ABSTRACT
BACKGROUND: Dermis-derived extracellular matrix, as a cartilage repair scaffold, provides a space for the growth of cartilage tissue, and promotes cell adhesion and proliferation. Bone marrow mesenchymal stem cells have the potential to differentiate into chondrocytes. Both of them used alone have disadvantages. OBJECTIVE: To evaluate the feasibility of bone marrow mesenchymal stem cells combined with calf acellular dermal matrix to repair beagle dog articular cartilage defects. METHODS: Beagle dog bone marrow blood was extracted from Beagle dogs. Bone marrow mesenchymal stem cells were obtained by density gradient centrifugation and passaged. Acellular dermal matrix was prepared from the dorsal dermis of neonatal calves by ultrasonic oscillation, freeze-drying and pepsin. 0. 2 mL of cell suspension was added to the surface of acellular dermal matrix until covered, then which was placed in a 5% CO2 incubator at 37 °C for 48 hours. Twelve adult beagle dogs were used to establish knee joint cartilage defect models, and then randomized into three groups: In the acellular dermal matrix combined with bone marrow mesenchymal stem cells group (combination group), cartilage defects were repaired with acellular dermal matrix combined with bone marrow mesenchymal stem cells. In the single acellular dermal matrix group, cartilage defects were repaired with acellular dermal matrix. The model control group received no treatment. At 12 weeks after surgery, the right knee joints were observed by stereomicroscope, hematoxylin-eosin staining and type II collagen immunohistochemical staining. RESULTS AND CONCLUSION: (1) Scanning electron microscopy showed that bone marrow mesenchymal stem cells adhered to and grew well in the acellular dermal matrix. (2) Hematoxylin-eosin staining revealed that the repaired surface in the combination group was slightly lower than that of the surrounding normal tissues, and the repaired tissues integrated well with the surrounding cartilages. The defects in the single acellular dermal matrix group were filled with fibrous tissues. Few surrounding tissues of defect were repaired in the model control group. (3) Type II collagen immunohistochemical staining showed that in the combination group, articular cartilage defects were filled with chondrocyte-like tissues. In the single acellular dermal matrix group, the defect was filled with fibrous tissues. No tissue was found in the model control group. (4) These results indicate that the new calf acellular dermal matrix has good biocompatibility and can promote the proliferation of bone marrow mesenchymal stem cells. Autologous bone marrow mesenchymal stem cells combined with acellular dermal matrix can effectively repair beagle dog knee joint cartilage defects.
ABSTRACT
Introducción El trasplante osteocondral autólogo es una técnica reproducible y con pocas complicaciones para el manejo de lesiones traumáticas grado III y IV de Outerbridge en patela. Con este estudio se busca evaluar los resultados funcionales e imagenológicos en pacientes manejados con esta técnica. Materiales y métodos Estudio descriptivo tipo serie de casos. Se incluyeron pacientes con lesiones traumáticas grado III y IV de Outerbridge (OB) en patela, menores de 25mm de diámetro, sin otras lesiones agregadas, operados con trasplante osteocondral autólogo entre marzo de 2013 y diciembre de 2016. Se evaluaron la escala visual análoga (EVA) y la escala funcional Kujala prequirúrgicas, y se compararon con los controles a los 3 y 6 meses. Se usó el score MOCART por resonancia magnética nuclear a los 6 meses postquirúrgicos para evaluar el porcentaje de osteointegración del injerto. Resultados El estudio incluyó 13 pacientes, 8 hombres (62%) con una edad promedio de 30 años. La lesión más frecuente fue la tipo IV de OB con un 86.6%. El EVA prequirúrgico promedio fue de 7.8 (±0.83), con controles a los 3 y 6 meses de 3.3 (±1.67) y 2.9 (±2.1) respectivamente, ambos con un valor de p <0.05. La escala funcional Kujala tuvo un promedio prequirúrgico de 33.3 (±10.1), con controles a los 3 y 6 meses de 56.1 (±21.1) y 74 (±17.6) respectivamente, ambos con un valor de p <0.05. El score MOCART promedio a los 6 meses fue de 70.5 (±12.1); 7 pacientes (53.8%) presentaron un valor mayor a 80. Discusión El Trasplante Osteocondral Autólogo en patela es una técnica con buenos resultados en pacientes con lesiones grado III y IV de OB, con mejoría significativa a los 3 y 6 meses del postoperatorio en la escala funcional de Kujala y reducción de la EVA. La tasa de integración del injerto medido por MOCART a los 6 meses fue 53%.
