those under the ACL-intact conditions (ACL intact, one-third ALS cut, all ALS cut) (P < .01). However, no statistically significant differences were observed among the intact, one-third ALS-cut, and all ALS-cut conditions, within the ACL-intact or ACL-cut conditions. CONCLUSION Intra-articular dissection of the ALS did not increase the ATT during the Lachman test or the APT and PTT during the pivot-shift test under the intact condition of the ITB, regardless of the integrity of the ACL. When the ITB is intact, the ALS does not have a significant role in either anterior or dynamic rotatory knee stability, while the ACL does. CLINICAL RELEVANCE Recent growing interest about ALL reconstruction or ALS augmentation may not have a large role in controlling either anterior or dynamic rotatory knee instability in isolated ACL-deficient knees.
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Affiliation(s)
- Daisuke Araki
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Takehiko Matsushita
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Yuichi Hoshino
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Kanto Nagai
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Kyohei Nishida
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Tomomasa Nakamura
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mai Katakura
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
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16
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Nakagawa Y, Watanabe T, Amano Y, Horie M, Nakamura T, Otabe K, Katakura M, Sekiya I, Muneta T, Koga H. Benefit of subcutaneous patient controlled analgesia after total knee arthroplasty. Asia Pac J Sports Med Arthrosc Rehabil Technol 2019; 18:18-22. [PMID: 31641618 PMCID: PMC6796556 DOI: 10.1016/j.asmart.2019.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 09/04/2019] [Accepted: 09/09/2019] [Indexed: 11/18/2022]
Abstract
Purpose Subcutaneous patient-controlled analgesia (PCA) has been widely used for orthopedic surgeries including total knee arthroplasty (TKA). This study aims to clarify the usefulness of subcutaneous PCA in the early phase after TKA. Methods Our subjects consisted of 88 osteoarthritis knee patients who underwent primary TKA, and were classified into two groups: 42 patients received a subcutaneous PCA (containing fentanyl and droleptan) after operation (PCA group), and 46 patients were managed without a subcutaneous PCA (control group). We compared the incidence of side effects for 3 days postoperatively, measuring the number of times patients used adjuvant analgesia and range of motion on day 7 between the two groups. 34 of 42 patients in the PCA group tolerated PCA use until POD 3 (continuation sub-group), while 8 patients could not continue PCA (interruption sub-group). Demographic data of the two sub-groups were compared. Results The mean number of times adjunctive analgesics were used by the PCA group (3.7 ± 2.2) was significantly less than in the control group (5.4 ± 2.8) (p = 0.0049). There were no significant differences in the frequency of side effects between the two groups. There was no significant difference in range of motion between the two groups. Comparing the continuation and interruption sub-groups, patients over 80 years old were at risk to discontinue a subcutaneous PCA (p = 0.0319, odds ratio 5.4). Conclusion These findings demonstrate that subcutaneous PCA would be a safe postoperative pain regimen for TKA patients, but the effect was not enough to promote early functional recovery. Levels of evidence Therapeutic, Level Ⅱ.
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Affiliation(s)
- Yusuke Nakagawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Toshifumi Watanabe
- Second Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, 2-1-50, Minami-Koshigaya, Koshigaya, Saitama, Japan
| | - Yusuke Amano
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Masafumi Horie
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Tomomasa Nakamura
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Koji Otabe
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Mai Katakura
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Ichiro Sekiya
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Takeshi Muneta
- Department of Orthopaedic Surgery, National Hospital Organization Disaster Medical Center, 3256, Midori-cho, Tachikawa, Tokyo, Japan
| | - Hideyuki Koga
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
- Corresponding author.
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Muneta T. Anatomic reconstruction of anterior cruciate ligament—concept, indication and its efficacy. Ann Joint 2019. [DOI: 10.21037/aoj.2019.09.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Kondo S, Nakagawa Y, Mizuno M, Katagiri K, Tsuji K, Kiuchi S, Ono H, Muneta T, Koga H, Sekiya I. Transplantation of Aggregates of Autologous Synovial Mesenchymal Stem Cells for Treatment of Cartilage Defects in the Femoral Condyle and the Femoral Groove in Microminipigs. Am J Sports Med 2019; 47:2338-2347. [PMID: 31306591 DOI: 10.1177/0363546519859855] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Previous work has demonstrated that patients with cartilage defects of the knee benefit from arthroscopic transplantation of autologous synovial mesenchymal stem cells (MSCs) in terms of magnetic resonance imaging (MRI), qualitative histologic findings, and Lysholm score. However, the effectiveness was limited by the number of cells obtained, so large-sized defects (>500 mm2) were not investigated. The use of MSC aggregates may enable treatment of larger defects by increasing the number of MSCs adhering to the cartilage defect. PURPOSE To investigate whether transplantation of aggregates of autologous synovial MSCs with 2-step surgery could promote articular cartilage regeneration in microminipig osteochondral defects. STUDY DESIGN Controlled laboratory study. METHODS Synovial MSCs derived from a microminipig were examined for in vitro colony-forming and multidifferentiation abilities. An aggregate of 250,000 synovial MSCs was formed with hanging drop culture, and 16 aggregates (for each defect) were implanted on both osteochondral defects (6 × 6 × 1.5 mm) created in the medial femoral condyle and femoral groove (MSC group). The defects in the contralateral knee were left empty (control group). The knee joints were evaluated at 4 and 12 weeks by macroscopic findings and histology. MRI T1rho mapping images were acquired at 12 weeks. For cell tracking, synovial MSCs were labeled with ferucarbotran before aggregate formation and were observed with MRI at 1 week. RESULTS Synovial MSCs showed in vitro colony-forming and multidifferentiation abilities. Regenerative cartilage formation was significantly better in the MSC group than in the control group, as indicated by International Cartilage Repair Society score (macro), modified Wakitani score (histology), and T1rho mapping (biochemical MRI) in the medial condyle at 12 weeks. Implanted cells, labeled with ferucarbotran, were observed in the osteochondral defects at 1 week with MRI. No significant difference was noted in the modified Wakitani score at 4 weeks in the medial condyle and at 4 and 12 weeks in the femoral groove. CONCLUSION Transplantation of autologous synovial MSC aggregates promoted articular cartilage regeneration at the medial femoral condyle at 12 weeks in microminipigs. CLINICAL RELEVANCE Aggregates of autologous synovial MSCs could expand the indications for cartilage repair with synovial MSCs.
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Affiliation(s)
- Shimpei Kondo
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yusuke Nakagawa
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.,Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mitsuru Mizuno
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenta Katagiri
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kunikazu Tsuji
- Department of Cartilage Regeneration, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | | | | | - Takeshi Muneta
- National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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Sekiya I, Koga H, Otabe K, Nakagawa Y, Katano H, Ozeki N, Mizuno M, Horie M, Kohno Y, Katagiri K, Watanabe N, Muneta T. Additional Use of Synovial Mesenchymal Stem Cell Transplantation Following Surgical Repair of a Complex Degenerative Tear of the Medial Meniscus of the Knee: A Case Report. Cell Transplant 2019; 28:1445-1454. [PMID: 31313604 PMCID: PMC6802148 DOI: 10.1177/0963689719863793] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Complex degenerative tears of the medial meniscus in the knee are usually treated using
meniscectomy. However, this procedure increases the risk of osteoarthritis, while other
treatments aimed at meniscal repair remain challenging due to the high possibility of
failure. The use of synovial mesenchymal stem cells (MSCs) is an attractive additional
approach for meniscal repair, as these cells have high proliferative and chondrogenic
potential. In this case report, we surgically repaired a complex degenerative tear of the
medial meniscus and then transplanted autologous synovial MSCs. We evaluated clinical
outcomes at 2 years and assessed adverse events. We enrolled patients with clinical
symptoms that included a feeling of instability in addition to pain caused by their
complex degenerative tears of the medial meniscus. Two weeks after surgical repair of the
torn meniscus, autologous synovial MSCs were transplanted onto the menisci of five
patients. The total Lysholm knee score, the Knee Injury and Osteoarthritis Outcome Scale
scores for “pain,” “daily living,” “sports activities,” and the Numerical Rating Scale
were significantly increased after 2 years. Three adverse events, an increase in
c-reactive protein, joint effusion, and localized warmth of the knee were recorded,
although these could have been due to the meniscal repair surgery. This first-in-human
study confirmed that the combination of surgical repair and synovial MSC transplantation
improved the clinical symptoms in patients with a complex degenerative tear of the medial
meniscus. No adverse events occurred that necessitated treatment discontinuation. These
findings will serve as pilot data for a future prospective study.
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Affiliation(s)
- Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Koji Otabe
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Yusuke Nakagawa
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Hisako Katano
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Nobutake Ozeki
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Mitsuru Mizuno
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Masafumi Horie
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Yuji Kohno
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Kenta Katagiri
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Naoto Watanabe
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
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Nakamura K, Tsuji K, Mizuno M, Koga H, Muneta T, Sekiya I. Initial cell plating density affects properties of human primary synovial mesenchymal stem cells. J Orthop Res 2019; 37:1358-1367. [PMID: 30035340 PMCID: PMC6585790 DOI: 10.1002/jor.24112] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 07/01/2018] [Indexed: 02/04/2023]
Abstract
Synovial mesenchymal stem cells (MSCs) appear to be an attractive cell source in cartilage and meniscus regeneration because of their high proliferative and chondrogenic potentials. Two methods are used to culture synovial nucleated cells in the preparation of primary synovial MSCs. In one method, the cells are plated at low density to make cell colonies. In the other method, the cells are plated at high density. We investigated the effects of initial cell density on proliferation, surface markers, and multipotentiality, including chondrogenesis in primary synovial MSCs. Human synovium was obtained from the knee joints of patients with osteoarthritis after total knee arthroplasty. Immediately after enzyme digestion, the synovial nucleated cells were plated in densities of 103 , 104 , or 105 cells/60-cm2 dish and cultured for 14 days. Proliferation, surface markers, chondrogenesis, adipogenesis, and calcification were examined in three populations. The cell colonies were distinct in the 103 cells/dish group, faint in the 104 cells/dish group, and obscure in the 105 cells/dish group. The total number of cells/dish was positively related to plating density, whereas the fold increase was negatively related to plating density (n = 13). Among 12 surface markers, a negative relation to plating density was distinct in CD105. The cartilage pellet weight was negatively related to the initial plating density. The oil red-o positive area and alizarin red positive area were positively related to the initial plating density. The initial cell plating density affected the properties of primary synovial MSCs. Synovial nucleated cells proliferated better when plated at low density, and the synovial MSCs obtained by this method contained a high chondrogenic potential. © 2018 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. J Orthop Res 37:1358-1367, 2019.
