WorldWideScience

Sample records for carillas articulares cervicales

  1. LOCATIONS AND LENGTHS OF OSTEOPHYTES IN THE CERVICAL VERTEBRAE. LOCALIZACIONES Y LONGITUD DE LOS OSTEOFITOS EN LAS VÉRTEBRAS CERVICALES

    Directory of Open Access Journals (Sweden)

    Patcharin Chanapa

    2016-03-01

    Full Text Available Muchos pacientes sufren de disfagia, vértigo, dolor en el brazo, entumecimiento o debilidad. Estos problemas pueden ser debidos a la aparición de osteofitos en las vértebras cervicales. El propósito de esta investigación ha sido estudiar las localizaciones y tamaño de los osteofitos en las vértebras cervicales. Se han usado 200 columnas cervicales (139 varones y 61 mujeres de vértebras secas C3-C7, de un promedio de edad de 71 años (36-98 años. Se han encontrado osteofitos en 184 columnas (92 %, la mayoría en C5, C6, C4, C7 y C3 (83, 77, 74, 65 y 64%, respectivamente. La media del tamaño de los osteofitos en C3 (4.44 ±1.31 mm ha sido mayor que los de C4-C7. La mayor cantidad de osteofitos se encontraron en los cuerpos vertebrales, carilla articular y foramen transverso (49,35 y 16% respectivamente. La mayor longitud de los osteofitos en el cuerpo de las vértebras se encontraron en la vértebra fue 4.28 ±1.65 mmen C6, en la cara articular fue 5.07 ±1.57 mmen  C5 y en el transverso foramen fue  2.49 ±1.57 mmen C6. La longitud de los osteofitos del lado anterior superior y de la cara inferior del cuerpo ha sido más larga que la de los lados posterior y lateral. La longitud de los osteofitos muestra una correlación significativa y directa con la edad. Conclusión: Los osteofitos que han aparecido en el cuerpo de las vértebras, la cara y el foramen transverso pueden incidir en las estructuras cercanas. Este estudio puede ayudar a explicar algunos problemas clínicos como la disfagia, insuficiencia vertebrobasilar y braquialgia. Many patients suffer from dysphagia, vertigo, arm pain, numbness or weakness. These problems may arise from osteophytes in the cervical vertebrae. The purpose was to study the distribution and lengths of osteophyte in the cervical vertebrae. We used 200 cervical columns (139 male and 61 female of dry C3-C7 vertebrae. Osteophytes were found in 184 columns (92%, mostly at C5, C6, C4, C7 and C3 (83, 77, 74

  2. Solución Estética a un dilema en las restauraciones indirectas con corona y carillas simultáneas: Reporte de un caso.

    OpenAIRE

    Hidalgo Lostaunau, Rony Christian; Chinchay Ríos, Paola

    2014-01-01

    El presente artículo presenta una alternativa de solución ante la necesidad de resolver el sector anterior con combinaciones de carillas y corona.Se confeccionó una infraestructura que simula a un diente natural tallado para carilla y luego la cementación de las carillas sobre dientes preparados y sobre la infrestructura adhoc.Esta es una alternativa ante la imposibilidad de coincidir estéticamente de manera adecuada una situación clínica en la cual la coincidencia estética sea un reto; el ma...

  3. Le traitement de la tuberculose ganglionnaire cervicale a propos de ...

    African Journals Online (AJOL)

    La durée de la chimiothérapie antituberculeuse est encore sujet de controverse. Mots clés : tuberculose ganglionnaire, adénopathie cervicale, antituberculeux, chirurgie. Objective : Lymph node infection is the most frequent localization of extrapulmonary tuberculosis. The treatment does not make general agreement.

  4. le traitement de la tuberculose ganglionnaire cervicale a propos de ...

    African Journals Online (AJOL)

    Introduction : La tuberculose ganglionnaire cervicale représente la localisation extra pulmonaire la plus fréquemment observée. Cependant, le traitement d'une affection aussi répandue dans le monde ne fait pas consensus. L'objectif de cette étude est de préciser, à travers une revue de la littérature, les différents moyens ...

  5. Tuberculose lymphonodale cervicale chez les enfants vaccines par ...

    African Journals Online (AJOL)

    La tuberculose ganglionnaire cervicale est une localisation extrapulmonaire relativement fréquente chez l'enfant. Elle pose essentiellement des difficultés de prévention. L'objectif de ce travail est d'étudier les particularités diagnostiques et thérapeutiques chez des enfants vaccinés par le BCG. Matériel et méthodes: Nôtre ...

  6. Effect of processing on the antioxidant vitamins and antioxidant capacity of Vigna sinensis Var. Carilla.

    Science.gov (United States)

    Doblado, Rosa; Zielinski, Henryk; Piskula, Mariusz; Kozlowska, Halina; Muñoz, Rosario; Frías, Juana; Vidal-Valverde, Concepción

    2005-02-23

    Cowpea (Vigna sinensis L. var. Carilla) flours obtained by fermentation with inoculum Lactobacillus plantarum (PF) or with the natural microorganisms present in the flour (NF) and subsequent heat treatment in an autoclave were prepared to study the effect of fermentation on the antioxidant vitamin content and on the antioxidant capacity. Bacterial counts and pH values, vitamins C and E, carotenoids, glutathione (GSH), superoxide dismutase-like activity (SOD-like activity), peroxyl radical-trapping capacity (PRTC), lipid peroxidation in unilamillar liposomes, and Trolox equivalent antioxidant capacity (TEAC) were evaluated in raw and processed cowpea flours. gamma-Tocopherol and delta-tocopherol were found in raw cowpea, whereas vitamin C and carotenoids were not detected. An increase in the vitamin E activity was observed in PF, whereas vitamin C and carotenoids were not detected in fermented cowpea flours. Fermentation or heat treatment in an autoclave after fermentation produced processed cowpea flours with lower PRTC, glutathione content, and SOD-like activity than those of the raw seeds. However, those processes increased the capacity to inhibit the lipid peroxidation in unilamellar lipoposomes and TEAC. According to the results obtained in this study, the fermentation of cowpeas (naturally or with L. plantarum) and fermentation and subsequent heat treatment in an autoclave are good processes to obtain functional cowpea flours having higher antioxidant capacity than the raw legume.

  7. Profils étiologies des adénopathies cervicales chroniques en milieu ...

    African Journals Online (AJOL)

    La tuberculose a représenté 56% des étiologies et les lymphomes 26,67%. Vingt neuf patients soit 38,66% étaient infectés par le VIH dont 20 tuberculeux et 7 patients présentant un lymphome. La recherche de l'infection par le VIH doit être systématique devant ces deux étiologies. Mots clés : Adénopathies cervicales, ...

  8. Factores asociados a lesiones cervicales o presencia del virus del papiloma humano en dos poblaciones de estudiantes de Lima

    Directory of Open Access Journals (Sweden)

    María Valderrama C

    2007-07-01

    Full Text Available Objetivos: Determinar la prevalencia y factores asociados a lesiones cervicales o presencia del virus del papiloma humano (VPH en mujeres estudiantes en educación superior de 18 a 26 años de Lima. Materiales y métodos: Se realizó un estudio de corte transversal, en dos universidades y un instituto superior tecnológico de Lima, durante los meses de agosto a diciembre del 2001. Se aplicó un cuestionario y se colectaron muestras para Papanicolaou (PAP y detección del ADN de los VPH 6, 11, 16, 18 por el método de PCR (reacción en cadena de la polimerasa. Se incluyeron en el análisis 321 estudiantes que reportaron actividad sexual a quienes se tomó muestras para PAP y VPH. Resultados: La prevalencia de VPH (6, 11, 16, 18 fue de 8,4%, y para las lesiones cervicales fue 2,5% (diagnóstico a través del PAP. Las lesiones cervicales o presencia del VPH fueron más frecuentes en el grupo de 21 a 23 años (p= 0,024. La diferencia de edades (tres a más años entre la pareja sexual de mayor edad y la participante se asoció significantemente con lesiones cervicales o presencia del VPH (OR:8,8; IC95:1,9-39,6. La edad de la primera relación sexual, número de parejas sexuales y uso de condón, no mostraron significancia estadística. Conclusiones: Las lesiones cervicales o presencia del VPH son frecuentes en esta población de mujeres jóvenes. La edad y la diferencia de edades con la pareja sexual de mayor edad se asociaron a las lesiones cervicales o presencia del VPH.

  9. Espondilodiscitis cervicales

    OpenAIRE

    Barrecheguren, E.Gª. (E.Gª); Barriga, A. (A.); Barroso, J.L. (J.L.); Villas, C. (C.)

    2001-01-01

    Se revisaron nueve casos de discitis infecciosas de localización cervical de una serie de ochenta pacientes con espondilodiscitis (10%). Se valoraron mediante historia clínica, analítica y radiología simple todos ellos. Además, seis de ellos se valoraron por Resonancia Magnética, tres por gammagrafía ósea, y un caso por punción-biopsia. Los factores predisponentes eran claros en seis de los pacientes, encontrando entre ellos tres sepsis por Stafilococcus aureus, dos intervenciones quirúrgicas...

  10. Médiastinite compliquant une cellulite cervicale à porte d’entrée dentaire: à propos d’un cas et revue de la littérature

    Directory of Open Access Journals (Sweden)

    Issam Serghini

    2011-03-01

    Full Text Available Les cellulites cervicales ou fasciites cervicales nécrosantes sont des infections des parties molles développées à partir de foyer dentaire ou pharyngé dont le risque, si elles ne sont pas reconnues précocement, est l’extension vers le médiastin. Les premiers signes cliniques sont parfois frustres et peuvent conduire à un retard diagnostique. L’examen clé est la tomodensitométrie cervicale et thoracique. Le traitement consiste en des excisions tissulaires larges et répétées associées une antibiothérapie dirigée contre les germes aréo- et anaérobies. Nous rapportons le cas d’un homme connu diabétique présentant une cellulite cervicale d’origine dentaire compliquée de médiastinite.

  11. Development of artificial articular cartilage

    Indian Academy of Sciences (India)

    The present study describes the development of artificial articular cartilage on the basis of mimicking structural gel properties and mechanical gel properties of natural articular cartilage. It is synthesized from PVA/Si nanocomposite containing 20% Tetra ethoxy silane (TEOS) by sol–gel method. Mechanical strength of ...

  12. Grossesse cervicale à 7 semaines d’aménorrhée: défis de la prise en charge

    Science.gov (United States)

    Khachani, Imane; Alami, Mohamed Hassan; Bezad, Rachid

    2017-01-01

    La grossesse cervicale est une forme extrêmement rare de grossesse ectopique qui engage le pronostic vital maternel en raison du risque important d'hémorragie. Nous rapportons l'observation d’une patiente âgée de 35 ans, ayant accouché une première fois par césarienne et qui a présenté une grossesse cervicale diagnostiquée à 7 semaines d'aménorrhée. La prise en charge au sein de notre structure a fait appel au traitement médical puis chirurgical après échec du premier. L'intérêt de cette observation réside dans la démarche diagnostique et les différentes étapes de prise en charge thérapeutique. Cervical pregnancy is an extremely rare form of ectopic pregnancy which can be life-threatening due to the high risk of hemorrhage. We report a case of a 35-year-old woman, who first gave birth by caesarean section, with cervical pregnancy diagnosed at 7 weeks of amenorrhea. Patient management within our structure was based on medical treatment followed by surgery after failure of medical treatment. The importance of this study lies in the diagnostic approach and in the different stages of therapeutic management. PMID:28450982

  13. Evaluation of the Thompson articular index

    NARCIS (Netherlands)

    van den Brink, H. R.; van der Heide, A.; Jacobs, J. W.; van der Veen, M. J.; Bijlsma, J. W.

    1993-01-01

    Three articular indices for measuring disease activity are compared. In a cross sectional study the Thompson articular index (a modified Lansbury index) correlated better with laboratory variables than the Ritchie articular index or a swollen joint score (Thompson 0.74-0.77; Ritchie 0.57-0.58;

  14. Postnatal development of articular cartilage

    NARCIS (Netherlands)

    Turnhout, van M.C.

    2010-01-01

    Articular cartilage (AC) is the thin layer of tissue that covers the ends of the bones in the synovial joints in mammals. Functional adult AC has depth-dependent mechanical properties that are not yet present at birth. These depth-dependent mechanical properties in adult life are the result of a

  15. Development of artificial articular cartilage

    Indian Academy of Sciences (India)

    Mechanical strength of Poly(vinyl alcohol), PVA is improved up to 35 MPa. Manufacturing method is adopted considering colloidal stability of nano silica particle in PVA sol at specific pH = 1. An adhesive is also prepared from PVA/Si nanocomposite containing 40% TEOS for firm attachment of artificial articular cartilage on ...

  16. Engineering Lubrication in Articular Cartilage

    Science.gov (United States)

    McNary, Sean M.; Athanasiou, Kyriacos A.

    2012-01-01

    Despite continuous progress toward tissue engineering of functional articular cartilage, significant challenges still remain. Advances in morphogens, stem cells, and scaffolds have resulted in enhancement of the bulk mechanical properties of engineered constructs, but little attention has been paid to the surface mechanical properties. In the near future, engineered tissues will be able to withstand and support the physiological compressive and tensile forces in weight-bearing synovial joints such as the knee. However, there is an increasing realization that these tissue-engineered cartilage constructs will fail without the optimal frictional and wear properties present in native articular cartilage. These characteristics are critical to smooth, pain-free joint articulation and a long-lasting, durable cartilage surface. To achieve optimal tribological properties, engineered cartilage therapies will need to incorporate approaches and methods for functional lubrication. Steady progress in cartilage lubrication in native tissues has pushed the pendulum and warranted a shift in the articular cartilage tissue-engineering paradigm. Engineered tissues should be designed and developed to possess both tribological and mechanical properties mirroring natural cartilage. In this article, an overview of the biology and engineering of articular cartilage structure and cartilage lubrication will be presented. Salient progress in lubrication treatments such as tribosupplementation, pharmacological, and cell-based therapies will be covered. Finally, frictional assays such as the pin-on-disk tribometer will be addressed. Knowledge related to the elements of cartilage lubrication has progressed and, thus, an opportune moment is provided to leverage these advances at a critical step in the development of mechanically and tribologically robust, biomimetic tissue-engineered cartilage. This article is intended to serve as the first stepping stone toward future studies in functional

  17. Autophagy modulates articular cartilage vesicle formation in primary articular chondrocytes.

    Science.gov (United States)

    Rosenthal, Ann K; Gohr, Claudia M; Mitton-Fitzgerald, Elizabeth; Grewal, Rupinder; Ninomiya, James; Coyne, Carolyn B; Jackson, William T

    2015-05-22

    Chondrocyte-derived extracellular organelles known as articular cartilage vesicles (ACVs) participate in non-classical protein secretion, intercellular communication, and pathologic calcification. Factors affecting ACV formation and release remain poorly characterized; although in some cell types, the generation of extracellular vesicles is associated with up-regulation of autophagy. We sought to determine the role of autophagy in ACV production by primary articular chondrocytes. Using an innovative dynamic model with a light scatter nanoparticle counting apparatus, we determined the effects of autophagy modulators on ACV number and content in conditioned medium from normal adult porcine and human osteoarthritic chondrocytes. Healthy articular chondrocytes release ACVs into conditioned medium and show significant levels of ongoing autophagy. Rapamycin, which promotes autophagy, increased ACV numbers in a dose- and time-dependent manner associated with increased levels of autophagy markers and autophagosome formation. These effects were suppressed by pharmacologic autophagy inhibitors and short interfering RNA for ATG5. Caspase-3 inhibition and a Rho/ROCK inhibitor prevented rapamycin-induced increases in ACV number. Osteoarthritic chondrocytes, which are deficient in autophagy, did not increase ACV number in response to rapamycin. SMER28, which induces autophagy via an mTOR-independent mechanism, also increased ACV number. ACVs induced under all conditions had similar ecto-enzyme specific activities and types of RNA, and all ACVs contained LC3, an autophagosome-resident protein. These findings identify autophagy as a critical participant in ACV formation, and augment our understanding of ACVs in cartilage disease and repair. © 2015 by The American Society for Biochemistry and Molecular Biology, Inc.

  18. Detección molecular del virus papiloma humano de alto riesgo oncogénico en muestras cervicales. Laboratorio Central de Salud Pública. Primeros Resultados

    Directory of Open Access Journals (Sweden)

    Maria Liz Bobadilla

    2015-04-01

    Full Text Available El cáncer de cuello uterino es la primera causa de muerte por cáncer en mujeres en países en vías de desarrollo, con una tasa de incidencia de 34,2 por 100.000 mujeres y de mortalidad de 15,7 por 100.000 mujeres en Paraguay. La sensibilidad de la citología está entre 30-60%, mientras que la de la detección molecular del Virus Papiloma Humano (VPH en muestras cervicales, es mayor al 90% para detectar neoplasia intraepitelial cervical de grado 2 (CIN II o más. El objetivo de este trabajo fue describir la frecuencia de detección de VPH de alto riesgo (AR y su distribución por edad en mujeres que concurrieron al Hospital San Pablo, de mayo a agosto de 2.013. Se estudiaron 170 muestras cervicales de pacientes que accedieron a participar firmando un consentimiento informado. Se utilizó el sistema Cobas 4800 HPV Test (Roche que detecta los VPH-AR 16 y 18, y un pool de 10 VPH-AR (31,33,35,39,45,51,52,56,58,59 y dos de “probable” alto riesgo (66,68. La frecuencia de infección por VPH-AR fue del 16%, la infección decrecía con la edad y el mayor número de casos apareció en mujeres menores de 30 años. El VPH-16 fue encontrado en todos los grupos de edades. Este es el primer reporte de la detección de ADN de VPH-AR en el LCSP, y se muestra que la prevención y control del cáncer cérvico-uterino es una prioridad de salud pública en el país por la gran carga de la enfermedad evidenciada por su alta incidencia y mortalidad.

  19. Current strategies for articular cartilage repair

    OpenAIRE

    Redman S. N.; Oldfield S. F.; Archer C. W.

    2005-01-01

    Defects of articular cartilage that do not penetrate to the subchondral bone fail to heal spontaneously. Defects that penetrate to the subchondral bone elicit an intrinsic repair response that yields a fibrocartilaginous repair tissue which is a poor substitute for hyaline articular cartilage. Many arthroscopic repair strategies employed utilise this intrinsic repair response to induce the formation of a repair tissue within the defect. The goal, however, is to produce a repair tissue that ha...

  20. Growth factor transgenes interactively regulate articular chondrocytes.

    Science.gov (United States)

    Shi, Shuiliang; Mercer, Scott; Eckert, George J; Trippel, Stephen B

    2013-04-01

    Adult articular chondrocytes lack an effective repair response to correct damage from injury or osteoarthritis. Polypeptide growth factors that stimulate articular chondrocyte proliferation and cartilage matrix synthesis may augment this response. Gene transfer is a promising approach to delivering such factors. Multiple growth factor genes regulate these cell functions, but multiple growth factor gene transfer remains unexplored. We tested the hypothesis that multiple growth factor gene transfer selectively modulates articular chondrocyte proliferation and matrix synthesis. We tested the hypothesis by delivering combinations of the transgenes encoding insulin-like growth factor I (IGF-I), fibroblast growth factor-2 (FGF-2), transforming growth factor beta1 (TGF-β1), bone morphogenetic protein-2 (BMP-2), and bone morphogenetic protien-7 (BMP-7) to articular chondrocytes and measured changes in the production of DNA, glycosaminoglycan, and collagen. The transgenes differentially regulated all these chondrocyte activities. In concert, the transgenes interacted to generate widely divergent responses from the cells. These interactions ranged from inhibitory to synergistic. The transgene pair encoding IGF-I and FGF-2 maximized cell proliferation. The three-transgene group encoding IGF-I, BMP-2, and BMP-7 maximized matrix production and also optimized the balance between cell proliferation and matrix production. These data demonstrate an approach to articular chondrocyte regulation that may be tailored to stimulate specific cell functions, and suggest that certain growth factor gene combinations have potential value for cell-based articular cartilage repair. Copyright © 2012 Wiley Periodicals, Inc.

  1. Articular manifestations in patients with Lyme disease.

    Science.gov (United States)

    Vázquez-López, María Esther; Díez-Morrondo, Carolina; Sánchez-Andrade, Amalia; Pego-Reigosa, Robustiano; Díaz, Pablo; Castro-Gago, Manuel

    To determine the percentage of Lyme patients with articular manifestations in NW Spain and to know their evolution and response to treatment. A retrospective study (2006-2013) was performed using medical histories of confirmed cases of Lyme disease showing articular manifestations. Clinical and laboratory characteristics, together with the treatment and evolution of the patients, were analysed. Seventeen out of 108 LD confirmed patients (15.7%) showed articular manifestations. Regarding those 17 patients, 64.7%, 29.4% and 5.9% presented arthritis, arthralgia and bursitis, respectively. The knee was the most affected joint. Articular manifestations were often associated to neurological, dermatological and cardiac pathologies. Otherwise, most patients were in Stage III. The 11.8% of the cases progressed to a recurrent chronic arthritis despite the administration of an appropriate treatment. Lyme disease patients showing articular manifestations should be included in the diagnosis of articular affections in areas of high risk of hard tick bite, in order to establish a suitable and early treatment and to avoid sequels. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  2. [Osteo-articular manifestations of sarcoidosis].

    Science.gov (United States)

    Alaoui, Fatima-Zohra; Talaoui, Maha; Benamour, Saida

    2005-01-15

    Osteo-articular sarcoidosis may be evoked in the presence of peripheral articular manifestations or bone lesions that are sometimes asymptomatic. The aim of this work is to describe clinical and progressive features of sarcoidosis with osteo-articular involvement. Our retrospective study concerned 18 patients presenting with osteo-articular sarcoidosis from 1985 to 1999. We included patients with clinical diagnosis suggestive of sarcoidosis and with at least one positive biopsy. Among 35 cases of sarcoidosis, 18 patients had an osteo-articular manifestation (51.42%), which revealed the disease in 2 patients. The female sex was predominant (sex ratio M/F of 0.12), the mean age was 47 years and the time before diagnosis was 3.6 years. Articular involvement was the most frequent. Inflammatory joint pains were present in 11 cases, a Lofgren syndrome in 2 cases, a chronic arthritis in 4 cases and acute monoarthritis of the elbow in 1 case. A female patient exhibited a probable association with a spondylarthropathy. The bone involvement, revealing the disease in 1 case, was also noted in 5 cases, located exclusively on hands; this sarcoidosal dactyly was represented in 2 cases in the form of phalangeal geodes, in wired form (2 cases) and in large bulla form (1 case). The bone biopsy when it was performed was positive in all 3 cases. The patients responded well to corticosteroids. The osteo-articular involvement of sarcoidosis is polymorphic and can reveal the disease or may appear during the course of its progression.

  3. Articular chondrocyte metabolism and osteoarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Leipold, H.R.

    1989-01-01

    The three main objectives of this study were: (1) to determine if depletion of proteoglycans from the cartilage matrix that occurs during osteoarthritis causes a measurable increase of cartilage proteoglycan components in the synovial fluid and sera, (2) to observe what effect intracellular cAMP has on the expression of matrix components by chondrocytes, and (3) to determine if freshly isolated chondrocytes contain detectable levels of mRNA for fibronectin. Canine serum keratan sulfate and hyaluronate were measured to determine if there was an elevation of these serum glycosaminoglycans in a canine model of osteoarthritis. A single intra-articular injection of chymopapain into a shoulder joint increased serum keratan sulfate 10 fold and hyaluronate less than 2 fold in 24 hours. Keratan sulfate concentrations in synovial fluids of dogs about one year old were unrelated to the presence of spontaneous cartilage degeneration in the joints. High keratan sulfate in synovial fluids correlated with higher keratan sulfate in serum. The mean keratan sulfate concentration in sera of older dogs with osteoarthritis was 37% higher than disease-free controls, but the difference between the groups was not statistically significant. Treatment of chondrocytes with 0.5 millimolar (mM) dibutyryl cAMP (DBcAMP) caused the cells to adopt a more rounded morphology. There was no difference between the amount of proteins synthesized by cultures treated with DBcAMP and controls. The amount of fibronectin (FN) in the media of DBcAMP treated cultures detected by an ELISA was specifically reduced, and the amount of {sup 35}S-FN purified by gelatin affinity chromatography decreased. Moreover, the percentage of FN containing the extra domain. A sequence was reduced. Concomitant with the decrease in FN there was an increase in the concentration of keratan sulfate.

  4. Nuestra técnica de colgajo miocutáneo de pectoral mayor para reconstrucción de defectos cervicales

    Directory of Open Access Journals (Sweden)

    Roser García-Avellana

    Full Text Available Resumen Introducción y Objetivos Las técnicas actuales para reconstrucción de cabeza y cuello se basan principalmente en colgajos libres, fasciocutáneos o viscerales según el defecto. La evolución de la microcirugía ha relegado a un segundo plano a los colgajos pediculados. El colgajo miocutáneo pediculado de pectoral mayor ha sido uno de los más empleados hasta que se ha extendido el uso de los colgajos libres. Las desventajas que presenta, tales como su volumen o sus secuelas funcionales y estéticas, son responsables de su desuso actual. Presentamos una modificación de la técnica clásica del pectoral mayor para minimizar sus desventajas. Material y Método Hacemos una descripción técnica de la modificación desarrollada por Márquez-Cañada del colgajo de pectoral mayor para reconstrucción de defectos cervicales y un estudio descriptivo sobre un grupo de pacientes sometidos a la misma. Resultados Recogimos 6 casos, 5 varones y 1 mujer (edad media de 52.5 años, en los que se empleó la técnica descrita. El defecto más frecuente (66.7% fue el faringostoma secundario a laringuectomía total y vaciamiento cervical por carcinoma epidermoide de laringe. Tiempo medio entre intervenciones quirúrgicas de 5 semanas. En 2 casos hubo como complicación serohematoma en zona donante tras el primer tiempo quirúrgico, No hubo pérdida de injertos ni necrosis, fístulas o estenosis secundarias. Resultado estético aceptable; los pacientes conservaron movilidad completa del brazo. Conclusiones Observamos una reducción en el número de complicaciones respecto del uso del pectoral mayor clásico y los colgajos libres Creemos que la modificación técnica que presentamos, por su reproducibilidad y su baja tasa de complicaciones, podría emplearse en reconstrucción de cuello como colgajo de elección en pacientes de alto riesgo, no candidatos a técnicas microquirúrgicas.

  5. Imaging of the cervical articular pillar

    Energy Technology Data Exchange (ETDEWEB)

    Yeomans, E. [Orange Base Hospital, Orange, NSW (Australia)

    1998-12-01

    The cervical articular pillar, due to the complex anatomical structure of the cervical spine, is not well demonstrated in routine plain radiographic views. Dedicated views have been devised to demonstrate the pillar, yet their performance has abated considerably since the inception of Computed Tomography (CT) in the 1970`s. It is the consideration that CT does not image the articular pillar with a 10 per cent accuracy that poses the question: Is there still a need for plain radiography of the cervical articular pillar? This paper studies the anatomy, plain radiography, and incidence of injury to the cervical articular pillar. It discusses (with reference to current and historic literature) the efficacy of current imaging protocols in depicting this injury. It deals with plain radiography, CT, complex tomography, and Magnetic Resonance Imaging (MRI) of the cervical spine to conclude there may still be a position in current imaging protocols for plain radiography of the cervical articular pillar. Copyright (1998) Australian Institute of Radiography 43 refs., 5 figs.

  6. Tissue engineering techniques to regenerate articular cartilage using polymeric scaffolds.

    OpenAIRE

    PÉREZ OLMEDILLA, MARCOS

    2016-01-01

    [EN] Articular cartilage is a tissue that consists of chondrocytes surrounded by a dense extracellular matrix (ECM). The ECM is mainly composed of type II collagen and proteoglycans. The main function of articular cartilage is to provide a lubricated surface for articulation. Articular cartilage damage is common and may lead to osteoarthritis. Articular cartilage does not have blood vessels, nerves or lymphatic vessels and therefore has limited capacity for intrinsic healing and repair. ...

  7. Endogenous versus Exogenous Growth Factor Regulation of Articular Chondrocytes

    OpenAIRE

    Shi, Shuiliang; Chan, Albert G.; Mercer, Scott; Eckert, George J.; Trippel, Stephen B.

    2013-01-01

    Anabolic growth factors that regulate the function of articular chondrocytes are candidates for articular cartilage repair. Such factors may be delivered by pharmacotherapy in the form of exogenous proteins, or by gene therapy as endogenous proteins. It is unknown whether delivery method influences growth factor effectiveness in regulating articular chondrocyte reparative functions. We treated adult bovine articular chondrocytes with exogenous recombinant insulin-like growth factor-I (IGF-I) ...

  8. Prevalence and characteristics of articular manifestations in human ...

    African Journals Online (AJOL)

    Main outcome measure: Presence of articular manifestations that included HIV associated arthritis, HIV associated spondyloarthropathies, HIV associated arthralgia, painful articular syndrome and avascular necrosis. Results: Thirty three of these 193 patients had articular manifestation with a prevalence of 17.1 %. The type ...

  9. Intra-articular therapies for osteoarthritis.

    Science.gov (United States)

    Yu, Shirley P; Hunter, David J

    2016-10-01

    Conventional medical therapies for osteoarthritis are mainly palliative in nature, aiming to control pain and symptoms. Traditional intra-articular therapies are not recommended in guidelines as first line therapy, but are potential alternatives, when conventional therapies have failed. Current and future intra-articular drug therapies for osteoarthritis are highlighted, including corticosteroids, hyaluronate, and more controversial treatments marketed commercially, namely platelet rich plasma and mesenchymal cell therapy. Intraarticular disease modifying osteoarthritis drugs are the future of osteoarthritis treatments, aiming at structural modification and altering the disease progression. Interleukin-1β inhibitor, bone morphogenic protein-7, fibroblast growth factor 18, bradykinin B2 receptor antagonist, human serum albumin, and gene therapy are discussed in this review. The evolution of drug development in osteoarthritis is limited by the ability to demonstrate effect. High quality trials are required to justify the use of existing intra-articular therapies and to advocate for newer, promising therapies. Challenges in osteoarthritis therapy research are fundamentally related to the complexity of the pathological mechanisms of osteoarthritis. Novel drugs offer hope in a disease with limited medical therapy options. Whether these future intra-articular therapies will provide clinically meaningful benefits, remains unknown.

  10. Juxta-articular myxoma of the knee

    NARCIS (Netherlands)

    Somford, Matthijs P.; de Vries, Jasper S.; Dingemans, Willemijn; de Jonge, Milco; Maas, Mario; Schaap, Gerard R.; Bramer, Jos A. M.

    2011-01-01

    Juxta-articular myxoma is a benign lesion usually presenting as a slow-growing, well-circumscribed mass. Occasionally, however, the lesion grows rapidly and is poorly circumscribed, and it is this clinical presentation that arouses suspicion of malignancy. Furthermore, on histology a myxoma can also

  11. [Ibuprofen in osteo-articular (author's transl)].

    Science.gov (United States)

    Maigne, R; Le Corre, F; Juvin, P; Deletang, M

    The authors point out the good results which are obtained in osteo-articular pathology, in particular vertebral, with ibuprofen (Brufen 400). Providing that a sufficient dosage is given (1 600 mg - 2 400 mg per day), an obvious and fast favourable effect is noticed in 75% cases. According to these results, tolerance is quite satisfactory.

  12. Body weight independently affects articular cartilage catabolism.

    Science.gov (United States)

    Denning, W Matt; Winward, Jason G; Pardo, Michael Becker; Hopkins, J Ty; Seeley, Matthew K

    2015-06-01

    Although obesity is associated with osteoarthritis, it is unclear whether body weight (BW) independently affects articular cartilage catabolism (i.e., independent from physiological factors that also accompany obesity). The primary purpose of this study was to evaluate the independent effect of BW on articular cartilage catabolism associated with walking. A secondary purpose was to determine how decreased BW influenced cardiovascular response due to walking. Twelve able-bodied subjects walked for 30 minutes on a lower-body positive pressure treadmill during three sessions: control (unadjusted BW), +40%BW, and -40%BW. Serum cartilage oligomeric matrix protein (COMP) was measured immediately before (baseline) and after, and 15 and 30 minutes after the walk. Heart rate (HR) and rate of perceived exertion (RPE) were measured every three minutes during the walk. Relative to baseline, average serum COMP concentration was 13% and 5% greater immediately after and 15 minutes after the walk. Immediately after the walk, serum COMP concentration was 14% greater for the +40%BW session than for the -40%BW session. HR and RPE were greater for the +40%BW session than for the other two sessions, but did not differ between the control and -40%BW sessions. BW independently influences acute articular cartilage catabolism and cardiovascular response due to walking: as BW increases, so does acute articular cartilage catabolism and cardiovascular response. These results indicate that lower-body positive pressure walking may benefit certain individuals by reducing acute articular cartilage catabolism, due to walking, while maintaining cardiovascular response. Key pointsWalking for 30 minutes with adjustments in body weight (normal body weight, +40% and -40% body weight) significantly influences articular cartilage catabolism, measured via serum COMP concentration.Compared to baseline levels, walking with +40% body weight and normal body weight both elicited significant increases in

  13. Intra-articular osteoid osteoma as a differential diagnosis of diffuse mono-articular joint pain.

    Science.gov (United States)

    Rolvien, Tim; Zustin, Jozef; Mussawy, Haider; Schmidt, Tobias; Pogoda, Pia; Ueblacker, Peter

    2016-11-04

    The aim of this retrospective study was to investigate the frequency of intra-articular osteoid osteoma (iaOO) in a large study cohort and to demonstrate its clinical relevance as an important differential diagnosis of non-specific mono-articular joint pain. We searched the registry for bone tumours of the University Medical Centre Hamburg-Eppendorf for osteoid osteomas in the last 42 years. Herein, we present three selected iaOO which were detected in the three major weight-bearing joints. Computed tomography (CT) or magnetic resonance imaging (MRI) scans were performed for initial diagnosis. Out of a total of 367 osteoid osteomas, 19 (5.2 %) tumours were localized intra-articularly. In all three presented tumours, a history of severe mono-articular pain was reported; however, the mean time to correct diagnosis was delayed to 20.7 months. Clearly, the nidus seen in CT and MRI images in combination with inconsistent salicylate-responsive nocturnal pain led to the diagnosis of iaOO. Rarely, osteoid osteoma can occur in an intra-articular location. In cases of diffuse mono-articular pain, iaOO should be considered both in large and smaller joints to avoid delays in diagnosis and therapy of this benign bone tumour.

  14. Oxygen, nitric oxide and articular cartilage

    Directory of Open Access Journals (Sweden)

    B Fermor

    2007-04-01

    Full Text Available Molecular oxygen is required for the production of nitric oxide (NO, a pro-inflammatory mediator that is associated with osteoarthritis and rheumatoid arthritis. To date there has been little consideration of the role of oxygen tension in the regulation of nitric oxide production associated with arthritis. Oxygen tension may be particularly relevant to articular cartilage since it is avascular and therefore exists at a reduced oxygen tension. The superficial zone exists at approximately 6% O2, while the deep zone exists at less than 1% O2. Furthermore, oxygen tension can alter matrix synthesis, and the material properties of articular cartilage in vitro.The increase in nitric oxide associated with arthritis can be caused by pro-inflammatory cytokines and mechanical stress. Oxygen tension significantly alters endogenous NO production in articular cartilage, as well as the stimulation of NO in response to both mechanical loading and pro-inflammatory cytokines. Mechanical loading and pro-inflammatory cytokines also increase the production of prostaglandin E2 (PGE2. There is a complex interaction between NO and PGE2, and oxygen tension can alter this interaction. These findings suggest that the relatively low levels of oxygen within the joint may have significant influences on the metabolic activity, and inflammatory response of cartilage as compared to ambient levels. A better understanding of the role of oxygen in the production of inflammatory mediators in response to mechanical loading, or pro-inflammatory cytokines, may aid in the development of strategies for therapeutic intervention in arthritis.

  15. Current concepts of articular cartilage repair.

    Science.gov (United States)

    Schindler, Oliver S

    2011-12-01

    Articular cartilage provides a vital function in the homeostasis of the joint environment. It possesses unique mechanical properties, allowing for the maintenance of almost frictionless motion over a lifetime. However, cartilage is vulnerable to traumatic injury and due to its poor vascularity and inability to access mesenchymal stem cells, unable to facilitate a satisfactory healing response. Untreated chondral defects are thus likely to predispose patients to the development of osteoarthritis. Reconstitution and repair of articular cartilage is dependent on the neosynthesis or implantation of cartilage matrix elements, a goal which can be achieved through a variety of surgical means. Commonly used repair techniques include marrow stimulation, structural osteo-articular autografts or chondrocyte implantation. Despite substantial differences in the complexity and technical application of each method, all are united in the endeavour to restore joint function and prevent joint degeneration. Anyone attempting to treat cartilage defects must possess a basic understanding of the physiology of cartilage growth, and relevant factors affecting cartilage healing and repair. Furthermore, knowledge of the biomechanics and kinematics of the knee are essential in order to appreciate the forces acting on joint surfaces and repair tissues. Although clinical success is dependent on appropriate patient selection, accurate clinical assessment, definition of root causes and application of the right choice of treatment modality, the ultimate outcome of any intervention remains heavily reliant on the surgeon's proficiency in the technical aspects of the chosen surgical procedure.

  16. Mechanobiological implications of articular cartilage crystals.

    Science.gov (United States)

    Carlson, Alyssa K; McCutchen, Carley N; June, Ronald K

    2017-03-01

    Calcium crystals exist in both pathological and normal articular cartilage. The prevalence of these crystals dramatically increases with age, and crystals are typically found in osteoarthritic cartilage and synovial fluid. Relatively few studies have examined the effects of crystals on cartilage biomechanics or chondrocyte mechanotransduction. The purpose of this review is to describe how crystals could influence cartilage biomechanics and mechanotransduction in osteoarthritis. Crystals are found in both loaded and unloaded regions of articular cartilage. Exogenous crystals, in combination with joint motion, result in substantial joint inflammation. Articular cartilage vesicles promote crystal formation, and these vesicles are found near the periphery of chondrocytes. Crystallographic studies report monoclinic symmetry for synthetic crystals, suggesting that crystals will have a large stiffness compared with the cartilage extracellular matrix, the pericellular matrix, or the chondrocyte. This stiffness imbalance may cause crystal-induced dysregulation of chondrocyte mechanotransduction promoting both aging and osteoarthritis chondrocyte phenotypes. Because of their high stiffness compared with cartilage matrix, crystals likely alter chondrocyte mechanotransduction, and high concentrations of crystals within cartilage may alter macroscale biomechanics. Future studies should focus on understanding the mechanical properties of joint crystals and developing methods to understand how crystals affect chondrocyte mechanotransduction.

  17. Fundamental study on articular disc with magnetic resonance imagings

    International Nuclear Information System (INIS)

    Chiba, Toyokazu

    1993-01-01

    In order to establish criteria of reading MRI of the temporomandibular joint, a morphological comparison between MRI and the section, and an observation of the articular disc associated with the opening were made. Five temporomandibular joints isolated from 3 human cadavers were subjected to MRI, and sections were prepared to examine criteria of reading MRI. In 20 male adults, 40 temporomandibular joints underwent MRI in three conditions of the intercuspal position, 10 and 20 mm opening positions, and the kinetics of the articular disc were examined. External feature of the head of mandible and that of the articular fossa, the articular tubercule and the postglenoid process were outlined in a row of blacks. The articular disc was outlined in a row of dark ashen areas of the anterior band, the intermediate region, and the posterior band. In the intercuspal position, the head of mandible was rarely covered with the articular disc, and being situated postero-inferiorly, at the most rear point of the posterior band of the articular disc. In the 10 mm-opening position, the head of mandible was practically covered with the articular disc. In the 20 mm-opening position, the intermediate region of the articular disc, and the head of mandible were situated in an approximate position. Quantitative movement of the articular disc was slower than that of the head of mandible. Comparison of various points of the articular disc revealed that movements of the anterior and posterior band varied almost proportionally to the opening distance, but with lesser movement of the intermediate region. (author)

  18. Advances in treatment of articular cartilage injuries

    Directory of Open Access Journals (Sweden)

    Yuan-cheng LI

    2013-05-01

    Full Text Available Cartilage is a kind of terminally differentiated tissue devoid of vessel or nerve, and it is difficult to repair by itself after damage. Many studies for the treatment of cartilage injuries were performed in recent years aiming at repair of the structure and restoration of its function for injured joint. This article reviews the traditional methods of treatment for cartilage injuries, such as joint lavage with the aid of arthroscope, abrasion chondroplasty, laser abrasion and chondroplasty, and drilling of the subchondral bone-marrow space. The research advances in treatment of articular cartilage injuries with tissue engineering were summarized.

  19. Linezolid penetration into osteo-articular tissues.

    Science.gov (United States)

    Rana, B; Butcher, I; Grigoris, P; Murnaghan, C; Seaton, R A; Tobin, C M

    2002-11-01

    Penetration of linezolid into osteo-articular tissue and fluid was studied in 10 patients undergoing primary total knee replacement. Linezolid 600 mg 12 hourly was given orally over the 48 h before operation and intravenously 1 h before induction of anaesthesia. Mean concentrations of linezolid at 90 min after the final dose, in serum, synovial fluid, synovium, muscle and cancellous bone, assayed by HPLC, were at least twice the MIC(90) for staphylococci and streptococci. The concentrations obtained indicate good penetration of this antibiotic and support its use in the management of multidrug-resistant Gram-positive bone, joint and deep-seated soft-tissue infections.

  20. Clinicosocial aspect of osteo-articular tuberculosis.

    Science.gov (United States)

    Agarwal, R P; Mohan, N; Garg, R K; Bajpai, S K; Verma, S K; Mohindra, Y

    1990-11-01

    The study constituted clinicosocial analysis of 194 cases of osteo-articular tuberculosis. The disease was common in 1st and 2nd decades of life but not rare in old age with male preponderance. Majority of the patients were from rural area belonging to lower economic classes. Lesions were usually solitary (96.4%) situated in the weight bearing bones and joints (88.66%). Spinal tuberculosis was commonest (48.97%). The onset of disease was insidious in 94.8% cases. Chronic pain, swelling, impaired movements, deformities, sinus and cold abscess were found to be salient features of disease. Negligence and secondary infection were common.

  1. Clinical and Laboratory Predictors of Articular Disorders Among HIV ...

    African Journals Online (AJOL)

    Background: HIV infection may be associated with different arthropathies that are often underdiagnosed. There is also paucity of reported studies of relationship between clinical and laboratory features of HIV‑infected patients and articular disorders. Aims: To determine the predictors of articular disorders among ...

  2. Juxta-articular erosions in reflex sympathetic dystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Griffiths, H.J.; Virtama, P.

    Thirty-one patients with documented reflex sympathetic dystrophy syndrome (RSDS) were reviewed for their radiographic changes. Juxta-articular and metaphyseal bone loss was found in the majority of the patients. Juxta-articular bone loss closely resembling erosions seen in rheumatoid arthritis was found in all the patients. The significance of these findings is discussed.

  3. prevalence and characteristics of articular manifestations in human ...

    African Journals Online (AJOL)

    2010-10-10

    Oct 10, 2010 ... articular syndrome and avascular necrosis. Results:Thirty three of these 193 patients had articular manifestation with a prevalence of 17.1 %. The type prevalence was; HIV associated arthralgia, 15.6%; undifferentiated spondyloarthropathy, 1 % and HIV associated arthritis; 0.5%. Their mean age was 36±.

  4. PRP and Articular Cartilage: A Clinical Update

    Directory of Open Access Journals (Sweden)

    Antonio Marmotti

    2015-01-01

    Full Text Available The convincing background of the recent studies, investigating the different potentials of platelet-rich plasma, offers the clinician an appealing alternative for the treatment of cartilage lesions and osteoarthritis. Recent evidences in literature have shown that PRP may be helpful both as an adjuvant for surgical treatment of cartilage defects and as a therapeutic tool by intra-articular injection in patients affected by osteoarthritis. In this review, the authors introduce the trophic and anti-inflammatory properties of PRP and the different products of the available platelet concentrates. Then, in a complex scenario made of a great number of clinical variables, they resume the current literature on the PRP applications in cartilage surgery as well as the use of intra-articular PRP injections for the conservative treatment of cartilage degenerative lesions and osteoarthritis in humans, available as both case series and comparative studies. The result of this review confirms the fascinating biological role of PRP, although many aspects yet remain to be clarified and the use of PRP in a clinical setting has to be considered still exploratory.

  5. Intra-articular calcaneal fractures. Current concepts.

    Science.gov (United States)

    Stone, M L

    1995-10-01

    Intra-articular fractures of the calcaneus should be treated like any other fractures of major weight-bearing joints. Technology has advanced significantly in the evaluation of such complex pathology. Surgical instrumentation is now available to address any fracture classification. In the past, this had been a problem, as maintenance of the anatomic reduction, rigid internal/dynamic external fixation, and early mobilization may not have been attainable. The two remaining major variables are the mechanism of injury and its force that creates the fracture in combination with a very complex intra-articular anatomical structure. There will always be some morbidity in complex and serious fractures, but at least a more favorable outcome may be attainable with application of the current concepts discussed in this text. Finally, the most crucial factor when dealing with this trauma is the skill of the surgeon, which includes his or her decision-making, preoperative planning, surgical acumen, atraumatic technique, experience, and training and postoperative management of possible complications.

  6. Intra-articular injection of hyaluronic acid for treatment of osteoarthritis knee: comparative study to intra-articular corticosteroids

    Directory of Open Access Journals (Sweden)

    Soad A Elsawy

    2017-01-01

    Conclusion Both HA and corticosteroid groups showed improvement in pain and knee function, but the intra-articular HA was superior to corticosteroid on long-term follow-up. This supports the potential rate of intra-articular HA as an effective long-term therapeutic option for patients with OA of the knee.

  7. Osteo-articular manifestations of amyloidosis.

    Science.gov (United States)

    M'bappé, Pauline; Grateau, Gilles

    2012-08-01

    Whether it is overload disease or mispleated proteins, amyloid is a great pretender. This is especially true for all of the osteo-articular manifestations of amyloid light chain (AL) amyloidosis, which may mimic rheumatoid arthritis, polymyalgia rheumatica, a myeloma or a bone tumour. To improve the prognosis, AL amyloidosis must be considered in front of atypical osteo-articular manifestations. Amyloidosis Ab2M of chronic haemodialysis (members' arthropathy and destructive spondylitis) is a specific entity that needs to be differentiated from other osteoarthropathies of chronic renal failure. It has become exceptional since the progress of haemodialysis. Finally transthyretin amyloidosis(ATTR) can be responsible for carpal tunnel syndrome(CTS) in its genetic and senile form. Although amyloidosis is rare, it represents one of the aetiologies of CSC, regardless of its type. In the specific context of haemodialysis, this poses no difficulty for the clinician. Yet AL amyloidosis must be considered more often, as must senile amyloidosis ATTR in the elderly. It seems obvious that the anatomo-pathologic analysis with specific staining with Congo red - see typing - should be systematically performed in the case of surgical neurolysis. Amyloidosis is defined by the extracellular deposit of proteins which share common tinctorial affinities, a fibril aspect under electron microscopy and spatial conformation called beta pleated. Once regarded as a mere overload disease, it is currently considered as a disease of misfolded proteins. Indeed, it is certain that abnormalities of spatial pattern play an essential role in the responsibility for the pathology of many proteins whose amyloid fibre is the final common way. They involve both changes in the conformation of proteins and other major in vivo interactions between amyloid protein and the extracellular matrix. In most cases, amyloidosis represents the bulk of histopathological lesions and its pathogenic role is certain. In

  8. Intra-articular morphine in horses

    DEFF Research Database (Denmark)

    Lindegaard, Casper

    to a multimodal analgesia protocol. Despite that no research has investigated this issue in horses so far, IA injection of morphine after arthroscopic surgery has become common practice in several veterinary university teaching hospitals in Europe and USA. The aims of this thesis were to investigate the analgesic...... for pharmacological analysis were obtained repeatedly. Pain was evaluated by degree of lameness as well as using a visual analogue scale of pain intensity (VAS) and a composite measure pain scale (CMPS), developed for this purpose. Intra-articular injection of LPS elicited a marked synovitis resulting in lameness...... compared to the same dose administered IV, was demonstrated. In combination with the results of the pharmacologic analysis, this is highly suggestive of a peripherally mediated effect of IA morphine....

  9. [Osteo-articular ultrasonography of the shoulder].

    Science.gov (United States)

    Brasseur, J; Montagnon, D; Hacquard, B; Tardieu, M

    2000-03-01

    The objective of this course is to present the normal and pathological aspects of the various periarticular structures of the shoulder, and the practical modalities of their analysis. The anatomy and pitfalls of tendon imaging is recalled, as well as the interest to detect intra and peri articular effusions. The semiological aspects of complete and partial tears of the rotator cuff and the various impingement syndromes, well demonstrated with dynamic sonography, are then studied. The examination requires time and knowledge but the diagnostic and therapeutic impact is very important regarding the low cost of this technique. The standardisation of the procedure and the production of normal reference images seems to guarantee a global increase in quality of the sonographic examinations.

  10. The minor collagens in articular cartilage

    DEFF Research Database (Denmark)

    Luo, Yunyun; Sinkeviciute, Dovile; He, Yi

    2017-01-01

    , especially minor collagens, including type IV, VI, IX, X, XI, XII, XIII, and XIV, etc. Although accounting for only a small fraction of the mature matrix, these minor collagens not only play essential structural roles in the mechanical properties, organization, and shape of articular cartilage, but also...... these minor collagens. The generation and release of fragmented molecules could generate novel biochemical markers with the capacity to monitor disease progression, facilitate drug development and add to the existing toolbox for in vitro studies, preclinical research and clinical trials....... fulfil specific biological functions. Genetic studies of these minor collagens have revealed that they are associated with multiple connective tissue diseases, especially degenerative joint disease. The progressive destruction of cartilage involves the degradation of matrix constituents including...

  11. Fractures of the articular processes of the cervical spine

    International Nuclear Information System (INIS)

    Woodring, J.H.; Goldstein, S.J.

    1982-01-01

    Fractures of the articular processes occurred in 16 (20.8%) of 77 patients with cervical spine fractures as demonstrated by multidirectional tomography. Plain films demonstrated the fractures in only two patients. Acute cervical radiculopathy occurred in five of the patients with articular process fractures (superior process, two cases; inferior process, three cases). Persistent neck pain occurred in one other patient without radiculopathy. Three patients suffered spinal cord damage at the time of injury, which was not the result of the articular process fracture itself. In the other seven cases, no definite sequelae occurred. However, disruption of the facet joint may predispose to early degenerative joint disease and chronic pain; unilateral or bilateral facet dislocation was present in five patients. In patients with cervical trauma who develop cervical radiculopathy, tomography should be performed to evaluate the articular processes

  12. Fractures of the articular processes of the cervical spine

    Energy Technology Data Exchange (ETDEWEB)

    Woodring, J.H.; Goldstein, S.J.

    1982-08-01

    Fractures of the articular processes occurred in 16 (20.8%) of 77 patients with cervical spine fractures as demonstrated by multidirectional tomography. Plain films demonstrated the fractures in only two patients. Acute cervical radiculopathy occurred in five of the patients with articular process fractures (superior process, two cases; inferior process, three cases). Persistent neck pain occurred in one other patient without radiculopathy. Three patients suffered spinal cord damage at the time of injury, which was not the result of the articular process fracture itself. In the other seven cases, no definite sequelae occurred. However, disruption of the facet joint may predispose to early degenerative joint disease and chronic pain; unilateral or bilateral facet dislocation was present in five patients. In patients with cervical trauma who develop cervical radiculopathy, tomography should be performed to evaluate the articular processes.

  13. Follistatin Alleviates Synovitis and Articular Cartilage Degeneration Induced by Carrageenan

    Directory of Open Access Journals (Sweden)

    Jun Yamada

    2014-01-01

    Full Text Available Activins are proinflammatory cytokines which belong to the TGFβ superfamily. Follistatin is an extracellular decoy receptor for activins. Since both activins and follistatin are expressed in articular cartilage, we hypothesized that activin-follistatin signaling participates in the process of joint inflammation and cartilage degeneration. To test this hypothesis, we examined the effects of follistatin in a carrageenan-induced mouse arthritis model. Synovitis induced by intra-articular injection of carrageenan was significantly alleviated by preinjection with follistatin. Macrophage infiltration into the synovial membrane was significantly reduced in the presence of follistatin. In addition, follistatin inhibited proteoglycan erosion induced by carrageenan in articular cartilage. These data indicate that activin-follistatin signaling is involved in joint inflammation and cartilage homeostasis. Our data suggest that follistatin can be a new therapeutic target for inflammation-induced articular cartilage degeneration.

  14. Management of Posterior Articular Depression in Tibial Plateau Fractures.

    Science.gov (United States)

    Adams, John David; Della Rocca, Gregory J

    2016-01-01

    Fractures involving the posterior aspect of the tibial plateau are challenging fractures to treat. Articular depression in tibial plateau fractures is usually addressed by elevation of the fragment(s), filling the residual defect with bone graft or bone substitute, and "raft" support of the articular fracture reduction with screws through a medially and/or laterally based plate. Posterior tibial plateau articular depression presents unique challenges for obtaining and maintaining fracture reduction. To obtain the goals of anatomic reduction and stable fixation, a thorough understanding of the fracture, specific approaches, reduction techniques, and stabilization strategies is needed. This article reviews the most current strategies for treating tibial plateau fracture patients with posterior articular depression. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  15. Intra-Articular Therapeutic Delivery for Post-Traumatic Osteoarthritis

    Science.gov (United States)

    2017-10-01

    loading and disease progression timeframe in a large animal model in order to outline a pathway to human clinical trials of the treatment method . Our...AWARD NUMBER: W81XWH-14-2-0188 TITLE: Intra-Articular Therapeutic Delivery for Post-Traumatic Osteoarthritis PRINCIPAL INVESTIGATOR: Robert...Intra-Articular Therapeutic Delivery for Post-Traumatic Osteoarthritis 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-14-2-0188 5c. PROGRAM ELEMENT

  16. Imaging diagnosis of the juxta-articular bone cyst

    International Nuclear Information System (INIS)

    Zhang Zekun; Ren Jinjun; Wang Dongmei; Zhang Wei; Ding Jianping; Ding Yang

    2008-01-01

    Objective: To investigate the imaging features of the juxta-articular bone cyst(intra- osseous ganglia). Methods: The imaging findings of 54 cases histopathologically confirmed were studied retrospectively. X-ray, CT, and MRI were performed in 46 eases, 30 cases, and 14 cases, respectively. Results: Of the 54 cases, 27 arised from the ankle (including multiple lesions), 16 from the knee joint, 7 from the hip joint, 1 from the proximate end of the humerus, ulna, trapezium bone, the first phalange in each, and 1 from the talus and the distal end of the tibia. There were 43 cases (44 lesions) in the ankle and knee joints, with 29 (65.9%) lesions located in the medial articular surface. Fifty-four cases had thinning sclerotic rim, showing a unilocular round osteolytic appearance in 44 cases and a multiloculated-cystic appearance with septa in 10 cases. Discontinuous articular surface were seen in 15 cases, reticular surface collapse in 1, gas density in 3 and fluid-fluid plane in 1. (1) On x-ray films, 46 cases (47 lesions) with well-defined sclerotic rim revealed round, arch or irregular lyric areas at the adjacent articular surface. The fissures were found at the adjacent articular surface in 6 lesions. No joint spaces were abnormal. (2)On CT, 30 cases with sclerotic rim showed round in 19 lesions, arch in 3, and irregular in 8. The fissures were seen at the adjacent articular surface in 14 lesions. The density showed homogeneous in 27 lesions, and gas existed in 3. (3) Fourteen cases (15 lesions)showed hypointense to isointense signal on MR T 1 WI and hyperintense signal on T 2 WI. Fluid-fluid plane was found in 1 case. The fissures were observed at the adjacent articular surface in 8 lesions. 7 cases showed swelling soft tissue. Conclusion: The characteristic locations combined with the typical imaging features may suggest the diagnosis of jaxta-articular bone cyst. (authors)

  17. DOUBLE TRANSVERSE FORAMEN IN INFANTILE CERVICAL VERTEBRAE OF THE LATE 17TH AND EARLY 18TH CENTURIES. Doble foramen transverso en las vértebras infantiles cervicales de finales del siglo XVII y principios del XVIII

    Directory of Open Access Journals (Sweden)

    Laura Quiles-Guiñau

    2016-03-01

    Full Text Available La presencia de doble foramen transverso es una variante anatómica que se observa con frecuencia en el raquis cervical inferior y que presenta implicaciones clínicas en relación con la arteria vertebral. Aunque en la actualidad existe cierta controversia acerca de si el origen de esta variante cervical es congénito o adquirido, y a pesar de que la presencia de doble foramen transverso en población infantil descartaría un origen degenerativo-artrósico, se encuentra una falta de información acerca de su presencia en vértebras cervicales infantiles. En este sentido, nuestro objetivo ha sido analizar la presencia de doble foramen transverso en vértebras cervicales infantiles procedentes de restos óseos, datados entre finales del siglo XVII y principios del XVIII, y exhumados de una fosa común en la Iglesia de Nuestra Señora de los Ángeles en Castielfabib (Ademuz, España. Se encontraron 10 vértebras infantiles con doble foramen transverso, 4 de ellas pertenecientes a niños de menos de 4 años y 6 a niños de más de 4 años. Este hallazgo apoya un origen congénito de esta variante anatómica, frente a la hipótesis degenerativo-artrósica, y apunta a la necesidad de un estudio en profundidad acerca de la prevalencia actual de esta variante anatómica en población pediátrica, dadas sus posibles consecuencias clínicas. Double transverse foramen is an anatomical variant often observed in the inferior cervical spine and which may present clinical considerations with regard to the vertebral artery. There is some current controversy as to whether the origin of this cervical variant is congenital or acquired. Despite the fact that its presence in children would discard a degenerative osteo-arthritic origin, there is a lack of information on the origin and physiological meaning of this anatomical feature. In this respect, our objective was to analyse the presence of double transverse foramen in infantile cervical vertebrae in skeletal

  18. Pendulum mass affects the measurement of articular friction coefficient.

    Science.gov (United States)

    Akelman, Matthew R; Teeple, Erin; Machan, Jason T; Crisco, Joseph J; Jay, Gregory D; Fleming, Braden C

    2013-02-01

    Friction measurements of articular cartilage are important to determine the relative tribologic contributions made by synovial fluid or cartilage, and to assess the efficacy of therapies for preventing the development of post-traumatic osteoarthritis. Stanton's equation is the most frequently used formula for estimating the whole joint friction coefficient (μ) of an articular pendulum, and assumes pendulum energy loss through a mass-independent mechanism. This study examines if articular pendulum energy loss is indeed mass independent, and compares Stanton's model to an alternative model, which incorporates viscous damping, for calculating μ. Ten loads (25-100% body weight) were applied in a random order to an articular pendulum using the knees of adult male Hartley guinea pigs (n=4) as the fulcrum. Motion of the decaying pendulum was recorded and μ was estimated using two models: Stanton's equation, and an exponential decay function incorporating a viscous damping coefficient. μ estimates decreased as mass increased for both models. Exponential decay model fit error values were 82% less than the Stanton model. These results indicate that μ decreases with increasing mass, and that an exponential decay model provides a better fit for articular pendulum data at all mass values. In conclusion, inter-study comparisons of articular pendulum μ values should not be made without recognizing the loads used, as μ values are mass dependent. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Mesenchymal Stem Cells for Treating Articular Cartilage Defects and Osteoarthritis.

    Science.gov (United States)

    Wang, Yu; Yuan, Mei; Guo, Quan-yi; Lu, Shi-bi; Peng, Jiang

    2015-01-01

    Articular cartilage damage and osteoarthritis are the most common joint diseases. Joints are prone to damage caused by sports injuries or aging, and such damage regularly progresses to more serious joint disorders, including osteoarthritis, which is a degenerative disease characterized by the thinning and eventual wearing out of articular cartilage, ultimately leading to joint destruction. Osteoarthritis affects millions of people worldwide. Current approaches to repair of articular cartilage damage include mosaicplasty, microfracture, and injection of autologous chondrocytes. These treatments relieve pain and improve joint function, but the long-term results are unsatisfactory. The long-term success of cartilage repair depends on development of regenerative methodologies that restore articular cartilage to a near-native state. Two promising approaches are (i) implantation of engineered constructs of mesenchymal stem cell (MSC)-seeded scaffolds, and (ii) delivery of an appropriate population of MSCs by direct intra-articular injection. MSCs may be used as trophic producers of bioactive factors initiating regenerative activities in a defective joint. Current challenges in MSC therapy are the need to overcome current limitations in cartilage cell purity and to in vitro engineer tissue structures exhibiting the required biomechanical properties. This review outlines the current status of MSCs used in cartilage tissue engineering and in cell therapy seeking to repair articular cartilage defects and related problems. MSC-based technologies show promise when used to repair cartilage defects in joints.

  20. Avaliação de seis anos de fraturas cervicais subaxiais Evaluación de seis años de fracturas cervicales subaxiales Evaluation of six years of cervical sub-axial fractures

    Directory of Open Access Journals (Sweden)

    Leonardo Franco Pinheiro Gaia

    2013-01-01

    ón (AO. Se utilizaron radiografías en las incidencias frontal y lateral y tomografía computarizada, para dividir las fracturas en A (compresión, B (distracción y C (rotación, de acuerdo con el patrón de presentación. Se analizaron los siguientes parámetros: sexo, edad, clasificación AO, mecanismo de trauma, presencia de déficit neurológico y tratamiento quirúrgico o conservador. RESULTADOS: Fueron analizadas 264 historias clínicas, siendo 216 pacientes hombres e 48 mujeres. La media de edad de éstos pacientes fue de 38,55 años. El mecanismo de trauma más común de las fracturas cervicales subaxiales fue el accidente automovilístico, con 84 casos. En cuanto al tipo de fractura según la clasificación AO, la más frecuente fue el tipo B. De los casos evaluados, 136 pacientes presentaron déficit neurológico parcial o completo. El tratamiento quirúrgico fue realizado en 166 casos. CONCLUSIÓN: Queda claro que las fracturas cervicales representan un importante problema para la salud pública y privada en Brasil. La prevención de fracturas cervicales presenta la mejor relación costo beneficio en el abordaje de éstas lesiones.OBJECTIVE: Retrospectively assess the factors related to cervical trauma, according to the type of fracture based on the AO classification, taking into account etiological and epidemiological aspects of the event. METHODS: Records of patients with cervical fractures were retrospectively reviewed, from 2004 to 2009. The sub-axial fractures (C3-C7 were studied because they fit into only one classification (AO. Frontal and lateral x-rays were used as well as CTs to divide the fractures into A (compression, B (distraction and C (rotation, in accordance with the presented pattern. The following parameters were assessed: gender, age, AO classification, trauma mechanism, presence of neurological deficit, and conservative or surgical treatment. RESULTS: The study included 264 records from the spine, where 216 patients were male and 48

  1. Arthoscopy La artroscopia y las lesiones articulares

    Directory of Open Access Journals (Sweden)

    Raúl J. Naranjo

    1991-01-01

    Full Text Available

    A general view is presented on arthroscopy; its history, indications and limitations are described and analyzed; its advantages in comparison with open surgery are emphasized.

    La artroscopia es un procedimiento que permite, mediante un instrumento óptico, evaluar el Interior de las cavidades articulares. Comenzó a desarrollarse como un procedimiento diagnóstico y pronto sus grandes ventajas frente a las exploraciones abiertas aceleraron el desarrollo de las técnicas y del instrumental. La minimización del trauma a los tejidos y la menor morbilidad posoperatoria permiten que la deambulación y la recuperación funcional sean precoces lo cual, sumado a un mejor resultado estético, ha colocado a la artroscopia como procedimiento de elección para el diagnóstico y el tratamiento de múltiples estados patológicos intraarticulares.

  2. Hydrogen peroxide induced oxidative damage on mechanical properties of the articular cartilage.

    Science.gov (United States)

    Cicek, Ekrem

    2017-12-01

    Articular cartilage has unique mechanical and physicochemical properties which are responsible for its load carrying capabilities. This work investigates the effects of hydrogen peroxide induced oxidative damage on mechanical properties of articular cartilage. Bovine articular cartilage was exposed to hydrogen peroxide for a week. Dynamic and static mechanical tests applied to calculate articular cartilage compressive modulus. We observed higher control curve slopes than that of hydrogen peroxide curves which account for lesser stiffness values in the exposed articular cartilage. For the instantaneous experiments, results were statistically significant (p = 0.01, p hydrogen peroxide induced oxidative damage causes reduction in the stiffness of the articular cartilage.

  3. Endogenous versus exogenous growth factor regulation of articular chondrocytes.

    Science.gov (United States)

    Shi, Shuiliang; Chan, Albert G; Mercer, Scott; Eckert, George J; Trippel, Stephen B

    2014-01-01

    Anabolic growth factors that regulate the function of articular chondrocytes are candidates for articular cartilage repair. Such factors may be delivered by pharmacotherapy in the form of exogenous proteins, or by gene therapy as endogenous proteins. It is unknown whether delivery method influences growth factor effectiveness in regulating articular chondrocyte reparative functions. We treated adult bovine articular chondrocytes with exogenous recombinant insulin-like growth factor-I (IGF-I) and transforming growth factor-beta1 (TGF-β1), or with the genes encoding these growth factors for endogenous production. Treatment effects were measured as change in chondrocyte DNA content, glycosaminoglycan production, and aggrecan gene expression. We found that IGF-I stimulated chondrocyte biosynthesis similarly when delivered by either exogenous or endogenous means. In contrast, exogenous TGF-β1 stimulated these reparative functions, while endogenous TGF-β1 had little effect. Endogenous TGF-β1 became more bioactive following activation of the transgene protein product. These data indicate that effective mechanisms of growth factor delivery for articular cartilage repair may differ for different growth factors. In the case of IGF-I, gene therapy or protein therapy appear to be viable options. In contrast, TGF-β1 gene therapy may be constrained by a limited ability of chondrocytes to convert latent complexes to an active form. Published 2013 by Wiley Periodicals, Inc. on behalf of the Orthopaedic Research Society. This article is a U.S. Government work and is in the public domain in the USA.

  4. Bi-articular Knee-Ankle-Foot Exoskeleton Produces Higher Metabolic Cost Reduction than Weight-Matched Mono-articular Exoskeleton

    Science.gov (United States)

    Malcolm, Philippe; Galle, Samuel; Derave, Wim; De Clercq, Dirk

    2018-01-01

    The bi-articular m. gastrocnemius and the mono-articular m. soleus have different and complementary functions during walking. Several groups are starting to use these biological functions as inspiration to design prostheses with bi-articular actuation components to replace the function of the m. gastrocnemius. Simulation studies indicate that a bi-articular configuration and spring that mimic the m. gastrocnemius could be beneficial for orthoses or exoskeletons. Our aim was to test the effect of a bi-articular and spring configuration that mimics the m. gastrocnemius and compare this to a no-spring and mono-articular configuration. We tested nine participants during walking with knee-ankle-foot exoskeletons with dorsally mounted pneumatic muscle actuators. In the bi-articular plus spring condition the pneumatic muscles were attached to the thigh segment with an elastic cord. In the bi-articular no-spring condition the pneumatic muscles were also attached to the thigh segment but with a non-elastic cord. In the mono-articular condition the pneumatic muscles were attached to the shank segment. We found the highest reduction in metabolic cost of 13% compared to walking with the exoskeleton powered-off in the bi-articular plus spring condition. Possible explanations for this could be that the exoskeleton delivered the highest total positive work in this condition at the ankle and the knee and provided more assistance during the isometric phase of the biological plantarflexors. As expected we found that the bi-articular conditions reduced m. gastrocnemius EMG more than the mono-articular condition but this difference was not significant. We did not find that the mono-articular condition reduces the m. soleus EMG more than the bi-articular conditions. Knowledge of specific effects of different exoskeleton configurations on metabolic cost and muscle activation could be useful for providing customized assistance for specific gait impairments. PMID:29551959

  5. Bi-articular Knee-Ankle-Foot Exoskeleton Produces Higher Metabolic Cost Reduction than Weight-Matched Mono-articular Exoskeleton

    Directory of Open Access Journals (Sweden)

    Philippe Malcolm

    2018-03-01

    Full Text Available The bi-articular m. gastrocnemius and the mono-articular m. soleus have different and complementary functions during walking. Several groups are starting to use these biological functions as inspiration to design prostheses with bi-articular actuation components to replace the function of the m. gastrocnemius. Simulation studies indicate that a bi-articular configuration and spring that mimic the m. gastrocnemius could be beneficial for orthoses or exoskeletons. Our aim was to test the effect of a bi-articular and spring configuration that mimics the m. gastrocnemius and compare this to a no-spring and mono-articular configuration. We tested nine participants during walking with knee-ankle-foot exoskeletons with dorsally mounted pneumatic muscle actuators. In the bi-articular plus spring condition the pneumatic muscles were attached to the thigh segment with an elastic cord. In the bi-articular no-spring condition the pneumatic muscles were also attached to the thigh segment but with a non-elastic cord. In the mono-articular condition the pneumatic muscles were attached to the shank segment. We found the highest reduction in metabolic cost of 13% compared to walking with the exoskeleton powered-off in the bi-articular plus spring condition. Possible explanations for this could be that the exoskeleton delivered the highest total positive work in this condition at the ankle and the knee and provided more assistance during the isometric phase of the biological plantarflexors. As expected we found that the bi-articular conditions reduced m. gastrocnemius EMG more than the mono-articular condition but this difference was not significant. We did not find that the mono-articular condition reduces the m. soleus EMG more than the bi-articular conditions. Knowledge of specific effects of different exoskeleton configurations on metabolic cost and muscle activation could be useful for providing customized assistance for specific gait impairments.

  6. Bi-articular Knee-Ankle-Foot Exoskeleton Produces Higher Metabolic Cost Reduction than Weight-Matched Mono-articular Exoskeleton.

    Science.gov (United States)

    Malcolm, Philippe; Galle, Samuel; Derave, Wim; De Clercq, Dirk

    2018-01-01

    The bi-articular m. gastrocnemius and the mono-articular m. soleus have different and complementary functions during walking. Several groups are starting to use these biological functions as inspiration to design prostheses with bi-articular actuation components to replace the function of the m. gastrocnemius. Simulation studies indicate that a bi-articular configuration and spring that mimic the m. gastrocnemius could be beneficial for orthoses or exoskeletons. Our aim was to test the effect of a bi-articular and spring configuration that mimics the m. gastrocnemius and compare this to a no-spring and mono-articular configuration. We tested nine participants during walking with knee-ankle-foot exoskeletons with dorsally mounted pneumatic muscle actuators. In the bi-articular plus spring condition the pneumatic muscles were attached to the thigh segment with an elastic cord. In the bi-articular no-spring condition the pneumatic muscles were also attached to the thigh segment but with a non-elastic cord. In the mono-articular condition the pneumatic muscles were attached to the shank segment. We found the highest reduction in metabolic cost of 13% compared to walking with the exoskeleton powered-off in the bi-articular plus spring condition . Possible explanations for this could be that the exoskeleton delivered the highest total positive work in this condition at the ankle and the knee and provided more assistance during the isometric phase of the biological plantarflexors. As expected we found that the bi-articular conditions reduced m. gastrocnemius EMG more than the mono-articular condition but this difference was not significant. We did not find that the mono-articular condition reduces the m. soleus EMG more than the bi-articular conditions . Knowledge of specific effects of different exoskeleton configurations on metabolic cost and muscle activation could be useful for providing customized assistance for specific gait impairments.

  7. All-Extra-articular Repair of Anterosuperior Rotator Cuff Tears.

    Science.gov (United States)

    Holschen, Malte; Witt, Kai-Axel; Steinbeck, Jörn

    2018-02-01

    Anterosuperior rotator cuff tears involve the subscapularis tendon, supraspinatus tendon, and rotator interval. The long head of the biceps is usually affected and unstable in these complex lesions. Arthroscopic repair of anterosuperior rotator cuff tears often consists of 2 different procedures. Whereas the subscapularis tendon is reconstructed under intra-articular visualization, the supraspinatus tendon is reconstructed under extra-articular visualization. The rotator interval is often sacrificed to improve visualization and instrumentation. The presented technique uses an all-extra-articular approach, which helps to reconstruct these complex rotator cuff lesions in their whole extent without switching from the inside to the outside of the shoulder joint. The preservation of the rotator interval leads to a more stable and anatomic reconstruction.

  8. Evaluación del método de maduración ósea de las vértebras cervicales de Baccetti en pacientes de 8 a 15 años

    Directory of Open Access Journals (Sweden)

    Emerik Alvarado Torres

    2016-01-01

    Full Text Available El concepto de maduración relaciona la edad biológica del individuo con la edad cronológica pero la variación entre ellas puede ser grande, esto en razón a las diferencias individuales en el ritmo de desarrollo. Durante este proceso los pacientes pueden presentar maduración precoz, normal o tardía. Objetivo: Evaluar el método de maduración ósea de las vértebras cervicales (CVM de Baccetti en una población mexicana. Materiales y métodos: La muestra fue de 298 radiografías laterales de cráneo de las edades de 8 a 15 años. Se realizó la estadística descriptiva y se comparó mediante pruebas de t de Student en cada grupo de edad con los resultados del método CVM. Resultados: Se encontraron diferencias significativas en todos los grupos de la población. En los grupos de 8 y 9 años los estadios de maduración se encontraron adelantados en comparación con dicho método. En la población de mujeres de 10 años se encontró una pausa en el crecimiento, quedando por detrás del mismo grupo de CVM; mientras que en hombres de este grupo de edad también se presenta una pausa hasta llegar a igualarse con el grupo CVM. Los grupos de 11 a 15 años se encontraron retrasados en los estadios de maduración en comparación con el método CVM.. Conclusiones: La maduración ósea se presentó en forma anticipada en relación a los parámetros establecidos en el método CVM por lo que éste no es aplicable a la población estudiada.

  9. Evaluación de la maduración ósea a través de las vértebras cervicales en pacientes de ortodoncia Assessment of bone maturation in cervical vertebrae in Orthodontics patients

    Directory of Open Access Journals (Sweden)

    Gladia Toledo Mayarí

    2010-09-01

    Full Text Available Objetivo: Verificar si se puede prescindir de la radiografía de la mano izquierda en la evaluación de la maduración ósea en pacientes de Ortodoncia. Métodos: Se realizó un estudio transversal y descriptivo en 150 pacientes que ingresaron en la Clínica de Ortodoncia de la Facultad de Estomatología de La Habana en el período comprendido entre abril de 2004 y septiembre de 2006. Se seleccionaron pacientes con buen estado general de salud, ausencia de enfermedades crónicas y de oligodoncias, así como aquellos que por las características de su maloclusión necesitaran una telerradiografía lateral de cráneo. La misma se le realizó a cada paciente, y también una radiografía de la mano izquierda. En cada caso se evaluaron los métodos de Grave y Brown y Hassel y Farman, y se identificó la concordancia entre éstos mediante un coeficiente Kappa. Resultados: Se encontraron coeficientes de concordancia altos y estadísticamente muy significativos entre las evaluaciones realizadas a través de la mano izquierda y a través de las vértebras cervicales: sexo femenino Kappa= 0,828 (pObjective: To verify if it is possible to avoid the left hand radiography in assessment of bone maturation in Orthodontics patients. Methods: A cross sectional and descriptive study was conducted in 150 patients admitted in the Orthodontics Clinic of Stomatology Faculty of Havana City from April, 2004 to September, 2006. Patients selected had a good general health status, lack of chronic diseases and of oligodontias, as well as those with malocclusion and that will need a lateral teleradiography of skull carrying out in each patient and also a left hand radiography. In each case Grave's and Brown's and Hassel's and Farman's methods identifying the concordance among them by Kappa coefficient. Results: There were high and very significant statistic concordance coefficients among the assessment carried out in left hand and by cervical vertebrae: female sex Kappa= 0

  10. Multi-physics computational models of articular cartilage for estimation of its mechanical and physical properties

    NARCIS (Netherlands)

    Arbabi, V.

