ABSTRACT
SUMMARY: Meniscus tear is an important injury affecting the quality of life. This work is aimed to investigate the activity of CD68 and ADAMTS-5 in cells in synovial fluid in male and female patients with meniscal tear. In this study ,18 male and 22 female patients with meniscal tears were included. Local pain sensation during patients' physical examination, swelling, performing daily activities and difficulty in running-walking complaints were determined. 5 cc synovial fluids were aspirated from the lateral suprapatellar pouch part of the knees with meniscal pain. After routine histological follow-up of the samples, they were embedded in paraffin and sectioned with microtome and 5 micrometer thickness. CD68 and ADAMTS-5 primary antibodies were used for immunohistochemical analysis. Sections were taken and evaluated with a stylish microscope. The distribution of blood cells after meniscus tear was higher in female patients than in male patients. CD68 distribution in female patients appeared higher than in male patients. CD68 expression was high in macrophage cell cytoplasm. ADAMTS-5 expression was higher in female patients in degenerative cells and apoptotic cells. ADAMTS-5 is an important metallo-protein involved in the development of apoptotic signal and extracellular matrix synthesis in patients with ADAMTS-5 meniscus tear, and it may be an important criterion for the treatment developed after injury. CD68 and ADAMTS-5 activity was thought to be one of the important signal pathways that can be identified in the treatment of meniscus tear.
RESUMEN: La rotura del menisco es una lesión importante que afecta la calidad de vida. El objetivo fue investigar la actividad de CD68 y ADAMTS-5 en células del líquido sinovial en pacientes masculinos y femeninos con desgarro meniscal. Se incluyeron 18 pacientes masculinos y 22 femeninos con desgarros meniscales. Se determinó la sensación de dolor local durante el examen físico de los pacientes, la hinchazón, la realización de actividades diarias y la dificultad al correr y caminar. Se aspiraron 5 cc de líquido sinoviale de la parte de la bolsa suprapatelar lateral de las rodillas de los pacientes con dolor meniscal. Después del seguimiento histológico de rutina, las muestras se incluyeron en parafina y se seccionaron con un micrótomo de grosor de 5 micrómetros. Para el análisis inmunohistoquímico se usaron los anticuerpos primarios CD68 y ADAMTS-5. La distribución de las células sanguíneas después del desgarro del menisco fue mayor en pacientes femeninos que en pacientes masculinos. La distribución de CD68 en pacientes femeninos fue más alta que en pacientes masculinos. Además la expresión de CD68 fue alta en el citoplasma de los macrófagos. La expresión de ADAMTS-5 fue mayor en pacientes femeninos en las células degenerativas y células apoptóticas. ADAMTS-5 es una metaloproteína importante en el desarrollo de la señal apoptótica y la síntesis de matriz extracelular en pacientes con rotura de menisco ADAMTS-5, y puede ser un criterio importante para el tratamiento después de la lesión. La actividad de CD68 y ADAMTS-5 era una de las vías de señal importantes que se pueden identificar en el tratamiento de la rotura del menisco.
Subject(s)
Humans , Male , Female , Tibial Meniscus Injuries/metabolism , Tibial Meniscus Injuries/pathology , Knee Joint/metabolism , Knee Joint/pathology , Synovial Fluid/chemistry , Immunohistochemistry , Antigens, CD/analysis , Synoviocytes/metabolism , ADAMTS5 Protein/analysis , Knee Joint/cytologyABSTRACT
Objective@#To evaluate the necessity of arthroscopic suture repair for the stable ramp lesion.@*Methods@#From August 2008 to April 2012, 91 patients of consecutive cases were diagnosed as anterior cruciate ligament (ACL) injury associated with stable ramp lesion in Department of Sports Medicine Service of Beijing Jishuitan Hospital. All of the diagnosis was confirmed during arthroscopic surgeries. The patients were randomized into suture repair group and control group. The ACL was reconstructed using auto grafts of hamstring. MRI was used for evaluation of the healing of the ramp lesion during the follow-up period. The stability of the knee joint was evaluated using KT-1000 device. The clinical functional outcomes were analyzed with Lysholm and International Knee Documentation Committee(IKDC) score. t test and χ2 test were used to analyze the data, respectively.@*Results@#There were 73 patients (80%) were available for final follow-up. The follow-up period was 24 to 72 months (mean (38.9±16.1) months). The suture repair group included 40 patients, while the control group included 33 patients. There were no statistically difference in age(t=0.458, P>0.05), gender(χ2=0.222, P>0.05), time interval from injury(t=0.643, P>0.05) and associated injuries(χ2=0.658, P>0.05). At the final follow-up, the healing rate of ramp lesion in suture repair group was 97.5% (95% of complete healed, 2.5% of partial healed, and 2.5% of non-healed), in control group the healing rate was 93.9% (87.8% of complete healed, 6.1% of partial healed, and 6.1% of non healed), there were no significant differences between the two groups (χ2=0.446, P>0.05). There was no statistically significant difference of postoperative knee stability (t=-0.510, P>0.05). The healing status of ramp area from MRI evaluation had statistically significant correlation with the ACL stability (χ2=11.919, P<0.01). For the analysis of postoperative Lysholm scores and IKDC scores, there was no significant difference between the two groups (t=-0.166, P>0.05; t=0.032, P>0.05).@*Conclusions@#Stable ramp lesion could be well healed after arthroscopic treatment of all-inside suture repair as well as refreshment only. For patients with ACL injury and stable ramp lesion, there was no significant difference between the results of MRI evaluation in the early postoperative stage.The postoperative healing status of ramp area had statistically significant correlation with the stability of knee joint.