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Xu D, Schiphof D, Hirvasniemi J, Klein S, Oei EHG, Bierma-Zeinstra S, Runhaar J. Factors associated with meniscus volume in knees free of degenerative features. Osteoarthritis Cartilage 2023; 31:1644-1649. [PMID: 37598744 DOI: 10.1016/j.joca.2023.08.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 07/13/2023] [Accepted: 08/10/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVES To explore factors that were associated with meniscus volume in knees free of radiographic osteoarthritis (OA) features and symptoms of OA. METHODS In the third Rotterdam Study cohort, clinical, radiographic, and magnetic resonance data were obtained at baseline (BL) and after 5 years of follow-up. Meniscus volumes and their change over time were calculated after semi-automatic segmentation on Magnetic Resonance Imaging. Knees with radiographic OA features (Kellgren and Lawrence>0) or clinical diagnosis of OA (American College of Rheumatology) at BL were excluded. Ten OA risk factors were adjusted in the multivariable analysis (generalized estimating equations), treating two knees within subjects as repeated measurements. RESULTS From 1065 knees (570 subjects), the average (standard deviation) age and Body mass index (BMI) of included subjects were 54.3 (3.7) years and 26.5 (4.4) kg/m2. At BL, nine factors (varus alignment, higher BMI, meniscus pathologies, meniscus extrusion, cartilage lesions, injury, greater physical activity level, quadriceps muscle strength, and higher age) were significantly associated with greater meniscus volume. Five factors (injury, meniscus pathologies, meniscus extrusion, higher age, and change of BMI) were significantly associated with meniscus volume loss. CONCLUSIONS Modifiable factors (varus alignment, BMI, physical activity level, and quadriceps muscle strength) and non-modifiable factors (higher age, injury, meniscus pathologies, meniscus extrusion, and cartilage lesions) were all associated with meniscus volume or meniscus volume loss over time.
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Affiliation(s)
- Dawei Xu
- Dept. of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands
| | - Dieuwke Schiphof
- Dept. of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands
| | - Jukka Hirvasniemi
- Dept. of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, the Netherlands
| | - Stefan Klein
- Dept. of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, the Netherlands
| | - Edwin H G Oei
- Dept. of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, the Netherlands
| | - Sebastia Bierma-Zeinstra
- Dept. of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands; Dept. of Orthopedics & Sports Medicine, Erasmus MC University Medical Center Rotterdam, the Netherlands
| | - Jos Runhaar
- Dept. of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands.
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Hellberg I, Karjalainen VP, Finnilä MAJ, Jonsson E, Turkiewicz A, Önnerfjord P, Hughes V, Tjörnstrand J, Englund M, Saarakkala S. 3D analysis and grading of calcifications from ex vivo human meniscus. Osteoarthritis Cartilage 2023; 31:482-492. [PMID: 36356928 PMCID: PMC7614369 DOI: 10.1016/j.joca.2022.10.016] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 10/31/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Meniscal calcifications are associated with the pathogenesis of knee osteoarthritis (OA). We propose a micro-computed tomography (μCT) based 3D analysis of meniscal calcifications ex vivo, including a new grading system. METHOD Human medial and lateral menisci were obtained from 10 patients having total knee replacement for medial compartment OA and 10 deceased donors without knee OA (healthy references). The samples were fixed; one subsection was imaged with μCT, and the adjacent tissue was processed for histological evaluation. Calcifications were examined from the reconstructed 3D μCT images, and a new grading system was developed. To validate the grading system, meniscal calcification volumes (CVM) were quantitatively analyzed and compared between the calcification grades. Furthermore, we estimated the relationship between histopathological degeneration and the calcification severity. RESULTS 3D μCT images depict calcifications in every sample, including diminutive calcifications that are not visible in histology. In the new grading system, starting from grade 2, each grade results in a CVM that is 20.3 times higher (95% CI 13.3-30.5) than in the previous grade. However, there was no apparent difference in CVM between grades 1 and 2. The calcification grades appear to increase with the increasing histopathological degeneration, although histopathological degeneration is also observed with small calcification grades. CONCLUSIONS 3D μCT grading of meniscal calcifications is feasible. Interestingly, it seems that there are two patterns of degeneration in the menisci of our sample set: 1) with diminutive calcifications (calcification grades 1-2), and 2) with large to widespread calcifications (calcification grades 3-5).
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Affiliation(s)
- I Hellberg
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - V-P Karjalainen
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - M A J Finnilä
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - E Jonsson
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund, Sweden; Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Rheumatology and Molecular Skeletal Biology, Lund, Sweden.
| | - A Turkiewicz
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund, Sweden.
| | - P Önnerfjord
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Rheumatology and Molecular Skeletal Biology, Lund, Sweden.
| | - V Hughes
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund, Sweden.
| | - J Tjörnstrand
- Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Orthopaedics, Lund, Sweden.
| | - M Englund
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund, Sweden.