    2016-01-01

    Recent advances in the realm of computational modeling of complex multiphysics phenomena in articular cartilage enabled efficient and precise determination of articular cartilage properties. However, still accurate quantification of complicated indentation and diffusion processes tying closely with

  11. Total knee arthroplasty in patients with extra-articular deformity

    Directory of Open Access Journals (Sweden)

    Kaushik Hazratwala, MBBS, FRACS

    2016-03-01

    Full Text Available Multiple acceptable options are available for the correction of distal femoral deformity associated with knee arthritis. The treatment modality should be chosen based on the extent of deformity and attention to preservation of the collateral ligaments. Surgical options range from osteotomy alone, arthroplasty with intra-articular correction, or arthroplasty with extra-articular correction. Different implant choices and fixation methods for the osteotomy possess advantages and disadvantages which need to be considered carefully. In addition to discussing principles of management based on current literature, this article includes a case report using a previously undescribed technique using corrective osteotomy, intramedullary nail fixation, and total knee arthroplasty with computer navigation.

  12. Rare Extra-articular Manifestation of Rheumatoid Arthritis: Scleromalacia Perforans

    Directory of Open Access Journals (Sweden)

    Chen-Ching Wu

    2005-05-01

    Full Text Available Rheumatoid arthritis is a systemic disease with manifestations in many organs. In most cases, involvement of the locomotor system dominates the clinical picture. However, extra-articular manifestations can be detected in almost any organ system with varied incidence in different series. Ophthalmic presentations include Sjogren's syndrome, episcleritis, and scleritis. The most severe form of scleritis, scleromalacia perforans, is a very rare ophthalmic manifestation. We present the case of a 60-year-old man who had had rheumatoid arthritis for more than 10 years. He had scleromalacia perforans but no other extra-articular manifestations.

  13. Intra-Articular Osteotomy for Distal Humerus Malunion

    Directory of Open Access Journals (Sweden)

    René K. Marti

    2009-01-01

    Full Text Available Intra-articular osteotomy is considered in the rare case of malunion after a fracture of the distal humerus to restore humeral alignment and gain a functional arc of elbow motion. Traumatic and iatrogenic disruption of the limited blood flow to the distal end of the humerus resulting in avascular necrosis of capitellum or trochlea is a major pitfall of the this technically challenging procedure. Two cases are presented which illustrate the potential problems of intra-articular osteotomy for malunion of the distal humerus.

  14. [Osteo-articular ultrasonography of the hip and the knee].

    Science.gov (United States)

    Mathieu, P; Wybier, M

    2000-03-01

    Experience in the field of musculoskeletal diseases and advanced technology of medical sonographers allow increasing accuracy in US investigations of most lesions of both hip and knee superficial tendons. In this field, US is more and more widely replacing other imaging modalities, including MR imaging. Ultrasonography may now be used also for articular diseases purpose, including joint effusion, synovitis, intraarticular loose bodies, ligamentous injuries, articular cysts, as well as for certain osseous lesions like stress or insufficiency fractures of superficial bones. However, ultrasonography has still to be evaluated for these latter indications.

  15. Surgery for extra-articular trismus : a systematic review

    NARCIS (Netherlands)

    Bouman, M. A.; Dijkstra, P. U.; Reintsema, H.; Roodenburg, J. L. N.; Werkera, P. M. N.

    The aim of this systematic review was to identify operations that are used to improve mouth opening in patients with extra-articular trismus (caused by cancer and its treatment, oral submucous fibrosis, or noma) and to find out if they work. We searched the electronic databases PubMed, Embase,

  16. Intra-articular regional migratory osteoporosis of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Wambeek, N.; Munk, P.L.; Lee, M.J. [Dept. of Radiology, Vancouver General Hospital, BC (Canada); University of British Columbia, Vancouver (Canada); Meek, R.N. [Department of Orthopedic Surgery, Vancouver General Hospital, Vancouver (Canada)

    2000-02-01

    We report a case of lntra-articular regional migratory osteoporosis of the knee in a 53-year-old man. The case demonstrates an unusual pattern of migration of the marrow edema within the knee joint. This phenomenon has received scant attention in the radiological literature. (orig.)

  17. Segmenting articular cartilage automatically using a voxel classification approach

    DEFF Research Database (Denmark)

    Folkesson, Jenny; Dam, Erik B; Olsen, Ole F

    2007-01-01

    We present a fully automatic method for articular cartilage segmentation from magnetic resonance imaging (MRI) which we use as the foundation of a quantitative cartilage assessment. We evaluate our method by comparisons to manual segmentations by a radiologist and by examining the interscan repro...

  18. Segmentation of articular cartilage using active contours and prior knowledge.

    Science.gov (United States)

    Tejos, Cristian; Hall, Laurance; Cardenas-Blanco, Arturo

    2004-01-01

    A diffusion snake segmentation algorithm was evaluated on synthetic and real MR images of articular cartilage. The algorithm proved to be robust to missing boundaries and the initial contour converges over large distances. Compared with a standard B-spline snake, more accurate and reproducible segmentations were obtained, with less effort during initialization of the algorithm.

  19. Subtalar versus triple arthrodesis after intra-articular calcaneal fractures

    NARCIS (Netherlands)

    T. Schepers (Tim); B.C.T. Kieboom (Brenda); J.H.J.M. Bessems (Gert); L.M.M. Vogels (Lucas); E.M.M. van Lieshout (Esther); P. Patka (Peter)

    2010-01-01

    textabstractDepending upon initial treatment, between 2 and 30% of patients with a displaced intra-articular calcaneal fracture require a secondary arthrodesis. The aim of this study was to investigate the effect of subtalar versus triple arthrodesis on functional outcome. A total of 33 patients

  20. Early micromovement of the Articular Surface Replacement (ASR) femoral component

    DEFF Research Database (Denmark)

    Penny, J O; Ding, M; Varmarken, J E

    2012-01-01

    Radiostereometric analysis (RSA) can detect early micromovement in unstable implant designs which are likely subsequently to have a high failure rate. In 2010, the Articular Surface Replacement (ASR) was withdrawn because of a high failure rate. In 19 ASR femoral components, the mean micromovement...

  1. Clinical and Laboratory Predictors of Articular Disorders Among HIV ...

    African Journals Online (AJOL)

    radiologist for features of avascular necrosis (AVN) and sacroiliitis, respectively. Synovial fluid was obtained, for analysis and microscopy, culture/sensitivity testing and acid fast bacilli detection in those with demonstrable joint effusion. The clinically evident articular features, laboratory, and radiographic findings were used ...

  2. Subtalar versus triple arthrodesis after intra-articular calcaneal fractures

    NARCIS (Netherlands)

    Schepers, Tim; Kieboom, Brenda C. T.; Bessems, Gert H. J. M.; Vogels, Lucas M. M.; van Lieshout, Esther M. M.; Patka, Peter

    2010-01-01

    Depending upon initial treatment, between 2 and 30% of patients with a displaced intra-articular calcaneal fracture require a secondary arthrodesis. The aim of this study was to investigate the effect of subtalar versus triple arthrodesis on functional outcome. A total of 33 patients with 37

  3. Reduction of intra-articular adhesion by topical application of ...

    African Journals Online (AJOL)

    Effect of daidzein on intra articular adhesion was estimated by visual score through macroscopic examination, histopathology study, hydroxyproline content, fibroblast and collage density. Results: Data obtained in the study suggest that topical application of daidzein (5 and 10 mg/ml) loose the collagen and significantly ...

  4. [Surgical treatment of calcaneus fracture involving posterior subtalar articular facet].

    Science.gov (United States)

    Xu, Peng-Wu; Qiao, Lin; Zhang, Shu-Ming; Liu, Chun-Sheng; Zhang, Wei; Xu, Qing-Lei

    2010-06-01

    To investigate the methods of reduction and stable fixation for the treatment of calcaneus fracture involving posterior subtalar articular facet. From September 2004 to September 2008, 31 cases(38 feet) of calcaneus fracture involving posterior subtalar articular facet were treated with open reduction and plate fixation through L incision. There were 24 males and 7 females, with an average age of 39.6 years ranging from 20 to 65 years. All patients underwent systematic CT-scan with coronal and horizontal images and sagittal reconstruction. The classification of the fractures by the Sanders scale showed that there were 22 of type II,14 of type III, 2 of type IV. All cases were followed up for from 12 to 36 months with an average of 25 months, and all the fractures healed without skin flap necrosis. According to the Maryland foot scoring, the total score was (96.2 +/- 8.8) on average, the results were excellent in 32 feet, good in 4 feet, fair in 2 feet. The replacement of the posterior articular facet by X-ray control of Broden and open reduction and internal fixation with calcaneus plate and Schanz-Screw during the operation can keep stable of articular facet, and promote early rehabilitation of calcaneus fracture affected with subtalar joint.

  5. Insight into osteo-articular digital tomosynthesis: a pictorial essay.

    Science.gov (United States)

    Lacout, Alexis; Thariat, Juliette; El Hajjam, Mostafa; Marcy, Pierre-Yves

    2013-02-01

    The objectives of this pictorial essay are to describe osteo-articular imaging using digital tomosynthesis. We provide characteristic examples in eight patients. Digital tomosynthesis allows easy, fast and low-dose imaging, with excellent spatial resolution. © 2012 The Authors; Journal of Medical Imaging and Radiation Oncology © 2012 The Royal Australian and New Zealand College of Radiologists.

  6. Oncogene expression in the peri-articular osteophytes | Alonge ...

    African Journals Online (AJOL)

    Objective: The aim of this study was to ascertain the proliferative and probably reparative potentials of the peri-articular osteophytes by evaluating the sites of expression of c-myc, c-jun and c-fos oncogenes in this neoplastic repair tissue. Materials and Methods: Sections of osteophytes were obtained from knees of patients ...

  7. Automatic quantification of local and global articular cartilage surface curvature

    DEFF Research Database (Denmark)

    Folkesson, Jenny; Dam, Erik B; Olsen, Ole F

    2008-01-01

    The objective of this study was to quantitatively assess the surface curvature of the articular cartilage from low-field magnetic resonance imaging (MRI) data, and to investigate its role in populations with varying radiographic signs of osteoarthritis (OA), cross-sectionally and longitudinally. ...... curvature estimates from low-field MRI at different scales could potentially become biomarkers targeted at different stages of OA....

  8. A STUDY OF EXTRA-ARTICULAR MANIFESTATIONS OF RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    Harsha N. S

    2017-10-01

    Full Text Available BACKGROUND Diseases of musculoskeletal system are among the most common human afflictions. Rheumatoid Arthritis (RA is a systemic autoimmune disease of unknown aetiology characterised by symmetric erosive arthritis and in some cases extra-articular involvement. Characteristic feature of RA is persistent inflammatory synovitis usually involving peripheral joints in a symmetric distribution. The aim of the study is to study the extra-articular manifestations of Rheumatoid Arthritis (RA. MATERIALS AND METHODS 50 cases who satisfied the criteria for diagnosis of RA laid down by the American Rheumatism Association Criteria were selected. They were studied for evidence of extra-articular manifestations by clinical, biochemical, radiological, echocardiographic and pulmonary function tests. Data was collected and analysis was made using various statistical parameters. RESULTS Among the 50 cases of RA studied, the disease was common in females and maximum incidence was seen between 30-39 years of age (30%. Morning stiffness, pain and swelling in the joints were the commonest presenting symptoms. The joints of the hand (70% were the most commonly involved followed by wrist, knee, ankle and foot joints. In the present study, 28 (56% had extra-articular manifestations with more incidence in males than females. The commonest one was anaemia (20% followed by cardiac involvement (12%. Next, in the order of involvement were pulmonary, lymphadenopathy, vasculitis and rheumatoid nodule. Pericardial effusion was the most common cardiac finding followed by mitral regurgitation and aortic regurgitation. RA factor was positive in 33 (66% cases. All the patients who had extra-articular manifestation had RA factor positive. CONCLUSION Although, the rheumatoid arthritis was common among females, the extra-articular manifestations were common among males. Longer duration of disease and positive RA factor were associated with higher incidence of extra-articular

  9. Brother of CDO (BOC) expression in equine articular cartilage.

    Science.gov (United States)

    Vanderman, K S; Tremblay, M; Zhu, W; Shimojo, M; Mienaltowski, M J; Coleman, S J; MacLeod, J N

    2011-04-01

    Brother of CDO (BOC) is a cell surface receptor that derives its name from the structurally related protein, cell adhesion molecule-related/down-regulated by oncogenes (CDO, sometimes CDON). High levels of BOC mRNA and protein expression have been described in embryonic tissues with active cell proliferation and ongoing cellular differentiation(1,2). A microarray-based screen of RNA isolated from 11 different adult equine tissues unexpectedly identified BOC as having an expression pattern restricted to articular cartilage. The objective of this study was to further investigate BOC expression in adult articular cartilage relative to other tissues. Both RT-qPCR and mRNA sequencing confirmed the microarray data. Steady state BOC mRNA levels in articular cartilage were substantially higher than in the other adult tissues tested, neonatal tendon, placenta, and whole embryo. The expression of BOC displayed a pattern of tissue specificity comparable to well established cartilage matrix protein biomarkers. BOC mRNA levels in articular cartilage increased with age, but were rapidly down-regulated when chondrocytes were enzymatically isolated from the cartilage matrix and expanded in monolayer culture. Relative expression patterns of CDO were broadly similar, but displayed lower fold change differences. A functional role in articular cartilage that involves Hedgehog signaling is suggested by the known binding affinity of BOC for all three Hedgehog ligands. These data also extend BOC and CDO biology to a post-mitotic and highly differentiated cell type within a mature tissue. Copyright © 2011 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  10. Extra-articular hip impingement: a review of the literature.

    Science.gov (United States)

    Arévalo Galeano, N; Santamaría Guinea, N; Gredilla Molinero, J; Grande Bárez, M

    Hip and groin pain is a common clinical problem. Multiple causes can generate hip or groin pain, often sharing clinical and demographic characteristics. Diagnostic imaging tests play an important role in the etiological diagnosis. New forms of extra-articular hip impingement have recently been recognized as a cause of hip pain and limited function especially in young active patients. These conditions include ischiofemoral impingement, anterior inferior iliac spine and subspine impingement, iliopsoas impingement and greater trochanteric-pelvic impingement. In general, they are caused by a mechanical conflict with an abnormal or excessive contact between the proximal femur and pelvis and/or soft tissue between them. In this manuscript we review the physiopathology, clinical presentation, the most common radiologic findings and treatment of these forms of extra-articular hip impingement. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. [Osteo-articular tuberculosis and postpartum: a casual association?].

    Science.gov (United States)

    Sauvet, F; Imbert, I; Magnin, J; Souviat, C; Ponties, J E; Lechevalier, D

    2005-09-01

    Most cases of active tuberculosis in France are due to a recurrence of latent tuberculosis. It seems that immunorestitution during the postpartum can contribute to the return of latent tuberculosis. We report three observations of Mycobacterium tuberculosis osteo-articular infections (two Pott's diseases and one sterno-clavicular arthritis) occurring during the postpartum of women non infected by HIV. Two patients need a surgical treatment. The response to standard tuberculous treatment was favourable and all patients were cured. One must consider osteo-articular tuberculosis when a patient is suffering from osseous pains not proving reliable during the postpartum. We must remind ourselves of the relationships between tuberculosis and postpartum as well as the necessity to the threat both mother and child. Additional epidemiological studies should be realised. It appears necessary to increase in France measures for tracking tuberculosis in particularly about the latent forms.

  12. Chondroitin sulfate reduces the friction coefficient of articular cartilage.

    Science.gov (United States)

    Basalo, Ines M; Chahine, Nadeen O; Kaplun, Michael; Chen, Faye H; Hung, Clark T; Ateshian, Gerard A

    2007-01-01

    The objective of this study was to investigate the effect of chondroitin sulfate (CS)-C on the frictional response of bovine articular cartilage. The main hypothesis is that CS decreases the friction coefficient of articular cartilage. Corollary hypotheses are that viscosity and osmotic pressure are not the mechanisms that mediate the reduction in the friction coefficient by CS. In Experiment 1, bovine articular cartilage samples (n=29) were tested in either phosphate buffered saline (PBS) or in PBS containing 100mg/ml of CS following 48h incubation in PBS or in PBS+100mg/ml CS (control specimens were not subjected to any incubation). In Experiment 2, samples (n=23) were tested in four different solutions: PBS, PBS+100mg/ml CS, and PBS+polyethylene glycol (PEG) (133 or 170mg/ml). In Experiment 3, samples (n=18) were tested in three solutions of CS (0, 10 and 100mg/ml). Frictional tests (cartilage-on-glass) were performed under constant stress (0.5MPa) for 3600s and the time-dependent friction coefficient was measured. Samples incubated or tested in a 100mg/ml CS solution exhibited a significantly lower equilibrium friction coefficient than the respective PBS control. PEG solutions delayed the rise in the friction coefficient relative to the PBS control, but did not reduce the equilibrium value. Testing in PBS+10mg/ml of CS did not cause any significant decrease in the friction coefficient. In conclusion, CS at a concentration of 100mg/ml significantly reduces the friction coefficient of bovine articular cartilage and this mechanism is neither mediated by viscosity nor osmolarity. These results suggest that direct injection of CS into the joint may provide beneficial tribological effects.

  13. Articular Cartilage Repair Through Muscle Cell-Based Tissue Engineering

    Science.gov (United States)

    2011-03-01

    TaqMan probe AAC-CCT-CTT- TTC -GGA-TTA-ACC-CTG-CGA- GTT. Articular cartilage defect model and cell transplanta- tion. All animal experiments were... inhalation mask. The knee joint was exposed by medial parapa- tellar incision, and the trochlear groove was exposed by lateral dislocation of the...least significant difference test. P values less than 0.05 were considered significant. RESULTS In vitro MDSC characterization. Flow cytometric analysis

  14. [Osteo-articular tuberculosis in African (author's transl)].

    Science.gov (United States)

    Ferro, R; Barnaud, P; Carayon, A

    1979-01-01

    General, clinical and therapeutic features of osteo-articular tuberculosis in African, excluding vertebral localizations, are compiled from 81 records: The are: -- a frequency lower than in expatriated Africans and this indicates their special physical resistance when they live in their natural environment; -- frequently an easy diagnosis because of infected advanced foci with associated lesions; -- a surgical indication (curettage, resection, arthrodesis) as frequent as in vertebral localizations.

  15. Role of tenascin-C in articular cartilage.

    Science.gov (United States)

    Hasegawa, Masahiro; Yoshida, Toshimichi; Sudo, Akihiro

    2018-03-01

    Tenascin-C (TN-C) is a glycoprotein component of the extracellular matrix (ECM). TN-C consists of four distinct domains, including the tenascin assembly domain, epidermal growth factor-like repeats, fibronectin type III-like repeats, and the fibrinogen-like globe (FBG) domain. This review summarizes the role of TN-C in articular cartilage. Expression of TN-C is associated with the development of articular cartilage but markedly decreases during maturation of chondrocytes and disappears almost completely in adult articular cartilage. Increased expression of TN-C has been found at diseased cartilage and synovial sites in osteoarthritis (OA) and rheumatoid arthritis (RA). TN-C is increased in the synovial fluid in patients with OA and RA. In addition, serum TN-C is elevated in RA patients. TN-C could be a useful biochemical marker for joint disease. The addition of TN-C results in different effects among TN-C domains. TN-C fragments might be endogenous inducers of cartilage matrix degradation; however, full-length TN-C could promote cartilage repair and prevent cartilage degeneration. The deficiency of TN-C enhanced cartilage degeneration in the spontaneous OA in aged joints and surgical OA model. The clinical significance of TN-C effects on cartilage is not straightforward.

  16. MRI diagnosis of reverse and separation of meniscus articular capsule

    International Nuclear Information System (INIS)

    Tang Xiaofeng; Zhou Chengtao; Mu Renqi; Zhang Guanghui; Xu Yongzhong

    2005-01-01

    Objective: To explore the MR imaging of reverse and separation of meniscal articular capsule. Methods: MR imaging of reverse and separation of meniscus articular capsule confirmed by surgery and arthroscope were analyzed retrospectively in 8 cases. Results: The 'Butterfly knot sign' disappeared and was replaced with fluid signal on the sagittal slice of meniscal body in 8 cases. Part of back angle remained in 3 cases. 'Double anterior cruciate ligament sign' was showed on one side of middle sagittal slice in 7 cases. 'Reverse meniscus sign' was revealed in intercondylar fossa on the coronary view in 8 cases. Abnormal high signal was showed in the injured meniscus in 6 cases. Abnormal high signal was detected in the opposite meniscus in 5 cases. Conclusion: The MR findings of reverse and separation of meniscus articular capsule include disappearance of 'butterfly knot sign', appearance of 'reverse meniscus sign' and 'double anterior cruciate ligament sign'. The diagnosis would be established if the former 2 signs were present or all the 3 signs were present simultaneously. (authors)

  17. The efficacy of intra-articular bupivacaine for relief of pain following arthroscopy of the ankle.

    Science.gov (United States)

    Middleton, F; Coakes, J; Umarji, S; Palmer, S; Venn, R; Panayiotou, S

    2006-12-01

    The intra-articular injection of local anaesthetic is frequently used for pain relief after arthroscopy. There is, however, no published evidence of the analgesic effect of bupivacaine in the ankle. In a randomised, double-blind study, 35 patients undergoing arthroscopy of the ankle were allocated to receive intra-articular saline or bupivacaine. Pain was assessed using pain scores and additional analgesic requirements. Intra-articular bupivacaine had a significant analgesic effect in the immediate post-operative period, reducing pain scores and the need for additional analgesics. We recommend the use of intra-articular bupivacaine for post-operative analgesia in ankle surgery.

  18. Comparison of hyaluronic acid and PRP intra-articular injection with combined intra-articular and intraosseous PRP injections to treat patients with knee osteoarthritis.

    Science.gov (United States)

    Su, Ke; Bai, Yuming; Wang, Jun; Zhang, Haisen; Liu, Hao; Ma, Shiyun

    2018-05-01

    The aim of this study was to evaluate the benefit provided by intraosseous infiltration combined with intra-articular injection of platelet-rich plasma to treat mild and moderate stages of knee joint degeneration (Kellgren-Lawrence score II-III) compared with other treatments, specifically intra-articular injection of PRP and of HA. Eighty-six patients with grade II to grade III knee OA according to the Kellgren-Lawrence classification were randomly assigned to intra-articular combined with intraosseous injection of PRP (group A), intra-articular PRP (group B), or intra-articular HA (group C). Patients in group A received intra-articular combined with intraosseous injection of PRP (administered twice, 2 weeks apart). Patients in group B received intra-articular injection of PRP every 14 days. Patients in group C received a series of five intra-articular injections of HA every 7 days. All patients were evaluated using the Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities (WOMAC) score before the treatment and at 1, 3, 6, 12, and 18 months after treatment. There were significant improvements at the end of the 1st month. Notably, group A patients had significantly superior VAS and WOMAC scores than were observed in groups B and C. The VAS scores were similar in groups B and group C after the 6th month. Regarding the WOMAC scores, groups B and C differed at the 1st, 3rd, 6th, and 12th months; however, no significant difference was observed at the 18th month. The combination of intraosseous with intra-articular injections of PRP resulted in a significantly superior clinical outcome, with sustained lower VAS and WOMAC scores and improvement in quality of life within 18 months.

  19. Osteoarthritis: Control of human cartilage hypertrophic differentiation. Research highlight van: Gremlin1, frizzled-related protein, and Dkk-1 are key regulators of human articular cartilage homeostasis

    NARCIS (Netherlands)

    Buckland, J.; Leijten, Jeroen Christianus Hermanus; van Blitterswijk, Clemens; Karperien, Hermanus Bernardus Johannes

    2012-01-01

    Disruption of articular cartilage homeostasis is important in osteoarthritis (OA) pathogenesis, key to which is activation of articular chondrocyte hypertrophic differentiation. Healthy articular cartilage is resistant to hypertrophic differentiation, whereas growth-plate cartilage is destined to

  20. Shape of articular surface of crocodilian (Archosauria) elbow joints and its relevance to sauropsids.

    Science.gov (United States)

    Fujiwara, Shin-ichi; Taru, Hajime; Suzuki, Daisuke

    2010-07-01

    The determination of area and shape of articular surfaces on the limb bones of extinct archosaurs is difficult because of postmortem decomposition of the fibrous tissue and articular cartilages that provide the complex three-dimensional joint surfaces in vivo. This study aims at describing the shape of the articular cartilages in the elbow joints of six crocodilian specimens; comparing its structure with that of four birds, three testudines, and five squamates; and comparing the shapes of the surfaces of the calcified and the articular cartilages in the elbow joints of an Alligator specimen. The shapes of the articular cartilages of crocodilian elbow joint are shown to resemble those of birds. The humerus possesses an olecranon fossa positioned approximately at the midportion of the distal epiphysis and bordering the margin of the extensor side of the articular surface. The ulna possesses a prominent intercotylar process at approximately the middle of its articular surface, and splits the surface into the radial and ulnar cotylae. This divides the articular cartilage into an articular surface on the flexor portion, and the olecranon on the extensor portion. The intercotylar process fits into the olecranon fossa to restrict elbow joint extension. Dinosaurs and pterosaurs, phylogenetically bracketed by Crocodylia and Aves (birds), may have possessed a similar olecranon fossa and intercotylar process on their articular cartilages. Although these shapes are rarely recognizable on the bones, their impressions on the surfaces of the calcified cartilages provide an important indication of the extensor margin of the articular surfaces. This, in turn, helps to determine the maximum angle of extension of the elbow joint in archosaurs.

  1. Boundary lubrication of articular cartilage: role of synovial fluid constituents.

    Science.gov (United States)

    Schmidt, Tannin A; Gastelum, Nicholas S; Nguyen, Quynhhoa T; Schumacher, Barbara L; Sah, Robert L

    2007-03-01

    To determine whether the synovial fluid (SF) constituents hyaluronan (HA), proteoglycan 4 (PRG4), and surface-active phospholipids (SAPL) contribute to boundary lubrication, either independently or additively, at an articular cartilage-cartilage interface. Cartilage boundary lubrication tests were performed with fresh bovine osteochondral samples. Tests were performed using graded concentrations of SF, HA, and PRG4 alone, a physiologic concentration of SAPL, and various combinations of HA, PRG4, and SAPL at physiologic concentrations. Static (mu(static, Neq)) and kinetic () friction coefficients were calculated. Normal SF functioned as an effective boundary lubricant both at a concentration of 100% ( = 0.025) and at a 3-fold dilution ( = 0.029). Both HA and PRG4 contributed independently to a low mu in a dose-dependent manner. Values of decreased from approximately 0.24 in phosphate buffered saline to 0.12 in 3,300 mug/ml HA and 0.11 in 450 mug/ml PRG4. HA and PRG4 in combination lowered mu further at the high concentrations, attaining a value of 0.066. SAPL at 200 mug/ml did not significantly lower mu, either independently or in combination with HA and PRG4. The results described here indicate that SF constituents contribute, individually and in combination, both at physiologic and pathophysiologic concentrations, to the boundary lubrication of apposing articular cartilage surfaces. These results provide insight into the nature of the boundary lubrication of articular cartilage by SF and its constituents. They therefore provide insight regarding both the homeostatic maintenance of healthy joints and pathogenic processes in arthritic disease.

  2. Survivorship After Meniscal Allograft Transplantation According to Articular Cartilage Status.

    Science.gov (United States)

    Lee, Bum-Sik; Bin, Seong-Il; Kim, Jong-Min; Kim, Won-Kyeong; Choi, Jun Weon

    2017-04-01

    Clinical outcomes after meniscal allograft transplantation (MAT) in arthritic knees are unclear, and objective estimates of graft survival according to the articular cartilage status have not been performed. MAT should provide clinical benefits in knees with high-grade cartilage damage, but their graft survivorship should be inferior to that in knees with low-grade chondral degeneration after MAT. Cohort study; Level of evidence, 3. The records of 222 consecutive patients who underwent primary MAT were reviewed to compare clinical outcomes and graft survivorship. The patients were grouped according to the degree and location of articular cartilage degeneration: low-grade chondral lesions (International Cartilage Repair Society [ICRS] grade ≤2) on both the femoral and tibial sides (ideal indication), high-grade lesions (ICRS grade 3 or 4) on either the femoral or tibial side (relative indication), and high-grade lesions on both sides (salvage indication). Kaplan-Meier survival analysis with the log-rank test was performed to compare the clinical survival rates and graft survival rates between the groups. A Lysholm score of meniscal tear or meniscectomy of greater than one-third of the allograft, objectively evaluated by magnetic resonance imaging (MRI) and second-look arthroscopic surgery. The mean (±SD) Lysholm score significantly improved from 63.1 ± 15.1 preoperatively to 85.1 ± 14.3 at the latest follow-up of a mean 44.6 ± 19.7 months ( P lesions. However, better graft survival can be expected when articular cartilage is intact or if chondral damage is limited to a unipolar lesion. MAT should be considered before the progression of chondral damage to a bipolar lesion for better graft survivorship and should be performed cautiously in arthritic knees.

  3. Pediatric and adolescent intra-articular fractures of the calcaneus

    Directory of Open Access Journals (Sweden)

    Marcel Dudda

    2013-06-01

    Full Text Available Calcaneal fractures in childhood are very rare, whereas particularly intra-articular displaced fractures are not typical in skeletally immature children. Various techniques of osteosynthesis have been described. This study aimed to determine clinical and radiological outcome after surgical treatment of intra-articular calcaneal fractures. Fourteen intra-articular fractures of the calcaneus were included in this retrospective study. Eleven children (2 girls and 9 boys aged 6-16 years (average age 11.5 years underwent surgical treatment. One child sustained a Type II open fracture of both calcanei. All injuries occurred after a high-energy trauma; 3 patients had multiple additional fractures. The clinical and radiological postoperative follow up was an average 44 months. In 4 cases, a reduction through a minimally invasive approach and fixation with K-wires or screws could be achieved. Eleven fractures were treated with open reduction and internal fixation with plate osteosynthesis, K-wires or screws. In one case with open fractures of both heel bones, an additional external fixator was applied. The surgical treatment approach adopted enabled the pre-operative Boehler’s angle (average 16° to be improved to an average 30°. In all cases, except for the patient with open fractures, a good functional result and outcome could be achieved. In calcaneal fractures in childhood, anatomical reduction is the determining factor, as in fractures in adults, whereas the surgical technique seems to have no influence on clinical outcome in children. The wound healing problems that have often been described were not observed in this age group.

  4. Reemplazo articular temporomandibular debido a queratoquiste odontogénico

    Directory of Open Access Journals (Sweden)

    Pedro Angel Peñón Vivas

    2013-03-01

    Full Text Available Existen disímiles condiciones que hacen necesario el reemplazo articular temporomandibular; dentro de las más frecuentes se encuentran la anquilosis, la osteoatrosis, estadíos avanzados del Síndrome de disfunción temporomandibular, daño articular postrauma y procesos neoplásicos o tumorales. Los queratoquistes odontógenos que se agrupan para su estudio dentro de los quistes odontogénicos del desarrollo, representan cerca del 7 al 10 por ciento de todos los quistes maxilo-mandibulares. Se dice que tienen dos picos de incidencia entre la segunda y tercera década de vida y entre los 50 y 60 años de edad, con una ligera predilección por el sexo masculino. Aparece más frecuentemente en la región del tercer molar de la mandíbula con extensión a la rama ascendente El presente trabajo tuvo como objetivo mostrar el caso de un paciente masculino de 57 años de edad en el que fue necesario el reemplazo articular temporomandibular debido a un queratoquiste odontogénico que involucraba la totalidad de la rama mandibular derecha, incluyendo el proceso condíleo y coronoideo, así como el ángulo hasta el tercio posterior del cuerpo mandibular. Tras un año de realizada la intervención quirúrgica la evolución del paciente fue satisfactoria.

  5. Biochemical composition of the superficial layer of articular cartilage.

    Science.gov (United States)

    Crockett, R; Grubelnik, A; Roos, S; Dora, C; Born, W; Troxler, H

    2007-09-15

    To gain more information on the mechanism of lubrication in articular joints, the superficial layer of bovine articular cartilage was mechanically removed in a sheet of ice that formed on freezing the cartilage. Freeze-dried samples contained low concentrations of chondroitin sulphate and protein. Analysis of the protein by SDS PAGE showed that the composition of the sample was comparable to that of synovial fluid (SF). Attenuated total reflection infrared (ATR-IR) spectroscopy of the dried residue indicated that the sample contained mostly hyaluronan. Moreover, ATR-IR spectroscopy of the upper layer of the superficial layer, adsorbed onto silicon, showed the presence of phospholipids. A gel could be formed by mixing hyaluronan and phosphatidylcholine in water with mechanical properties similar to those of the superficial layer on cartilage. Much like the superficial layer of natural cartilage, the surface of this gel became hydrophobic on drying out. Thus, it is proposed that the superficial layer forms from hyaluronan and phospholipids, which associate by hydrophobic interactions between the alkyl chains of the phospholipids and the hydrophobic faces of the disaccharide units in hyaluronan. This layer is permeable to material from the SF and the cartilage, as shown by the presence of SF proteins and chondroitin sulphate. As the cartilage dries out after removal from the joint, the phospholipids migrate towards the surface of the superficial layer to reduce the surface tension. It is also proposed that the highly efficient lubrication in articular joints can, at least in part, be attributed to the ability of the superficial layer to adsorb and hold water on the cartilage surface, thus creating a highly viscous boundary protection. Copyright 2007 Wiley Periodicals, Inc.

  6. ROCK inhibitor prevents the dedifferentiation of human articular chondrocytes

    International Nuclear Information System (INIS)

    Matsumoto, Emi; Furumatsu, Takayuki; Kanazawa, Tomoko; Tamura, Masanori; Ozaki, Toshifumi

    2012-01-01

    Highlights: ► ROCK inhibitor stimulates chondrogenic gene expression of articular chondrocytes. ► ROCK inhibitor prevents the dedifferentiation of monolayer-cultured chondrocytes. ► ROCK inhibitor enhances the redifferentiation of cultured chondrocytes. ► ROCK inhibitor is useful for preparation of un-dedifferentiated chondrocytes. ► ROCK inhibitor may be a useful reagent for chondrocyte-based regeneration therapy. -- Abstract: Chondrocytes lose their chondrocytic phenotypes in vitro. The Rho family GTPase ROCK, involved in organizing the actin cytoskeleton, modulates the differentiation status of chondrocytic cells. However, the optimum method to prepare a large number of un-dedifferentiated chondrocytes is still unclear. In this study, we investigated the effect of ROCK inhibitor (ROCKi) on the chondrogenic property of monolayer-cultured articular chondrocytes. Human articular chondrocytes were subcultured in the presence or absence of ROCKi (Y-27632). The expression of chondrocytic marker genes such as SOX9 and COL2A1 was assessed by quantitative real-time PCR analysis. Cellular morphology and viability were evaluated. Chondrogenic redifferentiation potential was examined by a pellet culture procedure. The expression level of SOX9 and COL2A1 was higher in ROCKi-treated chondrocytes than in untreated cells. Chondrocyte morphology varied from a spreading form to a round shape in a ROCKi-dependent manner. In addition, ROCKi treatment stimulated the proliferation of chondrocytes. The deposition of safranin O-stained proteoglycans and type II collagen was highly detected in chondrogenic pellets derived from ROCKi-pretreated chondrocytes. Our results suggest that ROCKi prevents the dedifferentiation of monolayer-cultured chondrocytes, and may be a useful reagent to maintain chondrocytic phenotypes in vitro for chondrocyte-based regeneration therapy.

  7. [Symptomatic and evolutive characteristics of articular destruction noted in chondrocalcinosis].

    Science.gov (United States)

    Villiaumey, J; Larget-Piet, B; Menza, C D; Rotterdam, M

    1975-04-01

    Referring to 17 personal observations, the authors endeavour to clarify the main clinical and radiological traits of the destructive arthropathies occuring in patients suffering from diffuse, articular chondrocalcinosis. These arthropathies appear to be relatively frequent and older, obese women suffering from demineralization are more readily affected. The knees, coxo-femoral joints and the shoulders are principally concerned, and to a lesser extent the wrists, the trapezo-metacarpal joints and even the spine. The lesions can be polyarticular and symmetrical, be grouped in more or less random oligoarticular combinations or may occur in only a single joint space. Clinically, these destructive arthropathies give rise to severe pain and very marked functional impotence. The joints are swollen without any signs of inflammation. The joint movements are painful, stiff, and limited. Axial deviations are frequent. Radiologically, the lesions occur throughout the cartilage sheath, the inter-chondrial bone, and in the underlying epiphysary bone, in the form of massive geodes and massives loss of tissue substance. On the other hand, the process of reconstruction is very limited. In the patients studied, chondrocalcinosis was proved by the very characteristic pictures of calcic incrustations of the cartilage sheath and the fibro-cartilages, by the discovery of micro-crystals of calcium pyrophosphate in the articular fluid or, at biopsy, by the thickness of the synovial fluid. This chondrocalcinosis was primary in the cases. These destructive lesions were easily distinguishable from nervous or diabetic osteo-arthropathies, and from tumoral, infectious, rheumatic, or vascular changes. Thus, chondrocalcinosis is among the most common causes of osteo-articular destruction. It should be looked for systematically in all patients with lytic arthropathies of unknown etiology.

  8. Tratamiento farmacológico invasivo articular en la artrosis

    OpenAIRE

    D. Benítez Pareja; P. Benítez Pareja

    2016-01-01

    La degeneración de las articulaciones axiales y periféricas va unida al propio envejecimiento del ser humano. Es responsable del dolor e impotencia funcional, y su fisiopatología es compleja y no del todo conocida. El denominador común en la artrosis es la degeneración del cartílago articular, junto a otras alteraciones secundarias. Su abordaje y manejo del dolor supone todo un reto para las Unidades del Dolor. Históricamente, el tratamiento intervencionista se llevó a cabo mediante infiltrac...

  9. [Dosage of ionized calcium in osteo-articular pathology].

    Science.gov (United States)

    Eisinger, J; Schiano, A

    1978-06-01

    The dosage of calcium ionized serum using a selective electrode, was performed in a series of controls and patients with osteo-articular diseases. Normal values were 43 mg/l between 20 and 50 years of age, and 41 mg/l after 60 years. The level of ionized calcium, when given as a percentage of total blood calcium, did not decrease with age (normal value : 44%). It was increased in hyper-parathyroidism, rhumatoid polyarthritis and lytic bone metastasis. It did not vary in Paget's disease, osteoporosis, osteomalacia, condensing metastasis, Kahler's disease and spasmophilia. The ionized calcium in definitely diminished in hypoparathyroidism.

  10. [The stage of articular destruction in the rheumatoid hand].

    Science.gov (United States)

    de la Caffinière, J Y; Mazas, F; Achach, P C

    1975-01-01

    Function incapacitation of the hand in rheumatoid arthritis was studied on 33 patients (54 hands). 35 were operated on. All cases had reached the stage of articular destructions. The authors emphasize the importance of preserved proximal inter-phalangeal joint for digito-palmar pinch. Thumb unstability was not severely disabling as long as the other digits were normal. However, when it was associated with hyperextension deformities of the other fingers, the hand became useless. Surgical indications in rheumatoid hand were detailed. The importance of restoring thumb function was pointed out.

  11. Conditional knockdown of hyaluronidase 2 in articular cartilage stimulates osteoarthritic progression in a mice model.

    Science.gov (United States)

    Higuchi, Yoshitoshi; Nishida, Yoshihiro; Kozawa, Eiji; Zhuo, Lisheng; Arai, Eisuke; Hamada, Shunsuke; Morita, Daigo; Ikuta, Kunihiro; Kimata, Koji; Ushida, Takahiro; Ishiguro, Naoki

    2017-08-01

    The catabolism of hyaluronan in articular cartilage remains unclear. The aims of this study were to investigate the effects of hyaluronidase 2 (Hyal2) knockdown in articular cartilage on the development of osteoarthritis (OA) using genetic manipulated mice. Destabilization of the medial meniscus (DMM) model of Col2a promoter specific conditional Hyal2 knockout (Hyal -/- ) mice was established and examined. Age related and DMM induced alterations of articular cartilage of knee joint were evaluated with modified Mankin score and immunohistochemical staining of MMP-13, ADAMTS-5, KIAA11199, and biotinylated- hyaluronan binding protein staining in addition to histomorphometrical analyses. Effects of Hyal2 suppression were also analyzed using explant culture of an IL-1α induced articular cartilage degradation model. The amount and size of hyaluronan in articular cartilage were higher in Hyal2 -/- mice. Hyal2 -/- mice exhibited aggravated cartilage degradation in age-related and DMM induced mice. MMP-13 and ADAMTS-5 positive chondrocytes were significantly higher in Hyal2 -/- mice. Articular cartilage was more degraded in explant cultures obtained from Hyal2 -/- mice. Knockdown of Hyal2 in articular cartilage induced OA development and progression possibly mediated by an imbalance of HA metabolism. This suggests that Hyal2 knockdown exhibits mucopolysaccharidosis-like OA change in articular cartilage similar to Hyal1 knockdown.

  12. Listeria monocytogenes septic arthritis following intra-articular yttrium-90 therapy.

    Science.gov (United States)

    Wilson, A P; Prouse, P J; Gumpel, J M

    1984-01-01

    Listeria monocytogenes is a rare cause of septic arthritis, which usually occurs in a host compromised by systemic illness. Intra-articular irradiation with yttrium-90 is generally free of complication. We report a case of intra-articular sepsis of the knee joint by Listeria monocytogenes acquired under unusual circumstances. PMID:6742916

  13. Osteoprotegerin deficiency leads to deformation of the articular cartilage in femoral head.

    Science.gov (United States)

    Liu, Yi; Ge, Jianping; Chen, Danying; Weng, Yuteng; Du, Haiming; Sun, Yao; Zhang, Qi

    2016-10-01

    Osteoarthritis (OA) was a degenerative joint disease characterized by articular cartilage degradation and extensive remodeling of the subchondral bone. Multiple lines of evidence indicated that Osteoprotegerin (OPG), a member of TNF receptor superfamily that was expressed in the chondrocytes of articular cartilage and adjacent locations in the physiological setting, was involved in maintaining integrity of articular cartilage. OPG could prevent subchondral bone from resorption, and also protect cartilage from degradation. In this study, we used Osteoprotegerin-knockout mice (Opg-KO mice) to find out the role of OPG in articular cartilage. We examined articular cartilage in the femoral head of Opg-KO mice began in early adulthood using modern molecular and imaging methods. We found cartilage changes starting from adulthood and progressively with age, reminiscent of pathological changes in OA. Deficiency of OPG caused thinned articular cartilage and extensive remodeling of the subchondral bone in femoral head in comparison with wild-type mice (WT mice). Also, the articular cartilage of femoral head expressed significantly less of Aggrecan, Col-II and Col-X, but more Col-I and Matrix Metalloproteinases-13 (Mmp-13) than WT mice both at gene and protein level. Moreover, increased chondrocyte apoptosis and decreased chondrocyte proliferation were observed in femoral head of Opg-KO mice compared to WT mice. These data suggested that OPG played an important role in maintaining the homeostasis of articular cartilage of femoral head.

  14. Articular contact in a three-dimensional model of the knee

    NARCIS (Netherlands)

    Blankevoort, L.; Kuiper, J. H.; Huiskes, R.; Grootenboer, H. J.

    1991-01-01

    This study is aimed at the analysis of articular contact in a three-dimensional mathematical model of the human knee-joint. In particular the effect of articular contact on the passive motion characteristics is assessed in relation to experimentally obtained joint kinematics. Two basically different

  15. Indications for intra-articular steroid in osteoarthritis of the ankle and ...

    African Journals Online (AJOL)

    The results of treatment with intra-articular steroid in an unselected group of patients with osteo-arthritis of the ankle and metatarsophalangeal joint of the big toe are described. From the results of this trial it is possible to lay down indications for the use of intra-articular steroid in these conditions. In the ankle joint it is ...

  16. Surgery for extra-articular trismus: a systematic review.

    Science.gov (United States)

    Bouman, M A; Dijkstra, P U; Reintsema, H; Roodenburg, J L N; Werker, P M N

    2016-04-01

    The aim of this systematic review was to identify operations that are used to improve mouth opening in patients with extra-articular trismus (caused by cancer and its treatment, oral submucous fibrosis, or noma) and to find out if they work. We searched the electronic databases PubMed, Embase, Cinahl, and the Cochrane collaboration, and then systematically selected papers before we assessed their quality, extracted the data, and did a meta-analysis. We analysed 32 studies that included 651 patients, the median (IQR) size of which was 11 (7-26). The quality of the methods used and of reporting were relatively low. Median (IQR) duration of follow-up was 12 (8-22) months. Operations resulted in a weighted mean (SD) increase in mouth opening of 19.3 (6.3) mm. None of the operations was better than the others for the improvement of mouth opening. We conclude that operations can improve mouth opening in extra-articular trismus, but the evidence is of moderate quality and there is a need for further research. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. Articular Eminence Inclination in Medieval and Contemporary Croatian Population

    Science.gov (United States)

    Kranjčić, Josip; Šlaus, Mario; Vodanović, Marin; Peršić, Sanja; Vojvodić, Denis

    2016-12-01

    Articular eminence inclination (AEI) of the temporomandibular joint leads the mandible in its movements. Therefore, the aim of the present study was to determine AEI values in medieval (MP) and recent (RP) Croatian population. The study was carried out on two groups of specimens: first group with 30 MP human dry skulls, while the other, serving as control group consisted of 137 dry skulls. The AEI was measured on lateral digital skull images as the angle between the best fi t line drawn along the posterior wall of the articular eminence and the Frankfurt horizontal plane. No statistically significant (p>0.05) differences between the left and right side AEI were found between MP skulls and RP skulls. The mean value of MP AEI was 45.5˚, with a range of 20.9˚-64˚. The mean RP AEI value was steeper (61.99˚), with a range of 30˚-94˚. Difference between the mean MP and RP AEI values was statistically significant (pmedieval time, and consequently different masticatory loads and forces.

  18. Outcome of ACL Reconstruction and Concomitant Articular Injury Treatment

    Directory of Open Access Journals (Sweden)

    Seyed Mohammad Tahami

    2015-10-01

    Full Text Available Background: Articular cartilage injuries are a common clinical problem at the time of ACL reconstruction with an incidence rate of 16-46%. Good results of ACL reconstruction combined with the treatment of chondral lesions have been published in some studies. Method: After statistical analysis 30 patients were selected and divided in 2 groups. TheFfirst group consisted of 15 patients wite isolated ACL tear without any other concomitant injuries and the second group consisted of 15 patients with ACL tear and concomitant high grade (grade 3 or 4 of outerbridge classification contained articular cartilage injuries during arthroscopy. Group 1 underwent ACL reconstruction and group 2 underwent ACL reconstruction combined with chondroplasty via the drilling and microfracture technique. For each patient the Lysholm knee score questionnaire was completed before surgery, 6 months and 1 year after surgery. Results: The mean Lysholm knee score in both groups improves: 9.6 points after 6 months and 16.06 points after 1 year in group 1 and 23.26 points after 6 months and 30.66 after 1 year in group 2, whict was statistically significant (Pvalue

  19. Radiation synovectomy stimulates glycosaminoglycan synthesis by normal articular cartilage

    International Nuclear Information System (INIS)

    Myers, S.L.; Slowman, S.D.; Brandt, K.D.

    1989-01-01

    Radiation synovectomy has been considered a therapeutic alternative to surgical synovectomy. Whether intraarticular irradiation affects the composition or biochemistry, and therefore the biomechanical properties, of normal articular cartilage has not been established. In the present study, yttrium 90 silicate was injected into one knee of nine normal adult dogs, and three other dogs received nonradioactive yttrium silicate. When the animals were killed 4 to 13 weeks after the injection, synovium from the irradiated knees showed areas of necrosis and fibrosis. Up to 29% less hyaluronate was synthesized in vitro by the synovial intima from irradiated knees than by the intima from the contralateral knees (mean difference 18%). Morphologic abnormalities were not observed in articular cartilage from either the irradiated or control knees, nor did the water content or concentrations of uronic acid or DNA in cartilage from the irradiated knees differ from that in cartilage from the contralateral knees. However, net 35 SO 4 -labeled glycosaminoglycan synthesis in organ cultures of cartilage from irradiated knees was increased (mean difference 21%, p = 0.03) in comparison with that in cultures of contralateral knee cartilage

  20. Radiation synovectomy stimulates glycosaminoglycan synthesis by normal articular cartilage

    Energy Technology Data Exchange (ETDEWEB)

    Myers, S.L.; Slowman, S.D.; Brandt, K.D.

    1989-07-01

    Radiation synovectomy has been considered a therapeutic alternative to surgical synovectomy. Whether intraarticular irradiation affects the composition or biochemistry, and therefore the biomechanical properties, of normal articular cartilage has not been established. In the present study, yttrium 90 silicate was injected into one knee of nine normal adult dogs, and three other dogs received nonradioactive yttrium silicate. When the animals were killed 4 to 13 weeks after the injection, synovium from the irradiated knees showed areas of necrosis and fibrosis. Up to 29% less hyaluronate was synthesized in vitro by the synovial intima from irradiated knees than by the intima from the contralateral knees (mean difference 18%). Morphologic abnormalities were not observed in articular cartilage from either the irradiated or control knees, nor did the water content or concentrations of uronic acid or DNA in cartilage from the irradiated knees differ from that in cartilage from the contralateral knees. However, net /sup 35/SO/sub 4/-labeled glycosaminoglycan synthesis in organ cultures of cartilage from irradiated knees was increased (mean difference 21%, p = 0.03) in comparison with that in cultures of contralateral knee cartilage.

  1. Osteo-articular diseases as comorbidity in non-orthopaedic surgery.

    Science.gov (United States)

    Vucetić, Cedomir; Dulić, Borislav; Milaković, Branko; Simić, Dusica; Djurasić, Ljubomir; Vukasinović, Zoran

    2011-01-01

    Osteo-articular diseases have significant presence among general population. Osteo-articular disorders can be caused by disease or by trauma. There are many osteo-articular diseases which have influence on general state of the organysm and on other present diseases in a various level. The influence appears by increasing risk of main disease complications, limited movement complicates postoperative treatment of main disease and medicament therapy of osteo-articular disease sometimes modifies perioperative therapy of main disease. Trauma as comorbidity needs urgent care and, in the same time, it is a huge complication for the injured condition. Osteoarticular trauma healing usually lasts several weeks, so it prolongs the healing of intercurrent surgical disease. Osteo-articular changes as comorbidity during the acute surgical disease healing need proper preoperative preparing, With the aim to minimise perioperative morbidity and mortality.

  2. Detailed Analysis of the Articular Domain in Patients with Primary Sjögren Syndrome.

    Science.gov (United States)

    Moerman, Rada V; Arends, Suzanne; Meiners, Petra M; Vissink, Arjan; Spijkervet, Frederik K L; Kroese, Frans G M; Brouwer, Elisabeth; Bootsma, Hendrika

    2017-03-01

    We used the 28-joint Disease Activity Score (DAS28) and the European League Against Rheumatism Sjögren's Syndrome Disease Activity Index (ESSDAI) articular domain to assess the effect of rituximab (RTX) and abatacept (ABA) on articular involvement in primary Sjögren syndrome (pSS). Patients with pSS treated with RTX (n = 18) or ABA (n = 13) and having a DAS28 erythrocyte sedimentation rate (ESR)/C-reactive protein (CRP) level ≥ 3.2 at baseline were selected. Generalized estimating equations were used to analyze the DAS28 and ESSDAI articular domain over time. In the RTX group, DAS28-ESR/CRP decreased significantly up to 48 weeks. In the ABA group, DAS28-ESR/CRP decreased significantly up to 24 weeks. DAS28 correlated significantly with ESSDAI articular domain. DAS28 is useful to evaluate the effect of biologicals on articular involvement in patients with pSS.

  3. Secondary knee instability caused by fracture of the stabilizing insert in a dual-articular total knee

    DEFF Research Database (Denmark)

    Boesen, Morten P; Jensen, Tim Toftgaard; Husted, Henrik

    2004-01-01

    A case of a fractured polyethylene stabilizing insert causing secondary knee instability in a Dual-articular total knee arthroplasty (TKA) is presented. A 65-year-old woman who underwent surgery with a Dual-articular TKA 4 years earlier had a well-functioning prosthesis until a fall, after which......-articular knee....

  4. Comparison of efficacy of intra-articular morphine and steroid in patients with knee osteoarthritis

    Directory of Open Access Journals (Sweden)

    Serbülent Gökhan Beyaz

    2012-01-01

    Full Text Available Introduction: Primary therapeutic aim in treatment of osteoarthritis of the knee is to relieve the pain of osteoarthritis. The aim of this study was to compare the efficacy of intra-articular triamcinolone with intra-articular morphine in pain relief due to osteoarthritis of the knee in the elderly population. Materials and Methods: Patients between 50 and 80 years of age were randomized into three groups. Group M received morphine plus bupivacaine intra-articularly, Group T received triamcinolone plus bupivacaine intra-articularly, and Group C received saline plus bupivacaine intra-articularly. Patients were evaluated before injection and in 2nd, 4th, 6th, and 12th weeks after injection. First-line supplementary analgesic was oral paracetamol 1500 mg/day. If analgesia was insufficient with paracetamol, oral dexketoprofen trometamol 50 mg/day was recommended to patients. Results: After the intra-articular injection, there was statistically significant decrease in visual analog scale (VAS scores in Groups M and T, when compared to Group C. The decrease of VAS scores seen at the first 2 weeks continued steadily up to the end of 12th week. There was a significant decrease in Groups M and T in the WOMAC scores, when compared to Group C. There was no significant difference in the WOMAC scores between morphine and steroid groups. Significantly less supplementary analgesics was used in the morphine and steroid groups. Conclusion: Intra-articular morphine was as effective as intra-articular triamcinolone for analgesia in patients with osteoarthritis knee. Intra-articular morphine is possibly a better option than intra-articular steroid as it has lesser side effects.

  5. Intra-articular injection of tenoxicam in rats: assessment of the local effects on the articular cartilage and synovium.

    Science.gov (United States)

    Ozyuvaci, H; Bilgic, B; Ozyuvaci, E; Altan, A; Altug, T; Karaca, C

    2004-01-01

    This study investigated the possible local adverse effects of intra-articular administration of tenoxicam in the rat knee joint. A total of 50 rats were given 0.25 ml of a standard preparation of tenoxicam by injection into the right knee joint and 0.25 ml of 0.9% saline solution by injection into the left knee joint as a control. Groups of 10 rats were killed 24 h, 48 h, 7 days, 14 days and 21 days after tenoxicam administration. Two rats were sham operated; one was killed on the first day and the other on the second day after this procedure. All the joints were prepared and sectioned for histological examination. Tissue loss and oedema were observed in the specimens obtained 24 h and 48 h after treatment with tenoxicam. No pathological changes were observed in the 7-day, 14-day and 21-day specimens, or in the control joints. Caution should be exercised when using intra-articular tenoxicam for post-operative analgesia.

  6. Articular cartilage repair and the evolving role of regenerative medicine

    Directory of Open Access Journals (Sweden)

    Pieter K Bos

    2010-10-01

    Full Text Available Pieter K Bos1, Marloes L van Melle1, Gerjo JVM van Osch1,21Department of Orthopaedic Surgery, Erasmus MC, Rotterdam, the Netherlands; 2Department of Otorhinolaryngology, Erasmus MC, Rotterdam, the NetherlandsAbstract: Among the growing applications of regenerative medicine, clinical articular cartilage repair has now been used for 2 decades and forms a successful example of translational medicine. Cartilage is characterized by a limited intrinsic repair capacity following injury. Articular cartilage defects cause symptoms, are not spontaneously repaired, and are generally believed to result in early osteoarthritis. Marrow stimulation techniques, osteochondral transplantation, and cell-based therapies, such as autologous chondrocyte implantation (ACI and use of mesenchymal stem cells (MSCs, are used for tissue regeneration, symptom relief, and prevention of further joint degeneration. The exact incidence of cartilage defects and the natural outcome of joints with these lesions are unclear. Currently available cartilage repair techniques are designed for defect treatment in otherwise healthy joints and limbs, mostly in young adults. The natural history studies presented in this review estimated that the prevalence of cartilage lesions in this patient group ranges from 5% to 11%. The background and results from currently available randomized clinical trials of the three mostly used cartilage repair techniques are outlined in this review. Osteochondral transplantation, marrow stimulation, and ACI show improvement of symptoms with an advantage for cell-based techniques, but only a suggestion that risk for joint degeneration can be reduced. MSCs, characterized by their good proliferative capacity and the potential to differentiate into different mesenchymal lineages, form an attractive alternative cell source for cartilage regeneration. Moreover, MSCs provide a regenerative microenvironment by the secretion of bioactive factors. This trophic activity

  7. Intra-Articular Polyacrylamide Hydrogel Injections Are Not Innocent

    Directory of Open Access Journals (Sweden)

    Murat Tonbul

    2014-01-01

    Full Text Available Osteoarthritis is a chronic disorder characterized by joint cartilage degeneration with concomitant changes in the synovium and subchondral bone metabolism. Many conservative treatment modalities, one of which is intra-articular injections, have been described for the treatment of this disorder. Traditionally, hyaluranic acid and corticosteroids are the agents that have been used for this purpose. Recently, polyacrylamide hydrogels are being used widely. Biocompatibility, nonbioabsorbability, and anti-infectious effect obtained by silver addition made polyacrylamide hydrogels more popular. In this paper, we present a case and the method of our management, in whom host tissue reaction (foreign body granuloma, edema, inflammation, and redness induration has been observed, as the first and unique adverse effect reported in the literature.

  8. Skin Necrosis from Intra-articular Hyaluronic Acid Injection.

    Science.gov (United States)

    Kim, Whan B; Alhusayen, Raed O

    2015-01-01

    Tissue necrosis is a rare yet potentially serious complication of intra-articular (IA) hyaluronic acid (HA) injections for treatment of knee osteoarthritis. To report a case of a patient with cutaneous necrosis after IA HA injection for treatment of knee osteoarthritis, presenting as a livedoid violaceous patch on the right knee. We report a case of cutaneous necrosis as a rare complication of IA HA injection for treatment of knee osteoarthritis. A literature review was undertaken of similar cases. Use of HA IA injections in the treatment of osteoarthritis can result in similar skin necrosis at uncommon anatomic locations corresponding to the site of HA injection. Although tissue necrosis is a rare complication, physicians need to be aware of this possibility as a complication of HA IA injections in the treatment of osteoarthritis and should be mindful of potential treatment options to manage this adverse event. © 2014 Canadian Dermatology Association.

  9. Multiphysical modelling of fluid transport through osteo-articular media.

    Science.gov (United States)

    Lemaire, Thibault; Naili, Salah; Sansalone, Vittorio

    2010-03-01

    In this study, a multiphysical description of fluid transport through osteo-articular porous media is presented. Adapted from the model of Moyne and Murad, which is intended to describe clayey materials behaviour, this multiscale modelling allows for the derivation of the macroscopic response of the tissue from microscopical information. First the model is described. At the pore scale, electrohydrodynamics equations governing the electrolyte movement are coupled with local electrostatics (Gauss-Poisson equation), and ionic transport equations. Using a change of variables and an asymptotic expansion method, the macroscopic description is carried out. Results of this model are used to show the importance of couplings effects on the mechanotransduction of compact bone remodelling.

  10. Osteo-articular tuberculosis: its presentation in coloured races.

    Science.gov (United States)

    Goldblatt, M; Cremin, B J

    1978-11-01

    Four hundred and ninety-nine cases of osteo-articular tuberculosis have been analysed with special emphasis on the "unusual" presentation. Sclerotic bone reaction in association with active tuberculous osteitis is not at all uncommon and may occur in any affected bone. Maintenance of disc spaces with tuberculous spondylitis is not uncommon. Periosteal reactions, often very gross, occur commonly both in multicystic tuberculosis as well as in isolated lesions. Multiple bone involvement occurred in 8.2% of this series. Tomography delineates the total extent of involvement especially in central involvement of vertebral bodies. Healed tuberculosis may give rise to block vertebrae indistinguishable from the congenital type except for the absence of waisting at the level of fusion.

  11. [Methods of using component alloplasty in osteo-articular surgery].

    Science.gov (United States)

    Bellendir, E N; Salmagambetov, I U

    1990-10-01

    In accordance with the principle of component plasty the authors have developed methods of procurement of the alloplastic material and its use. The following plastic materials are procured and supplied to health service: spongy bone allotransplants devoid of bone marrow (allospongiosis BS), allotransplants of the viable joint cartilage on a thin bone base (allocartilage BS) and demineralized bone matrix in the form of a film for protection of the bone formation zone and stimulation of osteogenesis (allofilm BS). Results of the component plasty in 300 patients are much superior in their efficiency to those known earlier. The terms of restorative processes became 2-3 times shorter. The above plastic materials are recommended for wide use in osteo-articular surgery.

  12. Contact mechanics of articular cartilage layers asymptotic models

    CERN Document Server

    Argatov, Ivan

    2015-01-01

    This book presents a comprehensive and unifying approach to articular contact mechanics with an emphasis on frictionless contact interaction of thin cartilage layers. The first part of the book (Chapters 1–4) reviews the results of asymptotic analysis of the deformational behavior of thin elastic and viscoelastic layers. A comprehensive review of the literature is combined with the authors’ original contributions. The compressible and incompressible cases are treated separately with a focus on exact solutions for asymptotic models of frictionless contact for thin transversely isotropic layers bonded to rigid substrates shaped like elliptic paraboloids. The second part (Chapters 5, 6, and 7) deals with the non-axisymmetric contact of thin transversely isotropic biphasic layers and presents the asymptotic modelling methodology for tibio-femoral contact. The third part of the book consists of Chapter 8, which covers contact problems for thin bonded inhomogeneous transversely isotropic elastic layers, and Cha...

  13. Articular cartilage tissue engineering: the role of signaling molecules

    Science.gov (United States)

    Kwon, Heenam; Paschos, Nikolaos K.; Hu, Jerry C.; Athanasiou, Kyriacos

    2017-01-01

    Effective early disease modifying options for osteoarthritis remain lacking. Tissue engineering approach to generate cartilage in vitro has emerged as a promising option for articular cartilage repair and regeneration. Signaling molecules and matrix modifying agents, derived from knowledge of cartilage development and homeostasis, have been used as biochemical stimuli toward cartilage tissue engineering and have led to improvements in the functionality of engineered cartilage. Clinical translation of neocartilage faces challenges, such as phenotypic instability of the engineered cartilage, poor integration, inflammation, and catabolic factors in the arthritic environment; these can all contribute to failure of implanted neocartilage. A comprehensive understanding of signaling molecules involved in osteoarthritis pathogenesis and their actions on engineered cartilage will be crucial. Thus, while it is important to continue deriving inspiration from cartilage development and homeostasis, it has become increasing necessary to incorporate knowledge from osteoarthritis pathogenesis into cartilage tissue engineering. PMID:26811234

  14. Intra-articular findings in symptomatic minor instability of the lateral elbow (SMILE).

    Science.gov (United States)

    Arrigoni, Paolo; Cucchi, Davide; D'Ambrosi, Riccardo; Butt, Usman; Safran, Marc R; Denard, Patrick; Randelli, Pietro

    2017-07-01

    Lateral epicondylitis is generally considered an extra-articular condition. The role of minor instability in the aetiology of lateral elbow pain has rarely been considered. The aim of this study was to evaluate the correlation of lateral ligamentous laxity with aspects of intra-articular lateral elbow pathology and investigate the role of minor instability in lateral elbow pain. Thirty-five consecutive patients aged between 20 and 60 years with recalcitrant lateral epicondylitis who had failed conservative therapy and had no previous trauma or overt instability, were included. The presence of three signs of lateral ligamentous patholaxity and five intra-articular findings were documented during arthroscopy. The relative incidence of each of these was calculated, and the correlation between patholaxity and intra-articular pathology was evaluated. At least one sign of lateral ligamentous laxity was observed in 48.6% of the studied cohort, and 85.7% demonstrated at least one intra-articular abnormal finding. Radial head ballottement was the most common sign of patholaxity (42.9%). Synovitis was the most common intra-articular aspect of pathology (77.1%), followed by lateral capitellar chondropathy (40.0%). A significant correlation was found between the presence of lateral ligamentous patholaxity signs and capitellar chondropathy (p = 0.0409), as well as anteromedial synovitis (p = 0.0408). Almost one half of patients suffering from recalcitrant lateral epicondylitis display signs of lateral ligamentous patholaxity, and over 85% demonstrate at least one intra-articular abnormality. The most frequent intra-articular findings are synovitis and lateral capitellar chondropathy, which correlate significantly with the presence of lateral ligamentous patholaxity. The fact that several patients demonstrated multiple intra-articular findings in relation to laxity provides support to a sequence of pathologic changes that may result from a symptomatic minor instability of

  15. Clinical potential and challenges of using genetically modified cells for articular cartilage repair

    Science.gov (United States)

    Madry, Henning; Cucchiarini, Magali

    2011-01-01

    Articular cartilage defects do not regenerate. Transplantation of autologous articular chondrocytes, which is clinically being performed since several decades, laid the foundation for the transplantation of genetically modified cells, which may serve the dual role of providing a cell population capable of chondrogenesis and an additional stimulus for targeted articular cartilage repair. Experimental data generated so far have shown that genetically modified articular chondrocytes and mesenchymal stem cells (MSC) allow for sustained transgene expression when transplanted into articular cartilage defects in vivo. Overexpression of therapeutic factors enhances the structural features of the cartilaginous repair tissue. Combined overexpression of genes with complementary mechanisms of action is also feasible, holding promises for further enhancement of articular cartilage repair. Significant benefits have been also observed in preclinical animal models that are, in principle, more appropriate to the clinical situation. Finally, there is convincing proof of concept based on a phase I clinical gene therapy study in which transduced fibroblasts were injected into the metacarpophalangeal joints of patients without adverse events. To realize the full clinical potential of this approach, issues that need to be addressed include its safety, the choice of the ideal gene vector system allowing for a long-term transgene expression, the identification of the optimal therapeutic gene(s), the transplantation without or with supportive biomaterials, and the establishment of the optimal dose of modified cells. As safe techniques for generating genetically engineered articular chondrocytes and MSCs are available, they may eventually represent new avenues for improved cell-based therapies for articular cartilage repair. This, in turn, may provide an important step toward the unanswered question of articular cartilage regeneration. PMID:21674822

  16. Partial rotator cuff injury in athletes: bursal or articular?

    Directory of Open Access Journals (Sweden)

    Cassiano Diniz Carvalho

    2015-08-01

    Full Text Available ABSTRACTA painful shoulder is a very common complaint among athletes, especially in the case of those in sports involving throwing. Partial lesions of the rotator cuff may be very painful and cause significant functional limitation to athletes' sports practice. The incidence of partial lesions of the cuff is variable (13-37%. It is difficult to make the clinical and radiological diagnosis, and this condition should be borne in mind in the cases of all athletes who present symptoms of rotator cuff syndrome, including in patients who are diagnosed only with tendinopathy. OBJECTIVE: To evaluate the epidemiological behavior of partial lesions of the rotator cuff in both amateur and professional athletes in different types of sports. METHODS: We evaluated 720 medical files on athletes attended at the shoulder service of the Discipline of Sports Medicine at the Sports Traumatology Center, Federal University of São Paulo. The majority of them were men (65%. Among all the patients, 83 of them were diagnosed with partial lesions of the rotator cuff, by means of ultrasonography or magnetic resonance, or in some cases using both. We applied the binomial test to compare the proportions found. RESULT: It was observed that intra-articular lesions predominated (67.6% and that these occurred more frequently in athletes in sports involving throwing (66%. Bursal lesions occurred in 32.4% of the athletes, predominantly in those who did muscle building (75%. CONCLUSION: Intra-articular lesions are more frequent than bursal lesions and they occur predominantly in athletes in sports involving throwing, while bursal lesions were more prevalent in athletes who did muscle building.

  17. Multiphysical modelling of fluid transport through osteo-articular media

    Directory of Open Access Journals (Sweden)

    Thibault Lemaire

    2010-03-01

    Full Text Available In this study, a multiphysical description of fluid transport through osteo-articular porous media is presented. Adapted from the model of Moyne and Murad, which is intended to describe clayey materials behaviour, this multiscale modelling allows for the derivation of the macroscopic response of the tissue from microscopical information. First the model is described. At the pore scale, electrohydrodynamics equations governing the electrolyte movement are coupled with local electrostatics (Gauss-Poisson equation, and ionic transport equations. Using a change of variables and an asymptotic expansion method, the macroscopic description is carried out. Results of this model are used to show the importance of couplings effects on the mechanotransduction of compact bone remodelling.Neste estudo uma descrição multifísica do transporte de fluidos em meios porosos osteo articulares é apresentada. Adaptado a partir do modelo de Moyne e Murad proposto para descrever o comportamento de materiais argilosos a modelagem multiescala permite a derivação da resposta macroscópica do tecido a partir da informação microscópica. Na primeira parte o modelo é apresentado. Na escala do poro as equações da eletro-hidrodinâmica governantes do movimento dos eletrolitos são acopladas com a eletrostática local (equação de Gauss-Poisson e as equações de transporte iônico. Usando uma mudança de variáveis e o método de expansão assintótica a derivação macroscópica é conduzida. Resultados do modelo proposto são usados para salientar a importância dos efeitos de acoplamento sobre a transdução mecânica da remodelagem de ossos compactados.

  18. [Chondrocalcinosis. Clinical impact of intra-articular calcium phosphate crystals].

    Science.gov (United States)

    Fuerst, M

    2014-06-01

    Calcium pyrophosphate dihydrate (CPPD) crystals are known to cause acute attacks of pseudogout in joints but crystal deposition has also been reported to be associated with osteoarthritis (OA). Aside from CPPD crystals, basic calcium phosphates (BCPs), consisting of carbonate-substituted hydroxyapatite (HA), tricalcium phosphate and octacalcium phosphate, have been found in synovial fluid, synovium and cartilage of patients with OA. Although CPPD crystals have been found to be associated with OA and are an important factor in joint disease, this has also recently been associated with a genetic defect. However, according to the most recent findings, the association of BCP crystals, such as apatite with OA is much stronger, as their presence significantly correlates with the severity of cartilage degeneration. Identification of BCP crystals in OA joints remains problematic due to a lack of simple and reliable methods of detection. The clinical and pathological relevance of cartilage mineralization in patients with OA is not completely understood. It is well established that mineralization of articular cartilage is often found close to hypertrophic chondrocytes. A significant correlation between the expression of type X collagen, a marker for chondrocyte hypertrophy and cartilage mineralization was observed. In the process of endochondral ossification, the link between hypertrophy and matrix mineralization is particularly well described. Hypertrophic chondrocytes in OA cartilage and at the growth line share certain features, not only hypertrophy but also a capability to mineralize the matrix. Recent data indicate that chondrocyte hypertrophy is a key factor in articular cartilage mineralization strongly linked to OA and does not characterize a specific subset of OA patients, which has important consequences for therapeutic strategies for OA.

  19. Partial rotator cuff injury in athletes: bursal or articular?

    Science.gov (United States)

    Carvalho, Cassiano Diniz; Cohen, Carina; Belangero, Paulo Santoro; Figueiredo, Eduardo Antônio; Monteiro, Gustavo Cará; de Castro Pochini, Alberto; Andreoli, Carlos Vicente; Ejnisman, Benno

    2015-01-01

    A painful shoulder is a very common complaint among athletes, especially in the case of those in sports involving throwing. Partial lesions of the rotator cuff may be very painful and cause significant functional limitation to athletes' sports practice. The incidence of partial lesions of the cuff is variable (13-37%). It is difficult to make the clinical and radiological diagnosis, and this condition should be borne in mind in the cases of all athletes who present symptoms of rotator cuff syndrome, including in patients who are diagnosed only with tendinopathy. To evaluate the epidemiological behavior of partial lesions of the rotator cuff in both amateur and professional athletes in different types of sports. We evaluated 720 medical files on athletes attended at the shoulder service of the Discipline of Sports Medicine at the Sports Traumatology Center, Federal University of São Paulo. The majority of them were men (65%). Among all the patients, 83 of them were diagnosed with partial lesions of the rotator cuff, by means of ultrasonography or magnetic resonance, or in some cases using both. We applied the binomial test to compare the proportions found. It was observed that intra-articular lesions predominated (67.6%) and that these occurred more frequently in athletes in sports involving throwing (66%). Bursal lesions occurred in 32.4% of the athletes, predominantly in those who did muscle building (75%). Intra-articular lesions are more frequent than bursal lesions and they occur predominantly in athletes in sports involving throwing, while bursal lesions were more prevalent in athletes who did muscle building.

  20. Tratamiento no protésico de las lesiones del cartílago articular

    OpenAIRE

    Carranza Bencano, A.

    1997-01-01

    Las alteraciones del cartílago articular constituyen un gran reto planteado a la Cirugía Ortopédica actual, por el aumento de traumatismos articulares y ante el incremento del porvenir de la vida de la población con el consiguiente envejecimiento del aparato locomotor y el desarrollo de artrosis degenerativas. Los éxitos de las prótesis articulares quedan ensombrecidos por su porvenir incierto en largos períodos de seguimiento. Por ello, en este artículo se revisa la situación actual de los m...

  1. Black Colouration of the Knee Articular Cartilage after Spontaneously Recurrent Haemarthrosis

    Directory of Open Access Journals (Sweden)

    Kazu Matsumoto

    2016-01-01

    Full Text Available Mild discolouration of the articular cartilage is known to gradually occur during aging. However, pathological tissue pigmentation is occasionally induced under several specific conditions. In the present case, we performed total knee replacement in a patient with recurrent haemarthrosis. However, during the operation, we observed severe black colouration of the knee articular cartilage, due to the deposition of hemosiderin and lipofuscin. To our knowledge, this is the first report of severe cartilage pigmentation, due to hemosiderin and lipofuscin deposition in articular cartilage.

  2. Effects of immobilization on thickness of superficial zone of articular cartilage of patella in rats

    Directory of Open Access Journals (Sweden)

    Khadija Iqbal

    2012-01-01

    Conclusion: Each segment of superficial zone behaves differentially on immobilization and remobilization. Perhaps a much longer duration of remobilization is required to reverse changes of immobilization in articular cartilage and plays a significant role in knee joint movements.

  3. Intra-articular Nodular Fasciitis: An Unexpected Diagnosis for a Joint Lesion: A Case Report

    Directory of Open Access Journals (Sweden)

    MF Michelle Chan

    2014-07-01

    Full Text Available Pathological lesions in and around a joint can arise from underlying dermis, subcutis, deep muscle, bone or synovium. Clinical presentation can include joint pain, joint swelling, palpable masses and mechanical restriction. Whilst giant cell tumour of tendon sheath, pigmented villonodular synovitis, synovial chondromatosis, lipoma arborescens, juxta articular myxomas and inflammatory arthritis are the better-known conditions of the joint. Intra-articular nodular fasciitis, on the other hand, is less well recognized both clinically and radiologically. It is rarely seen in routine practice and is only described in case reports in the literature. Due to the non-specific clinical and radiological findings as well as the unfamiliarity with the entity, the diagnosis of intra-articular nodular fasciitis is usually clinched only after histological examination. We present a case of intra-articular nodular fasciitis arising in the knee joint which was not suspected clinically or radiologically.

