Changes In Articular Surfaces Research Articles

Assessing the Correlation between the Radiological, Macroscopic and Histological Examination of Degenerative Changes of Articular Surfaces in Knee Osteoarthritis with Varus Deformity

Our study aims to compare the results of preoperative radiography and intraoperative visual assessment of the cartilage with histological assessment of joint surfaces of the medial and lateral compartments resected in patients during the total knee replacement. The cohort included 20 patients (9 men and 11 women) with the mean age of 66.6 (±7.0) years who met the inclusion criteria of the study. Degenerative changes of the knee joint seen on a preoperative weight-bearing anteroposterior X-ray were evaluated according to the Kellgren-Lawrence grading system separately for the medial and lateral compartment. Based on the visual appearance, the condition of articular surfaces was assessed using the International Cartilage Repair Society Score (ICRS Grade). The histological assessment of degenerative changes was conducted by a pathologist with the use of the Osteoarthritis Research Society International Osteoarthritis Cartilage Histopathology Assessment System based on six grades of articular cartilage degeneration. The mean degree of degenerative changes based on the radiological classification was assessed as 3.5 (±0.6) for the medial compartment and 2.1 (±0.4) for the lateral compartment. The visually assessed chondropathy according to the ICRS Grade was 3.7 (±0.6) for the medial femoral condyle and 1.8 (±1.0) for the lateral femoral condyle. The histological score obtained using the Osteoarthritis Research Society International Osteoarthritis Cartilage Histopathology Assessment was 4.9 (±1.1) for the medial femoral condyle and 2.4 (±0.7) for the lateral femoral condyle. In respect of the medial compartment, there was no statistically significant parametric correlation between the intraoperative visual assessment of the cartilage degeneration and the preoperative radiological grade r = 0.45. The histological assessment showed a statistically significant concordance both with the degree of chondropathy r = 0.76 and the radiological grade r = 0.64. In the lateral compartment, the parametric test showed a statistically significant concordance only between the radiological grade and the histological score r = 0.72. The correlation between the visual assessment of chondropathy and the radiological grade r = 0.27 as well as the histological score r = 0.24 was very low. In our cohort assessing the early degenerative changes of the lateral compartment as well as the more advanced degenerative changes of the medial compartment, the correlation between the intraoperative assessment of cartilage degeneration as a diagnostic method to examine the lateral compartment and the preoperative radiological grade was not confirmed. Our results failed to confirm a better reporting value of the visual cartilage degeneration assessment of the lateral compartment as against the preoperative X-ray. The space width without narrowing on an X-ray has no reporting value for this compartment in case of varus deformity. The results clearly indicate that the assessment of macroscopic appearance of the cartilage degeneration during arthroscopy does not necessarily guarantee good long-term clinical outcomes after high tibial osteotomy. The respective degrees of cartilage degeneration identified during the intraoperative visual assessment and the radiological grading of osteoarthritic changes did not correlate in either compartment. In the lateral compartment, the initial radiological and histological findings preceded the visually detectable cartilage changes. knee, cartilage, osteoarthritis, radiology, histology, arthroscopy, osteotomy.

Using Nonlinear Vibroartrographic Parameters for Age-Related Changes Assessment in Knee Arthrokinematics.

Changes in articular surfaces can be associated with the aging process and as such may lead to quantitative and qualitative impairment of joint motion. This study is aiming to evaluate the age-related quality of the knee joint arthrokinematic motion using nonlinear parameters of the vibroarthrographic (VAG) signal. To analyse the age-related quality of the patellofemoral joint (PFJ), motion vibroarthrography was used. The data that were subject to analysis represent 220 participants divided into five age groups. The VAG signals were acquired during flexion/extension knee motion and described with the following nonlinear parameters: recurrence rate () and multi-scale entropy (). and decrease almost in a linear way with age (main effects of group ; means (): ; and . The post-hoc analysis showed that there were statistically significant differences () in all comparisons with the exception of the 5th–6th life decade. For , statistically significant differences () occurred for: 3rd–7th, 4th–7th, 5th–7th and 6th life decades. Our results imply that degenerative age-related changes are associated with lower repeatability, greater heterogeneity in state space dynamics, and greater regularity in the time domain of VAG signal. In comparison with linear VAG measures, our results provide additional information about the nature of changes of the vibration dynamics of PFJ motion with age.

