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1.
Rev. bras. ortop ; 56(6): 689-696, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1357130

ABSTRACT

Abstract Osteoarthritis (OA) is characterized by a chronic, progressive and irreversible degradation of the joint surface associated with joint inflammation. The main etiology of ankle OA is post-traumatic and its prevalence is higher among young and obese people. Despite advances in the treatment of fractures around the ankle, the overall risk of developing posttraumatic ankle OA after 20 years is almost 40%, especially in Weber type B and C bimalleolar fractures and in fractures involving the posterior tibial border. In talus fractures, this prevalence approaches 100%, depending on the severity of the lesion and the time of follow-up. In this context, the current understanding of the molecular signaling pathways involved in senescence and chondrocyte apoptosis is fundamental. The treatment of ankle OA is staged and guided by the classification systems and local and patient conditions. The main problems are the limited ability to regenerate articular cartilage, low blood supply, and a shortage of progenitor stem cells. The present update summarizes recent scientific evidence of post-traumatic ankle OA with a major focus on changes of the synovia, cartilage and synovial fluid; as well as the epidemiology, pathophysiology, clinical implications, treatment options and potential targets for therapeutic agents.


Resumo A osteoartrite (OA) é caracterizada por uma degradação crônica, progressiva e irreversível da superfície articular, associada a inflamação articular. A principal etiologia da OA do tornozelo é pós-traumática e sua prevalência é maior entre os jovens e obesos. Apesar dos avanços no tratamento das fraturas ao redor do tornozelo, o risco geral de desenvolver OA pós-traumática do tornozelo após 20 anos do trauma é de quase 40%; especialmente nas fraturas bimaleolares de Weber tipo B e C e fraturas envolvendo a borda tibial posterior. Nas fraturas do tálus, essa prevalência se aproxima de 100%, dependendo da gravidade da lesão e do tempo de seguimento. Nesse cenário, é fundamental a compreensão atual das vias de sinalização moleculares envolvidas na senescência e apoptose dos condrócitos. O tratamento da OA do tornozelo é estagiado e guiado pelos sistemas de classificação, condições locais e do paciente. Os principais problemas são a limitada capacidade de regeneração da cartilagem articular, o baixo suprimento de sangue e a escassez de células-tronco progenitoras. A presente atualização resume evidências científicas básicas recentes da OA póstraumática do tornozelo, com foco principal nas alterações metabólicas da sinóvia, da cartilagem e do líquido sinovial. Epidemiologia, fisiopatologia, implicações clínicas, e opções de tratamento são também discutidas.


Subject(s)
Humans , Osteoarthritis/diagnosis , Osteoarthritis/therapy , Synovial Fluid , Cartilage , Cartilage, Articular , Prevalence , Fractures, Bone , Ankle Fractures , Ankle/physiopathology
2.
Rev. bras. ortop ; 56(4): 470-477, July-Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1341162

ABSTRACT

Abstract Objective The aim of our study is to analyze the clinical and functional results obtained using autologous chondrocytes embedded in a fibrin scaffold in knee joint injuries. Methods We included 56 patients, 36 men and 20 women, with a mean age 36 years. Six of the patients were professional athletes, with single knee injuries that were either chondral or osteochondral (43 chondral, 9 osteochondral, 2 cases of osteochondritis dissecans and 2 osteochondral fractures), 2 to 10 cm2 in size and ≤ 10 mm deep, with no signs of osteoarthritis. The location of the injury was in the patella (8), the medial femoral condyle (40) and lateral femoral condyle (7) and one in the trochlea. The mean follow-up was 3 (range: 1-6) years. The clinical course was assessed using the Cincinnati and Knee Injury and Osteoarthritis Outcome (KOOS) scores, 6 and 12 months after surgery. The paired Student t-test was used to compare pre-and postoperative results. Results Six months after the implant, patients resumed their everyday activities. On the assessment scores, their condition was improving in comparison with their presurgical state (p < 0.05). They were also able to carry out their sporting activities more easily than prior to surgery (p < 0.05). Conclusion The seeding of chondrocytes in fibrin may provide a favorable microenvironment for the synthesis of extracellular matrix and improved the clinical condition and activity of the patients 1 year after surgery.


Resumo Objetivo O objetivo do nosso estudo é analisar os resultados clínicos e funcionais do tratamento de lesões nas articulações do joelho com condrócitos autólogos embebidos em arcabouço de fibrina. Métodos O estudo foi realizado com 56 pacientes (36 homens e 20 mulheres) com idade média de 36 anos; 6 indivíduos eram atletas profissionais. Os pacientes apresentavam lesões únicas, condrais ou osteocondrais (43 condrais, nove osteocondrais, 2 casos de osteocondrite dissecante e duas fraturas osteocondrais) no joelho, com 2 a 10 cm2 de tamanho e ≤ 10 mm de profundidade, sem sinais de osteoartrite. As lesões estavam localizadas na patela (8), no côndilo femoral medial (40), no côndilo femoral lateral (7) e na tróclea (1). O período médio de acompanhamento foi de 3 anos (faixa de 1-6 anos). A evolução clínica foi avaliada pelos escores de Cincinnati e Knee Injury and Osteoarthritis Outcome (KOOS), 6 e 12 meses após a cirurgia. O teste t de Student pareado foi utilizado para comparação dos achados pré e pós-operatórios. Resultados Os pacientes retomaram suas atividades diárias 6 meses após o implante. Os escores avaliados demonstraram a melhora em comparação ao estado pré-cirúrgico (p < 0,05). Além disso, os pacientes conseguiram realizar suas atividades esportivas com mais facilidade do que antes da cirurgia (p < 0,05). Conclusão A cultura de condrócitos em fibrina pode proporcionar um microambiente favorável para a síntese de matriz extracelular e melhorar a condição clínica e a atividade dos pacientes 1 ano após a cirurgia


Subject(s)
Humans , Male , Female , Fibrin , Cartilage , Chondrocytes , Scaphoid Bone , Knee
3.
Rev. bras. ortop ; 56(3): 326-332, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1288672

