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1.
Phys Sportsmed ; 51(5): 449-457, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-36166373

RESUMO

OBJECTIVES: Describe the epidemiology of dance-related musculoskeletal injury leading to forced time-loss in elite pre-professional dancers and provide descriptive data on the prevalence concerning diagnoses, location, and injury type, stratified by gender and skill level. METHODS: Retrospective cohort, over a 3-year period on a full-time pre-professional Portuguese dance school featuring 70 both gender students with a mean age of 14.87 years. A total of 110 injuries were analyzed. Non-parametric statistics were used. RESULTS: The most prevalent diagnosis leading to forced time-loss in female dancers were Medial Tibial Stress Syndrome (MTSS), 14.29%, and Posterior Ankle Impingement Syndrome (PAIS), 7.14%, whereas in male dancers these were Hallux Sprain, 17.50%, and Lumbar Spine Joint Injuries, 7.50%. Differences were found in injuries' anatomical location between genders and in Incidence Proportion and Clinical Incidence between skill levels. 72.20% of the chronic injuries and 50.00% of the acute injuries occurred in Level III students. CONCLUSIONS: With respect to forced time-loss injuries, male dancers were found to sustain more acute traumatic injuries and female dancers overuse, respectively, sprains and MTSS and PAIS. Identifying which injuries are most likely to lead to forced time-loss may be useful for helping health-care professionals in clinical decision-making and in developing more effective injury prevention and management strategies.


Assuntos
Dança , Doenças Musculoesqueléticas , Entorses e Distensões , Humanos , Masculino , Feminino , Pré-Escolar , Adolescente , Estudos Retrospectivos , Dança/lesões , Articulações/lesões
2.
Am J Vet Res ; 83(10)2022 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-35973004

RESUMO

OBJECTIVE: Mesenchymal stromal (stem) cells (MSCs) have been studied to treat many common orthopedic injuries in horses. However, there is limited information available on when and how to use this treatment effectively. The aim of this retrospective study is to report case features, treatment protocols, and clinical outcomes in horses treated with MSCs. ANIMALS: 65 horses presenting with tendinous, ligamentous, and articular injuries, and treated with MSCs prepared by a single laboratory between 2016 and 2019. Outcome information was available for 26 horses. PROCEDURES: Signalment, clinical signs, diagnostic methods, treatment protocol features (prior and concurrent therapies, cell origin, dose, application site and number), and effective outcomes were analyzed. The analysis was focused on comparing the effect of different MSC treatment protocols (eg, autologous vs allogeneic) on outcome rather than the effectiveness of MSC treatment. RESULTS: MSC treatment resulted in 59.1% (clinical lameness) to 76.9% (imaging structure) improvement in horses with diverse ages, breeds, sex, and lesions. The use of other therapeutic methods before MSC application (eg, anti-inflammatories, shockwave, laser, icing, resting, bandage and stack wrap, intra-articular injections, and/or surgical debridement) was shown to be statistically more effective compared to MSCs used as the primary therapeutic procedure (P < .05). Autologous versus allogeneic treatment outcomes were not significantly different. CLINICAL RELEVANCE: A prospective MSC treatment study with standardization and controls to evaluate the different features of MSC treatment protocols is needed. The various case presentations and treatment protocols evaluated can be used to inform practitioners who are currently using MSCs in clinical practice.


Assuntos
Cavalos/lesões , Transplante de Células-Tronco Mesenquimais/veterinária , Células-Tronco Mesenquimais/fisiologia , Animais , Injeções Intra-Articulares/veterinária , Articulações/lesões , Ligamentos/lesões , Estudos Retrospectivos , Traumatismos dos Tendões/terapia , Traumatismos dos Tendões/veterinária
3.
Medicine (Baltimore) ; 101(5): e28737, 2022 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-35119023