Background Autologous osteochondral grafting is a reproducible technique with few complications for the management of grade III and IV Outerbridge patellar injuries. This study aims to evaluate the functional and imaging results in patients managed with this technique. Methods A Case Series study was performed. The study included patients with grade III and IV Outerbridge (OB) traumatic patellar injuries of less than 25mm in diameter, with no other aggregate lesions, and operated on using autologous osteochondral grafts between March 2013 and December 2016. A pre-surgical assessment was made using a visual analogue scale (VAS) and the Kujala functional scale, and was compared with controls at 3 and 6 months. The MOCART score was used by nuclear magnetic resonance at 6 months post-operatively to evaluate the percentage of osteointegration of the graft. Results The study included 13 patients, 8 men (62%) with a mean age of 30 years. The most frequent lesion was type IV OB, with 86.6%. The mean pre-surgical VAS was 7.8 (± 0.83), with controls at 3 and 6 months of 3.3 (± 1.67) and 2.9 (± 2.1), respectively, both with a value of P<.05. The Kujala functional scale had a pre-surgical mean of 33.3 (± 10.1), with controls at 3 and 6 months of 56.1 (± 21.1) and 74 (± 17.6), respectively, both with a value of P<.05. The mean (magnetic resonance observation of cartilage repair tissue) MOCART score at 6 months was 70.5 (± 12.1), and 7 patients (53.8%) had a value greater than 80. Discussion Autologous osteochondral graft in the patella is a technique that obtained good results in patients with grade III and IV OB lesions. There is a significant improvement 3 and 6 months after surgery in the Kujala functional scale and a reduction of the VAS. The graft integration rate measured by MOCART at 6 months was 53%.
Subject(s)
Humans , Cartilage, Articular , Patella , Therapeutics , TransplantationABSTRACT
Knee osteoarthritis (KOA) is a common chronic degenerative joint disease. Hip muscle training, with the advantage of convenience and non-invasion, has been attached great importance by people gradually. Hip muscle training may affect keen medial compartment load, the strength and the electromyography signal of the muscle around the knee joint, and strong hip abductor can protect cartilage, which leads to change the load of the knee joint, and alleviate clinical symptoms. This article reviewed the mechanism of hip muscle training for knee osteoarthritis from the views of biomechanical simulation and electromyography.
ABSTRACT
Objective To compare the femur tibia angle(FTA) and tibia tubercle to trochlear groove (TT-TG) measured on the magnetic resonance imaging(MRI) between patients with anterior cruciate ligament(ACL) rupture and healthy controls with intact ACL,and to observe the change of the tibia-femur rotation and explore its relationship with the patellofemoral cartilage injury.Methods Fifty patients with ACL ruptures were divided into an experimental group,while another 50 healthy counterparts were chosen into a control group.All subjects were given MRI to get FTA and TT-TG.For the experimental group,all parameters were measured before and after ACL reconstruction.The results were analyzed by variance analysis and t test.Results MRI measurements showed that the average FTA in the experimental group was 6.5° ± 6.1° and 6.0° ± 5.6° before and after the ACL reconstruction,significantly higher than that in the control group,which was 3.6° ± 4.9° (P=0.0003 and P=0.033,respectively).No significant differences were found in the average TT-TG of the experimental group,6.4 ± 3.3 mm before ACL reconstruction and 6.9 mm ± 4.0 mm after ACL reconstruction,and that of the control group,6.3 ± 3.6 mm(P=0.678).Moreover,all patients in the experimental group underwent a second check under the arthroscopy,which revealed that the patellofemoral cartilage injury was aggravat ed in 26 patients measured by the Outerbridge grading.However,there was no significant difference in FTA and TT-TG between patients with and without aggravated patellofemoral cartilage degeneration.Conclusions After ACL reconstruction,the external rotation angle of the knee could not completely recover to the normal level with the knee extension at 0°.Patellofemoral cartilage degeneration after the ACL reconstruction is caused by many factors.The results of the second arthroscopy after the ACL reconstruction find no relationship between patellofemoral cartilage degeneration and the increased tibia external rotation angle relative to the femur.Moreover,after the ACL reconstruction,if the femur tibia angle is bigger than the range of motion of the knee,it cannot be concluded that the anterior cruciate ligament is reruptured.
