Synovial Cartilage Research Articles

Cervical anatomy and its relation to foraging habits in aquatic birds (Aves: Neornithes: Neoaves).

Birds have extremely flexible necks, which help in their search for food. However, studies on the variation in bird cervical anatomy and its relationship with foraging are rare, despite the different habits presented between species. Here, we analyze the anatomy of the neck of aquatic birds and relate it to their foraging strategies. We dissected specimens representing four species of Charadriiformes, 11 species of Phaethoquornithes, and two specimens belonging to the outgroup Telluraves. We chose to emphasize Charadriiformes and Phaethoquornithes because they present several strategies that require cervical mobility and stability. We note that vertebral anatomy and dimensions vary, which affects the shape and size of the soft tissues attached throughout the neck. The synovial cartilage present in the articulatio intercorporalis represents an additional length in the neck, however, this is not longer than that observed in animals with intervertebral discs. Our analysis indicates that birds have a prevalence of dorsoventral movements in the middle of the neck and lateral and rotational movements near the base of the neck, while the region near the head presents a wide range of movement in all directions. Cervical ligaments and muscles throughout the neck provide stability in all segments, although the robustness of the soft tissues indicates that the most caudal portion of the neck is the most stable. The vertebral and soft tissue anatomy is consistent with the extensive mobility in pitching, yaw, and roll movements performed mainly by the head and first segment of the neck during the different foraging of the analyzed birds. Furthermore, the muscles closer to the skull are robust and allow the execution of a variety of habits to capture food in different species. The subsequent cervical segments present differences that explain their reduction in mobility, but they are equally stable.

Arthrological reconstructions of the pterosaur neck and their implications for the cervical position at rest.

The lack of any pterosaur living descendants creates gaps in the knowledge of the biology of this group, including its cervical biomechanics, which makes it difficult to understand their posture and life habits. To mitigate part of this issue, we reconstructed the cervical osteology and arthrology of three pterosaurs, allowing us to make inferences about the position of the neck of these animals at rest. We used scans of three-dimensionally preserved cervical series of Anhanguera piscator, Azhdarcho lancicollis and Rhamphorhynchus muensteri for the reconstructions, thus representing different lineages. For the recognition of ligaments, joint cartilages, and levels of overlapping of the zygapophyses, we applied the Extant Phylogenetic Bracket method, based on various extant birds and on Caiman latirostris. We inferred that pterosaur intervertebral joints were probably covered by a thin layer of synovial cartilage whose thickness varied along the neck, being thicker in the posterior region. Ignoring this cartilage can affect reconstructions. According to the vertebral angulation, their neck was slightly sinuous when in rest position. Our analyses also indicate that pterosaurs had segmented and supra-segmented articular cervical ligaments, which could confer stabilization, execute passive forces on the neck and store elastic energy.

Mechanistic Evaluation of Antiarthritic Effects of Citronellol in CFA-Induced Arthritic Rats.

Rheumatoid arthritis (RA) is an autoimmune disease characterized by systemic inflammation, joint tissue damage, pain, and synovitis. It leads to deformity of joints, disability, and even premature death. Markers of inflammation are highly expressed in synovium fluid and serum of arthritic patients and play an important role in the pathophysiology of RA. These transcription factors promote the fabrication of type I interferons and inflammatory cytokines. In RA, degradation of synovial cartilage and bone results from stimulation of proinflammatory cytokines. Citronellol (Ct), a monoterpene alcohol, is found in citrus fruits and essential oils of many aromatic plants. It possesses numerous pharmacological properties such as antioxidant activity and potential antinociceptive and anti-inflammatory effects. Keeping in view the significant anti-inflammatory role of Ct, a trial of 28 days was conducted. Ct was administered orally at three different doses (25, 50, and 100) mg/kg in Freund's adjuvant-induced arthritic rats, and the results were compared with piroxicam, chosen as the standard drug. The antiarthritic activity of the compound was evaluated through measurements of arthritic scoring and plethysmometry before and after treatment. The blood biochemical and hematological parameters and histopathological analyses were performed. Additionally, qPCR was conducted to analyze the mRNA expression levels of TNF-α, IL-1β, NF-κB, MMP3, IL-6, and IL-4 in the blood. ELISA was performed to evaluate the levels of PGE2. The results demonstrated that Ct showed significant results at all doses, but the highest dose proved to be most significant in terms of decreasing arthritic scoring and paw edema, indicating the antiarthritic potential of Ct. Furthermore, the compound was found to downregulate all the proinflammatory cytokines (TNF-α, IL-1β, NF-κB, MMP3, and IL-6) and upregulate the anti-inflammatory cytokine (IL-4). The levels of PGE2 were also reduced which further supported the antiarthritic effects of Ct and validated it as a potential antiarthritic candidate.