ABSTRACT

Abstract Objective The aim of the present study was to quantify the urinary concentration of the C-terminal cross-linked telopeptide of type-II collagen (CTX-II) biomarker in patients who suffered an isolated ACL injury, and to compare the concentrations found in this population with a control group of patients with no metabolic changes in the knee that could lead to cartilage degeneration. Methods A cross-sectional pilot study was performed in two groups: patients with ACL tears and a control group (each group with 10 male subjects, with an age range between 18 and 35 years, and body mass index below 30 kg/m2). In both groups, urine concentrations of a biomarker related to the degradation of type-II collagen (CTX-II) was measured. For the group with ACL tears, a temporal relationship between the time after the injury and the amount of the biomarker was also examined. Results There were significant differences in the concentrations of urinary CTX-II between the ACL group and the control group (p = 0.009). No significant relationship was observed between the time after the injury and the quantity of the biomarker. Conclusions Patients with ACL injury had higher concentrations of urinary CTX-II biomarker than those with no ACL injury (p = 0.009). However, there was no correlation between the concentration of this biomarker and the elapsed time after the injury (p≥ 0.05).


Resumo Objetivo Quantificar a concentração urinária do biomarcador telopeptídeo C de ligação cruzada de colágeno de tipo II (C-terminal cross-linked telopeptide of type-II collagen, CTX-II) em casos de lesão isolada do ligamento cruzado anterior (LCA), e comparar as concentrações observadas nessa população com um grupo controle composto por pacientes sem alterações metabólicas no joelho que possam levar à degeneração da cartilagem. Métodos Este é um estudo piloto transversal com dois grupos: pacientes com ruptura do LCA e grupo controle (cada grupo era composto por 10 indivíduos do sexo masculino, com 18 a 35 anos de idade, e índice de massa corporal inferior a 30 kg/m2). Nos dois grupos, as concentrações urinárias de um biomarcador relacionado à degradação do colágeno de tipo II (CTX-II) foram medidas. No grupo com ruptura do LCA, a relação entre o tempo pós-lesão e a quantidade do biomarcador também foi analisada. Resultados Houve diferenças significativas nas concentrações urinárias de CTX-II entre o grupo LCA e o grupo controle (p = 0,009). Não foi observada relação significativa entre o tempo de lesão e a quantidade do biomarcador. Conclusões Pacientes com lesão do LCA apresentaram maiores concentrações urinárias do biomarcador CTX-II do que aqueles sem lesão do LCA (p = 0,009). No entanto, não houve correlação entre a concentração desse biomarcador e o tempo decorrido após a lesão (p≥ 0,05).


Subject(s)
Humans , Osteoarthritis , Patients , Biomarkers , Cartilage , Pilot Projects , Anterior Cruciate Ligament Injuries
4.
São Paulo; s.n; 20210523. 75 p.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1369753

ABSTRACT

A cartilagem de Meckel é uma estrutura transitória embrionária presente durante os estágios iniciais da formação da mandíbula, localizada em toda sua extensão e dividida em três porções, anterior, intermediária e posterior. O enfoque deste trabalho foi direcionado à elucidação do destino final da porção intermediária por meio de um estudo temporal sequenciado. Por isso, foi investigado a presença de células de reabsorção e a presença de fibras colágenas, bem como da proteína óssea osteopontina (OPN) na cartilagem de Meckel na região do germe do 1º molar inferior e no seu entorno. Foram utilizados fetos de ratos Wistar em períodos gestacionais pré-estabelecidos, G18 a G21 (grupos de dias intrauterinos), bem como P0 e P1 (recém-nascidos) para remoção das cabeças. Em sequência, os espécimes foram fixados em solução de formaldeído 4% + glutaraldeído 0,1% com tampão fosfato 0,1M, descalcificados em EDTA 4,13%, desidratados em concentrações crescentes de etanol e incluídos em parafina. As amostras foram coradas em hematoxilina e eosina (HE) e tricrômico de Mallory para análise histológica. Adicionalmente, os grupos G19 a P0 foram submetidos à reação histoquímica de TRAP para determinação da presença de células clásticas. Além disso, os grupos G21 e P0 (dia do nascimento) passaram por reações de imunomarcação para análise da expressão de OPN. Foi observado a degeneração gradual da cartilagem com a observação de mudanças estruturais, a justaposição de células clásticas na superfície da cartilagem por reação histoquímica TRAP a partir do G21, o aparecimento de colágeno tipo I nas fases terminais da degeneração, assim como a marcação positiva para a osteopontina na superfície de G21 e em todo o remanescente da cartilagem de Meckel no grupo P0. O estudo apontou um processo de degeneração da cartilagem com evidências de formação de matriz mineralizada de natureza óssea, a qual foi reabsorvida por células clásticas, sugerindo a ossificação da porção intermediária da cartilagem de Meckel.


Subject(s)
Osteoclasts , Cartilage , Osteopontin , Mandible
5.
Article in Chinese | WPRIM | ID: wpr-921929

ABSTRACT

Osteoarthritis(OA) is one of the most common joint diseases. As Chinese society enters the age of aging, the incidence of OA has been soar year by year, and research on its pathogenesis has been continuously valued by researchers. Studies have found that inflammatory cytokines, mainly interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α), were responsible for the construction of OA inflammatory networks. It was also found that the overexpression of proteases, mainly matrix metalloproteinases(MMPs) and a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS), was the direct cause of OA cartilage deficiency. What's more, signaling pathways such as stromal cell derived factor-1 (SDF-1) and Wnt, chondrocytic senescence and the senescence-associated secretory phenotype (SASP), chondrocyte apoptosis and autophagy, and estrogen all play significant roles in OA pathogenesis. This paper extensively reviews the research literature relevant to the pathogenesis of OA in recent years, and systematically expounds the pathogenesis of OA from two aspects:molecular level and cell level. At the end of the paper, we discussed and predicted some potential directions in the future clinical diagnosis and treatment of OA.


