Degree Of Cartilage Damage Research Articles

Changes of bone remodeling, cartilage damage and apoptosis-related pathways in broilers with femoral head necrosis 1

Femoral head necrosis (FHN) is a common leg disorder in the poultry industry often leads to significant cartilage damage. The mechanism behind abnormal apoptosis in FHN broilers, leading to cartilage damage, remains unclear; although endoplasmic reticulum stress (ERS) has been found to play a role in glucocorticoid-induced FHN broilers. In this study, we collected samples from broilers with femoral head separation (FHS) and femoral head separation accompanied with growth plate lacerations (FHSL) in a broiler farm. The aim was to investigate the potential association between the severity of FHN, bone remodeling and cartilage damage. Additionally, primary chondrocytes were treated with methylprednisolone (MP) to construct an in vitro FHN model, followed by inhibition or activation of ERS or hypoxia inducible factor-1α (HIF-1α) to further investigate the mechanism of apoptosis in cartilage. The results suggested that cartilage appeared to be the appropriate tissue to investigate the potential mechanisms of FHN, as the degree of cartilage damage was found to be closely related to the severity of the disease. Bone quality was only affected in FHSL broilers, although factors related to bone metabolism were significantly altered among FHN-affected broilers. In addition, cartilage in FHN-affected broilers exhibited high levels of apoptosis and upregulated expression of ERS-related and HIF-1α, which was consistent with both in vivo and in vitro findings after MP treatment. The results were further supported by treatment with HIF-1α or ERS inhibition or activation. In conclusion, bone remodeling and cartilage homeostasis were affected in FHN broilers, but only cartilage damage was significantly exacerbated with FHN development. Moreover, activation of ERS or HIF-1α resulted in apoptosis in cartilage, thus exhibiting a significant correlation with FHN severity.

Analysis of the correlation between media meniscus displacement index and medial tibiofemoral articular cartilage damage

To investigate the correlation between the medial meniscal indentation index (MDI) and medial tibiofemoral articular cartilage damage more than 3 degrees in patients aged 40 to 60 years old with suspected or complicated knee osteoarthritis at non-weight-bearing position, and to determine the predictive threshold. From June 2016 to June 2020, a total of 308 patients who underwent initial knee arthroscopic exploration for chronic knee pain were collected. The age ranged from 36 to 71 years old with an average of(56.40±1.82) years old, including 105 males and 203 females. And patients with extra-articular malformations (abnormal force lines), a history of trauma, inflammatory arthritis and other specific arthritis were excluded. Finally, 89 eligible cases were obtained, aged from 42 to 60 years old with an average of (59.50±0.71) years old, including 45 males and 44 females. The degree of cartilage damage in the medial compartment of the knee joint was recorded, which was divided into two groups(≥degree 3 and<degree 3) according to Outer-Bridge classification system. The possible risk factors were determined by univariate analysis in the age, gender, affected sides, body mass index (BMI), synovial thickening grade, meniscus injury and MDI of 2 groups. Then, the independent risk factors for cartilage injury of more than grade 3 were determined by further binary Logistic regression analysis. If MDI was taken as an independent risk factor, receiver operating characteristic (ROC) analysis was performed to confirm whether it had diagnostic value for cartilage damage of above degree 3 and calculate the critical value of MDI. A total of 89 eligible patients were obtained. Univariate analysis showed age, BMI, MDI and meniscus injury may be the independent risk factors for cartilage damage of more than 3 degrees, further binary Logistic regression analysis confirmed that MDI[OR=1.66, 95%CI(1.64, 1.69), P=0.01]and BMI [OR=1.58, 95%CI(1.17, 2.15), P=0.03] were independent risk factors for cartilage injury of more than degree 3 in enrolled patients. ROC analysis showed that MDI had more diagnostic value than BMI, and the critical value was 0.355 with a sensitivity of 89.1% and a specificity of 88.2%. In doubt or accompanied by 40 to 60 years old patients with knee osteoarthritis, the MDI measured by non-weight-bearing knee MRI has predictive value for cartilage injury of more than degree 3 in medial tibiofemoral joint, and the critical value for diagnosis of cartilage injury of more than degree 3 is 0.355.