ABSTRACT
OBJETIVO: Analisar os níveis séricos sanguíneos de CTX-II em atletas profissionais de futebol de salão, em três momentos distintos durante uma temporada: no início da pré-temporada, quatro meses após (período que marca o meio da temporada) e no fim da temporada. MÉTODOS: Foram incluídos 14 atletas do gênero masculino e média de idade de 19 anos. Foram coletados 3 mL de sangue de cada indivíduo. As amostras foram analisadas pelo teste do tipo Elisa. RESULTADOS: Houve aumento significativo dos níveis séricos de CTX-II nos atletas de futebol de salão, comparando-se o início e o fim de uma temporada (p < 0,01). CONCLUSÃO: Esses dados sugerem a ocorrência de degradação articular nos atletas, ao término desse período. Fica evidente a necessidade de futuros estudos, com rigor metodológico, que possam contribuir efetivamente para a elucidação precisa da etiologia da OA e sua relação com os biomarcadores como instrumento de diagnóstico precoce.
OBJECTIVE:The aim of this study was to analyze the blood serum levels of CTX-II in professional indoor soccer players, at three different times during one season: at the start of the pre-season, four months later (a time that marks the middle of the season) and at the end of the season.METHODS:Fourteen male soccer players of mean age 19 years were included. Blood samples of 3 mL were collected from each individual. The samples were analyzed by means of Elisa tests.RESULTS:There was a significant increase in the serum level of CTX-II in the indoor soccer players, from the beginning to the end of the season (p< 0.01).CONCLUSION:These data suggest that joint degradation had occurred in these soccer players, by the end of this period. It is evident that further studies are needed, with methodological rigor, so as to make an effective contribution toward precise elucidation of the etiology of this osteoarthritis and its relationship with the biomarkers, as a tool fr early diagnosis.
Subject(s)
Humans , Male , Young Adult , Athletes , Biomarkers, Pharmacological , Cartilage, Articular , OsteoarthritisABSTRACT
Objective To investigate the effect of running exercise on cartilage in rats with an unstable knee joint.Methods Twenty 8-week-old Sprague-Dawley rats had their left anterior cruciate ligament cut to model an unstable knee.They were randomly divided into a control group and an experimental group,10 rats in each group.The control group was given no intervention,while the experimental group accepted running exercise training on na animal treadmill at a velocity of 15 m/min for an hour every day.After 3 and 6 weeks of training,5 rats were sacrificed and cartilage from the medial condyle of the femur was sampled,decalcificated,embedded and sliced on the sagittal plane.After hematoxylin-eosin staining,toluidine blue staining and immunohistochemical staining,the cartilage thickness,Mankin' score,the content of matrix collagen and the proteoglycan content of the cartilage matrix were assessed,and the shape and structure of the unstable knee joints were observed under a transmission electron microscope.Results The cartilage thicknesses and Mankin's scores at 6 weeks were significantly different from those at 3 weeks in both groups.In the experimental group the average thickness of cartilage was 154 ± 13 μm at 3 weeks and 131 ± 15 μm at 6 weeks.The corresponding Mankin's scores were 9.93 ± 1.36 and 11.23 ± 1.57,respectively.Both were significantly different from the control group averages at the same time points.There was also a significant difference in the positive rate of toluidine blue and collagen type Ⅱ staining between the experimental group and the control group at both time points,and in the experimental group between 3 and 6 weeks of training.After 3 weeks of training,fewer chondrocytes were observed under the transmission electron microscope in the experimental group,and fissures were seen on the surface of the cartilages.However,3 weeks later,quite a few ruptures and a lot of necrotic cells could be seen.Conclusions Running exercise can damage the cartilage of unstable knee joints and speed up the development of osteoarthritis.Even moderate exercise could aggravate damage to unstable joints and the cartilage matrix,and accelerate chondrocyte degeneration.