Intestinal flora, intestinal metabolism, and intestinal immunity changes in complete Freud's adjuvant-rheumatoid arthritis C57BL/6 mice

Rheumatoid arthritis (RA) is an inflammatory-mediated autoimmune disease characterized by persistent joint enlargement, synovial cartilage damage, and inflammatory infiltrates. Although the pathogenesis and treatment of RA are still currently insufficient, the importance of the intestine flora, metabolism and immunity for RA has been gradually recognized, and many intestine regulatory strategies have been used to treat RA. However, the relationship between RA and intestine flora, metabolism and immunity has not been fully expounded. In this study, Complete Freund's Adjuvant (CFA) was used to establish RA model, CyTOF technology was used to study the changes of intestinal immune cell types, 16S rRNA technology was used to analyze the differences of intestinal flora, and LC-MS technology was used to explain the effects of metabolites produced by the changed intestinal flora on RA. Moreover, we systematically explored how the imbalance of intestinal flora changed the intestinal immune status through its metabolites in RA mice. Our results showed that the intestinal flora of RA mice changed significantly, and the bacteria producing short-chain fatty acids (SCFAs), indole classes and secondary bile acids were significantly reduced. The abundance of SCFAs, indole classes and secondary bile acids in the intestine were significantly decreased. The balance of immune cells in the intestine of RA mice was significantly disrupted, with an overall decrease in immune cells. This work reveals the possible relationship between intestinal flora, metabolism and immunity and RA in mice, which will provide new therapeutic strategies for RA.

Expression and diagnostic significance of integrin beta-2 in synovial fluid of patients with osteoarthritis.

Osteoarthritis (OA) is characterized by synovial cartilage degeneration and is the leading cause of disability and pain worldwide. This study sought to investigate the expression of integrin beta-2 (ITGB2) in synovial fluid of OA patients and its clinical significance. A total of 110 OA patients were enrolled, who were classified into grade I (N = 35), II (N = 42), and III (N = 33) according to the Kellgren-Lawrence classification, with 110 healthy subjects as controls, and their clinical data were compared. ITGB2 level was detected by RT-qPCR. The receiver operating characteristic curve was used to analyze the predictive value of ITGB2 on OA occurrence. The correlation between ITGB2 and bone metabolism indexes procollagen type I N-terminal peptide (PINP), bone glaprotein (BGP), bone alkaline phosphatase (BALP), and β-collagen I telopeptide (β-CTX) was analyzed by the Pearson method. Logistic regression model was performed to analyze the influencing factors of OA. The content of red blood cells, white blood cells, PINP, BGP, and BALP was lowered in OA patients, while β-CTX was elevated. ITGB2 was highly-expressed in OA patients, negatively-correlated with PINP, BGP, and BALP, but positively-correlated with β-CTX. ITGB2 level increased with the elevation of OA grade. The ITGB2 level >1.375 had certain diagnostic values for OA. ITGB2 level is related to OA severity and may be a biomarker for OA classification. ITGB2 was an independent risk factor for OA. High expression of ITGB2 in synovial fluid can assist OA diagnosis and may be a biomarker for OA grade.