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Affiliation(s)
- Kaori Nakamura
- Department of Joint Surgery and Sports MedicineTokyo Medical and Dental UniversityTokyoJapan
| | - Kunikazu Tsuji
- MedicineDepartment of Cartilage RegenerationTokyo Medical and Dental UniversityTokyoJapan
| | - Mitsuru Mizuno
- Center for Stem Cell and Regenerative MedicineTokyo Medical and Dental University1‐5‐45 YushimaBunkyo‐kuTokyo113–8519Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports MedicineTokyo Medical and Dental UniversityTokyoJapan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports MedicineTokyo Medical and Dental UniversityTokyoJapan
- National Hospital OrganizationDisaster Medical CenterTokyoJapan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative MedicineTokyo Medical and Dental University1‐5‐45 YushimaBunkyo‐kuTokyo113–8519Japan
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Naritomi M, Mizuno M, Katano H, Ozeki N, Otabe K, Komori K, Fujii S, Ichinose S, Tsuji K, Koga H, Muneta T, Sekiya I. Petaloid recombinant peptide enhances in vitro cartilage formation by synovial mesenchymal stem cells. J Orthop Res 2019; 37:1350-1357. [PMID: 29737046 PMCID: PMC6585959 DOI: 10.1002/jor.24042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 04/27/2018] [Indexed: 02/04/2023]
Abstract
In vitro chondrogenesis of mesenchymal stem cells (MSCs) mimics in vivo chondrogenesis of MSCs. However, the size of the cartilage pellets that can be attained in vitro is limited by current methods; therefore, some modifications are required to obtain larger pellets. Petaloid pieces of recombinant peptide (petaloid RCP) have the advantage of creating spaces between cells in culture. The RCP used here is based on the alpha-1 sequence of human collagen type I and contains 12 Arg-Gly-Asp motifs. We examined the effect and mechanisms of adding petaloid RCP on the in vitro chondrogenesis of human synovial MSCs by culturing 125k cells with or without 0.125 mg petaloid RCP in chondrogenic medium for 21 days. The cartilage pellets were sequentially analyzed by weight, sulfated glycosaminoglycan content, DNA retention, and histology. Petaloid RCP significantly increased the weight of the cartilage pellets: The petaloid RCP group weighed 7.7 ± 1.2 mg (n = 108), whereas the control group weighed 5.3 ± 1.6 mg. Sulfated glycosaminoglycan and DNA contents were significantly higher in the petaloid RCP group than in the control group. Light and transmission electron microscopy images showed that the petaloid RCP formed the framework of the pellet at day 1, the framework was broken by production of cartilage matrix by the synovial MSCs at day 7, and the cartilage pellet grew larger, with diffuse petaloid RCP remaining, at day 21. Therefore, petaloid RCP formed a framework for the pellet, maintained a higher cell number, and promoted in vitro cartilage formation of synovial MSCs. © 2018 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. J Orthop Res 37:1350-1357, 2019.
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Affiliation(s)
- Mana Naritomi
- Center for Stem Cell and Regenerative MedicineTokyo Medical and Dental University1‐5‐45 Yushima, Bunkyo‐kuTokyo 113‐8510Japan
| | - Mitsuru Mizuno
- Center for Stem Cell and Regenerative MedicineTokyo Medical and Dental University1‐5‐45 Yushima, Bunkyo‐kuTokyo 113‐8510Japan
| | - Hisako Katano
- Center for Stem Cell and Regenerative MedicineTokyo Medical and Dental University1‐5‐45 Yushima, Bunkyo‐kuTokyo 113‐8510Japan
| | - Nobutake Ozeki
- Center for Stem Cell and Regenerative MedicineTokyo Medical and Dental University1‐5‐45 Yushima, Bunkyo‐kuTokyo 113‐8510Japan
| | - Koji Otabe
- Center for Stem Cell and Regenerative MedicineTokyo Medical and Dental University1‐5‐45 Yushima, Bunkyo‐kuTokyo 113‐8510Japan
| | - Keiichiro Komori
- Center for Stem Cell and Regenerative MedicineTokyo Medical and Dental University1‐5‐45 Yushima, Bunkyo‐kuTokyo 113‐8510Japan
| | - Shizuka Fujii
- Center for Stem Cell and Regenerative MedicineTokyo Medical and Dental University1‐5‐45 Yushima, Bunkyo‐kuTokyo 113‐8510Japan
| | - Shizuko Ichinose
- Center for Stem Cell and Regenerative MedicineTokyo Medical and Dental University1‐5‐45 Yushima, Bunkyo‐kuTokyo 113‐8510Japan
| | - Kunikazu Tsuji
- Department of Cartilage RegenerationTokyo Medical and Dental UniversityTokyoJapan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports MedicineTokyo Medical and Dental UniversityTokyoJapan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports MedicineTokyo Medical and Dental UniversityTokyoJapan,National Hospital Organization Disaster Medical CenterTokyoJapan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative MedicineTokyo Medical and Dental University1‐5‐45 Yushima, Bunkyo‐kuTokyo 113‐8510Japan
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Watanabe T, Aoki A, Hoshi K, Muneta T, Sekiya I, Koga H. Anterior Tibial Post Impingement During Stair Climbing: A Kinematic Analysis and Clinical Outcomes. J Arthroplasty 2019; 34:379-384. [PMID: 30473229 DOI: 10.1016/j.arth.2018.10.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 10/02/2018] [Accepted: 10/23/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Anterior tibial post impingement during gait and stair ambulation was reported in knees with posterior-stabilized prostheses. However, the link between anterior post impingement and knee kinematics and between anterior post impingement and the clinical outcome has not been well investigated. Therefore, the purpose of this study was to assess the anterior impingement to clarify the relevant kinematics and clinical results including patient-reported outcomes. METHODS We analyzed 40 well-functioning knees in 20 patients with a posterior-stabilized prosthesis due to osteoarthritis and who were followed up for 2 years or more. Dynamic lateral radiographs during stair-climbing activity were analyzed using a shape-matching technique, and anterior post impingement and the clinical outcome were assessed. RESULTS Anterior impingement of the tibial post was observed in 13 knees (33%) during the latter half of the stance phase and at the beginning of the swing phase with the average implant flexion angle of -2.4°. Implant flexion was significantly smaller, while the femoral component was located more posterior in the impingement knees. The posterior tibial slope was significantly greater in the impingement group (6.7° ± 2.0°, 5.3° ± 1.9°, respectively; P = .041); however, no significant differences were demonstrated in anteroposterior laxity and patient-derived assessments. CONCLUSION To avoid anterior post impingement, the posterior tibial slope should be made at 5° or less. Femoral notch-anterior post articulation should be designed to have good congruency in order to act as an anterior stabilizer in the case of impingement at knee extension.
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Affiliation(s)
- Toshifumi Watanabe
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan; Second Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Akino Aoki
- Graduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, Higashihiroshima-shi, Japan
| | - Kenji Hoshi
- Graduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, Higashihiroshima-shi, Japan
| | - Takeshi Muneta
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Ichiro Sekiya
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Hideyuki Koga
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan
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23
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Inomata K, Tsuji K, Onuma H, Hoshino T, Udo M, Akiyama M, Nakagawa Y, Katagiri H, Miyatake K, Sekiya I, Muneta T, Koga H. Time course analyses of structural changes in the infrapatellar fat pad and synovial membrane during inflammation-induced persistent pain development in rat knee joint. BMC Musculoskelet Disord 2019; 20:8. [PMID: 30611247 PMCID: PMC6320593 DOI: 10.1186/s12891-018-2391-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/21/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Osteoarthritis (OA) is a common joint disease in aging societies, which is accompanied by chronic inflammation and degeneration of the joint structure. Inflammation of the infrapatellar fat pad (IFP) and synovial membrane (IFP surface) plays essential roles in persistent pain development in patients with OA. To identify the point during the inflammatory process critical for persistent pain development, we performed a time course histological analysis in a rat arthritis model. METHODS Wistar rats received single intra-articular injection of monoiodoacetic acid (MIA, 0.2 or 1.0 mg/30 μL) in the right knees or phosphate-buffered saline (PBS, 30 μL) as a control in the left knees. Pain avoidance behaviors (weight-bearing asymmetry and tactile hypersensitivity of the plantar surface of the hind paw) were evaluated on days 0, 1, 3, 5, 7, and 14 after injection. Histological assessments of the knee joint were performed on days 0, 1, 3, 5, and 7 after MIA injection. RESULTS Weight-bearing asymmetry was observed along with the onset of acute inflammation in both the low- (0.2 mg) and high-dose (1.0 mg) groups. In the low-dose group, weight-bearing asymmetry was completely reversed on day 10, indicating that joint pain seemed to alleviate between days 7 and 10. In contrast, we observed persistent joint pain after day 10 in the high-dose group. Histological assessments of the high-dose group indicated that the initial sign of inflammatory responses was observed in the perivascular region inside the IFP. Inflammatory cell infiltration from the perivascular region to the parenchymal region of the IFP was observed on day 3 and reached the IFP surface (synovial membrane) on day 7. Extensive fibrosis throughout the IFP was observed between days 5 and 7 after MIA injection. CONCLUSION Our data indicated that acute joint pain occurs along with the onset of acute inflammatory process. Irreversible structural changes in the IFP, such as extensive fibrosis, are observed prior to persistent pain development. Thus, we consider that this process may play important roles in persistent pain development.
