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Knee cartilage injury

Ingrid Eitzen, Hege Grindem, Agnethe Nilstad, Håvard Moksnes, May Arna Risberg
BACKGROUND: Reduced quadriceps strength influences knee function and increases the risk of knee osteoarthritis. Thus, it is of significant clinical relevance to precisely quantify strength deficits in patients with knee injuries. PURPOSE: To evaluate isokinetic concentric quadriceps muscle strength torque values, assessed both from peak torque and at specific knee flexion joint angles, in patients with anterior cruciate ligament (ACL) injury, focal cartilage lesions, and degenerative meniscus tears...
October 2016: Orthopaedic Journal of Sports Medicine
Sebastian Zabierek, Jakub Zabierek, Adam Kwapisz, Marcin E Domzalski
BACKGROUND AND PURPOSE: The patella plays an important role in knee biomechanics and provides anterior coverage of the knee joint. One to two percent of the population has an anatomical variant of patella called a bipartite patella that usually does not case pain. However, occasionally after injury or overuse during sport it can be a source of anterior knee pain. The purpose of this case report was to present a rare variant of bipartite patella and highlight conservative treatment of this condition...
October 2016: International Journal of Sports Physical Therapy
Kristine M Fischenich, Hannah M Pauly, Keith D Button, Ryan S Fajardo, Charles E DeCamp, Roger C Haut, Tammy L Haut Donahue
OBJECTIVE: The objective of this study was to monitor the progression of joint damage in two animal models of knee joint trauma using two non-invasive, clinically available imaging modalities. METHODS: A 3-T clinical magnet and micro-computed tomography was used to document changes immediately following injury (acute) and post injury (chronic) at time points of 4, 8, or 12 weeks. Joint damage was recorded at dissection and compared to the chronic MRI record. Fifteen Flemish Giant rabbits were subjected to a single tibiofemoral compressive impact (ACLF), and 18 underwent a combination of ACL and meniscal transection (mACLT)...
October 15, 2016: Osteoarthritis and Cartilage
Sung Il Wang
In symptomatic discoid medial meniscus, partial meniscectomy is the principal treatment method and can yield promising short-term results. However, unlike the nondiscoid meniscus, discoid medial meniscus is frequently associated with horizontal cleavage tears, attributable to the presence of myxoid degeneration in the intrameniscal substance, in that it may potentially occur deteriorating long-term results because of re-tearing of remaining meniscus or secondary degeneration of cartilage of the medial compartment after meniscectomy...
October 14, 2016: Acta Orthopaedica et Traumatologica Turcica
Humberto G Rosas
Although rare, posterolateral corner (PLC) injuries can result in sustained instability and failed cruciate ligament reconstruction if they are not diagnosed. The anatomy of the PLC was once thought to be perplexing and esoteric-in part because of the varying nomenclature applied to this region in the literature, which added unnecessary complexity. More recently, three major structures have been described as the primary stabilizers of the PLC on the basis of biomechanical study findings: the lateral collateral ligament, popliteus tendon, and popliteofibular ligament...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Lin Lin, Jing-Sheng Li, Willem A Kernkamp, Ali Hosseini, ChangWan Kim, Peng Yin, Lianxin Wang, Tsung-Yuan Tsai, Peter Asnis, Guoan Li
This study was to investigate the in vivo tibiofemoral cartilage contact locations before and after anterior cruciate ligament (ACL) reconstruction at 6 and 36 months. Ten patients with unilateral ACL injury were included. A step-up motion was analyzed using a combined magnetic resonance modeling and dual fluoroscopic imaging techniques. The preoperative (i.e. ACL deficient and healthy contralateral) and postoperative cartilage contact locations at 6 and 36 months were analyzed. Similar patterns of the cartilage contact locations during the step-up motion were found for the preoperative and postoperative knee states as compared to the preoperative healthy contralateral side...
October 3, 2016: Journal of Biomechanics
André Struglics, Marcin Okroj, Per Swärd, Richard Frobell, Tore Saxne, L Stefan Lohmander, Anna M Blom
BACKGROUND: The complement system is suggested to be involved in the pathogenesis of osteoarthritis (OA), and proinflammatory cytokines may play a role in OA development by inducing proteases. The association between complement factors, cytokines and OA has not been investigated. The aim of the present study was to explore the involvement of the complement system after knee trauma and in OA. METHODS: C4d, C3bBbP and soluble terminal complement complex (sTCC) resulting from complement activation were immunoassayed in synovial fluid from subjects with healthy knees (reference), OA, rheumatoid arthritis (RA; positive control), pyrophosphate arthritis (PPA; positive control) and knee injury; other biomarkers were previously assessed...