RESUMO

BACKGROUND: Integrated neuromuscular training (INT) is a comprehensive and holistic training method. It combines general functional movement training with specialized strength, balance, speed, sensitivity, coordination, enhanced training or rapid telescopic compound training. From the existing research results, the mechanism of INT mainly lies in improving the proprioception of the human body and cognitive level to achieve the impact on the motor sensory system, so as to effectively prevent joint injury and promote the recovery after joint injury. METHOD: This article is assisted by the third and fourth authors to search the relevant literature. The search strategy is divided into 2 parts: English literature and Chinese literature. English literature search: the keywords "integrated neurological training", "joint investigation", and "restoration" are jointly searched with "meta analysis" and "system evaluation", respectively. The search databases include PsycINFO, Science Direct, PubMed, Eric, and Willey. Chinese literature search: the keywords "integrated neuromuscular training", "joint injury", and "recovery" are jointly searched with "meta analysis" and "system evaluation", respectively. The search databases include the general library of online publishing of academic journals of China Knowledge Network (CNKI) and the full-text database of excellent doctoral theses of China Knowledge Network (CNKI). At the same time, the supplementary search is carried out through literature backtracking, Google Scholar. RESULTS: This study will provide new evidence for the effect of INT on the recovery of joint injury. CONCLUSION: To provide a method to help the prevention and restoration of joint injury by INT. INPLASY REGISTRATION NUMBER: INPLASY2021120136.


Assuntos
Traumatismos em Atletas/terapia , Articulações/lesões , Propriocepção , China , Humanos , Metanálise como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto
4.
Mol Immunol ; 142: 83-94, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34971867

RESUMO

Rheumatoid arthritis (RA) synovium was identified as "tumor-like" tissues because of the hypoxic microenvironment, significant cell proliferation, and invasion phenotypes. It was reported that hypoxia promoted tumor aggressiveness via up-regulated expression of fascin-1 in cancer. However, the role of fascin-1 in RA synovial hyperplasia and joint injury progression remains unknown. In the current study, we first identified that both fascin-1 and HIF-1α were highly expressed in the RA synovium, in which they were widely colocalized, compared to osteoarthritis(OA). As well, levels of fascin-1 in RA fibroblast-like synoviocytes(FLSs) were found significantly higher than those in OA FLSs. Further, it was demonstrated that the mRNA and protein levels of fascin-1 in RA FLSs were up-regulated in hypoxia (3 % O2) and experimental hypoxia induced by cobalt chloride. Mechanistically, the HIF-1α-mediated hypoxia environment activated the gene expression of the fascin-1 protein, which in turn promoted the migration and invasion of RA FLSs. Accordingly, the restoration of FLSs migration and invasion was observed following siRNA-mediated silencing of fascin-1 and HIF-1α expression. Notably, under the experimental hypoxia, we found that the expression levels of fascin-1, HIF-1α, and p-STAT3 were increased in a time-dependent manner, and fascin-1and HIF-1α expressions were dependent on p-STAT3. Our results indicated that hypoxia-induced fascin-1 up-regulation promoted RA FLSs migration and invasion through the STAT3/HIF-1α/fascin-1 axis, which might represent a novel therapeutic target for the treatment of RA.


Assuntos
Artrite Reumatoide/patologia , Proteínas de Transporte/metabolismo , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Proteínas dos Microfilamentos/metabolismo , Fator de Transcrição STAT3/metabolismo , Membrana Sinovial/patologia , Sinoviócitos/patologia , Proteínas de Transporte/genética , Hipóxia Celular/fisiologia , Movimento Celular/fisiologia , Proliferação de Células/fisiologia , Células Cultivadas , Humanos , Hiperplasia/patologia , Subunidade alfa do Fator 1 Induzível por Hipóxia/genética , Articulações/lesões , Proteínas dos Microfilamentos/genética , Osteoartrite/patologia , Interferência de RNA , RNA Interferente Pequeno/genética , Fator de Transcrição STAT3/genética , Membrana Sinovial/citologia
5.
Osteoarthritis Cartilage ; 30(1): 160-171, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34687898