Subject(s)
Cartilage , Cartilage, Articular , Chondrocytes , Humans , Interleukin-1beta , Osteoarthritis/genetics , Signal Transduction , Tumor Necrosis Factor-alpha
6.
Article in English | LILACS, BBO | ID: biblio-1155006

ABSTRACT

ABSTRACT Objective: To evaluate the regeneration of mandibular cartilage defect after implantation of human umbilical cord mesenchymal stem cells (hUCMSC) over platelet rich fibrin (PRF) as scaffold. Material and Methods: 20 male Wistar rats were randomly divided into four experimental groups consisting of: a control group featuring untreated mandibular defects (C), experimental groups whose mandibular defects were implanted with hUCMSC (E1), mandibular defects implanted with PRF (E2), mandibular defects implanted with hUCMSC and PRF scaffold (E3). The subjects were sacrificed after six weeks of observation for immunohistochemical examination in order to evaluate the expression of Ki67, Sox9, FGF 18, type 2 collagen, and aggrecan, in addition to histology examination to evaluate chondrocyte number and cartilage thickness. Data was analyzed with univariate analysis (ANOVA). Results: The implantation of hUCMSC and PRF scaffold proved capable of regenerating mandibular cartilage defect through the expression of FGF 18, Sox9, Ki67, chondrosis counts, type 2 collagen, aggrecan, and cartilage thickness. The regeneration were significantly higher in group E3. Conclusion: Human umbilical cord mesenchymal stem cells in platelet rich fibrin scaffold proved capable of regenerating mandibular cartilage defect.


Subject(s)
Animals , Rats , Cartilage , Cord Blood Stem Cell Transplantation , Regenerative Medicine , Mesenchymal Stem Cells/microbiology , Platelet-Rich Fibrin/microbiology , Immunohistochemistry , Epidemiology, Experimental , Analysis of Variance , Rats, Wistar , Indonesia/epidemiology
7.
Electron. j. biotechnol ; 47: 36-42, sept. 2020. tab, ilus, graf
Article in Spanish | LILACS | ID: biblio-1253018

ABSTRACT

BACKGROUND: For more than a decade, water-soluble, eco-friendly, biocompatible, and low-toxicity fluorescent nanomaterials have received considerable attention for their numerous in vivo and in vitro applications in biomedical imaging, disease diagnostics, and environmental monitoring. Owing to their tunable photoluminescence properties, carbon-based luminescent nanomaterials have shown great potential in bioimaging, photocatalysis, and biosensing among other applications. RESULTS: Marine environments provide excellent resources for the fabrication of these nanomaterials, because many marine organisms contain interesting trigger organic compounds that can be used as precursors. Herein, we synthesize multi-color emissive carbon dots (CDs) with an intrinsic photoluminescence quantum yield of 20.46%. These nanostructures were achieved through the one-step hydrothermal treatment of marine polysaccharide chondroitin sulfate, obtained from shark cartilage, in aqueous solution. CONCLUSIONS: We successfully demonstrate the low toxicity of our marine resource-derived CDs in zebrafish, and provide an initial assessment of their possible use as a bioimaging agent. Notably, the newly synthesized CDs localize in the intestines of zebrafish larvae, thereby indicating their biocompatibility and potential use as in vivo dyes.


Subject(s)
Animals , Polysaccharides/chemistry , Sharks , Carbon/chemistry , Quantum Dots/chemistry , Zebrafish , Carbon/toxicity , Cartilage , Quantum Dots/toxicity , Luminescence , Nanostructures , Coloring Agents/toxicity , Coloring Agents/chemistry
8.
Rev. cuba. reumatol ; 22(2): e787, mayo.-ago. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1126811

ABSTRACT

La policondritis recidivante es una enfermedad rara caracterizada por la inflamación recurrente del cartílago y otros tejidos en todo el cuerpo. La afectación del oído es la característica más común, pero puede afectar otras áreas del cuerpo, incluidos el cartílago costal, los ojos, la nariz, las vías respiratorias, el corazón, el sistema vascular, la piel, las articulaciones, los riñones y el sistema nervioso. Los signos y síntomas varían de persona a persona según las partes del cuerpo afectadas. La causa subyacente exacta de la policondritis recidivante se desconoce, aunque los científicos sospechan que se trata de una enfermedad autoinmune. Las complicaciones respiratorias (colapso de la tráquea e infecciones) son la causa más común de muerte, seguidas de la afectación cardiovascular. Los objetivos principales del tratamiento son aliviar los síntomas actuales y preservar la estructura del cartílago afectado. Gracias a las mejoras en el tratamiento, en los últimos años las tasas de supervivencia han aumentado, incluso después de 10 años(AU)


Recurrent polychondritis is a rare condition characterized by recurrent inflammation of cartilage and other tissues throughout the body. Ear involvement is the most common feature, but a variety of other areas of the body may be compromised, including costal cartilage, eyes, nose, airways, heart, vascular system, skin, joints, kidneys and nervous system. The signs and symptoms vary from person to person depending on the body parts affected. The exact underlying cause of recurrent polychondritis is unknown; however, scientists suspect it is an autoimmune condition. The main goals of treatment for people with recurrent polychondritis are to alleviate current symptoms and preserve the structure of the affected cartilage(AU)


Subject(s)
Humans , Male , Female , Polychondritis, Relapsing/diagnosis , Polychondritis, Relapsing/drug therapy , Polychondritis, Relapsing/therapy , Cartilage , Rare Diseases , Survivorship
9.
Braz. j. otorhinolaryngol. (Impr.) ; 86(4): 483-489, July-Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1132618

ABSTRACT

Abstract Introduction Elevation of tympanomeatal flap is one of the basic steps of tympanoplasty. A satisfactory level of anatomic and functional success can be achieved by using different grafts with limited tympanomeatal flap elevation. Objectives We aimed to compare the anatomic and functional success of tragal cartilage perichondrium and temporal muscle fascia in cases of endoscopic type 1 tympanoplasty performed with limited tympanomeatal flap elevation. Methods In total, 81 cases (33 females, 48 males, mean age 22.1<±<10.1 years, interval 18-49 years) which underwent transcanal endoscopic type 1 tympanoplasty with limited elevation of tympanomeatal flap were included the present study. All cases were divided into two groups as tragal cartilage perichondrium (group A) and temporal muscle fascia (group B). The comparison of the groups were made considering the pre- and postoperative air-bone gap and the tympanic membrane status. Results There was no statistically significant difference between Group A and Group B in preoperative and in postoperative air-bone gap values (p<=<0.608 and 0.529, respectively). In Group A and B, postoperative air-bone gap values demonstrated significant decrease compared to the preoperative values (p<=<0.0001). Group A and group B did not demonstrate significant differences between postoperative improvements of air-bone gap values (p<=<0.687). Graft retention success was 92.6% in group A while it was 90.0% in group B. There was no statistically significant difference between the groups in terms of graft retention success (p<=<0.166). Conclusion In accordance with the results of this study, we believe that both tragal cartilage perichondrium and temporal muscle fascia, and also in limited tympanomeatal flap elevation in endoscopic tympanoplasty are all eligible for result in safe and successful surgery.