Charge-based drug delivery to cartilage: Hydrophobic and not electrostatic interactions are the dominant cause of competitive binding of cationic carriers in synovial fluid

Charge-based drug delivery has proven to be effective for targeting negatively charged cartilage for the treatment of osteoarthritis. Cartilage is surrounded by synovial fluid (SF), which is comprised of negatively charged hyaluronic acid and hydrophobic proteins that can competitively bind cationic carriers and prevent their transport into cartilage. Here we investigate the relative contributions of charge and hydrophobic effects on the binding of cationic carriers within healthy and arthritic SF by comparing the transport of arginine-rich cartilage targeting cationic peptide carriers with hydrophilic (CPC +14N) or hydrophobic property (CPC +14A). CPC +14N had significantly greater intra-cartilage uptake in presence of SF compared to CPC +14A in-vitro and in vivo. In presence of individual anionic SF constituents, both CPCs maintained similar high intra-cartilage uptake while in presence of hydrophobic constituents, CPC +14N had greater uptake confirming that hydrophobic and not charge interactions are the dominant cause of competitive binding within SF. Results also demonstrate that short-range effects can synergistically stabilize intra-cartilage charge-based binding – a property that can be utilized for enhancing drug-carrier residence time in arthritic cartilage with diminished negative fixed charge density. The work provides a framework for the rational design of cationic carriers for developing targeted therapies for another complex negatively charged environments. Statement of significanceThis work demonstrates that hydrophobic and not charge interactions are the dominant cause of the binding of cationic carriers in synovial fluid. Therefore, cationic carriers can be effectively used for cartilage targeting if they are made hydrophilic. This can facilitate clinical translation of various osteoarthritis drugs for cartilage repair that have failed due to a lack of effective cartilage targeting methods. It also demonstrates that short-range hydrogen bonds can synergistically stabilize electrostatic binding in cartilage offering a method for enhancing the targeting and residence time of cationic carriers within arthritic cartilage with reduced charge density. Finally, the cartilage-synovial fluid unit provides an excellent model of a complex negatively charged environment and allows us to generalize these findings and develop targeted therapies for other charged tissue-systems.

Effect of Buyi Pishen acupuncture on inflammatory factor and cartilage matrix in adjuvant arthritis rats

To observe the effect of Buyi Pishen acupuncture (acupuncture for invigorating spleen and kidney) on inflammatory factor and synovial cartilage matrix in adjuvant arthritis (AA) rats, and to explore the mechanism of acupuncture for rheumatoid arthritis (RA). A total of 60 clean male Wistar rats were randomized into a normal group, a model group, a tripterygium wilfordii polyglycoside tablet (TWP) group and an acupuncture group, 15 rats in each group. Rats in the model group, the TWP group and the acupuncture group received intradermal injection of Freund's complete adjuvant (FCA) at right hind foot pad to induce the AA model. TWP suspension of 8 mg/kg was given by gavage in the TWP group. Acupuncture was applied at "Shenshu" (BL 23), "Pishu" (BL 20) and right "Housanli" (ST 36), "Sanyinjiao" (SP 6), "Yanglingquan" (GB 34) in the acupuncture group, 15 min a time, once a day. The intervention was given 15 days in both TWP group and acupuncture group. The foot-pad swelling degree before modeling, before and after intervention and the arthritis index (AI) score before and after intervention were calculated; the serum levels of interleukin (IL)-1β, IL-4, IL-10 and tumor necrosis factor-α (TNF-α) were detected by ELISA method; the ultrastructure and histomorphological changes of synovium issue were observed by transmission electron microscope and HE staining; the positive expression of matrix metalloproteinase (MMP)-3 and MMP-9 in synovium issue was detected by immunohistochemistry method. Before intervention, foot-pad swelling degree of the model group, the TWP group and the acupuncture group was increased compared with the normal group (P<0.01). After intervention, foot-pad swelling degree and AI score were increased compared with the normal group (P<0.01), foot-pad swelling degree and AI scores in the TWP group and the acupuncture group were lower than the model group (P<0.05), and those in the acupuncture group were decreased compared with the TWP group (P<0.05). The model group exhibited unclear nuclear membrane of synovial cells, chromatin pyknosis, massive inflammatory cell infiltration and hyperplasia in synovial tissue; the TWP group and the acupuncture group exhibited clear and smooth nuclear membrane of synovial cells, inapparent chromatin pyknosis, less inflammatory cell infiltration and hyperplasia in synovial tissue, the acupuncture group exhibited less matrix destruction as well. Compared with the normal group, serum levels of IL-1β and TNF-α and positive expression of MMP-3 and MMP-9 in synovium issue were increased (P<0.01), while serum levels of IL-4 and IL-10 were decreased (P<0.01) in the model group. Compared with the model group, serum levels of IL-1β and TNF-α and positive expression of MMP-3 and MMP-9 in synovium issue were decreased (P<0.05, P<0.01), while serum levels of IL-4 and IL-10 were increased (P<0.05) in the TWP group and the acupuncture group; compared with the TWP group, serum level of TNF-α and positive expression of MMP-3 and MMP-9 in synovium issue were decreased (P<0.05), while serum levels of IL-4 and IL-10 were increased (P<0.05) in the acupuncture group. Buyi Pishen acupuncture can effectively improve the injury of articular cartilage in AA rats, its mechanism maybe related to reducing the inflammatory reaction in synovium and inhibiting the degradation of articular cartilage matrix.