Risk Factors for Graft Failure After Meniscal Allograft Transplantation: A Systematic Review and Meta-analysis

Background: Graft failure after meniscal allograft transplantation (MAT) may necessitate revision surgery or conversion to arthroplasty. A comprehensive understanding of the risk factors for failure after MAT of the knee may facilitate more informed shared decision-making discussions before surgery and help determine whether MAT should be performed based on patient risk. Purpose: To perform a systematic review and meta-analysis of risk factors associated with graft failure after MAT of the knee. Study Design: Systematic review; Level of evidence, 4. Methods: The PubMed, OVID/Medline, and Cochrane databases were queried in October 2021. Data pertaining to study characteristics and risk factors associated with failure after MAT were recorded. DerSimonian-Laird binary random-effects models were constructed to quantitatively evaluate the association between risk factors and MAT graft failure by generating effect estimates in the form of odds ratios (ORs) with 95% CIs. Qualitative analysis was performed to describe risk factors that were variably reported. Results: In total, 17 studies including 2184 patients were included. The overall pooled prevalence of failure at the latest follow-up was 17.8% (range, 3.3%-81.0%). In 10 studies reporting 5-year failure rates, the pooled prevalence of failure was 10.9% (range, 4.7%-23%). In 4 studies reporting 10-year failure rates, the pooled prevalence was 22.7% (range, 8.1%-55.0%). A total of 39 risk factors were identified, although raw data presented in a manner amenable to meta-analysis only allowed for 3 to be explored quantitatively. There was strong evidence to support that an International Cartilage Regeneration &amp; Joint Preservation Society grade &gt;3a (OR, 5.32; 95% CI, 2.75-10.31; P &lt; .001) was a significant risk factor for failure after MAT. There was no statistically significant evidence to incontrovertibly support that patient sex (OR, 2.16; 95% CI, 0.83-5.64; P = .12) or MAT laterality (OR, 1.11; 95% CI, 0.38-3.28; P = .85) was associated with increased risk of failure after MAT. Conclusion: Based on the studies reviewed, there was strong evidence to suggest that degree of cartilage damage at the time of MAT is associated with graft failure; however, the evidence was inconclusive on whether laterality or patient sex is associated with graft failure.

Estrogen alleviates post-traumatic osteoarthritis progression and decreases p-EGFR levels in female mouse cartilage

ObjectiveTo investigate the effect of estrogen on the progression of post-traumatic osteoarthritis (PTOA) in mice and its possible mechanism.MethodsTwelve-week-old ICR mice were divided into Group A (female control group), group B (ovariectomized(OVX) group), group C (OVX group supplemented with estrogen), and group D (male group) by destabilization of the medial meniscus (DMM)or sham operation. Safranin O staining was performed at 8 weeks and 12 weeks after operation, and the degree of articular cartilage lesion was evaluated using Mankin score. Twelve weeks after the operation, tissue sections were stained to analyze the matrix metalloproteinase 13(MMP13), phosphorylated epidermal growth factor receptor (p-EGFR) expression and apoptosis of chondrocytes.ResultsDecreased estrogen can significantly increase the weight of mice in female mice. The degree of cartilage damage in the knee joint on the DMM side of female mice was significantly severer than that on the Sham side. The DMM side also showed higher MMP13 expression and increased apoptotic chondrocytes. The degree of cartilage damage in the knee joint on the DMM side of female mice was significantly reduced after estrogen supplementation, and cartilage damage in the knee joint on the DMM side of female mice was less serious than that of male mice. As estrogen levels decreased, the severity of cartilage erosion in the knee joint on the DMM side was aggravated, and p-EGFR expression in the cartilage surface was also higher in female mice contrast to that in male mice. However, minimal changes in p-EGFR expression in the cartilage surface of bilateral knee joints of male mice were observe.ConclusionEstrogen has a regulatory effect on PTOA and its inhibits the expression of p-EGFR in cartilage on the knee joint surface and has a protective effect on articular cartilage in female mice.

Effects of different courses of moxibustion treatment on intestinal flora and inflammation of a rat model of knee osteoarthritis

ObjectiveThis study was done to determine the effects of different courses of moxibustion on a rat knee osteoarthritis (KOA) model, and explore the dose–effect relationship of moxibustion on KOA from the perspectives of intestinal flora and inflammatory factors. MethodsWistar rats were randomly divided into five groups: normal, model, moxibustion for 2 weeks, moxibustion for 4 weeks and moxibustion for 6 weeks groups (n = 5 each group). A KOA rat model was induced by monosodium iodoacetate, and moxibustion intervention was performed at the acupoints “Dubi” (ST35) and “Zusanli” (ST36), once every other day. Pathologic changes in the cartilage of rat knee joints were assessed after intervention, and fecal samples were subjected to 16S rRNA high-throughput sequencing for microbial diversity analysis. ResultsDamage to the knee articular cartilage was obvious in the model group, which also had increased levels of pro-inflammatory factors, decreased levels of anti-inflammatory factors, and intestinal flora disorders with decreased diversity. The degree of cartilage damage in the 4 and 6 weeks of moxibustion groups was significantly improved compared with the model group. The 4 and 6 weeks of moxibustion groups also demonstrated reduced levels of interleukin-1β and tumor necrosis factor-α and increased levels of interleukin-10 (P < 0.05). Both the abundance and diversity of the intestinal flora were increased, approaching those of the normal group. Abundances of probiotics Eubacterium coprostanoligenes group and Ruminococcaceae UCG-014 increased, while that of the pathogenic bacteria Lachnospiraceae NK4A136 group decreased (P < 0.05). Although the abundance of Lachnospiraceae NK4A136 group decreased in the 2 weeks of moxibustion group compared with the model group (P < 0.05), there was no statistically significant difference in serum inflammatory factors, flora species diversity or degree of pathological damage compared with the model group. ConclusionMoxibustion treatment led to significant improvements in the intestinal flora and inflammatory factors of rats with KOA. Moxibustion treatment of 4 and 6 weeks led to better outcomes than the 2-week course. Moxibustion for 4 and 6 weeks can regulate intestinal flora dysfunction with increased probiotics and reduced pathogenic bacteria, reduce pro-inflammatory factors and increase anti-inflammatory factors. No significant differences were seen between the effects of moxibustion for 4 weeks and 6 weeks.