  4. Bone morphogenetic proteins and articular cartilage: To serve and protect or a wolf in sheep clothing's?

    NARCIS (Netherlands)

    Kraan, P.M. van der; Davidson, E.N.; Berg, W.B. van den

    2010-01-01

    OBJECTIVE: Alterations in chondrocyte differentiation and matrix remodeling play a central role in osteoarthritis (OA). Chondrocyte differentiation and remodeling are amongst others regulated by the so-called Bone Morphogenetic Proteins (BMPs). Although BMPs are considered protective for articular

  5. Localization of Estrogen Receptors α and β in the Articular Surface of the Rat Femur

    International Nuclear Information System (INIS)

    Oshima, Yasushi; Matsuda, Ken-ichi; Yoshida, Atsuhiko; Watanabe, Nobuyoshi; Kawata, Mitsuhiro; Kubo, Toshikazu

    2007-01-01

    It has been suggested that the degradation of the articular cartilage and osteoarthritis (OA) are associated with gender and the estrogen hormone. Although many investigators have reported the presence of the estrogen receptors (ERs) α and β in the articular cartilage, the localization of these receptors and the difference in their in vivo expression have not yet been clearly demonstrated. We performed immunofluorescence staining of ERα and ERβ to elucidate the localization of the ERs and to note the effects of gender and the aging process on these receptors. The results revealed that ERα and ERβ were expressed in the articular cartilage and subchondral bone layers of adult rats of both sexes. We also observed the high expression of these receptors in immature rats. In contrast, their expression levels decreased in an ovariectomised model, as a simulation of postmenopause, and in aged female rats. Therefore, this study suggests the direct effects of estrogen and ER expression on articular surface metabolism

  6. Treatment of mallet finger due to intra-articular fracture of the distal phalanx.

    Science.gov (United States)

    Hamas, R S; Horrell, E D; Pierret, G P

    1978-07-01

    When a mallet finger deformity results from an intra-articular fracture of the distal phalanx comprising more than one third of the articular surface, an accurate reduction of this fracture is necessary to prevent secondary degenerative arthritis. A technique for open reduction is described in which the distal interphalangeal joint is exposed by dividing the extensor tendon and permitting a precise reduction of the fracutre fragment. Elective division of the extensor tendon had not compromised the results.

  7. The role of the superficial region in determining the dynamic properties of articular cartilage.

    OpenAIRE

    KELLY, DANIEL JOHN; GANNON, ALANNA

    2012-01-01

    PUBLISHED OBJECTIVE: The objective of this study was to elucidate the role of the superficial region of articular cartilage in determining the dynamic properties of the tissue. It is hypothesised that removal of the superficial region will influence both the flow dependent and independent properties of articular cartilage, leading to a reduction in the dynamic modulus of the tissue. METHODS: Osteochondral cores from the femoropatellar groove of three porcine knee joints were sub...

  8. Intra-articular ganglion cysts of the knee: clinical and MR imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Kim, M.G.; Cho, W.H. [Dept. of Radiology, Sanggye Paik Hospital, Inje University, Seoul (Korea); Kim, B.H.; Choi, J.A.; Lee, N.J.; Chung, K.B. [Dept. of Diagnostic Radiology, College of Medicine, Korea University, Seoul (Korea); Choi, Y.S.; Cho, S.B. [Dept. of Radiology, School of Medicine, Eulji University, Seoul (Korea); Lim, H.C. [Dept. of Orthopedic Surgery, College of Medicine, Korea University, Seoul (Korea)

    2001-05-01

    The purpose of this study was to present clinical and MR imaging features of intra-articular ganglion cysts of the knee. Retrospective review of 1685 consecutive medical records and MR examinations of the knee performed at three imaging centers allowed identification of 20 patients (13 men and 7 women; mean age 35 years), in whom evidence of intra-articular ganglion cyst was seen. Of the 20 ganglion cysts, 5 were found in the infrapatellar fat pad, 10 arose from the posterior cruciate ligament, and 5 from the anterior cruciate ligament. Three of five patients with ganglion cyst in the infrapatellar fat pad had a palpable mass. In 7 of 15 patients with ganglion cyst in the intercondylar notch, exacerbation of pain occurred in a squatting position. On four MR arthrographies, ganglion cysts were an intra-articular round, lobulated, low signal intensity lesion. Five cases of fat-suppressed contrast-enhanced T1-weighted SE images demonstrated peripheral thin rim enhancement. The clinical presentation of intra-articular ganglion cyst is varied according to its intra-articular location. The MR appearance of intra-articular ganglion cyst is characteristic and usually associated with the cruciate ligament or the infrapatellar fat pad. Magnetic resonance arthrography has no definite advantage over conventional MR in the evaluation of the lesion. For intra-articular ganglion cyst in the infrapatellar fat pad, fat-suppressed contrast-enhanced MR imaging could be useful, because a thin, rim-enhancing feature of intra-articular ganglion cyst allows it to be distinguished from synovial hemangioma and synovial sarcoma. (orig.)

  9. Analgesic efficacy of intracapsular and intra-articular local anaesthesia for knee arthroplasty

    DEFF Research Database (Denmark)

    Andersen, L Ø; Husted, H; Kristensen, B B

    2010-01-01

    -articular catheters with 20 ml ropivacaine 0.5% given at 6 h and again at 24 h, postoperatively. Analgesic efficacy was assessed for 3 h after each injection, using a visual analogue score, where 0 = no pain and 100 = worst pain. There was no statistically significant difference between groups. Maximum pain relief...... anaesthetic has similar analgesic efficacy to intra-articular after total knee arthroplasty....

  10. Diagnosis and management of an intra-articular foreign body in the foot.

    LENUS (Irish Health Repository)

    Mulhall, K J

    2002-10-01

    We describe a case of a small intra-articular foreign body in the foot presenting 48 hours following injury, which at operation showed early evidence of septic arthritis. It is essential to accurately localise periarticular foreign bodies in the foot and proceed to arthrotomy and debridement in all cases where there is radiological or clinical evidence to suggest intra-articular retention of a foreign body.

  11. Extra-articular, Intraepiphyseal Drilling for Osteochondritis Dissecans of the Knee

    OpenAIRE

    Pennock, Andrew T.; Bomar, James D.; Chambers, Henry G.

    2013-01-01

    Symptomatic osteochondritis dissecans lesions of the knee frequently occur in skeletally immature patients. When conservative treatment fails, retro-articular drilling, also known as intraepiphyseal extra-articular drilling, becomes a viable treatment option. The purpose of this article is to describe our surgical technique and postoperative management of patients with stable osteochondritis dissecans lesions involving the femoral condyles. This technique is reproducible, uses readily availab...

  12. Determination of piroxicam from rat articular tissue and plasma based on LC-MS/MS.

    Science.gov (United States)

    Kim, Han Sol; Cho, Ha Ra; Ho, Myoung Jin; Kang, Myung Joo; Choi, Yong Seok

    2016-12-01

    Osteoarthritis (OA) is the most common type of arthritis. To manage OA, in general, oral administration of non-steroidal anti-inflammatory drugs (NSAIDs) is used. Recently, the analgesic and anti-inflammatory efficacy of piroxicam (PX), a long-acting NSAID, by intra-articular (IA) administration in OA was reported, and the possibility that PX is distributed in articular tissues at a certain concentration was raised. Thus, herein, novel LC-MS/MS methods to detect PX in rat articular tissue and plasma are presented. For articular tissue, solvent extraction with acetonitrile for 12 h was employed and a protein precipitation method was used for the preparation of a plasma sample. The developed methods were validated by following the FDA guidelines, and the validated methods were successfully applied to a PK study of IA PX. The present study presents, to our knowledge, the first method of determining a drug in articular tissue. Additionally, the level of PX in articular tissue after IA PX administration was experimentally confirmed for the first time using the present methods. Therefore, the present methods provide a new direction for in vivo evaluation for IA PX formulations and contribute to the development of alternative IA PX formulations with better effects for the treatment of OA.

  13. Human Adipose-Derived Mesenchymal Progenitor Cells Engraft into Rabbit Articular Cartilage

    Directory of Open Access Journals (Sweden)

    Wen Wang

    2015-05-01

    Full Text Available Mesenchymal stem cells (MSCs are known to have the potential for articular cartilage regeneration, and are suggested for the treatment of osteoarthritis (OA. Here, we investigated whether intra-articular injection of xenogeneic human adipose-derived mesenchymal progenitor cells (haMPCs promoted articular cartilage repair in rabbit OA model and engrafted into rabbit articular cartilage. The haMPCs were cultured in vitro, and phenotypes and differentiation characteristics of cells were evaluated. OA was induced surgically by anterior cruciate ligament transection (ACLT and medical meniscectomy of knee joints. At six weeks following surgery, hyaluronic acid (HA or haMPCs was injected into the knee joints, the contralateral knee served as normal control. All animals were sacrificed at the 16th week post-surgery. Assessments were carried out by macroscopic examination, hematoxylin/eosin (HE and Safranin-O/Fast green stainings and immunohistochemistry. The data showed that haMPC treatment promoted cartilage repair. Signals of human mitochondrial can be directly detected in haMPC treated cartilage. The haMPCs expressed human leukocyte antigen I (HLA-I but not HLA-II-DR in vivo. These results suggest that intra-articular injection of haMPCs promotes regeneration of articular cartilage in rabbit OA model, and support the notion that MPCs are transplantable between HLA-incompatible individuals.

  14. Articular Cartilage Aging-Potential Regenerative Capacities of Cell Manipulation and Stem Cell Therapy

    Directory of Open Access Journals (Sweden)

    Magdalena Krajewska-Włodarczyk

    2018-02-01

    Full Text Available Changes in articular cartilage during the aging process are a stage of natural changes in the human body. Old age is the major risk factor for osteoarthritis but the disease does not have to be an inevitable consequence of aging. Chondrocytes are particularly prone to developing age-related changes. Changes in articular cartilage that take place in the course of aging include the acquisition of the senescence-associated secretory phenotype by chondrocytes, a decrease in the sensitivity of chondrocytes to growth factors, a destructive effect of chronic production of reactive oxygen species and the accumulation of the glycation end products. All of these factors affect the mechanical properties of articular cartilage. A better understanding of the underlying mechanisms in the process of articular cartilage aging may help to create new therapies aimed at slowing or inhibiting age-related modifications of articular cartilage. This paper presents the causes and consequences of cellular aging of chondrocytes and the biological therapeutic outlook for the regeneration of age-related changes of articular cartilage.

  15. Rehabilitation after Articular Cartilage Repair of the Knee in the Football (Soccer) Player.

    Science.gov (United States)

    Hambly, Karen; Silvers, Holly Jacinda; Steinwachs, Matthias

    2012-01-01

    Participation in football can put both male and female players at an increased risk for knee osteoarthritis. There is a higher prevalence of focal chondral defects in the knee of athletes compared to nonathletes. The management of chondral defects in the football player is complex and multifactorial. The aim of this study is to provide an overview of the current strategies for rehabilitation after articular cartilage repair of the knee in the football player. A review of current literature and the scientific evidence for rehabilitation after articular cartilage repair of the knee. Articular cartilage repair has been shown to allow return to sport but rehabilitation timescales are lengthy. Successful rehabilitation for a return to football after articular cartilage repair of the knee requires the player to be able to accept the load of the sport. This necessitates a multidisciplinary approach to rehabilitation, especially in the transition from therapy to performance care. It should be recognized that not all players will return to football after articular cartilage repair. The evidence base for rehabilitative practice after articular cartilage repair is increasing but remains sparse in areas.

  16. Rehabilitation after Articular Cartilage Repair of the Knee in the Football (Soccer) Player

    Science.gov (United States)

    Silvers, Holly Jacinda; Steinwachs, Matthias

    2012-01-01

    Background: Participation in football can put both male and female players at an increased risk for knee osteoarthritis. There is a higher prevalence of focal chondral defects in the knee of athletes compared to nonathletes. The management of chondral defects in the football player is complex and multifactorial. Objective: The aim of this study is to provide an overview of the current strategies for rehabilitation after articular cartilage repair of the knee in the football player. Design: A review of current literature and the scientific evidence for rehabilitation after articular cartilage repair of the knee. Conclusions: Articular cartilage repair has been shown to allow return to sport but rehabilitation timescales are lengthy. Successful rehabilitation for a return to football after articular cartilage repair of the knee requires the player to be able to accept the load of the sport. This necessitates a multidisciplinary approach to rehabilitation, especially in the transition from therapy to performance care. It should be recognized that not all players will return to football after articular cartilage repair. The evidence base for rehabilitative practice after articular cartilage repair is increasing but remains sparse in areas. PMID:26069608

  17. On the main stages of the history of intra-articular therapy

    Directory of Open Access Journals (Sweden)

    L. Punzi

    2011-09-01

    Full Text Available In this review the main stages in the history of intra-articular therapy of the rheumatic diseases are summarized. The first approach to such a local treatment has been likely performed in 1792 by the French physician Jean Gay, who injected in a swelling knee the “eau du Goulard” (Goulard’s water, namely a mixture based on lead compounds. In the XIX century iodine derivatives have been mainly applied as an intra-articular treatment. In the XX century, before the wide use of intra-articular corticosteroids, chiefly due to the Joseph Lee Hollander’s experiences, a variety of drugs has been employed, including cytostatics and sclerosing substances. A further important stage has been synoviorthesis, by using specific radionuclides, that would actually represent an anti-synovial treatment. In the last years a spread use of intra-articular hyaluronic acid, particularly in osteoarthritis, has been recorded, with the aim to warrant articular viscosupplementation. Future of intra-articular treatment should be represented by the biological drugs, i.e., anti-TNF, but it is still untimely to define the exact role of such a local treatment of arthritis.

  18. Hypoxia, RONS and energy metabolism in articular cartilage.

    Science.gov (United States)

    Fermor, B; Gurumurthy, A; Diekman, B O

    2010-09-01

    Increased pro-inflammatory cytokines and reactive oxygen and nitrogen species (RONS) occur in osteoarthritis (OA). Oxygen tension can alter the levels of RONS induced by interleukin-1 (IL-1). RONS such as nitric oxide (NO) can alter energy metabolism. The aim of this study was to determine if oxygen tension alters energy metabolism, in articular cartilage, in response to IL-1 or NO and to determine if cell death occurred. Porcine articular chondrocytes were incubated with IL-1 or the NO donor NOC-18 for 48 h in either 1, 5 or 20% O(2). Adenosine triphosphate (ATP) levels were measured and immunoblots for adenosine monophosphate-activated protein kinase (AMPK) were done. Protein translation was measured by S6 activation. Senescence and autophagy were determined by increased caveolin or conversion of LC3-I to LC3-II respectively. One percent O(2) significantly reduced ATP levels compared with 20% O(2). Five percent O(2) significantly increased ATP levels compared with 20% O(2). One percent O(2) significantly increased phospho-AMPK (pAMPK) protein expression compared with 5 or 20% O(2). Oxygen tension had no effects on pS6, caveolin or LC3-II levels. IL-1-induced NO production was significantly reduced with decreased oxygen tension, and significantly reduced ATP levels at all oxygen tensions, but pAMPK was only significantly increased at 5% O(2). IL-1 significantly reduced pS6 at all oxygen tensions. IL-1 had no effects on caveolin and significantly increased LC3-II at 20% O(2) only. NOC-18 significantly reduced ATP levels at all oxygen tensions, and significantly increased pAMPK at 5% O(2) only, and significantly decreased pAMPK at 1% O(2). NOC-18 significantly reduced pS6 at 1% O(2) and significantly increased caveolin at 5% O(2), and LC3-II at 1% O(2). Our data suggest 5% O(2) is optimal for energy metabolism and protective to some effects of IL-1 and NO. NO has the greatest effects on ATP levels and the induction of autophagy at 1% O(2). Copyright 2010

  19. Correlation of laminated MR apperance of articular cartilage with histology

    International Nuclear Information System (INIS)

    Kim, Dong Joon; Suh, Jin Suck; Jeong, Eun Kee; Shin, Kyu Ho; Yang, Woo Ick

    1999-01-01

    To determine the correlation of laminae of different signal intensities (SI) of articular cartilage, as seen on magnetic resonance(MR) imaging with histologic layers, using artificially constructed landmarks. For a landmark that can exactly correlate the cartilage specimen with the MR image, five 'V'-shaped markings of different depths were made on the surface of bovine patella. Both T1-weighted (TR/TE : 300/14) and FSE T2-weighted images (TR/TE : 2000/53) were obtained on a 1.5T system with high gradient echo strength (25mT/m) and a voxel size of 78X78X2000μm. Images were obtained with 1) changed frequency-encoding directions on T1-weighted study, and 2) changed readout gradient strength ( X2, X1/2) on T2-weighted sequence. Raw image data were transferred to a workstation and signal intensity profile was generated for each image. 1 : 1 correlation of histologic specimens and MR images was performed. Line profile through the cartilage showed few peaks, suggesting changes in signal intensity profile in the cartilage. On the basis of artificial landmarks, the histologic zone was accurately identified. The histologic tangential and transitional zones correlated with superficial high SI on T1WI, as well as high and low SI on T2WI. On T1WI, the radial zone correlated with a lamina of intermediate SI, and on T2WI, with a lamina for which SI gradually decreased from high to low. Additional well-defined low and intermediate SI bands were noted on bovine T1WI in the lower radial zone. In both T1 and T2 studies, calcified cartilage layers were of low SI. On T1-weighted study, changes in the direction of frequency gradient did not lead to changes in the laminae. The alteration of readout gradient strengths did not result in an inversely proportional difference in the thickness of the laminae. These became more distinct thus ruling out chemical shift and susceptibility artifacts. The laminated appearance of articular cartilage, as seen on spin echo and fast spin-echo MR

  20. Anticuerpo anticitrulina y manifestaciones extra articulares en artritis reumatoidea

    Directory of Open Access Journals (Sweden)

    María Jezabel Haye Salinas

    2013-02-01

    Full Text Available Los pacientes con artritis reumatidea (AR pueden desarrollar manifestaciones extra articulares (MExA, relacionadas a su morbi-mortalidad. Los anticuerpos anti-péptidos citrulinados cíclicos (ACCP son específicos para la AR y estan relacionados con el daño articular; y podrían tener rol patogénico en las MExA. Nuestro objetivo fue determinar la relación entre los anticuerpos ACCP y MExA en pacientes con AR. Se incluyeron 74 pacientes con diagnóstico de AR (ACR 1987 mayores de 18 años, de más de 6 meses de evolución, con MExA, y un control apareado por sexo y edad sin MExA por cada paciente. Las variables demográficas, clínicas y de laboratorio se compararon con test t, chi cuadrado o Mann-Whitney. Se realizó análisis multivariado; p ≤ 0.05. Los pacientes con MExA presentaron mayor título de anticuerpo ACCP (116 vs. 34, p < 0.01 y de factor reumatoideo (FR (108 vs. 34.5, p < 0.01. En el análisis multivariado hubo asociación entre la presencia de MExA y tabaquismo activo (p = 0.02, OR: 3.78, IC 95%: 1.17-12.2, FR positivo (p = 0.04, OR: 3.23, IC95%: 1.04-11.8 y anticuerpo ACCP positivo (p = 0.04, OR: 3.23, IC 95%: 1.04-10. Presentaron mayor título de anticuerpo ACCP que los controles los pacientes con xerostomía (109 vs. 34, p = 0.04, xeroftalmia (150 vs. 34, p < 0.01, nódulos sub-cutáneos (NSC (141 vs. 34, p < 0.01 y fibrosis pulmonar (158 vs. 34, p = 0.04. En conclusión, el anticuerpo ACCP positivo, el FR positivo y el tabaquismo activo fueron factores de riesgo independientes para el desarrollo de MExA.

  1. Intracortical chondroblastoma mimicking intra-articular osteoid osteoma

    Energy Technology Data Exchange (ETDEWEB)

    Ishida, Tsuyoshi; Mukai, Kiyoshi [First Department of Pathology, Tokyo Medical University, Shinjuku 6-1-1, Shinjuku-ku, Tokyo 160-8402 (Japan); Goto, Takahiro [Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo (Japan); Motoi, Noriko [Department of Pathology, Toranomon Hospital, Tokyo (Japan)

    2002-10-01

    We report a case of intra-articular intracortical chondroblastoma of the femoral condyle which radiologically appeared to be osteoid osteoma. A 19-year-old woman presented with a 3-year history of gradually increasing pain in the right knee and had been on nonsteroidal anti-inflammatory drugs for pain relief. Laboratory data were within normal limits. Radiographs showed a well-demarcated lucent lesion in the medial condyle of the right femur. A nidus-like lesion with calcifications and a sclerotic rim located in the cortex was imaged by computed tomography scan. Magnetic resonance imaging revealed bone marrow edema and soft tissue swelling around the lesion, with low signal intensity of the nidus-like lesion on both T1- and T2-weighted images. The lesion was excised en bloc and the histological diagnosis of chondroblastoma was made. A mild inflammatory reaction was observed in the bone marrow and synovium around the tumor. The chondroblastoma cells were shown to express cyclooxygenase-2 with immunohistochemistry. (orig.)

  2. The epidemiology of extra-articular manifestations in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Stolwijk, Carmen; Essers, Ivette; van Tubergen, Astrid

    2015-01-01

    OBJECTIVE: To assess the incidence and risks of common extra-articular manifestations (EAMs), that is, acute anterior uveitis (AAU), psoriasis and inflammatory bowel disease (IBD), in patients with ankylosing spondylitis (AS) compared with population-based controls. METHODS: All incident patients......-dependent adjustments for age, sex, comorbidity and medication use. RESULTS: At diagnosis of AS, the proportion of patients with an EAM was 11.4% for AAU, 4.4% for psoriasis and 3.7% for IBD. Incidence rates of EAMs were 8.9/1000 person-years for AAU, 3.4/1000 person-years for psoriasis and 2.4 /1000 person......-years for IBD in AS. The 20-year cumulative incidence was 24.5%, 10.1% and 7.5%, respectively. Risks of EAMs were 1.5-fold to 16-fold increased versus controls, with an adj HR of 15.5 (95% CI 11.6 to 20.7) for AAU, adj HR of 1.5 (95% CI 1.1 to 1.9) for psoriasis and adj HR of 3.3 (95% CI 2.3 to 4.8) for IBD...

  3. Proteoglycon synthesis by articular chondrocytes in agarose culture

    International Nuclear Information System (INIS)

    Sweet, M.B.E.; Grisillo, A.; Coehlo, A.; Schnitzler, C.M.

    1987-01-01

    Articular chondrocytes were isolated from knee joints of full-term bovine foetuses and grown in long-term agarose cultures. At intervals, cultures were labelled with 35 S-[sulphate] or D[6- 3 H] glucosamine. Newly synthesized proteoglycans were extracted with 4 M guanidine HCl and purified by isopycnic density gradient centrifugation or on DEAE cellulose in the presence of 8 M urea. Characterization of the proteoglycans revealed them to be identical in size to those present in the tissue and to be similarly capable of aggregation with hyaluronate. Newly synthesized chondroitin sulphate chains were identical in size, but newly synthesized keratan sulphate chains were somewhat larger than those present in the tissue. The newly synthesized proteoglycans were shown to contain the same range of O-linked oligosaccharides identified in proteoglycans of the Swarm rat chondrosarcoma. Cartilage-specific proteoglycan continued to be synthesized by the chondrocytes for up to 60 days; however, with time, proportionately more of a small non-aggregating proteoglycan appeared

  4. Bilateral Intra-Articular Radiofrequency Ablation for Cervicogenic Headache

    Directory of Open Access Journals (Sweden)

    Charles A. Odonkor

    2017-01-01

    Full Text Available Introduction. Cervicogenic headache is characterized by unilateral neck or face pain referred from various structures such as the cervical joints and intervertebral disks. A recent study of patients with cervical pain showed significant pain relief after cervical medial branch neurotomy but excluded patients with C1-2 joint pain. It remains unclear whether targeting this joint has potential for symptomatic relief. To address this issue, we present a case report of C1-2 joint ablation with positive outcomes. Case Presentation. A 27-year-old female presented with worsening cervicogenic headache. Her pain was 9/10 by visual analog scale (VAS and described as cramping and aching. Pain was localized suboccipitally with radiation to her jaw and posterior neck, worse on the right. Associated symptoms included clicking of her temporomandibular joint, neck stiffness, bilateral headaches with periorbital pain, numbness, and tingling. History, physical exam, and diagnostic studies indicated localization to the C1-2 joint with 80% decrease in pain after C1-2 diagnostic blocks. She underwent bilateral intra-articular radiofrequency ablation of the C1-C2 joint. Follow-up at 2, 4, 8, and 12 weeks showed improved function and pain relief with peak results at 12 weeks. Conclusion. Clinicians may consider C1-C2 joint ablation as a viable long-term treatment option for cervicogenic headaches.

  5. Hydrogels as a Replacement Material for Damaged Articular Hyaline Cartilage

    Directory of Open Access Journals (Sweden)

    Charlotte M. Beddoes

    2016-06-01

    Full Text Available Hyaline cartilage is a strong durable material that lubricates joint movement. Due to its avascular structure, cartilage has a poor self-healing ability, thus, a challenge in joint recovery. When severely damaged, cartilage may need to be replaced. However, currently we are unable to replicate the hyaline cartilage, and as such, alternative materials with considerably different properties are used. This results in undesirable side effects, including inadequate lubrication, wear debris, wear of the opposing articular cartilage, and weakening of the surrounding tissue. With the number of surgeries for cartilage repair increasing, a need for materials that can better mimic cartilage, and support the surrounding material in its typical function, is becoming evident. Here, we present a brief overview of the structure and properties of the hyaline cartilage and the current methods for cartilage repair. We then highlight some of the alternative materials under development as potential methods of repair; this is followed by an overview of the development of tough hydrogels. In particular, double network (DN hydrogels are a promising replacement material, with continually improving physical properties. These hydrogels are coming closer to replicating the strength and toughness of the hyaline cartilage, while offering excellent lubrication. We conclude by highlighting several different methods of integrating replacement materials with the native joint to ensure stability and optimal behaviour.

  6. Percutaneous Hallux Valgus Surgery Without Distal Metatarsal Articular Angle Correction.

    Science.gov (United States)

    Crespo Romero, Eusebio; Arcas Ordoño, Alvaro; Peñuela Candel, Raquel; Gómez Gómez, Silvia; Arias Arias, Angel; Gálvez González, Jaime; Crespo Romero, Ricardo

    2017-12-01

    Many factors are considered predictors of recurrence after hallux valgus (HV) surgery, including preoperative distal metatarsal articular angle (DMAA). The restoration of the bone and joint alignment would be more important than realigning the cartilaginous surface of the metatarsal head. Therefore, is DMAA correction essential for a good clinical and radiological results after HV surgery? This study aims to illustrate the results of percutaneous forefoot surgery (PFS) for correction of HV deformity without DMAA correction. A prospective single-center study of 74 patients (89 feet), with mild-to-moderate hallux valgus deformity, who underwent PFS. The mean latest follow-up was 57.3 months. Preoperative median visual analog scale was 7 points and AOFAS scores were 52 points. At the mean latest follow up both scores improved to 0 points and 90 points, respectively. Median HV angle and intermetatarsal angle changed from 30° and 12° preoperatively, to 21° and 11° at mean latest follow-up. Overall, 80% of the patients were satisfied or very satisfied. Recurrence of medial first metatarsal head pain occurred in 12 cases (13.5%). PFS, without DMAA correction, is a valid procedure for surgical correction in patients with HV, despite the slightly worse radiographic results in our study. Level II: Prospective study.

  7. Early Intra-Articular Complement Activation in Ankle Fractures

    Directory of Open Access Journals (Sweden)

    Hagen Schmal

    2014-01-01

    Full Text Available Cytokine regulation possibly influences long term outcome following ankle fractures, but little is known about synovial fracture biochemistry. Eight patients with an ankle dislocation fracture were included in a prospective case series and matched with patients suffering from grade 2 osteochondritis dissecans (OCD of the ankle. All fractures needed external fixation during which joint effusions were collected. Fluid analysis was done by ELISA measuring aggrecan, bFGF, IL-1β, IGF-1, and the complement components C3a, C5a, and C5b-9. The time periods between occurrence of fracture and collection of effusion were only significantly associated with synovial aggrecan and C5b-9 levels (P<0.001. Furthermore, synovial expressions of both proteins correlated with each other (P<0.001. Although IL-1β expression was relatively low, intra-articular levels correlated with C5a (P<0.01 and serological C-reactive protein concentrations 2 days after surgery (P<0.05. Joint effusions were initially dominated by neutrophils, but the portion of monocytes constantly increased reaching 50% at day 6 after fracture (P<0.02. Whereas aggrecan and IL-1β concentrations were not different in fracture and OCD patients, bFGF, IGF-1, and all complement components were significantly higher concentrated in ankle joints with fractures (P<0.01. Complement activation and inflammatory cell infiltration characterize the joint biology following acute ankle fractures.

  8. [Progress in diagnosis in osteo-articular pathology (author's transl)].

    Science.gov (United States)

    Ficat, P

    1975-04-01

    Osteo-articular diagnosis is too often considered at present to be synonymous with radiological diagnosis. This has come to be almost a sine qua non. Nevertheless a normal X-ray does not mean that the patient is free of disease. On the contrary, there exists the considerable handicap of the latent period between the onset of disease and the appearance of radiological signs. If blind faith in such a notion is allowed to persist, a profitable means of progress is closed both to our discipline and pathology in general. Over the last decade has emerged a new tendency towards the study of the initial phases of disease and an earlier diagnosis during the pre-radiological phase. This tendency, which opens new perspectives, already enjoys highly promising success and deserves wider recognition, encouragement, development and study. It results more from an attitude of mind rather than the development of a technique and for this reason should lead to the suggestion of other methods and solutions. In bringing us closer to the source of the pathological process it will aid in better understanding of its true nature and pathogenesis. In a word, it will help us to understand the starting phases of disease whilst radiology reveals only the active process. Inasmuch as early physiopathological processes are reversible, it should open the door to new therapeutic approaches.

  9. The Influence of Articular Cartilage Thickness Reduction on Meniscus Biomechanics.

    Science.gov (United States)

    Łuczkiewicz, Piotr; Daszkiewicz, Karol; Chróścielewski, Jacek; Witkowski, Wojciech; Winklewski, Pawel J

    2016-01-01

    Evaluation of the biomechanical interaction between meniscus and cartilage in medial compartment knee osteoarthritis. The finite element method was used to simulate knee joint contact mechanics. Three knee models were created on the basis of knee geometry from the Open Knee project. We reduced the thickness of medial cartilages in the intact knee model by approximately 50% to obtain a medial knee osteoarthritis (OA) model. Two variants of medial knee OA model with congruent and incongruent contact surfaces were analysed to investigate the influence of congruency. A nonlinear static analysis for one compressive load case was performed. The focus of the study was the influence of cartilage degeneration on meniscal extrusion and the values of the contact forces and contact areas. In the model with incongruent contact surfaces, we observed maximal compressive stress on the tibial plateau. In this model, the value of medial meniscus external shift was 95.3% greater, while the contact area between the tibial cartilage and medial meniscus was 50% lower than in the congruent contact surfaces model. After the non-uniform reduction of cartilage thickness, the medial meniscus carried only 48.4% of load in the medial compartment in comparison to 71.2% in the healthy knee model. We have shown that the change in articular cartilage geometry may significantly reduce the role of meniscus in load transmission and the contact area between the meniscus and cartilage. Additionally, medial knee OA may increase the risk of meniscal extrusion in the medial compartment of the knee joint.

  10. Avaliação microbiológica e molecular de líquidos articulares e peri-articulares de suínos

    Directory of Open Access Journals (Sweden)

    Ana Carolina S. Faria

    2011-08-01

    Full Text Available No presente estudo coletaram-se 115 amostras de líquido articular e peri-articular de suínos com suspeita clínica de doença articular oriundos de maternidade (30,43%, creche (44,35% e crescimento/terminação (25,22% de Sistemas Intensivos de Produção de Suínos (SIPs para avaliação microbiológica e molecular. Observaram-se 57 (49,5% amostras positivas em pelo menos uma das técnicas. No isolamento microbiano, 39,13% das amostras foram positivas, sendo Streptococcus spp. (19,72%, Arcabobacterium pyogenes (18,13% e Escherichia coli (12,68% os mais frequentes, havendo também a presença de Candida sp. (2,6%. Na técnica de Reação em Cadeia da Polimerase (PCR, em 20% das amostras foram detectados microrganismos com uma maior ocorrência de Mycoplasma hyosinoviae (34,09%, Erysipelotrix tonsilarum (20,45% e Haemophilus parasuis (15,90%. Os microrganismos mais frequentemente isolados em animais com artrite, apresentaram distribuição em todas as faixas etárias, entretanto a fase de crescimento/terminação apresentou maior percentual (69% de amostras positivas. Streptococcus spp. ocorreu em todas as fases sendo o microrganismo mais detectado. M. hyosinoviae foi observado principalmente em animais de creche. Na fase de crescimento/terminação as bactérias predominantes foram A. pyogenes, H. parasuis e E. tonsilarum. Aproximadamente metade dos casos foi negativo o que indica a provável ocorrência de processos degenerativos como a osteocondrose, embora a participação de infecções articulares e peri-articulares possam representar grandes perdas com menor ou maior impacto dependendo da fase de criação. Problemas articulares e/ou peri-articulares de origem infecciosas foram encontrados em todas as propriedades estudadas. O principal agente foi M. hyosynoviae, principalmente na creche, porém não se pode descartar o envolvimento de problemas degenerativos em associação.

  11. The role of PAF/PAFR signaling in zymosan-induced articular inflammatory hyperalgesia.

    Science.gov (United States)

    Guerrero, Ana T; Zarpelon, Ana C; Zaperlon, Ana C; Vieira, Silvio M; Pinto, Larissa G; Ferreira, Sérgio H; Cunha, Fernando Q; Verri, Waldiceu A; Cunha, Thiago M

    2013-01-01

    Platelet-activating factor (PAF) and its receptor (PAFR) have been shown to be involved in several inflammatory events, including neutrophil chemoattraction and nociception. The present study addressed the role of PAF in the genesis of articular hyperalgesia in a model of joint inflammation. Zymosan-induced articular hyperalgesia, oedema and neutrophil migration were dose-dependently reduced following pretreatment with selective PAFR antagonists, UK74505 (5, 10 and 20 mg/kg) and PCA4248 (3, 10, 30 mg/kg). These parameters were also reduced in PAF receptor-deficient mice (PAFR(-/-)). The hyperalgesic action of PAF was further confirmed by the demonstration that joint injection of PAF induces a dose- (0.3, 1 and 3 μg/joint), time- and PAFR-dependent articular hyperalgesia and oedema. The PAF hyperalgesic mechanisms were dependent on prostaglandins, leukotrienes and neutrophils, as PAF-induced articular hyperalgesia was inhibited by indomethacin (COX inhibitor), MK886 (leukotrienes synthesis inhibitor) or fucoidan (leukocyte rolling inhibitor). Furthermore, PAF-induced hyperalgesia was reduced in 5-lypoxigenase-null mice. In corroboration of these findings, intra-articular injection of PAF promotes the production of LTB(4) as well as the recruitment of neutrophils to the joint. These results suggest that PAF may participate in the cascade of events involved in the genesis of articular inflammatory hyperalgesia via stimulation of prostaglandins, leukotrienes and neutrophil migration. Finally, targeting PAF action (e.g., with a PAFR antagonist) might provide a useful therapeutic approach to inhibit articular inflammatory hyperalgesia.

  12. Amino acid racemization reveals differential protein turnover in osteoarthritic articular and meniscal cartilages

    Science.gov (United States)

    Stabler, Thomas V; Byers, Samuel S; Zura, Robert D; Kraus, Virginia Byers

    2009-01-01

    Introduction Certain amino acids within proteins have been reported to change from the L form to the D form over time. This process is known as racemization and is most likely to occur in long-lived low-turnover tissues such as normal cartilage. We hypothesized that diseased tissue, as found in an osteoarthritic (OA) joint, would have increased turnover reflected by a decrease in the racemized amino acid content. Methods Using high-performance liquid chromatography methods, we quantified the L and D forms of amino acids reported to racemize in vivo on a biological timescale: alanine, aspartate (Asp), asparagine (Asn), glutamate, glutamine, isoleucine, leucine (Leu), and serine (Ser). Furthermore, using a metabolically inactive control material (tooth dentin) and a control material with normal metabolism (normal articular cartilage), we developed an age adjustment in order to make inferences about the state of protein turnover in cartilage and meniscus. Results In the metabolically inactive control material (n = 25, ages 13 to 80 years) and the normal metabolizing control material (n = 19, ages 17 to 83 years), only Asp + Asn (Asx), Ser, and Leu showed a significant change (increase) in racemization with age (P Asx, Ser, and Leu when compared with the normal articular cartilage control were 97%, 74%, and 73% in OA meniscal cartilage and 97%, 70%, and 78% in OA articular cartilage. We also observed lower amino acid content in OA articular and meniscal cartilages compared with normal articular cartilage as well as a loss of total amino acids with age in the OA meniscal but not the OA articular cartilage. Conclusions These data demonstrate comparable anabolic responses for non-lesioned OA articular cartilage and OA meniscal cartilage but an excess of catabolism over anabolism for the meniscal cartilage. PMID:19267899

  13. Usefulness of fluoroscopy-guided intra-articular injection of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Myung, Jae Sung; Lee, Joon Woo [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Lee, Ji Yeon [Kangwon National University College of Medicine, Chuncheon (Korea, Republic of)] (and others)

    2007-06-15

    To determine the accuracy of the intra-articular location of hyaluronic acid injection using a blind approach and to establish the usefulness of fluoroscopy-guided intra-articular injection. A fluoroscopy unit was used for 368 intra-articular injections of hyaluronic acid to 93 knees in 65 patients. Initially, blind needle positioning was conducted on the fluoroscopy table. The failure rate of the blind approach among the 368 injections was evaluated, and a relationship between the Kellgren-Lawrence grade (K-L grade) and the incidence of repeated failures using the blind approach was determined for injections to 52 knees in 37 patients who received a complete cycle of injections (five consecutive injections with a one-week interval between injections). Using a blind approach, 298 of 368 trials (81.2%) resulted in a needle tip being placed in an intra-articular location, while 70 of 368 trials resulted in an extra-articular placement of the needle tip. Among 52 knees to which a complete cycle of injection (five consecutive injections with a one-week interval between injections) was administered, repeated failure of intra-articular placement using the blind approach was seen for 18 knees (34.6%); a more severe K-L grade assigned was associated with a higher rate of repeated failure. However, the trend was not statistically significant based on the Chi-squared test ({rho} value = 0.14). Fluoroscopy-guided needle placement may be helpful to ensure therapeutic intra-articular injection of the knee.

  14. Usefulness of fluoroscopy-guided intra-articular injection of the knee

    International Nuclear Information System (INIS)

    Myung, Jae Sung; Lee, Joon Woo; Lee, Ji Yeon

    2007-01-01

    To determine the accuracy of the intra-articular location of hyaluronic acid injection using a blind approach and to establish the usefulness of fluoroscopy-guided intra-articular injection. A fluoroscopy unit was used for 368 intra-articular injections of hyaluronic acid to 93 knees in 65 patients. Initially, blind needle positioning was conducted on the fluoroscopy table. The failure rate of the blind approach among the 368 injections was evaluated, and a relationship between the Kellgren-Lawrence grade (K-L grade) and the incidence of repeated failures using the blind approach was determined for injections to 52 knees in 37 patients who received a complete cycle of injections (five consecutive injections with a one-week interval between injections). Using a blind approach, 298 of 368 trials (81.2%) resulted in a needle tip being placed in an intra-articular location, while 70 of 368 trials resulted in an extra-articular placement of the needle tip. Among 52 knees to which a complete cycle of injection (five consecutive injections with a one-week interval between injections) was administered, repeated failure of intra-articular placement using the blind approach was seen for 18 knees (34.6%); a more severe K-L grade assigned was associated with a higher rate of repeated failure. However, the trend was not statistically significant based on the Chi-squared test (ρ value = 0.14). Fluoroscopy-guided needle placement may be helpful to ensure therapeutic intra-articular injection of the knee

  15. Effects of freezing rates and cryoprotectant on thermal expansion of articular cartilage during freezing process.

    Science.gov (United States)

    Xu, Y; Sun, H J; Lv, Y; Zou, J C; Lin, B L; Hua, T C

    2013-01-01

    The intact articular cartilage has not yet been successfully preserved at low temperature most likely due to the volume expansion from water to ice during freezing. The objective of this current study focuses on examining thermal expansion behavior of articular cartilage (AC) during freezing from 0 degree C to -100 degree C. Thermo Mechanical Analysis (TMA) was used to investigate the effects of different concentrations of dimethyl sulphoxide (DMSO) (0%, 10%, 30% and 60% v/v) and different freezing rates (1 C/min, 3 C/min and 5 C/min). The results showed that: (1) the inhomogeneous thermal expansion (or contraction) presents due to inhomogeneous water distributions in articular cartilage during freezing, which also may be the most likely reason that the matrix has been damaged in cryopreserved intact articular cartilage; (2) at the phase transition temperature range, the maximum thermal strain change value for 5C/min is approximately 1.45 times than that for 1 C/min, but the maximum thermal expansion coefficient of the later is about six times than that of the former; (3) the thermal expansion coefficient decreases with increasing cooling rate at the unfrozen temperature region, but some opposite results are obtained at the frozen temperature region; (4) the higher the DMSO concentration is, at the phase change temperature region, the smaller the thermal strain change as well as the maximum thermal expansion coefficient are, but DMSO concentration exhibits little effect on the thermal expansion coefficient at both unfrozen and frozen region. Once the DMSO concentration increasing enough, e.g. 60% v/v, the thermal strain decreases linearly and smoothly without any abrupt change due to little or no ice crystal forms (i.e. vitrification) in frozen articular cartilage. This study may improve our understanding of the thermal expansion (or contraction) behavior of cryopreserved articular cartilage and it may be useful for the future study on cryopreservation of intact

  16. A homeostatic function of CXCR2 signalling in articular cartilage.

    Science.gov (United States)

    Sherwood, Joanna; Bertrand, Jessica; Nalesso, Giovanna; Poulet, Blandine; Pitsillides, Andrew; Brandolini, Laura; Karystinou, Alexandra; De Bari, Cosimo; Luyten, Frank P; Pitzalis, Costantino; Pap, Thomas; Dell'Accio, Francesco

    2015-12-01

    ELR+ CXC chemokines are heparin-binding cytokines signalling through the CXCR1 and CXCR2 receptors. ELR+ CXC chemokines have been associated with inflammatory arthritis due to their capacity to attract inflammatory cells. Here, we describe an unsuspected physiological function of these molecules in articular cartilage homeostasis. Chemokine receptors and ligands were detected by immunohistochemistry, western blotting and RT-PCR. Osteoarthritis was induced in wild-type and CXCR2(-/-) mice by destabilisation of the medial meniscus (DMM). CXCR1/2 signalling was inhibited in vitro using blocking antibodies or siRNA. Chondrocyte phenotype was analysed using Alcian blue staining, RT-PCR and western blotting. AKT phosphorylation and SOX9 expression were upregulated using constitutively active AKT or SOX9 plasmids. Apoptosis was detected by terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL) assay. CXCL6 was expressed in healthy cartilage and was retained through binding to heparan sulfate proteoglycans. CXCR2(-/-) mice developed more severe osteoarthritis than wild types following DMM, with increased chondrocyte apoptosis. Disruption of CXCR1/2 in human and CXCR2 signalling in mouse chondrocytes led to a decrease in extracellular matrix production, reduced expression of chondrocyte differentiation markers and increased chondrocyte apoptosis. CXCR2-dependent chondrocyte homeostasis was mediated by AKT signalling since forced expression of constitutively active AKT rescued the expression of phenotypic markers and the apoptosis induced by CXCR2 blockade. Our study demonstrates an important physiological role for CXCR1/2 signalling in maintaining cartilage homeostasis and suggests that the loss of ELR+ CXC chemokines during cartilage breakdown in osteoarthritis contributes to the characteristic loss of chondrocyte phenotypic stability. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go

  17. Arthroscopic laser in intra-articular knee cartilage disorders

    Science.gov (United States)

    Nosir, Hany R.; Siebert, Werner E.

    1996-12-01

    Different assemblies have endeavored to develop arthroscopic laser surgery. Various lasers have been tried in the treatment of orthopaedic problems, and the most useful has turned out to be the Hol-YAG laser 2.1 nm which is a near- contact laser. By using the laser as a powerful tool, and cutting back on the power level, one is able to better achieve the desired treatment effect. Clinical studies to evaluating the role of the laser in different arthroscopic knee procedures, comparing to conventional techniques, showed that the overall outcome attains a momentous confidence level which is shifted to the side of the laser versus the conventional for all maneuvers, barring meniscectomy where there is not perceiving disparity between laser versus the conventional. Meniscectomy continues to be one of the most commonly performed orthopaedic procedures. Laser provides a single tool which can ablate and debride meniscal rims with efficiency and safety. Chondroplasty can also be accomplished with ease using defocused laser energy. Both lateral release and soft tissue cermilization benefit from the cutting effect of laser along with its hemostatic effect. Synovial reduction with a defocused laser is also easily accomplished. By one gadget, one can cut, ablate, smooth, coagulate, congeal and with authentic tissue depth control The future of laser arthroscopic surgery lies in its ability to weld or repair tissues. Our research study has shown that laser activated photoactive dyes can produce a molecular bonding of collagen fibers, and therefore a repair 'weld' can be achieved with both meniscal tissues and with articular cartilage lesions.

  18. Adaptive mechanically controlled lubrication mechanism found in articular joints

    Science.gov (United States)

    Greene, George W.; Banquy, Xavier; Lee, Dong Woog; Lowrey, Daniel D.; Yu, Jing; Israelachvili, Jacob N.

    2011-01-01

    Articular cartilage is a highly efficacious water-based tribological system that is optimized to provide low friction and wear protection at both low and high loads (pressures) and sliding velocities that must last over a lifetime. Although many different lubrication mechanisms have been proposed, it is becoming increasingly apparent that the tribological performance of cartilage cannot be attributed to a single mechanism acting alone but on the synergistic action of multiple “modes” of lubrication that are adapted to provide optimum lubrication as the normal loads, shear stresses, and rates change. Hyaluronic acid (HA) is abundant in cartilage and synovial fluid and widely thought to play a principal role in joint lubrication although this role remains unclear. HA is also known to complex readily with the glycoprotein lubricin (LUB) to form a cross-linked network that has also been shown to be critical to the wear prevention mechanism of joints. Friction experiments on porcine cartilage using the surface forces apparatus, and enzymatic digestion, reveal an “adaptive” role for an HA-LUB complex whereby, under compression, nominally free HA diffusing out of the cartilage becomes mechanically, i.e., physically, trapped at the interface by the increasingly constricted collagen pore network. The mechanically trapped HA-LUB complex now acts as an effective (chemically bound) “boundary lubricant”—reducing the friction force slightly but, more importantly, eliminating wear damage to the rubbing/shearing surfaces. This paper focuses on the contribution of HA in cartilage lubrication; however, the system as a whole requires both HA and LUB to function optimally under all conditions. PMID:21383143

  19. Nanosized fibers' effect on adult human articular chondrocytes behavior

    International Nuclear Information System (INIS)

    Stenhamre, Hanna; Thorvaldsson, Anna; Enochson, Lars; Walkenström, Pernilla; Lindahl, Anders; Brittberg, Mats; Gatenholm, Paul

    2013-01-01

    Tissue engineering with chondrogenic cell based therapies is an expanding field with the intention of treating cartilage defects. It has been suggested that scaffolds used in cartilage tissue engineering influence cellular behavior and thus the long-term clinical outcome. The objective of this study was to assess whether chondrocyte attachment, proliferation and post-expansion re-differentiation could be influenced by the size of the fibers presented to the cells in a scaffold. Polylactic acid (PLA) scaffolds with different fiber morphologies were produced, i.e. microfiber (MS) scaffolds as well as nanofiber-coated microfiber scaffold (NMS). Adult human articular chondrocytes were cultured in the scaffolds in vitro up to 28 days, and the resulting constructs were assessed histologically, immunohistochemically, and biochemically. Attachment of cells and serum proteins to the scaffolds was affected by the architecture. The results point toward nano-patterning onto the microfibers influencing proliferation of the chondrocytes, and the overall 3D environment having a greater influence on the re-differentiation. In the efforts of finding the optimal scaffold for cartilage tissue engineering, studies as the current contribute to the knowledge of how to affect and control chondrocytes behavior. - Highlights: ► Chondrocyte behavior in nanofiber-coated microfiber versus microfiber scaffolds ► High porosity (> 90%) and large pore sizes (a few hundred μm) of nanofibrous scaffolds ► Proliferation enhanced by presence of nanofibers ► Differentiation not significantly affected ► Cell attachment improved in presence of both nanofibers and serum

  20. Adaptive mechanically controlled lubrication mechanism found in articular joints.

    Science.gov (United States)

    Greene, George W; Banquy, Xavier; Lee, Dong Woog; Lowrey, Daniel D; Yu, Jing; Israelachvili, Jacob N

    2011-03-29

    Articular cartilage is a highly efficacious water-based tribological system that is optimized to provide low friction and wear protection at both low and high loads (pressures) and sliding velocities that must last over a lifetime. Although many different lubrication mechanisms have been proposed, it is becoming increasingly apparent that the tribological performance of cartilage cannot be attributed to a single mechanism acting alone but on the synergistic action of multiple "modes" of lubrication that are adapted to provide optimum lubrication as the normal loads, shear stresses, and rates change. Hyaluronic acid (HA) is abundant in cartilage and synovial fluid and widely thought to play a principal role in joint lubrication although this role remains unclear. HA is also known to complex readily with the glycoprotein lubricin (LUB) to form a cross-linked network that has also been shown to be critical to the wear prevention mechanism of joints. Friction experiments on porcine cartilage using the surface forces apparatus, and enzymatic digestion, reveal an "adaptive" role for an HA-LUB complex whereby, under compression, nominally free HA diffusing out of the cartilage becomes mechanically, i.e., physically, trapped at the interface by the increasingly constricted collagen pore network. The mechanically trapped HA-LUB complex now acts as an effective (chemically bound) "boundary lubricant"--reducing the friction force slightly but, more importantly, eliminating wear damage to the rubbing/shearing surfaces. This paper focuses on the contribution of HA in cartilage lubrication; however, the system as a whole requires both HA and LUB to function optimally under all conditions.

  1. Binding and lubrication of biomimetic boundary lubricants on articular cartilage.

    Science.gov (United States)

    Samaroo, Kirk J; Tan, Mingchee; Putnam, David; Bonassar, Lawrence J

    2017-03-01

    The glycoprotein, lubricin, is the primary boundary lubricant of articular cartilage and has been shown to prevent cartilage damage after joint injury. In this study, a library of eight bottle-brush copolymers were synthesized to mimic the structure and function of lubricin. Polyethylene glycol (PEG) grafted onto a polyacrylic acid (pAA) core mimicked the hydrophilic mucin-like domain of lubricin, and a thiol terminus anchored the polymers to cartilage surfaces much like lubricin's C-terminus. These copolymers, abbreviated as pAA-g-PEG, rapidly bound to cartilage surfaces with binding time constants ranging from 20 to 39 min, and affected lubrication under boundary mode conditions with coefficients of friction ranging from 0.140 ± 0.024 to 0.248 ± 0.030. Binding and lubrication were highly correlated (r 2  = 0.89-0.99), showing that boundary lubrication in this case strongly depends on the binding of the lubricant to the surface. Along with time-dependent and dose-dependent behavior, lubrication and binding of the lubricin-mimetics also depended on copolymer structural parameters including pAA backbone length, PEG side chain length, and PEG:AA brush density. Polymers with larger backbone sizes, brush sizes, or brush densities took longer to bind (p lubricate and protect cartilage in vivo. In copolymers with shorter pAA backbones, increasing hydrodynamic size inhibited lubrication (p lubricating efficacy as recombinant lubricins and as such have potential for in vivo treatment of post-traumatic osteoarthritis. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:548-557, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  2. MR diffusion weighted imaging experimental study on early stages of articular cartilage degeneration of knee

    International Nuclear Information System (INIS)

    Dai Jingru; Dai Shipeng; Pang Jun; Xu Xiaokun; Wang Yuexin; Zhang Zhigang

    2008-01-01

    Objective: To study the appearance of MR diffusion weighted imaging in early stages of cartilage degeneration and to detect its values. Methods: In 20 goat left knees, intra- articular injection of 5 units of papain was performed causing a loss of cartilage proteoglycan. Twenty right knees were used as control group. MR diffusion weighted imaging was performed at 24 hours after intra-articular injection of papain. ADC of each part of articular cartilage was measured and compared with each other. The proteoglycan content was measured biochemically and histochemically. Routine MRI and DWI were performed in 100 patients with osteoarthritis and 20 healthy people. The ADC of each interested part of articular cartilage was measured and compared with each other. Results: In experimental control group, the ADCav of articular cartilage was (14.2±2.3) x 10 -4 mm 2 /s. In early stages of cartilage degeneration group, the ADCav of articular cartilage was (17.5±4.2) x 10 -4 mm 2 /s. The ADCav of the control group was lower than that of the early stages of cartilage degeneration group (t=2.709; P=0.016). The proteloglycan content of articular cartilage was 4.22 x 10 6 μg/kg in control group, and 0.82 x 10 6 μg/kg in experimental group at 24 hours after injection of papain. The difference between control group and experimental group was significant (t=2.705, P=0.018). In healthy people, the ADCav of articular cartilage was (7.6±2.2) x 10 -4 mm 2 /s. In osteoarthritis group, the ADCav of articular cartilage was (10.3±4.2) x 10 -4 mm 2 /s. The ADCav in the healthy group was significantly lower than that in the osteoarthritis group (t=2.609,P=0.014). Conclusion: DWI is an useful method in detecting early stages of cartilage degeneration which can not be showed on routine sequences. (authors)

  3. Distance between parapatellar portal and intra-articular space for needle positioning in knee osteoarthritis

    Directory of Open Access Journals (Sweden)

    John Butarbutar

    2013-05-01

    Full Text Available Background: Intra-articular injection is a common therapeutic procedure in osteoarthritis (OA that need high accuracy. This study was aimed to measure the distance between parapatellar skin and intra-articular space as a guidance to choose the length of needle needed to perform intra-articular injection. Methods: Twenty one knees MRI were taken from 16 females with knee osteoarthritis. The length of the needle needed to reach intra-articular space was reconstructed by drawing straight line from skin to intra-articular fluid. Paired t-test was using to analyze the mean difference of measurement of left side compare with right side with significant indicator if p-value < 0.05. Results: The entry point on both medial and lateral parapatellar were more cranial than transverse mid-patellar line. On medial portal, the closest distance from skin to intra-articular space is 27.81 ± 7.58 mm. Mean point of entry is 4.46 ± 2.16 mm cranial to mid-patellar line, and 14.20 ± 4.45 mm posterior to the prominence of medial border of patella. On lateral portal, the closest distance from skin to intra-articular space is 16.84 ± 6.79 mm. Mean point of entry is 11.10 ± 5.94 mm cranial to mid-patellar line, and 8.91 ± 3.83 mm posterior to the prominence of lateral border of patella. Conclusion: MRI knee osteoarthritis study showed that the mean distance between skin and intra-articular joint space of medial portal is 27.81 ± 7.58 mm, and lateral portal is 16.84 ± 6.79 mm. The portals on both sides is cranial to midpoint of patella, lateral appears more proximal than medial. This should be put into consideration in choosing needle length and portal projection to increase intra-articular injection accuracy. (Med J Indones. 2013;22:83-7Keywords: Needle length, osteoarthritis, parapatellar skin portal

  4. Interspecific scaling patterns of talar articular surfaces within primates and their closest living relatives

    Science.gov (United States)

    Yapuncich, Gabriel S; Boyer, Doug M

    2014-01-01

    The articular facets of interosseous joints must transmit forces while maintaining relatively low stresses. To prevent overloading, joints that transmit higher forces should therefore have larger facet areas. The relative contributions of body mass and muscle-induced forces to joint stress are unclear, but generate opposing hypotheses. If mass-induced forces dominate, facet area should scale with positive allometry to body mass. Alternatively, muscle-induced forces should cause facets to scale isometrically with body mass. Within primates, both scaling patterns have been reported for articular surfaces of the femoral and humeral heads, but more distal elements are less well studied. Additionally, examination of complex articular surfaces has largely been limited to linear measurements, so that ‘true area' remains poorly assessed. To re-assess these scaling relationships, we examine the relationship between body size and articular surface areas of the talus. Area measurements were taken from microCT scan-generated surfaces of all talar facets from a comprehensive sample of extant euarchontan taxa (primates, treeshrews, and colugos). Log-transformed data were regressed on literature-derived log-body mass using reduced major axis and phylogenetic least squares regressions. We examine the scaling patterns of muscle mass and physiological cross-sectional area (PCSA) to body mass, as these relationships may complicate each model. Finally, we examine the scaling pattern of hindlimb muscle PCSA to talar articular surface area, a direct test of the effect of mass-induced forces on joint surfaces. Among most groups, there is an overall trend toward positive allometry for articular surfaces. The ectal (= posterior calcaneal) facet scales with positive allometry among all groups except ‘sundatherians', strepsirrhines, galagids, and lorisids. The medial tibial facet scales isometrically among all groups except lemuroids. Scaling coefficients are not correlated with sample

  5. Intra-Articular Synovial Sarcomas: Incidence and Differentiating Features from Localized Pigmented Villonodular Synovitis

    Directory of Open Access Journals (Sweden)

    D. Nordemar

    2015-01-01

    Full Text Available Purpose. To determine the incidence of intra-articular synovial sarcomas and investigate if any radiological variables can differentiate them from localized (unifocal pigmented villonodular synovitis (PVNS and if multivariate data analysis could be used as a complementary clinical tool. Methods. Magnetic resonance images and radiographs of 7 cases of intra-articular synovial sarcomas and 14 cases of localized PVNS were blindedly reviewed. Variables analyzed were size, extra-articular growth, tumor border, blooming, calcification, contrast media enhancement, effusion, bowl of grapes sign, triple signal intensity sign, synovial low signal intensity, synovitis, age, and gender. Univariate and multivariate data analysis, the method of partial least squares-discriminant analysis (PLS-DA, were used. Register data on all synovial sarcomas were extracted for comparison. Results. The incidence of intra-articular synovial sarcomas was 3%. PLS-DA showed that age, effusion, size, and gender were the most important factors for discrimination between sarcomas and localized PVNS. No sarcomas were misclassified as PVNS with PLS-DA, while some PVNS were misclassified as sarcomas. Conclusions. The most important variables in differentiating intra-articular sarcomas from localized PVNS were age, effusion, size, and gender. Multivariate data analysis can be helpful as additive information to avoid a biopsy, if the tumor is classified as most likely being PVNS.

  6. Osteoarthritis prevention through meniscal regeneration induced by intra-articular injection of meniscus stem cells.

    Science.gov (United States)

    Shen, Weiliang; Chen, Jialin; Zhu, Ting; Yin, Zi; Chen, Xiao; Chen, Longkun; Fang, Zhi; Heng, Boon Chin; Ji, Junfeng; Chen, Weishan; Ouyang, Hong-Wei

    2013-07-15

    Meniscus injury is frequently encountered in clinical practice. Current surgical therapy involving partial or complete meniscectomy relieves pain in the short-term but often leads to osteoarthritis (OA) in the long-term. Here, this study aimed to identify and characterize a novel population of meniscus-derived stem cells (MeSCs) and develop a new strategy of articular cartilage protection by intra-articular injection of these cells. The "stemness" and immune properties of MeSCs were investigated in vitro, while the efficacy of intra-articular injection of MeSCs for meniscus regeneration and OA prevention were investigated in vivo at 4, 8, and 12 weeks postsurgery. MeSCs displayed typical stem cell characteristics such as low immunogenicity and even possessed immunosuppressive function. In a rabbit meniscus injury model, transplantation of allogenous MeSCs did not elicit immunological rejection, but promoted neo-tissue formation with better-defined shape and more matured extracellular matrix. In a rabbit experimental OA model, transplantation of MeSCs further protected joint surface cartilage and maintained joint space at 12 weeks postsurgery, whereas extensive joint surface irregularities and joint space stenosis were observed in the control group. This study thus evoked a new strategy for articular cartilage protection and meniscus regeneration by intra-articular injection of MeSCs for patients undergoing meniscectomy.

  7. [Basophilic line of the articular cartilage in normal and various pathological states].

    Science.gov (United States)

    Gongadze, L R

    1987-04-01

    Epiphyses of long tubular bones in the man and animals of various age, as well as experimental material of the adjuvant arthritis, with special reference to the basal part of the articular cartilage have been studied by means of histological, histochemical and histometrical methods. The structural-chemical organization of the basophilic line (tidemark) of the articular cartilage ensures its barrier role and participation in regulating selective permeability. Reconstruction of the tidemark in the process of physiological ageing and in cases of the articular pathology is aimed to preserve its integrity and in this way a complete differentiation of the noncalcified and calcified structures is secured. Disturbance of the basophilic line results in changes of the articular selective permeability, in invasion of vessels and structural elements of the bone marrow, and in development of profound distrophic and destructive changes of the cartilage--in deforming artrosis. Deflations in the structural-chemical organization of the tidemark indicate certain disturbances in the state of the system articular cartilage--subchondral bone. These data can be of prognostic importance.

  8. Topographic matching of distal radius and proximal fibula articular surface for distal radius osteoarticular reconstruction.

    Science.gov (United States)

    Zhang, H; Chen, S; Wang, Z; Guo, Y; Liu, B; Tong, D

    2016-07-01

    During osteoarticular reconstruction of the distal radius with the proximal fibula, congruity between the two articular surfaces is an important factor in determining the quality of the outcome. In this study, a three-dimensional model and a coordinate transformation algorithm were developed on computed tomography scanning. Articular surface matching was performed and parameters for the optimal position were determined quantitatively. The mean radii of best-fit spheres of the articular surfaces of the distal radius and proximal fibula were compared quantitatively. The radial inclination and volar tilt following reconstruction by an ipsilateral fibula graft, rather than the contralateral, best resembles the values of the native distal radius. Additionally, the ipsilateral fibula graft reconstructed a larger proportion of the distal radius articular surface than did the contralateral. The ipsilateral proximal fibula graft provides a better match for the reconstruction of the distal radius articular surface than the contralateral, and the optimal position for graft placement is quantitatively determined. © The Author(s) 2015.

  9. Combined intra-articular glucocorticoid, bupivacaine and morphine reduces pain and convalescence after diagnostic knee arthroscopy

    DEFF Research Database (Denmark)

    Rasmussen, Sten; Lorentzen, Jan S; Larsen, Allan S

    2002-01-01

    We studied the effect of intra-articullar saline vs. bupivacaine + morphine or bupivacaine morphine + methylprednisolone after diagnostic knee arthroscopy. In a double-blind randomized study, 60 patients undergoing diagnostic knee arthroscopy without a therapeutic procedure were allocated to groups...... receiving intra-articular saline, intra-articular bupivacaine 150 mg + morphine 4 mg or the same dose of bupivacaine + morphine + intra-articular methylprednisolone 40 mg at the end of arthroscopy during general anesthesia. All patients were instructed to resume normal activities immediately after...... the procedure. Pain during movement and walking, leg muscle force and joint effusion, use of crutches and duration of sick leave were assessed. A combination of bupivacaine and morphine reduced pain, duration of immobilization and of convalescence. The addition of methylprednisolone further reduced pain, use...

  10. Extra-Articular Lateral Tenodesis for Anterior Cruciate Ligament Deficient Knee: A Case Report

    Directory of Open Access Journals (Sweden)

    Diego García-Germán

    2013-01-01

    Full Text Available We present the case of an extra-articular lateral tenodesis for an anterior cruciate ligament (ACL deficient knee. A 46-year-old male patient sustained an ACL graft rupture after a motorcycle accident. He complained of rotational instability and giving-way episodes. His previous graft was fixed by an intra-articular femoral staple that was not possible to remove at the time of the ACL revision. A modified Lemaire procedure was then performed. He gained rotational stability and was able to resume his sporting activities. We believe that isolated extra-articular reconstructions may still have a role in selected indications including moderate-demand patients complaining of rotational instability after ACL graft failure.

  11. Extra-Articular Lateral Tenodesis for Anterior Cruciate Ligament Deficient Knee: A Case Report

    Science.gov (United States)

    García-Germán, Diego; Menéndez, Pablo; de la Cuadra, Pablo; Rodríguez-Arozena, Ricardo

    2013-01-01

    We present the case of an extra-articular lateral tenodesis for an anterior cruciate ligament (ACL) deficient knee. A 46-year-old male patient sustained an ACL graft rupture after a motorcycle accident. He complained of rotational instability and giving-way episodes. His previous graft was fixed by an intra-articular femoral staple that was not possible to remove at the time of the ACL revision. A modified Lemaire procedure was then performed. He gained rotational stability and was able to resume his sporting activities. We believe that isolated extra-articular reconstructions may still have a role in selected indications including moderate-demand patients complaining of rotational instability after ACL graft failure. PMID:24369517

  12. Quantitative characterization of articular cartilage using Mueller matrix imaging and multiphoton microscopy.

    Science.gov (United States)

    Ellingsen, Pål Gunnar; Lilledahl, Magnus Borstad; Aas, Lars Martin Sandvik; Davies, Catharina de Lange; Kildemo, Morten

    2011-11-01

    The collagen meshwork in articular cartilage of chicken knee is characterized using Mueller matrix imaging and multiphoton microscopy. Direction and degree of dispersion of the collagen fibers in the superficial layer are found using a Fourier transform image-analysis technique of the second-harmonic generated image. Mueller matrix images are used to acquire structural data from the intermediate layer of articular cartilage where the collagen fibers are too small to be resolved by optical microscopy, providing a powerful multimodal measurement technique. Furthermore, we show that Mueller matrix imaging provides more information about the tissue compared to standard polarization microscopy. The combination of these techniques can find use in improved diagnosis of diseases in articular cartilage, improved histopathology, and additional information for accurate biomechanical modeling of cartilage.

  13. Intra-Articular Giant Heterotopic Ossification following Total Knee Arthroplasty for Charcot Arthropathy

    Directory of Open Access Journals (Sweden)

    Arata Nakajima

    2013-01-01

    Full Text Available Although the Charcot arthropathy may be associated with serious complications, total knee arthroplasty (TKA is the preferred choice of treatment by patients. This case report presents an 80-year-old man with intra-articular giant heterotopic ossification following loosening of femoral and tibial implants and femoral condylar fracture. He had undergone TKA because of Charcot neuropathy seven years ago and had been doing well since. Immediately after a left knee sprain, he became unable to walk. Because he had developed a skin ulcer on his left calf where methicillin-resistant Staphylococcus aureus was detected, we postponed revision surgery until the ulcer was completely healed. While waiting, intra-articular bony fragments grew larger and formed giant heterotopic ossified masses. Eventually, the patient underwent revision surgery, and two major ossified masses were carefully and successfully extirpated. It should be noted that intra-articular heterotopic giant ossification is a significant complication after TKA for neuropathic arthropathy.

  14. Comparison of analgesic effects of intra-articular tenoxicam and morphine in anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Guler, Gulen; Karaoglu, Sinan; Velibasoglu, Hediye; Ramazanogullari, Nesrin; Boyaci, Adem

    2002-07-01

    This study compared the analgesic effect of intra-articular injection of tenoxicam with that of morphine on postoperative pain after anterior cruciate ligament (ACL) reconstruction. Forty-two patients undergoing arthroscopically ACL reconstructions using hamstring tendons underwent the same anesthetic protocol. The patients were randomized to receive 25 ml normal saline, 20 mg tenoxicam in 25 ml normal saline, or 2 mg morphine in 25 ml normal saline. Postoperative pain was assessed using a visual analogue scale and measuring analgesic requirements. We found both that both intra-articular tenoxicam and intra-articular morphine provided better analgesia than that in the control group. Although pain scores were similar between tenoxicam and morphine groups 30 min postoperative, the analgesic requirements in with tenoxicam were significantly lower than those with morphine group 3-6 h postoperatively.

  15. Directed differentiation of induced pluripotent stem cells into chondrogenic lineages for articular cartilage treatment

    Directory of Open Access Journals (Sweden)

    Michał Lach

    2014-09-01

    Full Text Available In recent years, increases in the number of articular cartilage injuries caused by environmental factors or pathological conditions have led to a notable rise in the incidence of premature osteoarthritis. Osteoarthritis, considered a disease of civilization, is the leading cause of disability. At present, standard methods for treating damaged articular cartilage, including autologous chondrocyte implantation or microfracture, are short-term solutions with important side effects. Emerging treatments include the use of induced pluripotent stem cells, a technique that could provide a new tool for treatment of joint damage. However, research in this area is still early, and no optimal protocol for transforming induced pluripotent stem cells into chondrocytes has yet been established. Developments in our understanding of cartilage developmental biology, together with the use of modern technologies in the field of tissue engineering, provide an opportunity to create a complete functional model of articular cartilage.

  16. Large bone distractor for open reconstruction of articular fractures of the calcaneus

    Science.gov (United States)

    Twardosz, Wojciech; Tondel, Wieslaw; Olewicz-Gawlik, Anna; Hrycaj, Pawel

    2009-01-01

    The results of operative treatment of two groups of patients with articular fractures of the calcaneus were evaluated. Twenty-three cases were treated surgically using a standard reconstruction procedure. In the second group of 19 patients a large bone distractor was used; it held the soft tissue flap retracted, while aiding in articular and tuberosity fragment reduction and increasing visualisation by distraction of the posterior talocalcaneal joint. After a year, the anatomical and functional results, together with the operative time, were evaluated. All fractures healed with good or very good anatomical results. All cases, except those with complications (n = 3), achieved good (n = 28) or very good (n = 11) functional scoring. The distractor group had significantly shorter operative times, and less manpower was needed during surgery. We conclude that the large bone distractor is a useful tool in open reconstruction of articular calcaneal fractures. PMID:19404639

  17. The Variations in Calcaneal Articular Facets In North Indian Population and its Clinical Implication

    Directory of Open Access Journals (Sweden)

    Deepinder Kaur Gandhi

    2012-01-01

    Full Text Available Aims and Objectives- To know the most common type of calcanei in North Indian population and itsclinical importance. There are three articular facets on superior surface of calcaneus- anterior, middle andposterior. Three types of calcanei are noted according to number and arrangement of the articular facets-type A, B and C. Methodology - The present studywas done on 300 dry adult human calcanei of unknownsex taken from Department of Anatomy Sri Guru Ram Das Institute of Medical Sciences and ResearchVallah (Amritsar. Results- In our study Type B was found as the most common type. Type A is the nextmost common. Interpretation- The talocalcaneal joint is important in arthritis and coalition, flat foot, valgus deformity, congenital anomalies and intra articular fractures.

  18. Bilateral spondylolysis of inferior articular processes of the fourth lumbar vertebra: a case report.

    Science.gov (United States)

    Koakutsu, Tomoaki; Morozumi, Naoki; Hoshikawa, Takeshi; Ogawa, Shinji; Ishii, Yushin; Itoi, Eiji

    2012-03-01

    Lumbar spondylolysis, a well known cause of low back pain, usually affects the pars interarticularis of a lower lumbar vertebra and rarely involves the articular processes. We report a rare case of bilateral spondylolysis of inferior articular processes of L4 vertebra that caused spinal canal stenosis with a significant segmental instability at L4/5 and scoliosis. A 31-year-old male who had suffered from low back pain since he was a teenager presented with numbness of the right lower leg and scoliosis. Plain X-rays revealed bilateral spondylolysis of inferior articular processes of L4, anterolisthesis of the L4 vertebral body, and right lateral wedging of the L4/5 disc with compensatory scoliosis in the cephalad portion of the spine. MR images revealed spinal canal stenosis at the L4/5 disc level. Posterior lumbar interbody fusion of the L4/5 was performed, and his symptoms were relieved.

  19. Spatial regulation of bone morphogenetic proteins (BMPs) in postnatal articular and growth plate cartilage

    Science.gov (United States)

    Garrison, Presley; Yue, Shanna; Hanson, Jeffrey; Baron, Jeffrey; Lui, Julian C.

    2017-01-01

    Articular and growth plate cartilage both arise from condensations of mesenchymal cells, but ultimately develop important histological and functional differences. Each is composed of three layers—the superficial, mid and deep zones of articular cartilage and the resting, proliferative and hypertrophic zones of growth plate cartilage. The bone morphogenetic protein (BMP) system plays an important role in cartilage development. A gradient in expression of BMP-related genes has been observed across growth plate cartilage, likely playing a role in zonal differentiation. To investigate the presence of a similar expression gradient in articular cartilage, we used laser capture microdissection (LCM) to separate murine growth plate and articular cartilage from the proximal tibia into their six constituent zones, and used a solution hybridization assay with color-coded probes (nCounter) to quantify mRNAs for 30 different BMP-related genes in each zone. In situ hybridization and immunohistochemistry were then used to confirm spatial expression patterns. Expression gradients for Bmp2 and 6 were observed across growth plate cartilage with highest expression in hypertrophic zone. However, intracellular BMP signaling, assessed by phospho-Smad1/5/8 immunohistochemical staining, appeared to be higher in the proliferative zone and prehypertrophic area than in hypertrophic zone, possibly due to high expression of Smad7, an inhibitory Smad, in the hypertrophic zone. We also found BMP expression gradients across the articular cartilage with BMP agonists primarily expressed in the superficial zone and BMP functional antagonists primarily expressed in the deep zone. Phospho-Smad1/5/8 immunohistochemical staining showed a similar gradient. In combination with previous evidence that BMPs regulate chondrocyte proliferation and differentiation, the current findings suggest that BMP signaling gradients exist across both growth plate and articular cartilage and that these gradients may

  20. BMP receptor signaling is required for postnatal maintenance of articular cartilage.

    Directory of Open Access Journals (Sweden)

    Ryan B Rountree

    2004-11-01

    Full Text Available Articular cartilage plays an essential role in health and mobility, but is frequently damaged or lost in millions of people that develop arthritis. The molecular mechanisms that create and maintain this thin layer of cartilage that covers the surface of bones in joint regions are poorly understood, in part because tools to manipulate gene expression specifically in this tissue have not been available. Here we use regulatory information from the mouse Gdf5 gene (a bone morphogenetic protein [BMP] family member to develop new mouse lines that can be used to either activate or inactivate genes specifically in developing joints. Expression of Cre recombinase from Gdf5 bacterial artificial chromosome clones leads to specific activation or inactivation of floxed target genes in developing joints, including early joint interzones, adult articular cartilage, and the joint capsule. We have used this system to test the role of BMP receptor signaling in joint development. Mice with null mutations in Bmpr1a are known to die early in embryogenesis with multiple defects. However, combining a floxed Bmpr1a allele with the Gdf5-Cre driver bypasses this embryonic lethality, and leads to birth and postnatal development of mice missing the Bmpr1a gene in articular regions. Most joints in the body form normally in the absence of Bmpr1a receptor function. However, articular cartilage within the joints gradually wears away in receptor-deficient mice after birth in a process resembling human osteoarthritis. Gdf5-Cre mice provide a general system that can be used to test the role of genes in articular regions. BMP receptor signaling is required not only for early development and creation of multiple tissues, but also for ongoing maintenance of articular cartilage after birth. Genetic variation in the strength of BMP receptor signaling may be an important risk factor in human osteoarthritis, and treatments that mimic or augment BMP receptor signaling should be

  1. Is intra-articular magnesium effective for postoperative analgesia in arthroscopic shoulder surgery?

    Science.gov (United States)

    Saritas, Tuba Berra; Borazan, Hale; Okesli, Selmin; Yel, Mustafa; Otelcioglu, Şeref

    2015-01-01

    Various medications are used intra-articularly for postoperative pain reduction after arthroscopic shoulder surgery. Magnesium, a N-methyl-D-aspartate receptor antagonist, may be effective for reduction of both postoperative pain scores and analgesic requirements. A total of 67 patients undergoing arthroscopic shoulder surgery were divided randomly into two groups to receive intra-articular injections of either 10 mL magnesium sulphate (100 mg⁄mL; group M, n=34) or 10 mL of normal saline (group C, n=33). The analgesic effect was estimated using a visual analogue scale 1 h, 2 h, 6 h, 8 h, 12 h, 18 h and 24 h after operation. Postoperative analgesia was maintained by intra-articular morphine (0.01%, 10 mg) + bupivacaine (0.5%, 100 mL) patient-controlled analgesia device as a 1 mL infusion with a 1 mL bolus dose and 15 min lock-out time; for visual analogue scale scores >5, intramuscular diclofenac sodium 75 mg was administered as needed during the study period (maximum two times). Intra-articular magnesium resulted in a significant reduction in pain scores in group M compared with group C 1 h, 2 h, 6 h, 8 h and 12 h after the end of surgery, respectively, at rest and with passive motion. Total diclofenac consumption and intra-articular morphine + bupivacaine consumption were significantly lower in group M. Postoperative serum magnesium levels were significantly higher in group M, but were within the normal range. Magnesium causes a reduction in postoperative pain in comparison to saline when administered intra-articularly after arthroscopic shoulder surgery, and has no serious side effects.