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Affiliation(s)
- Kei Inomata
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kunikazu Tsuji
- Department of Cartilage Regeneration, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Hiroaki Onuma
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Hoshino
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mio Udo
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masako Akiyama
- Research Administration Unit, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yusuke Nakagawa
- Department of Cartilage Regeneration, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Hiroki Katagiri
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazumasa Miyatake
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.,National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
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Katakura M, Horie M, Watanabe T, Katagiri H, Otabe K, Ohara T, Nakamura K, Katagiri K, Ueki H, Zaffagnini S, Sekiya I, Muneta T, Koga H. Effect of meniscus repair on pivot-shift during anterior cruciate ligament reconstruction: Objective evaluation using triaxial accelerometer. Knee 2019; 26:124-131. [PMID: 30554908 DOI: 10.1016/j.knee.2018.11.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/12/2018] [Accepted: 11/16/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Some types of meniscus tear, especially lateral meniscus tear, have been reported to be associated with rotatory knee laxity. However, precise information regarding the effect of meniscus repair on rotatory laxity is limited. The purpose of this study was to investigate the effects of lateral and medial meniscus repair on rotatory laxity in anterior cruciate ligament (ACL) injured knees. METHODS Forty-one patients who underwent ACL reconstruction were included in the study. The tibial acceleration during the pivot shift test was measured using a triaxial accelerometer preoperatively under anesthesia and intraoperatively before and after medial and lateral meniscus repair and ACL reconstruction during surgery. Effects of meniscus tear and its repair on rotatory laxity were analyzed. RESULTS Preoperative measurements revealed that patients with lateral meniscus tear showed significantly higher tibial acceleration compared to the patients without meniscus tear (P = 0.006). Intraoperative measurements revealed that medial and lateral meniscus repair significantly reduced tibial acceleration by 1.46 m/s2 (P = 0.002) and 1.91 m/s2 (P < 0.001), respectively. CONCLUSION In ACL injured knees, knees with lateral meniscus tear showed greater rotatory laxity compared to the knees without meniscus tear. In addition, lateral meniscus repair, and to a lesser degree medial meniscus repair, reduced rotatory laxity during ACL reconstruction surgery. Therefore, the meniscus should be repaired as much as possible for its role as a secondary stabilizer of rotatory laxity. Besides, the effect of meniscus repair on rotatory laxity should be considered when the indication of anterolateral augmentation is determined.
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Affiliation(s)
- Mai Katakura
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan; Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Masafumi Horie
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan; Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Toshifumi Watanabe
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Hiroki Katagiri
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Koji Otabe
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Toshiyuki Ohara
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Kaori Nakamura
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Kenta Katagiri
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Hiroko Ueki
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Stefano Zaffagnini
- Dipartimento Rizzoli Sicilia, Ortopedia e Traumatologia, Università di Bologna, Bagheria, PA, Italy
| | - Ichiro Sekiya
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Takeshi Muneta
- National Hospital Organization Disaster Medical Center, Midoricho, Tachikawa-shi, Tokyo, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan; Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan.
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Ueki H, Nakagawa Y, Ohara T, Watanabe T, Horie M, Katagiri H, Otabe K, Katagiri K, Hiyama K, Katakura M, Hoshino T, Inomata K, Araya N, Sekiya I, Muneta T, Koga H. Risk factors for residual pivot shift after anterior cruciate ligament reconstruction: data from the MAKS group. Knee Surg Sports Traumatol Arthrosc 2018; 26:3724-3730. [PMID: 29947841 DOI: 10.1007/s00167-018-5005-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 05/30/2018] [Indexed: 01/03/2023]
Abstract
PURPOSE To investigate the risk factors for residual pivot shift test after anterior cruciate ligament (ACL) reconstruction based on a multicenter prospective cohort study. METHODS This study included patients who were registered in the Multicenter Arthroscopic Knee Surgery Study, a prospective longitudinal multicenter cohort study, and who underwent primary ACL reconstruction using autologous hamstring tendon graft between 2013 and 2016. The exclusion criteria included prior injuries or surgeries in the contralateral knee, prior ligamentous injuries in the involved knee, grade 2 or 3 concomitant ligament injuries, and inflammatory or other forms of osteoarthritis. Data from the preoperative period and at 1-year follow-up were used for further analysis, and patients with incomplete data, re-injury and loss to follow-up were also excluded. Logistic regression analysis was conducted with age, gender, Lachman test, pivot shift test, KT measurement, hyperextension, single-bundle vs. double-bundle, meniscus injury sites, and meniscus treatments as the independent variables, and postoperative pivot shift test was used as the dependent variable. RESULTS Three hundred and sixty-eight patients were included in the study. Hyperextension knee (P = 0.025) and a preoperative pivot shift test under anesthesia (P = 0.040) were identified as risk factors for a postoperative pivot shift via logistic regression analysis. There were no statistically significant differences in the other variables. CONCLUSIONS The results from a multicenter cohort study indicated that knee hyperextension and greater preoperative pivot shift under anesthesia were risk factors for residual pivot shift at 1 year after ACL reconstruction. In cases with a preoperative high-grade pivot shift and knee hyperextension, additional anterolateral structure augmentation might be considered in order to eliminate pivot shift and eventually obtain better outcomes after ACL reconstruction. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Hiroko Ueki
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Yusuke Nakagawa
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Toshiyuki Ohara
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Toshifumi Watanabe
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Masafumi Horie
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Hiroki Katagiri
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Koji Otabe
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Kenta Katagiri
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Kanehiro Hiyama
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Mai Katakura
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Takashi Hoshino
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Kei Inomata
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Naoko Araya
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Ichiro Sekiya
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Takeshi Muneta
- National Hospital Organization Disaster Medical Center, 3256 Midori, Tachikawa, Tokyo, 190-0014, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan. .,Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
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Koga H, Muneta T. Behind-remnant approach for anatomic anterior cruciate ligament reconstruction. Ann Joint 2018. [DOI: 10.21037/aoj.2018.12.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Hasegawa S, Horie M, Katagiri H, Tsuji K, Muneta T, Koga H. Bilateral Hypoplasia of Both Medial and Lateral Menisci Partially Fused With the Cartilage Surface of the Tibial Plateau. Orthopedics 2018; 41:e884-e887. [PMID: 30125038 DOI: 10.3928/01477447-20180815-08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 03/07/2018] [Indexed: 02/03/2023]
Abstract
Hypoplastic meniscus is an extremely rare abnormality. The authors present the first case of meniscal hypoplasia with a partial fusion of meniscus and tibial cartilage. A 22-year-old man underwent surgery for a chronic patellar dislocation. Preoperative magnetic resonance imaging and arthroscopy incidentally revealed hypoplasia of both medial and lateral menisci. Moreover, the posterior horn of the medial meniscus and middle body of the lateral meniscus were fused with the cartilage surface of the tibia. Magnetic resonance imaging of the contralateral knee showed similar meniscal anomalies. This case presents an interesting and extremely rare abnormality of the meniscus. [Orthopedics. 2018; 41(6):e884-e887.].
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Miura K, Tsuda E, Tohyama H, Iwahori Y, Mae T, Mochizuki Y, Nakagawa K, Nakamae A, Nakamura T, Takao M, Uchida S, Muneta T, Ochi M. Can arthroscopic Bankart repairs using suture anchors restore equivalent stability to open repairs in the management of traumatic anterior shoulder dislocation? A meta-analysis. J Orthop Sci 2018; 23:935-941. [PMID: 30057323 DOI: 10.1016/j.jos.2018.06.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 04/12/2018] [Accepted: 06/07/2018] [Indexed: 01/11/2023]
Abstract
BACKGROUND Recently, arthroscopic Bankart repairs have become much more popular than open repairs for the treatment of recurrent anterior shoulder instability. However, it is unclear whether the modern arthroscopic Bankart repairs using suture anchors could restore equivalent stability to open repairs. We conducted a meta-analysis to compare arthroscopic Bankart repairs using suture anchors and open repairs in regard to clinical outcomes. METHODS A literature review was performed according to the PRISMA guidelines. PubMed was searched from January 1966 to January 2017. Studies were identified using the terms 'anterior shoulder dislocation' or 'recurrent anterior shoulder dislocation' and 'Bankart repair'. The search yielded 36 publications. After reading the full-text articles, we included four randomized controlled trials and five retrospective studies that compared arthroscopic and open repairs using suture anchors. RESULTS No significant differences were found between the two procedures in frank re-dislocation and revision surgery due to recurrence. However, the overall recurrent instability including not only re-dislocation but also subluxation and apprehension was significantly higher in arthroscopic repairs than in open repairs, while a significantly higher Rowe score and lower loss of external rotation at 90° of abduction were observed following arthroscopic repairs compared to open repairs. CONCLUSIONS Modern arthroscopic Bankart repairs using suture anchors provide an equivalent outcome compared to open repairs in terms of apparent re-dislocation, but overall recurrent instability including subluxation or apprehension was still significantly higher in arthroscopic repairs than in open repairs.