| | - S Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
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3
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Chan KM, Yeater TD, Allen KD. Age alters gait compensations following meniscal injury in male rats. J Orthop Res 2022; 40:2780-2791. [PMID: 35285977 PMCID: PMC9470788 DOI: 10.1002/jor.25306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/03/2022] [Accepted: 02/21/2022] [Indexed: 02/04/2023]
Abstract
With age, susceptibility to osteoarthritis (OA) and OA-related pain and disability increases. Like in OA patients, gait patterns in rodent OA models shift to protect the injured limb during loading. However, unlike in OA patients, it is unknown how age affects gait changes in rodent OA models. In this study, gait compensations following meniscal injury in 3-, 6-, and 9-month-old rats were evaluated to examine age-effects of OA-related joint dysfunction. Rats 3, 6, and 9 months received medial collateral ligament transection plus medial meniscus transection (MCLT + MMT) surgery (n = 8/age group) or a skin incision (n = 8/age group). Postsurgery, rats underwent gait testing at 2, 4, 6, and 8 weeks. Postmortem, joints were processed for histology to assess cartilage damage. MCLT + MMT rats walked with reduced vertical loading in their injured limbs immediately after injury and throughout OA progression. Compared to sham-operated limbs, 6- and 9-month MCLT + MMT animals reduced loading in their injured limbs while 3-month MCLT + MMT animals did not. MCLT + MMT rats also increased stance time on the injured limb compared to the contralateral limb. Additionally, for the MCLT + MMT animals, 6- and 9-month animals had significantly worse cartilage damage compared to 3-month animals. These data indicated age at injury onset affects how animals load the OA-affected joint, with older animals developing gait compensations that more markedly reduce weight on the injured limb during walking.
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Affiliation(s)
- Kiara M. Chan
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Taylor D. Yeater
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Kyle D. Allen
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
- Department of Orthopedics and Sports Medicine, University of Florida, Gainesville, FL, USA
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He YJ, Liang X, Zhang XX, Li SS, Sun Y, Li TF. PTH1-34 inhibited TNF-α expression and antagonized TNF-α-induced MMP13 expression in MIO mice. Int Immunopharmacol 2021; 91:107191. [PMID: 33359852 DOI: 10.1016/j.intimp.2020.107191] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 10/22/2022]
Abstract
This study aims to investigate the effects and mechanisms of parathyroid hormone [1-34] (PTH1-34) on TNF-α-stimulated mice chondrocytes, as well as cartilage from a meniscus injury induced osteoarthritis (MIO) mice model. The C57BL/6J mice received medial meniscectomy, and then administrated with PTH1-34. The results showed that PTH1-34 administration decreased secondary allodynia and the pain-related transcripts. The IHC, ELISA, Micro-CT imaging and histopathology analysis revealed the significantly improved subchondral plate thickness and bone porosity, the reduced pro-inflammatory cytokines in serum and joint fluid. In vitro, mice chondrocyte was treated with TNF-α or co-cultured with synovial cells. The results showed that TNF-α markedly upregulated the MMP13 expression, and the ERK1/2, NF-κB or PI3K signaling pathway inhibitors could reverse the induction effect of TNF-α on expression of MMP13 in chondrocytes. PTH1-34 alone has no effect on the expression of MMP13 and NF-κB signaling pathways, but the PTH1-34 could reverse the induction effect of TNF-α on MMP13 expression and NF-κB signaling pathway activation in chondrocytes. In addition, PTH1-34 administration inhibited the expression of TNF-α and MMP13, and chondrocyte viability, while the PKA repressor reversed the effect of PTH1-34 in chondrocytes co-cultured with synovial cells. In conclusion, PTH1-34 has an obvious analgesic and anti-inflammatory effect, inhibits the matrix synthesis and alleviates the progression of osteoarthritis. In vitro, PTH1-34 inhibited TNF-α expression and antagonized TNF-α-induced MMP13 expression via the PKA pathway and the NF-κB signaling pathways, respectively.
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Affiliation(s)
- Yu-Jie He
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Xu Liang
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Xin-Xin Zhang
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Shan-Shan Li
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Yue Sun
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Tian-Fang Li
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China.
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Rebai MA, Sahnoun N, Abdelhedi O, Keskes K, Charfi S, Slimi F, Frikha R, Keskes H. Animal models of osteoarthritis: characterization of a model induced by Mono-Iodo-Acetate injected in rabbits. Libyan J Med 2020; 15:1753943. [PMID: 32281500 PMCID: PMC7178858 DOI: 10.1080/19932820.2020.1753943] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 03/30/2020] [Indexed: 11/04/2022] Open
Abstract
Knee Osteoarthritis is a considerable public health concern, both in terms of life quality and treatment financial impacts. To investigate this disease, animal models are deemed a promising alternative. In fact, although a perfect model is generally farfetched, the creation of models that simulate human disease as accurately as possible remains an important research stake. This study aims to highlight the usefulness of the model induced by injected Mono-Iodo-Acetate and to standardize it for the rabbit species. Osteoarthritis was induced by an infra-patellar injection of 0.2 ml of an MIA solution in the left knee of 24 female New Zealand rabbits. The right knee served as a control by receiving an injection of physiological serum. The rabbits were divided into 4 groups of 6 individuals each according to the dose of MIA received per knee. All rabbits were euthanized 30 days after the injection. After sacrifice, the knees were carefully dissected and macroscopic and microscopic scores of cartilage, meniscal and synovial lesions were attributed to each group. Our study followed the laboratory animal care and management guideline published in 2017 by the Canadian Council of Animal Care. The control knees of all rabbits showed no macroscopic or microscopic lesions. The macroscopic lesions: osteophytes, meniscal lesions, fibrillation and erosion of the cartilage and microscopic lesions: disorganization of the chondrocytes, decrease in proteoglycans and synovial inflammation clinically diagnosed in human pathology were all detected and were similarly reproducible among the knees of the same group. Through this work, we highlighted the merits of the arthritis model induced by MIA, namely its simulation of several aspects of human pathology. Further advantages are low cost, speed, reproducibility. This model notably avoids delicate and risky surgical operations.