  2. The protective effect of meniscus allograft transplantation on articular cartilage: a systematic review of animal studies.

    Science.gov (United States)

    Rongen, J J; Hannink, G; van Tienen, T G; van Luijk, J; Hooijmans, C R

    2015-08-01

    Despite widespread reporting on clinical results, the effect of meniscus allograft transplantation on the development of osteoarthritis is still unclear. The aim of this study was to systematically review all studies on the effect of meniscus allograft transplantation on articular cartilage in animals. Pubmed and Embase were searched for original articles concerning the effect of meniscus allograft transplantation on articular cartilage compared with both its positive (meniscectomy) and negative (either sham or non-operated) control in healthy animals. Outcome measures related to assessment of damage to articular cartilage were divided in five principal outcome categories. Standardized mean differences (SMD) were calculated and pooled to obtain an overall SMD and 95% confidence interval. 17 articles were identified, representing 14 original animal cohorts with an average timing of data collection of 24 weeks [range 4 weeks; 30 months]. Compared to a negative control, meniscus allograft transplantation caused gross macroscopic (1.45 [0.95; 1.95]), histological (3.43 [2.25; 4.61]) damage to articular cartilage, and osteoarthritic changes on radiographs (3.12 [1.42; 4.82]). Moreover, results on histomorphometrics and cartilage biomechanics are supportive of this detrimental effect on cartilage. On the other hand, meniscus allograft transplantation caused significantly less gross macroscopic (-1.19 [-1.84; -0.54]) and histological (-1.70 [-2.67; -0.74]) damage to articular cartilage when compared to meniscectomy. However, there was no difference in osteoarthritic changes on plain radiographs (0.04 [-0.48; 0.57]), and results on histomorphometrics and biomechanics did neither show a difference in effect between meniscus allograft transplantation and meniscectomy. In conclusion, although meniscus allograft transplantation does not protect articular cartilage from damage, it reduces the extent of it when compared with meniscectomy. Copyright © 2015 Osteoarthritis

  3. Occult Intra-articular Knee Injuries in Children With Hemarthrosis.

    Science.gov (United States)

    Askenberger, Marie; Ekström, Wilhelmina; Finnbogason, Thröstur; Janarv, Per-Mats

    2014-07-01

    Hemarthrosis after acute knee trauma is a sign of a potentially serious knee injury. Few studies have described the epidemiology and detailed injury spectrum of acute knee injuries in a general pediatric population. To document the current injury spectrum of acute knee injuries with hemarthrosis in children aged 9 to 14 years and to describe the distribution of sex, age at injury, type of activity, and activity frequency in this population. Descriptive epidemiology study. All patients in the Stockholm County area aged 9 to 14 years who suffered acute knee trauma with hemarthrosis were referred to Astrid Lindgren Children's Hospital, Karolinska University Hospital, from September 2011 to April 2012. The patients underwent clinical examination, radiography, and magnetic resonance imaging (MRI). The type of activity when injured, regular sports activity/frequency, and patient sex and age were registered. The diagnoses were classified into minor and serious injuries. The study included 117 patients (47 girls and 70 boys; mean age, 13.2 years). Seventy percent had a serious knee injury. Lateral patellar dislocations, anterior cruciate ligament ruptures, and anterior tibial spine fractures were the most common injuries, with an incidence of 0.6, 0.2, and 0.1 per 1000 children, respectively. The sex distribution was equal up to age 13 years; twice as many boys were seen at the age of 14 years. The majority of injuries occurred during sports. Forty-six patients (39%) had radiographs without a bony injury but with a serious injury confirmed on MRI. Seventy percent of the patients aged 9 to 14 years with traumatic knee hemarthrosis had a serious intra-articular injury that needed specific medical attention. Fifty-six percent of these patients had no visible injury on plain radiographs. Physicians who treat this group of patients should consider MRI to establish the diagnosis when there is no or minimal radiographic findings. The most common serious knee injury was a lateral

  4. Mapping the Articular Contact Area of the Long Head of the Biceps Tendon on the Humeral Head

    Directory of Open Access Journals (Sweden)

    Brent J. Morris

    2014-01-01

    Full Text Available The purpose of this investigation was to calculate the contact surface area of the long head of the biceps (LHB in neutral position and abduction. We sought to determine whether the LHB articulates with the humeral head in a consistent pattern comparing articular contact area in neutral position and abduction. Eleven fresh frozen matched cadaveric shoulders were analyzed. The path of the biceps tendon on the articular surface of the humeral head and the total articular surface were digitized using a MicronTracker 2 H3-60 three-dimensional optical tracker. Contact surface area was significantly less in abduction than in neutral position (P=0.002 with a median ratio of 41% (36%, 47.5%. Ratios of contact area in neutral position to full articular surface area were consistent between left and right shoulders (rho=1, P=0.017 as were ratios of abduction area to full articular surface area (rho= 0.97, P=0.005. The articular contact surface area is significantly greater in neutral position than abduction. The ratios of articular contact surface areas to total humeral articular surface areas have a narrow range and are consistent between left and right shoulders of the same cadaver.

  5. Autoradiographic evidence of sup 125 I-. beta. -endorphin binding sites in the articular cartilage of the rat

    Energy Technology Data Exchange (ETDEWEB)

    Castano, M.T.; Freire-Garabal, M.; Giraldez, M.; Nunez, M.J.; Belmonte, A.; Couceiro, J.; Jorge, J. (Univ. of Santiago (Spain))

    1991-01-01

    After {sup 125}I-{beta}-endorphin was intravenously injected to rats, an autoradiographic study of distal femur articular cartilage was performed. Results show a specific binding of {sup 125}I-{beta}-endorphin to chondrocytes, suggesting the possible existence of an opiate modulation of articular cartilage.

  6. Intra-articular hyaluronate, tenoxicam and vitamin E in a rat model of osteoarthritis: evaluation and comparison of chondroprotective efficacy.

    Science.gov (United States)

    Ozkan, Feyza Unlu; Uzer, Gokcer; Türkmen, Ismail; Yildiz, Yavuz; Senol, Serkan; Ozkan, Korhan; Turkmensoy, Fatih; Ramadan, Saime; Aktas, Ilknur

    2015-01-01

    The aim of this experimental study was to evaluate and compare the chondroprotective efficacy of intra-articular hyaluronic acid, tenoxicam and vitamin E in osteoarthritis. An osteoarthritis model was created by anterior cruciate ligament transection and medial menisectomy in knees of 28 rats. The rats were randomized into four groups; first group served as a control group and received intra-articular injections of saline solution, intra-articular HA, intra-articular tenoxicam and intra-articular Vit E were applied to the treatment groups. First intra-articular injections were applied at second week postoperatively and repeated once a week for 5 weeks. At 8th week after the operation groups were compared based on the histologic scores of cartilage degeneration by Mankin Histological Grading Scale. Total cartilage degeneration score was significantly increased in the control group (P=0.004). Total Mankin scores of HA, tenoxicam and Vit E groups were significantly lower than the control group (P=0.004, P=0.016, P=0.012 respectively). There was no statistically siginificant difference between the treatment groups in terms of total Mankin scores (P>0.05). Intra-articular application of HA, tenoxicam and Vit E are chondroprotective in early osteoarthritis model in rats. Chondroprotective activity of tenoxicam and Vit E are comparable with the beneficial effects of HA on articular cartilage.

  7. Demographics of extra-articular calcaneal fractures: Including a review of the literature on treatment and outcome

    NARCIS (Netherlands)

    T. Schepers (Tim); A.Z. Ginai (Abida); E.M.M. van Lieshout (Esther); P. Patka (Peter)

    2008-01-01

    textabstractIntroduction: Extra-articular calcaneal fractures represent 25-40% of all calcaneal fractures and an even higher percentage of up to 60% is seen in children. A disproportionately small part of the literature on calcaneal fractures involves the extra-articular type. The aim of this study

  8. Demographics of extra-articular calcaneal fractures: including a review of the literature on treatment and outcome

    NARCIS (Netherlands)

    Schepers, Tim; Ginai, Abida Z.; van Lieshout, Esther M. M.; Patka, Peter

    2008-01-01

    Extra-articular calcaneal fractures represent 25-40% of all calcaneal fractures and an even higher percentage of up to 60% is seen in children. A disproportionately small part of the literature on calcaneal fractures involves the extra-articular type. The aim of this study was to investigate the

  9. Traumatic humeral articular cartilage shear (THACS) lesion in a professional rugby player: a case report.

    Science.gov (United States)

    Jeon, I-H; Wallace, W A

    2004-08-01

    A 20 year old male professional rugby player was seen at the clinic for evaluation of shoulder pain after rugby play. Magnetic resonance imaging showed extensive subchondral bone bruising of the humeral head with defect of the articular cartilage. Arthroscopy showed that the inferior half of the humeral head had extensive articular cartilage loss with nearly 70% of the inferior head having lost its cartilage. Sports medicine doctors should be aware that the shoulder joint in young competitive athletes playing contact sports may be exposed to greater risk of this kind of injury.

  10. Hidrogeles biodegradables para la regeneración de cartílago articular

    OpenAIRE

    CANTÓ LORAS, PETRA

    2015-01-01

    [CAT] El cartílag articular és un teixit connectiu molt especialitzat present a les articulacions, que actua com amortidor suportant enormes carregues y proporcionant una superfície de lliscament de baixa fricció. Les patologies del cartílag articular suposen la pèrdua de l’estructura i de la funció del teixit i són una de les principals causes de discapacitat en persones grans. Es tracta d’un teixit avascular que presenta una capacitat d’autoreparació limitada. S’han desenvolupat nombrosos p...

  11. MRI features of three paediatric intra-articular synovial lesions: a comparative study

    Energy Technology Data Exchange (ETDEWEB)

    Kan, J.H. [Monroe Carell Jr. Children' s Hospital at Vanderbilt, Nashville, TN (United States)], E-mail: herman.kan@vanderbilt.edu; Hernanz-Schulman, M. [Monroe Carell Jr. Children' s Hospital at Vanderbilt, Nashville, TN (United States); Damon, B.M.; Yu, Chang [Vanderbilt University, Nashville, TN (United States); Connolly, S.A. [Boston Children' s Hospital, Boston, IL (United States)

    2008-07-15

    Aim: To determine reliable magnetic resonance imaging (MRI) features differentiating three paediatric intra-articular congenital or neoplastic synovial lesions that contain blood products, from post-traumatic or haemorrhagic inflammatory processes. Materials and methods: This was a retrospective review of MRI findings of 22 paediatric intra-articular congenital or neoplastic synovial lesions, including venous malformation (VM) (n = 12), pigmented villonodular synovitis (PVNS; n = 8), and synovial sarcoma (SS; n = 2). These MRI features were compared with 22 paediatric post-traumatic or inflammatory intra-articular processes containing blood products and producing mass effect. The following imaging features were assessed: presence of a discrete mass, extension, extra-articular oedema, susceptibility, joint effusion, and size. Fisher's exact test was used and results were considered statistically significant when p < 0.05. Results: The three intra-articular synovial lesions, compared with controls, were more likely to directly invade osseous structures when a discrete mass was present (13/16, 81.3% versus 1/9, 11.1%; p < 0.002) and extend into extra-articular soft tissues (13/21, 61.9% versus 2/17, 11.8%; p < 0.003), but were less likely to show extra-articular oedema (3/22, 13.6% versus 13/22, 59.1%; p < 0.004), a joint effusion (10/22,45.5% versus 19/22, 86.4%, p < 0.01), susceptibility within a joint effusion (0/22, 0% versus 11/22, 40.9%; p = 0.00), osseous oedema (3/16, 18.8% versus 7/9, 77.8%; p < 0.009), and synovial enhancement (8/21, 38.1% versus 14/16, 87.5%; p < 0.003). VMs had characteristic tubular vessels with internal fluid-fluid levels (11/12) that extended into bone (10/12) and extracapsular soft tissues (11/12). Conclusion: Our study indicates that, despite the overlapping presence of haemorrhagic products, intra-articular VM, PVNS, and SS show MRI features that permit distinction from acquired post-traumatic and haemorrhagic inflammatory

  12. 'Kissing sequestra'--a forgotten manifestation of osteo-articular tuberculosis. A case report.

    Science.gov (United States)

    Drummond-Webb, J J; Schnaid, E

    1986-04-12

    Osteo-articular tuberculosis may be difficult to diagnose radiologically. A male patient with pain in the left hip presented with radiological features of the disease--narrowing of the joint space, peri-articular osteopenia, subchondral erosions and cavity formation. In addition 'kissing sequestra' were present in the adjacent femoral head and acetabular joint surfaces. This radiological feature, described as common by Phemeister and Pomerantz in 1933, has been largely overlooked in recent literature. The presence of 'kissing sequestra' is a valuable diagnostic aid and should not be overlooked.

  13. Patients With Ligament Hiperlaxity With Rupture Of Previous Plastic For ACL. Reconstruction With Intra-articular And Extra-articular Combined Technics

    Science.gov (United States)

    Astore, Ignacio; Agotegaray, Juan Ignacio; Comba, Ignacio; Bisiach, Luciana

    2017-01-01

    Introduction: In cases of patients with ligament hiperlaxity with rupture of ACL, the use of a BTB graft is recommended for its reconstruction. Our job consists of the clinical and functional assessment of a group of 10 patients with ligament laxaty according to Beighton scale, who, after surgery for ACL rupture with BTB technique, suffered a rupture of the plastic. For its reconstruction a combination of intra-articular and extra-articular techniques was used with a BTB graft in the contralateral knee, associated with a modified Lemaire technique. Methods: The series consists of 10 patients, male, average age of 24.2 years, amateur athletes, operated for a second time in March, 2011 and November, 2013, with a minimum follow-up of 24 months. They were evaluated before surgery and 24 months after surgery based on Lysholm scale, IKDC evaluation form and a physical exam (Lachman - Pivot Shift). Results: After surgery, the average in Lysholm scale was of 87.6 and 86.3 for the IKDC subjetive form. In the physical exam, 8 patients showed Lachman 1+, while none of the patients showed Pivot Shift positive. 7 patients were able to return to their usual sport activities. As a postoperative disadvantage, 6 patients reported pain in the external face of the knee in the first 6 months. And 4 patients reported a subjetive loss of full extension that did not interfere with their sport activities. Conclusion: Based on our experience and literature, we believe that the combination of both techniques, intra-articular (BTB) and extra-articular (Lemaire), is a good alternative for patients with ligament laxaty, providing positive clinical and functional results.

  14. Caudal articular process dysplasia of thoracic vertebrae in neurologically normal French bulldogs, English bulldogs, and Pugs: Prevalence and characteristics.

    Science.gov (United States)

    Bertram, Simon; Ter Haar, Gert; De Decker, Steven

    2018-02-20

    The aims of this study were to evaluate the prevalence and anatomical characteristics of thoracic caudal articular process dysplasia in French bulldogs, English bulldogs and Pugs presenting for problems unrelated to spinal disease. In this retrospective cross-sectional study, computed tomography scans of the thoracic vertebral column of these three breeds were reviewed for the presence and location of caudal articular process hypoplasia and aplasia, and compared between breeds. A total of 271 dogs met the inclusion criteria: 108 French bulldogs, 63 English bulldogs, and 100 Pugs. A total of 70.4% of French bulldogs, 84.1% of English bulldogs, and 97.0% of Pugs showed evidence of caudal articular process dysplasia. Compared to French and English bulldogs, Pugs showed a significantly higher prevalence of caudal articular process aplasia, but also a lower prevalence of caudal articular process hypoplasia, a higher number of affected vertebrae per dog and demonstrated a generalized and bilateral spatial pattern more frequently. Furthermore, Pugs showed a significantly different anatomical distribution of caudal articular process dysplasia along the vertebral column, with a high prevalence of caudal articular process aplasia between T10 and T13. This area was almost completely spared in French and English bulldogs. As previously suggested, caudal articular process dysplasia is a common finding in neurologically normal Pugs but this also seems to apply to French and English bulldogs. The predisposition of clinically relevant caudal articular process dysplasia in Pugs is possibly not only caused by the higher prevalence of caudal articular process dysplasia, but also by breed specific anatomical characteristics. © 2018 American College of Veterinary Radiology.

  15. Intra-articular injection of dexketoprofen in rat knee joint: histopathologic assessment of cartilage & synovium.

    Science.gov (United States)

    Ekici, Aycan Guner; Akyol, Onat; Ekici, Murat; Sitilci, Tolga; Topacoglu, Hakan; Ozyuvaci, Emine

    2014-08-01

    Effective pain control following outpatient surgical procedures is an important aspect of patient discharge. This study was carried out with an aim to investigate the histopathological effects of intra-articular dexketoprofen trometamol injection in knee joint on synovium and cartilage in an experimental rat model. In each of 40 rats, the right knee was designated as the study group and the left knee as the control group (NS group). Under aseptic conditions, 35 rats received an injection of 0.25 ml (6.25 mg) dexketoprofen trometamol into the right knee joint and an injection of 0.25 ml 0.9 per cent normal saline solution into the left knee joint. On the 1st, 2nd, 7th, 14th, and 21st days after intra-articular injection, rats in specified groups were sacrificed by intraperitoneal injection of 120 mg/kg sodium thiopental. Knee joints were separated and sectioned for histopathological examination. Inflammatory changes in the joints were recorded according to a grade scale. No significant difference in terms of pathological changes both in synovium and cartilage was observed between the NS group and the study group on days 1, 2, 7, 14 and 21 after intra-articular injection of dexketoprofen or saline in the knee joint. The findings showed no evidence of significant histopathological damage to the cartilage and synovia for a period up to 21 days following intra-articular administration of dexketoprofen trometamol in the knee joints of rats.

  16. Articular cartilage lesions of the knee. MRI of tibial condylar fractures

    International Nuclear Information System (INIS)

    Nozaki, Hiroyuki

    1995-01-01

    Lesions of the articular cartilage are rarely observed in convensional radiography and CT, and may be one of the most important prognostic factors in assessing traumatic or degenerative disorders at the knee joints. To discuss the usefulness of MRI for detecting cartilage lesions, knees with tibial condylar fractures were examined with MRI. 47 patients with tibial condylar fractures were reviewed 4 months to 15 years (average of 4 years) after the fractures. Good to excellent results were obtained in 91.5% of them. It is known that anatomical reduction of conventional radiography is not consistent with the clinical outcome, because radiography can show the changes of bones only. However, the results of MRI examinations are consistent with the clinical outcome, because they can directly show the state of the articular surface, such as defects of cartilage in the joint. In my study, no abnormality of well repaired joint surfaces employing MRI were observed in the patients with excellent or good results, and various degrees of cartilage lesions were detected using MRI in the other patients. MRI is a useful method for noninvasively determining the integrity of articular cartilage, detecting cartilage lesions and degenerative disorders of tibial condyle, and also may be useful in studying and following the natural aging process in osteoarthritis following intra-articular fractures. (author) 52 refs

  17. Radiographic diagnosis of scapholunate dissociation among intra-articular fractures of the distal radius: interobserver reliability

    NARCIS (Netherlands)

    Gradl, Gertraud; Neuhaus, Valentin; Fuchsberger, Thomas; Guitton, Thierry G.; Prommersberger, Karl-Josef; Ring, David; Wahegaonkar, Abhijeet L.; Shafritz, Adam B.; Garcia, Aida E.; Caputo, Andrew E.; Terrono, Andrew L.; Spoor, Andy B.; Eschler, Anica; Vochteloo, Anne J. H.; Beumer, Annechien; Barquet, Antonio; Kristan, Anze; van der Zwan, Arnard L.; Berner, Arne; Ilyas, Asif; Jubel, Axel; Sutker, Ben; Nolan, Betsy M.; Petrisor, Brad; Cross, Brian J.; Wills, Brian P. D.; Barreto, Camilo J. R.; Fernandes, Carlos H.; Swigart, Carrie; Zalavras, Charalampos; Goldfarb, Charles A.; Cassidy, Charles; Eaton, Charles; Wilson, Chris; Cheng, Christine J.; Wall, Christopher J.; Walsh, Christopher J.; Jones, Christopher M.; Garnavos, Christos; Klostermann, Cyrus; Kirkpatrick, D. Kay; Osei, Daniel A.; Rikli, Daniel A.; Wascher, Daniel C.; Polatsch, Daniel; Silva, Dario Mejia; Nelson, David L.; Kalainov, David M.; Ruchelsman, David; Hoffmann, David Victoria; Weiss, David; Eygendaal, Denise; van Deurzen, Derek F. P.; McKee, Desirae M.; Verbeek, Diederik O. F.; Hanel, Doug; Hutchinson, Douglas T.; Brilej, Drago; Harvey, Edward; Stojkovska Pemovska, Emilija; Calvo, Emilio; Hammerberg, Eric Mark; Hofmeister, Eric P.; Kaplan, F. Thomas D.; Suarez, Fabio; Beeres, Frank J. P.; Walter, Frank L.; Frykman, Gary K.; Pess, Gary M.; Kuzma, Gary R.; Dyer, George S. M.; Thomas, George; Kohut, Georges; Kraan, Gerald A.; DeSilva, Gregory; Della Rocca, Gregory J.; Lob, Guenter; Gadbled, Guillaume; Bamberger, H. Brent; Mc Cutchan, Hal; Goost, Hans; Kreder, Hans J.; Grünwald, Heinz; Broekhuyse, Henry; Kimball, Hervey L.; Durchholz, Holger; van der Heide, Huub; McGraw, Iain; Choueka, Jack; Forigua, Jaime E.; Nappi, James F.; Reid, James G.; Kellam, James; Boler, James M.; Biert, Jan; Fanuele, Jason C.; Tavakolian, Jason D.; Jones, Jedediah; Johnson, Jeff W.; Wolf, Jennifer Moriatis; Murachovsky, Joel; Scheer, Johan H.; Rueger, Johannes M.; Erickson, John M.; McAuliffe, John; Boretto, Jorge G.; Rubio, Jorge; Ortiz, Jose A.; Ribeiro Filho, Jose Eduardo Grandi; Di Giovanni, José Fernando; Izzi, Joseph A.; Conflitti, Joseph M.; Abzug, Joshua M.; Cagnone, Juan Carlos; Adams, Julie; Chivers, Karel; Lee, Kendrick; Eng, Kevin; Malone, Kevin J.; Erol, Konul; Ponsen, Kornelis J.; Kabir, Koroush; Jeray, Kyle; Mica, Ladislav; Brunton, Lance M.; Adolfsson, Lars E.; Weiss, Lawrence; Katolik, Leonid; Paz, Lior; Poelhekke, Lodewijk M. S. J.; Escobar, Luis Felipe Naquira; Campinhos, Luiz Augusto B.; Abdel-Ghany, Mahmoud I.; Richard, Marc J. Richard; Swiontkowski, Marc; Rizzo, Marco; Pirpiris, Marinis; Boyer, Martin; Richardson, Martin; Kastelec, Matej; Turina, Matthias; Soong, Maximillian; Wood, Megan M.; Baskies, Michael; Behrman, Michael; Nancollas, Michael; Prayson, Michael; Quell, Michael; Verhofstad, Michael; Grafe, Michael W.; Kessler, Michael W.; van den Bekerom, Michel P. J.; van de Sande, Michiel A. J.; Mckee, Mike; Patel, Milan M.; Merchant, Milind; Tyllianakis, Minos; Wiegand, Mischa Ralph; Waseem, Mohammad; Parnes, Nata; Wilson, Neil; Elias, Nelson; Shortt, Nicholas L.; Schep, Niels; Semenkin, Oleg M.; Henry, Patrick D. G.; Martineau, Paul A.; Jebson, Peter; Kloen, Peter; Brink, Peter R. G.; Schandelmaier, Peter; Blazar, Philip; Streubel, Philipp N.; Vial, Philippe; Choudhari, Pradeep; Inna, Prashanth; Costanzo, Ralph M.; de Bedout, Ramon; Hauck, Randy; Smith, Raymond Malcolm; Fricker, Renato M.; Omid, Reza; Buckley, Richard; Jenkinson, Richard; Hutchison, Richard L.; GIlbert, Richard S.; Page, Richard S.; Nelissen, Rob; Haverlag, Robert; Wagenmakers, Robert; Pesantez, Rodrigo; Klinefelter, Ryan; Calfee, Ryan P.; Moghtaderi, Sam; Spruijt, Sander; Kakar, Sanjeev; Kaplan, Saul; Duncan, Scott F.; Mitchell, Scott; Rowinski, Sergio; Dodds, Seth; Kennedy, Stephen A.; Westly, Stephen K.; Kronlage, Steve; Beldner, Steven; McCabe, Steven J.; Rhemrev, Steven J.; Gosens, Taco; Baxamusa, Taizoon; Apard, Thomas; Dienstknecht, Thomas; Varecka, Thomas F.; Hughes, Thomas; Mittlmeier, Thomas; Pillukat, Thomas; Wright, Thomas; Havenhill, Timothy G.; Omara, Timothy; Siff, Todd; Giordano, Vincenzo; Hammert, Warren C.; Satora, Wojciech

    2013-01-01

    To evaluate the reliability and accuracy of diagnosis of scapholunate dissociation (SLD) among AO type C (compression articular) fractures of the distal radius. A total of 217 surgeons evaluated 21 sets of radiographs with type C fractures of the distal radius for which the status of the

  18. Development of biochemical heterogeneity of articular cartilage: Influences of age and exercise

    NARCIS (Netherlands)

    Brama, P.A.J.; Tekoppele, J.M.; Bank, R.A.; Barneveld, A.; Weeren, P.R. van

    2002-01-01

    The objective of this study was to document the development of biochemical heterogeneity from birth to maturity in equine articular cartilage, and to test the hypothesis that the amount of exercise during early life may influence this process. Neonatal foals showed no biochemical heterogeneity

  19. Treatment of extra-articular proximal and middle phalangeal fractures of the hand: a systematic review

    NARCIS (Netherlands)

    D. Verver (Daniëlle); L. Timmermans (Lucas); Klaassen, R.A.; C.H. van der Vlies (Cornelis); D.I. Vos (Dagmar); N.W.L. Schep (Niels)

    2017-01-01

    textabstractThe aim of the study was to systematically review the patient reported and functional outcomes of treatment for extra-articular proximal or middle phalangeal fractures of the hand in order to determine the best treatment options. The review methodology was registered with PROSPERO. A

  20. Accuracy of ultrasound-guided injections of thoracolumbar articular process joints in horses

    DEFF Research Database (Denmark)

    Fuglbjerg, Vibeke; Nielsen, J.V.; Thomsen, Preben Dybdahl

    2010-01-01

    in the literature. Objectives: To evaluate factors of affecting the accuracy of intra-articular injections of the APJs in the caudal thoracolumbar region. Method: One-hundred-and-fifty-four injections with blue dye were performed on APJs including the T14-L6 region in 12 horses subjected to euthanasia for reasons...

  1. The real-world effectiveness of vedolizumab on intestinal and articular outcomes in inflammatory bowel diseases.

    Science.gov (United States)

    Macaluso, Fabio Salvatore; Orlando, Rosalba; Fries, Walter; Scolaro, Mariangela; Magnano, Antonio; Pluchino, Dario; Cappello, Maria; Morreale, Gaetano Cristian; Siringo, Sebastiano; Privitera, Antonino Carlo; Ferracane, Concetta; Belluardo, Nunzio; Alberghina, Nadia; Ventimiglia, Marco; Rizzuto, Giulia; Renna, Sara; Cottone, Mario; Orlando, Ambrogio

    2018-03-01

    The effectiveness of vedolizumab in real-world practice is under evaluation, while its role in inflammatory bowel disease-associated spondyloarthritis is still unclear. To report real-world data about the effectiveness of vedolizumab on intestinal and articular symptoms after 10 and 22 weeks of treatment. Web-based data from the cohort of the Sicilian Network for Inflammatory Bowel Disease (SN-IBD) were extracted to perform a prospective multicentre observational study. 163 patients (84 with Crohn's disease and 79 with ulcerative colitis) were included. At week 10, a steroid-free remission was achieved in 71 patients (43.6%), while at week 22 a steroid-free remission was obtained in 40.8% of patients. A response on articular symptoms was reported after 10 weeks of treatment in 17 out of 43 (39.5%) patients with active spondyloarthritis at baseline, and in 10 out of 22 (45.4%) patients at week 22. The only factor associated with articular response was the coexistence of clinical benefit on intestinal symptoms (at week 10: OR 8.471, p = 0.05; at week 22: OR 5.600, p = 0.08). Vedolizumab showed good effectiveness after 10 and 22 weeks of treatment. A subset of patients reported improvement also on articular symptoms, probably as a consequence of the concomitant control of gut inflammation. Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  2. Cycloolefin-Copolymer/Polyethylene (COC/PE) Blend Assists with the Creation of New Articular Cartilage

    Czech Academy of Sciences Publication Activity Database

    Petrtýl, M.; Bastl, Zdeněk; Kruliš, Zdeněk; Hulejová, H.; Polanská, M.; Lísal, J.; Danešová, J.; Černý, P.

    294-I, - (2010), s. 120-132 ISSN 1022-1360 R&D Projects: GA ČR GA106/06/0761 Institutional research plan: CEZ:AV0Z40400503; CEZ:AV0Z40500505 Keywords : articular cartilage * biomaterials * cycloolefin-copolymer blend Subject RIV: CF - Physical ; Theoretical Chemistry

  3. Photoshop-based image analysis of canine articular cartilage after subchondral damage.

    Science.gov (United States)

    Lahm, A; Uhl, M; Lehr, H A; Ihling, C; Kreuz, P C; Haberstroh, J

    2004-09-01

    The validity of histopathological grading is a major problem in the assessment of articular cartilage. Calculating the cumulative strength of signal intensity of different stains gives information regarding the amount of proteoglycan, glycoproteins, etc. Using this system, we examined the medium-term effect of subchondral lesions on initially healthy articular cartilage. After cadaver studies, an animal model was created to produce pure subchondral damage without affecting the articular cartilage in 12 beagle dogs under MRI control. Quantification of the different stains was provided using a Photoshop-based image analysis (pixel analysis) with the histogram command 6 months after subchondral trauma. FLASH 3D sequences revealed intact cartilage after impact in all cases. The best detection of subchondral fractures was achieved with fat-suppressed TIRM sequences. Semiquantitative image analysis showed changes in proteoglycan and glycoprotein quantities in 9 of 12 samples that had not shown any evidence of damage during the initial examination. Correlation analysis showed a loss of the physiological distribution of proteoglycans and glycoproteins in the different zones of articular cartilage. Currently available software programs can be applied for comparative analysis of histologic stains of hyaline cartilage. After subchondral fractures, significant changes in the cartilage itself occur after 6 months.

  4. Histological and biochemical evaluation of perichondrial transplants in human articular cartilage defects

    NARCIS (Netherlands)

    Bouwmeester, P; Kuijer, R; Terwindt-Rouwenhorst, E; van der Linden, Ton; Bulstra, K

    1999-01-01

    From 1986 to 1992, 88 patients with articular defects in the knee were treated with a perichondrial arthroplasty. In this study, we report on the results for 22 biopsies of grafted tissue with a mean follow-up of 21 months. Biopsies were obtained at routine arthroscopy after approximately 1 year or

  5. Surgical treatment of a comminuted articular fracture of the accessory carpal bone in a thoroughbred horse

    International Nuclear Information System (INIS)

    Munroe, G.A.; Cauvin, E.

    1997-01-01

    The clinical, radiographic and ultrasonographic findings in a case ofa comminuted articular fracture of the accessory carpal bone of a thoroughbred chaser are described, and its surgical treatment and aftercare are detailed. The horse made an uneventful recovery and successfully returned to racing

  6. Direct Quantification of Solute Diffusivity in Agarose and Articular Cartilage Using Correlation Spectroscopy.

    Science.gov (United States)

    Shoga, Janty S; Graham, Brian T; Wang, Liyun; Price, Christopher

    2017-10-01

    Articular cartilage is an avascular tissue; diffusive transport is critical for its homeostasis. While numerous techniques have been used to quantify diffusivity within porous, hydrated tissues and tissue engineered constructs, these techniques have suffered from issues regarding invasiveness and spatial resolution. In the present study, we implemented and compared two separate correlation spectroscopy techniques, fluorescence correlation spectroscopy (FCS) and raster image correlation spectroscopy (RICS), for the direct, and minimally-invasive quantification of fluorescent solute diffusion in agarose and articular cartilage. Specifically, we quantified the diffusional properties of fluorescein and Alexa Fluor 488-conjugated dextrans (3k and 10k) in aqueous solutions, agarose gels of varying concentration (i.e. 1, 3, 5%), and in different zones of juvenile bovine articular cartilage explants (i.e. superficial, middle, and deep). In agarose, properties of solute diffusion obtained via FCS and RICS were inversely related to molecule size, gel concentration, and applied strain. In cartilage, the diffusional properties of solutes were similarly dependent upon solute size, cartilage zone, and compressive strain; findings that agree with work utilizing other quantification techniques. In conclusion, this study established the utility of FCS and RICS as simple and minimally invasive techniques for quantifying microscale solute diffusivity within agarose constructs and articular cartilage explants.

  7. The Effect of Preoperative Intra-Articular Methylprednisolone on Pain After TKA

    DEFF Research Database (Denmark)

    Luna, Iben E; Kehlet, Henrik; Jensen, Claus M

    2017-01-01

    In a randomized, double-blind, placebo controlled trial, we investigated the postoperative analgesic effect of a single intra-articular injection of 40 mg methylprednisolone acetate (MP) administered 1 week before total knee arthroplasty (TKA). Forty-eight patients with high pain osteoarthritis (...

  8. Intra-Articular Analgesia and Steroid Reduce Pain Sensitivity in Knee OA Patients

    DEFF Research Database (Denmark)

    Jørgensen, Tanja Schjødt; Graven-Nielsen, Thomas; Ellegaard, Karen

    2014-01-01

    before, immediately after, and two weeks after ultrasound guided intra-articular injection of lidocaine combined with glucocorticosteroid. Computer-controlled and manual pressure algometers were used to assess PPT on the knee, vastus lateralis, tibialis anterior, and the extensor carpi radialis longus...

  9. Stability of inter-joint coordination during circle drawing: Effects of shoulder-joint articular properties

    NARCIS (Netherlands)

    Bosga, J.; Meulenbroek, R.G.J.; Swinnen, S.P.

    2003-01-01

    The present study addressed the effect of articular conformity of the shoulder joint on the stability of inter-joint coordination during circular drawing movements. Twelve right-handed participants performed clockwise and counter-clockwise circular drawing movements at nine locations in the

  10. Intra-articular calcaneal fracture in a 14-year-old competing skier: case report.

    Science.gov (United States)

    Tudor, Anton; Sestan, Branko; Nemec, Boris; Prpic, Tomislav; Rubinic, Dusan

    2003-12-01

    Intra-articular calcaneal fracture as a skiing injury in children is extremely rare. We report on what we believe is a unique and previously unreported mechanism of a skiing injury, which caused intra-articular calcaneal fracture in a young competing skier, a member of the Croatian national ski team. This 14-year-old boy sustained a heel injury while training for giant slalom. There was no fall on the heel or obvious axial force that could have caused this type of calcaneal fracture. The skier had sophisticated equipment and used carving skies. We speculated that, when the skier tried to establish the lost balance during the fall, a violent contraction of triceps muscle occurred. Instead of an injury of a well-protected tuber or Achilles tendon, the strong pulling force of the Achilles tendon was transmitted more distally and anteriorly, generating axial compression force, which caused an intra-articular fracture of the calcaneus bone. Obviously, the existing ski boot did not sufficiently protect the calcaneus bone. We postulate that the calcaneal tuber and Achilles tendon were protected on the expense of the intra-articular calcaneal fracture. Our case warns of the possibility of a serious foot injury in young top skiers in spite of extensive improvement in the ski equipment. Sophisticated carving skis could be a contributing factor to an injury.

  11. Increasing lateral tibial slope: is there an association with articular cartilage changes in the knee?

    Energy Technology Data Exchange (ETDEWEB)

    Khan, Nasir; Shepel, Michael; Leswick, David A.; Obaid, Haron [University of Saskatchewan, Department of Medical Imaging, Royal University Hospital, and College of Medicine, Saskatoon, Saskatchewan (Canada)

    2014-04-15

    The geometry of the lateral tibial slope (LTS) plays an important role in the overall biomechanics of the knee. Through this study, we aim to assess the impact of LTS on cartilage degeneration in the knee. A retrospective analysis of 93 knee MRI scans (1.5 T or 3 T) for patients aged 20-45 years with no history of trauma or knee surgery, and absence of internal derangement. The LTS was calculated using the circle method. Chondropathy was graded from 0 (normal) to 3 (severe). Linear regression analysis was used for statistical analysis (p < 0.05). In our cohort of patients, a statistically significant association was seen between increasing LTS and worsening cartilage degenerative changes in the medial patellar articular surface and the lateral tibial articular surface (p < 0.05). There was no statistically significant association between increasing LTS and worsening chondropathy of the lateral patellar, medial trochlea, lateral trochlea, medial femoral, lateral femoral, and medial tibial articular surfaces. Our results show a statistically significant association between increasing LTS and worsening cartilage degenerative changes in the medial patella and the lateral tibial plateau. We speculate that increased LTS may result in increased femoral glide over the lateral tibial plateau with subsequent increased external rotation of the femur predisposing to patellofemoral articular changes. Future arthroscopic studies are needed to further confirm our findings. (orig.)

  12. Intra-articular injection of tenoxicam in osteoarthritic knee joints with effusion.

    Science.gov (United States)

    Oztuna, Volkan; Eskandari, Metin; Bugdayci, Resul; Kuyurtar, Fehmi

    2007-12-01

    Thirty patients who had grade II to III osteoarthritis according to Kellgren-Lawrence system and presenting with acute effusion of the knee joint were randomly assigned to 2 groups. All patients were treated with aspiration of the synovial fluid, cold application, and rest. Fifteen patients received an intra-articular injection of tenoxicam 20 mg following aspiration. The other group was administered oral tenoxicam 20 mg a day for 10 days. Patients were examined at 2, 4, and 8 weeks and then in 3-month intervals. At followup visits, pain was assessed using visual analog scale: range of motion, and effusion of the knee joint were recorded. A repeated measure test was used to determine the significance of changes in pain and mobility between the groups. Student's Neyman Keuls test was used to determine the significance of differences within the groups. Chi-square test was used for the number of episodes. The intra-articular injection group had more rapid pain relief than the oral treatment group (P < .01). At the end of 1 year, the number of effusions was significantly lower in the intra-articular treatment group (P < .01). These results indicate that intra-articular injection of tenoxicam provides rapid pain relief in the patients with acute flare-up of knee osteoarthritis and helps to prevent effusion.

  13. Porous polymers for repair and replacement of the knee joint meniscus and articular cartilage

    NARCIS (Netherlands)

    Klompmaker, Jan

    1992-01-01

    The studies presented here were initiated to answer a variety of questions concerning firstly the repair and replacement of the knee joint meniscus and, secondly, the repair of full-thickness defects of articular cartilage. AIMS OF THE STUDIES I To assess the effect of implantation of a porous

  14. Presence and mechanism of knee articular cartilage degeneration after meniscal reconstruction in dogs.

    NARCIS (Netherlands)

    Tienen, T. van; Heijkants, R.G.J.C.; Groot, J.H. de; Pennings, A.J.; Poole, A.R.; Veth, R.P.H.; Buma, P.

    2003-01-01

    OBJECTIVE: Partial meniscectomy is the golden standard for treating a bucket-handle tear in the meniscus of the knee, but it inevitably leads to articular cartilage degeneration. Surgical creation of an access channel between the lesion and the vascularized synovial lining is intended to induce

  15. Presence and mechanism of knee articular cartilage degeneration after meniscal reconstruction in dogs

    NARCIS (Netherlands)

    van Tienen, TG; Heijkants, RGJC; de Groot, JH; Pennings, AJ; Poole, AR; Veth, RPH; Buma, P

    Objective: Partial meniscectomy is the golden standard for treating a bucket-handle tear in the meniscus of the knee, but it inevitably leads to articular cartilage degeneration. Surgical creation of an access channel between the lesion and the vascularized synovial lining is intended to induce

  16. MRI of articular cartilaginous lesions. MRI findings in osteoarthritis of the knee joint

    International Nuclear Information System (INIS)

    Nozaki, Hiroyuki; Takezawa, Yuuichi; Suguro, Tohru; Igata, Atsuomi; Kudo, Yukihiko; Motegi, Mitsuo.

    1995-01-01

    An investigation was carried out to assess the usefulness of magnetic resonance imaging for imaging of the knee joint, especially for detecting articular cartilaginous lesions associated with osteoarthritis of the knee. A total of 141 patients with osteoarthritis were examined (23 males, 118 females). Their age range was 40-93 (mean age 66.2). Using radiotherapy examinations, patients were classified according to Hokkaido University Classification Criteria; 22, 49, 46, 16, and 8 patients were classified as Type I, II, III, IV and V, respectively. Articular cartilage defects were examined using MRI, and the number of such defects increased as the X-ray stage progressed. The appearance of a low signal intensity area in the bone marrow was examined using MRI, and the number of patients observed to have such areas increased as the x-ray stages progressed. JOA OA scores were significantly low for patients with meniscal tears. Patients were classified and results reviewed using MRI examinations. Classification by MRI of articular cartilage lesions correlated with the JOA OA scores. Low signal intensity areas in the bone marrow were frequently observed in advanced osteoarthritis cases, and there was correlation between FTA and MRI classifications of these areas. MRI is extremely valuable in detecting articular cartilage lesions in the knee joint, showing those lesions which cannot be detected by conventional radiography examinations. Thus, MRI is judged to be a clinically useful method for diagnosis of osteoarthritis. (author)

  17. Pure waterjet drilling of articular bone: an in vitro feasibility study.

    NARCIS (Netherlands)

    den Dunnen, Steven; Kraaij, Gert; Biskup, Christian; Kerkhoffs, Gino M. M. J.; Tuijthof, Gabriëlle J. M.

    2013-01-01

    The clinical application of waterjet technology for machining tough human tissues, such as articular bone, has advantages, as it produces clean sharp cuts without tissue heating. Additionally, water supply is possible via flexible tubing, which enables minimally invasive surgical access. This pilot

  18. Surgical treatment of intra-articular fractures of the distal part of the humerus

    NARCIS (Netherlands)

    Doornberg, Job N.; van Duijn, Pleun J.; Linzel, Durk; Ring, David C.; Zurakowski, David; Marti, Rene K.; Kloen, Peter

    2007-01-01

    Background: The short-term results of open reduction and internal fixation of intra-articular distal humeral fractures are good to excellent in approximately 75% of patients, but the long-term results have been less well studied. This investigation addressed the long-term clinical and radiographic

  19. The ultrastructure of the peri-articular osteophytes - an evaluation by ...

    African Journals Online (AJOL)

    The aim of this study was to offer a possible aetiology and or pathogenesis of this expendable yet important osteochondral tissue using the scanning electron microscopy to evaluate the structure of the cartilage mantle of osteophytes and the relationship of this mantle with that of the adjoining normal articular cartilage.

  20. Articular Cartilage Thickness Measured with US is Not as Easy as It Appears

    DEFF Research Database (Denmark)

    Torp-Pedersen, Søren; Bartels, E. M.; Wilhjelm, Jens E.

    2011-01-01

    Background: Theoretically, the high spatial resolution of US makes it well suited to monitor the decrease in articular cartilage thickness in osteoarthritis. A requirement is, however, that the borders of the cartilage are correctly identified and that the cartilage ismeasured under orthogonal...

  1. The effectiveness of hyaluronic acid intra-articular injections in managing osteoarthritic knee pain

    Science.gov (United States)

    Anand, A

    2013-01-01

    Introduction Knee osteoarthritis (OA) is a common and progressive joint disease. Treatment options for knee OA vary from simple analgesia in mild cases to knee replacement for advanced disease. Knee pain due to moderate OA can be targeted with intra-articular injections. Steroid injections have been used widely in managing acute flare-ups of the disease. In recent years, viscosupplementation has been used as a therapeutic modality for the management of knee OA. The principle of viscosupplementation is based on the physiological properties of the hyaluronic acid (HA) in the synovial joint. Despite a sound principle and promising in vitro studies, clinical studies have been less conclusive on the effectiveness of HA in managing osteoarthritic knee pain. The aim of this systematic review was to assess the effectiveness of HA intra-articular injections in the management of osteoarthritic knee pain. Methods A systematic review of the literature was performed using MEDLINE®, Embase™ and CINAHL® (Cumulative Index to Nursing and Allied Health Literature). The databases were searched for randomised controlled trials available on the effectiveness of HA intra-articular injections in managing osteoarthritic knee pain. Results The search yielded 188 studies. Of these, 14 met the eligibility criteria and were reviewed in chronological order. Conclusions HA intra-articular injections have a modest effect on early to moderate knee OA. The effect peaks at around 6–8 weeks following administration, with a doubtful effect at 6 months. PMID:24165334

  2. Tumoral calcinosis peri articular in infants: study by conventional radiology and CT

    International Nuclear Information System (INIS)

    Barrera, M.C.; Loyola, F.; Fernandez de Barrera, F.J.; Villanua, J.A.; Nogues, A.

    1994-01-01

    Tumoral calcinosis is an uncommon disease of poorly defined origin that effects the peri articular soft tissue. It is very rarely located in the region of the knee except in children. We present a case occurring in the knee in which the course of both the clinical and radiological signs was favorable. (Author)

  3. Adverse effects of extra-articular corticosteroid injections: A systematic review

    NARCIS (Netherlands)

    A. Brinks (Tineke); B.W. Koes (Bart); A.C. Volkers (Aloysius); J.A.N. Verhaar (Jan); S.M. Bierma-Zeinstra (Sita)

    2010-01-01

    textabstractBackground. To estimate the occurrence and type of adverse effects after application of an extra-articular (soft tissue) corticosteroid injection. Methods. A systematic review of the literature was made based on a PubMed and Embase search covering the period 1956 to January 2010. Case

  4. Is Mandibular Fossa Morphology and Articular Eminence Inclination Associated with Temporomandibular Dysfunction?

    Science.gov (United States)

    Paknahad, Maryam; Shahidi, Shoaleh; Akhlaghian, Marzieh; Abolvardi, Masoud

    2016-06-01

    Finding a significant relationship between temporomandibular joint (TMJ) morphology and the incidence of temporomandibular dysfunction (TMD) may help early prediction and prevention of these problems. The purpose of the present study was to determine the morphology of mandibular fossa and the articular eminence inclination in patients with TMD and in control group using cone beam computed tomography (CBCT). The CBCT data of bilateral TMJs of 40 patients with TMD and 23 symptom-free cases were evaluated. The articular eminence inclination, as well as the glenoid fossa depth and width of the mandibular fossa were measured. The paired t-test was used to compare these values between two groups. The articular eminence inclination and glenoid fossa width and depth were significantly higher in patients with TMD than in the control group (p < 0.05). The articular eminence inclination was steeper in patients with TMD than in the control group. Glenoid fossa width and depth were higher in patients with TMD than that in the control group. This information may shed light on the relationship between TMJ morphology and the incidence of TMD.

  5. Chicken collagen type II reduces articular cartilage destruction in a model of osteoarthritis in rats.

    Science.gov (United States)

    Xu, D; Shen, W

    2007-06-01

    To evaluate the therapeutic effects of domestic chicken collagen type II (CCII) on rat osteoarthritis (OA) and analyze concomitant changes in the level of Matrix metalloproteinase (MMP)-13, MMP-9, Cathepsin K and their mRNA as well as the tissue inhibitor of matrix metalloproteinase (TIMP)-1 mRNA in articular cartilage of osteoarthritic rats. Osteoarthritis models were surgically induced. Morphology of articular cartilage was done by haematoxylin and eosin staining and Mankin score was calculated, immunohistochemistry of MMP-13, MMP-9 and Cathepsin K was done by ABC method while the mRNA level for MMP-13, MMP-9, cathepsin K as well as TIMP-1 was evaluated by RT-PCR method. Oral administration of CCII reduced the morphological changes of osteoarthritic cartilage (shown by Mankin score), decreased levels of MMP-13, MMP-9, cathepsin K as well as their mRNA in articular cartilage from osteoarthritic rats while it exhibited no effect on TIMP-1 mRNA. Oral CCII reduced articular cartilage degradation of osteoarthritic rats and may probably be a potent drug candidate for OA treatment.

  6. Displaced Intra-articular Fractures of the Calcaneus: with an emphasis on minimally invasive surgery

    NARCIS (Netherlands)

    T. Schepers (Tim)

    2009-01-01

    textabstractDisplaced intra-articular calcaneal fractures are complex injuries. Classically these fractures are treated with open reduction and internal fixation (ORIF) or conservatively. When comparing these two treatment modalities, ORIF has a significantly higher rate of wound complications and

  7. Percutaneous Reduction and Screw Fixation of Displaced Intra-articular Fractures of the Calcaneus.

    Science.gov (United States)

    Tantavisut, Saran; Phisitkul, Phinit; Westerlind, Brian O; Gao, Yubo; Karam, Matthew D; Marsh, John L

    2017-04-01

    Extensile open approaches to reduce and fix intra-articular calcaneal fractures are associated with high levels of wound complications. To avoid these complications, a technique of percutaneous reduction and fixation with screws alone was developed. This study assessed the clinical outcomes, radiographs, and postoperative CT scans after operative treatment with this technique. 153 consecutive patients with 182 intra-articular calcaneal fractures were reviewed. All patients were assessed for early postoperative complications at 3 months from the injury. The clinical results were assessed for patients seen at a minimum of 1 year after surgery (mean follow-up of 2.6 years; 90 patients, 106 feet). In patients who had both preoperative and postoperative CT scans (50 patients, 60 feet), the articular reduction was quantitatively analyzed. At the 3-month follow-up, there were 1% superficial infections and 1% rate of screw irritation. The complications at a minimum of 1 year after injury included screw irritation 9.3%, subtalar osteoarthritis requiring subtalar fusion 5.5%, malunion 1.8%, and deep infection 0.9%. Bohler angle, calcaneal facet height, and width were significantly improved postoperatively ( P fractures using screws alone based on articular reduction and level of residual pain. Level IV, retrospective case series.

  8. Treatment of displaced intra-articular calcaneal fractures by ligamentotaxis: Current concepts' review

    NARCIS (Netherlands)

    T. Schepers (Tim); P. Patka (Peter)

    2009-01-01

    textabstractIntroduction: A large variety of therapeutic modalities for calcaneal fractures have been described in the literature. No single treatment modality for displaced intra-articular calcaneal fractures has proven superior over the other. This review describes and compares the different

  9. Intra-articular hyaluronic acid vs platelet-rich plasma in the treatment of hip osteoarthritis.

    Science.gov (United States)

    Di Sante, Luca; Villani, Ciro; Santilli, Valter; Valeo, Massimo; Bologna, Emmalisa; Imparato, Luca; Paoloni, Marco; Iagnocco, Annamaria

    2016-12-05

    To compare the efficacy of ultrasound-guided intra-articular (IA) treatment with platelet-rich plasma (PRP) versus viscosupplementation (hyaluronic acid HA) in hip osteoarthritis. METHODS: A total of 43 patients affected by monolateral severe hip osteoarthritis (OA) were included in the study. Patients were randomized to receive either intra-articular PRP (3 ml) or HA (30 mg/2 ml; 1,000-2,900 kDa), 3 injections in total - 1/week. Clinical assessments for each patient were made at baseline (T0), 4 (T1), and 16 weeks (T2) of follow-up. The primary efficacy outcome was pain reduction as measured by VAS and by WOMAC pain subscale. Data analysis revealed that, compared to T0, in the PRP-treated group VAS scores significantly decreased at T1 but not at T2, thereby indicating an early effect on pain which was not maintained at a longer term follow-up. In the HA group a significant decrease of both VAS and WOMAC values was registered only between T0 and T2. Intra-articular PRP had an immediate effect on pain that was not maintained at longer term follow-up when, on the contrary, the effects of intra-articular HA were evident.

  10. Efficacy and Safety of Methotrexate in Articular and Cutaneous Manifestations of systemic Lupus Erythematosus

    NARCIS (Netherlands)

    Islam, Nazrul; Hossain, Mohsin; Haq, Syed A.; Alam, Mohammad N.; ten Klooster, Peter M.; Rasker, Johannes J.

    2012-01-01

    Aim:  A prospective open-label study comparing the efficacy and safety of methotrexate (MTX) and chloroquine (CQ) in articular and cutaneous manifestations of systemic lupus erythematosus (SLE). Methods:  Consecutive SLE patients were randomly assigned to either 10 mg MTX weekly or 150 mg CQ daily

  11. Evaluation of influence of proteoglycans on hydration of articular cartilage with the use of ultrasound

    Directory of Open Access Journals (Sweden)

    Yi-yi YANG

    2015-04-01

    Full Text Available Objective To monitor the changes in hydration behaviour of articular cartilage induced by degradation of proteoglycans, and to explore the effect of proteoglycans on hydration behaviour of articular cartilage by using high-frequency ultrasound. Methods Twelve porcine patellae with smooth cartilage surface were prepared and equally divided into two groups: normal group without any enzyme treatment, and trypsin group they were treated with 0.25% trypsin for 8h to digest proteoglycan in the cartilage. The hydration behaviour of the cartilage tissue was scanned by high-frequency ultrasound system with a central frequency of 25MHz. Parameters including cartilage hydration strain and cartilage thickness were measured. The histopathological changes in the articular cartilage were observed under a light microscope. Results It took approximately 20min to reach equilibrium during the hydration process in the normal cartilages, while proteoglycan-degraded cartilage took only about 5min to achieve equilibrium. The equilibrium strain of normal cartilage was 3.5%±0.5%. The degradation of proteoglycans induced a significant decrease in equilibrium strain (1.8%±0.2%, P0.05. Conclusion Proteoglycans play an important role in hydration behaviour of articular cartilage. The degradation of proteoglycans could induce degeneration of cartilage structure and decrease in hydration behaviour after dehydration. DOI: 10.11855/j.issn.0577-7402.2015.03.03

  12. The role of type X collagen in facilitating and regulating endochondral ossification of articular cartilage.

    Science.gov (United States)

    Shen, G

    2005-02-01

    AUTHOR: Shen G Objective -This review was compiled to explore the role of type X collagen in growth, development and remodeling of articular cartilage by elucidating the linkage between the synthesis of this protein and the phenotypic changes in chondrogenesis and the onset of endochondral ossification. The current studies closely dedicated to elucidating the role of type X collagen incorporating into chondrogenesis and endochondral ossification of articular cartilage were assessed and analyzed to allow for obtaining the mainstream consensus on the bio-molecular mechanism with which type X collagen functions in articular cartilage. There are spatial and temporal correlations between synthesis of type X collagen and occurrence of endochondral ossification. The expression of type X collagen is confined within hypertrophic condrocytes and precedes the embark of endochondral bone formation. Type X collagen facilitates endochondral ossification by regulating matrix mineralization and compartmentalizing matrix components. Type X collagen is a reliable marker for new bone formation in articular cartilage. The future clinical application of this collagen in inducing or mediating endochondral ossification is perceived, e.g. the fracture healing of synovial joints and adaptive remodeling of madibular condyle.

  13. [Osteo-articular complications of sickle-cell-anemia in adult].

    Science.gov (United States)

    M'Bappé, Pauline; Girot, Robert

    2004-09-30

    Osteo-articular complications of sickle cell anaemia in adult are represented by bone marrow infarcts, osteomyelitis and osteonecrosis of femoral and humeral heads. The frequency and/or the severity of these complications provide a great functional disability in young patients whose life expectancy is growing. A well adapted treatment would may limit the sequels.

  14. Mechanical properties of the collagen network in human articular cartilage as measured by osmotic stress technique

    NARCIS (Netherlands)

    Basser, P.J.; Schneiderman, R.; Bank, R.A.; Wachtel, E.; Maroudas, A.

    1998-01-01

    We have used an isotropic osmotic stress technique to assess the swelling pressures of human articular cartilage over a wide range of hydrations in order to determine from these measurements, for the first time, the tensile stress in the collagen network, P(c), as a function of hydration. Osmotic

  15. Age-related accumulation of Maillard reaction products in human articular cartilage collagen

    NARCIS (Netherlands)

    Verzijl, N.; Degroot, J.; Oldehinkel, E.; Bank, R. A.; Thorpe, S. R.; Baynes, J. W.; Bayliss, M. T.; Bijlsma, J. W.; Lafeber, F. P.; TeKoppele, J. M.

    2000-01-01

    Non-enzymic modification of tissue proteins by reducing sugars, the so-called Maillard reaction, is a prominent feature of aging. In articular cartilage, relatively high levels of the advanced glycation end product (AGE) pentosidine accumulate with age. Higher pentosidine levels have been associated

  16. A comparison of analgesic effect of intra-articular levobupivacaine with bupivacaine following knee arthroscopy

    International Nuclear Information System (INIS)

    Karaman, Yucel; Bor, Canan; Kayali, Cemil; Ozturk, Hasan; Kaya, Ahmet

    2009-01-01

    To compare the postoperative analgesic effects of intra-articular levobupivacaine with bupivacaine following knee arthroscopy. Forty patients, aged between 20-60 years and undergoing elective knee arthroscopy were enrolled into the study protocol that was carried out in Tepecik Education and Research Hospital, Izmir, Turkey between January and June 2007. General anesthesia protocol was the same in all patients. At the end of surgery, the patients were randomly assigned into 2 groups (n=20 in each group). Group L received 20 ml 0.5% levobupivacaine and Group B received 20 ml 0.5% bupivacaine intra-articularly. We evaluated the level of postoperative pain (by visual analoque scale at 1, 2, 4, 6, 12, and 24 hours after surgery), first analgesic requirement time (period measured from the end of the surgery until further analgesia was demanded), and total analgesic consumption during 24 hours. There were no significant difference in the postoperative pain scores of the patients between groups. The first analgesic requirement times were not statistically different. Twelve patients in Group L (60%) and 9 patients in Group B (45%) needed no additional analgesic during the 24 hours (p>0.05). No complications and side effects were found related to the intra-articular treatment. The results of the study show that intra-articular 20 ml 0.5% levobupivacaine provides effective analgesia comparable to that provided by 20 ml 0.5% bupivacaine. (author)

  17. Treatment of displaced intra-articular calcaneal fractures with closed reduction and percutaneous screw fixation

    NARCIS (Netherlands)

    Tomesen, T.; Biert, J.; Frolke, J.P.M.

    2011-01-01

    BACKGROUND: Surgical treatment of displaced intra-articular fractures of the calcaneus is a standard procedure in many institutions. To avoid soft-tissue complications, several minimally invasive procedures have recently been introduced. The aim of this study was to assess the percutaneous treatment

  18. Chondrogenic differentiation of human articular chondrocytes differs in biodegradable PGA/PLA scaffolds

    DEFF Research Database (Denmark)

    Zwingmann, Joern; Mehlhorn, Alexander T; Südkamp, Norbert

    2007-01-01

    Cartilage tissue engineering is applied clinically to cover and regenerate articular cartilage defects. Two bioresorbable nonwoven scaffolds, polyglycolic acid (PGA) and poly(lactic-co-glycolic acid) (PLGA) (90/10 copolymer of L-lactide and glycolide), were seeded with human chondrocytes after...

  19. Pharmacokinetics of triamcinolone acetonide following intramuscular and intra-articular administration to exercised Thoroughbred horses.

    Science.gov (United States)

    Knych, H K; Vidal, M A; Casbeer, H C; McKemie, D S

    2013-11-01

    The use of triamcinolone acetonide (TA) in performance horses necessitates establishing appropriate withdrawal times prior to performance. To describe the plasma pharmacokinetics of TA and time-related urine and synovial fluid concentrations following i.m. and intra-articular administration to exercised Thoroughbred horses. Block design. Twelve racing fit adult Thoroughbred horses received a single i.m. administration of TA (0.1 mg/kg bwt). After an appropriate washout period, the same horses then received a single intra-articular TA administration (9 mg) into the right antebrachiocarpal joint. Blood, urine and synovial fluid samples were collected prior to, and at various times, up to 60 days post drug administration and analysed using liquid chromatography-mass spectrometry. Plasma data were analysed using noncompartmental analysis. Maximum measured plasma TA concentrations were 0.996 ± 0.391 at 13.2 h and 1.27 ± 0.278 ng/ml at 6.5 h for i.m. and intra-articular administration, respectively. The plasma terminal elimination half-life was 11.4 ± 6.53 and 0.78 ± 1.00 days for i.m. and intra-articular administration, respectively. Following i.m. administration, TA was below the limit of detection (LOD) by Days 52 and 60 in plasma and urine, respectively. Following intra-articular administration TA was undetectable by Day 7 in plasma and Day 8 in urine. Triamcinolone acetonide was also undetectable in any of the joints sampled following i.m. administration and remained above the limit of quantitation (LOQ) for 21 days following intra-articular administration. This study extends previous studies describing the pharmacokinetics of TA following i.m. and intra-articular administration to the horse and suggests that plasma and urine concentrations are not a good indicator of synovial fluid concentrations. Furthermore, results of this study supports an extended withdrawal time for TA given i.m. © 2013 EVJ Ltd.

  20. Prevalence and characteristics of pneumatized articular tubercle: First large series in Iranian people

    Energy Technology Data Exchange (ETDEWEB)

    Shokri, Abbas; Noruzi-Gangachin, Marruf [Dept. of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan (Iran, Islamic Republic of); Baharvand, Maryam; Mortazavi, Hamed [Dept. of Oral and Maxillofacial Medicine, Dental School, Shahid Beheshti University of Medical Sciences, Tehran (Iran, Islamic Republic of)

    2013-12-15

    This study was performed to determine the prevalence and characteristics of pneumatized articular tubercle or eminence among a defined group of Iranian people. Digital panoramic radiographs of 1694 patients in the Department of Oral and Maxillofacial Radiology, Hamadan Dental School, Iran were evaluated retrospectively to detect the above lesion. Finally, 1563 radiographs were selected according to inclusion criteria. Then, a review was done of 10 large case series found using a MEDLINE search of the literature. Chi-squared test was used to analyze the differences in variables such as age, gender, laterality, and locularity in our case series. The average age of our samples was 32.6±7.63 years. Pneumatized articular tubercle was found in 98 cases, representing a prevalence of 6.2% with a mean age of 22.8±7.9 and a range of 8 to 60 years. Sixty-four (65.3%) pneumatized articular tubercles were unilateral, with 30 lesions on the right and 34 on the left side. Bilateral lesions were found in 34 (34.7%) patients. 52 (53.06%) of the pneumatized articular tubercles were of the unilocular type and 46 (46.94%) were multilocular. The results showed no statistically significant differences regarding age (p=0.454), gender (p=0.634), laterality (p=0.252), or locularity (p=0.807) among the samples. Among ten large case series from other countries, the prevalence of pneumatized articular tubercle (6.2%) in Iranian patients was higher than that of all eight of the case series that used the same detection method as the present study of panoramic radiography.

  1. Identification of stable normalization genes for quantitative real-time PCR in porcine articular cartilage.

    Science.gov (United States)

    McCulloch, Ryan S; Ashwell, Melissa S; O'Nan, Audrey T; Mente, Peter L

    2012-11-12

    Expression levels for genes of interest must be normalized with an appropriate reference, or housekeeping gene, to make accurate comparisons of quantitative real-time PCR results. The purpose of this study was to identify the most stable housekeeping genes in porcine articular cartilage subjected to a mechanical injury from a panel of 10 candidate genes. Ten candidate housekeeping genes were evaluated in three different treatment groups of mechanically impacted porcine articular cartilage. The genes evaluated were: beta actin, beta-2-microglobulin, glyceraldehyde-3-phosphate dehydrogenase, hydroxymethylbilane synthase, hypoxanthine phosphoribosyl transferase, peptidylprolyl isomerase A (cyclophilin A), ribosomal protein L4, succinate dehydrogenase flavoprotein subunit A, TATA box binding protein, and tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein-zeta polypeptide. The stability of the genes was measured using geNorm, BestKeeper, and NormFinder software. The four most stable genes measured via geNorm were (most to least stable) succinate dehydrogenase flavoprotein, subunit A, peptidylprolyl isomerase A, glyceraldehyde-3-phosphate dehydrogenase, beta actin; the four most stable genes measured via BestKeeper were glyceraldehyde-3-phosphate dehydrogenase, peptidylprolyl isomerase A, beta actin, succinate dehydrogenase flavoprotein, subunit A; and the four most stable genes measured via NormFinder were peptidylprolyl isomerase A, succinate dehydrogenase flavoprotein, subunit A, glyceraldehyde-3-phosphate dehydrogenase, beta actin. BestKeeper, geNorm, and NormFinder all generated similar results for the most stable genes in porcine articular cartilage. The use of these appropriate reference genes will facilitate accurate gene expression studies of porcine articular cartilage and suggest appropriate housekeeping genes for articular cartilage studies in other species.

  2. Effectiveness of intra-articular lidocaine injection for reduction of anterior shoulder dislocation: randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Marcel Jun Sugawara Tamaoki

    Full Text Available CONTEXT AND OBJECTIVE: Shoulder dislocation is the most common dislocation among the large joints. The aim here was to compare the effectiveness of reduction of acute anterior shoulder dislocation with or without articular anesthesia. DESIGN AND SETTING: Prospective randomized trial conducted in Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp. METHODS: From March 2008 to December 2009, 42 patients with shoulder dislocation were recruited. Reductions using traction-countertraction for acute anterior shoulder dislocation with and without lidocaine articular anesthesia were compared. As the primary outcome, pain was assessed through application of a visual analogue scale before reduction, and one and five minutes after the reduction maneuver was performed. Complications were also assessed. RESULTS: Forty-two patients were included: 20 in the group without analgesia (control group and 22 in the group that received intra-articular lidocaine injection. The group that received intra-articular lidocaine had a statistically greater decrease in pain over time than shown by the control group, both in the first minute (respectively: mean 2.1 (0 to 5.0, standard deviation, SD 1.3, versus mean 4.9 (2.0 to 7.0, SD 1.5; P < 0.001 and the fifth minute (respectively: mean 1.0; 0 to 3.0; SD = 1.0 versus mean 4.0; 1.0 to 6.0; SD = 1.4; P < 0.001. There was one failure in the control group. There were no other complications in either group. CONCLUSION: Reduction of anterior shoulder dislocation using intra-articular lidocaine injection is effective, since it is safe and diminishes the pain. CLINICAL TRIAL REGISTRATION: ISRCTN27127703.

  3. Effects of Chondroitinase ABC-Mediated Proteoglycan Digestion on Decellularization and Recellularization of Articular Cartilage.

    Directory of Open Access Journals (Sweden)

    Catherine A Bautista

    Full Text Available Articular cartilage has a limited capacity to heal itself and thus focal defects often result in the development of osteoarthritis. Current cartilage tissue engineering strategies seek to regenerate injured tissue by creating scaffolds that aim to mimic the unique structure and composition of native articular cartilage. Decellularization is a novel strategy that aims to preserve the bioactive factors and 3D biophysical environment of the native extracellular matrix while removing potentially immunogenic factors. The purpose of this study was to develop a procedure that can enable decellularization and recellularization of intact articular cartilage matrix. Full-thickness porcine articular cartilage plugs were decellularized with a series of freeze-thaw cycles and 0.1% (w/v sodium dodecyl sulfate detergent cycles. Chondroitinase ABC (ChABC was applied before the detergent cycles to digest glycosaminoglycans in order to enhance donor chondrocyte removal and seeded cell migration. Porcine synovium-derived mesenchymal stem cells were seeded onto the decellularized cartilage scaffolds and cultured for up to 28 days. The optimized decellularization protocol removed 94% of native DNA per sample wet weight, while collagen content and alignment were preserved. Glycosaminoglycan depletion prior to the detergent cycles increased removal of nuclear material. Seeded cells infiltrated up to 100 μm into the cartilage deep zone after 28 days in culture. ChABC treatment enhances decellularization of the relatively dense, impermeable articular cartilage by reducing glycosaminoglycan content. ChABC treatment did not appear to affect cell migration during recellularization under static, in vitro culture, highlighting the need for more dynamic seeding methods.

  4. Evaluation of articular cartilage degeneration with contrast-enhanced magnetic resonance imaging

    International Nuclear Information System (INIS)

    Fujioka, Mikihiro

    1994-01-01

    The evaluation of glycosaminoglycan (GAG) concentration is important in the clinical diagnosis of articular cartilage degeneration. Glycosaminoglycan provides a large number of fixed negative charges. When manganese ion (Mn 2+ ) is administered to the cartilage matrix, this cation diffuses into the matrix and accumulates in accordance with the distribution of fixed negative charges owing to the electrostatic interaction. The accumulation of Mn 2+ causes a shortening of the relaxation times, resulting in high signal intensity in the MR image, when a T 1 -weighted image is obtained. The present study applied this new method to the articular cartilage to evaluate the degree of the cartilage degeneration. Small pieces of articular cartilage were dissected from the knee joints of young chickens. Experimentally degenerated articular cartilage was obtained by treating the specimen with various concentrations of papain solution. Then specimens were soaked in manganese solution until they obtained equilibrium and served for MR microimaging. The fixed charge density (FCD), the concentration of Mn 2+ and Na + , T 1 and T 2 relaxation times were also measured. In degenerated cartilage, lower accumulation of Mn 2+ due to lower GAG density caused a lower than normal signal intensity. Thus, administration of Mn 2+ enhances the biochemical change in the cartilage matrix in terms of differences in the relaxation time. The actual signal intensity on MRI of each specimen corresponded to the theoretical signal intensity, which was calculated from the FCD. It was concluded that MR images taken with contrast enhancement by Mn 2+ give direct visual information about the GAG density in the articular cartilage. MRI with cationic contrast agent could develop into a new method for early non-invasive diagnosis of cartilage dysfunction and degeneration. (author)

  5. A risk-benefit assessment of intra-articular corticosteroids in rheumatic disorders.

    Science.gov (United States)

    Hunter, J A; Blyth, T H

    1999-11-01

    The appeal of intra-articular corticosteroid therapy has increased with the growing emphasis on early disease control in rheumatoid disease. The impact on the patient's pain and stiffness is impressive and prompt. This may encourage patient compliance with longer term therapies given to slow the course of the disease. The release of corticosteroid into the circulation also provides some generalised improvement. This can prove helpful during the management of flares of inflammatory disease. There is less evidence to support the use of intra-articular corticosteroids in other inflammatory arthritides, but experience suggests that the benefits are similar. In osteoarthritis the benefits are less certain, but intra-articular therapy may prove important in patients who cannot undergo salvage operative procedures because of intercurrent illness. The benefits of intra-articular corticosteroids may be enhanced by rest after the injection, or by the additional administration of agents such as radio-colloids, rifampicin (rifampin), or osmic acid. Most controlled trial data have been published on knee injections, but other joints can be useful targets for local therapy. The risks are mainly related to the discomfort of the procedure, localised pain post-injection and flushing, but most feared is septic arthritis which probably occurs in about 1 in 10000 injections. Careful aseptic technique is the best protection. Tissue atrophy at the injection site, abnormal uterine bleeding, hypertension and hyperglycaemia rarely cause problems. Osteonecrosis might be as much a problem with uncontrolled painful arthritis as with a joint rendered less symptomatic by corticosteroid injections. Intra-articular corticosteroids form an important part of the management of inflammatory joint disease and might be considered where an inflammatory element occurs in osteoarthritis. They may be used at any stage in the arthritic process, but should be seen as an adjunct to other forms of symptom

  6. Modeling the transport of cryoprotective agents in articular cartilage for cryopreservation

    Science.gov (United States)

    Torqabeh, Alireza Abazari

    Loading vitrifiable concentrations of cryoprotective agents is an important step for cryopreservation of biological tissues by vitrification for research and transplantation purposes. This may be done by immersing the tissue in a cryoprotective agent (CPA) solution, and increasing the concentration, continuously or in multiple steps, and simultaneously decreasing the temperature to decrease the toxicity effects of the cryoprotective agent on the tissue cellular system. During cryoprotective agent loading, osmotic water movement from the tissue to the surrounding solution, and the resultant tissue shrinkage and stress-strain in the tissue matrix as well as on the cellular system can significantly alter the outcome of the cryopreservation protocol. In this thesis, a biomechanical model for articular cartilage is developed to account for the transport of the cryoprotective agent, the nonideal-nondilute properties of the vitrifiable solutions, the osmotic water movement and the resultant tissue shrinkage and stress-strain in the tissue matrix, and the osmotic volume change of the chondrocytes, during cryoprotective agent loading in the cartilage matrix. Four essential transport parameters needed for the model were specified, the values of which were obtained uniquely by fitting the model to experimental data from porcine articular cartilage. Then, it was shown that using real nonuniform initial distributions of water and fixed charges in cartilage, measured separately in this thesis using MRI, in the model can significantly affect the model predictions. The model predictions for dimethyl sulfoxide diffusion in porcine articular cartilage were verified by comparing to spatially and temporally resolved measurements of dimethyl sulfoxide concentration in porcine articular cartilage using a spectral MRI technique, developed for this purpose and novel to the field of cryobiology. It was demonstrated in this thesis that the developed mathematical model provides a novel tool

  7. Symposium: evidence for the use of intra-articular cortisone or hyaluronic acid injection in the hip

    Science.gov (United States)

    Chandrasekaran, Sivashankar; Lodhia, Parth; Suarez-Ahedo, Carlos; Vemula, S. Pavan; Martin, Timothy J.; Domb, Benjamin G.

    2016-01-01

    The primary purpose of this review article is to discuss the role of diagnostic, corticosteroid, hyaluronic acid (HA) and platelet rich plasma (PRP) in the treatment of osteoarthritis (OA) and femoroacetabular impingement (FIA). These treatments play an important biological role in the non-operative management of these conditions. Two independent reviewers performed an search of PubMed for articles that contained at least one of the following search terms pertaining to intra-articular hip injection—local anaesthetic, diagnostic, ultrasound, fluoroscopic, image guided, corticosteroid, HA, PRP, OA, labral tears and FAI. Seventy-two full text articles were suitable for inclusion. There were 18 articles addressing the efficacy of diagnostic intra-articular hip injections. With respect to efficacy in OA there were 25 articles pertaining to efficacy of corticosteroid, 22 of HA and 4 of PRP. There were three articles addressing the efficacy of biologics in FAI. Diagnostic intra-articular hip injections are sensitive and specific for differentiating between intra-articular, extra-articular and spinal causes of hip symptoms. Ultrasound and fluoroscopy improves the precision of intra-articular positioning of diagnostic injections. Corticosteroids are more effective than HA and PRP in alleviating pain from hip OA. A higher dose of corticosteroids produces a longer benefit but volume of injection has no significant effect. Intra-articular corticosteroids do not increase infection rates of subsequent arthroplasty. There is currently limited evidence to warrant the routine use of therapeutic injections in the management of labral tears and FIA. PMID:27026814

  8. The Use of an Intra-Articular Depth Guide in the Measurement of Partial Thickness Rotator Cuff Tears

    Directory of Open Access Journals (Sweden)

    Michael J. Carroll

    2013-01-01

    Full Text Available Purpose. The purpose of this study was to compare the accuracy of the conventional method for determining the percentage of partial thickness rotator cuff tears to a method using an intra-articular depth guide. The clinical utility of the intra-articular depth guide was also examined. Methods. Partial rotator cuff tears were created in cadaveric shoulders. Exposed footprint, total tendon thickness, and percentage of tendon thickness torn were determined using both techniques. The results from the conventional and intra-articular depth guide methods were correlated with the true anatomic measurements. Thirty-two patients were evaluated in the clinical study. Results. Estimates of total tendon thickness (r = 0.41, P = 0.31 or percentage of thickness tears (r = 0.67, P = 0.07 using the conventional method did not correlate well with true tendon thickness. Using the intra-articular depth guide, estimates of exposed footprint (r = 0.92, P = 0.001, total tendon thickness (r = 0.96, P = 0.0001, and percentage of tendon thickness torn (r = 0.88, P = 0.004 correlated with true anatomic measurements. Seven of 32 patients had their treatment plan altered based on the measurements made by the intra-articular depth guide. Conclusions. The intra-articular depth guide appeared to better correlate with true anatomic measurements. It may be useful during the evaluation and development of treatment plans for partial thickness articular surface rotator cuff tears.

