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Knee cartilage injury

Kurt P Spindler, Laura J Huston, Kevin M Chagin, Michael W Kattan, Emily K Reinke, Annunziato Amendola, Jack T Andrish, Robert H Brophy, Charles L Cox, Warren R Dunn, David C Flanigan, Morgan H Jones, Christopher C Kaeding, Robert A Magnussen, Robert G Marx, Matthew J Matava, Eric C McCarty, Richard D Parker, Angela D Pedroza, Armando F Vidal, Michelle L Wolcott, Brian R Wolf, Rick W Wright
BACKGROUND: The long-term prognosis and risk factors for quality of life and disability after anterior cruciate ligament (ACL) reconstruction remain unknown. Hypothesis/Purpose: Our objective was to identify patient-reported outcomes and patient-specific risk factors from a large prospective cohort at a minimum 10-year follow-up after ACL reconstruction. We hypothesized that meniscus and articular cartilage injuries, revision ACL reconstruction, subsequent knee surgery, and certain demographic characteristics would be significant risk factors for inferior outcomes at 10 years...
March 2018: American Journal of Sports Medicine
Darren de Sa, Ajaykumar Shanmugaraj, Melissa Weidman, Devin C Peterson, Nicole Simunovic, Volker Musahl, Olufemi R Ayeni
The all-inside technique (AIT) for anterior cruciate ligament reconstruction (ACLR) is gaining popularity as a more anatomic, less invasive, technique with the potential for more rapid recovery. This systematic review aims to critically assess components of the technique, its safety profile, outcomes, and complications. PUBMED, EMBASE, and MEDLINE were searched for studies discussing primary ACLR using the AIT. Article screening, quality assessment, and data abstraction were completed in duplicate, and a minimal clinically important difference (MCID) was used to frame the descriptive results in a clinically significant context...
February 8, 2018: Journal of Knee Surgery
Xiaobin Huang, Janine N Post, Leilei Zhong, Jeroen Leijten, Staffan Larsson, Marcel Karperien, André Struglics
OBJECTIVE: To explore the involvement of the WNT and BMP antagonists Dickkopf-related protein 1 (DKK1), Frizzled-related protein (FRZB) and Gremlin 1 (GREM1) in knee injury and osteoarthritis (OA). DESIGN: The antagonists were immunoassayed in synovial fluid from a cross-sectional cohort of 9 knee healthy reference subjects, patients with recent (0-77 days, n=158) or old (1-37 years, n=50) knee injuries, and OA (n=22). Cartilage (ARGS-aggrecan, cartilage oligomeric matrix protein and C2C type II collagen) and other biomarkers were assessed in synovial fluid in a subset of samples...
March 8, 2018: Osteoarthritis and Cartilage
Kolja Gelse, Peter Angele, Peter Behrens, Peter Brucker, Jakob Fay, Daniel Günther, Peter Kreuz, Jörg Lützner, Henning Madry, Peter E Müller, Philipp Niemeyer, Geert Pagenstert, Thomas Tischer, Markus Walther, Wolfgang Zinser, Gunter Spahn
BACKGROUND: In clinical practice, there is still no definite treatment algorithm for focal, partial thickness cartilage lesions (grade II - III). It is well-established that debridement (shaving/lavage) of large degenerative cartilage lesions is not recommended, but there is no such recommendation in the case of focal, partial thickness cartilage defects. MATERIALS AND METHODS: The scientific rationale of cartilage shaving and joint lavage was investigated and a systematic analysis was performed of the literature on the clinical effect of cartilage debridement...
March 9, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Nili Steinberg, Myriam Stern, Shay Tenenbaum, Alexander Blankstein, Aviva Zeev, Itzhak Siev-Ner
This study aimed at evaluating whether the prevalence of knee injuries and morphological features are different among pre-and-post menarche dancers; Sixty-seven pre-and-post menarche dancers were screened for anthropometric parameters; knee laxity; patella femoral pain syndrome (PFPS), pathologies and anatomical structure of the knees. Both groups showed a high and similar prevalence of PFPS. The post-menarche dancers produced a significantly higher rate of Tanner stages 3-4 (p = .010), greater weight (p < ...
March 8, 2018: Research in Sports Medicine
Kate E Webster, Julian A Feller, Alexander Kimp, Brian M Devitt
PURPOSE: Anterior cruciate ligament (ACL) injuries are frequently not isolated injuries and damage to the menisci and articular cartilage surfaces is common. The concomitant presence of meniscal and chondral damage has the potential to influence patient outcomes following ACL reconstruction surgery and especially following revision ACL reconstruction where these findings are more common. However, study results regarding the mid-term outcome have been inconsistent. The purpose of this study was to compare mid-term patient-reported outcomes and return to sport in patients with and without meniscal and chondral pathology at the time of revision ACL reconstruction surgery...