RESUMO

OBJECTIVE: We investigated the effect of berberine, a natural plant product that can activate AMP-activated protein kinase (AMPK), on Osteoarthritis (OA) development and associated pain in mice. DESIGN: Human primary knee chondrocytes were utilized to investigate how AMPK is activated by berberine. Both global knockout (KO) of AMPKα1 and congenic wild type (WT) mice were subjected to the post-traumatic OA through destabilization of medial meniscus (DMM) surgery. Two weeks after surgery, the mice were randomly divided into two groups with one group receiving berberine chloride daily via drinking water and were sacrificed at 6 and 12 weeks after surgery. OA severity was assessed by histological and histomorphometric analyses of cartilage degradation, synovitis, and osteophyte formation. OA-associated pain behavior was also determined. Immunohistochemistry (IHC) analyses were carried out to examine changes in AMPK signaling. RESULTS: Berberine induced phosphorylation of AMPKα (Thr172) via liver kinase B1 (LKB1), the major upstream kinase of AMPK, in chondrocytes in vitro. Both WT and AMPKα1KO developed OA and associated pain post DMM surgery. However, treatment with berberine significantly reduced severity of OA and associated pain in WT but not AMPKα1KO mice. IHC analysis of WT DMM knee cartilage further revealed that berberine inhibited concomitant loss of expression and phosphorylation of AMPKα and expression of SIRT1 and SIRT3, suggesting an important role of activation of AMPK signaling in mediating beneficial effect of berberine. CONCLUSIONS: Berberine acts through AMPK to reduce joint structural damage and pain associated with post-traumatic OA in mice in vivo.


Assuntos
Proteínas Quinases Ativadas por AMP/fisiologia , Artralgia/prevenção & controle , Berberina/administração & dosagem , Osteoartrite/prevenção & controle , Proteínas Quinases Ativadas por AMP/efeitos dos fármacos , Administração Oral , Animais , Artralgia/etiologia , Berberina/farmacologia , Articulações/lesões , Masculino , Camundongos , Osteoartrite/etiologia
6.
Comput Math Methods Med ; 2021: 9533573, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34938360

RESUMO

OBJECTIVE: To improve the clinical detection rate of bone and joint fractures of the extremities and to explore the value and significance of the application of multislice spiral computed tomography (MSCT) postprocessing technology in diagnosis. METHODS: 80 patients with bone and joint fractures of the extremities admitted to the hospital were selected as the research objects. The patients received X-ray digital radiography (DR) plain film examination and then MSCT examination. At the same time, multiplane reconstruction (MPR) and surface shadow display (SSD) and volume rendering three-dimensional imaging (VRT) technology and other postprocessing technologies compare the differences in the detection rate of limbs and joint fractures between the two inspection methods. RESULTS: A total of 100 fractures were found in 80 patients. The detection rate of X-ray DR was 69%. After MSCT postprocessing technology, the detection rates of MPR, SSD, and VRT were 96%, 98%, and 99%, respectively. The accuracy of MSCT postprocessing technology in diagnosing extremity bone and joint fractures was significantly higher than that of DR, and the difference between groups was statistically significant. CONCLUSION: MSCT postprocessing technology for patients with extremity bone and joint fractures has a good effect. It is not only noninvasive but also has a high detection rate. It can significantly reduce the missed and misdiagnosed rate and provide detailed imaging data for the formulation of clinical treatment plans.


Assuntos
Fraturas Ósseas/diagnóstico por imagem , Articulações/diagnóstico por imagem , Articulações/lesões , Tomografia Computadorizada Multidetectores/métodos , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Adulto , Biologia Computacional , Erros de Diagnóstico/prevenção & controle , Feminino , Fraturas Fechadas/diagnóstico por imagem , Humanos , Imageamento Tridimensional/métodos , Imageamento Tridimensional/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Diagnóstico Ausente/prevenção & controle , Tomografia Computadorizada Multidetectores/estatística & dados numéricos , Interpretação de Imagem Radiográfica Assistida por Computador/estatística & dados numéricos
7.
Amino Acids ; 53(10): 1493-1506, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34491424