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Affiliation(s)
- Kazutomo Miura
- Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Rehabilitation Medicine, Hirosaki University, School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
| | - Eiichi Tsuda
- Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Rehabilitation Medicine, Hirosaki University, School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan.
| | - Harukazu Tohyama
- Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, Sapporo 060-0812, Japan
| | - Yusuke Iwahori
- Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Orthopaedic Surgery, Aichi Medical University, School of Medicine, 1-1, Karimata, Yazakoaza, Oaza, Nagakute, Aichi 480-1195, Japan
| | - Tatsuo Mae
- Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka 565-0871, Japan
| | - Yu Mochizuki
- Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Orthopaedics Surgery, Hiroshima Prefectural Hospital, 1-5-54, Ujina-Kanda, Minami-ku, Hiroshima 734-8530, Japan
| | - Kohichi Nakagawa
- Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Orthopaedic Surgery, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba 285-8741, Japan
| | - Atsuo Nakamae
- Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Toshiyasu Nakamura
- Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Orthopaedic Surgery, Sanno Hospital, 8-10-16 Akasaka, Minato-ku, Tokyo 107-0052, Japan
| | - Masato Takao
- Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Clinical and Research Institute for Foot & Ankle Surgery, 341-1, Mangoku, Kisarazu, Chiba 292-0003, Japan
| | - Sohshi Uchida
- Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Orthopaedic Surgery, Wakamatsu Hospital for the University of Occupational and Environmental Health, 1-17-1 Hamamachi Wakamatsu Kitakyushu, Fukuoka 808-0024, Japan
| | - Takeshi Muneta
- Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Mitsuo Ochi
- Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Orthopaedic Surgery, Division of Clinical Medical Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
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Ueda K, Sasaki N, Goren A, Calhoun SR, Shinjo K, Enomoto H, Muneta T. Treatment satisfaction with pharmaceutical interventions in Japanese adults with osteoarthritis and chronic knee pain: an analysis of a web-based survey. Clin Interv Aging 2018; 13:2179-2191. [PMID: 30464427 PMCID: PMC6211312 DOI: 10.2147/cia.s176289] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Purpose Patient satisfaction is an important outcome in successful osteoarthritis (OA) treatment. The aim of this study was to evaluate treatment satisfaction for medication (TSM) in people with knee OA (KOA), identify the factors predictive of treatment satisfaction, and describe the burden of illness. Patients and methods This cross-sectional, patient-reported study used an Internet-based survey and analyzed responses of respondents with KOA (N=400) on characteristics including pain sites and levels (including pain ratings using the Numerical Rating Scale and Short-Form McGill Pain Questionnaire), treatment satisfaction (Global, Effectiveness, and Convenience scores) based on the Treatment Satisfaction Questionnaire for Medication (TSQM-9), and quality of life (QoL; based on the Arthritis Impact Measurement Scale 2-Short Form). Respondents with only KOA (n=237) were compared with those having KOA and additional painful sites (KOA+; n=163). Factors predicting TSM were identified using multivariable linear regression analyses. Results Respondents with KOA were more likely to report intermittent pain for 3 months or more compared with those with KOA+ (58.6% vs 48.5%, respectively; P=0.044), while those with KOA+ were more likely to report consistent pain for 3 months or more (P=0.022). Respondents with KOA+ also had more difficulty due to their knee pain while sleeping (P=0.022) and resting (P=0.015). Reported TSM did not differ significantly across KOA vs KOA+ groups, with both groups reporting low satisfaction; all domains of QoL were worse for those with KOA+. Knee pain reduction by medication predicted higher satisfaction across domains, while lower pre-medication pain and post-medication pain matching expectations predicted higher TSQM-9 Global and Effectiveness scores. Conclusion Medication treatment satisfaction rates were low among Japanese respondents with KOA. Given that lower pain, greater pain reduction post-medication, and meeting pain management expectations were predictive of higher satisfaction, treatment strategies that can better address pain may prove beneficial for overall patient satisfaction.
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Affiliation(s)
- Kaname Ueda
- Health Outcomes/Health Technology Assessment/Real World Evidence, Eli Lilly Japan, Kobe, Japan,
| | - Nao Sasaki
- Bio-Medicines, Medicines Development Unit, Eli Lilly Japan, Kobe, Japan
| | - Amir Goren
- Health Outcomes, Kantar Health, New York, NY, USA
| | | | - Katsuhiro Shinjo
- Bio-Medicines, Medicines Development Unit, Eli Lilly Japan, Tokyo, Japan
| | - Hiroyuki Enomoto
- Bio-Medicines, Medicines Development Unit, Eli Lilly Japan, Tokyo, Japan
| | - Takeshi Muneta
- Department of Orthopaedic Surgery, National Disaster Medical Center, Tokyo, Japan
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Hoshino T, Tsuji K, Onuma H, Udo M, Ueki H, Akiyama M, Abula K, Katagiri H, Miyatake K, Watanabe T, Sekiya I, Koga H, Muneta T. Persistent synovial inflammation plays important roles in persistent pain development in the rat knee before cartilage degradation reaches the subchondral bone. BMC Musculoskelet Disord 2018; 19:291. [PMID: 30115046 PMCID: PMC6097215 DOI: 10.1186/s12891-018-2221-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 08/03/2018] [Indexed: 11/18/2022] Open
Abstract
Background The major complaint of knee osteoarthritis (OA) is persistent pain. Unlike acute inflammatory pain, persistent pain is usually difficult to manage since its pathology is not fully understood. To elucidate the underlying mechanisms of persistent pain, we established 2 different inflammation-induced arthritis models by injecting monoiodo-acetic acid (MIA) into the joint cavity and performed integrated analyses of the structural changes in the synovial tissue and articular cartilage, sensory neuron rearrangement, and pain avoidance behavior in a rat arthritis model. Methods Male Wistar rats received intra-articular injections of MIA (0.2 mg/30 μL, low-dose group; 1 mg/30 μL, high-dose group) in the right knee and phosphate buffered saline (PBS; 30 μL, control group) in the left knee. Fluorogold (FG), a retrograde neural tracer, was used to label the nerve fibers for the identification of sensory neurons that dominate the joints in the dorsal root ganglion (DRG). Both knees were subjected to the intra-articular injection of 2% FG in PBS (5 μL) under anesthesia 5–7 days prior to sacrifice. We performed pain avoidance behavior tests (incapacitance and von Frey tests) at 0, 1, 3, 5, 7, 14, 21, and 28 days. At 5, 14, and 28 days, the rats were sacrificed and the knee joint and DRG were excised for histological assessment. The knee joints were stained with hematoxylin and eosin, safranin O, and calcitonin gene-related peptide (CGRP). The DRG were immunostained with CGRP. Results A transient inflammatory response followed by mild articular cartilage degeneration was observed in the low-dose MIA model versus persistent inflammation with structural changes in the synovial tissue (fibrosis) in the high-dose model. In the high-dose model, full-thickness cartilage degeneration was observed within 2 weeks post-MIA injection. The pain avoidance behavior tests indicated that persistent synovial inflammation and structural changes of the infrapatellar fat pad may play important roles in persistent knee joint pain before the articular cartilage degeneration reaches the subchondral bone. Conclusions Transient inflammation without structural changes of the synovial tissues did not induce persistent pain in the rat knee joint before degradation of the articular cartilage reached the subchondral bone plate. Electronic supplementary material The online version of this article (10.1186/s12891-018-2221-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Takashi Hoshino
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kunikazu Tsuji
- Department of Cartilage Regeneration, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Hiroaki Onuma
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mio Udo
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroko Ueki
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masako Akiyama
- Research Administration Unit, Tokyo Medical and Dental university, Tokyo, Japan
| | - Kahaer Abula
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroki Katagiri
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazumasa Miyatake
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshihumi Watanabe
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
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Katano H, Koga H, Ozeki N, Otabe K, Mizuno M, Tomita M, Muneta T, Sekiya I. Trends in isolated meniscus repair and meniscectomy in Japan, 2011-2016. J Orthop Sci 2018; 23:676-681. [PMID: 29724468 DOI: 10.1016/j.jos.2018.04.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 03/25/2018] [Accepted: 04/05/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Meniscus surgery is the most commonly performed orthopedic surgery, and despite recent emphasis on saving the meniscus, the current status of meniscus surgeries is little known in many countries, including Japan. The National Database of Health Insurance Claims and Specific Health Checkups of Japan and the Statistics of Medical Care Activities in Public Health Insurance track meniscus surgeries through health insurance claims. The National Database provides the numbers for 2014 and 2015, and the Statistics of Medical Care Activities provides the numbers from June 2011 to June 2016. Our aim was to analyze isolated meniscus surgery numbers and meniscus repair ratios by age group based on the National Database and evaluate trends of meniscus repair ratios for the latest six years from the Statistics of Medical Care Activities. METHODS Meniscus surgeries by age group were counted from the National Database for 2014-2015, and meniscus repair ratios (meniscus repairs/meniscus surgeries) were calculated. The numbers were also counted from the Statistics of Medical Care Activities in 2011-2016. For statistical analysis of annual trends of meniscus repair ratios, the Cochran-Armitage trend test was used. Meniscus surgeries with concomitant knee ligament surgeries were excluded. RESULTS According to the National Database, isolated meniscus surgeries totaled 34,966 in 2015, with peak ages of patients in their late teens and 60s. The meniscus repair ratio was 19% in 2014 and 24% in 2015. According to the Statistics of Medical Care Activities, the meniscus repair ratio was 9% in 2011 and significantly increased to 25% in 2016 (p = 0.0008). The ratio also increased significantly in each age group between the early 20s and late 70s. CONCLUSIONS Approximately 35,000 meniscus surgeries are performed in Japan annually, with peak ages in the late teens and 60s. The number of meniscus repairs has increased over the past six years.