March 7, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Jing Xie, Demao Zhang, Yunfeng Lin, Quan Yuan, Xuedong Zhou
BACKGROUND: The meniscus plays an important role in knee joint diseases such as osteoarthritis (OA). Meniscal injuries can be accompanied by joint catabolic events initiated by inflammation, leading to articular cartilage destruction, but the cellular events responsible for intrinsic meniscal injury and the extracellular matrix changes necessary for meniscal degradation are not well known. PURPOSE: To explore the cellular and matrix-related changes of menisci based on a mouse OA model of anterior cruciate ligament transection (ACLT)...
March 1, 2018: American Journal of Sports Medicine
Ciaran Thrush, Tabitha J Porter, Brian M Devitt
PURPOSE: Anterior cruciate ligament (ACL) rupture commonly occurs in conjunction with articular cartilage injury. However, there is no consensus on the most appropriate rehabilitation which should be carried out for ACL reconstruction (ACLR) and the surgical management of articular cartilage lesions of the knee. The purpose of this study was to systematically review the literature to investigate the recommended rehabilitation protocol for patients undergoing ACLR with concomitant articular cartilage injury with a view to develop guidelines on the most appropriate treatment...
March 6, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Shani Samuel, Raja Elina Ahmad, Thamil Selvee Ramasamy, Faizal Manan, Tunku Kamarul
BACKGROUND: It has been previously suggested that the use of regenerative promoters, which include bone marrow-derived mesenchymal stem cells (MSCs) or natural growth factors supplement such as platelet-rich concentrate (PRC) could promote cartilage regeneration. However, the notion that the concurrent use of both promoters may provide a synergistic effect that improves the repair outcome of focal cartilage injury has not been previously demonstrated. This study was thus conducted to determine whether the concomitant use of PRC could further enhance the reparative potential of MSCs encapsulated in alginate transplanted into focal cartilage injury in rabbits...
February 21, 2018: Injury
Jason A Grassbaugh
Cartilage injuries are prevalent in patients undergoing knee anterior cruciate ligament revision surgery.
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Matthew J Matava
Although the epidemiology and risk factors for chondral injuries of the knee among prospective National Football League athletes have been reported, the effect of previously untreated chondral injuries on players' early National Football League career performance has been unclear to this point. Despite not requiring surgical treatment, players with these untreated injuries were drafted later, played and started fewer games, and exhibited lower fantasy scores-a surrogate marker for performance. Untreated chondral injuries of the knee can have potentially deleterious effects on the playing careers (and financial prospects) of professional American football players...
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
A A Shetty, S J Kim, S Ahmed, S Trattnig, S A Kim, H J Jang
Introduction The morbidity and significant health economic impact associated with the chondral lesion has led to a large number of strategies for therapeutic neochondrogenesis. The challenge has been to develop techniques that are cost effective single-stage procedures with minimal surgical trauma that have undergone rigorous preclinical scrutiny and robust reproducible assessment of effectiveness. A biological repair requires the generation of a cellular and matrix composite with appropriate signalling for chondrogenic differentiation...
March 2018: Annals of the Royal College of Surgeons of England
Kyle John Hancock, Robert R Westermann, Alan Gregory Shamrock, Kyle R Duchman, Brian R Wolf, Annunziato Amendola
This study aims to evaluate the trends in treatment of knee articular cartilage lesions over the past decade using data obtained from the American Board of Orthopaedic Surgery (ABOS) Part II database. The ABOS Part II database was queried from 2004 to 2013 for chondroplasty, microfracture, and osteochondral grafting procedures. All cases were analyzed for patient age and operating surgeon's fellowship training status. Univariate analysis including chi-square test for categorical variables and Student's t -test for continuous variables was performed to determine if any significant changes in practice patterns were present...
February 28, 2018: Journal of Knee Surgery
Neil S Kumar, Cory Edgar, Tiahna Spencer, James K Ware, Dale N Reed, Mark P Cote, Robert A Arciero
Separation of the posteromedial meniscocapsular junction (PMC) is a unique injury seen in patients with disruption of the anterior cruciate ligament. PMC tears may go unrecognized despite preoperative magnetic resonance imaging and diagnostic arthroscopy of the medial compartment. Unrepaired lesions may lead to persistent laxity of the knee after anterior cruciate ligament reconstruction. Inside-out repair techniques risk iatrogenic injury to the articular cartilage during needle passage and require dissection of the posteromedial knee for suture retrieval...