RESUMO

Collagen peptide supplementation (COL), in conjunction with exercise, may be beneficial for the management of degenerative bone and joint disorders. This is likely due to stimulatory effects of COL and exercise on the extracellular matrix of connective tissues, improving structure and load-bearing capabilities. This systematic review aims to evaluate the current literature available on the combined impact of COL and exercise. Following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, a literature search of three electronic databases-PubMed, Web of Science and CINAHL-was conducted in June 2020. Fifteen randomised controlled trials were selected after screening 856 articles. The study populations included 12 studies in recreational athletes, 2 studies in elderly participants and 1 in untrained pre-menopausal women. Study outcomes were categorised into four topics: (i) joint pain and recovery from joint injuries, (ii) body composition, (iii) muscle soreness and recovery from exercise, and (iv) muscle protein synthesis (MPS) and collagen synthesis. The results indicated that COL is most beneficial in improving joint functionality and reducing joint pain. Certain improvements in body composition, strength and muscle recovery were present. Collagen synthesis rates were elevated with 15 g/day COL but did not have a significant impact on MPS when compared to isonitrogenous higher quality protein sources. Exact mechanisms for these adaptations are unclear, with future research using larger sample sizes, elite athletes, female participants and more precise outcome measures such as muscle biopsies and magnetic imagery.


Assuntos
Composição Corporal/efeitos dos fármacos , Colágeno/biossíntese , Exercício Físico , Articulações/lesões , Peptídeos/farmacologia , Colágeno/química , Colágeno/farmacologia , Suplementos Nutricionais , Exercício Físico/efeitos adversos , Exercício Físico/fisiologia , Humanos , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/fisiologia , Mialgia/tratamento farmacológico , Mialgia/metabolismo , Peptídeos/química
8.
Osteoarthritis Cartilage ; 29(12): 1638-1653, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34560260

RESUMO

Prevention is an attractive solution for the staggering and increasingly unmanageable burden of osteoarthritis. Despite this, the field of osteoarthritis prevention is relatively immature. To date, most of what is known about preventing osteoarthritis and risk factors for osteoarthritis is relative to the disease (underlying biology and pathophysiology) of osteoarthritis, with few studies considering risk factors for osteoarthritis illness, the force driving the personal, financial and societal burden. In this narrative review we will discuss what is known about osteoarthritis prevention, propose actionable prevention strategies related to obesity and joint injury which have emerged as important modifiable risk factors, identify where evidence is lacking, and give insight into what might be possible in terms of prevention by focussing on a lifespan approach to the illness of osteoarthritis, as opposed to a structural disease of the elderly. By targeting a non-specialist audience including scientists, clinicians, students, industry employees and others that are interested in osteoarthritis but who do not necessarily focus on osteoarthritis, the goal is to generate discourse and motivate inquiry which propel the field of osteoarthritis prevention into the mainstream.


Assuntos
Osteoartrite/prevenção & controle , Mau Alinhamento Ósseo , Exercício Físico , Predisposição Genética para Doença , Comportamentos Relacionados com a Saúde , Promoção da Saúde , Humanos , Articulações/anormalidades , Articulações/lesões , Articulações/cirurgia , Debilidade Muscular , Osteoartrite/etiologia , Sobrepeso/prevenção & controle , Educação de Pacientes como Assunto , Fatores de Risco , Fatores Sexuais
9.
ACS Nano ; 15(9): 14475-14491, 2021 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-34409835

RESUMO

Post-traumatic osteoarthritis (PTOA) associated with joint injury triggers a degenerative cycle of matrix destruction and inflammatory signaling, leading to pain and loss of function. Here, prolonged RNA interference (RNAi) of matrix metalloproteinase 13 (MMP13) is tested as a PTOA disease modifying therapy. MMP13 is upregulated in PTOA and degrades the key cartilage structural protein type II collagen. Short interfering RNA (siRNA) loaded nanoparticles (siNPs) were encapsulated in shape-defined poly(lactic-co-glycolic acid) (PLGA) based microPlates (µPLs) to formulate siNP-µPLs that maintained siNPs in the joint significantly longer than delivery of free siNPs. Treatment with siNP-µPLs against MMP13 (siMMP13-µPLs) in a mechanical load-induced mouse model of PTOA maintained potent (65-75%) MMP13 gene expression knockdown and reduced MMP13 protein production in joint tissues throughout a 28-day study. MMP13 silencing reduced PTOA articular cartilage degradation/fibrillation, meniscal deterioration, synovial hyperplasia, osteophytes, and pro-inflammatory gene expression, supporting the therapeutic potential of long-lasting siMMP13-µPL therapy for PTOA.