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Affiliation(s)
- Hisako Katano
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo, Medical and Dental University, Tokyo, Japan
| | - Nobutake Ozeki
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koji Otabe
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mitsuru Mizuno
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Makoto Tomita
- Clinical Research Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo, Medical and Dental University, Tokyo, Japan; National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
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Hayashi Y, Brun MA, Machida K, Lee S, Murata A, Omori S, Uchiyama H, Inoue Y, Kudo T, Toyofuku T, Nagasawa M, Uchimura I, Nakamura T, Muneta T. Simultaneous assessment of blood coagulation and hematocrit levels in dielectric blood coagulometry. Biorheology 2018; 54:25-35. [PMID: 28800301 PMCID: PMC5676769 DOI: 10.3233/bir-16118] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND In a whole blood coagulation test, the concentration of any in vitro diagnostic agent in plasma is dependent on the hematocrit level but its impact on the test result is unknown. OBJECTIVE The aim of this work was to clarify the effects of reagent concentration, particularly Ca2+, and to find a method for hematocrit estimation compatible with the coagulation test. METHODS Whole blood coagulation tests by dielectric blood coagulometry (DBCM) and rotational thromboelastometry were performed with various concentrations of Ca2+ or on samples with different hematocrit levels. DBCM data from a previous clinical study of patients who underwent total knee arthroplasty were re-analyzed. RESULTS Clear Ca2+ concentration and hematocrit level dependences of the characteristic times of blood coagulation were observed. Rouleau formation made hematocrit estimation difficult in DBCM, but use of permittivity at around 3 MHz made it possible. The re-analyzed clinical data showed a good correlation between permittivity at 3 MHz and hematocrit level (R2=0.83). CONCLUSIONS Changes in the hematocrit level may affect whole blood coagulation tests. DBCM has the potential to overcome this effect with some automated correction using results from simultaneous evaluations of the hematocrit level and blood coagulability.
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Affiliation(s)
- Yoshihito Hayashi
- LE Development Department, R&D Division, Medical Business Unit, Imaging Products & Solutions Sector, Sony Corporation, Tokyo, Japan
| | - Marc-Aurèle Brun
- Life Science Department, Biomedical R&D Division, RDS Platform, Sony Corporation, Tokyo, Japan
| | - Kenzo Machida
- LE Development Department, R&D Division, Medical Business Unit, Imaging Products & Solutions Sector, Sony Corporation, Tokyo, Japan
| | - Seungmin Lee
- LE Development Department, R&D Division, Medical Business Unit, Imaging Products & Solutions Sector, Sony Corporation, Tokyo, Japan
| | - Aya Murata
- LE Development Department, R&D Division, Medical Business Unit, Imaging Products & Solutions Sector, Sony Corporation, Tokyo, Japan
| | - Shinji Omori
- LE Development Department, R&D Division, Medical Business Unit, Imaging Products & Solutions Sector, Sony Corporation, Tokyo, Japan
| | - Hidetoshi Uchiyama
- Department of Surgical Specialities, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Yoshinori Inoue
- Department of Surgical Specialities, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Toshifumi Kudo
- Department of Surgical Specialities, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Takahiro Toyofuku
- Department of Surgical Specialities, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Masayuki Nagasawa
- Department of Pediatrics, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Pediatrics, Musashino Red Cross Hospital, Musashino-city, Tokyo, Japan
| | - Isao Uchimura
- Department of Endocrinology and Metabolism, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomomasa Nakamura
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Takeshi Muneta
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan
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Mizuno M, Katano H, Mabuchi Y, Ogata Y, Ichinose S, Fujii S, Otabe K, Komori K, Ozeki N, Koga H, Tsuji K, Akazawa C, Muneta T, Sekiya I. Specific markers and properties of synovial mesenchymal stem cells in the surface, stromal, and perivascular regions. Stem Cell Res Ther 2018; 9:123. [PMID: 29720268 PMCID: PMC5930798 DOI: 10.1186/s13287-018-0870-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 04/04/2018] [Accepted: 04/12/2018] [Indexed: 11/26/2022] Open
Abstract
Background Synovial mesenchymal stem cells (MSCs) are an attractive cell source for cartilage and meniscus regeneration. Synovial tissue can be histologically classified into three regions; surface, stromal and perivascular region, but the localization of synovial MSCs has not been fully investigated. We identified markers specific for each region, and compared properties of MSCs derived from each region in the synovium. Methods The intensity of immunostaining with 19 antibodies was examined for surface, stromal, and perivascular regions of human synovium from six osteoarthritis patients. Specific markers were identified and synovial cells derived from each region were sorted. Proliferation, surface marker expression, chondrogenesis, calcification and adipogenesis potentials were compared in synovial MSCs derived from the three regions. Results We selected CD55+ CD271− for synovial cells in the surface region, CD55− CD271− in the stromal region, and CD55− CD271+ in the perivascular region. The ratio of the sorted cells to non-hematopoietic lineage cells was 5% in the surface region, 70% in the stromal region and 15% in the perivascular region. Synovial cells in the perivascular fraction had the greatest proliferation potential. After expansion, surface marker expression profiles and adipogenesis potentials were similar but chondrogenic and calcification potentials were higher in synovial MSCs derived from the perivascular region than in those derived from the surface and stromal regions. Conclusions We identified specific markers to isolate synovial cells from the surface, stromal, and perivascular regions of the synovium. Synovial MSCs in the perivascular region had the highest proliferative and chondrogenic potentials among the three regions.
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Affiliation(s)
- Mitsuru Mizuno
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Hisako Katano
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Yo Mabuchi
- Department of Biochemistry and Biophysics, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yusuke Ogata
- Department of Biochemistry and Biophysics, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shizuko Ichinose
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Shizuka Fujii
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Koji Otabe
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Keiichiro Komori
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Nobutake Ozeki
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kunikazu Tsuji
- Department of Cartilage Regeneration, Tokyo Medical and Dental University, Tokyo, Japan
| | - Chihiro Akazawa
- Department of Biochemistry and Biophysics, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Muneta
- National Hospital Organization, Disaster Medical Center, Tokyo, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
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Katagiri H, Koga H, Muneta T. Review of Shino et al (1984) on anterior cruciate ligament reconstruction using allograft in the dog. J ISAKOS 2018. [DOI: 10.1136/jisakos-2017-000131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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35
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36
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Hiyama K, Nakagawa Y, Ohara T, Muneta T, Watanabe T, Horie M, Otabe K, Katagiri H, Katagiri K, Katakura M, Hoshino T, Ueki H, Inomata K, Araya N, Sekiya I, Koga H. Anterior cruciate ligament injuries result in a larger functional deficit in fighting sport athletes: comparison of functional status among different sport types. J ISAKOS 2018. [DOI: 10.1136/jisakos-2017-000172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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37
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Minami T, Muneta T, Sekiya I, Watanabe T, Mochizuki T, Horie M, Katagiri H, Otabe K, Ohara T, Katakura M, Koga H. Lateral meniscus posterior root tear contributes to anterolateral rotational instability and meniscus extrusion in anterior cruciate ligament-injured patients. Knee Surg Sports Traumatol Arthrosc 2018; 26:1174-1181. [PMID: 28484790 DOI: 10.1007/s00167-017-4569-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 05/03/2017] [Indexed: 01/26/2023]
Abstract
PURPOSE The purposes of this study were to investigate (1) meniscus status and clinical findings in anterior cruciate ligament (ACL)-injured patients to clarify associations between the meniscus posterior root tear (PRT) and knee instability, and (2) magnetic resonance imaging (MRI) findings of the PRT to clarify sensitivity and specificity of MRI and prevalence of meniscus extrusion. METHODS Three hundred and seventeen patients with primary ACL reconstruction were included. PRTs for both medial and lateral sides were confirmed by reviewing surgical records. Preoperative MRI was reviewed to evaluate sensitivity and specificity of the PRT and meniscus extrusion width (MEW). Clinical information regarding the number of giving-way episodes, preoperative KT-1000 measurements and preoperative pivot shift was also assessed. RESULTS Thirty-nine patients had a lateral meniscus (LM) PRT, whereas only four patients had a medial meniscus PRT. One hundred and seventeen patients had no meniscus tear (control). Twenty-eight patients (71.8%) showed positive signs of the LMPRT based on at least one view of MR images, with the coronal view showing the highest sensitivity. MEW in the LMPRT group was significantly larger than that in the control group. The preoperative pivot shift test grade in the LMPRT group was significantly greater than that in the control group. There were no significant differences in other parameters. CONCLUSIONS In ACL-injured patients, the LMPRT was associated with ALRI as well as with meniscus extrusion. The coronal view of MRI was useful in identifying the LMPRT, although its sensitivity was not high. Therefore, surgeons should prepare to repair PRTs at the time of ACL reconstruction regardless of MRI findings, and they should make every effort to repair the LMPRT. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Takao Minami
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1, Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Takeshi Muneta
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Ichiro Sekiya
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Toshifumi Watanabe
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Tomoyuki Mochizuki
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Masafumi Horie
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Hiroki Katagiri
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Koji Otabe
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Toshiyuki Ohara
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Mai Katakura
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Hideyuki Koga
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
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Minami T, Koga H, Sekiya I, Watanabe T, Horie M, Katagiri H, Otabe K, Ohara T, Katakura M, Muneta T. Posteriorly inserted anterior cruciate ligament in knees with discoid lateral meniscus corresponding to bony morphological characteristics of femoral lateral condyle. J Orthop Sci 2018; 23:350-355. [PMID: 29102413 DOI: 10.1016/j.jos.2017.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 09/25/2017] [Accepted: 10/12/2017] [Indexed: 02/09/2023]
Abstract
PURPOSE Discoid meniscus often causes mechanical problems and needs surgical treatment at an early age. However, many aspects of its morphological development and changes remain unknown. The purpose of this study was to investigate the insertion of the femoral anterior cruciate ligament (ACL) via the behind-ACL approach and the morphology of the lateral femoral condyle to which the ACL attaches to clarify the morphological characteristics of the knee with discoid lateral meniscus (DLM). METHOD Sixty-six patients with meniscus injury who underwent arthroscopic surgery were retrospectively reviewed. Preoperative plane radiographs were reviewed. To evaluate the shape of the femoral condyle, the ratio of the medial and lateral condyles, obliquity of the inter-epicondylar line, and the prominence ratio were assessed. From the arthroscopic observation using the behind-ACL approach, the insertion of the femoral ACL was classified as low, middle, and high based on the height from the deepest area of the articular surface to the direct insertion, including fibrous extension from the joint surface at 90° flexion. RESULTS Twenty-nine patients had DLM (DLM group), and 37 patients had a semilunar meniscal injury (non-DLM group). The ratio of the lateral femoral condyle, obliquity of the inter-epicondylar line, and prominence ratio in the DLM group were significantly smaller than those in the non-DLM group. On the other hand, no significant difference in the ratio of the medial femoral condyle was observed. Arthroscopic evaluation revealed that the femoral ACL was significantly inserted lower in the DLM group than in the non-DLM group. CONCLUSION The femoral ACL with DLM was inserted close to the femoral joint surface with morphological abnormality in the knees with DLM related to hypoplasic of the lateral femoral condyle.