  9. Surgical Indications and Technique for Anterior Cruciate Ligament Reconstruction Combined with Lateral Extra-articular Tenodesis or Anterolateral Ligament Reconstruction.

    Science.gov (United States)

    Vundelinckx, Bart; Herman, Benjamin; Getgood, Alan; Litchfield, Robert

    2017-01-01

    After anterior cruciate ligament (ACL) rupture, anteroposterior and rotational laxity in the knee causes instability, functional symptoms, and damage to other intra-articular structures. Surgical reconstruction aims to restore the stability in the knee, and to improve function and ability to participate in sports. It also protects cartilage and menisci from secondary injuries. Because of persistent rotational instability after ACL reconstruction, combined intra-articular and extra-articular procedures are more commonly performed. In this article, an overview of anatomy, biomechanical studies, current gold standard procedures, techniques, and research topics are summarized. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Secondary knee instability caused by fracture of the stabilizing insert in a dual-articular total knee

    DEFF Research Database (Denmark)

    Boesen, Morten P; Jensen, Tim Toftgaard; Husted, Henrik

    2004-01-01

    A case of a fractured polyethylene stabilizing insert causing secondary knee instability in a Dual-articular total knee arthroplasty (TKA) is presented. A 65-year-old woman who underwent surgery with a Dual-articular TKA 4 years earlier had a well-functioning prosthesis until a fall, after which...... she began complaining of an intermittent, audible clicking; pain; and instability. At surgery, a fractured polyethylene peg was discovered, and the tibial insert was replaced. At follow-up, she remains asymptomatic. This is the first description of a fractured stabilizing insert in a Dual......-articular knee....

  11. Micro- and Nano-Carrier Mediated Intra-Articular Drug Delivery Systems for the Treatment of Osteoarthritis

    International Nuclear Information System (INIS)

    Zhang, Z.; Huang, G.

    2012-01-01

    The objective of this paper is to provide readers with current developments of intra-articular drug delivery systems. In recent years, although the search for a clinically successful ideal carrier is ongoing, sustained-release systems, such as polymeric micro- and nanoparticles, liposomes, and hydrogels, are being extensively studied for intra-articular drug delivery purposes. The advantages associated with long-acting preparations include a longer effect of the drug in the action site and a reduced risk of infection due to numerous injections consequently. This paper discusses the recent developments in the field of intra-articular sustained-release delivery systems for the treatment of osteoarthritis

  12. Actividad fibrinolítica sinovial en caballos adultos y potros con patología articular

    OpenAIRE

    Ribera Townsend, Thaïs

    2013-01-01

    La patología articular en el caballo provoca, a corto o largo plazo, cojera en el caballo y es motivo de importantes pérdidas económicas en el mundo deportivo ecuestre. La fisiopatología articular en el caballo comporta una serie de procesos biopatológicos que, si no se detectan y tratan a tiempo, generan un ciclo catabólico autodestructivo que induce la degradación de los propios tejidos articulares. Estudios de medicina humana hace tiempo que han demostrado mediante la determinación de marc...

  13. A new building block: costo-osteochondral graft for intra-articular incongruity after distal radius fracture.

    Science.gov (United States)

    Tang, Chris Yuk Kwan; Fung, Boris; Poon, T L; Fok, Margaret

    2014-01-01

    Even with the invention of locking plates, intra-articular fractures of distal radius with extreme comminution remain a challenge for orthopaedic surgeons. Osteochondral graft is a potential choice to reconstruct the articular defect. We report a patient who had a fracture of distal radius with costo-osteochondral graft for articular reconstruction which has not yet been described in the English literature. At nine-year follow-up, he was pain free and had full range of movement of the wrist. The authors suggest that costo-osteochondral graft could be an option with satisfactory result.

  14. metastase cervicale d'un adenome pleomorphe cervical metastasis ...

    African Journals Online (AJOL)

    tic demeure bon. Cependant, les risques évolutifs de cette tumeur, avec un potentiel létal non négligeable, impose une surveillance régulière et prolongée des adénomes pléo- morphes opérés, surtout en cas de récidives locales. Un traitement initial adéquat de l'AP, consistant en une paroti- dectomie exofaciale ou totale ...

  15. tuberculose lymphonodale cervicale chez les enfants vaccines par ...

    African Journals Online (AJOL)

    The purpose of this work was to study the diagnostic and therapeutic features in children vaccinated with BCG. Material and Methods: Our study is retrospective including 23 cases of lymph ... nocturnes et de fébricule ont été retrouvés chez 1 patient qui présentait une localisation pulmonaire synchrone. A l'hémogramme ...

  16. le traitement de la tuberculose ganglionnaire cervicale a propos de ...

    African Journals Online (AJOL)

    Cependant, le traitement d'une affection aussi répandue dans le monde ne fait pas consensus. L'objectif de cette étude est de préciser, .... La récidive ganglionnaire après la fin du traitement a été observée chez 16 malades (4,4%) dont 4 ... ser à l'échelle nationale ce régime par rapport à celui de. 9 mois dans la population ...

  17. Spondylodiscite cervicale en consultation rhumatologique à Lomé ...

    African Journals Online (AJOL)

    ... outpatients in Lomé (Togo) The authors report the epidemiological and clinical features of 12 cases of cervical localization of spondylodiscitis. This survey reveals the rarity of this localization in spite of the importance of the spine localization of the infections in Lomé. Keys words: Africa, neck pain, spinal infection, Togo.

  18. tuberculose lymphonodale cervicale chez les enfants vaccines par ...

    African Journals Online (AJOL)

    dernière décennie, la fréquence des localisations extrapul- monaires semble en augmentation (2). L'objectif de ce tra- vail est de préciser les caractéristiques cliniques ainsi que .... cas, mais une culture positive des bacilles de Koch a été retrouvée chez 4 ... évidence des Bacille acido-alcoolo résistant (BAAR) à l'exa-.

  19. adenopathies cervicales metastatiques d'un carcinome non retrouve

    African Journals Online (AJOL)

    La tomodensitométrie cervico-faciale est actuellement systématique lors de la recherche du pri- mitif (12-13,20). Elle permet de détecter les lésions qui ne sont pas accessibles à l'examen clinique et endosco- pique : Les lésions nasopharyngées sous muqueuses, une néoplasie primaire au niveau de la base de la langue.

  20. Rehabilitation after arthroscopic repair of intra-articular disorders of the hip in a professional football athlete.

    Science.gov (United States)

    Philippon, Marc J; Christensen, Jesse C; Wahoff, Michael S

    2009-02-01

    To report the 4-phase rehabilitation progression of a professional athlete who underwent arthroscopic intra-articular repair of the hip after injury during the 2006-07 season. Case study; level of evidence, 4. Objective values were obtained by standard goniometric measurements, handheld dynamometer, dynamic sports testing, and clinical testing for intra-articular pathology. This case report illustrates improvements in hip mobility, muscle-force output, elimination of clinical signs of intra-articular involvement, and ability to perform high-level sport-specific training at 9 wk postsurgery. At 16 wk postsurgery, the patient was able to return to full preparation for sport for the following season. After the 4-phase rehabilitation program, the patient demonstrated improvement in all areas of high-level function after an arthroscopic intra-articular repair of the hip. The preoperative management to return to sport is outlined, with clinical outcomes and criteria for return to competition.

  1. Combination of optical coherence tomography and near infrared spectroscopy enhances determination of articular cartilage composition and structure

    NARCIS (Netherlands)

    Sarin, Jaakko K; Rieppo, Lassi; Brommer, Harold; Afara, Isaac O.; Saarakkala, Simo; Töyräs, Juha

    2017-01-01

    Conventional arthroscopic evaluation of articular cartilage is subjective and poorly reproducible. Therefore, implementation of quantitative diagnostic techniques, such as near infrared spectroscopy (NIRS) and optical coherence tomography (OCT), is essential. Locations (n = 44) with various

  2. Human papillomavirus genotypes in women with cervical cytological abnormalities from an area with high incidence of cervical cancer Genotipos de virus papiloma humano en mujeres con alteraciones citológicas cervicales de un área con alta incidencia de cáncer cervical

    Directory of Open Access Journals (Sweden)

    Gerardo Daniel Deluca

    2004-02-01

    Full Text Available It has been well demonstrated the relationship between the infection with high-risk human papillomavirus (HPVs genotypes and cervical cancer. In Northeastern Argentina a high incidence of this pathology has been described and therefore a high prevalence of HPV infection is expected. In order to identify HPV genotypes associated with malignant and pre-malignant cervical lesions present in the area, 53 ecto-endo cervical cell specimens obtained from women with cytohistological alterations were studied by a PCR-RFLP technique. Out of 53 patients, 34 (64.2% were positive for HPV infection, being HPV-16 (32.3% the most frequently found genotype, followed by HPV-58 (14.7%, -6, -18 and -45 (5.9%, -33, -52, -53, -54, -56, -66, -MM4 and -LVX100 (2.9%. Also 5 cases of infection caused by multiple genotypes were found, which corresponded to 14.7% of the positive cases. Results indicate that besides HPV-16 and -18, the most prevalent high-risk HPV genotypes worldwide, others like -45 and -58 as well as co-infection cases are frequent between women of Northeastern Argentina, and a particular attention should be paid to this circumstance because it could be an epidemiological feature of regional importance and a useful information for a future vaccination program.La relación entre la infección por los virus papiloma humanos (HPVs de alto riesgo y el cáncer de cuello de útero ha sido bien demostrada. En el Nordeste de Argentina se observa una alta incidencia de esta patología y en consecuencia se estima una alta prevalencia de infección por HPV. A fin de identificar los genotipos de HPV presentes en el área, asociados a casos de lesiones malignas y premalignas de cuello de útero, se estudiaron 53 muestras ecto-endo cervicales de mujeres con alteraciones citohistológicas residentes permanentes de las ciudades de Resistencia y Corrientes. De las 53 pacientes estudiadas, 34 resultaron positivas para HPV (64.2%, correspondiendo la mayor frecuencia a HPV

  3. Clinical characteristics of pain originating from intra-articular structures of the knee joint in patients with medial knee osteoarthritis

    OpenAIRE

    Ikeuchi, Masahiko; Izumi, Masashi; Aso, Koji; Sugimura, Natsuki; Tani, Toshikazu

    2013-01-01

    Purpose Although disease progression of osteoarthritis has been well documented, pain pathophysiology is largely unknown. This study was designed with two purposes: 1) to characterize patients with knee pain predominantly originating from intra-articular structures and 2) to describe the location and pattern of their pain. Materials and methods 103 patients with medial knee osteoarthritis underwent an intra-articular injection of local anesthetics (joint block). At least 70% pain relief was d...

  4. Relative volume measured with magnetic resonance imaging is an articular collapse predictor in hematological pediatric patients with femoral head osteonecrosis.

    Science.gov (United States)

    Ippolito, Davide; Masetto, Alessandro; Talei Franzesi, Cammillo; Bonaffini, Pietro A; Casiraghi, Alessandra; Sironi, Sandro

    2016-08-28

    To assess the potential value of femoral head (FH) volume measurements to predict joint collapse, as compared to articular surface involvement, in post-treatment osteonecrosis (ON) in pediatric patients affected by lymphoproliferative diseases. Considering 114 young patients with lymphoproliferative diseases undergone a lower-limbs magnetic resonance imaging (MRI) examination between November 2006 and August 2012 for a suspected post-treatment ON, we finally considered a total of 13 cases (7 males, mean age 15.2 ± 4.8 years), which developed a FH ON lesions (n = 23). The MRI protocol included coronal short tau inversion recovery and T1-weighted sequences, from the hips to the ankles. During the follow-up (elapsed time: 9.2 ± 2 mo), 13/23 FH articular surface (FHS) developed articular deformity. The first MRI studies with diagnosis of ON were retrospectively analyzed, measuring FH volume (FHV), FHS, ON volume (ONV) and the articular surface involved by ON (ONS). The relative involvement of FHS, in terms of volume [relative volume (RV): ONV/FHV] and articular surface [relative surface (RS): ONS/FHS], was then calculated. By using receiver operating characteristic curve analysis (threshold of 23% of volume involvement), RV predicted articular deformity in 13/13 FHS [sensitivity 100%, specificity 90%, accuracy 95%, positive predictive value (PPV) 93%, negative predictive value (NPV) 100%]. Considering a threshold of 50% of articular involvement, RS predicted articular deformity in 10/13 femoral heads (sensitivity 77%, specificity 100%, accuracy 87%, PPV 100%, NPV 77%). RV might be a more reliable parameter than RS in predicting FH deformity and could represent a potential complementary diagnostic tool in the follow-up of femoral heads ON lesions.

  5. The effect of intra-articular hyaluronate and tramadol injection on patients with adhesive capsulitis of the shoulder.

    Science.gov (United States)

    Kim, Kyung-Hee; Suh, Jung-Woo; Oh, Ki Young

    2017-08-03

    Local administration of opioids causes effective analgesia without adverse effects related to the central nervous system. After the beneficial demonstration of peripheral opioid receptors in joint synovia, intra-articular opioid injections were used for pain treatment. Clinical studies have reported the safety and efficacy of hyaluronate injection in the shoulder joint of patients with osteoarthritis, periarthritis, rotator cuff tears, and adhesive capsulitis. To estimate the efficacy of intra-articular hyaluronate and tramadol injection for adhesive capsulitis of the shoulder compared with that of intra-articular hyaluronate injection alone. Thirty patients with adhesive capsulitis of the shoulder were randomized to the hyaluronate group (n= 16) or the tramadol group (n= 14). Hyaluronate group members were administered five weekly intra-articular hyaluronate injections; tramadol group members were administered three weekly intra-articular hyaluronate and tramadol injections and then two weekly intra-articular injections of hyaluronate. Visual Analog Scale (VAS), passive range of motion (PROM) of the shoulder joint, and Shoulder Pain and Disability Index (SPADI) scores were assessed at baseline and weeks 1, 2, 3, 4, and 6 after the initial injection. A significant improvement was observed in VAS, PROM, and SPADI scores between time points in both groups. In comparison in both groups at weeks 1 and 2 after the initial injection the VAS scores of the tramadol group were significantly lower than those of the hyaluronate group. Intra-articular hyaluronate with tramadol showed more rapid and strong analgesic effects than intra-articular hyaluronate alone and did not induce any adverse effects.

  6. Combined nanoindentation testing and scanning electron microscopy of bone and articular calcified cartilage in an equine fracture predilection site

    OpenAIRE

    M Doube; EC Firth; A Boyde; AJ Bushby

    2010-01-01

    Condylar fracture of the third metacarpal bone (Mc3) is the commonest cause of racetrack fatality in Thoroughbred horses. Linear defects involving hyaline articular cartilage, articular calcified cartilage (ACC) and subchondral bone (SCB) have been associated with the fracture initiation site, which lies in the sagittal grooves of the Mc3 condyle. We discovered areas of thickened and abnormally-mineralised ACC in the sagittal grooves of several normal 18-month-old horses, at the same site tha...

  7. Geometry of the articular facets of the lateral atlanto-axial joints in the case of occipitalization.

    Science.gov (United States)

    Ryniewicz, A M; Skrzat, J; Ryniewicz, A; Ryniewicz, W; Walocha, J

    2010-08-01

    This study investigates if atlanto-occipital fusion affects the size and geometrical configuration of the articular facets of the atlanto-axial joint. Morphometric analysis was performed on the male adult skull, the occipital bone of which is assimilated with the first cervical vertebrae (the atlas). The perimeter, Feret's diameter, surface area, and circularity of the inferior articular fa-cets were measured. However, we did not observe significant bilateral differences in size of the inferior articular facets of the assimilated atlas compared to normal first cervical vertebrae. Geometrical conformation of the articular facets of the atlas and axis was assessed using a coordinate measuring machine (PMM - 12106, Leitz). The results obtained from this machine indicated that the inferior articular facets of the assimilated atlas presented asymmetrical orientation compared to the normal anatomy of the atlas. Hence, in the case of occipitalization, the gap between the articulating facets of the atlas and the axis was measured to be greater than in the normal atlanto-axial joint. Computer assisted tomography was applied to visualise the anatomical relationship between the inferior articular facets of the assimilated atlas and the corresponding facets located on the axis. In this case, radiographic examination revealed that the bilaterally articulating facets (inferior and superior) showed disproportion in their adjustment within the lateral atlanto-axial joints. Thus, we concluded that the fusion of the atlas with the occipital bone altered the geometry of the inferior articular facets of the atlas and influenced the orientation of the superior articular facets of the axis.

  8. Tendinopathy of the long head of the biceps tendon: histopathologic analysis of the extra-articular biceps tendon and tenosynovium

    OpenAIRE

    Shishani, Yousef; Streit,Jonathan; Rodgers,Mark; Gobezie,Reuben

    2015-01-01

    Jonathan J Streit,1 Yousef Shishani,1 Mark Rodgers,2 Reuben Gobezie1 1The Cleveland Shoulder Institute, 2Department of Pathology, University Hospitals of Cleveland, Cleveland, OH, USA Background: Bicipital tendinitis is a common cause of anterior shoulder pain, but there is no evidence that acute inflammation of the extra-articular long head of the biceps (LHB) tendon is the root cause of this condition. We evaluated the histologic findings of the extra-articular portion of the LHB tendon an...

  9. Morphological Study of the Proximal Fibular Articular Surface Using Computed Tomography: Which Side Is Preferred for Proximal Fibular Flap in Wrist Arthroplasty?

    Science.gov (United States)

    Lee, Jae Hoon; Chung, Duke Whan; Baek, Jong Hun; Kim, Young Jun; Park, So Young

    2017-02-01

    Background  Although proximal fibular flaps have been widely applied in wrist arthroplasty, controversy remains regarding which side of the proximal fibula is better for reconstruction of the distal radius. If the articular surface of the proximal fibula shows dorsal tilting, the ipsilateral (right) proximal fibula should be harvested in right wrist arthroplasty because the articular surface of the distal radius normally has volar tilt. This study investigated anatomical similarities between the proximal fibular articular surface and the distal radius articular surface based on morphologic analysis of the proximal fibula using computed tomography (CT). Methods  A total of 18 proximal fibulae from 18 adult volunteers were analyzed using CT. Tilt and length of the proximal fibular articular surface were measured in the section plane parallel to the proximal tibiofibular articular surface (simulated sagittal plane). The inclination angle of the articular surface was measured in the section plane perpendicular to the proximal tibiofibular articular surface (simulated coronal plane). Results  In the simulated sagittal plane, the articular surface of the proximal fibula showed a mean dorsal tilt of 4.1 degrees; the articular surface for each scan was 17.1 mm. In the simulated coronal plane, two articular surfaces were studied. The inclination angle of these surfaces was measured as 32.2 and 54.4 degrees, respectively. Conclusion  CT analysis of the proximal fibular articular surfaces suggested that ipsilateral proximal fibular transfer can result in improved anatomic restoration of normal volar tilt of the distal radius due to dorsal tilt of the proximal fibular articular surface. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  10. Andrographolide Enhances Proliferation and Prevents Dedifferentiation of Rabbit Articular Chondrocytes: An In Vitro Study

    Directory of Open Access Journals (Sweden)

    Li-ke Luo

    2015-01-01

    Full Text Available As the main active constituent of Andrographis paniculata that was applied in treatment of many diseases including inflammation in ancient China, andrographolide (ANDRO was found to facilitate reduction of edema and analgesia in arthritis. This suggested that ANDRO may be promising anti-inflammatory agent to relieve destruction and degeneration of cartilage after inflammation. In this study, the effect of ANDRO on rabbit articular chondrocytes in vitro was investigated. Results showed that not more than 8 μM ANDRO did no harm to chondrocytes (P0.05. The viability assay, hematoxylin-eosin, safranin O, and immunohistochemical staining also showed better performances in ANDRO groups. As to the doses, 3 μM ANDRO showed the best performance. The results indicate that ANDRO can accelerate proliferation of rabbit articular chondrocytes in vitro and meanwhile maintain the phenotype, which may provide valuable references for further exploration on arthritis.

  11. [Cutaneous atrophy and hypopigmentation secondary to intra-articular corticosteroid injection].

    Science.gov (United States)

    Loarte Pasquel, E P; Cabal García, A A

    2014-04-01

    Epicondylitis is the most common disease of the elbow. It is a tendinitis caused, in most cases, by repetitive motion of the forearm extensor muscles, and belongs to the group of occupational diseases that are related to work activity or sport. Intra-articular injections of glucocorticoids are often used by dermatologists, rheumatologists, orthopaedic surgeons, and primary care due to their ease of administration. However, this procedure has potential side effects. There are a limited number of case reports describing atrophy and hypopigmentation of the skin as a side effect. The general indications for glucocorticoid injections are monofocal and multifocal inflammatory disease, multifocal articular or soft tissue disease. It is more often used in more severe monofocal or multifocal inflammation, failure of drug treatment and/or rehabilitatory when other treatments are contraindicated. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  12. Large Intra-Articular Anterior Cruciate Ligament Ganglion Cyst, Presenting with Inability to Flex the Knee

    Directory of Open Access Journals (Sweden)

    Jake Sloane

    2010-01-01

    Full Text Available A 41-year-old female presented with a 3-month history of gradually worsening anterior knee pain, swelling and inability to flex the knee. Magnetic resonance imaging (MRI revealed a large intra-articular cystic swelling anterior to the anterior cruciate ligament (ACL, extending into the Hoffa's infrapatellar fat pad. Following manipulation under anaesthesia and arthroscopic debridement of the cyst, the patient's symptoms were relieved with restoration of normal knee motion. ACL ganglion cysts are uncommon intra-articular pathological entities, which are usually asymptomatic and diagnosed incidentally by MRI. This is the first reported case of an ACL cyst being so large as to cause a mechanical block to knee flexion.

  13. Optical characterization of porcine articular cartilage using a polarimetry technique with differential Mueller matrix formulism.

    Science.gov (United States)

    Chang, Ching-Min; Lo, Yu-Lung; Tran, Nghia-Khanh; Chang, Yu-Jen

    2018-03-20

    A method is proposed for characterizing the optical properties of articular cartilage sliced from a pig's thighbone using a Stokes-Mueller polarimetry technique. The principal axis angle, phase retardance, optical rotation angle, circular diattenuation, diattenuation axis angle, linear diattenuation, and depolarization index properties of the cartilage sample are all decoupled in the proposed analytical model. Consequently, the accuracy and robustness of the extracted results are improved. The glucose concentration, collagen distribution, and scattering properties of samples from various depths of the articular cartilage are systematically explored via an inspection of the related parameters. The results show that the glucose concentration and scattering effect are both enhanced in the superficial region of the cartilage. By contrast, the collagen density increases with an increasing sample depth.

  14. Soft tissues and osteo-articular infections in HIV-infected patients and other immunodeficient states.

    Science.gov (United States)

    Espinoza, L R; Berman, A

    1999-03-01

    Soft tissue and osteo-articular infections are rarely seen in patients with HIV infection and other immunodeficiency states. When present in HIV-infected patients, they tend to occur in the presence of low CD4(+)cell counts, intravascular indwelling catheters, extra-articular infection and trauma, and in intravenous drug users and haemophiliacs. A wide spectrum of clinical manifestations is seen, ranging from cellulitis and soft tissue abscesses to septic arthritis and pyomyositis. In general, the clinical picture and response to therapy is similar to that of patients without HIV infection. Causal micro-organisms are also similar to those in non-HIV populations, Staphylococcus aureus being the most common aetiological agent. Copyright 1999 Harcourt Publishers Ltd.

  15. Intra-articular temperatures of the knee in sports - an in-vivo study of jogging and alpine skiing.

    Science.gov (United States)

    Becher, Christoph; Springer, Jan; Feil, Sven; Cerulli, Guiliano; Paessler, Hans H

    2008-04-11

    Up to date, no information exists about the intra-articular temperature changes of the knee related to activity and ambient temperature. In 6 healthy males, a probe for intra-articular measurement was inserted into the notch of the right knee. Each subject was jogging on a treadmill in a closed room at 19 degrees C room temperature and skiing in a ski resort at -3 degrees C outside temperature for 60 minutes. In both conditions, temperatures were measured every fifteen minutes intra-articulary and at the skin surface of the knee. A possible influence on joint function and laxity was evaluated before and after activity. Statistical analysis of intra-articular and skin temperatures was done using nonparametric Wilcoxon's sign rank sum test and Mann-Whitney's-U-Test. Median intra-articular temperatures increased from 31.4 degrees C before activity by 2.1 degrees C, 4 degrees C, 5.8 degrees C and 6.1 degrees C after 15, 30, 45 and 60 min of jogging (all p jogging), the median intra-articular temperature was 19.6% (8.7%) higher than the skin surface temperature at the knee. Joint function and laxity appeared not to be different before and after activity within both groups. This study demonstrates different changes of intra-articular and skin temperatures during sports in jogging and alpine skiing and suggests that changes are related to activity and ambient temperature.

  16. Quantitative and temporal differential recovery of articular and muscular limitations of knee joint contractures; results in a rat model.

    Science.gov (United States)

    Trudel, Guy; Laneuville, Odette; Coletta, Elizabeth; Goudreau, Louis; Uhthoff, Hans K

    2014-10-01

    Joint contractures alter the mechanical properties of articular and muscular structures. Reversibility of a contracture depends on the restoration of the elasticity of both structures. We determined the differential contribution of articular and muscular structures to knee flexion contractures during spontaneous recovery. Rats (250, divided into 24 groups) had one knee joint surgically fixed in flexion for six different durations, from 1 to 32 wk, creating joint contractures of various severities. After the fixation was removed, the animals were left to spontaneously recover for 1 to 48 wk. After the recovery periods, animals were killed and the knee extension was measured before and after division of the transarticular posterior muscles using a motorized arthrometer. No articular limitation had developed in contracture of recent onset (≤2 wk of fixation, P > 0.05); muscular limitations were responsible for the majority of the contracture (34 ± 8° and 38 ± 6°, respectively; both P contractures of recent onset (1 and 2 wk of fixation, respectively). Long-lasting contractures (≥4 wk of fixation) presented articular limitations, irreversible in all 12 durations of recovery compared with controls (all 12 P contractures of recent onset were primarily due to muscular structures, and they were reversible during spontaneous recovery. Long-lasting contractures were primarily due to articular structures and were irreversible. Comprehensive temporal and quantitative data on the differential reversibility of mechanically significant alterations in articular and muscular structures represent novel evidence on which to base clinical practice. Copyright © 2014 the American Physiological Society.

  17. The effects of captive versus wild rearing environments on long bone articular surfaces in common chimpanzees (Pan troglodytes

    Directory of Open Access Journals (Sweden)

    Kristi L. Lewton

    2017-08-01

    Full Text Available The physical environments of captive and wild animals frequently differ in substrate types and compliance. As a result, there is an assumption that differences in rearing environments between captive and wild individuals produce differences in skeletal morphology. Here, this hypothesis is tested using a sample of 42 captive and wild common chimpanzees (Pan troglodytes. Articular surface areas of the humerus, radius, ulna, femur, and tibia were calculated from linear breadth measurements, adjusted for size differences using Mosimann shape variables, and compared across sex and environmental groups using two-way ANOVA. Results indicate that the articular surfaces of the wrist and knee differ between captive and wild chimpanzees; captive individuals have significantly larger distal ulna and tibial plateau articular surfaces. In both captive and wild chimpanzees, males have significantly larger femoral condyles and distal radius surfaces than females. Finally, there is an interaction effect between sex and rearing in the articular surfaces of the femoral condyles and distal radius in which captive males have significantly larger surface areas than all other sex-rearing groups. These data suggest that long bone articular surfaces may be sensitive to differences experienced by captive and wild individuals, such as differences in diet, body mass, positional behaviors, and presumed loading environments. Importantly, these results only find differences due to rearing environment in some long bone articular surfaces. Thus, future work on skeletal morphology could cautiously incorporate data from captive individuals, but should first investigate potential intraspecific differences between captive and wild individuals.

  18. Correlation between radiographic findings of osteoarthritis and arthroscopic findings of articular cartilage degeneration within the patellofemoral joint

    Energy Technology Data Exchange (ETDEWEB)

    Kijowski, Richard; Blankenbaker, Donna; Stanton, Paul; De Smet, Arthur [University of Wisconsin Hospital Clinical Science Center-E3/311, Department of Radiology, Madison, WI (United States); Fine, Jason [University of Wisconsin Clinical Science Center-K6/4675, Department of Statistics, Madison, WI (United States)

    2006-12-15

    To correlate radiographic findings of osteoarthritis on axial knee radiographs with arthroscopic findings of articular cartilage degeneration within the patellofemoral joint in patients with chronic knee pain. The study group consisted of 104 patients with osteoarthritis of the patellofemoral joint and 30 patients of similar age with no osteoarthritis of the patellofemoral joint. All patients in the study group had an axial radiograph of the knee performed prior to arthroscopic knee surgery. At the time of arthroscopy, each articular surface of the patellofemoral joint was graded using the Noyes classification system. Two radiologists retrospectively reviewed the knee radiographs to determine the presence of marginal osteophytes, joint-space narrowing, subchondral sclerosis, and subchondral cysts. The sensitivity and specificity of the various radiographic features of osteoarthritis for the detection of articular cartilage degeneration within the patellofemoral joint were determined. The sensitivity of marginal osteophytes, joint-space narrowing, subchondral sclerosis, and subchondral cysts for the detection of articular cartilage degeneration within the patellofemoral joint was 73%, 37%, 4%, and 0% respectively. The specificity of marginal osteophytes, joint-space narrowing, subchondral sclerosis, and subchondral cysts for the detection of articular cartilage degeneration within the patellofemoral joint was 67%, 90%, 100%, and 100% respectively. Marginal osteophytes were the most sensitive radiographic feature for the detection of articular cartilage degeneration within the patellofemoral joint. Joint-space narrowing, subchondral sclerosis, and subchondral cysts were insensitive radiographic features of osteoarthritis, and rarely occurred in the absence of associated osteophyte formation. (orig.)

  19. The effectiveness of 2 consecutive intra-articular polydeoxyribonucleotide injections compared with intra-articular triamcinolone for hemiplegic shoulder pain: A STROBE-complaint retrospective study.

    Science.gov (United States)

    Park, Donghwi; Yu, Kwang Jae; Cho, Ju Young; Woo, Seung Beom; Park, Junu; Lee, Zeeihn; Kim, Jong Min

    2017-11-01

    The aim of this study was to investigate the effects of intra-articular injection of polydeoxyribonucleotide (PDRN), compared with intraarticular triamcinolone (TA) injection, in subacute stroke patients with hemiplegic shoulder pain (HSP).Participants were subacute stroke patients with HSP who had undergone 2 consecutive intra-articular injections of TA or PDRN.Numeric rating scale (NRS) and passive range of motion (PROM) of hemiplegic shoulder were evaluated until 4 weeks after 2nd injection.In the results, there were significant improvements in all PROM measures 2 weeks after the second injection, compared with pre-injection results, in both groups (P < .05). In the PDRN group, however, none of the PROM measures were significantly improved at 3 and 4 weeks after the second injection, compared with pre-injection results (P ≥ .05). When comparing pre-injection results with those at 4 weeks after the second injection, all PROM and NRS measures in the TA group were more improved than in the PDRN group, but this was not statistically significant (P ≥ .05).In conclusion, considering the systemic side effects of steroids, especially among patients with diabetes or metabolic syndrome, PDRN seems to be a worthwhile treatment option for HSP, although PDRN does not seem to have an equivalent persistence effects when compared with TA.

  20. Rehabilitación ocluso-articular en un paciente bruxópata Occlusal-articular rehabilitation in a patient with bruxism

    Directory of Open Access Journals (Sweden)

    José Miguel Montero Parrilla

    2011-09-01

    Full Text Available Se realizó la presentación del caso de un paciente masculino de 68 años de edad que acudió a la Consulta de Trastornos Temporomandibulares de la Facultad de Estomatología de La Habana, por presentar problemas estéticos y dificultades masticatorias. Durante la anamnesis y el examen físico se observaron facetas de desgastes oclusales, disminución de la dimensión vertical y prominencias óseas asociadas al bruxismo. Se realizó la discusión del caso y el tratamiento seguido para su rehabilitación ocluso-articular. El resultado final fue la restauración de la estética y la función.This is the presentation of the case of a male patient aged 68 came to our consultation of temporomandibular disorders of the Stomatology Faculty of Ciudad de La Habana due to esthetic problems and mastication difficulty. During anamnesis and physical examination it was possible to note occlusal wear facets, decrease of vertical dimension and bone prominences associated with bruxism. Case was discussed and treatment was followed for its occlusal-articular rehabilitation. Final result was the restoration of esthetics and function.

  1. Intra-articular injection of dexketoprofen in rat knee joint : Histopathologic assessment of cartilage & synovium

    Directory of Open Access Journals (Sweden)

    Aycan Guner Ekici

    2014-01-01

    Full Text Available Background & objectives: Effective pain control following outpatient surgical procedures is an important aspect of patient discharge. This study was carried out with an aim to investigate the histopathological effects of intra-articular dexketoprofen trometamol injection in knee joint on synovium and cartilage in an experimental rat model. Methods: In each of 40 rats, the right knee was designated as the study group and the left knee as the control group (NS group. Under aseptic conditions, 35 rats received an injection of 0.25 ml (6.25 mg dexketoprofen trometamol into the right knee joint and an injection of 0.25 ml 0.9 per cent normal saline solution into the left knee joint. On the 1 st , 2 nd , 7 th , 14 th , and 21 st days after intra-articular injection, rats in specified groups were sacrificed by intraperitoneal injection of 120 mg/kg sodium thiopental. Knee joints were separated and sectioned for histopathological examination. Inflammatory changes in the joints were recorded according to a grade scale. Results: No significant difference in terms of pathological changes both in synovium and cartilage was observed between the NS group and the study group on days 1, 2, 7, 14 and 21 after intra-articular injection of dexketoprofen or saline in the knee joint. Interpretation & conclusions: The findings showed no evidence of significant histopathological damage to the cartilage and synovia for a period up to 21 days following intra-articular administration of dexketoprofen trometamol in the knee joints of rats.

  2. Finite element simulation of articular contact mechanics with quadratic tetrahedral elements.

    Science.gov (United States)

    Maas, Steve A; Ellis, Benjamin J; Rawlins, David S; Weiss, Jeffrey A

    2016-03-21

    Although it is easier to generate finite element discretizations with tetrahedral elements, trilinear hexahedral (HEX8) elements are more often used in simulations of articular contact mechanics. This is due to numerical shortcomings of linear tetrahedral (TET4) elements, limited availability of quadratic tetrahedron elements in combination with effective contact algorithms, and the perceived increased computational expense of quadratic finite elements. In this study we implemented both ten-node (TET10) and fifteen-node (TET15) quadratic tetrahedral elements in FEBio (www.febio.org) and compared their accuracy, robustness in terms of convergence behavior and computational cost for simulations relevant to articular contact mechanics. Suitable volume integration and surface integration rules were determined by comparing the results of several benchmark contact problems. The results demonstrated that the surface integration rule used to evaluate the contact integrals for quadratic elements affected both convergence behavior and accuracy of predicted stresses. The computational expense and robustness of both quadratic tetrahedral formulations compared favorably to the HEX8 models. Of note, the TET15 element demonstrated superior convergence behavior and lower computational cost than both the TET10 and HEX8 elements for meshes with similar numbers of degrees of freedom in the contact problems that we examined. Finally, the excellent accuracy and relative efficiency of these quadratic tetrahedral elements was illustrated by comparing their predictions with those for a HEX8 mesh for simulation of articular contact in a fully validated model of the hip. These results demonstrate that TET10 and TET15 elements provide viable alternatives to HEX8 elements for simulation of articular contact mechanics. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Fluid collections and juxta-articular cystic lesions of the shoulder: spectrum of MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Mellado, J.M.; Salvado, E.; Camins, A.; Ramos, A.; Sauri, A. [Institut de Diagnostic per la Imatge, Hospital Joan XXIII, Tarragona (Spain); Merino, X. [Institut de Diagnostic per la Imatge, Hospital Vall' Ebron, Barcelona (Spain); Calmet, J. [Orthopaedic Surgery, Hospital Joan XXIII, Carrer Doctor Mallafre Guasch, Tarragona (Spain)

    2002-03-01

    The MR imaging features of fluid collections and juxta-articular cystic lesions of the shoulder are discussed, with special focus on those related to subacromial impingement and rotator cuff tears. Other more unusual fluid collections and cystic lesions are described, including rice-bodies bursitis, idiopathic synovial osteochondromatosis, dialysis-related amyloid arthropathy, hemophilic arthropathy, infectious conditions, non-infectious inflammatory arthritis, and paralabral cysts. (orig.)

  4. Magnetic resonance imaging of articular cartilage abnormalities of the far posterior femoral condyle of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Ogino, Shuhei; Huang, Thomas; Watanabe, Atsuya; Iranpour-Boroujeni, Tannaz; Yoshioka, Hiroshi (Dept. of Radiology, Brigham and Women' s Hospital, Boston, MA (United States)), e-mail: hiroshi@uci.edu

    2010-01-15

    Background: Incidental articular cartilage lesions of the far posterior femoral condyle (FPFC) are commonly detected. Whether or not these cartilage lesions are symptomatic or clinically significant is unknown. Purpose: To characterize and assess prevalence of articular cartilage abnormalities of the FPFC and associated bone marrow edema (BME) and/or internal derangements through magnetic resonance (MR) images. Material and Methods: 654 knee MR examinations were reviewed retrospectively. Sagittal fast spin-echo proton density-weighted images with and without fat suppression were acquired with a 1.5T scanner, and were evaluated by two readers by consensus. The following factors were assessed: 1) the prevalence of cartilage abnormalities, 2) laterality, 3) the type of cartilage abnormalities, 4) cartilage abnormality grading, 5) associated BME, 6) complications such as meniscal injury and cruciate ligament injury, and 7) knee alignment (femorotibial angle [FTA]). Results: Articular cartilage abnormalities of the FPFC were demonstrated in 157 of the 654 patients (24%). Of these, 40 patients demonstrated medial and lateral FPFC cartilage abnormalities and were thus counted as 80 cases. Focal lateral FPFC abnormalities were demonstrated in 117 of 197 cases (59.4%), while diffuse lateral FPFC abnormalities were demonstrated in 24 of 197 cases (12.2%). Focal medial FPFC abnormalities were demonstrated in 23 of 197 cases (11.6%), while diffuse medial FPFC abnormalities were demonstrated in 33 of 197 cases (16.8%). No statistically significant pattern of associated BME, FTA, or internal derangements including meniscal and cruciate ligament injury was demonstrated. Conclusion: Articular cartilage abnormalities of the FPFC are common and were demonstrated in 24% of patients or 30% of cases. Lateral FPFC abnormalities occur 2.5 times more frequently than medial FPFC abnormalities and were more frequently focal compared with medial cohorts. BME is associated in 36.5% of cases

  5. A Clinically Realistic Large Animal Model of Intra-Articular Fracture

    Science.gov (United States)

    2013-10-01

    calcaneus to the talus via the tripod pins. The talus is driven into the anterior portion of the tibia causing an intra-articular fracture extending...scans (0.3mm x 0.3mm x 1mm voxels) were acquired prior to fracture (baseline) and 12 weeks after index surgery. The outer cortex of the distal tibia ...posterior epiphyseal bone of the fracture case to the intact surface while temporarily disregarding deviations resulting from the fracture . The

  6. Operative treatment of intra-articular calcaneal fractures with calcaneal plates and its complications

    Directory of Open Access Journals (Sweden)

    Rak Vaclav

    2009-01-01

    Full Text Available Background: In a retrospective study we analysed intra-articular calcaneal fracture treatment by comparing results and complications related to fracture stabilization with nonlocking calcaneal plates and locking compression plates. Materials and Methods: We performed 76 osteosynthesis (67 patients of intra-articular calcaneal fractures using the standard extended lateral approach from February 2004 to October 2007. Forty-two operations using nonlocking calcaneal plates (group A were performed during the first three years, and 34 calcaneal fractures were stabilized using locking compression plates (group B in 2007. In the Sanders type IV fractures, reconstruction of the calcaneal shape was attempted. Depending on the type of late complication, we performed subtalar arthroscopy in six cases, arthroscopically assisted subtalar distraction bone block arthrodesis in six cases, and plate removal with lateral-wall decompression in five cases. The patients were evaluated by the AOFAS Ankle-Hindfoot Scale. Results: Wound healing complications were 7/42 (17% in group A and 1/34 (3% in group B. No patient had deep osseous infection or foot rebound compartment syndrome. Preoperative size of Bφhler´s angle correlated with postoperative clinical results in both groups. There were no late complications necessitating corrective procedure or arthroscopy until December 2008 in Group B. All late complications ccurred in Group A. The overall results according to the AOFAS Ankle Hindfoot Scale were good or excellent in 23/42 (55% in group A and in 30/34 (85% in group B. Conclusion: Open reduction and internal fixation of intra-articular calcaneal fractures has become a standard surgical method. Fewer complications and better results related to treatment with locking compression plates confirmed in comparison to nonlocking ones were noted for all Sanders types of intra-articular calcaneal fractures. Age and Sanders type IV fractures are not considered to be the

  7. Freeze-thaw treatment effects on the dynamic mechanical properties of articular cartilage

    Directory of Open Access Journals (Sweden)

    Muldrew Ken

    2010-10-01

    Full Text Available Abstract Background As a relatively non-regenerative tissue, articular cartilage has been targeted for cryopreservation as a method of mitigating a lack of donor tissue availability for transplant surgeries. In addition, subzero storage of articular cartilage has long been used in biomedical studies using various storage temperatures. The current investigation studies the potential for freeze-thaw to affect the mechanical properties of articular cartilage through direct comparison of various subzero storage temperatures. Methods Both subzero storage temperature as well as freezing rate were compared using control samples (4°C and samples stored at either -20°C or -80°C as well as samples first snap frozen in liquid nitrogen (-196°C prior to storage at -80°C. All samples were thawed at 37.5°C to testing temperature (22°C. Complex stiffness and hysteresis characterized load resistance and damping properties using a non-destructive, low force magnitude, dynamic indentation protocol spanning a broad loading rate range to identify the dynamic viscoelastic properties of cartilage. Results Stiffness levels remained unchanged with exposure to the various subzero temperatures. Hysteresis increased in samples snap frozen at -196°C and stored at -80°C, though remained unchanged with exposure to the other storage temperatures. Conclusions Mechanical changes shown are likely due to ice lens creation, where frost heave effects may have caused collagen damage. That storage to -20°C and -80°C did not alter the mechanical properties of articular cartilage shows that when combined with a rapid thawing protocol to 37.5°C, the tissue may successfully be stored at subzero temperatures.

  8. Intra-articular pathology associated with isolated posterior cruciate ligament injury on MRI

    International Nuclear Information System (INIS)

    Ringler, Michael D.; Collins, Mark S.; Howe, B.M.; Shotts, Ezekiel E.

    2016-01-01

    Unlike with anterior cruciate ligament injury, little is known about the prevalence of intra-articular pathology associated with isolated posterior cruciate ligament (PCL) injury in the knee. The objectives of this study were to characterize and identify the frequency of meniscal tears and osteochondral injuries in these patients, and to see if management might be affected. Altogether, 48 knee MRI exams with isolated PCL tears were evaluated for the presence of: grade and location of PCL tear, meniscal tear, articular chondral lesion, bone bruise, and fracture. Comparisons between PCL tear grade and location, as well as mechanism of injury when known, with the presence of various intra-articular pathologies, were made using the chi-square or Fisher's exact test as appropriate. In all, 69 % of isolated PCL tears occur in the midsubstance, 27 % proximally. Meniscal tears were seen in 25 % of knees, involving all segments of both menisci, except for the anterior horn medial meniscus. Altogether, 23 % had focal cartilage lesions, usually affecting the central third medial femoral condyle and medial trochlea, while 12.5 % of knees had fractures, and 48 % demonstrated bone bruises, usually involving the central to anterior tibiofemoral joint. The presence of a fracture (p = 0.0123) and proximal location of PCL tear (p = 0.0016) were both associated with the hyperextension mechanism of injury. There were no statistically significant associations between PCL tear grade and presence of intra-articular abnormality. Potentially treatable meniscal tears and osteochondral injuries are relatively prevalent, and demonstrable on MRI in patients with isolated acute PCL injury of the knee. (orig.)

  9. Factors influencing intra-articular fluid temperature profiles with radiofrequency ablation.

    Science.gov (United States)

    Zoric, Bojan B; Horn, Nils; Braun, Sepp; Millett, Peter J

    2009-10-01

    Radiofrequency ablation devices are being used increasingly in arthroscopic surgery. However, there are concerns that excessive temperatures may damage the articular cartilage. The purpose of this study was to investigate the temperature profiles that occur within the glenohumeral space with the use of one commercially available radiofrequency ablation probe. Ten fresh-frozen human cadaver shoulder specimens were used. Intra-articular temperatures were measured at different time intervals over a two-minute period at a distance of 1, 3, 5, and 10 mm away from the probe. The radiofrequency probe was activated throughout the range of machine power settings, and irrigation fluid flow was varied (no flow, a flow at 60 mm Hg without suction, and a flow at 60 mm Hg with suction). Temperatures deleterious to articular cartilage chondrocytes (i.e., those in excess of 50 degrees C) were seen with an increased duration of application, a decreased distance between the thermometer and the probe, and a decreased irrigation fluid flow rate. The highest recorded irrigation fluid temperature reached >80 degrees C after two minutes in a no-flow setting. The flow rate was found to be the most significant predictor of intra-articular temperature profiles. The various machine power settings had no apparent influence on temperature, meaning that higher probe settings are not necessarily associated with higher temperature profiles. These results demonstrate the importance of the management of the irrigation fluid flow rate across the joint during arthroscopic procedures that involve radiofrequency ablation. Even short intervals of limited flow could lead to supraphysiological temperature profiles and potentially to cartilage damage.

  10. Displaced articular calcaneus fractures: classification and fracture scores: a preliminary study.

    Science.gov (United States)

    Harnroongroj, Thos; Chuckpaiwong, Bavornrit; Angthong, Chayanin; Nanakorn, Pongtep; Sudjai, Narumol; Harnroongroj, Thossart

    2012-03-01

    To review and group configurations of displaced articular calcaneal fracture advantaged for classification and radiographic fracture scores. Between 2002 and 2011, medical records and radiographs of patients who sustained acute displaced articular calcaneal fractures were reviewed. The calcanealfracture configurations were grouped as avulsion, bending, burst, or combination. Radiographic displaced articular calcaneal fracture score was designed to include Bohler and Gissane angles, degrees of posterior subtalar joint line parallel, degrees of varus, and burst. The calcaneal fracture score was modified as power of the fracture response to treatment (PFRT). Prevalence of the fracture types, pre- and post-reduction fracture scores including PFRT were studied and statistically analyzed. Sixty-four patients had 77 acute displaced articular calcaneal fractures. The classification consisted of type I avulsion, type II compression bending, type III compression burst, type IV avulsion burst, and type V bending burst. Type IV is the most common. The radiographic calcaneal fracture scores were 10 points. Pre-, post-reduction calcaneal fracture scores and PFRTof type I, II, III, IV, and V were 4.17 (0.41), 0 and 1 (0), 4.63 (2.13), 0.50 (0.93) and 0.84 (0.35), 6.94 (2.05), 3.18 (1.38) and 0.50 (0.27), 8.03 (1.12), 3.03 (2.42) and 0.62 (0.30), and 7.22 (2.11), 3.00 (2.50) and 0.59 (0.29) respectively. Statistical analysis showed significant difference (p fracture scores contained 10 points and were used for determining complexity of the fractures. PFRT was used for evaluating efficacy of fracture treatment.

  11. CT guided percutaneous calcaneoplasty: a case of metastatic intra-articular calcaneus fracture.

    Science.gov (United States)

    Kamalian, S; Hirsch, A E; Growney, M L; Raskin, K A; Yoo, A J; Krag, K J; Hirsch, J A

    2009-12-01

    Symptomatic bone metastases to the calcaneus are rare.1 Minimally invasive percutaneous augmentation is an option in the palliative management of patients with metastatic bone disease, and has been commonly used in the setting of vertebral compression fractures.2 Calcaneal augmentation can potentially allow for earlier weight bearing and a shorter period of disability. A case report is presented of percutaneous intra-articular calcaneal fracture augmentation using polymethyl methacrylate.

  12. Coordinate and synergistic effects of extensive treadmill exercise and ovariectomy on articular cartilage degeneration.

    Science.gov (United States)

    Miyatake, Kazumasa; Muneta, Takeshi; Ojima, Miyoko; Yamada, Jun; Matsukura, Yu; Abula, Kahaer; Sekiya, Ichiro; Tsuji, Kunikazu

    2016-05-31

    Although osteoarthritis (OA) is a multifactorial disease, little has been reported regarding the cooperative interaction among these factors on cartilage metabolism. Here we examined the synergistic effect of ovariectomy (OVX) and excessive mechanical stress (forced running) on articular cartilage homeostasis in a mouse model resembling a human postmenopausal condition. Mice were randomly divided into four groups, I: Sham, II: OVX, III: Sham and forced running (60 km in 6 weeks), and IV: OVX and forced running. Histological and immunohistochemical analyses were performed to evaluate the degeneration of articular cartilage and synovitis in the knee joint. Morphological changes of subchondral bone were analyzed by micro-CT. Micro-CT analyses showed significant loss of metaphyseal trabecular bone volume/tissue volume (BV/TV) after OVX as described previously. Forced running increased the trabecular BV/TV in all mice. In the epiphyseal region, no visible alteration in bone morphology or osteophyte formation was observed in any of the four groups. Histological analysis revealed that OVX or forced running respectively had subtle effects on cartilage degeneration. However, the combination of OVX and forced running synergistically enhanced synovitis and articular cartilage degeneration. Although morphological changes in chondrocytes were observed during OA initiation, no signs of bone marrow edema were observed in any of the four experimental groups. We report the coordinate and synergistic effects of extensive treadmill exercise and ovariectomy on articular cartilage degeneration. Since no surgical procedure was performed on the knee joint directly in this model, this model is useful in addressing the molecular pathogenesis of naturally occurring OA.

  13. 3D Morphology Analysis of TMJ Articular Eminence in Magnetic Resonance Imaging

    OpenAIRE

    Nascimento Falc?o, Izabella; Cal Alonso, Maria Beatriz Carrazzone; da Silva, Lucas Hian; Lopes, S?rgio L?cio Pereira de Castro; Comar, L?via Pichi; Costa, Andr? Luiz Ferreira

    2017-01-01

    Purpose The objective of this study was to evaluate the computational reconstruction of the articular eminence of the temporomandibular joint (TMJ) based on magnetic resonance imaging (MRI) and semiautomatic volumetric segmentation techniques for morphological classification of the TMJ structure. Materials and Methods A total of 36 MRI scans of TMJ individuals were selected and formatted by using the ITK-SNAP software, consisting of MRI segmentation and generation of 3D models. The TMJ articu...

  14. Viscoelastic properties of bovine articular cartilage attached to subchondral bone at high frequencies

    Directory of Open Access Journals (Sweden)

    Shepherd Duncan ET

    2009-06-01

    Full Text Available Abstract Background Articular cartilage is a viscoelastic material, but its exact behaviour under the full range of physiological loading frequencies is unknown. The objective of this study was to measure the viscoelastic properties of bovine articular cartilage at loading frequencies of up to 92 Hz. Methods Intact tibial plateau cartilage, attached to subchondral bone, was investigated by dynamic mechanical analysis (DMA. A sinusoidally varying compressive force of between 16 N and 36 N, at frequencies from 1 Hz to 92 Hz, was applied to the cartilage surface by a flat indenter. The storage modulus, loss modulus and phase angle (between the applied force and the deformation induced were determined. Results The storage modulus, E', increased with increasing frequency, but at higher frequencies it tended towards a constant value. Its dependence on frequency, f, could be represented by, E' = Aloge (f + B where A = 2.5 ± 0.6 MPa and B = 50.1 ± 12.5 MPa (mean ± standard error. The values of the loss modulus (4.8 ± 1.0 MPa mean ± standard deviation were much less than the values of storage modulus and showed no dependence on frequency. The phase angle was found to be non-zero for all frequencies tested (4.9 ± 0.6°. Conclusion Articular cartilage is viscoelastic throughout the full range of frequencies investigated. The behaviour has implications for mechanical damage to articular cartilage and the onset of osteoarthritis. Storage modulus increases with frequency, until the plateau region is reached, and has a higher value than loss modulus. Furthermore, loss modulus does not increase with loading frequency. This means that more energy is stored by the tissue than is dissipated and that this effect is greater at higher frequencies. The main mechanism for this excess energy to be dissipated is by the formation of cracks.

  15. Effective lubrication of articular cartilage by an amphiphilic hyaluronic acid derivative.

    Science.gov (United States)

    Schiavinato, Antonella; Whiteside, Robert A

    2012-06-01

    Intra-articular injection of hyaluronic acid based therapies is gaining popularity as a treatment option for non-operative management of patients with symptomatic osteoarthritis. Although there is an abundance of evidence for both biological and mechanical mechanisms of joint protection by hyaluronic acid, one clear intention of viscosupplementation is to reduce friction and wear by providing an extrinsic lubricant. We tested the in vitro friction response of a novel hyaluronic acid derivative that presents amphiphilic features to promote adhesion to the cartilage surface and thereby improve cartilage lubrication. Migrating Contact Area and Static Contact Area friction tests were conducted on bovine articular cartilage to assess the efficacy of two lubricants, a chemically modified amphiphilic hyaluronic acid and synovial fluid from a healthy joint, as well as a phosphate buffered saline negative control. No differences in lubrication (P=0.34) were evident between the three test articles during the Migrating Contact Area test, which represents articulation of healthy articular cartilage. The modified hyaluronic acid presented an equilibrium friction coefficient 2.8 times less than that of the synovial fluid (P ≤ 0.0005) and five times less than that of the PBS control (P ≤ 0.0001) during the Static Contact Area test, representing a mixed lubrication condition. The present study demonstrated that a chemically modified amphiphilic hyaluronic acid can provide equivalent lubrication to synovial fluid during articulation of loaded healthy articular cartilage and can provide superior lubrication as indicated by a lower coefficient of friction than synovial fluid under loading conditions potentially associated with cartilage wear. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Intra-articular membranous interposition detected by MRI in developmental dysplasia of the hip

    International Nuclear Information System (INIS)

    Watanabe, W.; Itoi, Eiji; Sato, Kozo

    2000-01-01

    Intra-articular membranous interposition was detected by MRI in the hip joint with residual subluxation of a girl aged 5 years 10 months. This structure, which had low signal intensity on both T1- and T2-weighted images, separated the femoral head from the acetabulum. Histological examination revealed chondrometaplasia, which suggested that this interposition might be transformed to a surface cartilaginous tissue of the secondary acetabulum often observed in residual subluxation of the hip. (orig.)

  17. Intra-articular membranous interposition detected by MRI in developmental dysplasia of the hip

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, W.; Itoi, Eiji; Sato, Kozo [Akita Univ. (Japan). Dept. of Orthopedic Surgery

    2000-12-01

    Intra-articular membranous interposition was detected by MRI in the hip joint with residual subluxation of a girl aged 5 years 10 months. This structure, which had low signal intensity on both T1- and T2-weighted images, separated the femoral head from the acetabulum. Histological examination revealed chondrometaplasia, which suggested that this interposition might be transformed to a surface cartilaginous tissue of the secondary acetabulum often observed in residual subluxation of the hip. (orig.)

  18. MRI evaluation of the patellar articular cartilage in patients with subluxation of the patella

    International Nuclear Information System (INIS)

    Nakanishi, Katsuyuki; Inoue, Masahiro; Harada, Koushi; Murakami, Takamichi; Kim, Shougen; Fujita, Norihiko; Sakurai, Kousuke; Kozuka, Takahiro

    1991-01-01

    In patients with subluxation of the patella, injury of the patellar articular cartilage is frequently observed and correct evaluation is important to manage these patients. We examined 11 patients with subluxation of the patella and five normal volunteers. In 12 patellofemoral joints of seven patients with subluxation of the patella, the abnormalities observed on MRI were compared with those on arthroscopy and/or at operation. MRI was performed with a Magnetom 1.5 T (Siemens) using the round surface coil. Pulse sequences were SE (TR 400 ms/TE 19 ms), FLASH(TR 320 ms/TE 15 ms FA 90deg and 40deg), and SE (TR 2000 ms/TE 26, 70 ms). We analysed MR findings of the 12 abnormal joints and 10 normal joints according to the following classification of abnormalities observed on arthroscopy; normal appearance (n=3 joints), softening and fibrillation (n=6), fragmentation (n=3), and erosion to bone (n=0). In only one of the six cases with softening and fibrillation observed on arthroscopy, MRI could visualize the thickening of patellar articular cartilage, but in all three cases with fragmentation observed on arthroscopy, MRI could visualize the thin inhomogeneous cartilage with irregular surface. The combination of SE (TR 400 ms/TE 19 ms) and FLASH (TR 320 ms/TE 15 ms FA 90deg) are extremely effective pulse sequence to detect the abnormalities of patellar articular cartilage. We conclude that MRI is a useful noninvasive method of detecting advanced changes in patellar articular cartilage. (author)

  19. Intra-articular pathology associated with isolated posterior cruciate ligament injury on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Ringler, Michael D.; Collins, Mark S.; Howe, B.M. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Shotts, Ezekiel E. [NEA Baptist Clinic, Jonesboro, AR (United States)

    2016-12-15

    Unlike with anterior cruciate ligament injury, little is known about the prevalence of intra-articular pathology associated with isolated posterior cruciate ligament (PCL) injury in the knee. The objectives of this study were to characterize and identify the frequency of meniscal tears and osteochondral injuries in these patients, and to see if management might be affected. Altogether, 48 knee MRI exams with isolated PCL tears were evaluated for the presence of: grade and location of PCL tear, meniscal tear, articular chondral lesion, bone bruise, and fracture. Comparisons between PCL tear grade and location, as well as mechanism of injury when known, with the presence of various intra-articular pathologies, were made using the chi-square or Fisher's exact test as appropriate. In all, 69 % of isolated PCL tears occur in the midsubstance, 27 % proximally. Meniscal tears were seen in 25 % of knees, involving all segments of both menisci, except for the anterior horn medial meniscus. Altogether, 23 % had focal cartilage lesions, usually affecting the central third medial femoral condyle and medial trochlea, while 12.5 % of knees had fractures, and 48 % demonstrated bone bruises, usually involving the central to anterior tibiofemoral joint. The presence of a fracture (p = 0.0123) and proximal location of PCL tear (p = 0.0016) were both associated with the hyperextension mechanism of injury. There were no statistically significant associations between PCL tear grade and presence of intra-articular abnormality. Potentially treatable meniscal tears and osteochondral injuries are relatively prevalent, and demonstrable on MRI in patients with isolated acute PCL injury of the knee. (orig.)

  20. Biomechanics of Meniscus Cells: Regional Variation and Comparison to Articular Chondrocytes and Ligament Cells

    OpenAIRE

    Sanchez-Adams, Johannah; Athanasiou, Kyriacos A.

    2012-01-01

    Central to understanding mechanotransduction in the knee meniscus is the characterization of meniscus cell mechanics. In addition to biochemical and geometric differences, the inner and outer regions of the meniscus contain cells that are distinct in morphology and phenotype. This study investigated the regional variation in meniscus cell mechanics in comparison to articular chondrocytes and ligament cells. It was found that the meniscus contains two biomechanically distinct cell populations,...

  1. Effects of sodium hyaluronate and methylprednisolone acetate on proteoglycan synthesis in equine articular cartilage explants.

    Science.gov (United States)

    Doyle, Aimie J; Stewart, Allison A; Constable, Peter D; Eurell, Jo Ann C; Freeman, David E; Griffon, Dominique J

    2005-01-01

    To determine effects of sodium hyaluronate (HA) on corticosteroid-induced cartilage matrix catabolism in equine articular cartilage explants. 30 articular cartilage explants from fetlock joints of 5 adult horses without joint disease. Articular cartilage explants were treated with control medium or medium containing methylprednisolone acetate (MPA; 0.05, 0.5, or 5.0 mg/mL), HA (0.1, 1.0, or 1.5 mg/mL), or both. Proteoglycan (PG) synthesis was measured by incorporation of sulfur 35-labeled sodium sulphate into PGs, and PG degradation was measured by release of radiolabeled PGs into the medium. Total glycosaminoglycan (GAG) content in media and explants and total explant DNA were determined. Methylprednisolone acetate caused a decrease in PG synthesis, whereas HA had no effect. Only the combination of MPA at a concentration of 0.05 mg/mL and HA at a concentration of 1.0 mg/mL increased PG synthesis, compared with control explants. Methylprednisolone acetate increased degradation of newly synthesized PGs into the medium, compared with control explants, and HA alone had no effect. Hyaluronate had no effect on MPA-induced PG degradation and release into media. Neither MPA alone nor HA alone had an effect on total cartilage GAG content. Methylprednisolone acetate caused an increase in release of GAG into the medium at 48 and 72 hours after treatment. In combination, HA had no protective effect on MPA-induced GAG release into the medium. Total cartilage DNA content was not affected by treatments. Our results indicate that HA addition has little effect on corticosteroid-induced cartilage matrix PG catabolism in articular cartilage explants.

  2. Quantitative analysis of morphological change in the articular disc of temporomandibular joint on MR image

    International Nuclear Information System (INIS)

    Igarashi, Chinami; Kobayashi, Kaoru; Imanaka, Masahiro; Yuasa, Masao; Yamamoto, Akira; Otonari, Takamichi

    2001-01-01

    This study investigated morphological changes of the articular disc by measurement of the volume of disc on MR images. This retrospective study investigated 16 joints; 8 showed an unchanged disc configuration and 8 showed a changed configuration during the follow-up period. MR imaging was performed with a 0.3 Tesla MR imager (HITACHI MEDICAL, Tokyo, Japan) using a surface coil measuring 9 cm in diameter. The images were obtained on a corrected sagittal plane in a closed mouth position. Volume measurements of the articular disc were as follows: Two regions of interest were placed over the articular disc. Measurements of the signal intensity were made directly on the MR imager. Maximal and minimal values of signal intensity were calculated from the mean value ±2SD. The maximal value of signal intensity was determined to be higher than the mean value +2SD. Minimal value of signal intensity was determined to be below the value -2SD. The area of the disc was measured directly using level detection software by inputting maximal and minimal signal intensities. Volume was calculated using the area identified on each slice multiplied by 4 mm (slice thickness). Wilcoxon matched-pairs signed-rank test was used for statistical analysis. Unchanged group showed similar disc volumes on both the initial MR image and follow up MR image. However, the changed group showed some difference in volume between initial MR image and follow-up MR image. This measurement technique has been shown to be a useful technique for quantitative analysis of morphological changes in the articular disc in the temporomandibular joint on MR image. (author)

  3. Significant Incidence of Extra-Articular Tibia Vara Affects Radiological Outcome of Total Knee Arthroplasty

    Science.gov (United States)

    Saibaba, Balaji; Chouhan, Devendra K.; Kanojia, Rajendra K.; Prakash, Mahesh; Bachhal, Vikas

    2015-01-01

    Purpose To identify and quantify the presence of extra-articular tibia vara that might influence the mechanical axis alignment after total knee arthroplasty (TKA). Materials and Methods A total of 48 TKAs in 30 osteoarthritic Indian patients were prospectively evaluated. The hip-knee-ankle angle (HKA), joint line convergence angle, and varus angulation at the femur and tibia were measured from the preoperative and postoperative standing hip-to-ankle radiographs. Four different methods were used to measure the varus angulation at the tibia: metaphyseo-diaphyseal angle (MDA), the angle between the anatomical axis and mechanical axis of the tibia, the angle between the proximal third and distal third of tibia and the angle between the proximal half and distal half of tibia. Results Extra-articular tibia vara quantified using MDA had the most positive correlation with HKA. Receiver operating characteristic plotting showed that MDA of >4° predicts abnormal postoperative HKA. Twenty-eight out of 48 knees had MDA of >4°, and 78.6% of these had postoperative HKA under-correction and 21.4% had less than ideal tibial component position. Conclusions A significant inherent extra-articular varus angulation best measured using MDA exists in the proximal tibia in osteoarthritic Indian patients undergoing TKA. MDA of >4° is associated with abnormal postoperative HKA. Computer navigation may be useful for achieving ideal correction in such cases. PMID:26389071

  4. Síndrome de hiperlaxitud articular benigno en el niño

    Directory of Open Access Journals (Sweden)

    D. Mariana Haro, Dra.

    2014-03-01

    Full Text Available El síndrome de hipermovilidad articular se caracteriza por la presencia de articulaciones con rango de movilidad aumentada, asociada a dolor y deterioro funcional del sistema musculoequelético. Su etiología correspondería a una alteración del colágeno tipo I genéticamente determinada con un patrón de herencia autosómico dominante. Su incidencia es mayor en mujeres y en niños. Se ha descrito asociación con algunos síntomas extraarticulares, por lo cual los síntomas podrían no estar solo limitados al sistema musculoesquelético. El sistema de Beighton es una herramienta útil en definir la condición de hiperlaxitud. Su validación para uso en niños fue publicada por Engelsman y cols el año 2011. No obstante para el diagnóstico de Sindrome de Hiperlaxitud articular sería insuficiente, sugiriéndose el uso del sistema de clasificación de Brighton. Su tratamiento se basa en la educación, estabilización articular global, reeducación postural y de la marcha, mejorar capacidad aeróbica, uso de plantillas y órtesis de pie.

  5. Behavioral trait of morningness-eveningness in association with articular and spinal diseases in a population.

    Directory of Open Access Journals (Sweden)

    Ilona Merikanto

    Full Text Available Earlier studies have revealed that the more the preference to schedule daily activities towards the evening hours is, the higher the odds for a range of health hazards are. Therefore, we wanted to analyze, whether the behavioral trait of morningness-eveningness is associated with articular and spinal diseases or those with musculoskeletal disorders. Participants (n = 6089, as part of the National FINRISK 2007 Study, were derived from the general population, aged 25 to 74 years, living in Finland. Chronotype was assessed based on six items from the original Horne-Östberg Morningness-Eveningness Questionnaire. Information about risk factors and the diagnoses of articular and spinal diseases were based on the self-reported information. Our results suggest that Evening-types have higher odds for articular and spinal diseases as compared with Morning-types, and this risk is heightened especially regarding spinal disease and backache (odds ratios of 1.8 to 2.1, and 1.6 to 1.8, respectively and remains significant after controlling for the sex, age, education, civil status, physical activity, alcohol use, and smoking, and additionally for the body-mass index, insufficient sleep, or depressive symptoms.

  6. Susceptibility tensor imaging and tractography of collagen fibrils in the articular cartilage.

    Science.gov (United States)

    Wei, Hongjiang; Gibbs, Eric; Zhao, Peida; Wang, Nian; Cofer, Gary P; Zhang, Yuyao; Johnson, G Allan; Liu, Chunlei

    2017-11-01

    To investigate the B 0 orientation-dependent magnetic susceptibility of collagen fibrils within the articular cartilage and to determine whether susceptibility tensor imaging (STI) can detect the 3D collagen network within cartilage. Multiecho gradient echo datasets (100-μm isotropic resolution) were acquired from fixed porcine articular cartilage specimens at 9.4 T. The susceptibility tensor was calculated using phase images acquired at 12 or 15 different orientations relative to B 0 . The susceptibility anisotropy of the collagen fibril was quantified and diffusion tensor imaging (DTI) was compared against STI. 3D tractography was performed to visualize and track the collagen fibrils with DTI and STI. STI experiments showed the distinct and significant anisotropic magnetic susceptibility of collagen fibrils within the articular cartilage. STI can be used to measure and quantify susceptibility anisotropy maps. Furthermore, STI provides orientation information of the underlying collagen network via 3D tractography. The findings of this study demonstrate that STI can characterize the orientation variation of collagen fibrils where diffusion anisotropy fails. We believe that STI could serve as a sensitive and noninvasive marker to study the collagen fibrils microstructure. Magn Reson Med 78:1683-1690, 2017. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

  7. The Regulatory Role of Signaling Crosstalk in Hypertrophy of MSCs and Human Articular Chondrocytes.

    Science.gov (United States)

    Zhong, Leilei; Huang, Xiaobin; Karperien, Marcel; Post, Janine N

    2015-08-14

    Hypertrophic differentiation of chondrocytes is a main barrier in application of mesenchymal stem cells (MSCs) for cartilage repair. In addition, hypertrophy occurs occasionally in osteoarthritis (OA). Here we provide a comprehensive review on recent literature describing signal pathways in the hypertrophy of MSCs-derived in vitro differentiated chondrocytes and chondrocytes, with an emphasis on the crosstalk between these pathways. Insight into the exact regulation of hypertrophy by the signaling network is necessary for the efficient application of MSCs for articular cartilage repair and for developing novel strategies for curing OA. We focus on articles describing the role of the main signaling pathways in regulating chondrocyte hypertrophy-like changes. Most studies report hypertrophic differentiation in chondrogenesis of MSCs, in both human OA and experimental OA. Chondrocyte hypertrophy is not under the strict control of a single pathway but appears to be regulated by an intricately regulated network of multiple signaling pathways, such as WNT, Bone morphogenetic protein (BMP)/Transforming growth factor-β (TGFβ), Parathyroid hormone-related peptide (PTHrP), Indian hedgehog (IHH), Fibroblast growth factor (FGF), Insulin like growth factor (IGF) and Hypoxia-inducible factor (HIF). This comprehensive review describes how this intricate signaling network influences tissue-engineering applications of MSCs in articular cartilage (AC) repair, and improves understanding of the disease stages and cellular responses within an OA articular joint.

  8. Articular cartilage response to a sliding load using two different-sized spherical indenters1.

    Science.gov (United States)

    Schätti, Oliver R; Colombo, Vera; Torzilli, Peter A; Gallo, Luigi M

    2018-01-01

    Cartilage surface contact geometry influences the deformational behavior and stress distribution throughout the extracellular matrix (ECM) under load. To test the correlation between the mechanical and cellular response of articular cartilage when loaded with two different-sized spherical indenters under dynamic reciprocating sliding motion. Articular cartilage explants were subjected to a reciprocating sliding load using a 17.6 mm or 30.2 mm spherical ball for 2000 cycles at 10 mm/s and 4 kg axial load. Deformation of the cartilage was recorded and contact parameters were calculated according to Hertzian theory. After mechanical loading cartilage samples were collected and analyzed for ECM collagen damage, gene regulation and proteoglycan (PG) loss. Significantly higher ECM deformation and strain and lower dynamic effective modulus were found for explants loaded with the smaller diameter indenter whereas contact radius and stress remained unaffected. Also, the 17.6 mm indenter increased PG loss and significantly upregulated genes for ECM proteins and enzymes as compared to the 30.2 mm indenter. Sliding loads that increase ECM deformation/strain were found to induce enzyme-mediated catabolic processes in articular cartilage explants. These observations provide further understanding of how changes in cartilage contact mechanics under dynamic conditions can affect the cellular response.

  9. 3D Morphology Analysis of TMJ Articular Eminence in Magnetic Resonance Imaging

    Directory of Open Access Journals (Sweden)

    Izabella Nascimento Falcão

    2017-01-01

    Full Text Available Purpose. The objective of this study was to evaluate the computational reconstruction of the articular eminence of the temporomandibular joint (TMJ based on magnetic resonance imaging (MRI and semiautomatic volumetric segmentation techniques for morphological classification of the TMJ structure. Materials and Methods. A total of 36 MRI scans of TMJ individuals were selected and formatted by using the ITK-SNAP software, consisting of MRI segmentation and generation of 3D models. The TMJ articular eminences were also classified according to the morphology analysis of the articular eminence in 3D reconstructions. Two independent trained and calibrated investigators performed the image analysis, which was repeated after thirty days. Results. There was no association between sex and eminence shape (p=0.456. Fisher’s test revealed no statistically significant association between disc classification and eminence shape on both sides (p=0.629. Chi-square test showed a significant statistically association between disc classification and disc displacement (p=0.000. Intra- and interrater correlation coefficients showed excellent reproducibility values. Conclusions. Anatomical variability of the sample investigated was found, with predominantly round shape and presence of correlation between this shape and normal disc position. The correlation of flattened and convex shapes with disc position reduction indicated that type of disc derangement is more prevalent.

  10. The effect of intra-articular Tenoxicam on knee effusion after arthroscopy.

    Science.gov (United States)

    Jawish, Roger; Najdi, Hassan; Abi Safi, Claude; Chameseddine, Ali

    2015-07-01

    NSAIDs and analgesic drugs are used intra-articularly after knee arthroscopy for pain relief. However, synovial effusion is still a common cause of delayed physical therapy. The aim of this study was to demonstrate the beneficial effect of intra-articular injection of Tenoxicam on knee effusion after arthroscopy. This was a prospective non-randomized study on 134 patients with a mean age of 36.7 years. Knee arthroscopy on a day-case basis was performed; normal saline was used for irrigation. At the end of the procedure, fluid was aspirated from the knee joint and 20 ml of Tenoxicam diluted with 20 ml of 0.9% normal saline was injected into the knee five minutes before deflation of limb tourniquet. The same surgeon performed clinical examination for knee effusion 14 days postoperatively. Encountered pathologies included meniscal injury, degenerative arthropathy, synovial plica and ACL rupture. Knee effusion developed in 15.7% of the patients, particularly in those with degenerative arthropathy (p = 0.006) and meniscal lesions (p = 0.06). Intra-articular Tenoxicam is a simple method for the prevention of postoperative knee effusion. Degenerative arthropathy and meniscal lesions are major risk factors for post arthroscopy knee effusion.

  11. Intra-articular injection of tenoxicam following temporomandibular joint arthrocentesis: a pilot study.

    Science.gov (United States)

    Aktas, I; Yalcin, S; Sencer, S

    2010-05-01

    This study examined the clinical and radiological effects of intra-articular tenoxicam injection following arthrocentesis and compared them with arthrocentesis alone in patients with disc displacement without reduction (DDwoR). 24 temporomandibular joints (TMJs) in 21 patients with DDwoR were studied. Patients were divided randomly into Group A in which only arthrocentesis was performed (14 TMJs in 14 patients) and Group AT which received arthrocentesis plus intra-articular injection of tenoxicam (10 TMJs in 7 patients). Patients were evaluated before the procedure, on postoperative day 7, then 2, 3, 4 weeks, and 2, 3, 4, 5, 6 months postoperatively. Intensity of joint pain was assessed using a visual analog scale. Maximum mouth opening was recorded at each follow-up. TMJ sounds and palpation scores were noted as positive or negative. Magnetic resonance imaging (MRI) was performed before and 6 months after treatment in both groups. Disc form, disc location during neutral position, reduction with movement, joint effusion, structures of the articular surfaces, and bone marrow anomalies were evaluated all in MRIs. Both treatments succesfully increased maximum mouth opening and reduced TMJ pain; there were no complications. Difference between the groups was not statistically significant and a larger controlled study is necessary to clarify this use of tenoxicam. Copyright 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  12. The Regulatory Role of Signaling Crosstalk in Hypertrophy of MSCs and Human Articular Chondrocytes

    Science.gov (United States)

    Zhong, Leilei; Huang, Xiaobin; Karperien, Marcel; Post, Janine N.