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Affiliation(s)
- Mohamed Ali Rebai
- Research Laboratory Cell Therapy and Experimental Musculoskeletal System LR 18SP11, Medecine University Sfax, Tunisia
| | - Nizar Sahnoun
- Department of Orthopedic Surgery and Traumatology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Oussema Abdelhedi
- Research Laboratory Cell Therapy and Experimental Musculoskeletal System LR 18SP11, Medecine University Sfax, Tunisia
| | - Khaled Keskes
- Department of Orthopedic Surgery and Traumatology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Slim Charfi
- Department of Pathology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Fathia Slimi
- Biology department, Science University, Sfax, Tunisia
| | - Rim Frikha
- Department of Genetics, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Hassib Keskes
- Research Laboratory Cell Therapy and Experimental Musculoskeletal System LR 18SP11, Medecine University Sfax, Tunisia
- Department of Orthopedic Surgery and Traumatology, Habib Bourguiba University Hospital, Sfax, Tunisia
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Zhao J, Su Y, Jiao J, Wang Z, Fang X, He X, Zhang X, Liu Z, Xu X. Identification of lncRNA and mRNA Biomarkers in Osteoarthritic Degenerative Meniscus by Weighted Gene Coexpression Network and Competing Endogenous RNA Network Analysis. Biomed Res Int 2020; 2020:2123787. [PMID: 32685450 PMCID: PMC7341399 DOI: 10.1155/2020/2123787] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/26/2020] [Accepted: 04/15/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Long noncoding RNAs (lncRNAs) play a crucial role in varieties of biological processes. This study is aimed at investigating meniscal degeneration-specific lncRNAs and mRNAs and their related networks in knee osteoarthritis (KOA). METHODS The dataset GSE98918, which included 24 meniscus samples and related clinical data, was downloaded from the Gene Expression Omnibus database. The differentially expressed lncRNAs and mRNAs in the meniscus between KOA and control groups were identified. Based on the enriched differentially expressed lncRNAs and mRNAs, we constructed the coexpression network using WGCNA (weighted correlation network analysis) and identified the critical module related to KOA. For mRNAs in the key module, gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses were carried out using the DAVID database. A competing endogenous RNA network (ceRNA) based on the screened mRNAs, lncRNAs, and related miRNAs was constructed to reveal presumptive biomarkers further. Finally, the hub lncRNAs and mRNAs were screened, and the diagnostic value was evaluated using a receiver operating characteristic (ROC) curve. Hub mRNAs were validated using the dataset GSE113825. RESULTS We screened 208 significantly differentially expressed lncRNAs and mRNAs in menisci between the KOA and non-KOA samples, which were enriched in sixteen modules using WGCNA, especially the green module. Coexpression network based on the enriched differentially expressed lncRNAs and mRNAs in the green module uncovered 5 lncRNAs and 56 mRNAs. The lncRNA-miRNA-mRNA ceRNA network revealed that lnc-HLA-DQA1-5, lnc-RP11-127H5.1.1-1, lnc-RTN2-1, IGFBP4 (insulin-like growth factor binding protein 4), and KLF2 (Kruppel-like factor 2) were significantly correlated with the meniscus degeneration of KOA. ROC curve analysis revealed that these hub lncRNAs and mRNAs showed excellent diagnostic value for KOA. CONCLUSIONS These hub lncRNAs and mRNAs were potential prognostic biomarkers for the meniscus degeneration of KOA. Further studies are required to validate these new biomarkers and better understand the pathological process of the meniscus degeneration of KOA.
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Affiliation(s)
- Jun Zhao
- Department of Orthopaedics, Heilongjiang University of Chinese Medicine, Heping Road, Xiangfang District, Harbin, Heilongjiang, China
| | - Yu Su
- Harbin Fifth Hospital, Jiankang Road, Xiangfang District, Harbin, Heilongjiang, China
| | - Jianfei Jiao
- Harbin Fifth Hospital, Jiankang Road, Xiangfang District, Harbin, Heilongjiang, China
| | - Zhengchun Wang
- Department of Orthopaedics, Heilongjiang University of Chinese Medicine, Heping Road, Xiangfang District, Harbin, Heilongjiang, China
| | - Xiangchun Fang
- Department of Orthopaedics, Heilongjiang University of Chinese Medicine, Heping Road, Xiangfang District, Harbin, Heilongjiang, China
| | - Xuefeng He
- Department of Orthopaedics, Heilongjiang University of Chinese Medicine, Heping Road, Xiangfang District, Harbin, Heilongjiang, China
| | - Xiaofeng Zhang
- Department of Orthopaedics, Heilongjiang University of Chinese Medicine, Heping Road, Xiangfang District, Harbin, Heilongjiang, China
| | - Zhao Liu
- Department of Orthopaedics, Heilongjiang University of Chinese Medicine, Heping Road, Xiangfang District, Harbin, Heilongjiang, China
| | - Xilin Xu
- Department of Orthopaedics, Heilongjiang University of Chinese Medicine, Heping Road, Xiangfang District, Harbin, Heilongjiang, China