Risk factors for the postoperative effect of symptomatic discoid lateral meniscus after arthroscopy

To explore the influencing factors of the postoperative effect of arthroscopic treatment of symptomatic discoid lateral meniscus (DLM). From September 2008 to September 2015, patients with symptomatic DLM treated by arthroscopic surgery were retrospectively analyzed. The knee function was evaluated by Lysholm scoring system. According to the scoring results, it was divided into excellent (≥90 points), good (80 to 89 points), fair (70 to 79 points) and poor (<70 points). Sixteen research factors were collected, namely gender, operation age, body mass index, work intensity, symptom duration, history of knee injury, involved knee side, DLM classification, DLM injury type, DLM injury site, medial meniscus injury, knee cartilage injury site and degree, Kellgren-Lawrence (K-L) classification, operation method, and latest follow-up time. According to the data type, Kruskall-Wallis rank sum test or χ2 test was used for univariate analysis, and ordinal Logistic regression model was used for multivariate analysis. Univariate analysis showed that the statistically significant factors were included in the multivariate analysis model, and the independent risk factors influencing the curative effect of symptomatic DLM were obtained. According to the inclusion and exclusion criteria, 502 patients were included. Lysholm functional grade at the latest follow-up was higher than that before operation (P<0.001). Univariate analysis showed that there were significant differences in gender, body mass index, work intensity, history of knee injury, age of operation, duration of symptoms, medial meniscus injury, K-L grade, operation method, location and degree of knee cartilage injury among Lysholm functional grades(P<0.05). Ordinal logistic regression analysis showed that female was an independent risk factor for postoperative efficacy (P=0.002, OR=0.370);body mass index (P=0.007, OR=0.894), work intensity(P=0.004, OR=0.525), age of operation(P<0.001, OR=0.953), duration of symptoms(P<0.001, OR=0.989), degree of cartilage damage (P=0.016, OR=0.631) were negatively correlated with Lysholm knee function classification. Arthroscopy is a safe and effective method for the treatment of symptomatic DLM. The gender, body mass index, work intensity, age of operation, duration of symptoms and degree of knee cartilage injury are independent influencing factors for the postoperative efficacy of symptomatic DLM.

Features of Arthrosis of the Shoulder Joint in the Conditions of Initially Realized Shoulder Instability and in Case of its Combination with Damage to the Rotator Cuff According to Magnetic Resonance Imaging and Arthroscopy

Relevance. Osteoarthritis (OA) leads to functional limitation and reduced quality of life; it is a major cause of pain and disability. Currently, there is a relatively small number of radiological studies concerning the features of OA of the shoulder joint (SJ) provoked by the realized instability and its combination with damage to the tendons of the rotator cuff (RC) of the shoulder.&#x0D; Objective: to study the features of the manifestations and course of SJ OA in the conditions of initially realized isolated instability in combination with damage to the tendons of the RC according to magnetic resonance imaging (MRI) and arthroscopy.&#x0D; Materials and Methods. The MRI and arthroscopy data of 75 patients with isolated Bankart lesion and combination with RC tendon damage were retrospectively analyzed. The results of the MRI examination were independently assessed by 2 radiologists with 8 and 10 years of experience. Arthroscopic diagnosis was performed at the beginning of the reconstructive stage by a standard examination from 21 points. The degree of articular cartilage damage on MRI was determined according to the adapted classification of R. Outerbridge.&#x0D; Results. In Bankart lesion, sites of chondromalacia of the glenoid cavity cartilage can be detected in the form of a linear or curvilinear hyperintensive MR signal on PDfs in the cartilage thickness or as its marginal defect. The thickness of the cartilage in primary dislocations is generally preserved. When instability is combined with RC tendon damage, the degree of cartilage damage is much greater with a decrease in its thickness. The largest area of cartilage damage is observed when 2 or more RC tendons are damaged.&#x0D; Conclusions. Primary SJ dislocation is not always accompanied by damage to the articular cartilage. The MR-semiotics of SJ OA in primary dislocation and in a combination with damage to the tendons of RC has the corresponding features. Delaying the restoration of stability in the shoulder joint with the help of surgical treatment is an unfavorable prognostic factor in the development of rheumatoid arthritis and OA SJ. Realized instability in combination with damage to the rotator cuff is an extremely aggravating prognostic factor for OA, as it adds an additional pathophysiological factor in the form of rotational arthropathy.