October 6, 2016: Arthritis Research & Therapy
Graeme P Whyte, Alberto Gobbi, Boguslaw Sadlik
Cartilage lesions of the knee are a frequent finding; however, treatment options that are capable of restoring hyaline-like tissue are not routinely used. Cell-based technology such as autologous chondrocyte implantation may in some cases provide durable cartilage repair, but availability of this procedure is often restricted due to cost constraints. There have been promising outcomes reported with the use of scaffolds seeded with activated bone marrow aspirate concentrate in cases of chondral injury. There are clear advantages to cell-based cartilage repair techniques that are performed as a single-stage procedure, particularly when the repair technology can be used in a minimally invasive manner...
August 2016: Arthroscopy Techniques
Michael D Ringler, Ezekiel E Shotts, Mark S Collins, B Matthew Howe
OBJECTIVE: 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. MATERIALS AND METHODS: 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...
October 4, 2016: Skeletal Radiology
J Martin Leland
With knee arthroscopy being the most common orthopaedic procedure performed in the United States, it is crucial to be able to access the entire knee without iatrogenic injury. Frequently orthopaedic surgeons encounter tight medial compartments, creating difficulty in accessing the posterior horn of the medial meniscus without damaging the articular cartilage. Partial release of the medial collateral ligament during knee arthroscopy protects chondrocytes.
October 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Kevin R Stone, Jonathan R Pelsis, Kellen Na, Ann W Walgenbach, Thomas J Turek
PURPOSE: The purpose of this study is to evaluate the clinical outcomes of the articular cartilage paste graft procedure at a minimum of 10 years from surgery. It is hypothesized that articular cartilage paste grafting can provide patients with a durable repair of severe full-thickness osteochondral injuries, measured by persistence of procedure-induced benefit and subjective outcome scores at 10 or more years. METHODS: Seventy-four patients undergoing paste grafting at a mean age of 45...
October 1, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Simon Décary, Philippe Ouellet, Pascal-André Vendittoli, Jean-Sébastien Roy, François Desmeules
INTRODUCTION: More evidence on diagnostic validity of physical examination tests for knee disorders is needed to lower frequently used and costly imaging tests. OBJECTIVE: To conduct a systematic review of systematic reviews (SR) and meta-analyses (MA) evaluating the diagnostic validity of physical examination tests for knee disorders. METHODS: A structured literature search was conducted in five databases until January 2016. Methodological quality was assessed using the AMSTAR...
August 5, 2016: Physical Therapy in Sport
Ulf Sigurdsson, Gunilla Müller, Carl Siversson, Eveliina Lammentausta, Jonas Svensson, Carl-Johan Tiderius, Leif E Dahlberg
BACKGROUND: Lesions in the meniscus are risk factors for developing knee osteoarthritis (OA), not least because of the role of the meniscus in the pathological progression of OA. Delayed gadolinium enhanced MRI of cartilage (dGEMRIC) has extensively been used to identify pre-radiographic cartilage changes in OA. In contrast, its counterpart with regard to examination of the meniscus, gadolinium enhanced MRI of meniscus (dGEMRIM), has been less utilized. In this study we use 3D dGEMRIM in patients with meniscus lesions and compare them with previous results of healthy individuals...
September 29, 2016: BMC Musculoskeletal Disorders
Huimin Yan, Xin Duan, Hua Pan, Nilsson Holguin, Muhammad Farooq Rai, Antonina Akk, Luke E Springer, Samuel A Wickline, Linda J Sandell, Christine T N Pham
Osteoarthritis (OA) is a major cause of disability and morbidity in the aging population. Joint injury leads to cartilage damage, a known determinant for subsequent development of posttraumatic OA, which accounts for 12% of all OA. Understanding the early molecular and cellular responses postinjury may provide targets for therapeutic interventions that limit articular degeneration. Using a murine model of controlled knee joint impact injury that allows the examination of cartilage responses to injury at specific time points, we show that intraarticular delivery of a peptidic nanoparticle complexed to NF-κB siRNA significantly reduces early chondrocyte apoptosis and reactive synovitis...