    2015-01-01

    Hypertrophic differentiation of chondrocytes is a main barrier in application of mesenchymal stem cells (MSCs) for cartilage repair. In addition, hypertrophy occurs occasionally in osteoarthritis (OA). Here we provide a comprehensive review on recent literature describing signal pathways in the hypertrophy of MSCs-derived in vitro differentiated chondrocytes and chondrocytes, with an emphasis on the crosstalk between these pathways. Insight into the exact regulation of hypertrophy by the signaling network is necessary for the efficient application of MSCs for articular cartilage repair and for developing novel strategies for curing OA. We focus on articles describing the role of the main signaling pathways in regulating chondrocyte hypertrophy-like changes. Most studies report hypertrophic differentiation in chondrogenesis of MSCs, in both human OA and experimental OA. Chondrocyte hypertrophy is not under the strict control of a single pathway but appears to be regulated by an intricately regulated network of multiple signaling pathways, such as WNT, Bone morphogenetic protein (BMP)/Transforming growth factor-β (TGFβ), Parathyroid hormone-related peptide (PTHrP), Indian hedgehog (IHH), Fibroblast growth factor (FGF), Insulin like growth factor (IGF) and Hypoxia-inducible factor (HIF). This comprehensive review describes how this intricate signaling network influences tissue-engineering applications of MSCs in articular cartilage (AC) repair, and improves understanding of the disease stages and cellular responses within an OA articular joint. PMID:26287176

  13. Efficacy of Intra-Articular Injection of Hyaluronic Acid in the Treatment of Knee Osteoarthritis

    Directory of Open Access Journals (Sweden)

    SS Narayanan

    2009-05-01

    Full Text Available This study was conducted to evaluate the efficacy of intra- articular injection of hyaluronic acid for the treatment of knee osteoarthritis. Patients with knee osteoarthritis were followed for a period of six months to assess the efficacy of intra-articular injection of hyaluronic acid given three times in three consecutive weeks. Fifty patients were reviewed at two, eight and 24 weeks post-injection. The average age was 60.9 years and female to male ratio was 3:1. Patients were assessed using the Lequesne Algofunctional Index for function, and the visual analogue score for pain and side effects. We found that the knee pain reduced and the function improved in most patients and these beneficial effects maintain till the last follow up. The only side effect noted was one case of acute non-septic joint effusion after the 3rd injection. We concluded that intra-articular injection of hyaluronic acid can produce pain relief and functional improvement for up to 6 months.

  14. Posterior facet cartilage injury in operatively treated intra-articular calcaneus fractures.

    Science.gov (United States)

    Rothberg, David L; Yoo, Brad J

    2014-10-01

    Direct visualization of the posterior facet in displaced intra-articular calcaneus fractures (DIACF) frequently shows partial or full thickness cartilage delamination. This is felt to be secondary to the depression of an osteoarticular segment of the posterior facet within the calcaneal body and the subsequent contact with fracture edges as it impacts caudally. The purpose of this study was to determine the frequency of cartilage injury and if it correlates with fracture classification. A single surgeon prospective, observational series of 28 patients with 28 DIACFs was reviewed for patient demographic and injury data, radiographic fracture characterization, and intraoperative observation of articular injury size, depth, and location over the time period of February 2010 to December 2012. Observations were correlated with the OTA and Sanders classification systems. Age, sex, mechanism of injury, and depth and location of cartilage injury were not significantly different between the 13 OTA/Sanders type 2 and 15 type 3 DIACFs evaluated in this study. Posterior facet articular cartilage delamination was found in 77% of type 2 and 100% of type 3 fractures (P = .09). Location of cartilage injury was common (56%) along the distal, lateral aspect of the posterior facet (P fractures (3.1%) then type 2 (1.3%) (P fractures compared to type 2 fractures. Level IV, prospective, observational series. © The Author(s) 2014.

  15. Intra-Articular Corticosteroids in Addition to Exercise for Reducing Pain Sensitivity in Knee Osteoarthritis

    DEFF Research Database (Denmark)

    Soriano-Maldonado, Alberto; Klokker, Louise; Bartholdy, Cecilie

    2016-01-01

    OBJECTIVE: To assess the effects of one intra-articular corticosteroid injection two weeks prior to an exercise-based intervention program for reducing pain sensitivity in patients with knee osteoarthritis (OA). DESIGN: Randomized, masked, parallel, placebo-controlled trial involving 100 particip......OBJECTIVE: To assess the effects of one intra-articular corticosteroid injection two weeks prior to an exercise-based intervention program for reducing pain sensitivity in patients with knee osteoarthritis (OA). DESIGN: Randomized, masked, parallel, placebo-controlled trial involving 100...... the injections all participants undertook a 12-week supervised exercise program. Main outcomes were changes from baseline in pressure-pain sensitivity (pressure-pain threshold [PPT] and temporal summation [TS]) assessed using cuff pressure algometry on the calf. These were exploratory outcomes from a randomized....... The mean group difference in changes from baseline at week 14 was 0.6 kPa (95% CI: -1.7 to 2.8; P = 0.626) for PPT and 384 mm×sec (95% CI: -2980 to 3750; P = 0.821) for TS. CONCLUSIONS: These results suggest that adding intra-articular corticosteroid injection 2 weeks prior to an exercise program does...

  16. Contact models of repaired articular surfaces: influence of loading conditions and the superficial tangential zone.

    Science.gov (United States)

    Owen, John R; Wayne, Jennifer S

    2011-07-01

    The superficial tangential zone (STZ) plays a significant role in normal articular cartilage's ability to support loads and retain fluids. To date, tissue engineering efforts have not replicated normal STZ function in cartilage repairs. This finite element study examined the STZ's role in normal and repaired articular surfaces under different contact conditions. Contact area and pressure distributions were allowed to change with time, tension-compression nonlinearity modeled collagen behavior in the STZ, and nonlinear geometry was incorporated to accommodate finite deformation. Responses to loading via impermeable and permeable rigid surfaces were compared to loading via normal cartilage, a more physiologic condition, anticipating the two rigid loading surfaces would bracket that of normal. For models loaded by normal cartilage, an STZ placed over the inferior repair region reduced the short-term axial compression of the articular surface by 15%, when compared to a repair without an STZ. Covering the repair with a normal STZ shifted the flow patterns and strain levels back toward that of normal cartilage. Additionally, reductions in von Mises stress (21%) and an increase in fluid pressure (13%) occurred in repair tissue under the STZ. This continues to show that STZ properties of sufficient quality are likely critical for the survival of transplanted constructs in vivo. However, response to loading via normal cartilage did not always fall within ranges predicted by the rigid surfaces. Use of more physiologic contact models is recommended for more accurate investigations into properties critical to the success of repair tissues.

  17. Conservative treatment of intra-articular distal phalanx fractures in horses not used for racing.

    Science.gov (United States)

    Ohlsson, J; Jansson, N

    2005-04-01

    To determine the success rate and whether specific patient and treatment factors influenced the outcome after conservative treatment with a bar shoe with quarter clips of intra-articular fractures of the distal phalanx in horses not used for racing. Retrospective study. Thirty-two client-owned horses. Hospital records of horses that had been treated conservatively for intra-articular fractures of the distal phalanx at Skara Equine Hospital or Halland Animal Hospital in Sweden between 1995 and 2001 were reviewed. Racehorses in active training and horses affected with other musculoskeletal diseases were excluded from the study. Follow-up was performed by questionnaire and telephone inquires to the owners 1 to 7 years after injury. Twenty-two horses (69%) returned to their previous or expected level of use and did not wear their bar shoe when they were put back into training. There was no statistically significant correlation between outcome and patient or treatment variables, or bony union of the fracture. Conservative treatment of intra-articular fractures of the distal phalanx carries a fair prognosis for return to previous or expected level of use in horses not used for racing. Radiographic evidence of fracture healing and age of the patient do not seem to influence the prognosis. Horses not used for racing do not need to be shod with a bar shoe with quarter clips for the rest of their athletic career.

  18. Correlation between apparent diffusion coefficient and viscoelasticity of articular cartilage in a porcine model.

    Science.gov (United States)

    Aoki, T; Watanabe, A; Nitta, N; Numano, T; Fukushi, M; Niitsu, M

    2012-09-01

    Quantitative MR imaging techniques of degenerative cartilage have been reported as useful indicators of degenerative changes in cartilage extracellular matrix, which consists of proteoglycans, collagen, non-collagenous proteins, and water. Apparent diffusion coefficient (ADC) mapping of cartilage has been shown to correlate mainly with the water content of the cartilage. As the water content of the cartilage in turn correlates with its viscoelasticity, which directly affects the mechanical strength of articular cartilage, ADC can serve as a potentially useful indicator of the mechanical strength of cartilage. The aim of this study was to investigate the correlation between ADC and viscoelasticity as measured by indentation testing. Fresh porcine knee joints (n = 20, age 6 months) were obtained from a local abattoir. ADC of porcine knee cartilage was measured using a 3-Tesla MRI. Indentation testing was performed on an electromechanical precision-controlled system, and viscosity coefficient and relaxation time were measured as additional indicators of the viscoelasticity of cartilage. The relationship between ADC and viscosity coefficient as well as that between ADC and relaxation time were assessed. ADC was correlated with relaxation time and viscosity coefficient (R(2) = 0.75 and 0.69, respectively, p viscoelasticity in the superficial articular cartilage. Both molecular diffusion and viscoelasticity were higher in weight bearing than non-weight-bearing articular cartilage areas.

  19. The Regulatory Role of Signaling Crosstalk in Hypertrophy of MSCs and Human Articular Chondrocytes

    Directory of Open Access Journals (Sweden)

    Leilei Zhong

    2015-08-01

    Full Text Available Hypertrophic differentiation of chondrocytes is a main barrier in application of mesenchymal stem cells (MSCs for cartilage repair. In addition, hypertrophy occurs occasionally in osteoarthritis (OA. Here we provide a comprehensive review on recent literature describing signal pathways in the hypertrophy of MSCs-derived in vitro differentiated chondrocytes and chondrocytes, with an emphasis on the crosstalk between these pathways. Insight into the exact regulation of hypertrophy by the signaling network is necessary for the efficient application of MSCs for articular cartilage repair and for developing novel strategies for curing OA. We focus on articles describing the role of the main signaling pathways in regulating chondrocyte hypertrophy-like changes. Most studies report hypertrophic differentiation in chondrogenesis of MSCs, in both human OA and experimental OA. Chondrocyte hypertrophy is not under the strict control of a single pathway but appears to be regulated by an intricately regulated network of multiple signaling pathways, such as WNT, Bone morphogenetic protein (BMP/Transforming growth factor-β (TGFβ, Parathyroid hormone-related peptide (PTHrP, Indian hedgehog (IHH, Fibroblast growth factor (FGF, Insulin like growth factor (IGF and Hypoxia-inducible factor (HIF. This comprehensive review describes how this intricate signaling network influences tissue-engineering applications of MSCs in articular cartilage (AC repair, and improves understanding of the disease stages and cellular responses within an OA articular joint.

  20. Role of magnetic resonance imaging in the evaluation of articular cartilage in painful knee joint

    Directory of Open Access Journals (Sweden)

    Digish Shah

    2014-01-01

    Full Text Available Aim: The aim of this study was to determine the role of the magnetic resonance imaging (MRI in patients with atraumatic knee pain. Background and Objectives: Knee pain is one of the most common problems faced by people from time immemorial. There is a wide range of disease ranging from traumatic to degenerative causing knee pain in which articular cartilage is involved. Over the past 15 years, MRI has become the premier, first-line imaging study that should be performed in the evaluation of the painful knee in particular in tears of menisci, cruciate and collateral ligaments, osteochondral abnormalities (chondromalacia, osteoarthritis and osteochondral defects, synovial cysts and bone bruises. MRI, by virtue of its superior soft-tissue contrast, lack of ionizing radiation and multiplanar capabilities, is superior to more conventional techniques for the evaluation of articular cartilage. Materials and Methods: A prospective study was carried out on 150 patients in the Department of Radio-diagnosis, Padmashree Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune over a period of 2 years from June 2011 to May 2013. Patients having fracture or dislocations of the knee joint were also excluded from the study. Detailed clinical history, physical and systemic examination findings of all patients were noted in addition to the laboratory investigations. All patients were subjected to radiograph of knee anterior-posterior and lateral view. MRI was performed with Siemens 1.5 Tesla MAGNETOM Avanto machine. Results: In our study of 150 patients with knee pain, articular cartilage defect was found in 90 patients (60%. Out of 90 patients with articular cartilage defect, 30 patients (20% had full thickness cartilage defects. Subchondral marrow edema was seen beneath 30 patients (20% with articular cartilage defects. 32 patients (21.1% had a complex or macerated meniscal tear. Complete anterior cruciate ligament tear was found in seven

  1. Efeitos do resfriamento e aquecimento articular no desempenho funcional do ombro

    Directory of Open Access Journals (Sweden)

    Dayane de Oliveira Estevam

    2015-06-01

    Full Text Available INTRODUÇÃO: Um dos recursos mais utilizados na reabilitação de lesões musculoesqueléticas é a termoterapia por subtração de calor (crioterapia, enquanto a termoterapia por adição de calor é considerada o procedimento mais antigo de reabilitação física. Entretanto, há poucas evidências que tenham investigado os efeitos desses recursos sobre o desempenho de membros superiores. OBJETIVO: Comparar o efeito do resfriamento e do aquecimento articular sobre o desempenho funcional do membro superior. MÉTODOS: Trinta e quatro voluntários (22,23 ± 2,17 anos; 22,39 ± 2,53 kg/m2, de ambos os sexos, foram divididos aleatoriamente em um dos três grupos: 1 grupo crioterapia GCR (n=10: submetidos ao resfriamento articular por compressas frias; 2 grupo termoterapia - GTE (n=10: submetidos ao aquecimento articular por ondas curtas e 3 grupo controle - GCO (n=14, não submetidos a qualquer intervenção. Os voluntários foram avaliados, pré e pós-intervenção, quanto ao desempenho funcional de membros superiores por meio dos testes de estabilidade da extremidade superior em cadeia cinética fechada (TEESCCF e das condições de equilíbrio em apoio bimanual sobre o baropodômetro. Ainda, os voluntários foram avaliados quanto ao desempenho funcional virtual por meio do jogo Mario Kart (Nintendo Wii (r . RESULTADOS: Houve melhora significativa nos valores pós-intervenção no TEESCCF para o GCR (p0,05. Entretanto, na condição de olhos fechados, houve piora de desempenho para GTE (p=0,04 e melhora de desempenho para o GCO (p=0,02. Não houve alteração significativa no desempenho funcional virtual para os três grupos (p>0,05. CONCLUSÃO: Embora não tenha favorecido o desempenho funcional em todos os testes reais e virtuais utilizados, o resfriamento articular foi mais efetivo que o aquecimento articular para manter o desempenho muscular do membro superior, especialmente nas condições de equilíbrio sobre membros superiores na condi

  2. Controversies in the management of intra-articular fractures of distal humerus in adults

    Directory of Open Access Journals (Sweden)

    Sudhir Babhulkar

    2011-01-01

    Full Text Available Background: The surgical approach, type of olecranon osteotomy, method of stabilization of osteotomy, type of fracture stabilization, orthogonal vs parallel plate fixation, need for transposition of ulnar nerve, place for primary total elbow replacement, and type of rehabilitation schedule after surgical fracture treatment are the controversial issues in the treatment of complex intra-articular distal humerus fractures (C2 and C3 in adults. Severe comminution, bone loss, and osteoporosis at the site of distal articular fractures of humerus often lead to unsatisfactory results due to inadequate fixation. We hereby report the outcome of a series of intracondylar fractures of the humerus treated by open reduction and internal fixation and discuss the controversies in light of published literature. Materials and Methods: One hundred and eighty-four patients of intra-articular fractures of distal humerus (C2 and C3 were operated by posterior transolecranon approach between January 1980 and December 2008. Initially, in the first part Chevron intra-articular osteotomy (n=108 was performed out of which 94 have been published in another publication. In later second part (1993 onward, extra-articular olecranon osteotomy (n=76 was routinely performed. Both columns were stably fixed by orthogonal methods; (n=174 however, during the last 2 years, in 10 patients with severe comminution with bone loss, stabilization was achieved by parallel plating. The osteotomy was routinely stabilized by tension band wiring with two parallel K-wires introduced up to the anterior ulnar cortex. The results were evaluated by the staging system of Caja et al. at a minimum follow-up of 2 years. Results: In the first part of the study (n=94, there was delayed union in 4% (n=4, with the fracture taking more than 20 weeks for union. There was delayed union of ulnar osteotomy (n=3 and failure of one tension band wiring, requiring revision. Some loss of motion was seen in 20% of

  3. Intra-articular temperatures of the knee in sports – An in-vivo study of jogging and alpine skiing

    Science.gov (United States)

    Becher, Christoph; Springer, Jan; Feil, Sven; Cerulli, Guiliano; Paessler, Hans H

    2008-01-01

    Background Up to date, no information exists about the intra-articular temperature changes of the knee related to activity and ambient temperature. Methods In 6 healthy males, a probe for intra-articular measurement was inserted into the notch of the right knee. Each subject was jogging on a treadmill in a closed room at 19°C room temperature and skiing in a ski resort at -3°C outside temperature for 60 minutes. In both conditions, temperatures were measured every fifteen minutes intra-articulary and at the skin surface of the knee. A possible influence on joint function and laxity was evaluated before and after activity. Statistical analysis of intra-articular and skin temperatures was done using nonparametric Wilcoxon's sign rank sum test and Mann-Whitney's-U-Test. Results Median intra-articular temperatures increased from 31.4°C before activity by 2.1°C, 4°C, 5.8°C and 6.1°C after 15, 30, 45 and 60 min of jogging (all p ≤ 0.05). Median intra-articular temperatures dropped from 32.2°C before activity by 0.5°C, 1.9°C, 3.6°C and 1.1°C after 15, 30, 45 and 60 min of skiing (all n.s.). After 60 minutes of skiing (jogging), the median intra-articular temperature was 19.6% (8.7%) higher than the skin surface temperature at the knee. Joint function and laxity appeared not to be different before and after activity within both groups. Conclusion This study demonstrates different changes of intra-articular and skin temperatures during sports in jogging and alpine skiing and suggests that changes are related to activity and ambient temperature. PMID:18405365

  4. Intra-articular temperatures of the knee in sports – An in-vivo study of jogging and alpine skiing

    Directory of Open Access Journals (Sweden)

    Cerulli Guiliano

    2008-04-01

    Full Text Available Abstract Background Up to date, no information exists about the intra-articular temperature changes of the knee related to activity and ambient temperature. Methods In 6 healthy males, a probe for intra-articular measurement was inserted into the notch of the right knee. Each subject was jogging on a treadmill in a closed room at 19°C room temperature and skiing in a ski resort at -3°C outside temperature for 60 minutes. In both conditions, temperatures were measured every fifteen minutes intra-articulary and at the skin surface of the knee. A possible influence on joint function and laxity was evaluated before and after activity. Statistical analysis of intra-articular and skin temperatures was done using nonparametric Wilcoxon's sign rank sum test and Mann-Whitney's-U-Test. Results Median intra-articular temperatures increased from 31.4°C before activity by 2.1°C, 4°C, 5.8°C and 6.1°C after 15, 30, 45 and 60 min of jogging (all p ≤ 0.05. Median intra-articular temperatures dropped from 32.2°C before activity by 0.5°C, 1.9°C, 3.6°C and 1.1°C after 15, 30, 45 and 60 min of skiing (all n.s.. After 60 minutes of skiing (jogging, the median intra-articular temperature was 19.6% (8.7% higher than the skin surface temperature at the knee. Joint function and laxity appeared not to be different before and after activity within both groups. Conclusion This study demonstrates different changes of intra-articular and skin temperatures during sports in jogging and alpine skiing and suggests that changes are related to activity and ambient temperature.

  5. Extra-articular deformities in arthritic knees-a grueling challenge for arthroplasty surgeons: An evidence-based update.

    Science.gov (United States)

    Khanna, Vishesh; Sambandam, Senthil N; Ashraf, Munis; Mounasamy, Varatharaj

    2017-12-14

    Critical to the success of a total knee arthroplasty (TKA) is the anatomical alignment. This may appear as a challenge in an extra-articular deformity (EAD) that may be inherent in certain people or result from fracture malunion, congenital disorders, nutritional, metabolic and infective causes. This appraisal aimed at providing the reader with an up-todate overview of the research carried out on, and existent evidence of EAD correction while planning a TKA. We reviewed the current English literature on TKA in extra-articular knee deformities. Among the published data, a common initial approach of mandatory clinical and radiological assessment emerges as an obligatory step while handling cases with EAD. While several methods of managing the deformity and arthritis have been described, a broad division into intra-articular and extra-articular means can be deciphered. The relatively old-school , yet reliable thought process of extra-articular correction allows an all-inclusive restoration of alignment with the inherent complications related to the necessary osteotomy. A cohort of younger and more venturesome surgeons seem inclined towards performing navigated, intra-articular correction for mild to moderate and sometimes, severe deformities. The crux of the matter lies is obtaining a well-balanced knee without violating the all-important cruciates. Restoring the patient's ambulatory status seems sooner with the intra-articular methods which are also more precise in determining the axes and while removing minimum bone. Greatest satisfaction is accomplished in those with less grotesque, rotationallyaligned knees while meticulously balancing soft-tissues and encouraging earlier weightbearing.

  6. Stimulation of the Superficial Zone Protein and Lubrication in the Articular Cartilage by Human Platelet-Rich Plasma

    Science.gov (United States)

    Sakata, Ryosuke; McNary, Sean M.; Miyatake, Kazumasa; Lee, Cassandra A.; Van den Bogaerde, James M.; Marder, Richard A.; Reddi, A. Hari

    2016-01-01

    Background Platelet-rich plasma (PRP) contains high concentrations of autologous growth factors that originate from platelets. Intra-articular injections of PRP have the potential to ameliorate the symptoms of osteoarthritis in the knee. Superficial zone protein (SZP) is a boundary lubricant in articular cartilage and plays an important role in reducing friction and wear and therefore is critical in cartilage homeostasis. Purpose To determine if PRP influences the production of SZP from human joint-derived cells and to evaluate the lubricating properties of PRP on normal bovine articular cartilage. Study Design Controlled laboratory study. Methods Cells were isolated from articular cartilage, synovium, and the anterior cruciate ligament (ACL) from 12 patients undergoing ACL reconstruction. The concentrations of SZP in PRP and culture media were measured by enzyme-linked immunosorbent assay. Cellular proliferation was quantified by determination of cell numbers. The lubrication properties of PRP from healthy volunteers on bovine articular cartilage were investigated using a pin-on-disk tribometer. Results In general, PRP stimulated proliferation in cells derived from articular cartilage, synovium, and ACL. It also significantly enhanced SZP secretion from synovium- and cartilage-derived cells. An unexpected finding was the presence of SZP in PRP (2.89 ± 1.23 µg/mL before activation and 3.02 ± 1.32 µg/mL after activation). In addition, under boundary mode conditions consisting of high loads and low sliding speeds, nonactivated and thrombin-activated PRP decreased the friction coefficient (μ = 0.012 and μ = 0.015, respectively) compared with saline (μ = 0.047, P lubricates bovine articular cartilage explants. Clinical Relevance These findings provide evidence to explain the biochemical and biomechanical mechanisms underlying the efficacy of PRP treatment for osteoarthritis or damage in the knee joint. PMID:25813869

  7. Atualização em infecções em próteses articulares Update on infections in articular prosthesis

    Directory of Open Access Journals (Sweden)

    Ana Lucia Lei Munhoz Lima

    2010-01-01

    Full Text Available O implante de próteses articulares, principalmente de quadril e joelho, vem se tornando cada vez mais frequente, representando significante redução no desconforto e imensurável melhora na mobilidade dos pacientes. As revisões da literatura mundial revelam que 1 a 5% destas próteses tornam-se infectadas, sendo importante lembrar que, conforme cresce o número de cirurgias para implantação destas próteses, cresce também o número de casos deste tipo de infecção. As bactérias gram-positivas são predominantes nas contaminações das próteses articulares, em especial o Staphylococcus aureus e o Staphylococcus epidermidis. As infecções causadas por bacilos gram-negativos e fungos como Candida sp vêm sendo relatadas com maior frequência em todo o mundo. As infecções de próteses articulares apresentam sinais característicos que podem ser divididos em manifestações agudas (dor severa, febre alta, toxemia, calor, rubor e secreção na ferida operatória e crônicas (dor progressiva, formação de fístulas cutâneas, com drenagem de secreção purulenta, sem febre. O diagnóstico definitivo da infecção deve ser realizado através do isolamento em cultura do micro-organismo obtido a partir da punção do líquido articular, secreção da ferida cirúrgica e materiais colhidos durante desbridamento cirúrgico. É fundamental a cobertura de S.aureus meticilino-resistente, visto a importância epidemiológica deste agente nessas infecções. O tempo total da antibioticoterapia varia de seis semanas a seis meses, sendo que o tratamento deve ser readequado quando necessário, com base nos resultados das culturas colhidas.The implantation of artificial joints, especially the hip and knee, is becoming increasingly common, representing a significant reduction in discomfort and an immeasurable improvement in patient mobility. Reviews of the global literature indicate that 1-5% of these grafts become infected, though it is important to

  8. Comparison of angle, shape, and position of articular processes in Dobermans and Great Danes with and without cervical spondylomyelopathy.

    Science.gov (United States)

    Bonelli, Marília de Albuquerque; da Costa, Ronaldo Casimiro; Martin-Vaquero, Paula; Lima, Carolina Gonçalves Dias

    2017-03-24

    Cervical spondylomyelopathy (CSM), also known as wobbler syndrome, affects mainly large and giant-breed dogs, causing compression of the cervical spinal cord and/or nerve roots. Structural and dynamic components seem to play a role in the development of CSM; however, pathogenesis is not yet fully understood. Physiologic and pathologic movements of the cervical spine depend on the morphology and morphometry of articular processes, as well as on intervertebral discs and vertebral column ligaments. Moreover, the characteristics of the articular processes affect motion and stability of the vertebral column. The goal of this study was to investigate the angle, shape, and position of the articular surfaces within the articular processes and compare them between Doberman Pinschers and Great Danes with and without cervical spondylomyelopathy. Magnetic resonance images were obtained for 60 dogs: 15 clinically normal Dobermans (Dob-N), 15 CSM-affected Dobermans (Dob-CSM), 15 clinically normal Great Danes (GD-N), and 15 CSM-affected Great Danes (GD-CSM). Angle, shape, and position (lateral distance) of the articular surfaces from the articular processes were analyzed from C 2-3 to C 7 -T 1 . Results indicate that the mean angle was different between Dob-CSM and GD-CSM at C 4-5 , C 5-6 , and C 6-7 , and between GD-N and GD-CSM at C 6-7 . There were differences between Dob-N and GD-N, and between Dob-CSM and GD-CSM for the lateral distance at most locations, except C 2-3 . Compared with Great Danes, Dobermans generally had a greater proportion of concave caudal surfaces at C 4-5 , C 5-6 , and C 6-7 . Concave articular surfaces have been associated with greater axial rotation. This may explain the high proportion of disc-associated CSM in Dobermans compared to Great Danes. The differences between breeds suggest they may have different motion patterns in the caudal cervical vertebral column. Considering that no differences in angle, shape, or position of the articular surfaces

  9. Spatial and temporal changes of subchondral bone proceed to articular cartilage degeneration in rats subjected to knee immobilization.

    Science.gov (United States)

    Xu, Lei; Li, Zhe; Lei, Lei; Zhou, Yue-Zhu; Deng, Song-Yun; He, Yong-Bin; Ni, Guo-Xin

    2016-03-01

    This study was aimed to investigate the spatial and temporal changes of subchondral bone and its overlying articular cartilage in rats following knee immobilization. A total of 36 male Wistar rats (11-13 months old) were assigned randomly and evenly into 3 groups. For each group, knee joints in 6 rats were immobilized unilaterally for 1, 4, or 8 weeks, respectively, while the remaining rats were allowed free activity and served as external control groups. For each animal, femurs at both sides were dissected after sacrificed. The distal part of femur was examined by micro-CT. Subsequently, femoral condyles were collected for further histological observation and analysis. For articular cartilage, significant changes were observed only at 4 and 8 weeks of immobilization. The thickness of articular cartilage and chondrocytes numbers decreased with time. However, significant changes in subchondral bone were defined by micro-CT following immobilization in a time-dependent manner. Immobilization led to a thinner and more porous subchondral bone plate, as well as a reduction in trabecular thickness and separation with a more rod-like architecture. Changes in subchondral bone occurred earlier than in articular cartilage. More importantly, immobilization-induced changes in subchondral bone may contribute, at least partially, to changes in its overlying articular cartilage. © 2016 Wiley Periodicals, Inc.

  10. Hyaluronic acid-coated bovine serum albumin nanoparticles loaded with brucine as selective nanovectors for intra-articular injection

    Directory of Open Access Journals (Sweden)

    Chen Z

    2013-10-01

    Full Text Available Zhipeng Chen,* Juan Chen,* Li Wu, Weidong Li, Jun Chen, Haibo Cheng, Jinhuo Pan, Baochang CaiDepartment of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, People's Republic of China*These authors contributed equally to this workObjective: To evaluate the potential of hyaluronic acid (HA-coated bovine serum albumin nanoparticles (BSANPs as a novel chondrocyte-targeting drug-delivery nanomedicine.Methods: The HA-BSANPs were characterized by dynamic light scattering, transmission electron microscopy, differential scanning calorimetry, and X-ray diffraction. Fluorescence imaging was used to visualize the distribution of nanoparticles after intra-articular injection. The chondrocyte-targeting efficiency and cellular uptake mechanism of HA-BSANPs were investigated using endocytic inhibitors.Results: HA-BSANPs were successfully prepared with HA coating the surface and amorphous drug in the core. Compared with BSANPs, HA-BSANPs exhibited improved uptake by chondrocytes through a receptor-mediated active uptake mechanism. The endocytosis process of BSANPs and HA-BSANPs involved clathrin-mediated endocytosis, caveolae-mediated endocytosis, and macropinocytosis. No apparent thickening or hyperplasia of the synovium was observed in either BSANPs or HA-BSANPs. The HA-BSANPs could reside in the articular cavity of rats for more than 14 days, which was significantly longer than BSANPs.Conclusion: HA-BSANPs are a promising carrier for articular-related diseases due to elongated articular residence and improved chondrocytic accumulation.Keywords: chondrocyte, intra-articular injection, hyaluronic acid, BSA, nanoparticles

  11. Dynamic MRI motion analysis of the condyle and articular disk in the sagittal plane during mouth opening and closing

    International Nuclear Information System (INIS)

    Tamura, Yoshinori; Uchida, Shinji; Inoue, Hiroshi

    2005-01-01

    We used dynamic magnetic resonance imaging (MRI) to analyze the velocity and excursion of the condyle and articular disk during mouth opening and closing. These parameters were compared between individuals with clicking sounds in the temporomandibular joint (TMD group, n=6) and those with no abnormalities in the joint (normal group, n=7). We used a Signa Horizon LX (1.5 Tesla, GE Inc., Wisconsin, USA) at fast spoiled gradient recalled acquisition in the steady state (SPGR), 7.7/1.4 ms echo time/repetition time (TR/TE), 8 mm thickness, and 40 sec duration. Each subject was instructed to open as widely as possible and then to close over a period of 40 seconds, during which time we measured the velocity and excursion of the condyle and articular disk. The degree of anterior displacement of the articular disk was quantified in the TMD patients. Compared with normal subjects, the degree of variance in movement velocity for opening and closing movements was significantly greater for the TMD patients. These findings suggest that dynamic MRI is useful for observing and quantifying the dynamics of the articular disk and that the degree of fluctuation in the velocity of articular disk movement is significantly greater for patients with clicking sounds. (author)

  12. Efeitos dos glicosaminoglicanos e sulfato de condroitina A sobre a cartilagem articular normal e com doença articular degenerativa em cães Glycosaminoglycans and chondroitin sulphate "A" effects on normal and osteoarthritic articular cartilage in dogs

    Directory of Open Access Journals (Sweden)

    N.T. Vieira

    2010-10-01

    Full Text Available Avaliaram-se os efeitos dos precursores dos glicosaminoglicanos (GAG e do sulfato de condroitina A (SC sobre a histomorfometria da cartilagem articular normal ou de cartilagem de cães com doença articular degenerativa (DAD experimental. Os grupos experimentais constituíram-se de animais com articulação direita normal, que não foi submetida a procedimento cirúrgico, e com articulação esquerda osteoartrótica e que foi submetida à intervenção cirúrgica. Os grupos foram subdivididos em animais com articulação não tratada e tratada, portanto: normais (N (n=5, NGAG (n=5 e NSC (n=4; e osteoartróticos (O (n=5, OGAG (n=5 e OSC (n=4. Secções de cartilagens do fêmur, da tíbia e da patela foram utilizadas neste estudo. Nos normais (N, NGAG e NSC, não se encontraram lesões que caracterizassem a DAD, embora tenha havido diminuição na celularidade nos de NGAG e NSC, em relação a N. Foram observadas alterações em graus variáveis entre os grupos osteoartróticos. Houve redução acentuada dos condrócitos no grupo O em comparação aos normais enquanto os grupos osteoartróticos tratados apresentaram celularidade semelhante aos normais tratados. Estes resultados foram confirmados pela análise do índice de proporção (IP, que se mostrou elevado em O, indicando menor síntese de proteoglicanos. Não houve diferença significativa entre os IPs dos grupos osteoartróticos tratados (OGAG, OSC apesar do comportamento distinto do OSC ao assemelhar-se aos grupos N e NSC. Estes resultados sugeriram que o SC agiu na cartilagem osteoartrótica de maneira mais eficaz, reduzindo a perda de proteoglicanos e estimulando a viabilidade celular e a atividade metabólica.The effects of precursors of glycosaminoglycans (GAG and chondroitin sulphate A (CS on the histomorphometry of normal articular cartilage and with experimental degenerative joint disease (DJD in dogs were evaluated. The groups were constituted as follows: normal joints were not

  13. Using Costal Chondrocytes to Engineer Articular Cartilage with Applications of Passive Axial Compression and Bioactive Stimuli.

    Science.gov (United States)

    Huwe, Le W; Sullan, Gurdeep K; Hu, Jerry C; Athanasiou, Kyriacos A

    2018-03-01

    Generating neocartilage with suitable mechanical integrity from a cell source that can circumvent chondrocyte scarcity is indispensable for articular cartilage regeneration strategies. Costal chondrocytes of the rib eliminate donor site morbidity in the articular joint, but it remains unclear how neocartilage formed from these cells responds to mechanical loading, especially if the intent is to use it in a load-bearing joint. In a series of three experiments, this study sought to determine efficacious parameters of passive axial compressive stimulation that would enable costal chondrocytes to synthesize mechanically robust cartilage. Experiment 1 determined a suitable time window for stimulation by its application during either the matrix synthesis phase, the maturation phase, or during both phases of the self-assembling process. The results showed that compressive stimulation at either time was effective in increasing instantaneous moduli by 92% and 87% in the synthesis and maturation phases, respectively. Compressive stimulation during both phases did not further improve properties beyond a one-time stimulation. The magnitude of passive axial compression was examined in Experiment 2 by applying 0, 3.3, 5.0, or 6.7 kPa stresses to the neocartilage. Unlike 6.7 kPa, both 3.3 and 5.0 kPa significantly increased neocartilage compressive properties by 42% and 48% over untreated controls, respectively. Experiment 3 examined how the passive axial compression regimen developed from the previous phases interacted with a bioactive regimen (transforming growth factor [TGF]-β1, chondroitinase ABC, and lysyl oxidase-like 2). Passive axial compression significantly improved the relaxation modulus compared with bioactive treatment alone. Furthermore, a combined treatment of compressive and bioactive stimulation improved the tensile properties of neocartilage 2.6-fold compared with untreated control. The ability to create robust articular cartilage from passaged costal

  14. Anti-Inflammatory Effects of Intra-Articular Hyaluronic Acid: A Systematic Review.

    Science.gov (United States)

    Altman, Roy; Bedi, Asheesh; Manjoo, Ajay; Niazi, Faizan; Shaw, Peter; Mease, Philip

    2018-02-01

    Objective Osteoarthritis (OA) is one of the leading causes of disability in the adult population. Common nonoperative treatment options include nonsteroidal anti-inflammatory drugs (NSAIDs), intra-articular corticosteroids, and intra-articular injections of hyaluronic acid (HA). HA is found intrinsically within the knee joint providing viscoelastic properties to the synovial fluid. HA therapy provides anti-inflammatory relief through a number of different pathways, including the suppression of pro-inflammatory cytokines and chemokines. Methods We conducted a systematic review to summarize the published literature on the anti-inflammatory properties of hyaluronic acid in osteoarthritis. Included articles were categorized based on the primary anti-inflammatory responses described within them, by the immediate cell surface receptor protein assessed within the article, or based on the primary theme of the article. Key findings aimed to describe the macromolecules and inflammatory-mediated responses associated with the cell transmembrane receptors. Results Forty-eight articles were included in this systematic review that focused on the general anti-inflammatory effects of HA in knee OA, mediated through receptor-binding relationships with cluster determinant 44 (CD44), toll-like receptor 2 (TLR-2) and 4 (TLR-4), intercellular adhesion molecule-1 (ICAM-1), and layilin (LAYN) cell surface receptors. Higher molecular weight HA (HMWHA) promotes anti-inflammatory responses, whereas short HA oligosaccharides produce inflammatory reactions. Conclusions Intra-articular HA is a viable therapeutic option in treating knee OA and suppressing inflammatory responses. HMWHA is effective in suppressing the key macromolecules that elicit the inflammatory response by short HA oligosaccharides.

  15. Physical properties of rabbit articular cartilage after transection of the anterior cruciate ligament.

    Science.gov (United States)

    Sah, R L; Yang, A S; Chen, A C; Hant, J J; Halili, R B; Yoshioka, M; Amiel, D; Coutts, R D

    1997-03-01

    The effect of unilateral transection of the anterior cruciate ligament on the confined compression and swelling properties of the distal femoral articular cartilage of skeletally mature rabbits at 9 weeks after surgery was determined. Gross morphological grading of the transected and contralateral control distal femora stained with India ink confirmed that cartilage degeneration had been induced by ligament transection. Osteochondral cores, 1.8 mm in diameter, were harvested from the medial femoral condyles. The modulus, permeability, and electrokinetic (streaming potential) coefficient of the articular cartilage of the osteochondral cores were assessed by confined compression creep experiments. The properties (mean +/- SD) of control cartilage were: confined compression modulus, 0.75 +/- 0.28 MPa; hydraulic permeability, 0.63 +/- 0.28 x 10(-15) m2/Pa*sec; and electrokinetic coefficient, 0.16 +/- 0.31 x 10(-9) V/Pa. In transected knees, the modulus was reduced by 18% (p = 0.04), while the permeability and electrokinetic coefficient were not detectably altered. The change in modulus was accompanied by a trend (p = 0.07) toward a decrease (-11%) in the glycosaminoglycan density within the tissue, a significant increase (p < 0.001) in the water content of the cartilage after equilibration in 1 x phosphate buffered saline from 70.3 +/- 4.1% in control knees to 75.2 +/- 4.0% in transected knees, and little further swelling after tissue equilibration in hypotonic saline. The compressive modulus of the cartilage from both control and transected knees was positively correlated with the density of tissue glycosaminoglycan. The alterations in the physical properties of the articular cartilage after transection of the anterior cruciate ligament in the rabbit show trends similar to those observed in human and other animal models of osteoarthritis and provide further support for the use of this model in the study of cartilage degeneration.

  16. Intra-articular corticosteroid injection in diabetic patients with adhesive capsulitis: a randomized controlled trial.

    Science.gov (United States)

    Roh, Young Hak; Yi, Seung Rim; Noh, Jung Ho; Lee, Sung Yup; Oh, Joo Han; Gong, Hyun Sik; Baek, Goo Hyun

    2012-10-01

    An intra-articular corticosteroid injection is considered an effective treatment for idiopathic adhesive capsulitis of the shoulder. This study examined the efficacy of corticosteroid injections for the treatment for adhesive capsulitis in patients with diabetes mellitus. Forty-five diabetic patients were randomized into a corticosteroid injection group or non-injection control group and received the same instruction for a home stretching exercise. The corticosteroid group patients were administered intra-articular corticosteroid injection composed of 40 mg triamcinolone acetonide. Pain by a visual analogue scale, shoulder range of motion, and functional state by the American Shoulder and Elbow score were assessed at the baseline, 4-, 12-, and 24-week follow-up. Diabetic patients treated with corticosteroid injections showed significant improvement in the pain score at 4 weeks and in the functional score at 12 weeks (P = 0.020 and P = 0.042, respectively). The range of motion in forward elevation and internal rotation was significantly higher in the corticosteroid group than in the non-corticosteroid group at the 12-week follow-up (P = 0.030 and 0.045, respectively), but there were no significant differences at the final follow-up between the corticosteroid and non-corticosteroid groups. A corticosteroid injection in diabetic patients decreases the pain perception and accelerates the functional recovery in the early post-injection period. An intra-articular corticosteroid injection is considered a viable option for the treatment for adhesive capsulitis with diabetes. Randomized clinical trial, therapeutic study, Level II.

  17. Intra-articular injection of hyaluronate versus corticosteroid in adhesive capsulitis.

    Science.gov (United States)

    Lim, Tae Kang; Koh, Kyoung Hwan; Shon, Min Soo; Lee, Seung Won; Park, Young Eun; Yoo, Jae Chul

    2014-10-01

    The goal of this study was to prospectively compare the early clinical results of intra-articular injection of hyaluronate or corticosteroid in patients with idiopathic adhesive capsulitis. The authors' hypothesis was that there would be no difference between groups. Sixty-eight patients with idiopathic adhesive capsulitis were equally randomized to receive either corticosteroid or hyaluronate injection. All patients underwent standard physical examination and magnetic resonance imaging. Intra-articular injection was performed through an anterior approach by the same orthopedic surgeon without image guidance. Patients were followed up 2 and 12 weeks after completion of the injection. The primary outcome was the Constant score at week 12. Secondary outcomes included the visual analog scale (VAS) pain score, the American Shoulder and Elbow Surgeons (ASES) score, and range of motion at each time point. No significant differences were noted in preoperative demographic features or baseline shoulder function between groups. After treatment, no significant differences were noted in early clinical outcomes (at weeks 2 and 12) with VAS, ASES, and Constant scores between groups (all P>.05). Evaluation of range of motion showed no difference in forward elevation or external rotation at each time point. Internal rotation was significantly lower at week 2 in the hyaluronate group compared with the corticosteroid group (P=.015). Internal rotation improved at week 12, with no significant difference between groups. Patients treated with intra-articular injection of hyaluronate and corticosteroid for idiopathic adhesive capsulitis showed significant improvement in early clinical scores and range of motion without significant differences between groups. Copyright 2014, SLACK Incorporated.

  18. Intra-articular Physeal Fractures of the Distal Femur: A Frequently Missed Diagnosis in Adolescent Athletes.

    Science.gov (United States)

    Pennock, Andrew T; Ellis, Henry B; Willimon, Samuel C; Wyatt, Charles; Broida, Samuel E; Dennis, M Morgan; Bastrom, Tracey

    2017-10-01

    Intra-articular physeal fractures of the distal femur are an uncommon injury pattern, with only a few small case series reported in the literature. To pool patients from 3 high-volume pediatric centers to better understand this injury pattern, to determine outcomes of surgical treatment, and to assess risk factors for complications. Case series; Level of evidence, 4. A multicenter retrospective review of all patients presenting with an intra-articular physeal fracture between 2006 and 2016 was performed. Patient demographic and injury data, surgical data, and postoperative outcomes were documented. Radiographs were evaluated for fracture classification (Salter-Harris), location, and displacement. Differences between patients with and without complications were compared by use of analysis of variance or chi-square tests. A total of 49 patients, with a mean age of 13.5 years (range, 7-17 years), met the inclusion criteria. The majority of fractures were Salter-Harris type III fractures (84%) involving the medial femoral condyle (88%). Football was responsible for 50% of the injuries. The initial diagnosis was missed in 39% of cases, and advanced imaging showed greater mean displacement (6 mm) compared with radiographs (3 mm). All patients underwent surgery and returned to sport with "good to excellent" results after 2 years. Complications were more common in patients with wide-open growth plates, patients with fractures involving the lateral femoral condyle, and patients who were casted ( P < .05). Clinicians evaluating skeletally immature athletes (particularly football players) with acute knee injuries should maintain a high index of suspicion for an intra-articular physeal fracture. These fractures are frequently missed, and advanced imaging may be required to establish the diagnosis. Leg-length discrepancies and angular deformities are not uncommon, and patients should be monitored closely. Surgical outcomes are good when fractures are identified, with high rates

  19. Percutaneous pinning for non-comminuted extra-articular fractures of distal radius

    Directory of Open Access Journals (Sweden)

    Abhishek K Das

    2011-01-01

    Full Text Available Background: Various treatment modalities have been described for the treatment of extra-articular distal radius fractures each with its own merits and demerits. Most of the work done with percutaneous pinning has shown a significant residual stiffness of the hand and wrist. Our technique involves percutaneous pinning of the fracture and immobilization in neutral position of the wrist for three weeks. This study′s aim was to examine the functional outcome of percutaneous K-wiring of these extra-articular distal radius fractures with immobilization in neutral position of the wrist. Materials and Methods: This is a prospective study of 32 patients aged between 18 and 70 years with extra-articular distal radius fracture. Patients were treated with closed reduction and percutaneous pinning using two or three K-wires. A below- elbow plaster of paris dorsoradial slab was applied in neutral position of the wrist for 3 weeks. At the end of 3 weeks, the slab was removed and wrist physiotherapy started. The radiographs were taken postoperatively, at 3 weeks, 6 weeks and 6 months. The functional evaluation of the patients was done at 6 months follow-up. We used Sarmiento′s modification of Lindstrom criteria and Gartland and Werley′s criteria for evaluation of results. Results: Excellent to good results were seen in 93.75% of the cases while 6.25% had fair results. The complications observed were pin loosening (n=13, pin tract infection (n=2, malunion (n=2, wrist joint stiffness (n=2, reduced grip strength (n=2 and injury to the superficial radial nerve (n=1. Conclusion: Percutaneous pinning followed by immobilization of the wrist in neutral position is a simple and effective method to maintain reduction and prevent stiffness of wrist and hand.

  20. Intra-articular transplantation of atsttrin-transduced mesenchymal stem cells ameliorate osteoarthritis development.

    Science.gov (United States)

    Xia, Qingqing; Zhu, Shouan; Wu, Yan; Wang, Jiaqiu; Cai, Youzhi; Chen, Pengfei; Li, Jie; Heng, Boon Chin; Ouyang, Hong Wei; Lu, Ping

    2015-05-01

    Osteoarthritis (OA) remains an intractable clinical challenge. Few drugs are available for reversing this degenerative disease, although some promising candidates have performed well in preclinical studies. Tumor necrosis factor α (TNFα) has been identified as a crucial effector modulating OA pathogenesis. This study aimed to investigate the therapeutic effects of Atsttrin, a novel TNFα blocker, on OA treatment. We developed genetically modified mesenchymal stem cells (MSCs) that expressed recombinant Atsttrin (named as MSC-Atsttrin). Expression levels of ADAMTS-5, MMP13, and iNOS of human chondrocytes were analyzed when cocultured with MSC-GFP/Atsttrin. OA animal models were induced by anterior cruciate ligament transection, and MSC-GFP/Atsttrin were injected into the articular cavity 1 week postsurgery. The results showed that MSC-Atsttrin significantly suppressed TNFα-driven up-regulation of matrix proteases and inflammatory factors. Intra-articular injection of MSC-Atsttrin prevented the progression of degenerative changes in the surgically induced OA mouse model. Additionally, levels of detrimental matrix hydrolases were significantly diminished. Compared with nontreated OA samples at 8 weeks postsurgery, the percentages of MMP13- and ADAMTS-5-positive cells were significantly reduced from 91.33% ± 9.87% to 24.33% ± 5.7% (p < .001) and from 91.33% ± 7.1% to 16.67% ± 3.1% (p < .001), respectively. Our results thus indicated that suppression of TNFα activity is an effective strategy for OA treatment and that intra-articular injection of MSCs-Atsttrin could be a promising therapeutic modality. ©AlphaMed Press.

  1. Forearm articular proportions and the antebrachial index in Homo sapiens, Australopithecus afarensis and the great apes.

    Science.gov (United States)

    Williams, Frank L'Engle; Cunningham, Deborah L; Amaral, Lia Q

    2015-12-01

    When hominin bipedality evolved, the forearms were free to adopt nonlocomotor tasks which may have resulted in changes to the articular surfaces of the ulna and the relative lengths of the forearm bones. Similarly, sex differences in forearm proportions may be more likely to emerge in bipeds than in the great apes given the locomotor constraints in Gorilla, Pan and Pongo. To test these assumptions, ulnar articular proportions and the antebrachial index (radius length/ulna length) in Homo sapiens (n=51), Gorilla gorilla (n=88), Pan troglodytes (n=49), Pongo pygmaeus (n=36) and Australopithecus afarensis A.L. 288-1 and A.L. 438-1 are compared. Intercept-adjusted ratios are used to control for size and minimize the effects of allometry. Canonical scores axes show that the proximally broad and elongated trochlear notch with respect to size in H. sapiens and A. afarensis is largely distinct from G. gorilla, P. troglodytes and P. pygmaeus. A cluster analysis of scaled ulnar articular dimensions groups H. sapiens males with A.L. 438-1 ulna length estimates, while one A.L. 288-1 ulna length estimate groups with Pan and another clusters most closely with H. sapiens, G. gorilla and A.L. 438-1. The relatively low antebrachial index characterizing H. sapiens and non-outlier estimates of A.L. 288-1 and A.L. 438-1 differs from those of the great apes. Unique sex differences in H. sapiens suggest a link between bipedality and forearm functional morphology. Copyright © 2015 Elsevier GmbH. All rights reserved.

  2. Intra-articular hip injection: does pain relief correlate with radiographic severity of osteoarthritis?

    International Nuclear Information System (INIS)

    Deshmukh, Ajit J.; Rodriguez, Jose A.; Panagopoulos, Georgia; Alizadeh, Ahmadreza; Klein, Devon A.

    2011-01-01

    Intra-articular injection is being used widely for both diagnostic and therapeutic purposes in the hip. However, its efficacy is not always predictable in patients with hip osteoarthritis (OA). The purpose of this study was to determine whether the degree of radiographic severity of OA was predictive of the response to intra-articular injection of local anesthetic with corticosteroid and to determine the relationship between immediate pain relief resulting from the anesthetic and delayed pain relief resulting from corticosteroid administration. This retrospective study included 217 patients (220 injections) with diagnosis of hip OA who underwent a fluoroscopically guided therapeutic hip injection of local anesthetic and corticosteroid. Hip radiographs were scored using the Kellgren-Lawrence scale. Immediate and delayed pain relief was documented using a visual analog scale. Logistic regression analysis was performed to investigate whether age, gender or radiographic severity of OA were independent predictors of pain relief. Degree of agreement between immediate and delayed response was assessed with the kappa coefficient. Immediate pain relief was reported in 68.2% of hips and delayed relief in 71.4% of hips. A high level of agreement was observed between immediate and delayed pain relief (kappa = 0.80, p < 0.001). 94% of patients reporting immediate relief also reported relief 2 weeks later. Univariate and multivariate analysis revealed that neither gender nor age was related to immediate or delayed pain relief. Only severity of OA (based on radiographic analysis) was observed to be predictive of pain relief. Pain relief following intra-articular hip injection correlated with radiographic severity of OA. This intervention may be of therapeutic and prognostic value in patients awaiting hip arthroplasty. (orig.)

  3. Mechanical Stimulation Protocols of Human Derived Cells in Articular Cartilage Tissue Engineering - A Systematic Review.

    Science.gov (United States)

    Khozoee, Baktash; Mafi, Pouya; Mafi, Reza; Khan, Wasim S

    2017-01-01

    Mechanical stimulation is a key factor in articular cartilage generation and maintenance. Bioreactor systems have been designed and built in order to deliver specific types of mechanical stimulation. The focus has been twofold, applying a type of preconditioning in order to stimulate cell differentiation, and to simulate in vivo conditions in order to gain further insight into how cells respond to different stimulatory patterns. Due to the complex forces at work within joints, it is difficult to simulate mechanical conditions using a bioreactor. The aim of this review is to gain a deeper understanding of the complexities of mechanical stimulation protocols by comparing those employed in bioreactors in the context of tissue engineering for articular cartilage, and to consider their effects on cultured cells. Allied and Complementary Medicine 1985 to 2016, Ovid MEDLINE[R] 1946 to 2016, and Embase 1974 to 2016 were searched using key terms. Results were subject to inclusion and exclusion criteria, key findings summarised into a table and subsequently discussed. Based on this review it is overwhelmingly clear that mechanical stimulation leads to increased chondrogenic properties in the context of bioreactor articular cartilage tissue engineering using human cells. However, given the variability and lack of controlled factors between research articles, results are difficult to compare, and a standardised method of evaluating stimulation protocols proved challenging. With improved standardisation in mechanical stimulation protocol reporting, bioreactor design and building processes, along with a better understanding of joint behaviours, we hope to perform a meta-analysis on stimulation protocols and methods. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  4. Temporomandibular Joint Condylar Changes Following Maxillomandibular Advancement and Articular Disc Repositioning

    Science.gov (United States)

    Goncalves, Joao Roberto; Wolford, Larry Miller; Cassano, Daniel Serra; da Porciuncula, Guilherme; Paniagua, Beatriz; Cevidanes, Lucia Helena

    2014-01-01

    Purpose To evaluate condylar changes 1 year after bimaxillary surgical advancement with or without articular disc repositioning using longitudinal quantitative measurements in 3-dimensional (3D) temporomandibular joint (TMJ) models. Methods Twenty-seven patients treated with maxillomandibular advancement (MMA) underwent cone-beam computed tomography before surgery immediately after surgery and at 1-year follow-up. All patients underwent magnetic resonance imaging before surgery to assess disc displacements. Ten patients without disc displacement received MMA only. Seventeen patients with articular disc displacement received MMA with simultaneous TMJ disc repositioning (MMA-Drep). Pre- and postsurgical 3D models were superimposed using a voxel-based registration on the cranial base. Results The location, direction, and magnitude of condylar changes were displayed and quantified by graphic semitransparent overlays and 3D color-coded surface distance maps. Rotational condylar displacements were similar in the 2 groups. Immediately after surgery, condylar translational displacements of at least 1.5 mm occurred in a posterior, superior, or mediolateral direction in patients treated with MMA, whereas patients treated with MMA-Drep presented more marked anterior, inferior, and mediolateral condylar displacements. One year after surgery, more than half the patients in the 2 groups presented condylar resorptive changes of at least 1.5 mm. Patients treated with MMA-Drep presented condylar bone apposition of at least 1.5 mm at the superior surface in 26.4%, the anterior surface in 23.4%, the posterior surface in 29.4%, the medial surface in 5.9%, or the lateral surface in 38.2%, whereas bone apposition was not observed in patients treated with MMA. Conclusions One year after surgery, condylar resorptive changes greater than 1.5 mm were observed in the 2 groups. Articular disc repositioning facilitated bone apposition in localized condylar regions in patients treated with MMA

  5. In vitro evaluation and intra-articular administration of biodegradable microspheres containing naproxen sodium.

    Science.gov (United States)

    Bozdağ, S; Caliş, S; Kaş, H S; Ercan, M T; Peksoy, I; Hincal, A A

    2001-01-01

    The dispersion of non-steroidal antiinflammatory drugs (NSAIDs) into biodegradable polymeric matrices have been accepted as a good approach for obtaining a therapeutic effect in a predetermined period of time meanwhile minimizing the side effects of NSAIDs. In the present study, it was aimed to prepare Naproxen Sodium (NS), (a NSAID) loaded microsphere formulation using natural Bovine Serum Albumin (BSA) and synthetic biodegradable polymers such as poly(lactide-co-glycolic acid) (PLGA) (50:50 MW 34,000 and 88,000 Da) for intra-articular administration, and to study the retention of the drug at the site of injection in the knee joint. NS incorporated microspheres were evaluated in vitro for particle size (the mean particle size; for BSA microspheres, 10.0 +/- 0.3 microm, for PLGA microspheres, 9.0 +/- 0.2 and 5.0 +/- 0.1 microm for MW 34,000 and 88,000 Da, respectively), yield value, drug loading, surface morphology and drug release. For in vivo studies, monoarticular arthritis was induced in the left knee joints of rabbits by using ovalbumin and Freund's Complete Adjuvant as antigen and adjuvant. A certain time (4 days) is allowed for the formation of arthritis in the knee joints, then the NS loaded microspheres were injected directly into the articular cavity. At specific time points, gamma scintigrams were obtained to determine the residence time of the microspheres in knee joints, in order to determine the most suitable formulation. This study indicated that PLGA, a synthetic polymer, is more promising than the natural type BSA microspheres for an effective cure of mono-articular arthritis in rabbits.

  6. Optimal Regression Method for Near-Infrared Spectroscopic Evaluation of Articular Cartilage.

    Science.gov (United States)

    Prakash, Mithilesh; Sarin, Jaakko K; Rieppo, Lassi; Afara, Isaac O; Töyräs, Juha

    2017-10-01

    Near-infrared (NIR) spectroscopy has been successful in nondestructive assessment of biological tissue properties, such as stiffness of articular cartilage, and is proposed to be used in clinical arthroscopies. Near-infrared spectroscopic data include absorbance values from a broad wavelength region resulting in a large number of contributing factors. This broad spectrum includes information from potentially noisy variables, which may contribute to errors during regression analysis. We hypothesized that partial least squares regression (PLSR) is an optimal multivariate regression technique and requires application of variable selection methods to further improve the performance of NIR spectroscopy-based prediction of cartilage tissue properties, including instantaneous, equilibrium, and dynamic moduli and cartilage thickness. To test this hypothesis, we conducted for the first time a comparative analysis of multivariate regression techniques, which included principal component regression (PCR), PLSR, ridge regression, least absolute shrinkage and selection operator (Lasso), and least squares version of support vector machines (LS-SVM) on NIR spectral data of equine articular cartilage. Additionally, we evaluated the effect of variable selection methods, including Monte Carlo uninformative variable elimination (MC-UVE), competitive adaptive reweighted sampling (CARS), variable combination population analysis (VCPA), backward interval PLS (BiPLS), genetic algorithm (GA), and jackknife, on the performance of the optimal regression technique. The PLSR technique was found as an optimal regression tool (R 2 Tissue thickness  = 75.6%, R 2 Dynamic modulus  = 64.9%) for cartilage NIR data; variable selection methods simplified the prediction models enabling the use of lesser number of regression components. However, the improvements in model performance with variable selection methods were found to be statistically insignificant. Thus, the PLSR technique is

  7. Morphometric and histopathological analysis of articular cartilage regeneration on tissue engineered scaffolds

    OpenAIRE

    Pedraza Concha, Celso Fernando

    2014-01-01

    El objetivo de este trabajo es estudiar la regeneración in vivo de cartílago articular inducido por scaffolds manufacturados mediante técnicas de ingeniería tisular, evaluando la formación de neotejido inducido por diferentes andamiajes, mediante técnicas histológicas y morfométricas. Previo al presente trabajo, en el centro de biomateriales se han diseñado y fabricado scaffolds bioestables compuestos por copolímeros de poli-etilacrilato e hidroxietil-acrilato p(EA-co-HEA), con 90% unid...

  8. Variabilidade da frequência cardíaca em mulheres com hipermobilidade articular

    OpenAIRE

    Nunes,Mariane de Oliveira; Rubira,Marcelo Custódio; Rubira,Ana Paula Fernandes De Angelis; Nascimento,Aline Cristina Pereira do; Paula Júnior,Alderico Rodrigues de; Osório,Rodrigo Alexis Lazo

    2011-01-01

    A hipermobilidade é a capacidade de desempenhar movimentos articulares com amplitude maior que o normal. A prevalência possui variações determinadas pela etnia, sexo, idade, atividade física e variações nos critérios de caracterização. Aproximadamente 30% dos adultos são portadores e apresentam feedback proprioceptivo, sensorial diminuído e espacial alterado da articulação levando a maior frequência de ativação e deformação dos mecanorreceptores nos músculos esqueléticos e na pele. O aumento ...

  9. Hyaluronan Protects Bovine Articular Chondrocytes against Cell Death Induced by Bupivacaine under Supraphysiologic Temperatures

    Science.gov (United States)

    Liu, Sen; Zhang, Qing-Song; Hester, William; O’Brien, Michael J.; Savoie, Felix H.; You, Zongbing

    2013-01-01

    Background Bupivacaine and supraphysiologic temperature can independently reduce cell viability of articular chondrocytes. In combination these two deleterious factors could further impair cell viability. Hypothesis Hyaluronan may protect chondrocytes from death induced by bupivacaine at supraphysiologic temperatures. Study Design Controlled laboratory study. Methods Bovine articular chondrocytes were treated with hyaluronan at physiologic (37°C) and supraphysiologic temperatures (45°C and 50°C) for one hour, and then exposed to bupivacaine for one hour at room temperature. Cell viability was assessed at three time points: immediately after treatment, six hours later, and twenty-four hours later using flow cytometry and fluorescence microscopy. The effects of hyaluronan on the levels of sulfated glycosaminoglycan in the chondrocytes were determined using Alcian blue staining. Results (1) Bupivacaine alone did not induce noticeable chondrocyte death at 37°C; (2) bupivacaine and temperature synergistically increased chondrocyte death, that is, when the chondrocytes were conditioned to 45°C and 50°C, 0.25% and 0.5% bupivacaine increased the cell death rate by 131% to 383% in comparison to the phosphate-buffered saline control group; and, (3) addition of hyaluronan reduced chondrocyte death rates to approximately 14% and 25% at 45°C and 50°C, respectively. Hyaluronan’s protective effects were still observed at six and twenty-four hours after bupivacaine treatment at 45°C. However, at 50°C, hyaluronan delayed but did not prevent the cell death caused by bupivacaine. One-hour treatment with hyaluronan significantly increased sulfated glycosaminoglycan levels in the chondrocytes. Conclusions Bupivacaine and supraphysiologic temperature synergistically increase chondrocyte death and hyaluronan may protect articular chondrocytes from death caused by bupivacaine. Clinical Relevance This study provides a rationale to perform pre-clinical and clinical studies to

  10. O Efeito de um protocolo de alongamento muscular passivo sobre a cartilagem articular.

    OpenAIRE

    Adriana Frias Renner

    2005-01-01

    Objetivo: Este estudo avaliou a resposta da cartilagem articular do tornozelo de ratos, após aplicação de um protocolo de alongamento muscular passivo cíclico em animais previamente submetidos à imobilização. Materiais e Métodos: Para isso foram utilizados 22 ratos albinos adultos jovens (280+25,4g) distribuídos aleatoriamente em 4 grupos: imobilizado (I), n=6, imobilizado e alongado (IA), n=5, alongado (A), n=6 e controle (C), n=5. Nos grupos I e IA foi utilizado um modelo de imobiliza...

  11. Tratamiento de los defectos del cartílago articular en la rodilla

    OpenAIRE

    Reverté Vinaixa, María Mercedes

    2015-01-01

    Las lesiones condrales y osteocondrales en la rodilla aparecen en gente joven, activa y con gran expectativa de vida. Estás suponen un gran problema, puesto que este una vez destruido, ya no se repara. Debido a la escasa capacidad intrínseca de curación del cartílago, sus lesiones tienden a causar morbilidad en forma de dolor articular y disfunción. Existen diferentes técnicas quirúrgicas que mejoran la sintomatología y la historia natural de las lesiones condrales. Las lesiones del cartílago...

  12. Hypersensitivity to mechanical and intra-articular electrical stimuli in persons with painful temporomandibular joints

    DEFF Research Database (Denmark)

    Ayesh, Emad; Jensen, Troels Staehelin; Svensson, P

    2007-01-01

    This study tested whether persons with TMJ arthralgia have a modality-specific and site-specific hypersensitivity to somatosensory stimuli assessed by quantitative sensory tests (QST). Forty-three healthy persons and 20 with TMJ arthralgia participated. The QST consisted of: sensory and pain...... detection thresholds and summation threshold to intra-articular electrical stimulation, tactile and pin-prick sensitivity in the TMJ area, pressure-pain threshold and tolerance on the lateral side of the TMJ and on the finger. Persons with TMJ arthralgia had lower pain detection and summation thresholds (P...

  13. The Effect of Aging and Mechanical Loading on the Metabolism of Articular Cartilage

    DEFF Research Database (Denmark)

    Jørgensen, Adam El Mongy; Kjaer, Michael; Heinemeier, Katja Maria

    2017-01-01

    , with the literature search made on PubMed using appropriate keywords regarding AC, age, and mechanical loading. Results. Following skeletal maturation, chondrocyte numbers decline while increasing senescence occurs. Lower cartilage turnover causes diminished maintenance capacity, which produces accumulation......Objective. The morphology of articular cartilage (AC) enables painless movement. Aging and mechanical loading are believed to influence development of osteoarthritis (OA), yet the connection remains unclear. Methods. This narrative review describes the current knowledge regarding this area...... of fibrillar crosslinks by advanced glycation end products, resulting in increased stiffness and thereby destruction susceptibility. Conclusion. Mechanical loading changes proteoglycan content. Moderate mechanical loading causes hypertrophy and reduced mechanical loading causes atrophy. Overloading produces...

  14. The effect og aging and mechanical loading on the metabolism og articular cartilage

    DEFF Research Database (Denmark)

    Jørgensen, Adam El Mongy; Kjær, Michael; Heinemeier, Katja Maria

    2017-01-01

    , with the literature search made on PubMed using appropriate keywords regarding AC, age, and mechanical loading. Results. Following skeletal maturation, chondrocyte numbers decline while increasing senescence occurs. Lower cartilage turnover causes diminished maintenance capacity, which produces accumulation......Objective. The morphology of articular cartilage (AC) enables painless movement. Aging and mechanical loading are believed to influence development of osteoarthritis (OA), yet the connection remains unclear. Methods. This narrative review describes the current knowledge regarding this area...... of fibrillar crosslinks by advanced glycation end products, resulting in increased stiffness and thereby destruction susceptibility. Conclusion. Mechanical loading changes proteoglycan content. Moderate mechanical loading causes hypertrophy and reduced mechanical loading causes atrophy. Overloading produces...

  15. Endoscopically Assisted Resection of a Rare Mass: Intra-Articular Osteochondroma of Shoulder Originated from Scapula

    Directory of Open Access Journals (Sweden)

    Baran Sarikaya

    2016-01-01

    Full Text Available Osteochondromas are the most common benign bone tumors which are mostly seen in the metaphysis of distal femur, proximal tibia, and proximal humerus. As arising from flat bones such as scapula is a rare case, intra-articular osteochondroma is also rare. When the literature is searched it appeared that the scapula and shoulder joint are an uncommon site for osteochondroma. We present a case in which a patient had an osteochondroma placed in shoulder joint and originated from scapula which is a rare situation determined in the literature.

  16. Exostosis-like intra-articular periosteal osteoblastoma: a rare case.

    Science.gov (United States)

    Abolghasemian, Mansour; Rezaie, Mitra; Behgoo, Abas; Shoushtarizadeh, Tina; Ghazavi, Mohammad Taghi

    2010-06-01

    Osteoblastoma is a relatively rare benign bone tumor, most often located in the vertebral column or metaphysis of the long bones, particularly the femur and the tibia. Periosteal osteoblastoma is the least common type. Exostosis-like appearance is not common even in periosteal osteoblastoma, a very rare type of this tumor. In addition, an intraarticular location is uncommon for osteoblastomas. Here we report the case of a 25-year-old man with intra-articular exostosis-like periosteal osteoblastoma of the hip that resulted in impingement and osteoarthritis.

  17. Intramedullary Percutaneous Fixation of Extra-Articular Proximal and Middle Phalanx Fractures.

    Science.gov (United States)

    Jovanovic, Nebojsa; Aldlyami, Ehab; Saraj, Basem; Fm Seidam, Mohamed; Badawi, Hamed; Shaat, Ahmed; Alawadi, Khalid; Dodakundi, Chaitanya

    2018-03-02

    Multiple methods have been described for treating unstable proximal and middle phalangeal fractures. Irrespective of using an open or closed technique of fixation, stiffness and extensor lag at the proximal/distal interphalangeal joint almost always occur. This issue can be avoided by allowing the patients to mobilize the fingers out of plaster or splint as early as possible from the day of surgery. We describe a technique of intramedullary percutaneous fixation of extra-articular proximal and middle phalanx fractures allowing immediate mobilization of fingers, concurrent stabilization with progressive healing and thus preventing such complications.

  18. Fracturas articulares de calcáneo: tratamiento incruento versus quirúrgico

    OpenAIRE

    Gracia Rodríguez, Indalecio; Pérez Aznar, A. T.; Sanz Reig, J.; Lizaur Utrilla, A.

    1997-01-01

    Se analiza la problemática que supone el tratamiento de las fracturas articulares de calcáneo. Han sido revisadas 85 fracturas tratadas, 43 ortopédicamente, y 42 según técnica de Westhues-Ehalt. El seguimiento medio fue de 24 meses. Los resultados clínicos fueron satisfactorios en el 43,5 %, no existiendo correlación con la disminución radiográfica del ángulo de Bóhler. El tipo de tratamiento empleado no influyó significativamente en el resultado clínico final, pero sí el grado...

  19. Impact of extra-articular pathologies on groin pain: An arthroscopic evaluation.

    Directory of Open Access Journals (Sweden)

    Mitsunori Kaya

    Full Text Available For patients who have anterior hip pain evaluated by Patrick's test and tenderness at Scarpa's triangle, we perform periarticular debridement based on the hypothesis that extra-articular pathologies are responsible for the hip pain. The purpose of this study was to categorize the endoscopic extra-articular findings and to evaluate the clinical significance of periarticular pathologies in anterior hip pain.Arthroscopic findings of 77 patients who underwent periarthritic debridement were evaluated. As extra-articular pathologies, injuries of the direct head and reflective head of the rectus femoris muscle were evaluated. A thin layer of fat tissue normally exists on the anterior inferior iliac spine (AIIS, the attachment site of the direct head of the rectus femoris muscle. The macroscopic appearance of the fat pad on the AIIS was categorized as normal, blood vessel-rich adipose tissue or adipose tissue with fibrosis or scar formation and histologically confirmed. Adhesion of gluteal muscles to the joint capsule was also evaluated.Of the 77 patients, 75 had rupture of the direct head of the rectus femoris. In contrast, rupture of the reflective head was extremely rare. Seven patients had a normal fat pad on the AIIS, 11 had blood vessel-rich adipose tissue and 55 had adipose tissue with fibrosis. Fat tissue was completely replaced by fibrous scar tissue in another 4 patients. In 64 patients, adhesion between the anterior joint capsule and gluteus muscles was marked. Groin pain disappeared soon after the operation even when labral tears were not repaired and all patients returned to daily life and sports activities within 2 weeks after operation.Rectus femoris tendinosis, fibrosis of the AIIS fat pad, and adhesion of gluteal and rectus femoris muscles are common extra-articular pathologies in patients with anterior hip pain. Management of only these lesions induces rapid relief of anterior hip pain even in the absence of labral tear repair. My

  20. POSSIBILITIES OF CURRENT CELLULAR TECHNOLOGIES FOR ARTICULAR CARTILAGE REPAIR (ANALYTICAL REVIEW

    Directory of Open Access Journals (Sweden)

    M. S. Bozhokin

    2016-01-01

    Full Text Available Despite a wide variety of surgical procedures utilized in clinical practice for treatment of articular cartilage lesions, the search for other options of articular reconstruction remains a relevant and open issue at the current stage of medicine and biotechnologies development. The recent years demonstrated a strong belief in cellular methods of hyaline cartilage repair such as implantation of autologous chondrocytes (ACI or cultures of mesenchymal stem cells (MSC including techniques for genetic modification of cells.The purpose of presented review is to summarize the published scientific data on up to date results of perspective cellular technologies for articular cartilage repair that are being developed. Autologous chondrocyte transplantation originally performed by Swedish researchers in 1987 is considered the first clinically applied technique for restoration of hyaline cartilage using cellular technologies. However, the transplanted cell culture featured low proliferative capacity and inability to form a regenerate resistant to high physical activity. Another generation of methods originated at the turn of the century utilized mesenchymal stem cells instead of autologous chondrocytes. Preparation of MSCs is a less invasive procedure compared to chondrocytes harvesting and the culture is featured by a higher proliferative ability. Researchers use various biodegradable carriers (matrices to secure cell fixation. Despite good clinical mid-term outcomes the transplanted tissue-engineering structures deteriorate with time due to cellular de-differentiation. Next generation of techniques being currently under pre-clinical studies is featured by the preliminary chondrogenic modification of transplanted cell culture. Usage of various growth factors, modified cell product and gene-activated matrices allow to gain a stable regulatory and key proteins synthesis and achieve a focused influence on regenerate's chondrogenic proliferation and in result

  1. Rehabilitation after Articular Cartilage Repair of the Knee in the Football (Soccer) Player

    OpenAIRE

    Hambly, Karen; Silvers, Holly Jacinda; Steinwachs, Matthias

    2012-01-01

    BACKGROUND\\ud \\ud Participation in football can put both male and female players at an increased risk for knee osteoarthritis. There is a higher prevalence of focal chondral defects in the knee of athletes compared to nonathletes. The management of chondral defects in the football player is complex and multifactorial.\\ud \\ud OBJECTIVE\\ud \\ud The aim of this study is to provide an overview of the current strategies for rehabilitation after articular cartilage repair of the knee in the football...

  2. A Critical Review: Management and Surgical Options for Articular Defects in the Hip.

    Science.gov (United States)

    Makhni, Eric C; Stone, Austin V; Ukwuani, Gift C; Zuke, William; Garabekyan, Tigran; Mei-Dan, Omer; Nho, Shane J

    2017-07-01

    Patients with articular cartilage lesions of the hip may present with pain and symptoms that may be vague in nature and onset. Therefore, a thorough history and physical examination should be performed for every patient presenting with hip pain and/or disability. The management may be operative or nonoperative. Nonoperative management includes a trial of rest and/or activity modification, along with anti-inflammatory medications, physical therapy, and biologic injections. Operative treatment in the form of arthroscopic techniques continues to decrease morbidity and offer innovative solutions and new applications for microfracture, ACT, and AMIC. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. [Physiology and main implications of magnesium in osteo-articular pathology].

    Science.gov (United States)

    Koeger, A C; Prier, A; Merlet, C; Camus, J P

    1983-04-30

    The role of magnesium in the constitution, metabolism and hormonal control of bone tissue can be deducted from what is known of its physiology. Magnesium deficiency may result in vitamin-D resistant hypocalcaemia or even biochemical signs of hypoparathyroidism, which only regress after the deficiency is corrected. Measurements of magnesium levels in blood and urine are justified when such abnormalities occur in patients with digestive disorders, predominantly alcoholism, liver diseases or malabsorption. In all other circumstances, magnesium therapy is very rarely indicated for osteo-articular diseases.

  4. [Analysis on ancient paper of Strabone concerning the dengue, osteo-articular system disease].

    Science.gov (United States)

    Ioli, Valerio; Rosa, Michele Attilio; Ioli, Antonino

    2004-01-01

    Strabone, a geographer lived between the 60 and 20 d.C., has been author of an interesting work, titlet "Geografica". From the lecture and the analysis of a chapter (XIV, 4, 24), important elements are deduced for the clinical hypothesis of the dengue, disease of osteo-articular system. The subjects are affected by lumbago and myalgia and paralysis on the face and other on the legs with functional importance and pain. Probably it's a particular case of the very rare illness and of the its historical documentation.