CHARACTERISTICS OF KNEE JOINT’S ULTRASOUND AND MAGNETIC RESONANCE IMAGING ON PATENTS WITH PRIMARY KNEE OSTEOARTHRITIS

Objectives: Describing the characteristics of ultrasound and magnetic resonance imaging of knee joints in patients with primary knee osteoarthritis.Subjects and methods: Prospective, descriptive, cross-sectional study on patients diagnosed with primary knee osteoarthritis who were examined as an outpatient or inpatient at 108 Military CentralHospital.Results: Ultrasound features: 100% articular cartilage damage, 87.8% bone spurs, 73.0% effusion, 9.3% popliteal cocoon, 3.4% synovial thickening. Degree of cartilage damage according toSaarakkala: grade 1: 2.1%, grade 2A: 63.7%, grade 2B: 29.1%, grade 3: 5.1%. Magnetic resonance characteristics: 100% articular cartilage damage, 96.3% bone spurs, 90.6% effusion, 84.1% bonemarrow edema, 69.2% bone cocoon, 61.7% meniscus tear, popliteal cocoon 11.3%. osteoarthritis lesions were more common in the medial femoral and tibial joints than in the lateral tibial and patellar joints.Conclusion: Cartilage damage, bone spurs, and effusion were common lessions on ultrasound and magnetic resonance imaging on patients with knee osteoarthritis.

Spectroscopic photoacoustic imaging of cartilage damage

Osteoarthritis (OA) is a chronic joint disease characterized by progressive degradation of cartilage. It affects more than 10% of the people aged over 60 years-old worldwide with a rising prevalence due to the increasingly aging population. OA is a major source of pain, disability, and socioeconomic cost. Currently, the lack of effective diagnosis and affordable imaging options for early detection and monitoring of OA presents the clinic with many challenges. Spectroscopic Photoacoustic (sPA) imaging has the potential to reveal changes in cartilage composition with different degrees of damage, based on optical absorption contrast. In this study, the capabilities of sPA imaging and its potential to characterize cartilage damage were explored. To this end, 15 pieces of cartilage samples from patients undergoing a total joint replacement were collected and were imaged ex vivo with sPA imaging at a wide optical spectral range (between 500nm and 1,300nm) to investigate the photoacoustic properties of cartilage tissue. All the PA spectra of the cartilage samples were analyzed and compared to the corresponding histological results. The collagen related PA spectral changes were clearly visible in our imaging data and were related to different degrees of cartilage damage. The results are in good agreement with histology and the current gold standard, i.e., the Mankin score. This study demonstrates the potential and possible clinical application of sPA imaging in OA.

Synovial Fluid Biomarkers Used to Predict the Degree of Articular Cartilage Injury in the Knee

Injury-driven changes to the intra-articular microenvironment are thought to initiate the development of post-traumatic osteoarthritis. The purpose of this study was to evaluate the accuracy with which synovial fluid and clinical data can predict the presence of high-grade cartilage lesions following intra-articular injury. Synovial fluid aspirate, collected immediately prior to surgical incision from prospectively enrolled patients, was processed using a multiplex magnetic bead immunoassay to determine the concentration of 10 pre-determined cytokines and chemokines. The degree of cartilage injury was assessed intraoperatively using ICRS grading. Logistic regression models were built to predict the presence of high-grade cartilage lesions based on clinical and biomarker data. The models were validated using repeated k-fold cross-validation, and accuracy and quality were assessed using likelihood-ratio tests. 249 patients (mean age: 41.42+/-14.02 years) were enrolled. These patients either had isolated ACL injuries (N=37), isolated meniscus injuries (N=118), combined ACL-meniscus injuries (N=76), or focal chondral lesions (N=18). Four logistic regression models were compared (Table 1). The full model, with 10 synovial fluid biomarker concentrations, age, BMI, and duration of time between injury and surgery, was found to predict high-grade ICRS cartilage damage with 85.71% accuracy. The isolated-biomarker model, consisting of all 10 biomarker concentrations, was found to have a 71.43% prediction accuracy. The isolated-clinical model was found to have a 71.43% prediction accuracy. The stepwise model, consisting of 6 biomarkers and the clinical variables, was found to predict high-grade ICRS cartilage damage with 83.67% accuracy. Through likelihood ratio testing, the stepwise model was confirmed to be superior to the other models. This study demonstrates that the combination of clinical variables and 6 synovial fluid biomarkers can be used to accurately predict high-grade cartilage lesions following intra-articular injury. This suggests that there are distinct inflammatory phenotypes among different degrees of cartilage damage with potential prognostic benefit.