Posttraumatic deformities of the bones, forming knee joint: general evaluation and treatment tactics

The aim of paper: to provide modern approach to diagnostics and treatment of deformities localized around knee joint and developed after distal metadiaphysis of femur and proximal metadiaphysis of tibia fractures. It was shown, that formed deformities provoke development of secondary adaptive changes in articular surfaces of knee and its stabilizers, thigh and shin muscles. It also impairs walking. The planning of treatment should be based on proper investigation: radiologic assessment of malaligned extremity and its computer tomography, ultrasound investigation of tendons and muscles, that provide function of knee joint, assess anatomic-functional characteristics of knee joint itself (range of motion, stability, osteoarthritic changes) and malfunction of whole extremity with malaligned segment, including walking ability. Standardized technique of roentgenographic investigation and standard parameters for proper image analysis are provided. The necessity to take into consideration all changes of impaired extremity and segment, but not only the results of roentgenograms assessment, for the working-out of treatment is emphasized. The main treatment goals are: restoration of weight-bearing ability, anatomic or almost anatomic realignment to restore three-dimension orientation of articular surfaces, improvement of walking function. The main types of treatment are: different osteotomies followed with fragments fixation using extrafocal or buried osteosynthesis (intramedullary nailing or plating), restoration of ligamentous structures, arthroplasty or arthrodesis. Main indications for every variant of surgical intervention are listed.

Mind the Gap: How Reference Samples Impact Skeletal Age Estimation in Forensic Casework

Forensic anthropologists are often tasked with determining skeletal age‐at‐death to assist law enforcement in identifying skeletal remains. If the remains are skeletally mature, degenerative changes in articular surfaces are typically assessed to determine age. If the skeleton is immature tooth eruption, dental development, and/or epiphyseal union are used to estimate age. Forensic anthropologists derive an age‐at‐death estimate by comparing our assessment of skeletal age indicator(s) to standards derived from skeletal collections of known age‐at‐death. Prior to the establishment of modern skeletal collections such at the William M. Bass Donated Collection at the University of Tennessee, anthropologists developed age estimation techniques using late 19th and early 20th century anatomical collections (e.g. the Hamann‐Todd Osteology Collection at the Cleveland Museum of Natural History and Terry Anatomical Collection at the Smithsonian Institution). However, research on Bass Collection skeletons has demonstrated remarkable changes in skeletal morphology in modern Americans compared to early 19th century birth cohorts, illustrating that standards derived from modern populations are imperative for forensic casework; anatomical collections and archaeological samples are not appropriate reference samples. Age estimation in forensic casework is further complicated by the age distribution of the forensic case population. Forensic cases often involve accidental deaths, homicides, and suicides of individuals from a younger age demographic than natural deaths which comprise many of the reference samples used to derive age estimates. This difference between the age distribution of the reference sample and that of the “target” population leads to ‘age mimicry’, whereby skeletal age‐at‐death may be under‐estimated. This presentation will highlight research that illustrates the impact of secular change and reference sample composition on the accuracy and precision of forensic skeletal age‐at‐death estimation. The documentation of significant changes in skeletal morphology illustrates what evolutionary biologists already know—phenotype is dynamic, not static. These short‐term evolutionary changes in skeletal form have implications for anatomical research beyond the hard tissues.Support or Funding InformationNational Institute of JusticeThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Age-related impairment of quality of joint motion in vibroarthrographic signal analysis.

Aging is associated with degenerative changes in articular surfaces leading to quantitative and qualitative impairment of joint motion. Therefore, the aim of this study is to evaluate an age-related quality of the patellofemoral joint (PFJ) motion in the vibroarthrographic (VAG) signal analysis. Two hundred and twenty individuals were enrolled in this study and divided into five groups according to age. The VAG signals were collected during flexion/extension knee motion using an acceleration sensor and described using four parameters (VMS, P1, P2, and H). We observed that values of parameters VMS, P1, and P2 increase in accordance with the age, but H level decreases. The most significant differences were achieved between the youngest and the oldest participants' groups. Moreover, we show that parameters VMS, P1, and P2 positively correlate with age, contrary to negatively associated H parameter. Our results suggest that the impairment of joint motion is a result of age-related osteoarticular degenerative changes.