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Ayaki M, Tachi N, Hashimoto Y, Kawashima M, Tsubota K, Negishi K. Diurnal variation of human tear meniscus volume measured with tear strip meniscometry self-examination. PLoS One 2019; 14:e0215922. [PMID: 31013328 PMCID: PMC6478337 DOI: 10.1371/journal.pone.0215922] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/10/2019] [Indexed: 12/26/2022] Open
Abstract
Purpose Tear secretion is critical for maintenance of healthy ocular surface and vision. Most of normal subjects and dry eye patients feel worsening of ocular dryness in the afternoon, however, diurnal variation of tear meniscus volume has not been directly measured because there was no appropriate method. We used a simple, non-invasive technique, tear strip meniscometry (SM) by self-examination. Previous investigations indicated the values of SM correlated strongly with those of the Schirmer test, tests of tear break up time, and tear meniscus height measurement by anterior optical coherence tomography. The purpose of this study was to capture diurnal variation of aqueous availability at the tear meniscus by measuring wetted length using SM through self-examination. Methods Thirty-six medical personnel (mean age; 35.7 years) participated and SM self-examination was performed using a mirror seven times a day. The strip is applied for 5 seconds to the lateral side of the lower lid tear meniscus without touching the ocular surface. Results The measured SM value was the highest upon awakening (4.44 ± 3.14 mm) and gradually decreased in the evening; 3.81 ± 3.12 at 9:00, 3.31 ± 2.72* at 12:00, 2.89 ± 1.88* at 15:00, 2.92 ± 1.87* at 18:00, 2.78 ± 1.85* at 21:00, and 2.89 ± 1.75* at bedtime with statistical significance compared to the value upon awakening (*P < 0.05, Dunnett’s multiple comparison test). Proportion of number of subjects with low SM value (< 4 mm) to total number of subjects was 52.8% upon awakening and 83.3% at 21:00, and gradually increased toward evening. Conclusion Our results could identify diurnal variation of tear meniscus volume in the general population.
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Affiliation(s)
- Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- Otake Clinic Moon View Eye Center, Yamato, Japan
- * E-mail: (MA); (KN)
| | - Naoko Tachi
- Shiseikai Toyama Hospital Eye Center, Toyama, Japan
| | | | - Motoko Kawashima
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- * E-mail: (MA); (KN)
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Zhu LY, Li L, Li ZA, Shi JP, Tang WL, Yang JQ, Jiang Q. Design and biomechanical characteristics of porous meniscal implant structures using triply periodic minimal surfaces. J Transl Med 2019; 17:89. [PMID: 30885229 PMCID: PMC6423829 DOI: 10.1186/s12967-019-1834-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 03/06/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Artificial meniscal implants can be used to replace a severely injured meniscus after meniscectomy and restore the normal functionality of a knee joint. The aim of this paper was to design porous meniscal implants and assess their biomechanical properties. METHODS Finite element simulations were conducted on eight different cases including intact healthy knees, knee joints with solid meniscal implants, and knee joints with meniscal implants with two types of triply periodic minimal surfaces. Compression stresses, shear stresses, and characteristics of stress concentrated areas were evaluated using an axial compressive load of 1150 N and an anterior load of 350 N. RESULTS Compared to the solid meniscal implant, the proposed porous meniscal implant produced lower levels of compression and shear stresses on the cartilage, which facilitated the cartilage to retain a semilunar characteristic similar to the natural meniscus. Moreover, both compression and shear stresses on the artificial cartilage were found to be sensitive to the pore properties of the meniscal implant. The meniscal implants with primitive surfaces (porosity: 41%) showed a better performance in disseminating stresses within the knee joint. CONCLUSION The present commercial meniscal implant has the problem of equivalent biomechanical properties compared to natural menisci. The main advantage of the proposed porous structure is that it can be used to prevent excessive compression and shear stresses on the articular cartilages. This structure has advantages both in terms of mechanics and printability, which can be beneficial for future clinical applications.
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Affiliation(s)
- Li-ya Zhu
- Jiangsu Key Laboratory of 3D Printing Equipment and Manufacturing, School of Electrical and Automation Engineering, Nanjing Normal University, Nanjing, China
- Nanjing Institute of Intelligent Advanced Equipment Industry Co., Ltd., Nanjing, China
| | - Lan Li
- School of Mechanical Engineering, Southeast University, Nanjing, China
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, China
| | - Zong-an Li
- Jiangsu Key Laboratory of 3D Printing Equipment and Manufacturing, School of Electrical and Automation Engineering, Nanjing Normal University, Nanjing, China
- Nanjing Institute of Intelligent Advanced Equipment Industry Co., Ltd., Nanjing, China
| | - Jian-ping Shi
- Jiangsu Key Laboratory of 3D Printing Equipment and Manufacturing, School of Electrical and Automation Engineering, Nanjing Normal University, Nanjing, China