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Affiliation(s)
- Takao Minami
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan; Department of Orthopaedic Surgery, Wakayama Medical University, 811-1, Kimiidera, Wakayama City, Wakayama 641-8509, Japan
| | - Hideyuki Koga
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Ichiro Sekiya
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Toshifumi Watanabe
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Masafumi Horie
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Hiroki Katagiri
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Koji Otabe
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Toshiyuki Ohara
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Mai Katakura
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Takeshi Muneta
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan; National Hospital Organization Disaster Medical Center, 3256 Midori, Tachikawa, Tokyo 190-0014, Japan.
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39
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Oyaizu T, Enomoto M, Yamamoto N, Tsuji K, Horie M, Muneta T, Sekiya I, Okawa A, Yagishita K. Hyperbaric oxygen reduces inflammation, oxygenates injured muscle, and regenerates skeletal muscle via macrophage and satellite cell activation. Sci Rep 2018; 8:1288. [PMID: 29358697 PMCID: PMC5778072 DOI: 10.1038/s41598-018-19670-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 01/04/2018] [Indexed: 12/17/2022] Open
Abstract
Hyperbaric oxygen treatment (HBO) promotes rapid recovery from soft tissue injuries. However, the healing mechanism is unclear. Here we assessed the effects of HBO on contused calf muscles in a rat skeletal muscle injury model. An experimental HBO chamber was developed and rats were treated with 100% oxygen, 2.5 atmospheres absolute for 2 h/day after injury. HBO reduced early lower limb volume and muscle wet weight in contused muscles, and promoted muscle isometric strength 7 days after injury. HBO suppressed the elevation of circulating macrophages in the acute phase and then accelerated macrophage invasion into the contused muscle. This environment also increased the number of proliferating and differentiating satellite cells and the amount of regenerated muscle fibers. In the early phase after injury, HBO stimulated the IL-6/STAT3 pathway in contused muscles. Our results demonstrate that HBO has a dual role in decreasing inflammation and accelerating myogenesis in muscle contusion injuries.
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Affiliation(s)
- Takuya Oyaizu
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8519, Japan.,Hyperbaric Medical Center, Medical Hospital, Tokyo Medical and Dental University, Tokyo, 113-8519, Japan
| | - Mitsuhiro Enomoto
- Hyperbaric Medical Center, Medical Hospital, Tokyo Medical and Dental University, Tokyo, 113-8519, Japan. .,Sports Medicine Clinical Center, Medical Hospital, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8519, Japan.
| | - Naoki Yamamoto
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8519, Japan.,Hyperbaric Medical Center, Medical Hospital, Tokyo Medical and Dental University, Tokyo, 113-8519, Japan
| | - Kunikazu Tsuji
- Department of Cartilage Regeneration, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Masaki Horie
- Hyperbaric Medical Center, Medical Hospital, Tokyo Medical and Dental University, Tokyo, 113-8519, Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Atsushi Okawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Kazuyoshi Yagishita
- Hyperbaric Medical Center, Medical Hospital, Tokyo Medical and Dental University, Tokyo, 113-8519, Japan.,Sports Medicine Clinical Center, Medical Hospital, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8519, Japan
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40
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Watanabe T, Koga H, Horie M, Katagiri H, Sekiya I, Muneta T. Post-Cam Design and Contact Stress on Tibial Posts in Posterior-Stabilized Total Knee Prostheses: Comparison Between a Rounded and a Squared Design. J Arthroplasty 2017; 32:3757-3762. [PMID: 28780225 DOI: 10.1016/j.arth.2017.07.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 07/06/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The post-cam mechanism in posterior stabilized (PS) prostheses plays an important role in total knee arthroplasty (TKA). The purpose of this study is to clarify the difference of the contact stress on the tibial post between a rounded post-cam design and a squared design during deep knee flexion and at hyperextension using the three-dimensional (3D) finite element models. METHODS We created 2 types of 3D, finite element models of PS prostheses (types A and B), whose surfaces were identical except for the post-cam geometries: type A has a rounded post-cam design, while type B has a squared design. Both types have a similar curved-shape intercondylar notch of the femoral component. Stress distributions, peak contact stresses, and contact areas on the tibial posts at 90°, 120°, and 150° flexion with/without 10° tibial internal rotation and at 10° hyperextension were compared between the 2 models. RESULTS Type B demonstrated more concentrated stress distribution compared to type A. The peak contact stresses were similar in both groups during neutral flexion; however, the stresses were much higher in type B during flexion with 10° rotation and at hyperextension. The higher peak contact stresses corresponded to the smaller contact areas in the tibial post. CONCLUSION A rounded post-cam design demonstrated less stress concentration during flexion with rotation and at hyperextension compared with a squared design. The results would be useful for development of implant designs and prediction of the contact stress on the tibial post in PS total knee arthroplasty.
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Affiliation(s)
- Toshifumi Watanabe
- Department of Orthopaedic Surgery, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hideyuki Koga
- Department of Orthopaedic Surgery, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masafumi Horie
- Department of Orthopaedic Surgery, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroki Katagiri
- Department of Orthopaedic Surgery, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ichiro Sekiya
- Department of Orthopaedic Surgery, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Muneta
- Department of Orthopaedic Surgery, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan
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Hiyama K, Muneta T, Koga H, Sekiya I, Tsuji K. Meniscal regeneration after resection of the anterior half of the medial meniscus in mice. J Orthop Res 2017; 35:1958-1965. [PMID: 27805288 DOI: 10.1002/jor.23470] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 10/23/2016] [Indexed: 02/04/2023]
Abstract
Various animal studies have indicated that reduced meniscal function significantly exacerbates articular-cartilage degeneration. Despite the importance of meniscal function for joint homeostasis and prevention of osteoarthritis, the healing process after meniscal injury and the regenerative process after meniscus removal have not been studied in detail. In this study, we examined the process of meniscal regeneration and cartilage degeneration after meniscectomy in mice. The left anterior halves of the medial menisci in male C57Bl/6J mice were resected, and histological assessment of the process of meniscal regeneration was conducted on day 3 and 2, 4, and 6 weeks after the surgical procedure. Extensive macrophagic infiltration into the synovial membrane around the meniscectomized area was observed on day 3. Synovial hyperplasia was detected 2 weeks after the operation. At this stage, synovial tissue was filled with many fibroblastic cells, which underwent chondrocytic differentiation and produced cartilage matrices by 4 weeks after the operation. At 6 weeks, regenerated tissues resembled those of an intact meniscus. The articular cartilage at the interface of the resected meniscus significantly degenerated between 2 and 4 weeks after the surgical procedure, but subtle progression in cartilage degeneration was observed between 4 and 6 weeks. This finding is suggestive of a balance between meniscal regeneration and cartilage homeostasis. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1958-1965, 2017.
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Affiliation(s)
- Kanehiro Hiyama
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kunikazu Tsuji
- Department of Cartilage Regeneration, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
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Inomata K, Sekiya I, Otabe K, Nakamura T, Horie M, Koga H, Watanabe T, Muneta T. Acute arterial occlusion after total knee arthroplasty: a case report. Clin Case Rep 2017; 5:1376-1380. [PMID: 28781862 PMCID: PMC5538231 DOI: 10.1002/ccr3.1075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 04/02/2017] [Accepted: 06/09/2017] [Indexed: 11/10/2022] Open
Abstract
Popliteal artery occlusion after total knee arthroplasty is rare (0.03–0.17%) but can lead to amputation if overlooked. We should carefully assess vascular patency by Doppler ultrasound and ankle brachial pressure index (ABPI) measurement before and after total knee arthroplasty (TKA) operation.