X-Ray Techniques in the Diagnosis of Sacroiliitis in Patients with Ankylosing Spondylitis

Background: The aim of the study was to improve X-ray diagnosis of sacroiliitis in ankylosing spondylitis by using oblique projections. Patients and Methods: The study included 35 patients (26 males, 9 females, aged 1840 years; average age 30.0 + 5.3 years; joint functional failure stage IIV) with bilateral sacroiliitis and 15 control subjects. All the patients had X-ray in the direct and oblique projections. In the direct projection, patient was on his back, and the beam was perpendicular to the surface of the body. In this case, the direction of X-ray beam was at an angle with the joint space. Additionally, we performed X-rays in the oblique projection, for each sacroiliac joint separately, with the patient turning 30 to the horizontal plane. The beam was parallel to the sacroiliac joint space. The width of the joint space, changes of articular surfaces (sclerosis, erosions), and the symmetry of the lesions were analyzed. All findings were verified by CT. Results: On the direct X-ray, bilateral sacroiliitis was found in 38 patients, of them, 33 cases were true positive and 5 were false positive. Two cases were false negative yielding a diagnostic accuracy of88%. On the oblique X- ray, sacroiliitis was noted in 35 patients, of them, 33 cases were true positive and 1 was false positive and three cases were false negative, yielding a diagnostic accuracy of 92%. The sensitivity of the direct projection radiography was 94%, and its specificity was 67%. The sensitivity of the oblique projection was 91% and its specificity was 93%. Conclusions: The oblique X-ray is more informative for the diagnosis of sacroiliitis and assessment of changes in the sacroiliac joints.

Thermosensitive TRP ion channels mediate cytosolic calcium response in human synoviocytes

The transient receptor potential (TRP) channels are important membrane sensors, responding to thermal, chemical, osmotic, or mechanical stimuli by activation of calcium and sodium fluxes. In this study, three distinct TRP channels were detected and their role established in mediating cytosolic free calcium concentration ([Ca(2+)](cyt)) response in tumor-derived SW982 synoviocytes and primary cultures of human synovial cells from patients with inflammatory arthropathies. As shown by fura-2 ratio measurements while cells were incubated in a temperature-regulated chamber, significant [Ca(2+)](cyt) elevation was elicited by rapid changes in bath temperature, application of TRPV1 receptor agonists capsaicin and resiniferatoxin, or a cold receptor stimulator, icilin. Temperature thresholds for calcium response were determined to be 12 +/- 1 degrees C for cold and 28 +/- 2 degrees C for heat activation. Temperature increases or decreases beyond these thresholds resulted in a significant rise in the magnitude of [Ca(2+)](cyt) spikes. Observed changes in [Ca(2+)](cyt) were completely abolished in calcium-free medium and thus resulted from direct calcium entry through TRP channels rather then by activation of voltage-dependent calcium channels. Two heat sensitive channels, TRPV1 and TRPV4, and a cold-sensitive channel, TRPA1, were detected by RT-PCR. Minimal mRNA for TRPV3 or TRPM8 was amplified. The RT-PCR results support the data obtained with the [Ca(2+)](cyt) measurements. We propose that the TRP channels are functionally expressed in human synoviocytes and may play a critical role in adaptive or pathological changes in articular surfaces during arthritic inflammation.

Three-dimensional and two-dimensional computerized tomographic demonstration of calcaneus fractures.

The objective of the study was to illustrate the diagnostic quality of three-dimensional computed tomography (3DCT) and to document its usefulness for detecting gross changes in articular surfaces of the calcaneus and posterior articular facet (PAF). Superior view 3DCT images of 51 calcanei in 39 different patients were reviewed based on bony fragments produced by primary fracture lines and involvement of the PAF. Of 49 intraarticular fractures examined, there were two severely comminuted and 47 comminuted fractures. Main characteristics of both groups were described. Important findings best seen on 3DCT images were the number and configuration of displaced PAF fragments, fracture lines separating the anterior process and the middle facet, and the extension of fracture lines into the calcaneocuboid facet. The double density sign seen in plain x-rays was identified as a double articular sign in 3DCT images.