Assuntos
Sistemas de Liberação de Medicamentos , Articulações/lesões , Metaloproteinase 13 da Matriz/administração & dosagem , Osteoartrite , Animais , Metaloproteinase 13 da Matriz/genética , Camundongos , Nanopartículas , Osteoartrite/terapia , RNA Interferente Pequeno
10.
J Orthop Surg (Hong Kong) ; 29(1): 23094990211000168, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33729061

RESUMO

PURPOSE: This study aimed to investigate how fibroblastic and chondrocytic properties of human meniscal fibrochondrocytes are affected in culture conditions according to the type of meniscal pathology and localization, and to provide basic information for tissue-engineering studies. METHODS: Primary fibrochondrocyte cultures were prepared from meniscus samples of patients who had either traumatic tear or degeneration due to osteoarthritis. Cultures were compared in terms of mRNA expression levels of COL1A1, COL2A1, COMP1, HIF1A, HIF2A, and SOX9 and secreted total collagen and sulfated sGAG levels according to the type of meniscal pathology, anatomical localization, and the number of subcultures. RESULTS: mRNA expression levels of COL1A1, COMP1, HIF1A, HIF2A, and SOX9 were found to be increased in subsequent subcultures in all specimens. COL1A1 mRNA expression levels of both lateral and medial menisci of patients with traumatic tear were significantly higher than in patients with degenerative pathology, indicating a more fibroblastic character. P1 subculture of lateral and P3 or further subculture of medial meniscus showed more fibroblastic characteristics in patients with degenerative pathology. Furthermore, in patients with degenerative pathology, the subcultures of the lateral meniscus (especially on the inner part) presented more chondrocytic characteristics than did those of medial meniscus. CONCLUSIONS: The mRNA expression levels of the cultures showed significant differences according to the anatomical localization and pathology of the meniscus, indicating distinct chondrocytic and fibroblastic features. This fundamental knowledge would help researchers to choose more efficient cell sources for cell-seeding of a meniscus scaffold, and to generate a construct resembling the original meniscus tissue.


Assuntos
Fibrocartilagem , Articulações/lesões , Menisco , Osteoartrite/patologia , Transcriptoma , Adolescente , Adulto , Idoso , Células Cultivadas , Condrócitos/citologia , Condrócitos/metabolismo , Condrócitos/patologia , Feminino , Fibrocartilagem/citologia , Fibrocartilagem/metabolismo , Fibrocartilagem/patologia , Perfilação da Expressão Gênica , Humanos , Articulações/metabolismo , Articulações/patologia , Masculino , Menisco/citologia , Menisco/lesões , Menisco/metabolismo , Menisco/patologia , Pessoa de Meia-Idade , Osteoartrite/genética , Osteoartrite/metabolismo , Cultura Primária de Células/métodos , Ruptura/genética , Ruptura/metabolismo , Ruptura/patologia , Adulto Jovem
11.
Osteoarthritis Cartilage ; 29(6): 915-923, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33640582

RESUMO

OBJECTIVE: Human and in vivo animal research implicates inflammation following articular fracture as contributing to post-traumatic arthritis. However, relevant immune cell subsets present following injury are currently undefined. Immunophenotyping human and murine synovial fluid may help to identify immune cell populations that play key roles in the response to articular fracture. METHODS: Immunophenotyping by polychromatic flow cytometry was performed on human and mouse synovial fluid following articular fracture. Specimens were collected in patients with closed ankle fracture at the time of surgical fixation and from C57BL/6 mice with closed articular knee fracture. Immune cells were collected from injured and uninjured joints in mice via a novel cell isolation method. Whole blood samples were also collected. Immunohistochemistry (IHC) was performed on mouse synovial tissue to assess for macrophages and T cells. RESULTS: Following intra-articular fracture, the prominent human synovial fluid immune cell subset was CD3+ T cells, containing both CD4+ and CD8+ T cells. In mice, infiltration of CD45+ immune cells in synovial fluid of the fractured limb was dominated by CD19+ B cells and CD3+ T cells at 7 days after intra-articular fracture. We also detected adaptive immune cells, including macrophages, NK cells, dendritic cells and monocytes. Macrophage and T cell findings were supported by IHC of murine synovial tissue. CONCLUSIONS: Determining specific cell populations that mediate the immune response is essential to elucidating the chain of events initiated after injury and may be an important step in identifying potential immune signatures predictive of PTA susceptibility or potential therapeutic targets.