Interleukin-1-Interleukin-17 Signaling Axis Induces Cartilage Destruction and Promotes Experimental Osteoarthritis.

Osteoarthritis (OA), which is the most common degenerative joint disorder, has been considered a non-inflammatory disease with abnormal mechanics. Interleukin (IL)-17 is a pleiotropic cytokine involved in inflammatory diseases and their production is driven by the cytokine including IL-1 and IL-23. However, little is known about the mechanism of IL-17 in the development of OA. Here, we investigated the role of IL-17 in the pathogenesis of OA using monosodium iodoacetate (MIA)-injected IL-17 and IL-1 receptor antagonist (IL-1Ra) double-deficient mice. In MIA-injected IL-1Ra KO mice, nociceptive properties, degree of cartilage damage, and the level of inflammatory factors in articular cartilage were increased compared to MIA-injected wild-type mice. Interestingly, the intestinal architecture was impaired in IL-1Ra KO mice compared to wild-type mice and the damage was further exacerbated by MIA injection. Deficiency of IL-17 reduced nociceptive properties and cartilage destruction, as well as inflammation-related factors in MIA-injected IL-1Ra KO mice compared to MIA-injected wild-type mice. Furthermore, IL-17-treated chondrocytes from OA patients showed enhanced expression of catabolic factors that are involved in the destruction of cartilage in OA. IL-17 accelerates the destruction of cartilage and small intestine via regulation of several inflammatory mediators in an OA murine model. These results suggest that IL-17 plays a critical role in the development of OA.

The Intra-Articular Hematoma Immediately after Ankle Fracture Causes Cartilage Damage That is Partially Attenuated by Anti-Inflammatory Agents

Category:Ankle Arthritis; Basic Sciences/BiologicsIntroduction/Purpose:Post-traumatic osteoarthritis (PTOA) is a frequent cause of disability. The most common predisposing factor for ankle PTOA is intra-articular ankle fracture. It has been hypothesized that an early inflammatory response after intra- articular injury could lead to cartilage damage. Our group recently demonstrated significantly elevated inflammatory cytokines in the synovial fluid fracture hematoma (SFFH) immediately after intra-articular ankle fracture. The negative effect that this inflammatory environment has on cartilage is unknown but may be the reason for PTOA development. The purpose of this study was to determine if cartilage occurred when exposed to intra-articular SFFH and if anti-inflammatory agents could attenuate this damage.Methods:SFFH was obtained from 52 intra-articular ankle fractures at the time of surgery. Samples were divided into three groups based on time from fracture: acute (0-2 days), intermediate (3-9 days), late (>=10 days). A biopsy punch was used to create 5mm cartilage discs from the medial and lateral shoulders of fresh human talus cartilage. The cartilage discs were weighed and cultured in standard chondrocyte media (SCM) for 3 days. Next, the discs were randomly assigned to one of 4 groups (n=10 each) and cultured as follows for 6 days: A=control, SCM only; Group B=acute SFFH+SCM; Group C=intermediate SFFH+SCM; Group D=late SFFH+SCM. After 6 days of culture, the discs were rinsed and transferred to new wells and cultured for 3 more days in SCM only, to determine inflammatory cytokine and MMP release from the cartilage discs (cartilage damage). The post SFFH spent culture media was collected. The initial and post SFFH culture spent media were analyzed for inflammatory cytokines, MMPs, CTXII (cartilage breakdown marker), and sGAG. Safranin-O staining was then performed on the discs. The initial and post SFFH media from groups A, B, C, and D were compared to determine if there was a difference in damage caused by SFFH based on time from fracture. Based on the results, Group B (early) was felt to cause the most damage. Therefore, the following treatment groups were created and cultured exactly as before: Group E=same as Group B + IL-1Ra treatment; Group F=same as Group B + doxycycline treatment. Groups B, E, and F were compared to determine if the addition of IL-1Ra or doxycycline (known MMP inhibitor) attenuated the damage.Results:Early, intermediate, and late SFFH all caused some degree of cartilage damage in the form of significantly elevated inflammatory cytokine and MMP production from the cartilage discs (Figure 1). The early SFFH (Group B) was noted to cause significantly elevated production of IL-6, IL-8, CTXII, and decreased safranin-O staining. Therefore, it was chosen to compare with the therapeutic anti-inflammatory agents. The addition of IL-1Ra or doxycycline significantly reduced the production of IL-6, IL-8, CTXII, and MMPs 3, 9, and 10 (Figure 2).Conclusion:This is the first study to show that intra-articular hematoma immediately after ankle fracture causes cartilage damage that can be partially attenuated by current clinically available therapeutic agents. Additionally, further research should be performed regarding the safety and efficacy of anti-inflammatory agents to prevent ankle PTOA.