Biotribology of synovial cartilage: Role of albumin in adsorbed film formation

A properly lubricated natural synovial joint is the basis of the proper function of the natural musculoskeletal system to lead an active and painless life. A properly lubricated natural synovial joint is the basis of the proper function of the natural movement system to lead an active and painless life. Well lubricated synovial joints are expressed, in particular, by an extremely low coefficient of friction and wear between cartilage surfaces. The presented manuscript is focused on the impact of albumin protein on the formation of adsorbed boundary layer in the contact of cartilage – a simplified model of synovial joint. This can contribute to better understanding of the lubrication in synovial joints. All presented experimental tasks were performed using a reciprocating tribometer along with fluorescence microscopy – friction forces were measured simultaneously with fluorescence records of contact. This unique experimental approach used a newly designed evaluating procedure based on image processing. The experimental results show a great impact of hyaluronic acid; adding of hyaluronic acid leads to a reduction in friction and a larger area of albumin adsorbed boundary layer; however, the phospholipids show the opposite effect. A combination of the individual protein solutions, albumin and γ-globulin, has no significant effect on the particles count of albumin clusters adsorbed in the contact; however, the area of albumin adsorbed boundary layer with simple albumin solution was much larger than the solution combining both proteins. The conclusions and discussion of this study describe the role of albumin protein in the lubricating process prevailing in a simplified model of synovial joint under conditions corresponding to slow human gait.

Intelligent gels – artificial soft tissue for the next era

AbstractA substantial part of the human body is made of soft tissue which is a hydrogel consisting mainly of collagen and proteoglycan fiber networks. In the last decades, great effort has been made to create artificial tissues using synthetic and biological hydrogels. Examples are superior hydrogels which exhibit excellent mechanical properties like connective tissue and extremely low frictional coefficients like synovial cartilage. A tunable photonic crystal showing a variety of structural colors using nano‐dotted hydrogel is another unique example. Various types of gel actuators with muscle‐like motility have also been developed. In this article recent trends and achievements of intelligent gels with tissue‐like functions are described after a brief overview of the extracellular matrix. © 2021 Society of Industrial Chemistry.

Arthroscopic Treatment of Atypical Synovial Osteochondromatosis of Infrapatellar Fat Pad: A 4-Year Follow-up Case Report and Literature Review

Primary synovial osteochondromatosis, also known as synovial chondromatosis, is a rare benign arthropathy caused by synovial cartilage metaplasia. The tumor is rarely seen outside the knee joint cavity, especially in the infrapatellar fat pad (IFP). This case presents an older woman who complained of left knee joint pain with a growing isolated mass for 2 years. Physical examination showed that a hard mass was palpable below the patella. X-ray and computed tomography examination of knee joint revealed cluster calcification foci under the patella. Under arthroscopy, the mass was found in the IFP and removed, with pathological examination indicating synovial osteochondromatosis. The patient recovered well after the operation, and no sign of recurrence was seen at a 4-year follow-up. This case report proposes that synovial osteochondromatosis in atypical sites, such as IFP, should heighten our attention and could be treated by arthroscopy.