Resumo Introdução O descolamento do retalho timpanomeatal é uma das etapas básicas da timpanoplastia. Um nível satisfatório de sucesso na restauração anatômica e funcional pode ser alcançado com o uso de diferentes enxertos e descolamento limitado do retalho timpanomeatal. Objetivos Comparar os resultados anatômicos e funcionais entre o uso de pericôndrio de cartilagem tragal e de fáscia do músculo temporal em timpanoplastias endoscópicas tipo 1 feitas com descolamento limitado do retalho timpanomeatal. Método Foram incluídos no estudo 81 pacientes (33 mulheres, 48 homens, média de 22,1 ± 10,1 anos, variação de 18-49 anos), submetidos a timpanoplastia endoscópica transcanal tipo 1 com descolamento limitado do retalho timpanomeatal. Todos os casos foram divididos em dois grupos: pericôndrio da cartilagem tragal (grupo A) e fáscia do músculo temporal (grupo B). Na comparação dos grupos consideraram-se o gap aéreo-ósseo, pré e pós-operatório, e a condição da membrana timpânica. Resultados Não houve diferença estatisticamente significante entre os grupos A e B no pré e pós-operatório (p = 0,608 e 0,529, respectivamente). Nos grupos A e B, os valores do gap aéreo-ósseo no pós-operatório demonstraram redução significante em relação aos valores pré-operatórios (p = 0,0001). Os grupos A e B não demonstraram diferenças significantes entre as medidas pré e pós-operatórias dos valores dos gaps (p = 0,687). O sucesso da retenção do enxerto foi de 92,6% no grupo A, enquanto no grupo B foi de 90,0%, não ocorreu diferença estatisticamente significante entre os grupos (p = 0,166). Conclusão De acordo com os resultados deste estudo, acreditamos que tanto o pericôndrio da cartilagem tragal como a fáscia do músculo temporal, usados com descolamento limitado do retalho timpanomeatal na timpanoplastia endoscópica, são elegíveis para uma cirurgia segura e bem-sucedida.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Tympanoplasty , Temporal Muscle , Cartilage , Retrospective Studies , Treatment Outcome , Tympanic Membrane Perforation , Fascia
10.
Arq. bras. med. vet. zootec. (Online) ; 72(3): 647-654, May-June, 2020. ilus, tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1128504

ABSTRACT

The elastic cartilage is composed by chondroblasts and chondrocytes, extracellular matrix and surrounded by perichondrium. It has a low regeneration capacity and is a challenge in surgical repair. One of obstacles in engineering a structurally sound and long-lasting tissue is selecting the most appropriate scaffold material. One of the techniques for obtaining biomaterials from animal tissues is the decellularization that decreases antigenicity. In this work, alkaline solution was used in bovine ear elastic cartilages to evaluate the decellularization and the architecture of the extracellular matrix. The cartilages were treated in alkaline solution (pH13) for 72 hours and lyophilized to be compared with untreated cartilages by histological analysis (hematoxylin-eosin, Masson's trichrome and Verhoeff slides). Areas of interest for cell counting and elastic fiber quantification were delineated, and the distribution of collagen and elastic fibers and the presence of non-fibrous proteins were observed. The results demonstrated that the alkaline solution caused 90% decellularization in the middle and 13% in the peripheral region, and maintenance of the histological characteristics of the collagen and elastic fibers and non-fibrous protein removal. It was concluded that the alkaline solution was efficient in the decellularization and removal of non-fibrous proteins from the elastic cartilages of the bovine ear.(AU)


A cartilagem elástica é composta por condroblastos e condrócitos, matriz extracelular e envolta por pericôndrio. Possui uma baixa capacidade de regeneração e é um desafio em reparos cirúrgicos. Um dos obstáculos na engenharia de tecido estruturalmente sólido e de longa duração é a seleção do material de arcabouço mais adequado. Uma das técnicas para obtenção de biomateriais oriundos de tecidos animais é a descelularização, que diminui a antigenicidade. Neste trabalho, foi utilizada solução alcalina em cartilagem elástica auricular bovina para avaliar a descelularização e a arquitetura da matriz extracelular. As cartilagens foram tratadas em solução alcalina (pH13) durante 72 horas e liofilizadas, e comparadas com cartilagens não tratadas por análise histológica (hematoxilina-eosina, tricrômio de Masson e Verhoeff). Foram determinadas as áreas de interesse para contagem celular e quantificação de fibras elásticas, observada a distribuição de colágeno e fibras elásticas e a presença de proteínas não fibrosas. Os resultados demonstraram que a solução alcalina causou 90% de descelularização na região central e 13% na região periférica, manutenção das características histológicas do colágeno e fibras elásticas e remoção das proteínas não fibrosas. Concluiu-se que a solução alcalina foi eficiente na descelularização e retirada de proteínas não fibrosas de cartilagens elásticas da orelha de bovinos.(AU)


Subject(s)
Biocompatible Materials , Chondrocytes , Tissue Engineering/veterinary , Elastic Cartilage , Extracellular Matrix , Cattle , Cartilage , Eosine Yellowish-(YS) , Alkalies
11.
Acta ortop. mex ; 34(1): 27-30, ene.-feb. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1345081