  5. Impact of extra-articular pathologies on groin pain: An arthroscopic evaluation.

    Science.gov (United States)

    Kaya, Mitsunori

    2018-01-01

    For patients who have anterior hip pain evaluated by Patrick's test and tenderness at Scarpa's triangle, we perform periarticular debridement based on the hypothesis that extra-articular pathologies are responsible for the hip pain. The purpose of this study was to categorize the endoscopic extra-articular findings and to evaluate the clinical significance of periarticular pathologies in anterior hip pain. Arthroscopic findings of 77 patients who underwent periarthritic debridement were evaluated. As extra-articular pathologies, injuries of the direct head and reflective head of the rectus femoris muscle were evaluated. A thin layer of fat tissue normally exists on the anterior inferior iliac spine (AIIS), the attachment site of the direct head of the rectus femoris muscle. The macroscopic appearance of the fat pad on the AIIS was categorized as normal, blood vessel-rich adipose tissue or adipose tissue with fibrosis or scar formation and histologically confirmed. Adhesion of gluteal muscles to the joint capsule was also evaluated. Of the 77 patients, 75 had rupture of the direct head of the rectus femoris. In contrast, rupture of the reflective head was extremely rare. Seven patients had a normal fat pad on the AIIS, 11 had blood vessel-rich adipose tissue and 55 had adipose tissue with fibrosis. Fat tissue was completely replaced by fibrous scar tissue in another 4 patients. In 64 patients, adhesion between the anterior joint capsule and gluteus muscles was marked. Groin pain disappeared soon after the operation even when labral tears were not repaired and all patients returned to daily life and sports activities within 2 weeks after operation. Rectus femoris tendinosis, fibrosis of the AIIS fat pad, and adhesion of gluteal and rectus femoris muscles are common extra-articular pathologies in patients with anterior hip pain. Management of only these lesions induces rapid relief of anterior hip pain even in the absence of labral tear repair. My observations suggest

  6. Surgical treatment of displaced intra-articular fractures of the calcaneus using a less invasive approach

    OpenAIRE

    Lopes, Fernando Araújo Silva; Pinto, Roberto Zambelli de Almeida; Gonçalves, Eduardo Luiz Nogueira; Melo, Gustavus Lemos Ribeiro; Leal, Renata Tavares dos Reis

    2008-01-01

    OBJETIVOS: Avaliar pacientes com fraturas articulares do calcâneo tratados entre dezembro de 2000 e agosto de 2007 por técnica cirúrgica minimamente invasiva, com ênfase nos resultados e complicações. MÉTODOS: Estudo retrospectivo de 21 pacientes com 22 fraturas desviadas do calcâneo, tratadas com redução aberta ou fechada e fixação mínima. Nos 16 pacientes nos quais foi necessária a redução aberta, utilizou-se o acesso lateral direto e em nenhum placas ou enxerto ósseo. RESULTADOS: O seguime...

  7. The "joint-elevation" calcaneus fracture: a rare variant of the intra-articular calcaneus fracture-dislocation.

    Science.gov (United States)

    Miller, Timothy J; Kwon, John Y

    2015-04-01

    Calcaneus fractures are the most commonly fractured tarsal bone with approximately 75% being intra-articular in nature. Böhler's angle has been found to be reliable and prognostic, and it has been used as a proxy for joint depression and articular involvement. It often guides the need for advanced imaging and/or operative intervention. We describe a rare variant of intra-articular calcaneus fracture-dislocation that results in elevation of a portion of the posterior facet above the posterior talus and a seemingly normal or increased Böhler's angle, which we call the "joint-elevation" calcaneus fracture. Orthopaedic surgeons should be aware of this previously undescribed variant in order to avoid inappropriate treatment or misdiagnosis. Therapeutic Level IV: Case Series. © 2014 The Author(s).

  8. Modelado matemático del comportamiento mecánico de un fragmento de cartílago articular

    OpenAIRE

    LANDÍNEZ, NANCY STELLA; VANEGAS, JUAN CARLOS; GARZÓN, DIEGO ALEXANDER

    2009-01-01

    El cartílago articular es un material biológico poroelástico que permite la distribución de las cargas mecánicas y el movimiento de las articulaciones. Como material bifásico, en presencia de carga, el cartílago articular deforma su matriz sólida y modifica la presión hidrostática del fluido en su interior. El objetivo del presente trabajo es implementar numéricamente un modelo matemático que predice el comportamiento mecánico del cartílago articular teniendo en cuenta la dualidad entre la ma...

  9. Extra-articular and transcutaneous migration of the poly-l/D-lactide interference screw after popliteal tendon reconstruction

    Directory of Open Access Journals (Sweden)

    Camilo Partezani Helito

    Full Text Available ABSTRACT Knee ligament reconstructions are commonly performed orthopedic procedures. Graft fixation is generally performed with metallic or absorbable interference screws. In a recent study, only ten reports of screw migration were retrieved; of these, only one was not related to the anterior cruciate ligament, and the majority was related to the use of poly-l-lactic acid (PLLA screws. Only one case retrieved in the literature reported screw migration in reconstructions of the posterolateral corner, and that was to the intra-articular region. In the present article, the authors report a case of extra-articular and transcutaneous migration of a poly-l/D-lactide (PDLLA interference screw following popliteal tendon reconstruction. Besides being the first case of popliteal tendon migration with extra-articular screw migration, no reports of PDLLA screw migration were retrieved in the literature.

  10. Poroviscoelastic finite element model including continuous fiber distribution for the simulation of nanoindentation tests on articular cartilage.

    Science.gov (United States)

    Taffetani, M; Griebel, M; Gastaldi, D; Klisch, S M; Vena, P

    2014-04-01

    Articular cartilage is a soft hydrated tissue that facilitates proper load transfer in diarthroidal joints. The mechanical properties of articular cartilage derive from its structural and hierarchical organization that, at the micrometric length scale, encompasses three main components: a network of insoluble collagen fibrils, negatively charged macromolecules and a porous extracellular matrix. In this work, a constituent-based constitutive model for the simulation of nanoindentation tests on articular cartilage is presented: it accounts for the multi-constituent, non-linear, porous, and viscous aspects of articular cartilage mechanics. In order to reproduce the articular cartilage response under different loading conditions, the model considers a continuous distribution of collagen fibril orientation, swelling, and depth-dependent mechanical properties. The model's parameters are obtained by fitting published experimental data for the time-dependent response in a stress relaxation unconfined compression test on adult bovine articular cartilage. Then, model validation is obtained by simulating three independent experimental tests: (i) the time-dependent response in a stress relaxation confined compression test, (ii) the drained response of a flat punch indentation test and (iii) the depth-dependence of effective Poisson's ratio in a unconfined compression test. Finally, the validated constitutive model has been used to simulate multiload spherical nanoindentation creep tests. Upon accounting for strain-dependent tissue permeability and intrinsic viscoelastic properties of the collagen network, the model accurately fits the drained and undrained curves and time-dependent creep response. The results show that depth-dependent tissue properties and glycosaminoglycan-induced tissue swelling should be accounted for when simulating indentation experiments. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. MODELADO MATEMÁTICO DEL COMPORTAMIENTO MECÁNICO DE UN FRAGMENTO DE CARTÍLAGO ARTICULAR

    Directory of Open Access Journals (Sweden)

    NANCY STELLA LANDÍNEZ

    2009-01-01

    Full Text Available El cartílago articular es un material biológico poroelástico que permite la distribución de las cargas mecánicas y el movimiento de las articulaciones. Como material bifásico, en presencia de carga, el cartílago articular deforma su matriz sólida y modifica la presión hidrostática del fluido en su interior. El objetivo del presente trabajo es implementar numéricamente un modelo matemático que predice el comportamiento mecánico del cartílago articular teniendo en cuenta la dualidad entre la matriz sólida y el líquido articular, y la característica de poroelasticidad. Utilizando una metodología basada en el método de los elementos finitos, se simuló el comportamiento de un fragmento de cartílago articular en una y dos dimensiones, ante cargas mecánicas de tensión, compresión y oscilación. El análisis de los resultados permite validar cualitativamente el comportamiento poroelástico del modelo debido a la deformación de la matriz sólida y a la salida de fluido que modifica la presión del mismo de manera similar a lo reportado en trabajos experimentales. Se concluye que el modelo matemático permite realizar predicciones sobre el comportamiento biomecánico del cartílago articular, contribuyendo al proceso investigativo en áreas como la biomecánica y la ingeniería de tejidos.

  12. Assessment of clinical practice guideline methodology for the treatment of knee osteoarthritis with intra-articular hyaluronic acid.

    Science.gov (United States)

    Altman, Roy D; Schemitsch, Emil; Bedi, Asheesh

    2015-10-01

    Clinical practice guidelines are of increasing importance in the decision making for the treatment of knee osteoarthritis. Inconsistent recommendations regarding the use of intra-articular hyaluronic acid for the treatment of knee osteoarthritis have led to confusion among treating physicians. Literature search to identify clinical practice guidelines that provide recommendations regarding the use of intra-articular hyaluronic acid treatment for knee osteoarthritis was conducted. Included guidelines were appraised using the AGREE II instrument. Guideline development methodologies, how the results were assessed, the recommendation formation, and work group composition were summarized. Overall, 10 clinical practice guidelines were identified that met our inclusion criteria. AGREE II domain scores were variable across the included guidelines. The methodology utilized across the guidelines was heterogeneous regarding the evidence inclusion criteria, analysis of evidence results, formulation of clinical practice recommendations, and work group composition. The recommendations provided by the guidelines for intra-articular hyaluronic acid treatment for knee osteoarthritis are highly inconsistent as a result of the variability in guideline methodology. Overall, 30% of the included guidelines recommended against the use of intra-articular hyaluronic acid in the treatment of knee osteoarthritis, while 30% deemed the treatment an appropriate intervention under certain scenarios. The remaining 40% of the guidelines provided either an uncertain recommendation or no recommendation at all, based on the high variability in reviewed evidence regarding efficacy and trial quality. There is a need for a standard "appropriate methodology" that is agreed upon for osteoarthritis clinical practice guidelines in order to prevent the development of conflicting recommendations for intra-articular hyaluronic acid treatment for knee osteoarthritis, and to assure that treating physicians who

  13. Reparación del cartílago articular con injerto libre de pericondrio estudio experimental

    OpenAIRE

    Ballesteros Vazquez, P.; Carranza Bencano, Andrés; Armas Padrón, J. R.; Saenz López de Rueda, F.

    1994-01-01

    Ante la incapacidad de regeneración espontánea de lesiones profundas y amplias del cartílago articular, estudiamos la reparación cartilaginosa con plastias de pericondrio tomadas de la región condro-costal e implantándolas con su cara condrogénica sobre una lesión osteocondral realizada en la superficie articular rotuliana. Macroscópica e histológicamente, a la octava semana, el neocartílago formado tenía igual apariencia que el cartílago hialino normal, no existiendo separació...

  14. Knee chondrolysis by infusion of bupivacaine with epinephrine through an intra-articular pain pump catheter after arthroscopic ACL reconstruction.

    Science.gov (United States)

    Buchko, Jordan Z; Gurney-Dunlop, Tanner; Shin, Jason J

    2015-02-01

    Postoperative knee chondrolysis caused by continuous intra-articular pain pumps infusing bupivacaine with epinephrine is a rare but serious complication. To determine the association between postoperative intra-articular infusion of bupivacaine with epinephrine and the development of knee chondrolysis in patients who have undergone arthroscopic anterior cruciate ligament reconstruction (ACLR). The authors hypothesized that the development of knee chondrolysis after ACLR is associated with postoperative high-dose intra-articular bupivacaine with epinephrine infusion. Cohort study; Level of evidence, 3. In this retrospective cohort study, the charts of all patients treated with arthroscopic ACLR by a single surgeon between January 1, 2004, and December 31, 2006, were reviewed. Patients with severe articular cartilage damage at the time of the index procedure, with known knee joint infection, inflammatory arthritis, multiligament knee injury, bilateral knee injury, or any previous knee surgery, were excluded. Patients were grouped into 2 cohorts: the exposure group (those who had postoperative infusion of bupivacaine with epinephrine via an intra-articular pain pump [IAPP]) and the nonexposure group (those without postoperative infusion). A total of 105 patients met the inclusion and exclusion criteria. There were 57 male and 48 female patients with a mean age at surgery of 25.5 ± 8.6 years (range, 13-52 years). The exposure group consisted of 46 patients and the control group of 59 patients. Thirteen of 46 patients (28.3%) who received an IAPP developed chondrolysis. There were no cases of chondrolysis in the control group. Of those in the exposure group, 32 patients were exposed to 0.5% bupivacaine with epinephrine and 12 developed chondrolysis (37.5%), while 14 patients were exposed to 0.25% bupivacaine with epinephrine and 1 developed chondrolysis (7.1%). Patients exposed to 0.5% bupivacaine with epinephrine had a significantly higher incidence of chondrolysis

  15. Intra-articular fibroma of tendon sheath in a knee joint associated with iliotibial band friction syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Dong Ho; Choi, Sun Seob; Kim, Soo Jin; Lih, Wang [Dong-A University Medical Center, Busan (Korea, Republic of)

    2015-02-15

    Iliotibial band (ITB) friction syndrome is a common overuse injury typically seen in the active athlete population. A nodular lesion on the inner side of the ITB as an etiology or an accompanying lesion from friction syndrome has been rarely reported. A 45-year-old male presented with recurrent pain and a movable nodule at the lateral joint area, diagnosed as ITB friction syndrome. The nodule was confirmed as a rare intra-articular fibroma of the tendon sheath (FTS) on the basis of histopathologic findings. We describe the MRI findings, arthroscopic and pathologic features, in this case of intra-articular FTS presenting with ITB friction syndrome.

  16. Study of the collagen structure in the superficial zone and physiological state of articular cartilage using a 3D confocal imaging technique

    Directory of Open Access Journals (Sweden)

    Zheng Ming H

    2008-07-01

    Full Text Available Abstract Introduction The collagen structure in the superficial zone of articular cartilage is critical to the tissue's durability. Early osteoarthritis is often characterized with fissures on the articular surface. This is closely related to the disruption of the collagen network. However, the traditional histology can not offer visualization of the collagen structure in articular cartilage because it uses conventional optical microscopy that does not have insufficient imaging resolution to resolve collagen from proteoglycans in hyaline articular cartilage. This study examines the 3D collagen network of articular cartilage scored from 0 to 2 in the scoring system of International Cartilage Repair Society, and aims to develop a 3D histology for assessing early osteoarthritis. Methods Articular cartilage was visually classified into five physiological groups: normal cartilage, aged cartilage, cartilage with artificial and natural surface disruption, and fibrillated. The 3D collagen matrix of the cartilage was acquired using a 3D imaging technique developed previously. Traditional histology was followed to grade the physiological status of the cartilage in the scoring system of International Cartilage Repair Society. Results Normal articular cartilage contains interwoven collagen bundles near the articular surface, approximately within the lamina splendens. However, its collagen fibres in the superficial zone orient predominantly in a direction spatially oblique to the articular surface. With age and disruption of the articular surface, the interwoven collagen bundles are gradually disappeared, and obliquely oriented collagen fibres change to align predominantly in a direction spatially perpendicular to the articular surface. Disruption of the articular surface is well related to the disappearance of the interwoven collagen bundles. Conclusion A 3D histology has been developed to supplement the traditional histology and study the subtle changes in

  17. Comparative study of intra-articular lidocaine and intravenous meperidine/diazepam for shoulder dislocations.

    Science.gov (United States)

    Orlinsky, Michael; Shon, Sammy; Chiang, Charles; Chan, Linda; Carter, Paul

    2002-04-01

    The purpose of this study was to compare the analgesic effectiveness of intra-articular lidocaine versus intravenous meperidine and diazepam during the reduction of anterior shoulder dislocations. Patients were randomized to one of the two methods before the reduction of shoulder dislocations. Patients marked a visual analog pain scale at baseline, after anesthesia just before reduction, and at the time of discharge. Interference with the procedure caused by pain or lack of muscle relaxation, perception of adequacy of analgesia by the patient, adverse effects, and time to discharge from the Emergency Department (ED) were measured. Differences of outcomes, relative risks (RR), and 95% confidence intervals (CIs) were derived. Fifty-four patients with anterior shoulder dislocations presenting from May 21, 1998 through January 21, 1999 were included in this study; 29 were randomly assigned to receive intra-articular lidocaine (IAL) and 25 to receive intravenous meperidine/diazepam (IVMD). IAL was less effective than IVMD in relieving pre-reduction pain (p = 0.045) but equally effective in overall pain relief (p = 0.98). IAL was more effective than IVMD in shortening recovery time (p = 0.025). There was an indication favoring IVMD in terms of physician-perceived muscle relaxation and patient's perception of analgesia adequacy. In conclusion, although the IVMD method appears to have some clinically and statistically significant advantages, IAL possesses some favorable features that render it to be an analgesia alternative in shoulder dislocation reduction.

  18. Effects of friction on the unconfined compressive response of articular cartilage: a finite element analysis.

    Science.gov (United States)

    Spilker, R L; Suh, J K; Mow, V C

    1990-05-01

    A finite element analysis is used to study a previously unresolved issue of the effects of platen-specimen friction on the response of the unconfined compression test; effects of platen permeability are also determined. The finite element formulation is based on the linear KLM biphasic model for articular cartilage and other hydrated soft tissues. A Galerkin weighted residual method is applied to both the solid phase and the fluid phase, and the continuity equation for the intrinsically incompressible binary mixture is introduced via a penalty method. The solid phase displacements and fluid phase velocities are interpolated for each element in terms of unknown nodal values, producing a system of first order differential equations which are solved using a standard numerical finite difference technique. An axisymmetric element of quadrilateral cross-section is developed and applied to the mechanical test problem of a cylindrical specimen of soft tissue in unconfined compression. These studies show that interfacial friction plays a major role in the unconfined compression response of articular cartilage specimens with small thickness to diameter ratios.

  19. FUNCTIONS OF THE mTOR SIGNALING PATHWAY IN NORMAL ARTICULAR CARTILAGE CHONDROCYTES AND IN OSTEOARTHRITIS

    Directory of Open Access Journals (Sweden)

    E. V. Chetina

    2016-01-01

    Full Text Available Osteoarthritis  (OA is a chronic disease associated with pain, stiffness, limited mobility and joint inflammation, as well as articular cartilage destruction.  Recent studies have shown the importance  of chondrocyte  differentiation (hypertrophy as one of the mechanisms  of cartilage degradation in OA. This suggests that chondrocyte  metabolism undergoes the profound changes during cartilage resorption,  which are due to dysregulation of cell function. One of the major cellular metabolic regulators is the protein mTOR (mechanistic target of rapamycin that controls cell growth, proliferation, protein biosynthesis and integrates extracellular signals from growth factors and hormones with amino acid availability and intracellular energy status. The importance  of mTOR activity for articular cartilage destruction  in OAis confirmed by significant changes in the work of mTOR regulatory network that involves multiple intracellular (growth factors, adenosine triphosphate, oxygen availability, and autophagy and extracellular (glucose, amino acids, lipids, and hexosamine signals. Moreover, the altered expression of the mTOR gene in the blood of patients with OA is associated with either increased pain or synovitis, which indicates that there is a strong metabolic heterogeneity in patients with OA and a need for a differentiated therapeutic  approach. The above problems are discussed in this review.

  20. Chronic changes in the articular cartilage and meniscus following traumatic impact to the lapine knee.

    Science.gov (United States)

    Fischenich, Kristine M; Button, Keith D; Coatney, Garrett A; Fajardo, Ryan S; Leikert, Kevin M; Haut, Roger C; Haut Donahue, Tammy L

    2015-01-21

    The objective of this study was to induce anterior cruciate ligament (ACL) and meniscal damage, via a single tibiofemoral compressive impact, in order to document articular cartilage and meniscal changes post-impact. Tibiofemoral joints of Flemish Giant rabbits were subjected to a single blunt impact that ruptured the ACL and produced acute meniscal damage. Animals were allowed unrestricted cage activity for 12 weeks before euthanasia. India ink analysis of the articular cartilage revealed higher degrees of surface damage on the impacted tibias (p=0.018) and femurs (ppermeability (p=0.054), 40.8% increase in femoral condyle permeability (p=0.029), and 20.1% decrease in femoral condyle matrix modulus (p=0.012) in impacted joints compared to controls. Both instantaneous and equilibrium moduli of the lateral and medial menisci were decreased compared to control (p<0.02). Histological analyses revealed significantly increased presence of fissures in the medial femur (p=0.036). In both meniscus and cartilage there was a significant decrease in GAG coverage for the impacted limbs. Based on these results it is clear that an unattended combined meniscal and ACL injury results in significant changes to the soft tissues in this experimental joint 12 weeks post-injury. Such changes are consistent with a clinical description of mid to late stage PTOA of the knee. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Chondrocyte secreted CRTAC1: a glycosylated extracellular matrix molecule of human articular cartilage.

    Science.gov (United States)

    Steck, Eric; Bräun, Jessica; Pelttari, Karoliina; Kadel, Stephanie; Kalbacher, Hubert; Richter, Wiltrud

    2007-01-01

    Cartilage acidic protein 1 (CRTAC1), a novel human marker which allowed discrimination of human chondrocytes from osteoblasts and mesenchymal stem cells in culture was so far studied only on the RNA-level. We here describe its genomic organisation and detect a new brain expressed (CRTAC1-B) isoform resulting from alternate last exon usage which is highly conserved in vertebrates. In humans, we identify an exon sharing process with the neighbouring tail-to-tail orientated gene leading to CRTAC1-A. This isoform is produced by cultured human chondrocytes, localized in the extracellular matrix of articular cartilage and its secretion can be stimulated by BMP4. Of five putative O-glycosylation motifs in the last exon of CRTAC1-A, the most C-terminal one is modified according to exposure of serial C-terminal deletion mutants to the O-glycosylation inhibitor Benzyl-alpha-GalNAc. Both isoforms contain four FG-GAP repeat domains and an RGD integrin binding motif, suggesting cell-cell or cell-matrix interaction potential. In summary, CRTAC1 acquired an alternate last exon from the tail-to-tail oriented neighbouring gene in humans resulting in the glycosylated isoform CRTAC1-A which represents a new extracellular matrix molecule of articular cartilage.

  2. Wear and damage of articular cartilage with friction against orthopedic implant materials.

    Science.gov (United States)

    Oungoulian, Sevan R; Durney, Krista M; Jones, Brian K; Ahmad, Christopher S; Hung, Clark T; Ateshian, Gerard A

    2015-07-16

    The objective of this study was to measure the wear response of immature bovine articular cartilage tested against glass or alloys used in hemiarthroplasties. Two cobalt chromium alloys and a stainless steel alloy were selected for these investigations. The surface roughness of one of the cobalt chromium alloys was also varied within the range considered acceptable by regulatory agencies. Cartilage disks were tested in a configuration that promoted loss of interstitial fluid pressurization to accelerate conditions believed to occur in hemiarthroplasties. Results showed that considerably more damage occurred in cartilage samples tested against stainless steel (10 nm roughness) and low carbon cobalt chromium alloy (27 nm roughness) compared to glass (10 nm) and smoother low or high carbon cobalt chromium (10 nm). The two materials producing the greatest damage also exhibited higher equilibrium friction coefficients. Cartilage damage occurred primarily in the form of delamination at the interface between the superficial tangential zone and the transitional middle zone, with much less evidence of abrasive wear at the articular surface. These results suggest that cartilage damage from frictional loading occurs as a result of subsurface fatigue failure leading to the delamination. Surface chemistry and surface roughness of implant materials can have a significant influence on tissue damage, even when using materials and roughness values that satisfy regulatory requirements. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Wear and Damage of Articular Cartilage with Friction Against Orthopaedic Implant Materials

    Science.gov (United States)

    Oungoulian, Sevan R.; Durney, Krista M.; Jones, Brian K.; Ahmad, Christopher S.; Hung, Clark T.; Ateshian, Gerard A.

    2015-01-01

    The objective of this study was to measure the wear response of immature bovine articular cartilage tested against glass or alloys used in hemiarthroplasties. Two cobalt chromium alloys and a stainless steel alloy were selected for these investigations. The surface roughness of one of the cobalt chromium alloys was also varied within the range considered acceptable by regulatory agencies. Cartilage disks were tested in a configuration that promoted loss of interstitial fluid pressurization to accelerate conditions believed to occur in hemiarthroplasties. Results showed that considerably more damage occurred in cartilage samples tested against stainless steel (10 nm roughness) and low carbon cobalt chromium alloy (27 nm roughness) compared to glass (10 nm) and smoother low or high carbon cobalt chromium (10 nm). The two materials producing the greatest damage also exhibited higher equilibrium friction coefficients. Cartilage damage occurred primarily in the form of delamination at the interface between the superficial tangential zone and the transitional middle zone, with much less evidence of abrasive wear at the articular surface. These results suggest that cartilage damage from frictional loading occurs as a result of subsurface fatigue failure leading to the delamination. Surface chemistry and surface roughness of implant materials can have a significant influence on tissue damage, even when using materials and roughness values that satisfy regulatory requirements. PMID:25912663

  4. Regional Differential Genetic Response of Human Articular Cartilage to Impact Injury.

    Science.gov (United States)

    Vernon, Lauren L; Vance, Danica D; Wang, Liyong; Rampersaud, Evadnie; Vance, Jeffery M; Pericak-Vance, Margaret; Huang, C-Y Charles; Kaplan, Lee D

    2016-04-01

    Normal physiological movement creates different weightbearing zones within a human knee: the medial condyle bearing the highest and the trochlea bearing the lowest weight. Adaptation to different physiological loading conditions results in different tissue and cellular properties within a knee. The objective of this study was to use microarray analysis to examine gene expression differences among three anatomical regions of human knee articular cartilage at baseline and following induction of an acute impact injury. Cartilage explants were harvested from 7 cadaveric knees (12 plugs per knee). A drop tower was utilized to introduce injury. Plugs were examined 24 hours after impact for gene expression using microarray. The primary analysis is the comparison of baseline versus impacted samples within each region separately. In addition, pairwise comparisons among the three regions were performed at baseline and after impact. False discovery rate (FDR) was used to evaluate significance of differential gene expression. In the comparison of before and after injury, the trochlear had 130 differentially expressed genes (FDR ≤ 0.05) while the condyles had none. In the comparison among regions, smaller sets of differentially expressed genes (n ≤ 21) were found, with trochlea being more different than the condyles. Most of more frequently expressed genes in trochlea are developmental genes. Within the experimental setup of this study, only the trochlea was displaying an acute genetic response on injury. Our data demonstrated the regional-specific response to injury in human articular cartilage.

  5. Development of body weight support gait training system using antagonistic bi-articular muscle model.

    Science.gov (United States)

    Shibata, Yoshiyuki; Imai, Shingo; Nobutomo, Tatsuya; Miyoshi, Tasuku; Yamamoto, Shin-Ichiroh

    2010-01-01

    The purpose of this study is to develop a body weight support gait training system for stroke and spinal cord injury. This system consists of a powered orthosis, treadmill and equipment of body weight support. Attachment of the powered orthosis is able to fit subject who has difference of body size. This powered orthosis is driven by pneumatic McKibben actuator. Actuators are arranged as pair of antagonistic bi-articular muscle model and two pairs of antagonistic mono-articular muscle model like human musculoskeletal system. Part of the equipment of body weight support suspend subject by wire harness, and body weight of subject is supported continuously by counter weight. The powered orthosis is attached equipment of body weight support by parallel linkage, and movement of the powered orthosis is limited at sagittal plane. Weight of the powered orthosis is compensated by parallel linkage with gas-spring. In this study, we developed system that has orthosis powered by pneumatic McKibben actuators and equipment of body weight support. We report detail of our developed body weight support gait training system.

  6. Task-dependent inhomogeneous muscle activities within the bi-articular human rectus femoris muscle.

    Directory of Open Access Journals (Sweden)

    Naokazu Miyamoto

    Full Text Available The motor nerve of the bi-articular rectus femoris muscle is generally split from the femoral nerve trunk into two sub-branches just before it reaches the distal and proximal regions of the muscle. In this study, we examined whether the regional difference in muscle activities exists within the human rectus femoris muscle during maximal voluntary isometric contractions of knee extension and hip flexion. Surface electromyographic signals were recorded from the distal, middle, and proximal regions. In addition, twitch responses were evoked by stimulating the femoral nerve with supramaximal intensity. The root mean square value of electromyographic amplitude during each voluntary task was normalized to the maximal compound muscle action potential amplitude (M-wave for each region. The electromyographic amplitudes were significantly smaller during hip flexion than during knee extension task for all regions. There was no significant difference in the normalized electromyographic amplitude during knee extension among regions within the rectus femoris muscle, whereas those were significantly smaller in the distal than in the middle and proximal regions during hip flexion task. These results indicate that the bi-articular rectus femoris muscle is differentially controlled along the longitudinal direction and that in particular the distal region of the muscle cannot be fully activated during hip flexion.

  7. Biomechanical properties of articular cartilage as a standard for biologically integrated interfaces.

    Science.gov (United States)

    Fierlbeck, J; Hammer, J; Englert, C; Reuben, R L

    2006-01-01

    Articular cartilage integration has been described in in-vitro models, which compare mechanical to biochemical behaviour and histological analysis, respectively. The emphasis of these findings is mainly on the biochemical and histological analysis, rather than on the mechanical performance. The complex in vitro loading conditions and high deviations in the mechanical results due to the biological variance, make interpretations difficult. The aim of this study is to analyse and define the mechanical stress and strain distribution in a single lap configuration by means of an optical strain measurement system. Supportive finite element computation is performed to indicate the heterogeneous stress strain distribution in the integration area. The optical failure analysis of the experiment reveals crack propagation through the integration area comparable to plane shear in fracture mode two. Using the optical strain measurement set up a direct estimation of the shear modulus is achievable by analysing the relative displacement within the bonded joint before the onset of delamination in the adhesive layer. This result lead to a better interpretation of the mechanical behaviour of articular cartilage integration in vitro.

  8. Dual mechanism for cAMP-dependent modulation of Ca2+ signalling in articular chondrocytes.

    Science.gov (United States)

    D'Andrea, P; Paschini, V; Vittur, F

    1996-09-01

    The ability of cAMP to modulate the actions of Ca(2+)-mobilizing agonists was studied in single Fura-2-loaded pig articular chondrocytes in primary culture. Forskolin and 8-Br-cAMP increased both the frequency and amplitude of Ca2+ oscillations induced by ATP, and, in unstimulated cells, induced single Ca2+ transients or even Ca2+ oscillations. The cAMP-dependent protein kinase inhibitor H89 totally prevented the effect of cAMP-elevating agents on Ca2+ signalling. Forskolin and 8-Br-cAMP promptly increased the rate of Mn2+ quenching, when administered in the presence of ATP, suggesting a potentiation of receptor-mediated Ca2+ influx. In Ca(2+)-free medium, ATP-induced Ca2+ oscillations decreased and stopped after a few cycles: subsequent ATP additions temporarily resumed the activity, an effect that could be mimicked by forskolin. The same agent induced single Ca2+ transients in 42% of the cell population maintained in Ca(2+)-free medium. Thapsigargin prevented Ca2+ responses to both ATP and forskolin. The results indicate a dual mechanism for cAMP-induced potentiation of Ca2+ signalling in articular chondrocytes: an increase of receptor-mediated Ca2+ influx and a positive modulation of intracellular Ca2+ release.

  9. Use of Particulated Juvenile Articular Cartilage Allograft for Osteochondral Lesions of the Wrist.

    Science.gov (United States)

    Hess, Daniel E; Werner, Brian C; Deal, D Nicole

    2017-09-01

    Articular cartilage injuries are a common injury among young, active patients, and the most appropriate treatment for these injuries remains controversial. A promising new technology in the treatment of high-grade cartilage injuries is particulated juvenile articular cartilage (PJAC) allograft (DeNovo NT, Zimmer, Warsaw, Indiana). This has been shown to be successful in multiple joints including the knee, talus, and elbow. No studies or case reports exist in supporting or discouraging its use in injuries of the wrist, in specific, the scaphoid. The use of PJAC allograft is described for the treatment of an active 21-year-old male with an Outerbridge Grade IV chondral lesion on the proximal pole of his right scaphoid and right distal radius scaphoid facet who had failed conservative management. The patient was followed clinically and radiographically for 21 months. The patient had return to full sport (jujutsu) and full range-of-motion, both of which represented an improvement from his preoperative exam. Radiographically, the chondral lucency seen had decreased in size and was almost completely absent on radiographs after 21 months. The results of this case suggest that PJAC can be used safely and effectively in the wrist thereby potentially broadening the indications for its use.

  10. Stem cells and other innovative intra-articular therapies for osteoarthritis: what does the future hold?

    Directory of Open Access Journals (Sweden)

    Singh Jasvinder A

    2012-05-01

    Full Text Available Abstract Osteoarthritis (OA, the most common type of arthritis in the world, is associated with suffering due to pain, productivity loss, decreased mobility and quality of life. Systemic therapies available for OA are mostly symptom modifying and have potential gastrointestinal, renal, hepatic, and cardiac side effects. BMC Musculoskeletal Disorders recently published a study showing evidence of reparative effects demonstrated by homing of intra-articularly injected autologous bone marrow stem cells in damaged cartilage in an animal model of OA, along with clinical and radiographic benefit. This finding adds to the growing literature showing the potential benefit of intra-articular (IA bone marrow stem cells. Other emerging potential IA therapies include IL-1 receptor antagonists, conditioned autologous serum, botulinum toxin, and bone morphogenetic protein-7. For each of these therapies, trial data in humans have been published, but more studies are needed to establish that they are safe and effective. Several additional promising new OA treatments are on the horizon, but challenges remain to finding safe and effective local and systemic therapies for OA. Please see related article: http://www.biomedcentral.com/1471-2474/12/259

  11. Effect of extracellular fatty acids on lipid metabolism in cultured rabbit articular chondrocytes

    International Nuclear Information System (INIS)

    Nagao, M.; Ishii, S.; Murata, Y.; Akino, T.

    1991-01-01

    Rabbit articular chondrocytes were cultured for 8 h in the presence of various concentrations (5-500 microM) of 14 C oleic, 14 C linoleic, and 3H arachidonic acids. The radioactive unsaturated fatty acids were incorporated into triacylglycerol (TG) and phosphatidylcholine (PC) in a concentration-dependent manner; more fatty acids were incorporated into TG than into PC, at higher concentrations of extracellular fatty acids. Among these fatty acids, arachidonic acid was incorporated into TG much more than into PC, in spite of a very low concentration of arachidonic acid in TG. After transfer of the labeled cells to maintenance medium, the radioactivity in TG declined rapidly and 3 H arachidonic acid radioactivity in PC increased continuously during the chase time periods. Palmitoyl-unsaturated species were mainly formed in PC when cultured at a concentration of 5 microM of each fatty acid. However, when cultured at 500 microM, unsaturated-unsaturated species, specific for each unsaturated fatty acid were actively formed. These findings indicate that (1) fatty acid composition of TG and PC in articular chondrocytes is influenced by the degree of fatty acid supply, (2) formation and turnover of TG plays a role in fatty acid metabolism of cells, and (3) fatty acid pairing in PC is modulated by extracellular fatty acid concentrations

  12. Synergy between Piezo1 and Piezo2 channels confers high-strain mechanosensitivity to articular cartilage

    Science.gov (United States)

    Lee, Whasil; Leddy, Holly A.; Chen, Yong; Lee, Suk Hee; Zelenski, Nicole A.; McNulty, Amy L.; Wu, Jason; Beicker, Kellie N.; Coles, Jeffrey; Zauscher, Stefan; Grandl, Jörg; Sachs, Frederick; Liedtke, Wolfgang B.

    2014-01-01

    Diarthrodial joints are essential for load bearing and locomotion. Physiologically, articular cartilage sustains millions of cycles of mechanical loading. Chondrocytes, the cells in cartilage, regulate their metabolic activities in response to mechanical loading. Pathological mechanical stress can lead to maladaptive cellular responses and subsequent cartilage degeneration. We sought to deconstruct chondrocyte mechanotransduction by identifying mechanosensitive ion channels functioning at injurious levels of strain. We detected robust expression of the recently identified mechanosensitive channels, PIEZO1 and PIEZO2. Combined directed expression of Piezo1 and -2 sustained potentiated mechanically induced Ca2+ signals and electrical currents compared with single-Piezo expression. In primary articular chondrocytes, mechanically evoked Ca2+ transients produced by atomic force microscopy were inhibited by GsMTx4, a PIEZO-blocking peptide, and by Piezo1- or Piezo2-specific siRNA. We complemented the cellular approach with an explant-cartilage injury model. GsMTx4 reduced chondrocyte death after mechanical injury, suggesting a possible therapy for reducing cartilage injury and posttraumatic osteoarthritis by attenuating Piezo-mediated cartilage mechanotransduction of injurious strains. PMID:25385580

  13. The Glenoid Labral Articular Teardrop Lesion: A Chondrolabral Injury With Distinct Magnetic Resonance Imaging Findings.

    Science.gov (United States)

    Lederman, Evan S; Flores, Stephen; Stevens, Christopher; Richardson, Damien; Lund, Pamela

    2018-02-01

    Evaluation and description of a pathognomonic lesion identified on magnetic resonance imaging (MRI) of a chondrolabral injury of the glenohumeral joint. Patients were prospectively identified at the time of MRI by a characteristic teardrop appearance of a pedicled displaced chondrolabral flap in the axillary recess on coronal imaging and retrospectively reviewed. In a sample of 36 patients, there were 30 males (83%), and the average age was 27 years (14-75 years). Twenty-four (67%) were noted to have sustained an instability episode or had findings of instability on physical examination; 19 patients (53%) were playing a sport at the time of injury. The characteristic teardrop lesion measured 3.36 mm (1-9 mm) in the coronal plane, 6.98 mm (2-20 mm) sagittal and 11.78 mm (1-25 mm) longitudinal. The lesion was located in the anterior inferior quadrant of the glenoid. The glenoid labral articular teardrop (GLAT) lesion represents a pathognomonic lesion in the spectrum of chondral labral injury, indicating articular cartilage damage to the glenoid. Level IV, therapeutic case series. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  14. New perspectives for articular cartilage repair treatment through tissue engineering: A contemporary review

    Science.gov (United States)

    Musumeci, Giuseppe; Castrogiovanni, Paola; Leonardi, Rosalia; Trovato, Francesca Maria; Szychlinska, Marta Anna; Di Giunta, Angelo; Loreto, Carla; Castorina, Sergio

    2014-01-01

    In this paper review we describe benefits and disadvantages of the established methods of cartilage regeneration that seem to have a better long-term effectiveness. We illustrated the anatomical aspect of the knee joint cartilage, the current state of cartilage tissue engineering, through mesenchymal stem cells and biomaterials, and in conclusion we provide a short overview on the rehabilitation after articular cartilage repair procedures. Adult articular cartilage has low capacity to repair itself, and thus even minor injuries may lead to progressive damage and osteoarthritic joint degeneration, resulting in significant pain and disability. Numerous efforts have been made to develop tissue-engineered grafts or patches to repair focal chondral and osteochondral defects, and to date several researchers aim to implement clinical application of cell-based therapies for cartilage repair. A literature review was conducted on PubMed, Scopus and Google Scholar using appropriate keywords, examining the current literature on the well-known tissue engineering methods for the treatment of knee osteoarthritis. PMID:24829869

  15. Prognostic factors after intra-articular hyaluronic acid injection in ankle osteoarthritis.

    Science.gov (United States)

    Han, Seung Hwan; Park, Do Young; Kim, Tae Hun

    2014-07-01

    The goal of this study was to identify baseline prognostic factors of outcome in ankle osteoarthritis patients after intra-articular hyaluronic acid injection. Patients with ankle osteoarthritis who received hyaluronic acid injection therapy were retrospectively reviewed. Each patient received weekly intra-articular hyaluronic acid injections (2 mL) for 3 weeks. Six predictors including gender, age, symptom duration, radiographic osteoarthritis stage, radiographic subchondral cyst, and fracture history were evaluated. Visual analogue scale (VAS) and patient satisfaction were evaluated as outcome measures. These predictors and outcome measurements were included in a logistic regression model for statistical analysis. Total of 40 consecutive patients (21 male, 19 female) were included in this study. Mean age was 60.6. Average follow up period was 13 months. The mean VAS recorded 3, 6, and 12 months after the first injection was 3.6 (SD 2.54, phyaluronic acid injection for ankle osteoarthritis is a safe and effective treatment, careful selection of patients should be made according to the above prognostic predictors.

  16. Management of valgus extra-articular calcaneus fracture malunions with a lateral opening wedge osteotomy.

    Science.gov (United States)

    Aly, Tarek

    2011-01-01

    A total of 34 cases of symptomatic valgus deformity of the hindfoot secondary to a malunited extra-articular calcaneal fracture were corrected with laterally based open wedge calcaneal osteotomy. The pre- and postoperative radiographic parameters were compared, and a postoperative clinical evaluation was performed using the American Orthopedic Foot and Ankle Society ankle and hindfoot scoring system. The mean follow-up period was 56.2 (range 24.1 to 97) months. The most significant radiographic changes were improvement in the talonavicular coverage angle (mean 17.3°) on the anteroposterior view. The mean postoperative American Orthopedic Foot and Ankle Society hindfoot and ankle score was 90, with 23 excellent, 8 good, and 3 poor results. Laterally based opening wedge osteotomy of the calcaneus is effective in the management of a valgus heel resulting from malunited extra-articular calcaneal fractures. Lateral decompression of the peroneal tendons and the sural nerve was achieved indirectly through opening wedge lateral calcaneal osteotomy that shifted the weight-bearing axis laterally. Copyright © 2011 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Plasma rich in growth factors to treat an articular cartilage avulsion: a case report.

    Science.gov (United States)

    Sánchez, Mikel; Azofra, Juan; Anitua, Eduardo; Andía, Isabel; Padilla, Sabino; Santisteban, Juanma; Mujika, Iñigo

    2003-10-01

    The application of an autologous plasma rich in growth factors is beneficial in restoring connective tissues, as shown by clinical evidence in oral surgery and more recently in arthroscopic anterior cruciate ligament reconstruction and two cases of ruptured Achilles tendon in professional athletes. This is attributed to the slow delivery of growth factors from harvested platelets that have been activated by endogenous thrombin promoted by the addition of calcium chloride. This case report describes a new application of this therapy in the arthroscopic treatment of a large, nontraumatic avulsion of articular cartilage in the knee of an adolescent soccer player. After arthroscopic reattachment of the large (>2 cm) loose chondral body in its crater in the medial femoral condyle, autologous plasma rich in growth factors was injected into the area between the crater and the fixed fragment. Despite the extremely poor prognosis of the case, complete articular cartilage healing was considerably accelerated, and the functional outcome was excellent, allowing a rapid resumption of symptom-free athletic activity. This technique opens new perspectives for human tissue regeneration.

  18. Articular cartilage compression: how microstructural response influences pore pressure in relation to matrix health.

    Science.gov (United States)

    Fick, James M; Thambyah, Ashvin; Broom, Neil D

    2010-04-01

    Our research investigated the influence of degeneration on both the pore-pressure development and microstructural response of cartilage during indentation with a flat-porous-indenter. Experiments were conducted to link the mechanical and structural responses of normal and degenerate articular cartilage. We found that from the instant of loading the degenerate matrix generated a higher peak hydrostatic excess pore pressure in a shorter period of time than the normal matrix. Following the attainment of this peak value the pore pressure in both tissue groups then gradually decayed toward zero over time, thus demonstrating a classical consolidation response. The microstructural analysis provided a unique insight into the influence of degeneration on the mechanisms of internal stress-sharing within the loaded matrix. Both disruption of the articular surface and general matrix destructuring results in an altered deformation field in both the directly loaded and nondirectly loaded regions. It is argued that the higher levels of matrix shear combined with less of the applied load being redirected into the wider cartilage continuum accounts for the elevated levels of peak hydrostatic pore pressure generated in the degenerate matrix.

  19. Infecton is not specific for bacterial osteo-articular infective pathology

    Energy Technology Data Exchange (ETDEWEB)

    Dumarey, Nicolas; Blocklet, Didier; Schoutens, Andre [Division of Nuclear Medicine, Universite Libre de Bruxelles, Brussels (Belgium); Appelboom, Thierry; Tant, Laure [Division of Rheumatology, Universite Libre de Bruxelles, Brussels (Belgium)

    2002-04-01

    The aim of this study was to re-examine, by retrospective analysis of our case material, the specificity and sensitivity of technetium-99m ciprofloxacin scan in discriminating between infection and other conditions. {sup 99m}Tc-ciprofloxacin scintigraphy was performed in 71 patients: 30 patients referred for suspicion of osteomyelitis (OM) or septic arthritis (SA) (group 1) and 41 controls (group 2). Imaging was performed at 4 h post injection and, when possible, at 8 or 24 h post injection. Tracer uptake was visually assessed in different joint groups, and in the sites suspicious for infection. Several soft tissue sites were also evaluated. In the group referred for osteo-articular infection, we found a lower specificity (54.5%) than has previously been reported in the literature. Evaluation of tracer uptake at late imaging did not improve discrimination between sterile and non-sterile inflammation. Additionally, articular uptake was seen in many control patients. Infecton uptake in growth cartilage, thyroid gland, vascular pool, lungs, liver and intestines is discussed. (orig.)

  20. Infecton is not specific for bacterial osteo-articular infective pathology.

    Science.gov (United States)

    Dumarey, Nicolas; Blocklet, Didier; Appelboom, Thierry; Tant, Laure; Schoutens, André

    2002-04-01

    The aim of this study was to re-examine, by retrospective analysis of our case material, the specificity and sensitivity of technetium-99m ciprofloxacin scan in discriminating between infection and other conditions. (99m)Tc-ciprofloxacin scintigraphy was performed in 71 patients: 30 patients referred for suspicion of osteomyelitis (OM) or septic arthritis (SA) (group 1) and 41 controls (group 2). Imaging was performed at 4 h post injection and, when possible, at 8 or 24 h post injection. Tracer uptake was visually assessed in different joint groups, and in the sites suspicious for infection. Several soft tissue sites were also evaluated. In the group referred for osteo-articular infection, we found a lower specificity (54.5%) than has previously been reported in the literature. Evaluation of tracer uptake at late imaging did not improve discrimination between sterile and non-sterile inflammation. Additionally, articular uptake was seen in many control patients. Infecton uptake in growth cartilage, thyroid gland, vascular pool, lungs, liver and intestines is discussed.

  1. Articular Eminence Inclination, Height, and Condyle Morphology on Cone Beam Computed Tomography

    Directory of Open Access Journals (Sweden)

    Dilhan İlgüy

    2014-01-01

    Full Text Available Aim. The aim of the present study was to examine the relationship between articular eminence inclination, height, and thickness of the roof of the glenoid fossa (RGF according to age and gender and to assess condyle morphology including incidental findings of osseous characteristics associated with osteoarthritis (OA of the temporomandibular joint (TMJ using cone beam computed tomography (CBCT. Materials and Methods. CBCT images of 105 patients were evaluated retrospectively. For articular eminence inclination and height, axial views on which the condylar processes were seen with their widest mediolateral extent being used as a reference view for secondary reconstruction. Condyle morphology was categorized both in the sagittal and coronal plane. Results. The mean values of eminence inclination and height of males were higher than those of females (P<0.05. There were significant differences in the RGF thickness in relation to sagittal condyle morphology. Among the group of OA, the mean value of the RGF thickness for “OA-osteophyte” group was the highest (1.59 mm, whereas the lowest RGF values were seen in the “OA-flattening.” Conclusion. The sagittal osteoarthritic changes may have an effect on RGF thickness by mechanical stimulation and changed stress distribution. Gender has a significant effect on eminence height (Eh and inclination.

  2. Load distribution of articular cartilage from MR-images by neural nets

    International Nuclear Information System (INIS)

    Seidel, P.; Hanke, G.; Gruender, W.

    2005-01-01

    Artificial neural nets were used to determine the Young's modulus and spatial load distribution in articular cartilage by means of T2-weighted MR imaging. MR images were obtained in vitro (ex vivo?) from the joints of sheep of different ages (3 months, 9 months, 15 months, 1.5 years, 5 years, 5.5 years) and pigs (4 and 6 months) with a Bruker AMX 300 (7 T) spectrometer equipped with a micro-imaging unit. The knee of a 29-year-old male volunteer was studied in vivo under mechanical load using a clinical Siemens Vision MRT (1.5 T). The load of the cartilage is understood as a non-linear image transformation of loaded versus unloaded images. The artificial neural net was used to recognize given reference pixels of the unloaded cartilage within the image of the loaded cartilage. The Young's modulus was calculated from the local strain and the external pressure using the Hooke's law. With this method, the average Young's modulus was obtained in relationship to the biological age of the cartilage. The investigated age interval showed a progressive increase of 0.5 ± 0.3 MPa per year. These results are consistent with published results. As shown in this pilot study, the method of neural nets allows the visualization of the spatial load distribution within the articular cartilage. (orig.)

  3. Ángulo óptimo articular y ejercicio: bases y aplicaciones

    Directory of Open Access Journals (Sweden)

    Pablo Antonio Rubio-Sobrino

    2012-09-01

    Full Text Available El ángulo óptimo se refiere a la posición articular en la que se produce el pico máximo de momento de fuerza, dentro de la curva ángulo-momento articular. Este parámetro puede utilizarse para estimar las modificaciones en la curva fuerza-longitud de un grupo muscular. El ángulo óptimo puede ser obtenido a partir de medidas en tests isométricos o dinámicos, y esto debe ser tenido en cuenta a la hora de establecer comparaciones. El ángulo óptimo puede ser modificado tanto de forma aguda como crónica. Los principales factores que lo modifican son la intensidad y el volumen del ejercicio, la longitud muscular, el modo de contracción y la velocidad de contracción. La capacidad para evaluar y modificar el ángulo óptimo puede utilizarse en programas de prevención de lesiones musculares, especialmente en deportes de equipo como el fútbol. Esta revisión analiza y discute los estudios que se encuentran en la bibliografía relacionados con este tema.

  4. Exploring reasons for the observed inconsistent trial reports on intra-articular injections with hyaluronic acid in the treatment of osteoarthritis

    DEFF Research Database (Denmark)

    Johansen, Mette; Bahrt, Henriette; Altman, Roy D

    2016-01-01

    OBJECTIVE: The aim was to identify factors explaining inconsistent observations concerning the efficacy of intra-articular hyaluronic acid compared to intra-articular sham/control, or non-intervention control, in patients with symptomatic osteoarthritis, based on randomized clinical trials (RCTs......,216 patients), had adequate data available for inclusion in the primary meta-analysis. Overall, compared with placebo, intra-articular hyaluronic acid reduced pain with an effect size of -0.39 [-0.47 to -0.31; P ... with no data available reduced the combined estimate to -0.30 [-0.36 to -0.23; P hyaluronic acid. CONCLUSION: Based on available trial data, intra-articular hyaluronic acid showed a better effect than intra-articular saline on pain reduction in osteoarthritis. Publication bias...

  5. What lies beneath: sub-articular long bone shape scaling in eutherian mammals and saurischian dinosaurs suggests different locomotor adaptations for gigantism.

    Directory of Open Access Journals (Sweden)

    Matthew F Bonnan

    Full Text Available Eutherian mammals and saurischian dinosaurs both evolved lineages of huge terrestrial herbivores. Although significantly more saurischian dinosaurs were giants than eutherians, the long bones of both taxa scale similarly and suggest that locomotion was dynamically similar. However, articular cartilage is thin in eutherian mammals but thick in saurischian dinosaurs, differences that could have contributed to, or limited, how frequently gigantism evolved. Therefore, we tested the hypothesis that sub-articular bone, which supports the articular cartilage, changes shape in different ways between terrestrial mammals and dinosaurs with increasing size. Our sample consisted of giant mammal and reptile taxa (i.e., elephants, rhinos, sauropods plus erect and non-erect outgroups with thin and thick articular cartilage. Our results show that eutherian mammal sub-articular shape becomes narrow with well-defined surface features as size increases. In contrast, this region in saurischian dinosaurs expands and remains gently convex with increasing size. Similar trends were observed in non-erect outgroup taxa (monotremes, alligators, showing that the trends we report are posture-independent. These differences support our hypothesis that sub-articular shape scales differently between eutherian mammals and saurischian dinosaurs. Our results show that articular cartilage thickness and sub-articular shape are correlated. In mammals, joints become ever more congruent and thinner with increasing size, whereas archosaur joints remained both congruent and thick, especially in sauropods. We suggest that gigantism occurs less frequently in mammals, in part, because joints composed of thin articular cartilage can only become so congruent before stress cannot be effectively alleviated. In contrast, frequent gigantism in saurischian dinosaurs may be explained, in part, by joints with thick articular cartilage that can deform across large areas with increasing load.

  6. What lies beneath: sub-articular long bone shape scaling in eutherian mammals and saurischian dinosaurs suggests different locomotor adaptations for gigantism.

    Science.gov (United States)

    Bonnan, Matthew F; Wilhite, D Ray; Masters, Simon L; Yates, Adam M; Gardner, Christine K; Aguiar, Adam

    2013-01-01

    Eutherian mammals and saurischian dinosaurs both evolved lineages of huge terrestrial herbivores. Although significantly more saurischian dinosaurs were giants than eutherians, the long bones of both taxa scale similarly and suggest that locomotion was dynamically similar. However, articular cartilage is thin in eutherian mammals but thick in saurischian dinosaurs, differences that could have contributed to, or limited, how frequently gigantism evolved. Therefore, we tested the hypothesis that sub-articular bone, which supports the articular cartilage, changes shape in different ways between terrestrial mammals and dinosaurs with increasing size. Our sample consisted of giant mammal and reptile taxa (i.e., elephants, rhinos, sauropods) plus erect and non-erect outgroups with thin and thick articular cartilage. Our results show that eutherian mammal sub-articular shape becomes narrow with well-defined surface features as size increases. In contrast, this region in saurischian dinosaurs expands and remains gently convex with increasing size. Similar trends were observed in non-erect outgroup taxa (monotremes, alligators), showing that the trends we report are posture-independent. These differences support our hypothesis that sub-articular shape scales differently between eutherian mammals and saurischian dinosaurs. Our results show that articular cartilage thickness and sub-articular shape are correlated. In mammals, joints become ever more congruent and thinner with increasing size, whereas archosaur joints remained both congruent and thick, especially in sauropods. We suggest that gigantism occurs less frequently in mammals, in part, because joints composed of thin articular cartilage can only become so congruent before stress cannot be effectively alleviated. In contrast, frequent gigantism in saurischian dinosaurs may be explained, in part, by joints with thick articular cartilage that can deform across large areas with increasing load.

  7. Fisiopatología celular de la osteoartritis: el condrocito articular como protagonista = Osteoarthritis cellular pathophysiology: The articular chondrocyte as a central player

    Directory of Open Access Journals (Sweden)

    Sánchez Naranjo, Julio César

    2011-06-01

    Full Text Available La osteoartritis es una de las enfermedades más prevalentes y que más discapacidad produce en todo el mundo, lo que ocasiona costos altos para el paciente y la sociedad. En años recientes se ha venido obteniendo información importante sobre el funcionamiento normal del condrocito, la única célula presente en el cartílago articular y responsable de la síntesis de matriz extracelular. El condrocito responde a las condiciones fluctuantes del medio, generadas por los cambios de presión, modificando su composición iónica y alterando el transporte de solutos y agua en su membrana. Esta capacidad de respuesta es clave para el mantenimiento de la matriz extracelular y, por ende, de un cartílago funcional. Diversos factores relacionados con enfermedades crónicas metabólicas inician una cascada de eventos que termina con una respuesta inadecuada del condrocito ante la carga mecánica, lo cual lleva a un predominio del catabolismo de la matriz y a un cartílago defectuoso que es la base del desarrollo de la osteoartritis. En este proceso están implicadas diversas citocinas y hormonas que afectan la homeostasis del cartílago y que pueden constituirse en blancos terapéuticos prometedores.

  8. Intra-Articular Analgesia and Steroid Reduce Pain Sensitivity in Knee OA Patients: An Interventional Cohort Study

    Directory of Open Access Journals (Sweden)

    Tanja Schjødt Jørgensen

    2014-01-01

    Full Text Available Objectives. To assess the effects of intra-articular therapy on pain sensitivity in the knee and surrounding tissues in knee OA patients. Methods. Twenty-five knee OA patients with symptomatic knee OA were included in this interventional cohort study. Pressure pain thresholds (PPT were recorded before, immediately after, and two weeks after ultrasound guided intra-articular injection of lidocaine combined with glucocorticosteroid. Computer-controlled and manual pressure algometers were used to assess PPT on the knee, vastus lateralis, tibialis anterior, and the extensor carpi radialis longus muscles (control site. Results. Significantly increased PPTs were found following intra-articular injection, at both the knee P<0.0001 and the surrounding muscles P<0.042. The treatment effects were sustained for two weeks, and at some points the effect was even greater at two weeks P<0.026. Albeit not statistically significant, a similar trend was observed at the control site. Conclusions. Intra-articular anesthesia, combined with glucocorticosteroid, reduced pain sensitivity in both the knee and surrounding muscles for at least two weeks.

  9. Functional-conservative treatment of extra-articular physeal fractures of the proximal phalanges in children and adolescents.

    Science.gov (United States)

    Franz, Torsten; Jandali, Abdul R; Jung, Florian J; Leclère, Franck M; von Wartburg, Urs; Hug, Urs

    2013-08-01

    Fractures of the proximal phalanges of the fingers are common injuries in children and adolescents. The majority can be treated by closed reduction and splinting, and complications are rare. The purpose of the prospective study was to document the results of functional-conservative treatment of extra-articular physeal fractures using either a functional forearm cast or the Lucerne Cast (LuCa). Clinical and radiographic results of 13 pediatric patients having 13 extra-articular physeal fractures (e.g., juxta-epiphyseal fractures, Salter-Harris type I or II physeal fractures) of the proximal phalanges were recorded through a minimum follow-up of 6 months. Intra-articular physeal fractures (Salter-Harris type III or IV), fractures involving the proximal interphalangeal joint (PIPJ), pathological fractures, open fractures, and concomitant injuries of the tendons were excluded. Fracture consolidation was achieved in all cases within 4 weeks. No palmar apex angulations, no rotational deformities, and no PIPJ extension lags could be observed. All patients achieved full total active range of motion within 3 months. Well-reduced extra-articular physeal fractures of the proximal phalanges can be effectively treated using functional-conservative casts. Although children may need a functional forearm cast, a LuCa is adequate in compliant adolescents.Level of Evidence The level of evidence for the study is Level II (therapeutic studies). Georg Thieme Verlag KG Stuttgart · New York.

  10. A protocol for developing a clinical practice guideline for intra-articular injection for treating knee osteoarthritis

    Directory of Open Access Journals (Sweden)

    Dan Xing

    2018-01-01

    Ethics and dissemination: The protocol will provide us a roadmap to systematically develop evidence-based CPG for intra-articular injection for knee OA. The work will be disseminated electronically and in print. The guideline would be the first CPG that is developed primarily by orthopedic specialists in China and strictly based on systematic methodology.

  11. The bio in the ink : cartilage regeneration with bioprintable hydrogels and articular cartilage-derived progenitor cells

    NARCIS (Netherlands)

    Levato, Riccardo; Webb, William R; Otto, Iris A; Mensinga, Anneloes; Zhang, Yadan; van Rijen, Mattie; van Weeren, P. René; Khan, Ilyas M.; Malda, Jos

    2017-01-01

    Cell-laden hydrogels are the primary building blocks for bioprinting, and, also termed bioinks, are the foundations for creating structures that can potentially recapitulate the architecture of articular cartilage. To be functional, hydrogel constructs need to unlock the regenerative capacity of

  12. [On the preparation and mechanical properties of PVA hydrogel bionic cartilage/bone composite artificial articular implants].

    Science.gov (United States)

    Meng, Haoye; Zheng, Yudong; Huang, Xiaoshan; Yue, Bingqing; Xu, Hong; Wang, Yingjun; Chen, Xiaofeng

    2010-10-01

    In view of the problems that conventional artificial cartilages have no bioactivity and are prone to peel off in repeated uses as a result of insufficient strength to bond with subchondral bone, we have designed and prepared a novel kind of PVA-BG composite hydrogel as bionic artificial articular cartilage/bone composite implants. The effects of processes and conditions of preparation on the mechanical properties of implant were explored. In addition, the relationships between compression strain rate, BG content, PVA hydrogels thickness and compressive tangent modulus were also explicated. We also analyzed the effects of cancellous bone aperture, BG and PVA content on the shear strength of bonding interface of artificial articular cartilage with cancellous bone. Meanwhile, the bonding interface of artificial articular cartilage and cancellous bone was characterized by scanning electron microscopy. It was revealed that the compressive modulus of composite implants was correspondingly increased with the adding of BG content and the augments of PVA hydrogel thickness. The compressive modulus and bonding interface were both related to the apertures of cancellous bone. The compressive modulus of composite implants was 1.6-2.23 MPa and the shear strength of bonding interface was 0.63-1.21 MPa. These results demonstrated that the connection between artificial articular cartilage and cancellous bone was adequately firm.

  13. Body mass index and active range of motion exercise treatment after intra-articular injection in adhesive capsulitis

    Directory of Open Access Journals (Sweden)

    Hsi-Hsien Lin

    2013-04-01

    Conclusion: Active range of motion exercise after an intra-articular injection of corticosteroid and lidocaine improved pain and functional outcome at 8 weeks in normal-weight (BMI < 25 kg/m2 patients with primary adhesive capsulitis. Manipulation under anesthesia may be considered a priority in overweight patients.

  14. The relationship between ultra-short telomeres, aging of articular cartilage and the development of human hip osteoarthritis

    DEFF Research Database (Denmark)

    Harbo, M; Delaisse, J M; Kjaersgaard-Andersen, P

    2013-01-01

    Ultra-short telomeres caused by stress-induced telomere shortening are suggested to induce chondrocyte senescence in human osteoarthritic knees. Here we have further investigated the role of ultra-short telomeres in the development of osteoarthritis (OA) and in aging of articular cartilage in human...

  15. Operative Treatment of Intra-Articular Distal Radius Fractures With versus Without Arthroscopy : Study protocol for a randomised controlled trial

    NARCIS (Netherlands)

    M.A.M. Mulders (Marjolein A. M.); C.A. Selles (Caroline); J.W. Colaris (Joost); R.W. Peters (Rolf); M. van Heijl (Mark); B.I. Cleffken (Berry); N.W.L. Schep (Niels)

    2018-01-01

    markdownabstract__Background:__ In the past several years, an increase in open reduction and internal fixation (ORIF) for intra-articular distal radius fractures has been observed. This technique leads to a quicker recovery of function compared to non-operative treatment. However, some patients

  16. Operative Treatment of Intra-Articular Distal Radius Fractures With versus Without Arthroscopy: study protocol for a randomised controlled trial

    NARCIS (Netherlands)

    Mulders, Marjolein A. M.; Selles, Caroline A.; Colaris, Joost W.; Peters, Rolf W.; van Heijl, Mark; Cleffken, Berry I.; Schep, Niels W. L.

    2018-01-01

    Background: In the past several years, an increase in open reduction and internal fixation (ORIF) for intra-articular distal radius fractures has been observed. This technique leads to a quicker recovery of function compared to non-operative treatment. However, some patients continue to have a

  17. Comparison between Chondrogenic Markers of Differentiated Chondrocytes from Adipose Derived Stem Cells and Articular Chondrocytes In Vitro

    Directory of Open Access Journals (Sweden)

    Mohmmad Mardani

    2013-06-01

    Full Text Available   Objective(s: Osteoarthritis is one of the most common diseases in middle-aged population in the world. Cartilage tissue engineering (TE has been presented as an effort to introduce the best combination of cells, biomaterial scaffolds and stimulating growth factors to produce a cartilage tissue similar to the natural articular cartilage. In this study, the chondrogenic potential of adipose derived stem cells (ADSCs was compared with natural articular chondrocytes cultured in alginate scaffold.   Materials and Methods: Human ADSCs were obtained from subcutaneous adipose tissue and human articular chondrocytes from non-weight bearing areas of knee joints. Cells were seeded in 1.5% alginate and cultured in chondrogenic media for three weeks with and without TGFβ3. The genes expression of types II and X collagens was assessed by Real Time PCR and the amount of aggrecan (AGC and type I collagen measured by ELISA and the content of glycosaminoglycan evaluated by GAG assay. Results: Our findings showed that type II collagen, GAG and AGC were expressed, in differentiated ADSCs. Meanwhile, they produced a lesser amount of types II and X collagens but more AGC, GAG and type I collagen in comparison with natural chondrocytes (NCs. Conclusion: Further attempt should be carried out to optimize achieving type II collagen in DCs, as much as, natural articular chondrocytes and decline of the production of type I collagen in order to provide efficient hyaline cartilage after chondrogenic induction, prior to the usage of harvested tissues in clinical trials.

  18. Pain and disability in patients with osteoarthritis of hip or knee: the relationship with articular, kinesiological, and psychological characteristics

    NARCIS (Netherlands)

    van Baar, M. E.; Dekker, J.; Lemmens, J. A.; Oostendorp, R. A.; Bijlsma, J. W.

    1998-01-01

    To determine to what extent articular, kinesiological, and psychological factors each contribute to pain and disability in patients with osteoarthritis (OA), after controlling for other factors. Cross sectional study among 200 patients with OA of the hip or knee. Dependent variables include pain

  19. Are intra-articular injections of hyaluronic acid effective for the treatment of temporomandibular disorders? A systematic review.

    Science.gov (United States)

    Goiato, M C; da Silva, E V F; de Medeiros, R A; Túrcio, K H L; Dos Santos, D M

    2016-12-01

    This systematic review aimed to investigate whether intra-articular injections of hyaluronic acid (HA) are better than other drugs used in temporomandibular joint arthrocentesis, for the improvement of temporomandibular disorder (TMD) symptoms. Two independent reviewers performed an electronic search of the MEDLINE and Web of Science databases for relevant studies published in English up to March 2016. The key words used included a combination of 'hyaluronic acid', 'viscosupplementation', 'intra-articular injections', 'corticosteroids', or 'non steroidal anti inflammatory agents' with 'temporomandibular disorder'. Selected studies were randomized clinical trials and prospective or retrospective studies that primarily investigated the application of HA injections compared to other intra-articular medications for the treatment of TMD. The initial screening yielded 523 articles. After evaluation of the titles and abstracts, eight were selected. Full texts of these articles were accessed and all fulfilled the inclusion criteria. Intra-articular injections of HA are beneficial in improving the pain and/or functional symptoms of TMDs. However, other drug therapies, such as corticosteroid and non-steroidal anti-inflammatory drug injections, can be used with satisfactory results. Well-designed clinical studies are necessary to identify an adequate protocol, the number of sessions needed, and the appropriate molecular weight of HA for use. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. Low-intensity pulsed ultrasound (LIPUS) and pulsed electromagnetic field (PEMF) treatments affect degeneration of cultured articular cartilage explants

    NARCIS (Netherlands)

    Tan, Lijun; Ren, Yijin; van Kooten, Theo G.; Grijpma, Dirk W.; Kuijer, Roelof

    PURPOSE: Articular cartilage has some capacity for self-repair. Clinically used low-intensity pulsed ultrasound (LIPUS) and pulsed electromagnetic field (PEMF) treatments were compared in their potency to prevent degeneration using an explant model of porcine cartilage. METHODS: Explants of porcine

  1. Low-intensity pulsed ultrasound (LIPUS) and pulsed electromagnetic field (PEMF) treatments affect degeneration of cultured articular cartilage explants

    NARCIS (Netherlands)

    Tan, Lijun; Tan, Lijun; Ren, Yijin; van Kooten, Theo G.; Grijpma, Dirk W.; Kuijer, Roel

    2015-01-01

    Purpose: Articular cartilage has some capacity for self-repair. Clinically used low-intensity pulsed ultrasound (LIPUS) and pulsed electromagnetic field (PEMF) treatments were compared in their potency to prevent degeneration using an explant model of porcine cartilage. Methods: Explants of porcine

  2. Quantitative description of collagen structure in the articular cartilage of the young and adult equine distal metacarpus

    NARCIS (Netherlands)

    Turnhout, van M.C.; Haazelager, M.B.; Gijsen, M.A.L.; Schipper, H.; Kranenbarg, S.; Leeuwen, van J.L.

    2008-01-01

    The orientation and organisation of collagen fibrils play an important role in the mechanical functioning of the articular cartilage (AC) that covers the surfaces in the diarthrodial joints. In the adult animal, typically an arcade like 'Benninghoff structure' is found. Because the remodelling

  3. A comparative study of intramedullary interlocking nailing and minimally invasive plate osteosynthesis in extra articular distal tibial fractures

    Directory of Open Access Journals (Sweden)

    Arup K Daolagupu

    2017-01-01

    Conclusion: IMLN group was associated with lesser duration of surgery, earlier weight bearing and union rate, lesser incidence of infection and implant irritation which makes it a preferable choice for fixation of extra-articular distal tibial fractures. However, larger randomized controlled trials are required for confirming the results.

  4. Viscoelasticity of articular cartilage: Analysing the effect of induced stress and the restraint of bone in a dynamic environment.

    Science.gov (United States)

    Lawless, Bernard M; Sadeghi, Hamid; Temple, Duncan K; Dhaliwal, Hemeth; Espino, Daniel M; Hukins, David W L

    2017-11-01

    The aim of this study was to determine the effect of the induced stress and restraint provided by the underlying bone on the frequency-dependent storage and loss stiffness (for bone restraint) or modulus (for induced stress) of articular cartilage, which characterise its viscoelasticity. Dynamic mechanical analysis has been used to determine the frequency-dependent viscoelastic properties of bovine femoral and humeral head articular cartilage. A sinusoidal load was applied to the specimens and out-of-phase displacement response was measured to determine the phase angle, the storage and loss stiffness or modulus. As induced stress increased, the storage modulus significantly increased (p 0.05); however, off-bone, articular cartilage loss stiffness demonstrated a logarithmic frequency-dependency (p < 0.05). In conclusion, the frequency-dependent trends of storage and loss moduli of articular cartilage are dependent on the induced stress, while the restraint provided by the underlying bone removes the frequency-dependency of the loss stiffness. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Pain and disability in patients with osteoarthritis of hip or knee: the relationship with articular, kinesiological, and psychological characteristics.

    NARCIS (Netherlands)

    Baar, M.E. van; Dekkers, J.; Lemmens, J.A.M.; Oostendorp, R.A.B.; Bijlsma, J.W.J.

    1998-01-01

    Objective: To determine to what extent articular, kinesiological, and psychological factors each contribute to pain and disability in patients with osteoarthritis (OA), after controlling for other factors. Methods: Cross sectional study among 200 patients with OA of the hip or knee. Dependent

  6. Acute anterior uveitis and other extra-articular manifestations of spondyloarthritis.

    Science.gov (United States)

    Mitulescu, T C; Popescu, C; Naie, A; Predeţeanu, D; Popescu, V; Alexandrescu, C; Voinea, L M

    2015-01-01

    Spondyloarthritis (SpA) is associated with an array of peripheral manifestations. Our study aims to evaluate extra-articular manifestations of SpA in a Romanian academic clinical setting and to observe their associations with different disease measures. The study was designed to note the extra-articular manifestations of SpA patients in a cross-sectional and retrospective manner. Records included demographics, inflammation markers, SpA clinical characteristics, treatment regimes, associated osteoporosis and cardiovascular morbidity. Data were assessed by using appropriate non-parametric tests. A total of 126 SpA patients were included. The most common extra-articular manifestations were skin involvement in the form of psoriasis (34.1%), eye involvement in the form of acute anterior uveitis (8.7%) and dactylitis (7.2%). Compared to patients with no record of uveitis, uveitis-affected cases were more frequently males, more frequently diagnosed with ankylosing spondylitis, but less frequently dyslipidemic and diagnosed with psoriasis. Psoriasis-affected patients were older and had a higher prevalence of peripheral SpA diagnosis, but a lower prevalence of radiographic sacroiliitis. Acute anterior uveitis in SpA predominantly affects males with AS. This is relevant both to clinical and fundamental science, since its management requires both ophthalmology and rheumatology clinical settings. Psoriasis was associated more frequently with peripheral SpA. AHT = arterial hypertension, AS = ankylosing spondylitis, ASAS = Assessment in SpondyloArthritis international Society, aSpA = axial spondyloarthritis, BASFI = Bath Ankylosing Spondylitis Functional Index, BASDAI = Bath Ankylosing Spondylitis Disease Activity Index, CRP = C-reactive protein, ESR = erythrocyte sedimentation rate, DM2 = type 2 diabetes mellitus, HLA = human leukocyte antigen, IBD = inflammatory bowel disease, MRI = magnetic resonance imaging, mSpA = mixed (peripheral and axial) spondyloarthritis, NSAIDs = non

  7. Antagonistic Mono- and Bi-Articular Lower-Limb Muscle Activities’ Model Characterization at Different Speeds

    Directory of Open Access Journals (Sweden)

    Dzahir M.A.M

    2017-01-01

    Full Text Available Nowadays, medical rehabilitation system has become a requirement due to increment in national rehabilitation centres and medical hospitals. An assistive rehabilitation orthosis becomes essential and was used for rehabilitation therapy, condition monitoring, and physical strengthening. This study focused on the lower limb assistive rehabilitation orthosis development using pneumatic artificial muscle. To successfully control this orthosis system which consists of antagonistic mono- and biarticular muscle actuators, it is necessary to construct a reliable control algorithm. The suitable control scheme and strategy to manoeuvre this orthosis system similar to human musculoskeletal system have yet to be fully developed and established. Based on the review study, it is said that the co-contraction controls of anterior-posterior pneumatic muscles was able to improve the joint stiffness and stability of the orthosis as well as good manoeuvrability. Therefore, a characterization model of an antagonistic mono- and bi-articular muscles activities of human's lowerlimb during walking motion will be necessary. A healthy young male subject was used as test subject to obtain the sEMG muscle activities for antagonistic mono- and bi-articular muscles (i.e., Vastus Medialis-VM, Vastus Lateralis-VL, Rectus Femoris-RF, and Bicep Femoris-BF. The tests were carried out at different speeds of 2km/h, 3km/h, and 4km/h for one minute walking motion on a treadmill. Then, the patterns of the sEMG muscle activities were modelled and characterised using fifth order polynomial equation. Based on the results, it is shown that the anterior and posterior muscles were exhibited a muscle synergy in-between multiple anterior or posterior muscles and muscle co-contraction between anteriorposterior muscles in order to control the movements at the joints during walking motion. As conclusion, it is proven that the sEMG muscle activities of the antagonistic mono- and bi-articular

  8. Manifestações articulares nas viroses exantemáticas Joint complaints in exanthematic diseases

    Directory of Open Access Journals (Sweden)

    Solange Artimos de Oliveira

    1999-04-01

    Full Text Available A freqüência de manifestações articulares foi avaliada em 251 pacientes com diagnóstico clínico e laboratorial (detecção de IgM por ensaio imunoenzimático de virose exantemática. As artropatias (artralgia e/ou artrite foram mais observadas nos casos de dengue (49% e de rubéola (38,2% do que naqueles com parvovirose humana (30% e sarampo (28,1%. Com exceção do sarampo, as artropatias predominaram nos adultos (315 anos de idade, sendo tal diferença estatisticamente significativa. A ocorrência maior de artropatias em adultos foi mais evidente nos pacientes com parvovirose (75%, rubéola (65% e dengue (57,7% do que naqueles com sarampo (31%. As queixas articulares também predominaram nos pacientes do sexo feminino para todas as viroses avaliadas. Os resultados encontrados demonstram o freqüente acometimento articular nas doenças estudadas, e indicam a necessidade de comprovação laboratorial para o diagnóstico diferencial entre elas.The frequency of arthropathy was evaluated in 251 patients with clinical and serological diagnosis (specific IgM detection by enzyme immunoassay of exanthematic disease. Arthropathy (arthralgia and/or arthritis was more frequent in dengue fever (49% and rubella (38.2% cases than in human parvovirus (30% and measles (28.1% cases. Except for measles cases, joint complaints prevailed in adults (315 years of age and this difference was significant. The higher frequency of arthropathy in adults was more evident in human parvovirus (75%, rubella (65% and dengue fever (57.7% cases than in measles cases (31%. Arthropathy was also more frequent in females for all rash diseases studied. The results of this study showed the high occurrence of joint complaints in the diseases described here and the importance of laboratory confirmation for their differential diagnosis.