Effect of electroacupuncture modulating synovial autophagy on joint function and serum inflammatory factor levels in patients with knee osteoarthritis

Purpose: To investigate the effect of electroacupuncture modulating synovial autophagy on the improvement of joint function and the effect of serum interleukin (IL)-1, tumor necrosis factor (TNF)-α and matrix metalloproteinase (MMP)-3 levels in patients with osteoarthritis of the knee (KOA). Methods: Ninety-eight patients with KOA were selected and randomly divided into a control group and an observation group of 49 patients each according to the random number table method. 2 groups were given glucosamine sulfate capsules orally, 0.5g each time, 3 times a day; the control group was fumigated with a self-prescribed prescription of reeducation of paralysis once a day for 4 weeks; the observation group was given electroacupuncture therapy once every 2 days for 4 weeks on the basis of fumigation of traditional Chinese medicine. 4 weeks later, the 2 groups were compared. Group knee motion function Lysholm scale (LKSS score), visual analogue score (VAS score), Western Ontario and McMaster University Osteoarthritis Index (WOMAC score), and changes in serum IL-1, TNF-α, and MMP-3 levels. Results: After treatment, the LKSS score was significantly higher than that of the control group (P<0.01), and the WOMAC scale index and VAS score were significantly lower than that of the control group (P<0.01); after treatment, the serum IL-1, TNF-α, and MMP-3 levels were significantly lower than that of the control group (P<0.01). Conclusions: Electroacupuncture regulates synovial autophagy in the treatment of KOA, which can effectively improve the joint function of patients, and its mechanism may inhibit synovial inflammation and delay synovial cartilage degeneration by down-regulating IL-1, TNF-α and MMP-3 levels, thus playing a certain therapeutic role in KOA.View Large Image Figure ViewerDownload Hi-res image Download (PPT)View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Biotribology of Synovial Cartilage: A New Method for Visualization of Lubricating Film and Simultaneous Measurement of the Friction Coefficient

A healthy natural synovial joint is very important for painless active movement of the natural musculoskeletal system. The right functioning of natural synovial joints ensures well lubricated contact surfaces with a very low friction coefficient and wear of cartilage tissue. The present paper deals with a new method for visualization of lubricating film with simultaneous measurements of the friction coefficient. This can contribute to better understanding of lubricating film formation in a natural synovial joint. A newly developed device, a reciprocating tribometer, is used to allow for simultaneous measurement of friction forces with contact visualization by fluorescence microscopy. The software allowing for snaps processing and subsequent evaluation of fluorescence records is developed. The evaluation software and the follow-up evaluation procedure are also described. The experiments with cartilage samples and model synovial fluid are carried out, and the new software is applied to provide their evaluation. The primary results explaining a connection between lubrication and friction are presented. The results show a more significant impact of albumin proteins on the lubrication process, whereas its clusters create a more stable lubrication layer. A decreasing trend of protein cluster count, which corresponds to a decrease in the thickness of the lubrication film, is found in all experiments. The results highlight a deeper connection between the cartilage friction and the lubrication film formation, which allows for better understanding of the cartilage lubrication mechanism.

Gelatin hydrogels with eicosapentaenoic acid can prevent osteoarthritis progression in vivo in a mouse model.