The tibial spine sign does not indicate cartilage damage in the central area of the distal lateral femoral condyle.

A radiographic overlap of the lateral femoral condyle and the lateral tibial spine ('tibial spine sign') might indicate lateral compartment cartilage damage and might be considered a contraindication for unicompartmental knee arthroplasty (UKA). Therefore, the following research questions were asked: (1) does the presence of a 'tibial spine sign' on radiographs correlate with cartilage lesions on the medial aspect of the lateral femoral condyle on corresponding MRIs?; (2) do cartilage lesions on the medial aspect of the lateral femoral condyle indicate cartilage damage in the central area of the distal lateral femur?; and 3) is the 'tibial spine sign' impacted by the degree of varus deformity, the amount of coronal tibiofemoral subluxation or the functional status of the ACL? One hundred consecutive knees with varus OA in 84 patients were prospectively included. The relationship of the lateral femoral condyle and the tibial spine was graded from 0 to 2 based on the degree of overlap on AP standing knee radiographs. On MRI, cartilage on the medial aspect of the lateral femoral condyle was assessed. Cartilage in the weight-bearing area of the distal lateral femur was analysed according to the OARSI system. The 'tibial spine sign' assessment correlated well with the degree of cartilage damage on the medial aspect of the lateral condyle (rs = 0.7, p < 0.001) but did not impact histological OARSI grades in the central weight bearing area of the lateral condyle (n.s.). Mechanical varus and tibiofemoral subluxation were not associated (n.s.) with a positive tibial spine sign. Knees with suggestive ACL insufficiency on MRI had more often a positive tibial spine sign; however, this difference was not statistically significant (n.s.). A positive tibial spine sign does not indicate histologic cartilage damage in the central area of the distal lateral femur and may not be considered a contraindication for medial UKA. Level III, diagnostic study.

The impact of glenoid labrum damages on condition of the cartilage of the shoulder joint

The joint labrum is an anatomical structure of the shoulder joint, one of the functions of which is to ensure the stability of the shoulder. It has been proven that instability, direct trauma and surgery of any joint eventually lead to cartilage damage and osteoarthritis. It is still unknown whether and how the damage to the joint labrum affect the condition of the cartilage of the shoulder joint. Aim of study – investigation of impact of glenoid labrum damages on condition of the cartilage of the shoulder joint. For the period from 2006 to 2016, on the basis of State Institution “Institute of Traumatology and Orthopedics of AMS of Ukraine”, MC “Modern Orthopedics”, Kyiv, a study was conducted on an array of 467 patients. Used clinical diagnostics, MRI diagnostics, arthroscopic diagnostics. Fact verification and localization of joint damage was performed during arthroscopic examination. Localization of cartilage damage was divided into separate areas on the articular surfaces of the shoulder scapula and head. The degree of cartilage damage was classified by Outerbridge. Quantitative analysis of the results was performed using Microsoft Excel in the summary tables. It has been found that damage to the shoulder labrum is the cause of cartilage defects in the joint surfaces of the shoulder. The incidence and severity of cartilage defects increase over time since the injury. The worst prognosis for the development of damage to the articular cartilage is characteristic of patients with damage to the posterior part of the labrum. Thus, damage to the joint labrum is a significant factor in the occurrence of defects in the articular cartilage of the shoulder. Early active surgical tactics for the treatment of damage to the joint labrum are necessary to prevent deterioration of the condition of the joint surfaces and the prevention of osteoarthrosis.

Return to racing after surgical management of third carpal bone slab fractures in thoroughbred and standardbred racehorses.