ABSTRACT

Resumen: Introducción: El cartílago rotuliano está sometido a altas demandas mecánicas y es una localización muy frecuente de lesiones. No existe consenso en cuanto a su tratamiento. El trasplante osteocondral autólogo puede ser una alternativa para los defectos condrales de pequeño o mediano tamaño con resultados variables en la bibliografía. Nuestro objetivo es analizar los resultados funcionales a mediano plazo de los pacientes con lesiones del cartílago patelar grado III-IV de la International Cartilage Repair Society (ICRS) tratados en nuestro centro. Material y métodos: Estudio retrospectivo con pacientes menores de 55 años, con un defecto condral patelar sintomático, diámetro menor de 2 cm, grado III-IV de la ICRS tratados mediante trasplante osteocondral autólogo entre los años 2012 y 2018. Se evalúan las siguientes variables: edad, sexo, tamaño de la lesión, faceta afectada, número de cilindros trasplantados, escala de Kujala pre y postoperatoria y escala visual analógica del dolor (EVA) pre y postoperatoria. Resultados: Integramos en nuestro estudio 11 pacientes. La mediana de edad fue de 47 años. La mediana del diámetro del defecto condral 1.3 cm. La mediana de seguimiento 3.9 años (1.84-5.58 años). La mediana del cuestionario Kujala preoperatoria es 33 y asciende a 89 al final del seguimiento (p = 0.003). La mediana de la puntuación EVA preoperatoria es nueve y dos al final del seguimiento (p = 0.003). Conclusión: El trasplante osteocondral autólogo generó una importante mejora subjetiva de la función y del dolor.


Abstract: Introduction: Patellar cartilage is subject to high mechanical requests and is a very frequent location of injuries. There is no consensus on their treatment. Autologous osteochondral transplantation may be an alternative to small to medium-sized condral defects with varying results in the literature. Our goal is to analyze the medium-term functional outcomes of patients with grade III-IV patellar cartilage injuries from the International Cartilage Repair Society (ICRS) treated at our facility. Material and methods: Retrospective study in patients under 55 years of age, with a symptomatic patellar condral defect, diameter less than 2 cm, grade III-IV of ICRS treated by autologous osteochondral transplant between 2012 and 2018. The following variables are evaluated: age, sex, injury size, affected facet, number of transplanted cylinders, pre- and postoperative Kujala score, and pre- and postoperative analog visual pain scale (EVA). Results: Eleven patients integrated into our study. The median age was 47 years. The median diameter of the condral defect 1.3 cm. Median follow-up 3.9 years (1.84-5.58 years). The median of the preoperative Kujala questionnaire is 33 and is 89 at the end of the follow-up (p = 0.003). The median of the preoperative EVA score is 9 and 2 at the end of the follow-up (p = 0.003). Conclusion: Autologous osteochondral transplantation generated a significant subjective improvement in function and pain.


Subject(s)
Humans , Patella , Bone Transplantation , Transplantation, Autologous , Cartilage , Retrospective Studies , Follow-Up Studies , Treatment Outcome , Middle Aged
12.
J. Health Biol. Sci. (Online) ; 8(1): 1-6, 20200101. ilus
Article in English | LILACS | ID: biblio-1130007

ABSTRACT

Objective: To investigate the prevalence of calcified triticeous cartilage (CTC)-compatible images on digital panoramic radiographs of a significant Brazilian population sample. Methods: In this retrospective study, 2500 digital panoramic radiographs were analyzed by a trained examiner using contrast and brightness adjustments of the Adobe® Photoshop® CC 2015 software. Data were collected and exported for statistical analysis (p-value <0.05 was considered statistically significant). Results: The prevalence of CTC-compatible images was 4.5% (61.1% in women and 38.9% in men). The most prevalent age ranged between 51 and 60 years (32.7%), and bilateral occurrence had a higher prevalence (46.9%). Women between the ages of 61 and 70 years showed a significantly higher prevalence of CTC-compatible images (p=0.027). Conclusion: This study showed a low prevalence of CTC-compatible images, which mainly occurred in women close to 70 years of age.


Objetivo: Investigar a prevalência de imagens compatíveis com calcificação da cartilagem tritícea (CCT) em radiografias panorâmicas digitais de uma significante amostra populacional brasileira. Métodos: Neste estudo retrospectivo, 2500 radiografias panorâmicas digitais foram analisadas por um examinador treinado utilizando ajustes de contraste e brilho através do software Adobe® Photoshop® CC 2015. Os dados foram coletados e exportados para análise estatística (p<0,05 foi considerado como valor estatisticamente significante). Resultados: A prevalência de imagens compatíveis com CCT foi de 4,5% (61.1% em mulheres e 38.9% em homens). A idade mais prevalente variou entre 51 e 60 anos (32,7%), sendo a ocorrência bilateral a mais comum (46,9%). Mulheres com idade entre 61 e 70 anos apresentaram prevalência significativamente maior de imagens compatíveis com CCT (p=0,027). Conclusão: O presente estudo evidenciou uma baixa prevalência de imagens compatíveis com CCT, que ocorreram, principalmente, em mulheres com idade próxima aos 70 anos.


Subject(s)
Calcification, Physiologic , Cartilage , Population , Thyroid Cartilage , Women , Radiography, Panoramic , Prevalence , Men
13.
Article in English | WPRIM | ID: wpr-881038

ABSTRACT

Due to the poor repair ability of cartilage tissue, regenerative medicine still faces great challenges in the repair of large articular cartilage defects. Quercetin is widely applied as a traditional Chinese medicine in tissue regeneration including liver, bone and skin tissues. However, the evidence for its effects and internal mechanisms for cartilage regeneration are limited. In the present study, the effects of quercetin on chondrocyte function were systematically evaluated by CCK8 assay, PCR assay, cartilaginous matrix staining assays, immunofluorescence assay, and western blotting. The results showed that quercetin significantly up-regulated the expression of chondrogenesis genes and stimulated the secretion of GAG (glycosaminoglycan) through activating the ERK, P38 and AKT signalling pathways in a dose-dependent manner. Furthermore, in vivo experiments revealed that quercetin-loaded silk protein scaffolds dramatically stimulated the formation of new cartilage-like tissue with higher histological scores in rat femoral cartilage defects. These data suggest that quercetin can effectively stimulate chondrogenesis in vitro and in vivo, demonstrating the potential application of quercetin in the regeneration of cartilage defects.