Assuntos
Fraturas Ósseas/imunologia , Sistema Imunitário/citologia , Articulações/lesões , Líquido Sinovial/citologia , Animais , Feminino , Humanos , Imunofenotipagem , Masculino , Camundongos , Camundongos Endogâmicos C57BL
12.
Curr Opin Rheumatol ; 33(1): 74-83, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33186246

RESUMO

PURPOSE OF REVIEW: Current thinking in the study of posttraumatic osteoarthritis (PTOA) is overviewed: the osteoarthritis which follows acute joint injury. The review particularly highlights important publications in the last 18 months, also reflecting on key older literature, in terms of what have we have we learned and have yet to learn from PTOA, which can advance the osteoarthritis field as a whole. RECENT FINDINGS: PTOA is a mechanically driven disease, giving insight into mechanical drivers for osteoarthritis. A mechanosensitive molecular tissue injury response (which includes activation of pain, degradative and also repair pathways) is triggered by acute joint injury and seen in osteoarthritis. Imaging features of PTOA are highly similar to osteoarthritis, arguing against it being a different phenotype. The inflammatory pathways activated by injury contribute to early joint symptoms. However, later structural changes appear to be dissociated from traditional measures of synovial inflammation. SUMMARY: PTOA remains an important niche in which to understand processes underlying osteoarthritis and seek interventional targets. Whether PTOA has true molecular or clinical differences to osteoarthritis as a whole remains to be understood. This knowledge is important for a field where animal modelling of the disease relies heavily on the link between injury and osteoarthritis.


Assuntos
Articulações/lesões , Osteoartrite/epidemiologia , Animais , Fenômenos Biomecânicos , Humanos , Inflamação/epidemiologia , Imageamento por Ressonância Magnética/métodos , Modelos Animais , Osteoartrite/diagnóstico por imagem , Osteoartrite/fisiopatologia , Fenótipo
13.
Arthroscopy ; 37(3): 932-940.e2, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33227321

RESUMO

PURPOSE: To compare tibiofemoral contact mechanics after horizontal or ripstop (horizontal plus vertical) sutures in inside-out and transtibial repair for meniscal radial tears with 10 porcine knees in each group. METHODS: Ten matched pairs of porcine knees were tested under a 1500-N axial compressive load at 0°, 30°, 60°, and 90° of knee flexion. Each knee underwent 4 testing conditions consecutively: (1) intact, (2) medial meniscal radial tear, (3) horizontal suture repair configuration, and (4) ripstop suture repair configuration. Tekscan sensors measured tibiofemoral contact pressure and contact area in the medial and lateral compartments. RESULTS: All repair groups improved their contact mechanics when compared with the tear state among all flexion angles analyzed (all P < .05). Furthermore, ripstop sutures with both inside-out and transtibial repairs restored intact knee contact area and pressures (peak and mean) in the medial compartment at all flexion angles, whereas the horizontal sutures alone failed to do so for contact pressures at 60° and 90° and for contact surface areas at all flexion angles. However, the aforementioned parameters were not significantly different between inside-out sutures and transtibial sutures, regardless of horizontal or ripstop configuration (P > .05). CONCLUSIONS: Radial tears of the meniscus in a porcine model significantly decreased medial contact area and increased mean and peak contact pressure. Both inside-out and transtibial ripstop repairs for radial tears aid in restoring intact tibiofemoral contact mechanics at all assessed knee flexion angles. CLINICAL RELEVANCE: Our results suggest that both inside-out and transtibial ripstop repairs for radial tears can restore tibiofemoral contact mechanics to the intact state. Since the study were performed in an open fashion porcine model, the results should be carefully used in clinical practices, and the efficacy of the techniques through arthroscopic method should be further explored.