- Nanjing Institute of Intelligent Advanced Equipment Industry Co., Ltd., Nanjing, China
| | - Wen-lai Tang
- Jiangsu Key Laboratory of 3D Printing Equipment and Manufacturing, School of Electrical and Automation Engineering, Nanjing Normal University, Nanjing, China
- Nanjing Institute of Intelligent Advanced Equipment Industry Co., Ltd., Nanjing, China
| | - Ji-quan Yang
- Jiangsu Key Laboratory of 3D Printing Equipment and Manufacturing, School of Electrical and Automation Engineering, Nanjing Normal University, Nanjing, China
- Nanjing Institute of Intelligent Advanced Equipment Industry Co., Ltd., Nanjing, China
| | - Qing Jiang
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, China
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9
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McKinney JM, Doan TN, Wang L, Deppen J, Reece DS, Pucha KA, Ginn S, Levit RD, Willett NJ. Therapeutic efficacy of intra-articular delivery of encapsulated human mesenchymal stem cells on early stage osteoarthritis. Eur Cell Mater 2019; 37:42-59. [PMID: 30693466 PMCID: PMC7549187 DOI: 10.22203/ecm.v037a04] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Mesenchymal stem cells (MSCs) represent a great therapeutic promise in pre-clinical models of osteoarthritis (OA), but many questions remain as to their therapeutic mechanism of action: engraftment versus paracrine action. Encapsulation of human MSCs (hMSCs) in sodium alginate microspheres allowed for the paracrine signaling properties of these cells to be isolated and studied independently of direct cellular engraftment. The objective of the present study was to quantitatively assess the efficacy of encapsulated hMSCs as a disease-modifying therapeutic for OA, using a medial meniscal tear (MMT) rat model. It was hypothesized that encapsulated hMSCs would have a therapeutic effect, through paracrine-mediated action, on early OA development. Lewis rats underwent MMT surgery to induce OA. 1 d post-surgery, rats received intra-articular injections of encapsulated hMSCs or controls (i.e., saline, empty capsules, non-encapsulated hMSCs). Microstructural changes in the knee joint were quantified using equilibrium partitioning of a ionic contrast agent based micro-computed tomography (EPIC-μCT) at 3 weeks post-surgery, an established time point for early OA. Encapsulated hMSCs significantly attenuated MMT-induced increases in articular cartilage swelling and surface roughness and augmented cartilaginous and mineralized osteophyte volumes. Cellular encapsulation allowed to isolate the hMSC paracrine signaling effects and demonstrated that hMSCs could exert a chondroprotective therapeutic role on early stage OA through paracrine signaling alone. In addition to this chondroprotective role, encapsulated hMSCs augmented the compensatory increases in osteophyte formation. The latter should be taken into strong consideration as many clinical trials using MSCs for OA are currently ongoing.
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Affiliation(s)
| | | | | | | | | | | | | | | | - N J Willett
- Atlanta Veteran Affairs Medical Center, 1670 Clairmont Rd, Room 5A-115, Decatur, GA 30033,
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10
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Chou WY, Cheng JH, Wang CJ, Hsu SL, Chen JH, Huang CY. Shockwave Targeting on Subchondral Bone Is More Suitable than Articular Cartilage for Knee Osteoarthritis. Int J Med Sci 2019; 16:156-166. [PMID: 30662339 PMCID: PMC6332487 DOI: 10.7150/ijms.26659] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 04/13/2018] [Accepted: 11/29/2018] [Indexed: 11/05/2022] Open
Abstract
Our study compared the effects of extracorporeal shockwave therapy (ESWT) on the subchondral bone and the articular cartilage in the treatment of early osteoarthritis (OA) of rat knee. The rats were divided into 5 groups which included Sham group, Meniscus group (ESWT applied on medial meniscus), OA group (arthrotomy and medial menisectomy (MMx) and anterior cruciate ligament transection (ACLT), T(M) group (arthrotomy and MMx and ACLT followed by ESWT on medial tibial subchondral bone) and Articular cartilage group (arthrotomy and MMx and ACLT followed by ESWT on medial articular cartilage). Evaluations included the pathological changes of the synovium, articular cartilage and subchondral bone, and compared with ESWT on the meniscus, medial tibial subchondral bone and articular cartilage. The ESWT (0.25 mJ/mm² and 800 impulses) did not cause any damages on the cartilage of the meniscus and the tissue of the joint when compared with Sham group. Among the treatment of osteoarthritic groups (OA, T(M) and Articular cartilage groups), T(M) group showed significant in pathological examination, micro-CT analysis, cartilage grading score and grading of synovium changes by compared with OA and Articular cartilage groups (P < 0.05) in the treatment of early OA knee. In immunohistochemical analysis, T(M) group significantly increased the expression of TGF-β1 but reduced DMP-1, MMP-13 and ADAMTS-5 in the cartilage by compared with OA group and Articular cartilage group (P < 0.05). Our results showed that subchondral bone was an excellent target than articular cartilage for ESWT on early knee osteoarthritis.