ABSTRACT
This work evaluated the effect of freezing on chondrocytes maintained in culture, aiming the establishment of a cell bank for future application as heterologous implant. Chondrocytes extracted from joint cartilage of nine healthy New Zealand White rabbits were cultivated and frozen with the cryoprotector 5 percent dimethylsulfoxide for six months. Phenotypic and scanning electron microscopy analyses were carried out to identify morphological and functional differences between fresh and thawed cells. After enzymatic digestion, a total of 4.8x10(5)cells per rabbit were obtained. Fresh chondrocytes showed a high mitotic rate and abundant matrix was present up to 60 days of culture. Loss of phenotypic stability was notable in the thawed chondrocytes, with a low labeling of proteoglycans and weak immunostaining of type II collagen. The present study showed important loss of chondrocyte viability under the freezing conditions. For future in vivo studies of heterologous implant, these results suggests that a high number of cells should be implanted in the host site in order to achieve an adequate number of viable cells. Furthermore, the chondrocytes should be implanted after two weeks of culture, when the highest viability rate is found.
Avaliaram-se os efeitos do congelamento sobre condrócitos mantidos em cultura, com o objetivo de se estabelecer um banco celular para futura aplicação como implante heterólogo. Condrócitos extraídos da cartilagem articular de nove coelhos saudáveis, da raça Nova Zelândia Branca, foram cultivados e submetidos ao congelamento, com o citoprotetor sulfóxido de dimetila a 5 por cento, por um período de seis meses. Análises fenotípicas e de microscopia eletrônica de varredura foram realizadas com o objetivo de identificar diferenças morfológicas e funcionais entre as células frescas e as descongeladas. Após a digestão enzimática, foram obtidas 4,8x10(5) células por coelho. Os condrócitos frescos apresentaram elevada taxa mitótica e abundante presença de matriz até os 60 dias de cultura. Nas culturas dos condrócitos descongelados, a perda de estabilidade fenotípica foi marcante, o que foi demonstrado pela baixa intensidade da coloração dos proteoglicanos e pela fraca imunomarcação do colágeno tipo II. Sob as condições de congelamento utilizadas, houve importante perda de viabilidade condrocítica. Para futuros estudos in vivo de implante heterólogo, estes resultados sugerem que o elevado número de células deve ser implantado no sítio hospedeiro, com o objetivo de se obter maior quantidade de células viáveis, e que os condrócitos deverão ser implantados com duas semanas de cultivo, período em que apresentam melhor taxa de viabilidade.
Subject(s)
Animals , Rabbits , Chondrocytes/cytology , Freezing , Microscopy, Electron, Scanning , Cell- and Tissue-Based TherapyABSTRACT
PROPOSTA: Revisamos 71 pacientes com diagnóstico de lesão do ligamento cruzado anterior em 72 joelhos. Foi avaliado a incidência de lesões associadas (meniscais ou condrais) de acordo com o tempo até a cirurgia de reconstrução do ligamento. TIPO DE ESTUDO: Estudo retrospectivo de série de casos. MÉTODOS: Realizado análise estatística do efeito do tempo até a cirurgia com o aumento de lesões associadas. RESULTADOS: Não houve alteração, estatisticamente significante, da incidência de lesões condrais e meniscais avaliadas nos períodos 2 a 3 meses, 4 a 6 meses, 7 a 12 meses, 13 a 24 meses e mais que 24 meses. CONCLUSÕES: Embora haja uma tendência de aumento de lesões meniscais após 6 meses e de lesões condrais após 12 meses da lesão do ligamento cruzado anterior, tal fato não mostrou significância estatistica.