August 2017: Arthroscopy Techniques
Myung-Ku Kim, Chul-Won Ha, Yong In, Sung-Do Cho, Eui-Sung Choi, Jeong-Ku Ha, Ju-Hong Lee, Jae-Doo Yoo, Seong-Il Bin, Choong-Hyeok Choi, Hee-Soo Kyung, Myung-Chul Lee
OBJECTIVE: To test the clinical efficacy of TissueGene-C (TG-C), a cell and gene therapeutic for osteoarthritis consisting of non-transformed and transduced chondrocytes (3:1), retrovirally transduced to overexpress TGF-β1. DESIGN: We randomly assigned 163 with knee osteoarthritis to receive intra-articular TG-C or placebo in Kellgren-Lawrence grade 3 patients for clinical trial. Primary efficacy measures included criteria for subjective assessment by International Knee Documentation Committee (IKDC) and pain severity by Visual Analog Scale (VAS) for 52 weeks...
February 27, 2018: Human Gene Therapy. Clinical Development
Nicholas N DePhillipo, Mark E Cinque, Nicholas I Kennedy, Jorge Chahla, Gilbert Moatshe, Robert F LaPrade
Background and Purpose: Early sport specialization (ESS) refers to intense training year round in a specific sport starting at a young age with no or limited participation in other sports. This approach to training is highly controversial; recent literature suggests that this type of specialized training could be a contributing source to overuse injuries in youth athletes. The purpose of this case report was to describe a patellofemoral articular cartilage defect of the knee in a preadolescent skier due to overuse and repetitive microtrauma as a result of ESS...
February 2018: International Journal of Sports Physical Therapy
Michelle L Delco, Edward D Bonnevie, Hazel S Szeto, Lawrence J Bonassar, Lisa A Fortier
No disease-modifying osteoarthritis (OA) drugs are available to prevent posttraumatic osteoarthritis (PTOA). Mitochondria (MT) mediate the pathogenesis of many degenerative diseases, and recent evidence indicates that MT dysfunction is a peracute (within minutes to hours) response of cartilage to mechanical injury. The goal of this study was to investigate cardiolipin-targeted mitoprotection as a new strategy to prevent chondrocyte death and cartilage degeneration after injury. Cartilage was harvested from bovine knee joints and subjected to a single, rapid impact injury (24...
February 22, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Michael J Gardner, Thomas A Higgins, William H Harvin, James P Stannard, Mark A Lee, Brett D Crist
Fracture surgeons do a great job of managing bone issues, but they may overlook the associated soft tissue injuries that play a significant role in the final outcome after musculoskeletal injury. The soft tissue reconstruction ladder can help guide reconstructive procedures based on the least complex procedure that allows the best chance of fracture healing. Muscle injury, volume loss, and deconditioning occur with traumatic injury and during the recovery phase. Neuromuscular stimulation, nutrition, and strength training are potential ways to aid in recovery...
March 2018: Journal of Orthopaedic Trauma
Ji Li, Zhong-Li Li, Hao Zhang, Ke-Tao Wang, Yi-Meng Yang, Xiang-Zheng Su
OBJECTIVE: To evaluate the clinical effects of popliteal cyst excision combined with debridement of the knee under arthroscopy with local anesthesia. METHODS: From February 2009 to August 2014, 52 patients with popliteal cysts were treated in our hospital, including 34 males and 18 females with an average age of 43.6 years old ranging from 14 to 62 years old; 29 cases were on the right knee and 23 on the left knee. Preoperative diagnosis was performed according to MRI findings and to determine whether other knee disorders were associated with the disease, 52 patients were diagnosed as popliteal cyst before operation; 23 cases of simple meniscus injury or cartilage injury, 18 cases of osteoarthritis, 7 cases of cruciate ligament injury, 2 cases of gouty arthritis, 1 case of rheumatoid arthritis, 1 case of pigmented villonodular arthritis...
October 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Xu-Hui Zhang, Lei Xia, Gang-Tao Wang, Tan Li
OBJECTIVE: To study clinical effects of multi-point fixation with bioabsorbable cartilage screws for the treatment of osteochondral fracture caused by patellar instability. METHODS: During the period from August 2014 to Steptember 2016, there were 21 patients with osteochondral fracture caused by patellar dislocation, including 7 males and 14 females, ranging in age from 12 to 42 years old, with an average of 27 years old. During the operation, free fractures fragments of cartilage were found with a open surgery, and the patients were treated with fixation by absorbable cartilage screws combined with lateral retinaculum release and medial retinaculum shrinkage...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
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