Eicosapentanoic acid (EPA) is an antioxidant and omega-3 polyunsaturated fatty acid that reduces inflammatory cytokine production. Gelatin hydrogel can be used as a carrier of a physiologically active substance that release it gradually for an average of ~3 weeks. Therefore, this study aimed to clarify the effect of EPA-incorporating gelatin hydrogels on osteoarthritis (OA) progression in vivo. Ten-week-old male C57BL/6J mice were randomly divided into six groups (n = 6): Sham, destabilization of the medial meniscus (DMM), Corn: DMM + 2 µL corn oil, EPA injection alone (EPA-I): DMM + 2 µL corn oil + 125 μg/μL EPA, Gel: DMM + gelatin hydrogels, and EPA-G: DMM + 125 μg/μL EPA-incorporating gelatin hydrogels. The mice were euthanized at 8 weeks after DMM or Sham surgery, and subjected to histological evaluation. Matrix-metalloproteinases-3 (MMP-3), MMP-13, interleukin-1β (IL-1β), p-IKK α/β, CD86, and CD163 protein expression in the synovial cartilage was detected by immunohistochemical staining. F4/80 expression was also assessed using the F4/80 score of macrophage. Histological score was significantly lower in EPA-G than in EPA-I. MMP-3-, MMP-13-, IL-1β-, and p-IKK α/β-positive cell ratio was significantly lower in EPA-G than in EPA-I. However, CD86- and CD163-positive cell ratio was not significantly different between EPA-I and EPA-G. The average-sum F4/80 score of macrophage in EPA-G was significantly lower than that in EPA-I. EPA-incorporating gelatin hydrogels were shown to prevent OA progression in vivo more effectively than EPA injection alone. Our results suggested that intra-articular administration of controlled-release EPA can be a new therapeutic approach for treating OA.

Cartilage Oligomeric Matrix Protein Levels in Synovial Fluid in Patients With Primary Knee Osteoarthritis And Healthy Controls: A Preliminary Comparative Analysis With Serum Cartilage Oligomeric Matrix Protein.

This study aims (i) to compare synovial fluid and serum cartilage oligomeric matrix protein levels in patients with primary knee osteoarthritis and healthy controls, (ii) compare variations of synovial fluid and serum cartilage oligomeric matrix protein levels according to sex, Kellgren-Lawrence grades, and daytime sampling, and (iii) correlate the synovial fluid and serum cartilage oligomeric matrix protein levels with age, severity of disease, and daytime sampling. One hundred and twenty-four individuals (44 males, 80 females; median age 66 years; range 42 to 87 years) were diagnosed with primary knee osteoarthritis according to the American College of Rheumatology guidelines. Additionally, 105 healthy healthy individuals (49 males, 56 females; median age 50 years; range 30 to 75 years) were included as the control group. For both groups, a thorough clinical history and physical examination were performed. Moreover, weight-bearing anteroposterior and lateral bending 30 degrees knee X-rays were collected. Cartilage oligomeric matrix protein in serum and synovial fluid was measured by enzyme-linked immunosorbent assay. Total synovial fluid cartilage oligomeric matrix protein levels were considerably higher than total serum levels for both groups. Levels of cartilage oligomeric matrix protein in synovial fluid and serum were higher in patients than in controls for both sexes. However, only cartilage oligomeric matrix protein levels in synovial fluid were higher in female patients. The levels of synovial fluid cartilage oligomeric matrix protein were significantly higher when sampling after 12 pm. A positive correlation was found between synovial fluid and serum cartilage oligomeric matrix protein levels, age, and daytime sampling. These findings may suggest a possible role for synovial fluid and serum cartilage oligomeric matrix protein as a measure for primary knee osteoarthritis. However, more studies need to be performed to address other factors that may influence the levels of cartilage oligomeric matrix protein in synovial fluid and serum.

Multiple Psychiatric Manifestations in an Iraqi Patient with Facet Joint Osteoarthritis: A Case Report

Introduction: Generalized anxiety disorder (GAD) is a common psychiatric condition, which is more common in females. The associated individual-societal burden of GAD is substantial. GAD can be further complicated by panic disorder (PD), a disabling condition, which is often accompanied by other psychiatric and medical conditions, including GAD. In this case, PD was accompanied by facet joint osteoarthritis (FJOA) of the lumbar spine. FJOA is a functional failure of synovial facet joints due to variable degrees of loss of the synovial cartilage. This case report aimed to present a unique interaction of psychiatric manifestations and a physical disability, both of which interacted and augmented each other substantially. Case Presentation: This was a challenging case of a young 32-year old male patient from Baghdad,Iraq. His psychiatric medical condition lasted for about three years (2012 - 2015). Almost all the patient’s problems originated from an imbalanced relationship with an older female colleague. This relationship was the source of psychological disturbance that gradually affected the patient’s routine life, work and professionalism, social interactions, and family relationships. The patient’s psychological distress was centered around the female’s past sexual life, including her past marital life, and her pre-marital experience with multiple sexual partners. The patient became gradually convinced that the female was in desperate need of his persistent support to overcome her recent divorce, which eventually exhausted the patient. Later, he developed a parallel medical condition, facet joints’ degeneration of the lumbar spine. His psychiatric condition manifested as signs and symptoms of generalized anxiety, relapsing depression, and frequent panic attacks. Conclusions: This unique case of persistent lumbar back pain became a two-faceted agent, interfering with patient’s daily physically activity, causing significant emotional distress, depression, anxiety, and frequent panic attacks. His lumbar spine problem persisted for approximately a year, but it was improved dramatically in late 2015; since then no residual effects interfered with his psychological improvement, apart from the sporadic and negligible flashbacks of his emotionally traumatic experience. In this peculiar case, the physical illness of the patient played a key role in augmenting, impending, and delaying the full psychological recovery.