Subject(s)
Animals , Cartilage/cytology , Chondrocytes/drug effects , Chondrogenesis/drug effects , Extracellular Matrix/metabolism , Quercetin/pharmacology , Rats , Signal Transduction/drug effects , Tissue Scaffolds
14.
Article in Chinese | WPRIM | ID: wpr-827552

ABSTRACT

OBJECTIVE@#This study aimed to compare the cartilage regeneration of the stromal vascular fraction (SVF) cells and adipose-derived mesenchymal stem cells (ASCs) cocultured with chondrocytes seeded on the scaffolds.@*METHODS@#The cellular morphologies and proliferation capabilities on the scaffolds were evaluated. The scaffolds with the cocul-ture of ASCs/SVF and chondrocytes were implanted into the full thickness cartilage defective rabbit joints for 10 weeks.@*RESULTS@#The cells seeded into the scaffolds showed good adhesion and proliferation. Implantation with SVF and chondrocytes revealed desirable in vitro healing outcomes.@*CONCLUSIONS@#The SVF cells were better than ASCs in terms of the formation of cartilage matrix in a coimplantation model. Without in vitro expansion, the SVF cells are good cell sources for cartilage repair.


Subject(s)
Adipose Tissue , Animals , Cartilage , Chondrocytes , Coculture Techniques , Rabbits , Regeneration
15.
Article in English | WPRIM | ID: wpr-786142

ABSTRACT

OBJECTIVE: The aim of this study was to determine the relationships of serum and urine uric acid with severity or activity in knee osteoarthritis (OA).METHODS: A total of 42 patients with knee OA was enrolled, together with 58 healthy controls. Serum uric acid and spot urine uric acid levels were assessed for all patients. The severity and activity of knee OA were assessed by musculoskeletal ultrasound (MSUS) and plain radiography of the knee joint. Ultrasonographic abnormalities in knee OA includedsynovial hypertrophy, suprapatellar effusion, cartilage degradation, and osteophyte formation. Kellgren-Lawrence (K-L) grade was used to evaluate radiological progression of knee OA.RESULTS: Patients with K-L grade III had a higher urine uric acid/creatinine ratio compared to those with K-L grade I (p=0.043). Patients with synovial hypertrophy had higher serum uric acid level compared to those without synovial hypertrophy (p=0.016). The urine uric acid/creatinine ratio was higher in patients with cartilage degradation compared to those without cartilage degradation (p=0.022). Serum uric acid was significantly associated with synovial hypertrophy thickness (r=0.375, p=0.018) but not with cartilage thickness after adjusting for age and body mass index. Lower urine uric acid was related with knee OA compared to healthy controls (odds ratio=0.974, 95% confidence interval 0.954~0.994, p=0.013).CONCLUSION: The results of our study suggest that serum and urine uric acid reflects synovial inflammation based on MSUS and radiographic progression and then is associated with the pathogenesis of knee OA.


Subject(s)
Body Mass Index , Cartilage , Humans , Hypertrophy , Inflammation , Knee Joint , Knee , Osteoarthritis , Osteoarthritis, Knee , Osteophyte , Radiography , Ultrasonography , Uric Acid
16.
Article in Spanish | LILACS, COLNAL | ID: biblio-1102964

ABSTRACT

Introducción: las perforaciones septales y su corrección quirúrgica constituyen un reto para los otorrinolaringólogos. En la literatura se describen diferentes técnicas para el cierre de las perforaciones septales; sin embargo, sus resultados en términos de efectividad son muy variables y con pocos pacientes. Desde hace 8 años se viene realizando la técnica de cierre de perforación septal con injertos de cartílago en el servicio de otorrinolaringología del Hospital de San José, y se ha observado una respuesta clínica exitosa. El objetivo del presente estudio fue describir los resultados posoperatorios de los pacientes manejados con la técnica de cierre quirúrgico de perforación septal con injertos de cartílago, en términos de aparición de complicaciones y frecuencia de perforación septal residual. Materiales y métodos: mediante un estudio de cohorte descriptiva se presentan los pacientes manejados con la técnica de cierre quirúrgico de perforación septal con injertos de cartílago de banco o cartílago autólogo. Se incluyen pacientes a partir enero de 2014 a junio 2018. De la historia clínica se extrajeron los datos demográficos, clínicos, complicaciones y presentación de perforación septal residual. Resultados: la tasa de éxito de cierre de perforación septal fue de 78,3 %; siendo las etiologías más frecuentes antecedente de cirugía e idiopática. La complicación más común fue epistaxis en el 26 % de los pacientes, seguida de dolor en el 21,7 % en el posoperatorio mediato, el cual mejoró en los controles posteriores. Conclusión: los resultados con la técnica de cierre de perforación septal con injerto de banco fueron satisfactorios en esta población.


Introduction: septal perforations and surgical correction are a challenge for ENT specialists. Several techniques for closing septal perforations are described in the literature; however, its results in terms of effectiveness are variable and with small sample sizes. The technique of closure of septal perforation with cartilage grafts has been performed for 8 years in the ENT department of Hospital de San José with a successful clinical response. Aims: to describe the postoperative results of patients managed with the technique of surgical closure of septal perforation with cartilage grafts, in terms of complications and frequency of residual septal perforation. Design: descriptive cohort study. Methods: a cohort of patients managed with the surgical closure technique of septal perforation with grafts of bank cartilage or autologous cartilage are described. Patients were included from January 2014 to June 2018. Demographic, clinical data, complications and presentation of residual septal perforation were extracted from the clinical history. Results: The success rate of septal perforation closure was 78.3 %; being the most frequent etiologies antecedent of surgery and idiopathic. The most common complication was epistaxis in 26 % of patients, followed by pain in 21.7 % in the postoperative period, which improved in subsequent controls. Conclusion: the results with the technique of closure of septal perforation with bank grafting were satisfactory in this population.