To determine the prognosis for racing of horses surgically treated for slab fractures of the third carpal bone (C3). Retrospective case study. Horses (n = 125) surgically treated for C3 slab fractures. Medical records of horses surgically treated for dorsal or sagittal C3 fractures were reviewed for age, sex, breed, limb, fracture type, degree of cartilage damage, and surgical treatment. Radiographs were evaluated to determine fracture depth, width, and displacement. Osteophytes, C3 lysis, and fragmentation were scored. Racing performance was obtained from online databases. Univariable and multivariable analyses were used to determine associations between independent variables and outcomes. Fifty-four (43%) horses raced postoperatively. Among thoroughbreds, 35% (30/86) with dorsal fractures and 63% (17/27) with sagittal fractures raced postoperatively. Among standardbreds, 77% (10/13) with dorsal fractures and 0% (0/2) with sagittal fractures raced postoperatively. Fracture displacement, C3 lysis, and cartilage damage affected the likelihood of racing postoperatively. Placement of 3.5-mm screws vs 4.5-mm screws and the placement of fewer screws were associated with improved likelihood of racing. The prognosis for postoperative racing of thoroughbreds with dorsal C3 fractures was less favorable than that previously reported. Concurrent joint pathology, such as cartilage damage at time of surgery, affected the ability of the horse to race postoperatively. Although internal fixation of C3 slab fractures is required to restore joint congruity, return to racing should be expected in only 42% of thoroughbreds and 67% of standardbreds.

Synovial fluid proteome changes in ACL injury-induced posttraumatic osteoarthritis: Proteomics analysis of porcine knee synovial fluid.

Surgical transection of the anterior cruciate ligament (ACL) in the porcine model leads to posttraumatic osteoarthritis if left untreated. However, a recently developed surgical treatment, bridge-enhanced ACL repair, prevents further cartilage damage. Since the synovial fluid bathes all the intrinsic structures of knee, we reasoned that a comparative analysis of synovial fluid protein contents could help to better understand the observed chondroprotective effects of the bridge-enhanced ACL repair. We hypothesized that post-surgical changes in the synovial fluid proteome would be different in the untreated and repaired knees, and those changes would correlate with the degree of cartilage damage. Thirty adolescent Yucatan mini-pigs underwent unilateral ACL transection and were randomly assigned to either no further treatment (ACLT, n = 14) or bridge-enhanced ACL repair (BEAR, n = 16). We used an isotopically labeled high resolution LC MS/MS-based proteomics approach to analyze the protein profile of synovial fluid at 6 and 12 months after ACL transection in untreated and repaired porcine knees. A linear mixed effect model was used to compare the normalized protein abundance levels between the groups at each time point. Bivariate linear regression analyses were used to assess the correlations between the macroscopic cartilage damage (total lesion area) and normalized abundance levels of each of the identified secreted proteins. There were no significant differences in cartilage lesion area or quantitative abundance levels of the secreted proteins between the ACLT and BEAR groups at 6 months. However, by 12 months, greater cartilage damage was seen in the ACLT group compared to the BEAR group (p = 0.005). This damage was accompanied by differences in the abundance levels of secreted proteins, with higher levels of Vitamin K-dependent protein C (p = 0.001), and lower levels of Apolipoprotein A4 (p = 0.021) and Cartilage intermediate layer protein 1 (p = 0.049) in the ACLT group compared to the BEAR group. There were also group differences in the secreted proteins that significantly changed in abundance between 6 and 12 months in ACLT and BEAR knees. Increased concentration of Ig lambda-1 chain C regions and decreased concentration of Hemopexin, Clusterin, Coagulation factor 12 and Cartilage intermediate layer protein 1 were associated with greater cartilage lesion area. In general, ACLT knees had higher concentrations of pro-inflammatory proteins and lower concentrations of anti-inflammatory proteins than BEAR group. In addition, the ACLT group had a lower and declining synovial concentrations of CILP, in contrast to a consistently high abundance of CILP in repaired knees. These differences suggest that the knees treated with bridge-enhanced ACL repair may be maintaining an environment that is more protective of the extracellular matrix, a function which is not seen in the ACLT knees.

Talar process fractures: An overview and update of the literature.

Fractures of the lateral and the posterior processes of the talus are uncommon and frequently missed because of a low level of suspicion and difficulty in interpretation on plain radiographs. Missed fractures can lead to persistent pain and reduced function.Lateral process fractures are usually a consequence of forced dorsiflexion and inversion of fixed pronated foot. These are also commonly known as snowboarder’s fractures.The posterior process of the talus is composed of medial and lateral tubercles, separated by the groove for the flexor hallucis longus tendon.The usual mechanism of injury is forced hyperplantarflexion and inversion causing direct compression of the posterior talus, or an avulsion fracture caused by the posterior talofibular ligament. CT scans are helpful in cases of high clinical suspicion.There is a lack of consensus regarding optimal management of these fractures; however, management depends on the size, location and displacement of the fragment, the degree of cartilage damage and instability of the subtalar joint. Non-operative treatment includes immobilization and protected weight-bearing for six weeks. Surgical treatment includes open reduction and internal fixation or excision of the fragments, depending on the size.Fractures of the lateral and the posterior processes of the talus are uncommon but important injuries that may result in significant disability in cases of missed diagnosis or delayed or inadequate treatment. Early diagnosis and timely management of these fractures help to avoid long-term complications, including malunion, nonunion or severe subtalar joint osteoarthritis.Cite this article: EFORT Open Rev 2018;3:85-92. DOI: 10.1302/2058-5241.3.170040

MiR-300 Serves as Potential Biomarker to Screen Knee Osteoarthritis Patients by Targeting TNFα.