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Affiliation(s)
- Kei Inomata
- Department of Joint Surgery and Sports Medicine Tokyo Medical and Dental University Hospital Bunkyo-ku Tokyo Japan
| | - Ichiro Sekiya
- Department of Joint Surgery and Sports Medicine Tokyo Medical and Dental University Hospital Bunkyo-ku Tokyo Japan
| | - Koji Otabe
- Department of Joint Surgery and Sports Medicine Tokyo Medical and Dental University Hospital Bunkyo-ku Tokyo Japan
| | - Tomomasa Nakamura
- Department of Joint Surgery and Sports Medicine Tokyo Medical and Dental University Hospital Bunkyo-ku Tokyo Japan
| | - Masafumi Horie
- Department of Joint Surgery and Sports Medicine Tokyo Medical and Dental University Hospital Bunkyo-ku Tokyo Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine Tokyo Medical and Dental University Hospital Bunkyo-ku Tokyo Japan
| | - Toshifumi Watanabe
- Department of Joint Surgery and Sports Medicine Tokyo Medical and Dental University Hospital Bunkyo-ku Tokyo Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine Tokyo Medical and Dental University Hospital Bunkyo-ku Tokyo Japan
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Mizuno M, Katano H, Otabe K, Komori K, Kohno Y, Fujii S, Ozeki N, Horie M, Tsuji K, Koga H, Muneta T, Sekiya I. Complete human serum maintains viability and chondrogenic potential of human synovial stem cells: suitable conditions for transplantation. Stem Cell Res Ther 2017; 8:144. [PMID: 28610596 PMCID: PMC5470274 DOI: 10.1186/s13287-017-0596-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 05/12/2017] [Accepted: 05/24/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In our clinical practice, we perform transplantations of autologous synovial mesenchymal stem cells (MSCs) for cartilage and meniscus regenerative medicine. One of the most important issues to ensuring clinical efficacy involves the transport of synovial MSCs from the processing facility to the clinic. Complete human serum (100% human serum) is an attractive candidate material in which to suspend synovial MSCs for their preservation during transport. The purpose of this study was to investigate whether complete human serum maintained MSC viability and chondrogenic potential and to examine the optimal temperature conditions for the preservation of human synovial MSCs. METHODS Human synovium was harvested from the knees of 14 donors with osteoarthritis during total knee arthroplasty. Passage 2 synovial MSCs were suspended at 2 million cells/100 μL in Ringer's solution or complete human serum at 4, 13, and 37 °C for 48 h. These cells were analyzed for live cell rates, cell surface marker expression, metabolic activity, proliferation, and adipogenic, calcification, and chondrogenic differentiation potentials before and after preservation. RESULTS After preservation, synovial MSCs maintained higher live cell rates in human serum than in Ringer's solution at 4 and 13 °C. Synovial MSCs preserved in human serum at 4 and 13 °C also maintained high ratios of propidium iodide- and annexin V- cells. MSC surface marker expression was not altered in cells preserved at 4 and 13 °C. The metabolic activities of cells preserved in human serum at 4 and 13 °C was maintained, while significantly reduced in other conditions. Replated MSCs retained their proliferation ability when preserved in human serum at 4 and 13 °C. Adipogenesis and calcification potential could be observed in cells preserved in each condition, whereas chondrogenic potential was retained only in cells preserved in human serum at 4 and 13 °C. CONCLUSION The viability and chondrogenic potential of synovial MSCs were maintained when the cells were suspended in human serum at 4 and 13 °C.
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Affiliation(s)
- Mitsuru Mizuno
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Hisako Katano
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Koji Otabe
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Keiichiro Komori
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Yuji Kohno
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Shizuka Fujii
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Nobutake Ozeki
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Masafumi Horie
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Kunikazu Tsuji
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hideyuki Koga
- Department of Cartilage Regeneration, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Muneta
- Department of Cartilage Regeneration, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.,National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
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Takada R, Jinno T, Koga D, Miyatake K, Muneta T, Okawa A. Comparison of wear rate and osteolysis between second-generation annealed and first-generation remelted highly cross-linked polyethylene in total hip arthroplasty. A case control study at a minimum of five years. Orthop Traumatol Surg Res 2017; 103:537-541. [PMID: 28300705 DOI: 10.1016/j.otsr.2017.02.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 02/15/2017] [Accepted: 02/22/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND There is no previous report that directly compared wear resistance of second-generation annealed highly cross-linked polyethylene with that of first-generation remelted highly cross-linked polyethylene. We therefore performed a retrospective study at a minimum of 5-year follow-up comparing second-generation annealed and first-generation remelted highly cross-linked polyethylene in order to: (1) assess wear rates and (2) compare the incidence of osteolysis between, (3) identify the frequency of complication related to the two types of highly cross-linked polyethylene. HYPOTHESIS There is a difference in the linear wear rate and the incidence of osteolysis between the two types of highly cross-linked polyethylene in total hip arthroplasty. MATERIALS AND METHODS In a single centre study, we reviewed 123 primary cementless total hip arthroplasties between 2010 and 2011 that were performed with 32mm alumina ceramic on second-generation annealed (X3) or first-generation remelted (Longevity) highly cross-linked polyethylene liner. There was no specific reason for the choice of the type of highly cross-linked polyethylene. There were no significant differences between the two groups in respect of gender, diagnosis, body mass index, pre- and post-operative functional and activity score, cup size, and cup orientation except the younger age in the X3 group. The mean wear rate and the incidence of osteolysis were evaluated at the latest follow-up. RESULTS One hundred nine cases followed over 5 years post-operatively (88.6% in all consecutive cases) were evaluated. X3 and Longevity were used in 54 and 55 cases, respectively. The mean follow-up was 5.3 years in both groups. The mean linear wear rate of X3 and Longevity group was 0.045±0.023mm/year and 0.076±0.031mm/year, respectively (P<0.001). No osteolysis was found on plain X-rays in both groups and no specific complication was related to these highly cross-linked components. DISCUSSION Excellent wear resistance of both types of highly cross-linked polyethylene liner was revealed in our study. The difference of wear rate between two materials should be monitored in a longer follow-up. LEVEL OF EVIDENCE Level III retrospective case control study.
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Affiliation(s)
- R Takada
- Department of Orthopaedic Surgery, Medical Hospital, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - T Jinno
- Department of Orthopaedic Surgery, Medical Hospital, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
| | - D Koga
- Department of Orthopaedic Surgery, Medical Hospital, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - K Miyatake
- Department of Orthopaedic Surgery, Medical Hospital, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - T Muneta
- Department of Orthopaedic Surgery, Medical Hospital, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - A Okawa
- Department of Orthopaedic Surgery, Medical Hospital, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
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Kondo S, Muneta T, Nakagawa Y, Koga H, Watanabe T, Tsuji K, Sotome S, Okawa A, Kiuchi S, Ono H, Mizuno M, Sekiya I. Transplantation of autologous synovial mesenchymal stem cells promotes meniscus regeneration in aged primates. J Orthop Res 2017; 35:1274-1282. [PMID: 26916126 DOI: 10.1002/jor.23211] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 02/17/2016] [Indexed: 02/04/2023]
Abstract
Transplantation of aggregates of synovial mesenchymal stem cells (MSCs) enhanced meniscus regeneration in rats. Anatomy and biological properties of the meniscus depend on animal species. To apply this technique clinically, it is valuable to investigate the use of animals genetically close to humans. We investigated whether transplantation of aggregates of autologous synovial MSCs promoted meniscal regeneration in aged primates. Chynomolgus primates between 12 and 13 years old were used. After the anterior halves of the medial menisci in both knees were removed, an average of 14 aggregates consisting of 250,000 synovial MSCs were transplanted onto the meniscus defect. No aggregates were transplanted to the opposite knee for the control. Meniscus and articular cartilage were analyzed macroscopically, histologically, and by MRI T1rho mapping at 8 (n = 3) and 16 weeks (n = 4). The medial meniscus was larger and the modified Pauli's histological score for the regenerated meniscus was better in the MSC group than in the control group in each primate at 8 and 16 weeks. Mankin's score for the medial femoral condyle cartilage was better in the MSC group than in the control group in all primates at 16 weeks. T1rho value for both the regenerated meniscus and adjacent articular cartilage in the MSC group was closer to the normal meniscus than in the control group in all primates at 16 weeks. Transplantation of aggregates of autologous synovial MSCs promoted meniscus regeneration and delayed progression of degeneration of articular cartilage in aged primates. This is the first report dealing with meniscus regeneration in primates. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1274-1282, 2017.
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Affiliation(s)
- Shimpei Kondo
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yusuke Nakagawa
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.,Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshifumi Watanabe
- Department of Cartilage Regeneration, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Kunikazu Tsuji
- Department of Cartilage Regeneration, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Shinichi Sotome
- Department of Orthopaedic Research and Development, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Atsushi Okawa
- Department of Orthopaedic and Spinal Surgery, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | | | | | - Mitsuru Mizuno
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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Kohno Y, Mizuno M, Ozeki N, Katano H, Komori K, Fujii S, Otabe K, Horie M, Koga H, Tsuji K, Matsumoto M, Kaneko H, Takazawa Y, Muneta T, Sekiya I. Yields and chondrogenic potential of primary synovial mesenchymal stem cells are comparable between rheumatoid arthritis and osteoarthritis patients. Stem Cell Res Ther 2017; 8:115. [PMID: 28511664 PMCID: PMC5434623 DOI: 10.1186/s13287-017-0572-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 04/30/2017] [Accepted: 05/03/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Mesenchymal stem cells derived from the synovial membrane (synovial MSCs) are a candidate cell source for regenerative medicine of cartilage and menisci due to their high chondrogenic ability. Regenerative medicine can be expected for RA patients with the inflammation well-controlled as well as OA patients and transplantation of synovial MSCs would also be a possible therapeutic treatment. Some properties of synovial MSCs vary dependent on the diseases patients have, and whether or not the pathological condition of RA affects the chondrogenesis of synovial MSCs remains controversial. The purpose of this study was to compare the properties of primary synovial MSCs between RA and OA patients. METHODS Human synovial tissue was harvested during total knee arthroplasty from the knee joints of eight patients with RA and OA respectively. Synovial nucleated cells were cultured for 14 days. Total cell yields, surface markers, and differentiation potentials were analyzed for primary synovial MSCs. RESULTS Nucleated cell number per 1 mg synovium was 8.4 ± 3.9 thousand in RA and 8.0 ± 0.9 thousand in OA. Total cell number after 14-day culture/1 mg synovium was 0.7 ± 0.4 million in RA and 0.5 ± 0.3 million in OA, showing no significant difference between in RA and OA. Cells after 14-day culture were mostly positive for CD44, CD73, CD90, CD105, negative for CD45 both in RA and OA. There was no significant difference for the cartilage pellet weight and sGAG content per pellet between in RA and OA. Both oil red O-positive colony rate and alizarin red-positive colony rate were similar in RA and OA. CONCLUSIONS Yields, surface markers and chondrogenic potential of primary synovial MSCs in RA were comparable to those in OA. Synovium derived from RA patients can be the cell source of MSCs for cartilage and meniscus regeneration.