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Affiliation(s)
- Wen-Yi Chou
- Section of Sports Medicine, Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Jai-Hong Cheng
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Medical Research, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ching-Jen Wang
- Section of Sports Medicine, Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shan-Ling Hsu
- Section of Sports Medicine, Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Jen-Hung Chen
- Section of Sports Medicine, Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chien-Yiu Huang
- Section of Sports Medicine, Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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11
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Gao S, Chen M, Wang P, Li Y, Yuan Z, Guo W, Zhang Z, Zhang X, Jing X, Li X, Liu S, Sui X, Xi T, Guo Q. An electrospun fiber reinforced scaffold promotes total meniscus regeneration in rabbit meniscectomy model. Acta Biomater 2018; 73:127-140. [PMID: 29654991 DOI: 10.1016/j.actbio.2018.04.012] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 03/28/2018] [Accepted: 04/04/2018] [Indexed: 12/28/2022]
Abstract
Low vascularization in meniscus limits its regeneration ability after injury, and tissue engineering is the most promising method to achieve meniscus regeneration. In this study, we fabricated a kind of composite scaffold by decellularized meniscus extracellular matrix/polycaprolactone (DMECM/PCL) electrospinning fibers and porous DMECM, in which DMECM/PCL fibers were used as reinforcing component. The tensile modulus of the composite scaffold in longitudinal and crosswise directions were 8.5 ± 1.9 and 2.3 ± 0.3 MPa, respectively. Besides that, the DMECM/PCL electrospinning fibers enhanced suture resistance of the composite scaffold more than 5 times than DMECM scaffold effectively. In vitro cytocompatibility showed that the porous structure provided by DMECM component facilitated meniscus cells' proliferation. DMECM was also the main component to regulate cell behaviors, which promoted meniscus cells expressing extracellular matrix related genes such as COL I, COL II, SOX9 and AGG. Rabbits with total meniscectomy were used as animal model to evaluated the composited scaffolds performance in vivo at 3 and 6 months. Results showed that rabbits with scaffold implanting could regenerate neo-menisci in both time points. The neo-menisci had similar histology structure and biochemical content with native menisci. Although neo-menisci had inferior tensile modulus than native ones, its modulus was improved with implanting time prolonging. MRI imaging showed the signal of neo-meniscus in the body is clear, and X-ray imaging of knee joints demonstrated the implantation of scaffolds could relief joint space narrowing. Moreover, rabbits with neo-menisci had better cartilage condition in femoral condyle and tibial plateau compared than meniscectomy group. STATEMENT OF SIGNIFICANCE We fabricated the meniscus scaffold by combining porous decellularized meniscus extracellular matrix (DMECM) and DMECM/PCL electrospinning fibers together, which used the porous structure of DMECM, and the good tensile property of electrospinning fibers. We believe single material cannot satisfy increasing needs of scaffold. Therefore, we combined not only materials but also fabrication methods together to develop scaffold to make good use of each part. DMECM in electrospinning fibers also made these two components possible to be integrated through crosslinking. Compared to existing meniscus scaffold, the composite scaffold had (1) soft structure and extrusion would not happen after implantation, (2) ability to be trimmed to suitable shape during surgery, and (3) good resistance to suture.
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Affiliation(s)
- Shuang Gao
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
| | - Mingxue Chen
- Institute of Orthopedics, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries in PLA, Chinese PLA General Hospital, Beijing 100853, China
| | - Pei Wang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
| | - Yan Li
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
| | - Zhiguo Yuan
- Institute of Orthopedics, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries in PLA, Chinese PLA General Hospital, Beijing 100853, China
| | - Weimin Guo
- Institute of Orthopedics, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries in PLA, Chinese PLA General Hospital, Beijing 100853, China
| | - Zengzeng Zhang
- Institute of Orthopedics, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries in PLA, Chinese PLA General Hospital, Beijing 100853, China
| | - Xueliang Zhang
- Institute of Orthopedics, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries in PLA, Chinese PLA General Hospital, Beijing 100853, China
| | - Xiaoguang Jing
- Institute of Orthopedics, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries in PLA, Chinese PLA General Hospital, Beijing 100853, China
| | - Xu Li
- Institute of Orthopedics, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries in PLA, Chinese PLA General Hospital, Beijing 100853, China
| | - Shuyun Liu
- Institute of Orthopedics, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries in PLA, Chinese PLA General Hospital, Beijing 100853, China
| | - Xiang Sui
- Institute of Orthopedics, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries in PLA, Chinese PLA General Hospital, Beijing 100853, China
| | - Tingfei Xi
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China; Shenzhen Institute, Peking University, Shenzhen 518057, China.
| | - Quanyi Guo
- Institute of Orthopedics, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries in PLA, Chinese PLA General Hospital, Beijing 100853, China.
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Degnan AJ, Kietz DA, Grudziak JS, Shah A. Bilateral absence of the cruciate ligaments with meniscal dysplasia: Unexpected diagnosis in a child with juvenile idiopathic arthritis. Clin Imaging 2018; 49:193-197. [PMID: 29635139 DOI: 10.1016/j.clinimag.2018.03.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 03/21/2018] [Accepted: 03/23/2018] [Indexed: 01/17/2023]
Abstract
Bilateral agenesis of the cruciate ligaments is a rare congenital anomaly. We report a unique case of a young girl who had congenital short femur and diagnosed with polyarticular juvenile idiopathic arthritis (JIA) and later discovered to have congenital absence of both anterior and posterior cruciate ligaments and meniscal dysplasia in both the knees when MRI was performed at 11 years of age. The MRI was performed to evaluate knee laxity and persistent symptoms despite medical management and multiple steroid injections for arthritis treatment. This patient is one of the youngest with congenital absence of both the cruciate ligaments to be treated with ACL reconstruction. We highlight the unique radiographic imaging manifestations of congenital cruciate ligament agenesis and emphasize the role of MRI to confirm and depict additional intraarticular abnormalities.
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Affiliation(s)
- Andrew J Degnan
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Daniel A Kietz
- Department of Rheumatology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, United States
| | - Jan S Grudziak
- Division of Orthopedics, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, United States
| | - Amisha Shah
- Department of Radiology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, United States.