Assuntos
Articulações/lesões , Articulações/cirurgia , Meniscos Tibiais/cirurgia , Técnicas de Sutura , Lesões do Menisco Tibial/cirurgia , Animais , Fenômenos Biomecânicos , Doenças das Cartilagens/cirurgia , Modelos Animais de Doenças , Lacerações/cirurgia , Menisco/cirurgia , Pressão , Amplitude de Movimento Articular , Projetos de Pesquisa , Ruptura/cirurgia , Suturas , Suínos
16.
Postgrad Med ; 132(4): 377-384, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32100608

RESUMO

Globally, osteoarthritis (OA) is the most prevalent arthritic condition in those aged over 60 years. OA has a high impact on patient disability and is associated with a significant economic burden. Pain is the most common first sign of disease and the leading cause of disability. Data demonstrating the increasing global prevalence of OA, together with a greater understanding of the burden of the disease, have led to a reassessment of the seriousness of OA and calls for the designation of OA as a serious disease in line with the diseases impact on comorbidity, disability, and mortality. While OA was traditionally seen as a prototypical 'wear and tear' disease, it is now more accurately thought of as a disease of the whole joint involving cartilage together with subchondral bone and synovium. As more has become known of the pathophysiology of OA, it has become increasingly common for it to be described using a number of overlapping phenotypes. Patients with OA will likely experience multiple phenotypes during their disease. This review focuses on what we feel are three key phenotypes: post-trauma, metabolic, and aging. A greater understanding of OA phenotypes, particularly at the early stages of disease, may be necessary to improve treatment outcomes. In the future, non-pharmacological and pharmacological treatments could be tailored to patients based on the key features of their phenotype and disease pathway.


Assuntos
Envelhecimento/fisiologia , Doenças Metabólicas/complicações , Osteoartrite/etiologia , Osteoartrite/fisiopatologia , Ferimentos e Lesões/complicações , Humanos , Inflamação/fisiopatologia , Artropatias/fisiopatologia , Articulações/lesões , Doenças Metabólicas/fisiopatologia , Síndrome Metabólica/complicações , Síndrome Metabólica/fisiopatologia , Obesidade/complicações , Obesidade/fisiopatologia , Ferimentos e Lesões/fisiopatologia
17.
J Orthop Res ; 38(8): 1826-1835, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-31965593

RESUMO

The objectives of this study were to evaluate temporal changes in lubricin, hyaluronan (HA), and HA molecular weight (MW) distributions in three distinct models of equine joint injury affecting the carpal (wrist), tarsal (ankle), and femoropatellar (knee) joints. To establish ranges for lubricin, HA, and HA MW distributions across multiple joints, we first evaluated clinically healthy, high-motion equine joints. Synovial fluid was collected from high-motion joints in horses without clinical signs of joint disease (n = 11 horses, 102 joints) and from research horses undergoing carpal osteochondral fragmentation (n = 8), talar cartilage impact injury (n = 7), and femoral trochlear ridge full-thickness cartilage injury (n = 22) prior to and following arthroscopically induced joint injury. Lubricin and HA concentrations were measured via enzyme-linked immunosorbent assays, and gel electrophoresis was performed to evaluate HA MW distributions. Synovial fluid parameters were analyzed via linear regression models, revealing that lubricin and HA concentrations were conserved across healthy, high-motion joints. Lubricin concentrations increased post-injury in all osteoarthritis models (carpal fragmentation P = .001; talar impact P < .001; femoral trochlear ridge cartilage defect P = .03). Sustained loss of HA was noted post-arthroscopy following carpal osteochondral fragmentation (P < .0001) and talar impact injury (P < .001). Lubricin may be elevated to compensate for the loss of HA and to protect cartilage post-injury. Further investigation into the mechanisms regulating lubricin and HA following joint injury and their effects on joint homeostasis is warranted, including whether lubricin has value as a biomarker for post-traumatic osteoarthritis.