Subject(s)
Humans , Nasal Septal Perforation , Cartilage , Nose Deformities, Acquired , Reconstructive Surgical Procedures
17.
Rev. med. Risaralda ; 25(2): 83-94, jul.-dic. 2019. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1115751

ABSTRACT

Resumen La osteoartritis (OA) es una enfermedad degenerativa, cuyo tratamiento convencional incluye medicamentos, fisioterapia o prótesis. Las células madre con Plasma Rico en Plaquetas y factores de crecimiento son una opción que promete controlar los síntomas, mejorar la función y regenerar el cartílago; sin embargo, no se han especificado muchos detalles del tratamiento, como el tipo y la cantidad de células madre que se deben aplicar para obtener mejores resultados. En este estudio buscamos comparar la efectividad, la seguridad y los costos de dos dosis (1X107vs 3X107) de células madre derivadas de tejido adiposo (ADSC), aplicadas por vía intraarticular. Diez pacientes, con OA de rodilla grados II y III, fueron aleatorizados para recibir 10 (n = 5) o 30 millones (n = 5) de ADSC autólogos. Al inicio y 6 a 10 meses después de la inyección, se evaluaron de acuerdo con los criterios clínicos (evaluación médica, escala WOMAC, calidad de vida) y paraclínicos (artroscopia, resonancia, biopsia). En términos de efectividad y seguridad no se observaron diferencias entre los dos grupos de dosificación, ya que todos los pacientes tuvieron una mejoría de acuerdo con los criterios médicos y la escala WOMAC (P = 0,001); en el control artroscópico, 7 pacientes tuvieron una respuesta "buena / muy buena", 1 "neutral" y 2 abandonaron el control; Las biopsias confirman la regeneración articular, aunque no hubo diferencias en las resonancias magnéticas anteriores y posteriores. En la osteoartritis de rodilla, la aplicación de 10 o 30 millones de ADSC fue igualmente efectiva y segura; sin embargo, el protocolo con 10 millones de células no requiere expansión in vitro, requiere menos tiempo, es más simple y tiene un costo menor. Este estudio muestra una buena razón para realizar ensayos clínicos aleatorios para obtener evidencia de mayor calidad.


Abstract Osteoarthritis (OA) is a degenerative disease where conventional treatment includes drugs, physiotherapy, or prostheses. Stem cells and growth factors are a promising option in controlling symptoms, functional improvement and cartilage regeneration; however, many treatment details have not been specified, such as type and number of stem cells that should be applied to obtain optimal results. In this study we sought to compare effectiveness, safety and costs of two doses (1X107vs 3X107) of adipose tissue derived stem cells (ADSC), applied intra-articularly. Ten patients, with knee OA grades II and III, were randomized to receive 10 (n=5) or 30 million (n=5) of autologous ADSCs. At baseline and 6 to 10 months after injection, they were evaluated according to clinical (medical evaluation, WOMAC scale, quality of life) and paraclinical criteria (arthroscopy, resonance, biopsy). In terms of effectiveness and safety there were no differences observed among the two dosage groups since all patients had improvement according to medical criteria and the WOMAC scale (P=0,001); in the arthroscopic control, 7 patients had "good/very good" response, 1 "neutral" and 2 forwent control; biopsies confirm joint regeneration, although there were no differences in the before and after magnetic resonances. In knee osteoarthritis, the application of 10 or 30 million ADSCs was equally effective and safe; however, the protocol with 10 million cells does not require in vitro expansion, requires less time, is simpler and has a lower cost. This study shows good reason to undertake randomized clinical trials to gain higher quality evidence.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Osteoarthritis , Stem Cells , Regeneration , Effectiveness , Cartilage , Regenerative Medicine , Knee
18.
Rev. bras. ortop ; 54(6): 679-684, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1057950

ABSTRACT

Abstract Objective To describe a postarthroscopic treatment classification system for acetabular chondral damage in the hip and to report the intraobserver and interobserver reliability of such classification. Methods This is a retrospective review of ninety-nine digital video recordings made during arthroscopic surgery. Patients who underwent arthroscopic treatment for femoroacetabular impingement and evaluated at the hip arthroscopy outpatient clinic between March 2015 and March 2016 were included in the study. Patients with a history of previous hip surgery, radiologic evidence of advanced osteoarthritis (Tönnis grade > 2), who underwent labral resection, or whose digital recordings were incomplete or of insufficient quality for adequate review were excluded. Two orthopedic surgeons, who did not participate in the surgery, independently reviewed the video recordings and classified the remaining acetabular cartilage using the post-treatment classification system. Intraobserver and interobserver analysis was then conducted using intraclass correlation coefficient (ICC). Results Excellent intraobserver reliability (ICC = 0.790; p < 0.001) and interobserver reliability (ICC = 0.882; p < 0.001) were observed. Both ICC values were statistically significant. Conclusion The posttreatment classification of the remaining acetabular cartilage has excellent intra and interobserver reliability.


Resumo Objetivo Descrever um sistema de classificação de tratamento pós-artroscópico para as lesões condrais acetabulares no quadril e relatar as confiabilidades intra e interobservador deste sistema. Métodos Esta é uma revisão retrospectiva de 99 gravações de vídeo digital realizadas durante artroscopia. Os pacientes submetidos a tratamento artroscópico para impacto femoroacetabular e avaliados no ambulatório de quadril entre março de 2015 e março de 2016 foram incluídos no estudo. Os pacientes com histórico de cirurgia anterior do quadril, evidência radiológica de osteoartrose avançada (Tönnis > 2), pacientes submetidos à ressecção labral ou cujas gravações digitais estavam incompletas ou de qualidade insuficiente para avaliação adequada foram excluídos. Dois ortopedistas, que não participaram da cirurgia, revisaram de forma independente as gravações de vídeo e classificaram a cartilagem acetabular remanescente usando o sistema de classificação pós-tratamento. A análise intra e interobservador foi então realizada utilizando o coeficiente de correlação intraclasse (CCI). Resultados Excelente confiabilidade intraobservador (CCI = 0,790; p < 0,001) e confiabilidade interobservador (CCI = 0,882; p < 0,001). Ambos os valores de CCI foram estatisticamente significativos. Conclusão a classificação pós-tratamento da cartilagem acetabular remanescente possui excelente confiabilidade intra e interobservador.