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13
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Roczniak W, Brodziak-Dopierała B, Cipora E, Jakóbik-Kolon A, Kluczka J, Babuśka-Roczniak M. Factors that Affect the Content of Cadmium, Nickel, Copper and Zinc in Tissues of the Knee Joint. Biol Trace Elem Res 2017; 178:201-209. [PMID: 28070864 PMCID: PMC5506214 DOI: 10.1007/s12011-016-0927-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 09/20/2016] [Accepted: 12/28/2016] [Indexed: 12/13/2022]
Abstract
Osteoarthritis causes the degradation of the articular cartilage and periarticular bones. Trace elements influence the growth, development and condition of the bone tissue. Changes to the mineral composition of the bone tissue can cause degenerative changes and fractures. The aim of the research was to determine the content of cadmium (Cd), nickel (Ni), copper (Cu) and zinc (Zn) in the tibia, the femur and the meniscus in men and women who underwent a knee replacement surgery. Samples were collected from 50 patients, including 36 women and 14 men. The determination of trace elements content were performed by ICP-AES method, using Varian 710-ES. Average concentration in the tissues of the knee joint teeth amounted for cadmium 0.015, nickel 0.60, copper 0.89 and zinc 80.81 mg/kg wet weight. There were statistically significant differences in the content of cadmium, copper and zinc in different parts of the knee joint. There were no statistically significant differences in the content of cadmium, nickel, copper and zinc in women and men in the examined parts of the knee joint. Among the elements tested, copper and nickel showed a high content in the connective tissue (the meniscus) compared to the bone tissue (the tibia and the femur).
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Affiliation(s)
- Wojciech Roczniak
- Medical Institute, The Jan Grodek Higher Vocational State School, 21 Mickiewicza Str. 38-500, Sanok, Poland
| | - Barbara Brodziak-Dopierała
- School of Pharmacy with the Division of Laboratory Medicine, Department of Toxicology, Medical University of Silesia, 4 Jagiellonska Str. 41-200, Sosnowiec, Poland.
| | - Elżbieta Cipora
- Medical Institute, The Jan Grodek Higher Vocational State School, 21 Mickiewicza Str. 38-500, Sanok, Poland
| | - Agata Jakóbik-Kolon
- Faculty of Chemistry, Department of Inorganic, Analytical Chemistry and Electrochemistry, Silesian University of Technology, 6 B. Krzywoustego Str. 44-100, Gliwice, Poland
| | - Joanna Kluczka
- Faculty of Chemistry, Department of Inorganic, Analytical Chemistry and Electrochemistry, Silesian University of Technology, 6 B. Krzywoustego Str. 44-100, Gliwice, Poland
| | - Magdalena Babuśka-Roczniak
- Medical Institute, The Jan Grodek Higher Vocational State School, 21 Mickiewicza Str. 38-500, Sanok, Poland
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14
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Kloefkorn HE, Allen KD. Quantitative histological grading methods to assess subchondral bone and synovium changes subsequent to medial meniscus transection in the rat. Connect Tissue Res 2017; 58:373-385. [PMID: 27797605 PMCID: PMC5568641 DOI: 10.1080/03008207.2016.1251425] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 10/16/2016] [Indexed: 02/03/2023]
Abstract
AIM OF THE STUDY The importance of the medial meniscus to knee health is demonstrated by studies which show meniscus injuries significantly increase the likelihood of developing osteoarthritis (OA), and knee OA can be modeled in rodents using simulated meniscus injuries. Traditionally, histological assessments of OA in these models have focused on damage to the articular cartilage; however, OA is now viewed as a disease of the entire joint as an organ system. The aim of this study was to develop quantitative histological measures of bone and synovial changes in a rat medial meniscus injury model of knee OA. MATERIALS AND METHODS To initiate OA, a medial meniscus transection (MMT) and a medial collateral ligament transection (MCLT) were performed in 32 male Lewis rats (MMT group). MCLT alone served as the sham procedure in 32 additional rats (MCLT sham group). At weeks 1, 2, 4, and 6 post-surgery, histological assessment of subchondral bone and synovium was performed (n = 8 per group per time point). RESULTS Trabecular bone area and the ossification width at the osteochondral interface increased in both the MMT and MCLT groups. Subintimal synovial cell morphology also changed in MMT and MCLT groups relative to naïve animals. CONCLUSIONS OA affects the joint as an organ system, and quantifying changes throughout an entire joint can improve our understanding of the relationship between joint destruction and painful OA symptoms following meniscus injury.
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Affiliation(s)
- Heidi E Kloefkorn
- a J. Crayton Pruitt Family Department of Biomedical Engineering , University of Florida , Gainesville , FL , USA
| | - Kyle D Allen
- a J. Crayton Pruitt Family Department of Biomedical Engineering , University of Florida , Gainesville , FL , USA
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15
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Łuczkiewicz P, Daszkiewicz K, Chróścielewski J, Witkowski W, Winklewski PJ. The Influence of Articular Cartilage Thickness Reduction on Meniscus Biomechanics. PLoS One 2016; 11:e0167733. [PMID: 27936066 PMCID: PMC5147969 DOI: 10.1371/journal.pone.0167733] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 11/18/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Evaluation of the biomechanical interaction between meniscus and cartilage in medial compartment knee osteoarthritis. METHODS The finite element method was used to simulate knee joint contact mechanics. Three knee models were created on the basis of knee geometry from the Open Knee project. We reduced the thickness of medial cartilages in the intact knee model by approximately 50% to obtain a medial knee osteoarthritis (OA) model. Two variants of medial knee OA model with congruent and incongruent contact surfaces were analysed to investigate the influence of congruency. A nonlinear static analysis for one compressive load case was performed. The focus of the study was the influence of cartilage degeneration on meniscal extrusion and the values of the contact forces and contact areas. RESULTS In the model with incongruent contact surfaces, we observed maximal compressive stress on the tibial plateau. In this model, the value of medial meniscus external shift was 95.3% greater, while the contact area between the tibial cartilage and medial meniscus was 50% lower than in the congruent contact surfaces model. After the non-uniform reduction of cartilage thickness, the medial meniscus carried only 48.4% of load in the medial compartment in comparison to 71.2% in the healthy knee model. CONCLUSIONS We have shown that the change in articular cartilage geometry may significantly reduce the role of meniscus in load transmission and the contact area between the meniscus and cartilage. Additionally, medial knee OA may increase the risk of meniscal extrusion in the medial compartment of the knee joint.