October 11, 2016: Proceedings of the National Academy of Sciences of the United States of America
Timothy J Ewald, Justin A Walker, Eric Alexander Lewallen, William H Trousdale, Michael J Yaszemski, Arlen D Hanssen, Bernard F Morrey, Andre J van Wijnen, Joaquin Sanchez-Sotelo, Mark E Morrey, Matthew P Abdel
Implantable biomaterials supporting extended release of pharmacologic agents may permit localized intra-articular delivery of drugs that modulate the fibrotic response to injuries and surgery. Oligo[Poly (ethylene glycol)] Fumarate (OPF) is an attractive organic carrier, but its safety profile within synovial joints remains unclear. Here, we assessed the safety of OPF sponges using a validated in vivo model of knee arthrofibrosis. A cohort of 102 rabbits was divided into 5 groups: arthrotomy only (24), arthrotomy with OPF scaffold placement (24), surgically induced contracture (24), surgically induced contracture with OPF scaffold placement (24), and control without any surgical intervention (6)...
September 27, 2016: Tissue Engineering. Part C, Methods
Gregory M Freisinger, Erin E Hutter, Jacqueline Lewis, Jeffrey F Granger, Andrew H Glassman, Matthew D Beal, Xueliang Pan, Laura C Schmitt, Robert A Siston, Ajit M W Chaudhari
Increased varus-valgus laxity has been reported in individuals with knee osteoarthritis (OA) compared to controls. However, the majority of previous investigations may not report truly passive joint laxity, as their tests have been performed on conscious participants who could be guarding against motion with muscle contraction during laxity evaluation. The purpose of this study was to investigate how a measure of passive knee laxity, recorded when the participant is under anesthesia, is related to varus-valgus excursion during gait, clinical measures of performance, perceived instability, and self-reported function in participants with severe knee OA...
September 24, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Stefanie A Pawelek, Jennifer D Illes, John A Taylor
OBJECTIVE: The purpose of this case report is to describe a case where calcium pyrophosphate dehydrate crystal deposition disease (CPPD) simulated osteoarthritis of the knee. CLINICAL FEATURES: A 78-year-old woman had a 2-week history of severe right knee pain accompanied by mild swelling. The onset was sudden and did not involve a history of trauma or previous injury to the right knee. Inspection and palpation revealed pain along the medial joint line and marked difficulty ambulating...
September 2016: Journal of Chiropractic Medicine
Christopher V Nagelli, James L Cook, Kei Kuroki, Chantelle Bozynski, Richard Ma, Timothy E Hewett
Complications following anterior cruciate ligament (ACL) injury and reconstruction that include chronic dysfunction, second ACL injury, and posttraumatic osteoarthritis (OA) may be interrelated and stem from the inability to fully restore native ACL integrity and function. The loss of ACL sensory input following injury may significantly contribute to joint dysfunction. We developed a novel preclinical animal model to assess the contributions of ACL sensory afferents to knee joint function and health. We hypothesized that ACL sensory denervation would manifest in knee joint dysfunction and development of early OA...
September 20, 2016: Journal of Knee Surgery
Katariina A H Myller, Mikael J Turunen, Juuso T J Honkanen, Sami P Väänänen, Jarkko T Iivarinen, Jari Salo, Jukka S Jurvelin, Juha Töyräs
In post-traumatic osteoarthritis, both articular cartilage and subchondral bone undergo characteristic pathological changes. This study investigates potential of delayed cone beam computed tomography arthrography (dCBCTa) to simultaneously detect variations in cartilage and subchondral bone. The knees of patients (n = 17) with suspected joint injuries were imaged using a clinical CBCT scanner at 5 and 45 min after the intra-articular injection of anionic contrast agent (Hexabrix™) with hydroxyapatite phantoms around the knee...
September 19, 2016: Annals of Biomedical Engineering
L Felli, G Garlaschi, A Muda, A Tagliafico, M Formica, A Zanirato, M Alessio-Mazzola
PURPOSE: The aim of this study was to compare the accuracy of clinical examination to that of MRI evaluated by two independent radiologists for the diagnosis of meniscal tears and chronic anterior cruciate ligament injuries and to assess the MRI accuracy in the diagnosis of cartilage defects. METHODS: Seventy-six consecutive patients with suspected intra-articular knee pathology were prospectively evaluated by objective examination, 1.5 T MRI, re-examined by trained radiologist and arthroscopy...
September 14, 2016: Musculoskeletal Surgery
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