This study mainly explored the serum level of miR-300 with the risk of knee OA, thereby evaluating their diagnostic ability for treatment of knee osteoarthritis (KOA) patients. In the current study, we evaluated the level of TNFα in KOA patients and HCs. The serum was used to quantify the level of TNF-α by way of a sandwich enzyme-linked immunosorbent assay. Dual luciferase reporter assay was carried out to identify the possible target gene of miR-300. In line with previous studies, our data showed that serum TNFα level was increased along with K/L grades and WOMAC scoring, suggesting TNFα induced inflammatory responses correlating with the severity of KOA. We also showed that serum miR-300 level was increased with the severity of KOA according to X ray examination and K/L grades. Furthermore, we showed that serum miR-300 level positively correlated with K/L grades, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scoring and WOMAC function scoring. Bioinformatic predictions showed a conserved binding site of miR-300 in the 3'UTR of IκBα. We then carried out a dual luciferase reporter assay and found miR-300 significantly suppressed pmirGLO-IκBα-3'UTR luciferase activity. Serum miR-300 is increased with the severity of KOA according to X-ray examination and K/L grades, thereby reflecting the severity of KOA and the degree of cartilage damage. Therefore, it could be used as a potential biomarker to screen KOA patients from healthy controls.

An Experimental and Finite Element Protocol to Investigate the Transport of Neutral and Charged Solutes across Articular Cartilage.

Osteoarthritis (OA) is a debilitating disease that is associated with degeneration of articular cartilage and subchondral bone. Degeneration of articular cartilage impairs its load-bearing function substantially as it experiences tremendous chemical degradation, i.e. proteoglycan loss and collagen fibril disruption. One promising way to investigate chemical damage mechanisms during OA is to expose the cartilage specimens to an external solute and monitor the diffusion of the molecules. The degree of cartilage damage (i.e. concentration and configuration of essential macromolecules) is associated with collisional energy loss of external solutes while moving across articular cartilage creates different diffusion characteristics compared to healthy cartilage. In this study, we introduce a protocol, which consists of several steps and is based on previously developed experimental micro-Computed Tomography (micro-CT) and finite element modeling. The transport of charged and uncharged iodinated molecules is first recorded using micro-CT, which is followed by applying biphasic-solute and multiphasic finite element models to obtain diffusion coefficients and fixed charge densities across cartilage zones.

Anti-IL-20 monoclonal antibody inhibited inflammation and protected against cartilage destruction in murine models of osteoarthritis.

Osteoarthritis (OA) is a degenerative joint disease characterized by progressive destruction of articular cartilage. Interleukin (IL)-20 is a proinflammatory cytokine involved in the pathogenesis of rheumatoid arthritis. We investigated the role of IL-20 in OA and evaluated whether anti-IL-20 antibody (7E) treatment attenuates disease severity in murine models of surgery-induced OA. Immunohistochemical staining was used to detect IL-20 and its receptors expression in synovial tissue and cartilage from OA patients, and in OA synovial fibroblasts (OASFs) and chondrocytes (OACCs) from rodents with surgery-induced OA. RTQ-PCR and western blotting were used to determine IL-20-regulated OA-associated gene expression in OASFs and OACCs. OA rats and OA mice were treated with 7E. Arthritis severity was determined based on the degree of cartilage damage and the arthritis severity score. We found that IL-20 and its receptors were expressed in OASFs and OACCs. IL-20 induced TNF-α, IL-1β, MMP-1, and MMP-13 expression by activating ERK-1/2 and JNK signals in OASFs. IL-20 not only upregulated MCP-1, IL-6, MMP-1, and MMP-13 expression, but also downregulated aggrecan, type 2 collagen, TGF-β, and BMP-2 expression in OACCs. Arthritis severity was significantly lower in 7E-treated OA rats, and 7E- or MSC-treated OA mice. Therefore, we concluded that IL-20 was involved in the progression and development of OA through inducing proinflammatory cytokines and OA-associated gene expression in OASFs and OACCs. 7E reduced the severity of arthritis in murine models of surgery-induced OA. Our findings provide evidence that IL-20 is a novel target and that 7E is a potential therapeutic agent for OA.