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Affiliation(s)
- Yuji Kohno
- Center for Stem Cells and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Mitsuru Mizuno
- Center for Stem Cells and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Nobutake Ozeki
- Center for Stem Cells and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Hisako Katano
- Center for Stem Cells and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Keiichiro Komori
- Center for Stem Cells and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Shizuka Fujii
- Center for Stem Cells and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Koji Otabe
- Center for Stem Cells and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Masafumi Horie
- Center for Stem Cells and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Kunikazu Tsuji
- Department of Cartilage Regeneration, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Mikio Matsumoto
- Department of Orthopaedic Surgery, Juntendo University Hospital, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan
| | - Haruka Kaneko
- Department of Orthopaedic Surgery, Juntendo University Hospital, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan
| | - Yuji Takazawa
- Department of Orthopaedic Surgery, Juntendo University Hospital, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.,National Hospital Organization Disaster Medical Center, 3256 Midoricho, Tachikawa-shi, Tokyo, 190-0014, Japan
| | - Ichiro Sekiya
- Center for Stem Cells and Regenerative Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
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Ozeki N, Muneta T, Kawabata K, Koga H, Nakagawa Y, Saito R, Udo M, Yanagisawa K, Ohara T, Mochizuki T, Tsuji K, Saito T, Sekiya I. Centralization of extruded medial meniscus delays cartilage degeneration in rats. J Orthop Sci 2017; 22:542-548. [PMID: 28351717 DOI: 10.1016/j.jos.2017.01.024] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 11/25/2016] [Accepted: 01/22/2017] [Indexed: 12/26/2022]
Abstract
BACKGROUND Meniscus extrusion often observed in knee osteoarthritis has a strong correlation with the progression of cartilage degeneration and symptom in the patients. We recently reported a novel procedure "arthroscopic centralization" in which the capsule was sutured to the edge of the tibial plateau to reduce meniscus extrusion in the human knee. However, there is no animal model to study the efficacy of this procedure. The purposes of this study were [1] to establish a model of centralization for the extruded medial meniscus in a rat model; and [2] to investigate the chondroprotective effect of this procedure. METHODS Medial meniscus extrusion was induced by the release of the anterior synovial capsule and the transection of the meniscotibial ligament. Centralization was performed by the pulled-out suture technique. Alternatively, control rats had only the medial meniscus extrusion surgery. Medial meniscus extrusion was evaluated by micro-CT and macroscopic findings. Cartilage degeneration of the medial tibial plateau was evaluated macroscopically and histologically. RESULTS By micro-CT analysis, the medial meniscus extrusion was significantly improved in the centralization group in comparison to the extrusion group throughout the study. Both macroscopically and histologically, the cartilage lesion of the medial tibial plateau was prevented in the centralization group but was apparent in the control group. CONCLUSIONS We developed medial meniscus extrusion in a rat model, and centralization of the extruded medial meniscus by the pull-out suture technique improved the medial meniscus extrusion and delayed cartilage degeneration, though the effect was limited. Centralization is a promising treatment to prevent the progression of osteoarthritis.
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Affiliation(s)
- Nobutake Ozeki
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Japan; Department of Orthopaedic Surgery, Yokohama City University, Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Japan
| | - Kenichi Kawabata
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Japan
| | - Yusuke Nakagawa
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Japan; Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Japan
| | - Ryusuke Saito
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Japan
| | - Mio Udo
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Japan
| | - Katsuaki Yanagisawa
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Japan
| | - Toshiyuki Ohara
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Japan
| | - Tomoyuki Mochizuki
- Department of Joint Reconstruction, Graduate School, Tokyo Medical and Dental University, Japan
| | - Kunikazu Tsuji
- Department of Cartilage Regeneration, Graduate School, Tokyo Medical and Dental University, Japan
| | - Tomoyuki Saito
- Department of Orthopaedic Surgery, Yokohama City University, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Japan.
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Katagiri K, Matsukura Y, Muneta T, Ozeki N, Mizuno M, Katano H, Sekiya I. Fibrous Synovium Releases Higher Numbers of Mesenchymal Stem Cells Than Adipose Synovium in a Suspended Synovium Culture Model. Arthroscopy 2017; 33:800-810. [PMID: 28043752 DOI: 10.1016/j.arthro.2016.09.033] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 09/23/2016] [Accepted: 09/28/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE To develop an in vitro model, the "suspended synovium culture model," to demonstrate the mobilization of mesenchymal stem cells (MSCs) from the synovium into a noncontacted culture dish through culture medium. In addition, to examine which synovium, fibrous synovium or adipose synovium, released more MSCs in the knee with osteoarthritis. METHODS Human synovial tissue was harvested during total knee arthroplasty from knee joints of 34 patients with osteoarthritis (28 patients: only fibrous synovium, 6 patients: fibrous and adipose synovium). One gram of synovium was suspended with a thread in a bottle containing 40 mL of culture medium and a 3.5-cm-diameter culture dish at the bottom. After 7 days, the culture dish in the bottle was examined. For the cells harvested, multipotentiality and surface epitopes were analyzed. The numbers of colonies derived from fibrous synovium and adipose synovium were also compared. RESULTS Colonies of spindle-shaped cells were observed in the culture dish in all 28 donors. Colonies numbered 26 on average, and the cells derived from colony-forming cells had multipotentiality for chondrogenesis, adipogenesis, calcification, and surface epitopes similar to MSCs. The number was colonies was significantly higher in fibrous synovium than in adipose synovium (P < .05, n = 6). CONCLUSIONS We developed a suspended synovium culture model. Suspended synovium was able to release MSCs into a noncontacted culture dish through medium in a bottle. Fibrous synovium was found to release greater numbers of MSCs than adipose synovium in our culture model. CLINICAL RELEVANCE: This model could be a valuable tool to screen drugs capable of releasing MSCs from the synovium into synovial fluid.
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Affiliation(s)
- Kenta Katagiri
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yu Matsukura
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Nobutake Ozeki
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mitsuru Mizuno
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hisako Katano
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
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Kondo T, Muneta T, Fukui T. Evaluation of the relationship between the static measurement of transverse arch flexibility of the forefoot and gait parameters in healthy subjects. J Phys Ther Sci 2017; 29:413-418. [PMID: 28356622 PMCID: PMC5361001 DOI: 10.1589/jpts.29.413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 11/24/2016] [Indexed: 01/31/2023] Open
Abstract
[Purpose] To investigate the relationship between the static measurement of the
transverse arch of the forefoot, using a 3-dimensional (3D) foot scanner, and kinetics and
kinematics of gait parameters in the sagittal plane. [Subjects and Methods] Twenty healthy
subjects participated in this study. The transverse arch of the forefoot was measured
under three conditions as follows: condition 1, sitting; condition 2, standing; and
condition 3, foot forward and lower leg tilting anteriorly to the maximum position with
heel contact. Gait parameters were recorded using a 3D motion analysis system and force
plate. Correlation coefficients between TAF for each comparison of conditions and gait
parameters were calculated using the Spearman correlation analysis. [Results] Rates of the
transverse arch of the forefoot width and height between condition 2 and condition 3 were
significantly correlated with the anterior and posterior component of ground reaction
forces, the hip joint extension angle, and the ankle plantar flexion moment. [Conclusion]
Our study’s findings indicated that increased stiffness of the transverse arch of the
forefoot was related to the increase in ankle plantar moment, and decreased stiffness of
the transverse arch of the forefoot was related to the increase in hip joint extension
angle during gait.
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Affiliation(s)
- Takashi Kondo
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Japan; Sports Management Center, Graduate School, Bunkyo Gakuin University, Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Japan
| | - Tsutomu Fukui
- Sports Management Center, Graduate School, Bunkyo Gakuin University, Japan
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Ohara T, Muneta T, Nakagawa Y, Matsukura Y, Ichinose S, Koga H, Tsuji K, Sekiya I. <Original Article>Hypoxia enhances proliferation through increase of colony formation rate with chondrogenic potential in primary synovial mesenchymal stem cells. J Med Dent Sci 2017; 63:61-70. [PMID: 28049938 DOI: 10.11480/jmds.630401] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Synovial mesenchymal stem cells (MSCs) are an attractive cell source for cartilage and meniscus regeneration. Use of primary MSCs is the preferable because these cells are safer than cells passaged several times in terms of probability of chromosome abnormalities. The effect of hypoxia on the proliferation of MSCs is controversial and remains unknown in primary synovial MSCs. Primary synovial MSCs were cultured at normoxia or hypoxia, and colony number, cell number, surface epitopes, mitochondria activity, TEM finding, and chondrogenic potential were analyzed. To investigate the effect of hypoxia on attachment of synovial MSCs, cells were cultured at hypoxia for the first 3 days, then cultured at normoxia. To investigate the effect of hypoxia on proliferation, cells were also cultured at hypoxia for the last 11 days. Hypoxia increased colony number and cell number per dish in primary synovial MSCs. Hypoxia did not affect cell number per colony, surface epitopes, mitochondria activity, TEM finding or chondrogenic potential. Hypoxia for the first 3 days did not alter colony number per dish or cell number per dish, while hypoxia for the last 11 days increased. Hypoxia enhanced proliferation through increase of colony formation rate with chondrogenic potential in primary synovial MSCs.
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Affiliation(s)
- Toshiyuki Ohara
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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