Assuntos
Glicoproteínas/metabolismo , Ácido Hialurônico/metabolismo , Artropatias/metabolismo , Articulações/lesões , Líquido Sinovial/metabolismo , Animais , Feminino , Cavalos , Masculino
18.
J Am Acad Orthop Surg ; 28(3): 102-111, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31977606

RESUMO

Evaluation of periarticular traumatic wounds for joint penetration is a common clinical concern for orthopaedic surgeons. Wounds that violate the joint capsule can result in deep infection and sepsis. Understanding the anatomic landmarks and capsular extensions of the major joints is key to proper evaluation. Initial evaluation of periarticular wounds includes thorough examination of the wound and plain radiographs. Historically, the saline load test has been the diagnostic test of choice for assessing traumatic arthrotomy; however, CT has recently been shown to have excellent sensitivity and specificity for detecting open knee joint injuries. Current treatment of traumatic arthrotomy includes intravenous antibiotics and surgical irrigation and débridement. Future areas of research must focus on further validation of CT evaluation and its use in other major joints, standardizing antibiotic treatment, and further delineating the role of nonsurgical management in minor injuries.


Assuntos
Articulações/lesões , Articulações/cirurgia , Ferimentos e Lesões/cirurgia , Testes Diagnósticos de Rotina , Humanos , Articulações/diagnóstico por imagem , Águas Salinas , Ferimentos e Lesões/diagnóstico por imagem
19.
J Mech Behav Biomed Mater ; 101: 103422, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31527014

RESUMO

Healthy articular cartilage is crucial to joint function, as it provides the low friction and load bearing surface necessary for joint articulation. Nonetheless, joint injury places patients at increased risk of experiencing both accelerated cartilage degeneration and wear, and joint dysfunction due to post-traumatic osteoarthritis (PTOA). In this study, we used our ex vivo convergent stationary contact area (cSCA) explant testing configuration to demonstrate that high-speed sliding of healthy tissues against glass could drive consistent and reproducible recovery of compression-induced cartilage deformation, through the mechanism of 'tribological rehydration'. In contrast, the presence of physical cartilage damage, mimicking those injuries known to precipitate PTOA, could compromise tribological rehydration and the sliding-driven recovery of cartilage function. Full-thickness cartilage injuries (i.e. fissures and chondral defects) markedly suppressed sliding-driven tribological rehydration. In contrast, impaction to cartilage, which caused surface associated damage, had little effect on the immediate tribomechanical response of explants to sliding (deformation/strain, tribological rehydration, and friction/lubricity). By leveraging the unique ability of the cSCA configuration to support tribological rehydration, this study permitted the first direct ex vivo investigation of injury-dependent strain and friction outcomes in cartilage under testing conditions that replicate and maintain physiologically-relevant levels of fluid load support and frictional outcomes under high sliding speeds (80 mm/s) and moderate compressive stresses (~0.3 MPa). Understanding how injury alters cartilage tribomechanics during sliding sheds light on mechanisms by which cartilage's long-term resilience and low frictional properties are maintained, and can guide studies investigating the functional consequences of physical injury and joint articulation on cartilage health, disease, and rehabilitation.


Assuntos
Cartilagem Articular/lesões , Cartilagem Articular/metabolismo , Fenômenos Mecânicos , Animais , Fenômenos Biomecânicos , Cartilagem Articular/fisiopatologia , Bovinos , Força Compressiva , Fricção , Articulações/lesões , Estresse Mecânico
20.
Vet Clin North Am Small Anim Pract ; 50(1): 213-230, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31635914

RESUMO

Articular fractures are common injuries in veterinary medicine. The principles of articular fracture repair are anatomic reduction and rigid fixation in order to optimize joint function. Fluoroscopy and arthroscopy are tools commonly used to allow for anatomic reduction with a minimally invasive approach. Minimally invasive techniques can decrease morbidity and promote an early return to function. Different types of articular fractures and options for minimally invasive repair are reviewed in this article.


Assuntos
Fixação Interna de Fraturas/veterinária , Fraturas Ósseas/veterinária , Articulações/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/veterinária , Animais , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Articulações/lesões , Procedimentos Cirúrgicos Minimamente Invasivos/métodos
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