Disseminated Knee Synovial Chondromatosis treated by Arthroscopy and combined Anterior and Posterior Approaches

Synovial Chondromatosis (also called Synovial Osteochondromatosis) is a rare benign joint disease caused by synovial cartilage metaplasia, the etiology remains unknown and the disease is characterized by the formation of cartilaginous nodules in the synovium. Calcification or ossification can occur at a late stage of the disease. A 48-year-old Chinese woman presented to out-patient department complaining of recurrent and progressively worsening right knee pain, swelling and stiffness after a minor contusion 4 years ago. She underwent careful preoperative imaging and planning followed by a two-stage arthroscopic and open surgery (combined anterior and posterior approaches). Histopathological examination of the specimens confirmed our suspected diagnosis of Synovial Chondromatosis. 15 months after surgery, she has regained full range of movement, but continues to experience residual insidious knee pain when standing for a long time. Synovial chondromatosis is a rare proliferative disorder that causes pain, swelling, and restriction of movement to the joints it affects. It low incidence rate and differential diagnosis makes it sometimes difficult to diagnose, reason why adequate radiology imaging and arthroscopic exploration are decisive for the diagnosis. Surgical lavage and excision have proven to be the reasonable and preferable course of treatment of synovial chondromatosis.

Anti-rheumatoid arthritis effect of Vitex rotundifolia extract on mice with collagen-induced arthritis

Effects of 70% ethanol extract of the stems and leaves of V. rotundifolia (VRE) on the activation of IgG2 and histology in collagen-induced arthritis (CIA) as a model of rheumatoid arthritis were examined. Histological changes in the knee joints were evaluated and determined the serum anti-type II collagen IgG2a and IgG2b levels in CIA. VRE treatment significantly decreased the arthritis index, the synovial cartilage erosion, and the serum IgG2a and IgG2b levels, suggesting that V. rotundifolia might be useful for treating rheumatoid arthritis.

Three-dimensional double-echo steady-state (3D-DESS) magnetic resonance imaging of the knee: establishment of flip angles for evaluation of cartilage at 1.5 T and 3.0 T

The effect of flip angle (FA) on synovial fluid and cartilage signal and on image contrast using three-dimensional double-echo steady-state (3D-DESS) sequence have only been performed with 1.0-T but not with 1.5-T or 3.0-T scanners. To identify the FA that gives the maximum synovial fluid and cartilage values, and to identify the FA at which maximum values of synovial fluid-cartilage contrast-to-noise ratio (CNR) in 3D-DESS sequences when 1.5-T and 3.0-T scanners are used. Using 3D-DESS with water-excitation pulse, mid-sagittal plane images of the knees of 10 healthy volunteers (5 men, 5 women; age range, 21-42 years) were obtained with FA varying from 10° to 90°. Synovial fluid signals, cartilage signals, and background were measured at each FA, and the FA that gave the highest synovial fluid and cartilage values was obtained. Synovial fluid-cartilage CNR was also calculated, and the FA that gave the largest CNR was obtained. At 1.5 T, the maximum synovial fluid signal was at FA 90°, and the maximum cartilage signal was at FA 30°. Synovial fluid-cartilage CNR was highest at FA 90° (P < 0.05). At 3.0 T, the maximum synovial fluid signal was at FA 90°, and the maximum cartilage signal was at FA 20°. Synovial fluid-cartilage CNR was highest at FA 90° (P < 0.05). In order to improve the visibility of cartilage itself, FA settings of 30° at 1.5 T and 20° at 3.0 T are apparently ideal. For observing the cartilage surface, the most effective FA setting is 90° for both 1.5 T and 3.0 T.