  9. Effect of Hypertonic Saline in Intra-Articular Hydraulic Distension for Adhesive Capsulitis.

    Science.gov (United States)

    Lee, Jong Hwa; Kim, Sang Beom; Lee, Kyeong Woo; Lee, Sook Joung; Lee, Jae Uk

    2015-07-01

    Maintaining the integrity of the capsule along with infusing a sufficient amount of fluid is 1 of the therapeutic concepts in intra-articular hydraulic distension (IHD) for adhesive capsulitis. It has been known that hypertonic saline solution decreases tissue edema and increases the fluid volume within the epidural space, causing microdissection, in epidural adhesiolysis. To investigate the effect of hypertonic saline solution in capsule-preserving intra-articular hydraulic distension (CPIHD) for adhesive capsulitis. Prospective randomized controlled trial. University outpatient clinic of physical medicine and rehabilitation. A total of 64 patients who were diagnosed as adhesive capsulitis of shoulder were randomly assigned to 1 of 2 treatment groups. The hypertonic saline group was treated by CPIHD with hypertonic saline (3% NaCl), and the normal saline group with normal saline solution (0.9% NaCl). Both groups were treated with CPIHD, a method that preserves the capsule with maximal distension without inducing capsule rupture. The volume of saline solution necessary to adequately distend the capsule was recorded. Injection materials contained 4 mL of 1% lidocaine, 1 mL of triamcinolone (10 mg), and saline solution (hypertonic or normal saline). The intra-articular injection was monitored with ultrasound to maximize the infused volume while preserving the capsule. The Shoulder Pain and Disability Index (SPADI) and shoulder passive range of motion (PROM) was measured before the procedure and 2 weeks after CPIHD. The mean CPIHD volume was 20.2 ± 5.2 mL for the hypertonic saline group and 19.5 ± 5.9 mL for the normal saline group. The hypertonic saline group showed statistically significant improvement in shoulder PROM and SPADI score compared with the normal saline group. Side effects such as soreness or complications related to injection were not reported. Our results suggest that CPIHD with hypertonic saline solution is more effective than that using normal

  10. FUNCTIONAL OUTCOME OF INTERNAL FIXATION FOR DISPLACED INTRA-ARTICULAR CALCANEAL FRACTURE

    Directory of Open Access Journals (Sweden)

    Saket Jati

    2016-12-01

    Full Text Available BACKGROUND There are always difference of opinion in the importance of Bohler’s angle in evaluating the severity of displaced intra-articular calcaneal fractures and predicting the functional outcome following surgical fixation. The purpose of this research, the relationship exists between Bohler’s angle and the injury severity of displaced calcaneal fractures and between surgical improvement of Bohler’s angle and its practical outcome. MATERIALS AND METHODS Patients were treated surgically for unilateral closed displaced intra-articular calcaneal fractures from May 2014 to October 2016 were identified. The Bohler’s angles of bilateral calcaneus were measured and was compared to the dimension of the uninjured foot was used as its normal control. The difference in the value of Bohler’s angle measured preoperatively or after surgery between the angle of the damaged foot and that of the contralateral calcaneus was calculated, respectively. The change in Bohler’s angle by ratio was calculated by dividing the variation in the value of Bohler’s angle between bilateral calcaneus by its typical control. The injury severity was assessed according to Sanders classification. The functional outcomes were assessed using American Orthopaedic Foot and Ankle Society hindfoot scores. RESULTS 30 patients were included into the study with a mean follow-up duration of 30 months. According to Sanders classification, the fracture pattern included 12 type II, 10 type III and 8 type IV fractures. According to American Orthopaedic Foot and Ankle Society hindfoot scoring system, the excellent, good, fair and poor results were achieved in 10, 8, 4 and 2 patients, respectively. The preoperative Bohler’s angle, difference value of Bohler’s angle between bilateral calcaneus and change in Bohler’s angle by ratio each has a significant relationship with Sanders classification (P=0.003; P=0.004; P=0.005, respectively, however, is not correlated with

  11. Primary cutaneous marginal zone lymphoma associated with juxta-articular fibrotic nodules in a teenager.

    Science.gov (United States)

    Ghatalia, Pooja; Porter, Joanne; Wroblewski, Danielle; Carlson, John Andrew

    2013-05-01

    Primary cutaneous marginal zone lymphoma (PCMZL) has rarely been reported in teenagers and is occasionally associated with Borrelia burgdorferi infection. Juxta-articular fibrotic nodules represent a unique, localized fibrosing response to spirochete infections, namely Borreliosis. Herein, we report a 15-year-old healthy boy who presented with a 4-year history of progressive acquisition of asymptomatic, erythematous nodules, ≤ 3 cm, beginning with his right forearm (3), then right arm (1) and lastly his right inner thigh (1). Biopsy showed PCMZL in three of five samples, and inflamed, fibrotic nodules, near the elbow in two. The bottom heavy lymphomatous nodules consisted of mostly small CD20+ CD43+ lymphocytes, some with plasmacytoid features. Mature plasma cells were lambda light chain restricted by in situ hybridization. The juxta-articular fibrotic nodules were located in the deep dermis and subcutis, had peripheral plasma cell-rich infiltrates, and showed nodular sclerosis (morphea profunda-like) in one, and lamellar and angiocentric sclerosis in the other reminiscent of quiescent lesions of chronic localized fibrosing leukocytoclastic vasculitis. Immunohistochemistry for B. burgdorferi revealed rare positive organisms; however, polymerase chain reaction (PCR) and serology were negative for B. burgdorferi as were serologic and/or PCR assays for Bartonella henselae, Ba. quintana, Ehrlichia chaffeensis, Treponema pallidum, Helicobacter pylori and Babesia microti. No evidence of extracutaneous disease was found by the review of systems and imaging studies. A 4-week trial of doxycycline therapy failed, whereas intralesional (IL) corticosteroid therapy induced rapid regression of his nodules. After two local recurrences, also treated with IL corticosteroids, he is well, without cutaneous disease, 20 months later. A literature review of 19 pediatric cases PCMZL reveals a similar natural history as adult PCMZL. Despite negative serology and PCR for B. burgdorferi

  12. Vulnerability of the Superficial Zone of Immature Articular Cartilage to Compressive Injury

    Energy Technology Data Exchange (ETDEWEB)

    Rolauffs, R.; Muehleman, C; Li, J; Kurz, B; Kuettner, K; Frank, E; Grodzinsky, A

    2010-01-01

    The zonal composition and functioning of adult articular cartilage causes depth-dependent responses to compressive injury. In immature cartilage, shear and compressive moduli as well as collagen and sulfated glycosaminoglycan (sGAG) content also vary with depth. However, there is little understanding of the depth-dependent damage caused by injury. Since injury to immature knee joints most often causes articular cartilage lesions, this study was undertaken to characterize the zonal dependence of biomechanical, biochemical, and matrix-associated changes caused by compressive injury. Disks from the superficial and deeper zones of bovine calves were biomechanically characterized. Injury to the disks was achieved by applying a final strain of 50% compression at 100%/second, followed by biomechanical recharacterization. Tissue compaction upon injury as well as sGAG density, sGAG loss, and biosynthesis were measured. Collagen fiber orientation and matrix damage were assessed using histology, diffraction-enhanced x-ray imaging, and texture analysis. Injured superficial zone disks showed surface disruption, tissue compaction by 20.3 {+-} 4.3% (mean {+-} SEM), and immediate biomechanical impairment that was revealed by a mean {+-} SEM decrease in dynamic stiffness to 7.1 {+-} 3.3% of the value before injury and equilibrium moduli that were below the level of detection. Tissue areas that appeared intact on histology showed clear textural alterations. Injured deeper zone disks showed collagen crimping but remained undamaged and biomechanically intact. Superficial zone disks did not lose sGAG immediately after injury, but lost 17.8 {+-} 1.4% of sGAG after 48 hours; deeper zone disks lost only 2.8 {+-} 0.3% of sGAG content. Biomechanical impairment was associated primarily with structural damage. The soft superficial zone of immature cartilage is vulnerable to compressive injury, causing superficial matrix disruption, extensive compaction, and textural alteration, which results

  13. Periarticular dextrose prolotherapy instead of intra-articular injection for pain and functional improvement in knee osteoarthritis

    Directory of Open Access Journals (Sweden)

    Rezasoltani Z

    2017-05-01

    Full Text Available Zahra Rezasoltani,1 Mehrdad Taheri,2 Morteza Kazempour Mofrad,3 Seyed Amir Mohajerani2 1Department of Physical Medicine and Rehabilitation, AJA University of Medical Sciences, 2Department of Anesthesiology and Pain Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, 3Department of Anesthesiology and Pain Medicine, AJA University of Medical Sciences, Tehran, Iran Background: Osteoarthritis (OA is a degenerative disease that can lead to painful and dysfunctional joints. Prolotherapy involves using injections to produce functional restoration of the soft tissues of the joint. Intra-articular injections are controversial because of the introduction of needles into the articular capsule.Objectives: To compare the effect of periarticular versus intra-articular prolotherapy on pain and disability in patients with knee OA.Study design: Randomized double-blind controlled clinical trial.Setting: Single center, university hospital (Imam Hossein Hospital, Tehran, Iran.Methods: A total of 104 patients with chronic knee OA were enrolled. In the intra-articular group, 8 mL of 10% dextrose and 2 mL of 2% lidocaine were injected. Injections were repeated at 1 and 2 weeks after the first injection. In the periarticular group, 5 mL of 20% dextrose and 5 mL of 1% lidocaine were injected subcutaneously at 4 points in the periarticular area. Pain and disability, as assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC, were recorded at each follow-up visit at 1, 2, 3, 4, and 5 months post-injection.Results: The visual analog scale score was significantly lower in the periarticular compared with the intra-articular group at the 2-, 3-, 4-, and 5-month visits but not at 1 month. Morning stiffness and difficulty in rising from sitting were improved in both groups and were not significantly different in the peri- and intra-articular groups. Pain, joint locking, and limitation scores were all improved in both

  14. Comprehensive Genome-Wide Transcriptomic Analysis of Immature Articular Cartilage following Ischemic Osteonecrosis of the Femoral Head in Piglets.

    Directory of Open Access Journals (Sweden)

    Naga Suresh Adapala

    Full Text Available Ischemic osteonecrosis of the femoral head (ONFH in piglets results in an ischemic injury to the immature articular cartilage. The molecular changes in the articular cartilage in response to ONFH have not been investigated using a transcriptomic approach. The purpose of this study was to perform a genome-wide transcriptomic analysis to identify genes that are upregulated in the immature articular cartilage following ONFH.ONFH was induced in the right femoral head of 6-week old piglets. The unoperated femoral head was used as the normal control. At 24 hours (acute ischemic-hypoxic injury, 2 weeks (avascular necrosis in the femoral head and 4 weeks (early repair after surgery (n = 4 piglets/time point, RNA was isolated from the articular cartilage of the femoral head. A microarray analysis was performed using Affymetrix Porcine GeneChip Array. An enrichment analysis and functional clustering of the genes upregulated due to ONFH were performed using DAVID and STRING software, respectively. The increased expression of selected genes was confirmed by a real-time qRTPCR analysis.Induction of ONFH resulted in the upregulation of 383 genes at 24 hours, 122 genes at 2 weeks and 124 genes at 4 weeks compared to the normal controls. At 24 hours, the genes involved in oxidoreductive, cell-survival, and angiogenic responses were significantly enriched among the upregulated genes. These genes were involved in HIF-1, PI3K-Akt, and MAPK signaling pathways. At 2 weeks, secretory and signaling proteins involved in angiogenic and inflammatory responses, PI3K-Akt and matrix-remodeling pathways were significantly enriched. At 4 weeks, genes that represent inflammatory cytokines and chemokine signaling pathways were significantly enriched. Several index genes (genes that are upregulated at more than one time point following ONFH and are known to be important in various biological processes including HIF-1A, VEGFA, IL-6, IL6R, IL-8, CCL2, FGF2, TGFB2, MMP1, MMP3, ITGA

  15. Regulation of the friction coefficient of articular cartilage by TGF-beta1 and IL-1beta.

    Science.gov (United States)

    DuRaine, Grayson; Neu, Corey P; Chan, Stephanie M T; Komvopoulos, Kyriakos; June, Ronald K; Reddi, A Hari

    2009-02-01

    Articular cartilage functions to provide a low-friction surface for joint movement for many decades of life. Superficial zone protein (SZP) is a glycoprotein secreted by chondrocytes in the superficial layer of articular cartilage that contributes to effective boundary lubrication. In both cell and explant cultures, TGF-beta1 and IL-1beta have been demonstrated to, respectively, upregulate and downregulate SZP protein levels. It was hypothesized that the friction coefficient of articular cartilage could also be modulated by these cytokines through SZP regulation. The friction coefficient between cartilage explants (both untreated and treated with TGF-beta1 or IL-1beta) and a smooth glass surface due to sliding in the boundary lubrication regime was measured with a pin-on-disk tribometer. SZP was quantified using an enzyme-linked immunosorbant assay and localized by immunohistochemistry. Both TGF-beta1 and IL-1beta treatments resulted in the decrease of the friction coefficient of articular cartilage in a location- and time-dependent manner. Changes in the friction coefficient due to the TGF-beta1 treatment corresponded to increased depth of SZP staining within the superficial zone, while friction coefficient changes due to the IL-1beta treatment were independent of SZP depth of staining. However, the changes induced by the IL-1beta treatment corresponded to changes in surface roughness, determined from the analysis of surface images obtained with an atomic force microscope. These findings demonstrate that the low friction of articular cartilage can be modified by TGF-beta1 and IL-1beta treatment and that the friction coefficient depends on multiple factors, including SZP localization and surface roughness.

  16. Comparison of intra-articular tenoxicam and oral tenoxicam for pain and physical functioning in osteoarthritis of the knee.

    Science.gov (United States)

    Unlu, Zeliha; Ay, Kamuran; Tuzun, Cigdem

    2006-02-01

    This study was designed to compare efficacy of local administration of a nonsteroidal anti-inflammatory drug with systemic administration in patients with osteoarthritis (OA) of the knee. For this purpose, intra-articular tenoxicam and oral tenoxicam therapies were applied and the improvement in control of pain and physical functioning were evaluated. A total of 69 patients with OA of the knee were randomized into three groups. Patients in the first group (41 knees of 23 patients) were treated for 1-3 weeks with once weekly intra-articular injection of tenoxicam 20 mg. Patients in the second group (45 knees of 26 patients) received 20 mg/day tenoxicam orally for 3 weeks and only physical exercises were applied to the third group (32 knees of 20 patients). Physical examination of the knee joint, Western Ontario and McMaster Universities Index and the Lequesne Algofunctional Index were used as outcome measurements at baseline, and the 1st, 3rd and 6th months. More significant improvement in pain and disability parameters was observed in groups 1 and 2 than group 3 compared with baseline measures. Among the patients' responses a few of the differences were statistically significant, more in favour of tenoxicam, and tenoxicam seemed to be superior to exercise alone especially at the final evaluation. There was no significant difference between the oral and intra-articular tenoxicam treatment regimens. The results of this study showed that treatment of OA of the knee with intra-articular tenoxicam is as effective as that with oral tenoxicam. It can be thought that intra-articular administration can be preferred to oral therapy due to minimal possibility of systemic side effects.

  17. In Vivo Identification and Induction of Articular Cartilage Stem Cells by Inhibiting NF-κB Signaling in Osteoarthritis.

    Science.gov (United States)

    Tong, Wenxue; Geng, Yiyun; Huang, Yan; Shi, Yu; Xiang, Shengnan; Zhang, Ning; Qin, Ling; Shi, Qin; Chen, Qian; Dai, Kerong; Zhang, Xiaoling

    2015-10-01

    Osteoarthritis (OA) is a highly prevalent and debilitating joint disorder characterized by the degeneration of articular cartilage. However, no effective medical therapy has been found yet for such condition. In this study, we directly confirmed the existence of articular cartilage stem cells (ACSCs) in vivo and in situ for the first time both in normal and OA articular cartilage, and explored their chondrogenesis in Interleukin-1β (IL-1β) induced inflammation environment and disclose whether the inhibition of NF-κB signaling can induce ACSCs activation thus improve the progression of experimental OA. We found an interesting phenomenon that ACSCs were activated and exhibited a transient proliferative response in early OA as an initial attempt for self-repair. During the in vitro mechanism study, we discovered IL-1β can efficiently activate the NF-κB pathway and potently impair the responsiveness of ACSCs, whereas the NF-κB pathway inhibitor rescued the ACSCs chondrogenesis. The final in vivo experiments further confirmed ACSCs' activation were maintained by NF-κB pathway inhibitor, which induced cartilage regeneration, and protected articular cartilage from injury in an OA animal model. Our results provided in vivo evidence of the presence of ACSCs, and disclosed their action in the early OA stage and gradual quiet as OA process, presented a potential mechanism for both cartilage intrinsic repair and its final degradation, and demonstrated the feasibility of inducing endogenous adult tissue-specific mesenchymal stem cells for articular cartilage repair and OA therapy. © 2015 AlphaMed Press.

  18. 24R,25-Dihydroxyvitamin D3 Protects against Articular Cartilage Damage following Anterior Cruciate Ligament Transection in Male Rats.

    Directory of Open Access Journals (Sweden)

    Barbara D Boyan

    Full Text Available Osteoarthritis (OA in humans is associated with low circulating 25-hydroxyvitamin D3 [25(OHD3]. In vitamin D replete rats, radiolabeled 24R,25-dihydroxyvitamin D3 [24R,25(OH2D3] accumulates in articular cartilage following injection of [3H]-25(OHD3. Previously, we showed that 24R,25(OH2D3 blocks chondrocyte apoptosis via phospholipase D and p53, suggesting a role for 24R,25(OH2D3 in maintaining cartilage health. We examined the ability of 24R,25(OH2D3 to prevent degenerative changes in articular cartilage in an OA-like environment and the potential mechanisms involved. In vitro, rat articular chondrocytes were treated with IL-1β with and without 24R,25(OH2D3 or 1α,25(OH2D3. 24R,25(OH2D3 but not 1α,25(OH2D3 blocked the effects of IL-1β in a dose-dependent manner, and its effect was partially mediated through the TGF-β1 signaling pathway. In vivo, unilateral anterior cruciate ligament transections were performed in immunocompetent rats followed by intra-articular injections of 24R,25(OH2D3 or vehicle (t = 0, 7, 14, 21 days. Tissues were harvested on day 28. Joints treated with vehicle had changes typical of OA whereas joints treated with 24R,25(OH2D3 had less articular cartilage damage and levels of inflammatory mediators. These results indicate that 24R,25(OH2D3 protects against OA, and suggest that it may be a therapeutic approach for preventing trauma-induced osteoarthritis.

  19. Snorc is a novel cartilage specific small membrane proteoglycan expressed in differentiating and articular chondrocytes

    DEFF Research Database (Denmark)

    Heinonen, J; Taipaleenmäki, H; Roering, P

    2011-01-01

    and interaction partners are still likely to be discovered. Our focus in this study was to characterize a novel cartilage specific gene that was identified in mouse limb cartilage during embryonic development. METHODS: Open access bioinformatics tools were used to characterize the gene, predicted protein...... subgroups. Cartilage specific expression was highest in proliferating and prehypertrophic zones during development, and in adult articular cartilage, expression was restricted to the uncalcified zone, including chondrocyte clusters in human osteoarthritic cartilage. Studies with experimental chondrogenesis...... and orthologs in vertebrate species. Immunohistochemistry and mRNA expression methodology were used to study tissue specific expression. Fracture callus and limb bud micromass culture were utilized to study the effects of BMP-2 during experimental chondrogenesis. Fusion protein with C-terminal HA...

  20. Hierarchical Structure of Articular Bone-Cartilage Interface and Its Potential Application for Osteochondral Tissue Engineering

    Science.gov (United States)

    Bian, Weiguo; Qin, Lian; Li, Dichen; Wang, Jin; Jin, Zhongmin

    2010-09-01

    The artificial biodegradable osteochondral construct is one of mostly promising lifetime substitute in the joint replacement. And the complex hierarchical structure of natural joint is important in developing the osteochondral construct. However, the architecture features of the interface between cartilage and bone, in particular those at the micro-and nano-structural level, remain poorly understood. This paper investigates these structural data of the cartilage-bone interface by micro computerized tomography (μCT) and Scanning Electron Microscope (SEM). The result of μCT shows that important bone parameters and the density of articular cartilage are all related to the position in the hierarchical structure. The conjunctions of bone and cartilage were defined by SEM. All of the study results would be useful for the design of osteochondral construct further manufactured by nano-tech. A three-dimensional model with gradient porous structure is constructed in the environment of Pro/ENGINEERING software.

  1. Imobilização articular: efeitos sobre o tecido muscular de camundongos obesos e desnutridos

    OpenAIRE

    Renato Rissi; George Azevedo Lemos; Bernardo Neme Ide; Rafael Ludemann Camargo; Renato Chaves Souto Branco; Priscila Neder Morato; Evanisi Teresa Palomari

    2016-01-01

    DOI: http://dx.doi.org/10.5007/1980-0037.2016v18n1p1   Embora seja um recurso muito utilizado para tratamento de lesões musculoesqueléticas, a imobilização causa efeitos deletérios no tecido muscular após curto período de tempo. O presente estudo teve como objetivo avaliar os músculos gastrocnêmio e tibial anterior de animais obesos e desnutridos proteicamente sob a condição de imobilização articular. Foram utilizados 28 camundongos (C57/BL6) machos adultos, distribuídos em quatro gru...

  2. Elements for successful functional result after surgical treatment of intra-articular distal humeral fractures.

    Science.gov (United States)

    Darabos, Nikica; Bajs, Ivana Dovzak; Sabalić, Srećko; Pavić, Roman; Darabos, Anela; Cengić, Tomislav

    2012-12-01

    Intra-articular distal humeral fractures (DHF) present great challenge to an orthopedic-trauma surgeon. We analyzed the relationship between functional results of DHF surgical treatment and elements that can affect patient recovery. During the 5-year follow-up study, 32 patients were treated for DHF at our Trauma Department, 30 of them by surgical procedure. Functional results of surgical treatment were scored according to the Jupiter criteria. According to the A-O classification of DHF, there were 11 type A fractures, 5 type B fractures and 14 type C fractures. Postoperative complications were infections, neural lesions, inadequate healing, and instability of osteosynthesis. Analysis of functional results in patients with operated C type fractures according to different elements influencing postoperative result revealed correct healing in 74% of patients, which was statistically significantly higher than the percentage of unsatisfactory results (p elements for successful functional recovery.

  3. Gene Modification of Mesenchymal Stem Cells and Articular Chondrocytes to Enhance Chondrogenesis

    Directory of Open Access Journals (Sweden)

    Saliya Gurusinghe

    2014-01-01

    Full Text Available Current cell based treatment for articular cartilage and osteochondral defects are hampered by issues such as cellular dedifferentiation and hypertrophy of the resident or transplanted cells. The reduced expression of chondrogenic signalling molecules and transcription factors is a major contributing factor to changes in cell phenotype. Gene modification of chondrocytes may be one approach to redirect cells to their primary phenotype and recent advances in nonviral and viral gene delivery technologies have enabled the expression of these lost factors at high efficiency and specificity to regain chondrocyte function. This review focuses on the various candidate genes that encode signalling molecules and transcription factors that are specific for the enhancement of the chondrogenic phenotype and also how epigenetic regulators of chondrogenesis in the form of microRNA may also play an important role.

  4. A Novel Model for the Mass Transfer of Articular Cartilage: Rolling Depression Load Device

    Science.gov (United States)

    Fan, Zhenmin; Zhang, Chunqiu; Liu, Haiying; Xu, Baoshan; Li, Jiang; Gao, Lilan

    The mass transfer is one of important aspects to maintain the physiological activity proper of tissue, specially, cartilage cannot run without mechanical environment. The mechanical condition drives nutrition in and waste out in the cartilage tissue, the change of this process plays a key role for biological activity. Researchers used to adopt compression to study the mass transfer in cartilage, here we firstly establish a new rolling depression load (RDL) device, and also put this device into practice. The device divided into rolling control system and the compression adjusting mechanism. The rolling control system makes sure the pure rolling and uniform speed of roller applying towards cultured tissue. The compression adjusting mechanism can realize different compressive magnitudes and uniform compression. Preliminary test showed that rolling depression load indeed enhances the process of mass transfer articular cartilage.

  5. The role of radiology in the evolution of the understanding of articular disease.

    Science.gov (United States)

    Huang, Mingqian; Schweitzer, Mark E

    2014-11-01

    Both the clinical practice of radiology and the journal Radiology have had an enormous effect on our understanding of articular disease. Early descriptions of osteoarthritis (OA) appeared in Radiology. More recently, advanced physiologic magnetic resonance (MR) techniques have furthered our understanding of the early prestructural changes in patients with OA. Sodium imaging, delayed gadolinium-enhanced MR imaging of cartilage, and spin-lattice relaxation in the rotating frame (or T1ρ) sequences have advanced understanding of the pathophysiology and pathoanatomy of OA. Many pioneering articles on rheumatoid arthritis (RA) also have been published in Radiology. In the intervening decades, our understanding of the natural history of RA has been altered by these articles. Many of the first descriptions of crystalline arthropathies, including gout, calcium pyrophosphate deposition, and hydroxyapatite deposition disease, appeared in Radiology.

  6. Combined Intra-Articular and Intravenous Tranexamic Acid Reduces Blood Loss in Total Knee Arthroplasty

    DEFF Research Database (Denmark)

    Nielsen, Christian Skovgaard; Jans, Øivind; Ørsnes, Thue

    2016-01-01

    outcome was the 24-hour calculated blood loss. Secondary outcomes were blood loss on postoperative day 2, thromboembolic complications, and transfusion rate. Blood loss was calculated by hemoglobin differences using the Gross formula. RESULTS: Data on the primary outcome were available for all 60 included......BACKGROUND: In total knee arthroplasty, both intravenous (IV) and intra-articular (IA) administration of tranexamic acid (TXA) have been shown to reduce blood loss in several randomized controlled trials, although routine use of systemic TXA is considerably more common. However, to our knowledge......, the additional benefit of IA administration of TXA when combined with IV administration, without the use of a tourniquet, has not been previously investigated. Thus, the aim of this study was to evaluate whether combined IV and IA administration of TXA reduced total blood loss compared with IV...

  7. Protocols for the in vitro design of animal articular cartilage based on tissue engineering methods

    Directory of Open Access Journals (Sweden)

    Diego Correa

    2002-01-01

    Full Text Available The articular cartilage is the structure that covers the joint ends. It has some specific tasks crucial to the correct joint physiology. It may experience a large amount of injuries that could generate considerable disabilities. Unfortunately its selfrepair capacity is too limited; therefore, many treatments have been developed with partial success, given the suboptimal biomechanical behavior of the resultant tissue. Given that, Tissue Engineering offers an alternative, based on the design of a new tissue with biological and biomechanical features which resembles the native tissue. In this work, the authors describe the methodologies followed to accomplish that goal, studying the chondrocytes harvesting, the cellular cultures, the scaffold seeding processes, the mechanical stimulation and the structural and biomechanical evaluation. Finally, exposed some of the preliminary results, as a experimental validation of the methods proposed are.

  8. Stretchable Heater Using Ligand-Exchanged Silver Nanowire Nanocomposite for Wearable Articular Thermotherapy.

    Science.gov (United States)

    Choi, Suji; Park, Jinkyung; Hyun, Wonji; Kim, Jangwon; Kim, Jaemin; Lee, Young Bum; Song, Changyeong; Hwang, Hye Jin; Kim, Ji Hoon; Hyeon, Taeghwan; Kim, Dae-Hyeong

    2015-06-23

    Thermal therapy is one of the most popular physiotherapies and it is particularly useful for treating joint injuries. Conventional devices adapted for thermal therapy including heat packs and wraps have often caused discomfort to their wearers because of their rigidity and heavy weight. In our study, we developed a soft, thin, and stretchable heater by using a nanocomposite of silver nanowires and a thermoplastic elastomer. A ligand exchange reaction enabled the formation of a highly conductive and homogeneous nanocomposite. By patterning the nanocomposite with serpentine-mesh structures, conformal lamination of devices on curvilinear joints and effective heat transfer even during motion were achieved. The combination of homogeneous conductive elastomer, stretchable design, and a custom-designed electronic band created a novel wearable system for long-term, continuous articular thermotherapy.

  9. Manual reduction of articular disc after traumatic extraction of mandibular third molar: a case report

    Directory of Open Access Journals (Sweden)

    Rubens Camino Junior

    2015-10-01

    Full Text Available Introduction: Disc displacement without reduction with limited opening is an intracapsular biomechanical disorder involving the condyle-disc complex. With the mouth closed, the disc is in an anterior position in relation to the condylar head and does not reduce with mouth opening. This disorder is associated with persistent limited mandibular opening.Case report:The patient presented severe limitation to fully open the mouth, interfering in her ability to eat. Clinical examination also revealed maximum assisted jaw opening (passive stretch with less than 40 mm of maximum interincisal opening. Magnetic resonance imaging was the method of choice to identify the temporomandibular disorders.Conclusion: By means of reporting this rare case of anterior disc displacement without reduction with limited opening, after traumatic extraction of a mandibular third molar, in which manual reduction of temporomandibular joint articular disc was performed, it was possible to prove that this technique is effective in the prompt restoration of mandibular movements.

  10. Intra-articular injections of mesenchymal stem cells for knee osteoarthritis.

    Science.gov (United States)

    Rodríguez-Merchán, Emérito Carlos

    2014-12-01

    Knee osteoarthritis (KOA) represents an enormous societal burden. This review article summarizes the knowledge on the efficacy of using intra-articular injections of mesenchymal stem cells (MSCs) to treat KOA. PubMed (Medline) and the Cochrane Library were searched for literature related to MSC therapy and KOA up until January 31, 2014. The key search terms used were stem cells and knee osteoarthritis. One hundred thirty-five reports were found, but only the 25 fully focused on the topic were used for analysis. Only 3 randomized controlled trials (level II evidence) found pain relief and functional improvement over the short term. The other human studies also reported encouraging results, but their evidence level was very low (IV). Larger randomized controlled trials are needed to support these preliminary encouraging results. The relatively short duration of the studies is also a limitation for the technique at present.

  11. Rehabilitación ocluso-articular en un paciente bruxópata

    Directory of Open Access Journals (Sweden)

    José Miguel Montero Parrilla

    2011-09-01

    Full Text Available Se realizó la presentación del caso de un paciente masculino de 68 años de edad que acudió a la Consulta de Trastornos Temporomandibulares de la Facultad de Estomatología de La Habana, por presentar problemas estéticos y dificultades masticatorias. Durante la anamnesis y el examen físico se observaron facetas de desgastes oclusales, disminución de la dimensión vertical y prominencias óseas asociadas al bruxismo. Se realizó la discusión del caso y el tratamiento seguido para su rehabilitación ocluso-articular. El resultado final fue la restauración de la estética y la función.

  12. Minimally-invasive treatment of high velocity intra-articular fractures of the distal tibia.

    LENUS (Irish Health Repository)

    Leonard, M

    2012-02-01

    The pilon fracture is a complex injury. The purpose of this study was to evaluate the outcome of minimally invasive techniques in management of these injuries. This was a prospective study of closed AO type C2 and C3 fractures managed by early (<36 hours) minimally invasive surgical intervention and physiotherapist led rehabilitation. Thirty patients with 32 intra-articular distal tibial fractures were treated by the senior surgeon (GK). Our aim was to record the outcome and all complications with a minimum two year follow-up. There were two superficial wound infections. One patient developed a non-union which required a formal open procedure. Another patient was symptomatic from a palpable plate inferiorly. An excellent AOFAS result was obtained in 83% (20\\/24) of the patients. Early minimally invasive reduction and fixation of complex high velocity pilon fractures gave very satisfactory results at a minimum of two years follow-up.

  13. Associação entre ansiedade e hipermobilidade articular: estudos com diferentes amostras

    OpenAIRE

    Simone Bianchi Sanches

    2014-01-01

    Introdução: A ansiedade pode se manifestar por meio de sintomas físicos e autonômicos. Os transtornos de ansiedade são geralmente descritos por uma interação de sintomas somáticos e sinais subjetivos, o que aumenta a importância de um conhecimento mais amplo sobre como esses fatores estão relacionados e ocorrem em conjunto com distúrbios psiquiátricos e não psiquiátricas. Assim, a ansiedade pode estar associada a diversas condições médicas, entre as quais a hipermobilidade articular. A hiperm...

  14. Combined administration of oxycodone/naloxone in chronic osteo-articular diseases pain therapy.

    Science.gov (United States)

    Rosa, Palomba; Federica, Miralto; Annamaria, Vinciguerra; Fabiana, Salvato; Anna, Vaccarella

    2014-04-01

    The aim of this study is the analysis of the beneficial impact of using opioid receptor antagonist associated to opioid analgesic on the quality of life in patients suffering from chronic non-cancer pain. We recruited 60 patients suffering from osteo-articular diseases who were randomized into two groups of treatment. The group A was treated with the association of opioid receptor antagonist and opioid agonist, represented by Oxycodone. The group B was treated with the opioid analgesics Oxycodone, transdermal Fentanil, and Hidromorphone, without the opioid antagonist. The end-points assessed were the duration of titration, the average reached dosage, the duration of the stability of dosage and the opioid-induced constipation (OIC) using the BFI.

  15. The distribution of YKL-40 in osteoarthritic and normal human articular cartilage

    DEFF Research Database (Denmark)

    Volck, B; Ostergaard, K; Johansen, J S

    1999-01-01

    YKL-40, also called human cartilage glycoprotein-39, is a major secretory protein of human chondrocytes in cell culture. YKL-40 mRNA is expressed by cartilage from patients with rheumatoid arthritis, but is not detectable in normal human cartilage. The aim was to investigate the distribution of YKL......-40 in osteoarthritic (n=9) and macroscopically normal (n=5) human articular cartilage, collected from 12 pre-selected areas of the femoral head, to discover a potential role for YKL-40 in cartilage remodelling in osteoarthritis. Immunohistochemical analysis showed that YKL-40 staining was found...... staining for YKL-40 was in general low in normal cartilage. The present findings, together with previous observations, suggests that YKL-40 may be of importance in cartilage remodelling/degradation of osteoarthritic joints....

  16. MR imaging of canine osteoarthritis shows sustained hypertrophic repair of articular cartilage

    International Nuclear Information System (INIS)

    Braunstein, E.M.; Albrecht, M.; Brandt, K.D.

    1989-01-01

    This paper reports MR imaging used to evaluate cartilage abnormalities in three dogs in which the anterior cruciate ligament (ACL) of one hind limb had been transected to produce osteoarthritis. In this model changes mirror those in human osteoarthritis, but they are not progressive after a few months. The authors performed serial plain radiography and MR imaging of the osteoarthritic knee and control knee 3 years after ACL transection. Coronal T1- weighted images and sagittal multiecho and field echo summed images were obtained. Radiographs showed osteophytes, geodes, and subchondral sclerosis of the operated knees, with no progression between 2 and 3 years. Contralateral knees were normal. On MR images in each case there was indistinctness and thickening of articular cartilage in the abnormal knee compared with the contralateral knee

  17. Deficiency of Thrombospondin-4 in Mice Does Not Affect Skeletal Growth or Bone Mass Acquisition, but Causes a Transient Reduction of Articular Cartilage Thickness.

    Directory of Open Access Journals (Sweden)

    Anke Jeschke

    Full Text Available Although articular cartilage degeneration represents a major public health problem, the underlying molecular mechanisms are still poorly characterized. We have previously utilized genome-wide expression analysis to identify specific markers of porcine articular cartilage, one of them being Thrombospondin-4 (Thbs4. In the present study we analyzed Thbs4 expression in mice, thereby confirming its predominant expression in articular cartilage, but also identifying expression in other tissues, including bone. To study the role of Thbs4 in skeletal development and integrity we took advantage of a Thbs4-deficient mouse model that was analyzed by undecalcified bone histology. We found that Thbs4-deficient mice do not display phenotypic differences towards wildtype littermates in terms of skeletal growth or bone mass acquisition. Since Thbs4 has previously been found over-expressed in bones of Phex-deficient Hyp mice, we additionally generated Thbs4-deficient Hyp mice, but failed to detect phenotypic differences towards Hyp littermates. With respect to articular cartilage we found that Thbs4-deficient mice display transient thinning of articular cartilage, suggesting a protective role of Thbs4 for joint integrity. Gene expression analysis using porcine primary cells revealed that Thbs4 is not expressed by synovial fibroblasts and that it represents the only member of the Thbs gene family with specific expression in articular, but not in growth plate chondrocytes. In an attempt to identify specific molecular effects of Thbs4 we treated porcine articular chondrocytes with human THBS4 in the absence or presence of conditioned medium from porcine synovial fibroblasts. Here we did not observe a significant influence of THBS4 on proliferation, metabolic activity, apoptosis or gene expression, suggesting that it does not act as a signaling molecule. Taken together, our data demonstrate that Thbs4 is highly expressed in articular chondrocytes, where its

  18. Fractional calculus model of articular cartilage based on experimental stress-relaxation

    Science.gov (United States)

    Smyth, P. A.; Green, I.

    2015-05-01

    Articular cartilage is a unique substance that protects joints from damage and wear. Many decades of research have led to detailed biphasic and triphasic models for the intricate structure and behavior of cartilage. However, the models contain many assumptions on boundary conditions, permeability, viscosity, model size, loading, etc., that complicate the description of cartilage. For impact studies or biomimetic applications, cartilage can be studied phenomenologically to reduce modeling complexity. This work reports experimental results on the stress-relaxation of equine articular cartilage in unconfined loading. The response is described by a fractional calculus viscoelastic model, which gives storage and loss moduli as functions of frequency, rendering multiple advantages: (1) the fractional calculus model is robust, meaning that fewer constants are needed to accurately capture a wide spectrum of viscoelastic behavior compared to other viscoelastic models (e.g., Prony series), (2) in the special case where the fractional derivative is 1/2, it is shown that there is a straightforward time-domain representation, (3) the eigenvalue problem is simplified in subsequent dynamic studies, and (4) cartilage stress-relaxation can be described with as few as three constants, giving an advantage for large-scale dynamic studies that account for joint motion or impact. Moreover, the resulting storage and loss moduli can quantify healthy, damaged, or cultured cartilage, as well as artificial joints. The proposed characterization is suited for high-level analysis of multiphase materials, where the separate contribution of each phase is not desired. Potential uses of this analysis include biomimetic dampers and bearings, or artificial joints where the effective stiffness and damping are fundamental parameters.

  19. Gentiopicroside prevents interleukin-1 beta induced inflammation response in rat articular chondrocyte.

    Science.gov (United States)

    Zhao, Lei; Ye, Juan; Wu, Guo-Tai; Peng, Xue-Jing; Xia, Peng-Fei; Ren, Yuan

    2015-08-22

    In traditional Chinese medicine, Gentiana macrophylla Pall have been prescribed for the treatment of pain and inflammatory conditions. In addition, it is a common Tibetan medicinal herb used for the treatment of tonsillitis, urticaria, and rheumatoid arthritis (RA), while the flowers of G. macrophylla Pall have been traditionally treated as an anti-inflammatory agent to clear heat in Mongolian medicine. The secoiridoid glycosides and their derivatives are the primary active components of G. macrophylla and have been demonstrated to be effective as anti-inflammatory agents. Solvent extraction and D101 macroporous resin columns were employed to concentratethe gentiopicroside. Gentiopicroside cytotoxicity was assessed by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay; the toxicity of gentiopicroside in chondrocytes was reconfirmed using Hoechst staining. Western blotting, reverse transcriptase-polymerase chain reaction (RT-PCR) and immunohistochemistry were utilized to explore the protective effects and mechanisms of gentiopicroside prevents interleukin-1 beta induced inflammation response in rat articular chondrocyte. The MTT assay demonstrated that 50, 500, and 1,500 μg/mL of gentiopicroside exhibited no significant toxicity to chondrocytes (P>0.05) after 24h. Using immunohistochemistry, ELISA, RT-PCR, Western blot method to explore the protective effect and mechanism of gentiopicroside on chondrocytes induced by IL-1β. The results showed some pathways of IL-1β signal transduction were inhibited by gentiopicroside in rat chondrocytes: p38, ERK and JNK. Meanwhile, gentiopicroside showed inhibition in the IL-1β-induced release of MMPs while increasing Collagen type II expression. The current study demonstrated that gentiopicroside exhibited a potent protective effect on IL-1β induced inflammation response in rat articular chondrocyte. Thus, gentiopicroside could be a potential therapeutic strategy for treatment of OA. Copyright © 2015

  20. Quantitative assessment of murine articular cartilage and bone using X-ray phase-contrast imaging.

    Directory of Open Access Journals (Sweden)

    Jun Li

    Full Text Available Murine models for rheumatoid arthritis (RA research can provide important insights for understanding RA pathogenesis and evaluating the efficacy of novel treatments. However, simultaneously imaging both murine articular cartilage and subchondral bone using conventional techniques is challenging because of low spatial resolution and poor soft tissue contrast. X-ray phase-contrast imaging (XPCI is a new technique that offers high spatial resolution for the visualisation of cartilage and skeletal tissues. The purpose of this study was to utilise XPCI to observe articular cartilage and subchondral bone in a collagen-induced arthritis (CIA murine model and quantitatively assess changes in the joint microstructure. XPCI was performed on the two treatment groups (the control group and CIA group, n = 9 per group to monitor the progression of damage to the femur from the knee joint in a longitudinal study (at 0, 4 and 8 weeks after primary injection. For quantitative assessment, morphologic parameters were measured in three-dimensional (3D images using appropriate image analysis software. Our results showed that the average femoral cartilage volume, surface area and thickness were significantly decreased (P<0.05 in the CIA group compared to the control group. Meanwhile, these decreases were accompanied by obvious destruction of the surface of subchondral bone and a loss of trabecular bone in the CIA group. This study confirms that XPCI technology has the ability to qualitatively and quantitatively evaluate microstructural changes in mouse joints. This technique has the potential to become a routine analysis method for accurately monitoring joint damage and comprehensively assessing treatment efficacy.

  1. Effect of glutaraldehyde fixation on the frictional response of immature bovine articular cartilage explants.

    Science.gov (United States)

    Oungoulian, Sevan R; Hehir, Kristin E; Zhu, Kaicen; Willis, Callen E; Marinescu, Anca G; Merali, Natasha; Ahmad, Christopher S; Hung, Clark T; Ateshian, Gerard A

    2014-02-07

    This study examined functional properties and biocompatibility of glutaraldehyde-fixed bovine articular cartilage over several weeks of incubation at body temperature to investigate its potential use as a resurfacing material in joint arthroplasty. In the first experiment, treated cartilage disks were fixed using 0.02, 0.20 and 0.60% glutaraldehyde for 24h then incubated, along with an untreated control group, in saline for up to 28d at 37°C. Both the equilibrium compressive and tensile moduli increased nearly twofold in treated samples compared to day 0 control, and remained at that level from day 1 to 28; the equilibrium friction coefficient against glass rose nearly twofold immediately after fixation (day 1) but returned to control values after day 7. Live explants co-cultured with fixed explants showed no quantitative difference in cell viability over 28d. In general, no significant differences were observed between 0.20 and 0.60% groups, so 0.20% was deemed sufficient for complete fixation. In the second experiment, cartilage-on-cartilage frictional measurements were performed under a migrating contact configuration. In the treated group, one explant was fixed using 0.20% glutaraldehyde while the apposing explant was left untreated; in the control group both explants were left untreated. From day 1 to 28, the treated group exhibited either no significant difference or slightly lower friction coefficient than the untreated group. These results suggest that a properly titrated glutaraldehyde treatment can reproduce the desired functional properties of native articular cartilage and maintain these properties for at least 28d at body temperature. © 2013 Published by Elsevier Ltd.

  2. Aberrant Calreticulin Expression in Articular Cartilage of Dio2 Deficient Mice.

    Directory of Open Access Journals (Sweden)

    Nils Bomer

    Full Text Available To identify intrinsic differences in cartilage gene expression profiles between wild-type- and Dio2-/--mice, as a mechanism to investigate factors that contribute to prolonged healthy tissue homeostasis.Previously generated microarray-data (Illumina MouseWG-6 v2 of knee cartilage of wild-type and Dio2 -/- -mice were re-analyzed to identify differential expressed genes independent of mechanical loading conditions by forced treadmill-running. RT-qPCR and western blot analyses of overexpression and knockdown of Calr in mouse chondro-progenitor cells (ATDC5 were applied to assess the direct effect of differential Calr expression on cartilage deposition.Differential expression analyses of articular cartilage of Dio2-/- (N = 9 and wild-type-mice (N = 11 while applying a cutoff threshold (P |1,5| resulted in 1 probe located in Calreticulin (Calr that was found significantly downregulated in Dio2-/- mice (FC = -1.731; P = 0.044. Furthermore, overexpression of Calr during early chondrogenesis in ATDC5 cells leads to decreased proteoglycan deposition and corresponding lower Aggrecan expression, whereas knocking down Calr expression does not lead to histological differences of matrix composition.We here demonstrate that the beneficial homeostatic state of articular cartilage in Dio2-/- mice is accompanied with significant lower expression of Calr. Functional analyses further showed that upregulation of Calr expression could act as an initiator of cartilage destruction. The consistent association between Calr and Dio2 expression suggests that enhanced expression of these genes facilitate detrimental effects on cartilage integrity.

  3. Of mice, men and elephants: the relation between articular cartilage thickness and body mass.

    Directory of Open Access Journals (Sweden)

    Jos Malda

    Full Text Available Mammalian articular cartilage serves diverse functions, including shock absorption, force transmission and enabling low-friction joint motion. These challenging requirements are met by the tissue's thickness combined with its highly specific extracellular matrix, consisting of a glycosaminoglycan-interspersed collagen fiber network that provides a unique combination of resilience and high compressive and shear resistance. It is unknown how this critical tissue deals with the challenges posed by increases in body mass. For this study, osteochondral cores were harvested post-mortem from the central sites of both medial and lateral femoral condyles of 58 different mammalian species ranging from 25 g (mouse to 4000 kg (African elephant. Joint size and cartilage thickness were measured and biochemical composition (glycosaminoclycan, collagen and DNA content and collagen cross-links densities were analyzed. Here, we show that cartilage thickness at the femoral condyle in the mammalian species investigated varies between 90 µm and 3000 µm and bears a negative allometric relationship to body mass, unlike the isometric scaling of the skeleton. Cellular density (as determined by DNA content decreases with increasing body mass, but gross biochemical composition is remarkably constant. This however need not affect life-long performance of the tissue in heavier mammals, due to relatively constant static compressive stresses, the zonal organization of the tissue and additional compensation by joint congruence, posture and activity pattern of larger mammals. These findings provide insight in the scaling of articular cartilage thickness with body weight, as well as in cartilage biochemical composition and cellularity across mammalian species. They underscore the need for the use of appropriate in vivo models in translational research aiming at human applications.

  4. Healing results in meniscus and articular cartilage photochemically welded with 1,8-naphthalimide dyes

    Science.gov (United States)

    Judy, Millard M.; Jackson, Robert W.; Nosir, Hany R.; Matthews, James Lester; Loyd, John D.; Lewis, David E.; Utecht, Ronald E.; Yuan, Dongwu

    1997-05-01

    Meniscal tears and partial thickness defects in articular cartilage do not heal spontaneously. In this paper results are described of studies of a procedure for evoking the healing response in such lesions by a non-thermal tissue sparing photochemical weld using 1,8-naphthalimide dyes. Fifteen essentially mature Barbados sheep 40 - 60 pounds in weight received a 2 - 3 mm flap tear by incision in the red white zone of the medial meniscus oriented parallel to the table of the tibia. The animals were divided into four groups; Group I, no treatment; Group II, treatment by laser activated photoactive dyes; Group III, treatment by suturing; Group IV, treatment by laser irradiation only; Group V, treatment by photoactive dyes only. In another group of 12 sheep partial thickness flap tear was created by incision in the articular cartilage of the femoral condyle. These were divided into four groups as for the meniscus study, omitting the sutured control. Welds were made using the dimeric dye MBM Gold BW 012-012-012 at 12 mM in PBS, 457.9 nm argon ion laser radiation at 800 mW/cm2, 7.5 minutes (360 J/cm2) with approximately 2 kg/cm2 externally applied pressure. Animals were sacrificed at 24 hr, 4 weeks, 3 and 6 months postoperatively. Gross appearance of menisci and cartilage in all welded knees was normal and all welds resisted deformation or loosening under forceful probing. Histology of studies of both tissues out to 6 moths disclosed close bonding of welded area, continuing healing response in the form of cellular recruitment and protein deposition and the absence of inflammatory response. Tissue erosion and arthritic changes were evident in all unwelded controls.

  5. Gold Nanoparticles of Diameter 13 nm Induce Apoptosis in Rabbit Articular Chondrocytes

    Science.gov (United States)

    Huang, Hao; Quan, Ying-yao; Wang, Xiao-ping; Chen, Tong-sheng

    2016-05-01

    Gold nanoparticles (AuNPs) have been widely used in biomedical science including antiarthritic agents, drug loading, and photothermal therapy. In this report, we studied the effects of AuNPs with diameters of 3, 13, and 45 nm, respectively, on rabbit articular chondrocytes. AuNPs were capped with citrate and their diameter and zeta potential were measured by dynamic light scattering (DLS). Cell viability was evaluated by Cell Counting Kit-8 (CCK-8) assay after the rabbit articular chondrocytes were pre-incubated with 3, 13, and 45 nm AuNPs, respectively, for 24 h. Flow cytometry (FCM) analysis with annexin V/propidium iodide (PI) double staining and fluorescence imaging with Hoechst 33258 staining were used to determine the fashion of AuNPs-induced chondrocyte death. Further, 13 nm AuNPs (2 nM) significantly induced chondrocyte death accompanying apoptotic characteristics including mitochondrial damage, externalization of phosphatidylserine and nuclear concentration. However, 3 nm AuNPs (2 nM) and 45 nm (0.02 nM) AuNPs did not induce cytotoxicity in chondrocytes. Although 13 nm AuNPs (2 nM) increased the intracellular reactive oxygen species (ROS) level, pretreatment with Nacetyl cysteine (NAC), a ROS scavenger, did not prevent the cytotoxicity induced by 13 nm AuNPs, indicating that 13 nm AuNPs (2 nM) induced ROS-independent apoptosis in chondrocytes. These results demonstrate the size-dependent cytotoxicity of AuNPs in chondrocytes, which must be seriously considered when using AuNPs for treatment of osteoarthritis (OA).

  6. Isolation and characterization of human articular chondrocytes from surgical waste after total knee arthroplasty (TKA

    Directory of Open Access Journals (Sweden)

    Jakob Naranda

    2017-03-01

    Full Text Available Background Cartilage tissue engineering is a fast-evolving field of biomedical engineering, in which the chondrocytes represent the most commonly used cell type. Since research in tissue engineering always consumes a lot of cells, simple and cheap isolation methods could form a powerful basis to boost such studies and enable their faster progress to the clinics. Isolated chondrocytes can be used for autologous chondrocyte implantation in cartilage repair, and are the base for valuable models to investigate cartilage phenotype preservation, as well as enable studies of molecular features, nature and scales of cellular responses to alterations in the cartilage tissue. Methods Isolation and consequent cultivation of primary human adult articular chondrocytes from the surgical waste obtained during total knee arthroplasty (TKA was performed. To evaluate the chondrogenic potential of the isolated cells, gene expression of collagen type 2 (COL2, collagen 1 (COL1 and aggrecan (ACAN was evaluated. Immunocytochemical staining of all mentioned proteins was performed to evaluate chondrocyte specific production. Results Cartilage specific gene expression of COL2 and ACAN has been shown that the proposed protocol leads to isolation of cells with a high chondrogenic potential, possibly even specific phenotype preservation up to the second passage. COL1 expression has confirmed the tendency of the isolated cells dedifferentiation into a fibroblast-like phenotype already in the second passage, which confirms previous findings that higher passages should be used with care in cartilage tissue engineering. To evaluate the effectiveness of our approach, immunocytochemical staining of the evaluated chondrocyte specific products was performed as well. Discussion In this study, we developed a protocol for isolation and consequent cultivation of primary human adult articular chondrocytes with the desired phenotype from the surgical waste obtained during TKA. TKA is a

  7. Treatment of moderate hallux valgus by percutaneous, extra-articular reverse-L Chevron (PERC) osteotomy.

    Science.gov (United States)

    Lucas y Hernandez, J; Golanó, P; Roshan-Zamir, S; Darcel, V; Chauveaux, D; Laffenêtre, O

    2016-03-01

    The aim of this study was to report a single surgeon series of consecutive patients with moderate hallux valgus managed with a percutaneous extra-articular reverse-L chevron (PERC) osteotomy. A total of 38 patients underwent 45 procedures. There were 35 women and three men. The mean age of the patients was 48 years (17 to 69). An additional percutaneous Akin osteotomy was performed in 37 feet and percutaneous lateral capsular release was performed in 22 feet. Clinical and radiological assessments included the type of forefoot, range of movement, the American Orthopedic Foot and Ankle (AOFAS) score, a subjective rating and radiological parameters. The mean follow-up was 59.1 months (45.9 to 75.2). No patients were lost to follow-up. The mean AOFAS score increased from 62.5 (30 to 80) pre-operatively to 97.1 (75 to 100) post-operatively. A total of 37 patients (97%) were satisfied. At the last follow up there was a statistically significant decrease in the hallux valgus angle, the intermetatarsal angle and the proximal articular set angle. The range of movement of the first metatarsophalangeal joint improved significantly.. There was more improvement in the range of movement in patients who had fixation of the osteotomy of the proximal phalanx. Preliminary results of this percutaneous approach are promising. This technique is reliable and reproducible. Its main asset is that it maintains an excellent range of movement. The PERC osteotomy procedure is an effective approach for surgical management of moderate hallux valgus which combines the benefits of percutaneous surgery with the versatility of the chevron osteotomy whilst maintaining excellent first MTPJ range of motion. ©2016 The British Editorial Society of Bone & Joint Surgery.

  8. Management of pain on hallux valgus with percutaneous intra-articular Pulse-Dose Radiofrequency.

    Science.gov (United States)

    Masala, Salvatore; Fiori, Roberto; Calabria, Eros; Raguso, Mario; de Vivo, Dominique; Cuzzolino, Alessandro; Simonetti, Giovanni

    2017-01-01

    The purpose of our study was to investigate the role of intra-articular pulse-dose radiofrequency in management of painful hallux valgus refractory to conservative therapies. Between November 2010 and April 2012, 51 patients (15 male, 36 female) with a median age of 71.4 years were included in our clinical trial. Under fluoroscopic guidance we introduced a 22 gauge 10 cm length cannula by a percutaneous access in the first metatarsophalangeal joint and its tip was placed intra-articularly. After removing the spindle, a radiofrequency needle with a 5 mm active tip was introduced. The following parameters were used: 1200 pulses at high voltage (45 V) with 20 msec duration followed by 480 msec silent phases. A great reduction in pain intensity was documented at 1 week, 1 month and 3 months after procedures. Pain intensity increased between 5 and 8 months after treatments, so we performed a second procedure in all patients between 7 months and 9 months since the first treatment. Also in this case we obtained a great reduction of pain intensity in the first 3 months after the procedure. Pain intensity returned at preprocedural values after 9 months after second procedure. No complications were observed. Our experience shows pulse-dose radiofrequency is a safe, repeatable and effective technique for managing patients with symptomatic hallux valgus in the short and medium term. Pulse-dose radiofrequency may improve pain control and quality of life in patients with hallux valgus refractory to conservative therapies. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  9. Clinical and imaging features of intra-articular osteoid osteoma in the femoral neck

    International Nuclear Information System (INIS)

    Zeng Yonghan; Cheng Xiaoguang; Gu Xian; Luan Yixin; Li Jiangtao

    2012-01-01

    Objective: To evaluate the clinical and imaging characteristics of osteoid osteoma in femoral neck and to improve diagnostic accuracy of this disease. Methods: Twenty-one patients (18 males and 3 females, age, 7-26 years, median age, 13 years) with pathologically proven osteoid osteoma of the femoral neck were retrospectively analyzed for their clinical profile and radiologic features. CT and X-ray examinations were performed in all patients, 10 of them performed post-contrast CT scan and 4 of them performed MRI examinations. Results: Nineteen patients had hip pain (pain worse at night in 11, and 8 received salicylates treatment with good response), and 2 patients only with intermittent claudication. The duration ranged from 2 months to 54 months (median duration 12 months). X-ray: Nidus was seen on plain film in 10 cases, 18 cases showed different degrees of bone sclerosis of the nidus. CT: Nidus was demonstrated in all cases. Among them, 8 were intracortical, 6 were subperiosteal, 7 were endosteal. Twenty cases showed different degrees of bone sclerosis of the nidus-extra-articular anteromedial cortical surface of the femur neck. Nineteen cases showed 'vascular groove sign'. MRI: Nidus was seen in 4 cases. Bone sclerosis was low signal on all sequences. Three cases had joint effusion, 4 cases had bone marrow edema, and 2 cases had synovial thickening. Conclusions: Although osteoid osteoma of femoral neck has non-specific clinical features, the radiographic findings are usually typical. The nidus of osteoid osteoma is often located within the joint. Bony sclerosis occurs at the area of extra-articular anteromedial cortical surface of the femur neck.CT examination remains an optimal method to identify the nidus. (authors)

  10. Management of intra-articular fracture of calcaneus by combined percutaneous and minimal internal fixation.

    Science.gov (United States)

    Lamichhane, A; Mahara, D

    2013-01-01

    Fractures of the calcaneus are among the most challenging for the orthopaedic surgeon. The treatment of the intra-articular calcaneum fracture remains controversial due to complications and complexity of surgical anatomy. Treatment of calcaneal fracture ranges from non-operative treatment to operative. We present intraarticular fracture of calcaneus treated by combined percutaneous and minimal internal fixation. All cases evaluated either by X-ray or CT scan. All fractures were sanders two or three type evaluated by CT scan and either joint depression or tongue type fracture by X-ray. Lateral approach was used, posterior facet was exposed, reduced and fixed with one 4 mm canulated cancellous screws and 2 axial pins percutaneously from tuberosity. Clinical evaluation of the outcomes was done by modified Rowe Score. Out of 22 patients, 14 were male and 8 cases were female. Average age of the patients was 30.5 yrs (15-63 yrs). Mode of the injury was RTA in 6 cases and fall from height in 16 cases. There was no soft tissue problem in any patient. All fractures united without secondary displacement in an average of 8 weeks. Average duration of follow up was 26 months (6-37 months). Average Modified Rowe Score was 80 (Range 55-95). Ten patients had excellent, 10 had good and 2 had satisfactory outcome. Intra-articular fracture of the calcaneus can be well managed by minimal opening at the fracture and fixation by single cancellous screw and 2 axial k-wires, so minimizes complications and results in comparable outcomes.

  11. Percutaneous treatment of high-risk patients with intra-articular calcaneus fractures: a case series.

    Science.gov (United States)

    Hammond, Allan William; Crist, Brett D

    2013-11-01

    Diabetics, smokers, patients with open fractures and drug addicts have shown to be at increased risk of having wound complications with traditional calcaneus fixation. The purpose of the study is to examine if high-risk patients with intra-articular calcaneus fractures can be managed safely using percutaneous reduction and fixation by examining a consecutive series of patients treated by the senior author. The treatment group consisted of the senior author's first 17 percutaneously treated calcaneus fractures in high-risk patients. Risk factors included: open fracture, smoking, diabetes and cocaine, alcohol and solvent abuse. Reduction techniques included temporary external fixation, inflatable bone tamps, and arthroscopic assisted reduction manoeuvres. Fixation was accomplished with cannulated 4.5mm screws. Patients were followed up for 3 months minimum to look for wound complications and subsidence. Surgery was performed within 15 days from injury (average 6.7 days). Risk factors included: open fracture 1, smoking 16, diabetes 2, and substance abuse 9. Sanders' classification described: six type 2, nine type 3 and two type 4. Bohlers' angle increased from an average of -1.5° (range -37° to +30) to 25.8° (range 7-36°). There were no wound issues or infections with the calcaneal fixation. Reduction was deemed excellent or good in 14, fair in 2 and poor in 1. Loss of Bohlers' angle of >4° occurred in four cases; in three of these, the patients were non-compliant with weight bearing. High-risk patients with intra-articular calcaneus fractures that meet the criteria for surgical management can be managed with percutaneous surgical techniques with low risk of wound complications. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Navigation system for robot-assisted intra-articular lower-limb fracture surgery.

    Science.gov (United States)

    Dagnino, Giulio; Georgilas, Ioannis; Köhler, Paul; Morad, Samir; Atkins, Roger; Dogramadzi, Sanja

    2016-10-01

    In the surgical treatment for lower-leg intra-articular fractures, the fragments have to be positioned and aligned to reconstruct the fractured bone as precisely as possible, to allow the joint to function correctly again. Standard procedures use 2D radiographs to estimate the desired reduction position of bone fragments. However, optimal correction in a 3D space requires 3D imaging. This paper introduces a new navigation system that uses pre-operative planning based on 3D CT data and intra-operative 3D guidance to virtually reduce lower-limb intra-articular fractures. Physical reduction in the fractures is then performed by our robotic system based on the virtual reduction. 3D models of bone fragments are segmented from CT scan. Fragments are pre-operatively visualized on the screen and virtually manipulated by the surgeon through a dedicated GUI to achieve the virtual reduction in the fracture. Intra-operatively, the actual position of the bone fragments is provided by an optical tracker enabling real-time 3D guidance. The motion commands for the robot connected to the bone fragment are generated, and the fracture physically reduced based on the surgeon's virtual reduction. To test the system, four femur models were fractured to obtain four different distal femur fracture types. Each one of them was subsequently reduced 20 times by a surgeon using our system. The navigation system allowed an orthopaedic surgeon to virtually reduce the fracture with a maximum residual positioning error of [Formula: see text] (translational) and [Formula: see text] (rotational). Correspondent physical reductions resulted in an accuracy of 1.03 ± 0.2 mm and [Formula: see text], when the robot reduced the fracture. Experimental outcome demonstrates the accuracy and effectiveness of the proposed navigation system, presenting a fracture reduction accuracy of about 1 mm and [Formula: see text], and meeting the clinical requirements for distal femur fracture reduction procedures.

  13. Strain-rate-dependent non-linear tensile properties of the superficial zone of articular cartilage.

    Science.gov (United States)

    Ahsanizadeh, Sahand; Li, LePing

    2015-11-01

    The tensile properties of articular cartilage play an important role in the compressive behavior and integrity of the tissue. The stress-strain relationship of cartilage in compression was observed previously to depend on the strain-rate. This strain-rate dependence has been thought to originate mainly from fluid pressurization. However, it was not clear to what extent the tensile properties of cartilage contribute to the strain-rate dependence in compressive behavior of cartilage. The aim of the present study was to quantify the strain-rate dependent stress-strain relationship and hysteresis of articular cartilage in tension. Uniaxial tensile tests were performed to examine the strain-rate dependent non-linear tensile properties of the superficial zone of bovine knee cartilage. Tensile specimens were oriented in the fiber direction indicated by the India ink method. Seven strain-rates were used in the measurement ranging from 0.1 to 80%/s, which corresponded to nearly static to impact joint loadings. The experimental data showed substantial strain-rate and strain-magnitude dependent load response: for a given strain-magnitude, the tensile stress could vary by a factor of 1.95 while the modulus by a factor of 1.58 with strain-rate; for a given strain-rate, the modulus at 15% strain could be over four times the initial modulus at no strain. The energy loss in cartilage tension upon unloading exhibited a complex variation with the strain-rate. The strain-rate dependence of cartilage in tension observed from the present study is relatively weaker than that in compression observed previously, but is considerable to contribute to the strain-rate dependent load response in compression.

  14. Tribological changes in the articular cartilage of a human femoral head with avascular necrosis.

    Science.gov (United States)

    Seo, Eun-Min; Shrestha, Suman K; Duong, Cong-Truyen; Sharma, Ashish Ranjan; Kim, Tae-Woo; Vijayachandra, Ayyappan; Thompson, Mark S; Cho, Myung Guk; Park, Sungchan; Kim, Kwanghoon; Park, Seonghun; Lee, Sang-Soo

    2015-06-29

    The present study evaluated the tribological properties of the articular cartilage surface of the human femoral head with postcollapse stage avascular necrosis (AVN) using atomic force microscopy. The cartilage surface in the postcollapse stage AVN of the femoral head was reported to resemble those of disuse conditions, which suggests that the damage could be reversible and offers the possibilities of success of head-sparing surgeries. By comparing the tribological properties of articular cartilage in AVN with that of osteoarthritis, the authors intended to understand the cartilage degeneration mechanism and reversibility of AVN. Human femoral heads with AVN were explanted from the hip replacement surgery of four patients (60-83 years old). Nine cylindrical cartilage samples (diameter, 5 mm and height, 0.5 mm) were sectioned from the weight-bearing areas of the femoral head with AVN, and the cartilage surface was classified according to the Outerbridge Classification System (AVN0, normal; AVN1, softening and swelling; and AVN2, partial thickness defect and fissuring). Tribological properties including surface roughness and frictional coefficients and histochemistry including Safranin O and lubricin staining were compared among the three groups. The mean surface roughness Rq values of AVN cartilage increased significantly with increasing Outerbridge stages: Rq = 137 ± 26 nm in AVN0, Rq = 274 ± 49 nm in AVN1, and Rq = 452 ± 77 nm in AVN2. Significant differences in Rq were observed among different Outerbridge stages in all cases (p tribological properties, the cartilage degeneration mechanism in AVN was similar to that of osteoarthritis without reversibility.

  15. Contribution of proteoglycan osmotic swelling pressure to the compressive properties of articular cartilage.

    Science.gov (United States)

    Han, EunHee; Chen, Silvia S; Klisch, Stephen M; Sah, Robert L

    2011-08-17

    The negatively charged proteoglycans (PG) provide compressive resistance to articular cartilage by means of their fixed charge density (FCD) and high osmotic pressure (π(PG)), and the collagen network (CN) provides the restraining forces to counterbalance π(PG). Our objectives in this work were to: 1), account for collagen intrafibrillar water when transforming biochemical measurements into a FCD-π(PG) relationship; 2), compute π(PG) and CN contributions to the compressive behavior of full-thickness cartilage during bovine growth (fetal, calf, and adult) and human adult aging (young and old); and 3), predict the effect of depth from the articular surface on π(PG) in human aging. Extrafibrillar FCD (FCD(EF)) and π(PG) increased with bovine growth due to an increase in CN concentration, whereas PG concentration was steady. This maturation-related increase was amplified by compression. With normal human aging, FCD(EF) and π(PG) decreased. The π(PG)-values were close to equilibrium stress (σ(EQ)) in all bovine and young human cartilage, but were only approximately half of σ(EQ) in old human cartilage. Depth-related variations in the strain, FCD(EF), π(PG), and CN stress profiles in human cartilage suggested a functional deterioration of the superficial layer with aging. These results suggest the utility of the FCD-π(PG) relationship for elucidating the contribution of matrix macromolecules to the biomechanical properties of cartilage. Copyright © 2011 Biophysical Society. Published by Elsevier Inc. All rights reserved.

  16. Trapezial-metacarpal joint arthritis: radiographic correlation between first metacarpal articular tilt and dorsal subluxation.

    Science.gov (United States)

    Kurosawa, Kazuya; Tsuchiya, Ichiro; Takagishi, Kenji

    2013-02-01

    Dorsal subluxation of the base of the first metacarpal is a typical finding in trapezial-metacarpal (TM) osteoarthritis. The purpose of this study was to clarify the correlation between dorsal subluxation and articular tilt of the metacarpal facet in TM osteoarthritis. We investigated 50 subjects between 25 and 70 years of age (mean, 45 ± 11 y) with normal thumbs (100 hands) and 98 subjects between 43 and 89 years of age (mean, 61 ± 11 y) with TM osteoarthritis (132 hands). We established 3 groups: normal (normal thumbs), mild arthritis (40 hands, Eaton stage 1 or 2), and severe arthritis (92 hands, Eaton stage 3 or 4). We took sagittal-plane radiographs of all TM joints. We defined the dorsal subluxation angle as the angle formed by a tangent drawn on the dorsal margin of the first metacarpal base and trapezium and the longitudinal axis of the second metacarpal. The facet angle was defined as the complementary angle between the tangent to the dorsal cortex of the first metacarpal and the line of the metacarpal facet of the TM joint. We compared the dorsal subluxation angle and facet angle between groups and investigated the correlation between these angles among the 132 hands with TM osteoarthritis. Both the dorsal subluxation angle and facet angle were significantly greater in the mild arthritis group than in the normal group and significantly greater in the severe arthritis group than in the mild arthritis group. A significant moderately positive correlation was also apparent between dorsal subluxation and facet angle in patients with TM osteoarthritis. Articular tilt and dorsal subluxation of the first metacarpal base are closely related, and both are increased with advanced-stage TM osteoarthritis. Therapeutic III. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  17. Articular soft tissue anatomy of the archosaur hip joint: Structural homology and functional implications.

    Science.gov (United States)

    Tsai, Henry P; Holliday, Casey M

    2015-06-01

    Archosaurs evolved a wide diversity of locomotor postures, body sizes, and hip joint morphologies. The two extant archosaurs clades (birds and crocodylians) possess highly divergent hip joint morphologies, and the homologies and functions of their articular soft tissues, such as ligaments, cartilage, and tendons, are poorly understood. Reconstructing joint anatomy and function of extinct vertebrates is critical to understanding their posture, locomotor behavior, ecology, and evolution. However, the lack of soft tissues in fossil taxa makes accurate inferences of joint function difficult. Here, we describe the soft tissue anatomies and their osteological correlates in the hip joint of archosaurs and their sauropsid outgroups, and infer structural homology across the extant taxa. A comparative sample of 35 species of birds, crocodylians, lepidosaurs, and turtles ranging from hatchling to skeletally mature adult were studied using dissection, imaging, and histology. Birds and crocodylians possess topologically and histologically consistent articular soft tissues in their hip joints. Epiphyseal cartilages, fibrocartilages, and ligaments leave consistent osteological correlates. The archosaur acetabulum possesses distinct labrum and antitrochanter structures on the supraacetabulum. The ligamentum capitis femoris consists of distinct pubic- and ischial attachments, and is homologous with the ventral capsular ligament of lepidosaurs. The proximal femur has a hyaline cartilage core attached to the metaphysis via a fibrocartilaginous sleeve. This study provides new insight into soft tissue structures and their osteological correlates (e.g., the antitrochanter, the fovea capitis, and the metaphyseal collar) in the archosaur hip joint. The topological arrangement of fibro- and hyaline cartilage may provide mechanical support for the chondroepiphysis. The osteological correlates identified here will inform systematic and functional analyses of archosaur hindlimb evolution and

  18. Preparation of Extracellular Matrix Developed Using Porcine Articular Cartilage and In Vitro Feasibility Study of Porcine Articular Cartilage as an Anti-Adhesive Film

    Directory of Open Access Journals (Sweden)

    Ji Hye Baek

    2016-01-01

    Full Text Available In this study, we examined whether porcine articular cartilage (PAC is a suitable and effective anti-adhesive material. PAC, which contained no non-collagenous tissue components, was collected by mechanical manipulation and decellularization of porcine knee cartilage. The PAC film for use as an anti-adhesive barrier was easily shaped into various sizes using homemade silicone molds. The PAC film was cross-linked to study the usefulness of the anti-adhesive barrier shape. The cross-linked PAC (Cx-PAC film showed more stable physical properties over extended periods compared to uncross-linked PAC (UnCx-PAC film. To control the mechanical properties, Cx-PAC film was thermally treated at 45 °C or 65 °C followed by incubation at room temperature. The Cx-PAC films exhibited varying enthalpies, ultimate tensile strength values, and contact angles before and after thermal treatment and after incubation at room temperature. Next, to examine the anti-adhesive properties, human umbilical vein endothelial cells (HUVECs were cultured on Cx-PAC and thermal-treated Cx-PAC films. Scanning electron microscopy, fluorescence, and MTT assays showed that HUVECs were well adhered to the surface of the plate and proliferated, indicating no inhibition of the attachment and proliferation of HUVECs. In contrast, Cx-PAC and thermal-treated Cx-PAC exhibited little and/or no cell attachment and proliferation because of the inhibition effect on HUVECs. In conclusion, we successfully developed a Cx-PAC film with controllable mechanical properties that can be used as an anti-adhesive barrier.

  19. Reconstruction of the anterior cruciate ligament: comparison of analgesia using intrathecal morphine, intra-articular morphine and intra-articular levobupivacaine

    Directory of Open Access Journals (Sweden)

    Leandro Queiroz Pinheiro

    2015-06-01

    Full Text Available OBJECTIVE: To compare the analgesic effect of intra-articular administration of morphine and levobupivacaine (separately or in combination with intrathecal administration of morphine in patients undergoing anterior cruciate ligament (ACL reconstruction using autologous grafts from the patellar tendon.METHODS: This was a retrospective analysis on data gathered from the medical files of 60 patients aged 20 to 50 years who underwent knee video arthroscopy for ACL reconstruction. The patients were divided into four groups of 15 individuals (A, B, C and D according to the agent administered into the joint and around the incision: 20 mL of saline solution with 5 mg of morphine in A; 20 mL of 0.5% levobupivacaine solution in B; 10 mL of solution with 2.5 mg of morphine plus 10 mL of 0.5% levobupivacaine solution in C; and morphine administered intrathecally in D.RESULTS: All the groups presented low pain scores during the first 12 h after the surgery. Groups B and C presented significantly greater pain scores than shown by group D (control, 24 h after the surgery. There was no statistical difference in pain scores between group A and group D.CONCLUSION: The patients in group A presented analgesia comparable to that of the patients in group D, whereas the procedure of group C was no capable of reproducing the analgesic effect observed in group D, as observed 24 h after the surgery. Further studies are needed in order to show the exact mechanism of action, along with the ideal dose and concentration for applying opioids to joints.

  20. Evaluation of relationship between disc position and morphology of Articular eminance of TMJ in MRI images of patients with TMD

    Directory of Open Access Journals (Sweden)

    Daryosh Goodarzipour

    2013-05-01

    Full Text Available Background and Aims: Because of high prevalence of TMJ dysfunctions , increased promotion of diagnostic and treatment methods is necessary. In many cases, in addition to disc position, morphology of other joint components such as articular eminence can be changed and therefore the probable correlation between disc position and morphology of hard tissue components can be used for prediction of internal derangements. The aim of this study was to evaluate the correlation between the position of disc and morphology of articular eminence of TMD`s patients using magnetic resonance imaging (MRI. Materials and Methods: In this cross sectional study by evaluation of digital MRI files, ultimately 78 joint images were identified which had sufficient quality and resolution for review. Then the MRI images, were observed and evaluated by 3 oral and maxillofacial radiologists to determine the disc position (normal, anterior displacement with and without reduction, and posterior displacement and morphology of articular eminence (Box, Sigmoid, Flattened. Ultimately the results that were reported at least by 2 observers were included as the final results and were recorded in the check list. Data were analyzed using Chi-Square test and Fisher test. Results: In this study, no case of posterior disc displacement was found and therefore was excluded from the study. Articular eminence morphology (Flattened versus Sigmoid showed statistically significant correlation with anterior disc displacement with and without reduction (P-values for anterior displacement with and without reduction were 0.03 and 0.002, respectively. No significant difference was found between the sigmoid and box types in relationship with disc displacement (P-values for anterior displacement with and without reduction were 0.72 and 0.70. In this study, no significant difference between the anterior disc displacement with reduction and anterior disc displacement without reduction in relationship