Subject(s)
Humans , Osteoarthritis , Arthroscopy , Cartilage , Treatment Outcome , Chondrocytes/classification , Hip Injuries , Orthopedic Surgeons
19.
Rev. bras. ortop ; 54(5): 509-515, Sept.-Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1057940

ABSTRACT

Abstract Objective To determine whether type-II collagen degradation is determined by the type of sport. Carboxy-terminal telepoptide of type-II collagen (CTX-II), a serum biomarker of collagen degradation, was measured in athletes who play different sports, and was compared with matched controls. Methods The sample size consisted of 70 female participants aged between 18 and 25 years, 15 of whom were members of a soccer team, 10 of a futsal (a variant of association football played on a hard court) team, 10 of a handball team, 18 of a volleyball team, and 7 of a swimming team. A total of 9 age- and sex-matched individuals with sedentary lifestyles were included in the control group. 3-mL blood samples were collected from each participant, and they were analyzed using an enzyme-linked immunosorbent assay (ELISA). Results A comparison of the CTX-II concentrations of the players of different sports with those of the control group resulted in the following p-values: volleyball (p = 0.21); soccer (p = 0.91); handball (p = 0.13); futsal (p = 0.02); and swimming (p = 0.0015). Therefore, in the investigated population, futsal represented the highest risk for type-II collagen degradation and, consequently, for articular cartilage degradation, whereas swimming was a protective factor for the articular cartilage. No statistically significant difference was found in the body mass index among the groups. Conclusion Futsal players are exposed to greater articular degradation, while swimmers exhibited less cartilage degradation compared with the control group in the study population, suggesting that strengthening the periarticular muscles and aerobic exercise in low-load environments has a positive effect on the articular cartilage.


Resumo Objetivo Determinar se a degradação de colágeno tipo II é determinada pelo tipo de esporte. O telopeptídeo carboxiterminal do colágeno tipo II (CTX-II), biomarcador de soro de degradação de colágeno, foi medido em atletas de esportes diferentes e comparado aos controles correspondentes. Métodos A amostra consistiu em 70 participantes do sexo feminino com idade entre 18 a 25 anos, das quais 15 eram membros de uma equipe de futebol, 10 de uma equipe de futebol de salão, 10 de uma equipe de handebol, 18 de uma equipe de voleibol, e 7 de uma equipe de natação. Foram incluídos no grupo de controle 9 indivíduos sedentários, pareados por idade e sexo. Uma amostra de sangue de 3 ml foi coletada de cada participante e analisada usando um ensaio imunossorvente ligado a enzima (ELISA, do inglês enzyme-linked immunosorbent assay). Resultados Uma comparação das concentrações de CTX-II das praticantes de diferentes esportes em comparação com o grupo de controle apresentou os seguintes valores de p: voleibol (p = 0,21); futebol (p = 0,91); handebol (p = 0,13); futebol de salão (p = 0,02) e natação (p = 0,0015). Portanto, na população investigada, o futebol de salão apresentou o maior risco de degradação do colágeno tipo II, e, consequentemente, de degradação da cartilagem articular, enquanto a prática de natação foi um fator protetor para a cartilagem articular. Não foi observada diferença estatisticamente significativa no índice de massa corporal entre os grupos. Conclusão As jogadoras de futebol de salão estão expostas a uma maior degradação articular, enquanto as nadadoras apresentam menor degradação da cartilagem em comparação com o grupo de controle na população estudada, o que sugere que o fortalecimento dos músculos periarticulares e o exercício aeróbico em ambientes de baixa carga têm um efeito positivo na cartilagem articular.


Subject(s)
Humans , Female , Adult , Play and Playthings , Soccer , Sports , Swimming , Enzyme-Linked Immunosorbent Assay , Biomarkers , Exercise , Cartilage , Body Mass Index , Control Groups , Collagen , Volleyball , Athletes , Protective Factors , Football , Life Style
20.
Rev. bras. ortop ; 54(5): 556-563, Sept.-Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1057932

ABSTRACT

Abstract Objective To demonstrate that the intraosseous (IO) access is more effective compared with the intravenous (IV) access for prophylactic antibiotic administration in knee joint surgeries, using 36 pigs as live models. Materials and Methods Skin, subcutaneous tissue, cartilage, and bone samples were collected, analyzed and compared after the administration of IV or IO antibiotic in different groups. Results When comparing the IO and IV groups, the IO group showed a higher concentration of prophylactic antibiotic in the skin (p = 0.049), cartilage (p = 0.018), and bone (p = 0.002), in the analysis of the first 24 hours after 30 minutes of infusion. Conclusion Since complications regarding this practice are rare, the use of this pathway may be an alternative to reduce the risk of surgical site infection in orthopedic surgeries, leading to a decrease in morbidity and mortality and hospital expenses with readmission or prolonged hospitalization time. However, further research and further experimental studies in humans are required, as the effectiveness of the method in pigs has been proved.


Resumo Objetivo Demonstrar, em 36 porcos usados como modelos vivos, que o acesso intraósseo (IO) é mais eficaz em comparação com o acesso endovenoso (EV) na administração de antibiótico profilático em cirurgias na articulação do joelho. Materiais e Métodos Foram coletadas, analisadas e comparadas amostras de pele, tecido subcutâneo, cartilagem e osso, após administração de antibiótico profilático EV e IO em grupos diferentes. Resultado A comparação entre os grupos IO e EV indicou que no grupo IO houve maior concentração de antibiótico profilático na pele (p = 0,049), na cartilagem (p = 0,018) e no osso (p = 0,002), na análise das primeiras 24 horas após 30 minutos de infusão. Conclusão Visto que as complicações dessa prática são raras, o uso dessa via pode ser uma opção para a diminuição do risco de infecção do sítio cirúrgico nas cirurgias ortopédicas, pois leva à diminuição da morbimortalidade e dos gastos hospitalares com reabordagens ou com tempo prolongado de internação. Contudo, são necessários mais pesquisas e novos estudos experimentais em seres humanos, dado que está comprovada a eficácia do método em porcos.


Subject(s)
Animals , Arthroplasty , Swine , Cartilage , Indicators of Morbidity and Mortality , Antibiotic Prophylaxis , Infections , Anti-Bacterial Agents
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