Evaluation of cartilage surface injuries using 3D-double echo steady state (3D-DESS): Effect of changing flip angle from 40° to 90°

In magnetic resonance imaging (MRI) with 3D-double-echo steady-state (3D-DESS) sequences, the cartilage-synovial fluid contrast is reported to be better with a flip angle of 90° than with the conventional flip angle of 40°, and the detection rate of knee cartilage injury may be improved. To compare the diagnostic performance and certainty of diagnosis with 3D-DESS images made using two flip angle settings, 40° and 90°, for knee cartilage surface lesions of Grade 2 or above confirmed by arthroscopy. Images were obtained with 3D-DESS flip angles of 40° and 90° at 1.0T in 13 consecutive patients (2 men, 11 women, age range 18-68 years) evaluated for superficial cartilage injury by arthroscopy. Two radiologists classified the presence or absence of cartilage damage of ≥Grade 2 as 'positive (p)' or 'negative (n)', respectively. The rate of agreement with arthroscopic diagnosis was then examined, and the diagnostic performance compared. Diagnostic confidence was assessed scoring the presence or absence of cartilage damage into three categories: 3 = can diagnose with absolute confidence; 2 = can diagnose with a level of certainty as probably present or probably absent; and 1 = cannot make a diagnosis. In a comparison of the rate of agreement between diagnosis by 3D-DESS images and arthroscopy, the rate of agreement was significantly higher and diagnostic performance was better in 90° images for the medial femoral condyle only. Diagnostic confidence was significantly better with 90° flip angle images than with 40° flip angle images for all six cartilage surfaces. In evaluating knee cartilage surface lesions with 3D-DESS sequences, a flip angle setting of 90° is more effective than the conventional setting of 40°.

The effect of molecular weight on hyaluronan’s cartilage boundary lubricating ability – alone and in combination with proteoglycan 4

(1) assess the molecular weight dependence of hyaluronan's (HA) cartilage boundary lubricating ability, alone and in combination with proteoglycan 4 (PRG4), at physiological concentrations; (2) determine if HA and PRG4 interact in solution via electrophoretic mobility shift assay (EMSA). The cartilage boundary lubricating ability of a broad range of MW HA (20 kDa, 132 kDa, 780 kDa, 1.5 MDa, and 5 MDa) at 3.33 mg/ml, both alone and in combination with PRG4 at 450 μg/ml, was assessed using a previously described cartilage-on-cartilage friction test. Static, μ(static, Neq), and kinetic, <μ(kinetic, Neq)>, were calculated. An EMSA was conducted with PRG4 and monodisperse 150 kDa and 1,000 kDa HA. Friction coefficients were reduced by HA, in a MW-dependent manner. Values of <μ(kinetic, Neq)> in 20 kDa HA, 0.098 (0.089, 0.108), were significantly greater compared to both 780 kDa, 0.080 (0.072, 0.088), and 5 MDa, 0.079 (0.070, 0.089). Linear regression showed a significant correlation between both μ(static, Neq) and <μ(kinetic, Neq)>, and log HA MW. Friction coefficients were also reduced by PRG4, and with subsequent addition of HA; however the synergistic effect was not dependent on HA MW. Values of <μ(kinetic, Neq)> in PRG4, 0.080 (0.047, 0.113), were significantly greater than values of PRG4+various MW HA (similar in value, averaging 0.040 (0.033, 0.047)). EMSA indicated that migration of 150 kDa and 1,000 kDa HA was retarded when combined with PRG4 at high PRG4:HA ratios. These results suggest alterations in HA MW could significantly affect synovial fluid's cartilage boundary lubricating ability, yet this diminishment in function could be circumvented by physiological levels of PRG4 forming a complex, potentially in solution, with HA.