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Affiliation(s)
- Piotr Łuczkiewicz
- II Clinic of Orthopaedics and Kinetic Organ Traumatology, Medical University of Gdańsk, Gdańsk, Poland
- * E-mail:
| | - Karol Daszkiewicz
- Department of Mechanics of Materials, Faculty of Civil and Environmental Engineering, Gdańsk University of Technology, Gdańsk, Poland
| | - Jacek Chróścielewski
- Department of Mechanics of Materials, Faculty of Civil and Environmental Engineering, Gdańsk University of Technology, Gdańsk, Poland
| | - Wojciech Witkowski
- Department of Mechanics of Materials, Faculty of Civil and Environmental Engineering, Gdańsk University of Technology, Gdańsk, Poland
| | - Pawel J. Winklewski
- Institute of Human Physiology, Medical University of Gdańsk, Gdańsk, Poland
- Institute of Health Sciences, Pomeranian University of Słupsk, Słupsk, Poland
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16
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Babu J, Shalvoy RM, Behrens SB. Diagnosis and Management of Meniscal Injury. R I Med J (2013) 2016; 99:27-30. [PMID: 27706275] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Meniscal injury is a common cause for presentation to the emergency department or primary care physician's office. Meniscal injuries can be the result of a forceful, twisting event in a young athlete's knee or it can insidiously present in the older patient. Many patients with meniscal pathology appropriately undergo conservative management with a primary care physician while some may need referral to an orthopedist for operative intervention. Arthroscopic surgery to address the menisci is the most frequently performed procedure on the knee and one of the most regularly performed surgeries in orthopedic surgery.1 The purpose of this paper is to help elucidate the diagnosis and management of meniscal pathology resulting in knee pain. [Full article available at http://rimed.org/rimedicaljournal-2016-10.asp].
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Affiliation(s)
- Jacob Babu
- Resident, Department of Orthopaedics, Alpert Medical School of Brown University, Providence, RI
| | - Robert M Shalvoy
- Executive Chief of Orthopedic Surgery & Sports Medicine, Care New England Health System, Assistant Professor of Orthopedic Surgery, Alpert Medical School of Brown University, Providence, RI
| | - Steve B Behrens
- Attending Orthopedic Surgeon, Care New England Health System, Providence, RI
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Mikkelsen S, Brauer C, Pedersen EB, Alkjær T, Koblauch H, Simonsen EB, Helweg-Larsen K, Thygesen LC. A Cohort Study on Meniscal Lesions among Airport Baggage Handlers. PLoS One 2016; 11:e0157336. [PMID: 27299861 PMCID: PMC4907513 DOI: 10.1371/journal.pone.0157336] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 05/28/2016] [Indexed: 11/18/2022] Open
Abstract
Meniscal lesions are common and may contribute to the development of knee arthrosis. A few case-control and cross-sectional studies have identified knee-straining work as risk factors for meniscal lesions, but exposure-response relations and the role of specific exposures are uncertain, and previous results may be sensitive to reporting and selection bias. We examined the relation between meniscal lesions and cumulative exposure to heavy lifting in a prospective register-based study with complete follow-up and independent information on exposure and outcome. We established a cohort of unskilled men employed at Copenhagen Airport or in other companies in the metropolitan Copenhagen area from 1990 to 2012 (the Copenhagen Airport Cohort). The cohort at risk included 3,307 airport baggage handlers with heavy lifting and kneeling or squatting work tasks and 63,934 referents with a similar socioeconomic background and less knee-straining work. Baggage handlers lifted suitcases with an average weight of approximately 15 kg, in total approximately five tonnes during a 9-hour workday. The cohort was followed in the National Patient Register and Civil Registration System. The outcome was a first time hospital diagnosis or surgery of a meniscal lesion. Baggage handlers had a higher incidence of meniscal lesions than the referents. Within baggage handlers spline regression showed that the incidence rate ratio was 1.91 (95% confidence interval: 1.29-2.84) after five years as a baggage handler and then decreased slowly to reach unity after approximately 30 years, adjusted for effects of potential confounders. This relation between baggage handling and meniscal lesions was present for work on the apron which involves lifting in a kneeling or squatting position, but not in the baggage hall, which only involves lifting in standing positions. The results support that long-term heavy lifting in a kneeling or squatting position is a risk factor for the development of symptomatic meniscal lesions.
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Affiliation(s)
- Sigurd Mikkelsen
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
- * E-mail:
| | - Charlotte Brauer
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Ellen Bøtker Pedersen
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Tine Alkjær
- Department of Neuroscience and Pharmacology, University of Copenhagen, Panum Institute, Copenhagen, Denmark
| | - Henrik Koblauch
- Department of Neuroscience and Pharmacology, University of Copenhagen, Panum Institute, Copenhagen, Denmark
| | - Erik Bruun Simonsen
- Department of Neuroscience and Pharmacology, University of Copenhagen, Panum Institute, Copenhagen, Denmark
| | - Karin Helweg-Larsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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