PURPOSE: We reviewed 71 patients diagnosed with anterior cruciate ligament (ACL) injury on 72 knees. The incidence of associated injuries (meniscal and joint cartilage injuries) were evaluated according to the time elapsed until ACL reconstruction. STUDY DESIGN: Retrospective case series. METHODS: Statistical analysis of the relationship between the time elapsed until surgery and the increase of associated lesions. RESULTS: There was no statistically significant difference on the incidence of joint-cartilage and meniscal injuries assessed for the periods within 2-3 months, 4-6 months, 7-12 months, 13-24 months and above 24 months. CONCLUSION: Although a trend towards a higher number of meniscal injuries after 6 months, and of joint-cartilage injuries after 12 months since the primary anterior cruciate ligament injury, such fact showed no statistical significance.
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Middle Aged , Anterior Cruciate Ligament , Anterior Cruciate Ligament Reconstruction , Cartilage, Articular , Anterior Cruciate Ligament/physiopathology , Brazil , Knee Injuries , Knee Joint , Anterior Cruciate Ligament/surgery , Retrospective StudiesABSTRACT
[Objective] To observe the effect of medical ozone on cartilage in the model of osteoarthritis(OA)to explore its therapeutic mechanism.[Method] Forty healthy adult SD rats were randomly divided into five groups :A(group normal)、B(group model)、C(group air),D(group O2~O3 35 ?g/ml)and E(group O2~O3 70 ?g/ml)(n=8 in each group).The OA model was duplicated by performed anterior eruciate ligament transection(ACLT)and partial meniscectomy of 1/3 inside.Air was injected into joints of group C,according to concentration different,which O2~O3 35 ?g/ml and O2~O3 70 ?g/ml were respectively injected into joints to D and E group every other day,every time 1～1.5 ml,and after a week injected again.After the model was successfully made,the condylar cartilage of femur was excised after 4 weeks for the observation by transmissive microscope of HE staining.Mankin's index was recorded.At the end of the experiment,douche fluid of the diseased joints were obtained for the measurements of superoxide dismutase(SOD)and malondialdehyde(MDA).[Result]The OA model in B group founded obviously degenerative changes under microscopy,resulting in mostly blue and green color destaining of Masson staining at superficial cartilage.The activity of SOD in the douche fluid of the diseased joints degraded and the quantity of MDA in the serum in the OA model group increased.The Mankin's index in the group D was significantly higher than that in the group B、 C(P
ABSTRACT
@#ObjectiveTo explore the effect and feasibility of autograft and allograft bone and cartilage transplantation.Methods63 rabbits were made experimental defect in the same side knee joint,and were divided randomly into group A(autograft group),group B(allograft group) and group C(control group).Group A was divided further into 2 column limiting motion subgroup(A2M group),not limiting motion subgroup(A2N group) and 4 column subgroup(A4M group).In the same way,group B was divided further into B2M group,B2N group and B4M group.Every subgroup included nine rabbits,and the transplantation was made in no weight-bear area of knee joint.The generally observation were made,the joint movable range and the thickness of the repairing tissue were measured,histology change of transplanted tissue(through light,electronic microscope)were observed.ResultsGroup A had a satisfactory result,and the result of no limiting groups were better.The result of A4M group was better than A2M group (P≤0.05).The result of group B was not good.ConclusionThe bone-cartilage column of small diameter and general number are beneficial in repairing the defect of joint cartilage.The allograft bone and cartilage transplantation can cause seriously immunoreaction and the absorption of cartilage pole,and is detrimental to repair the defect of joint cartilage.