RESUMO
Septic arthritis is common in newborn calves due to poor birth and housing hygiene. This study investigated the pathological deformities caused by arthritis in the carpal bones of calves using geometric morphometry. The changes in the carpal joint bones of newborn calves with septic arthritis were examined through shape analysis. The study included 20 healthy Simmental calves and 30 Simmental calves with septic arthritis. Dorso-palmar x-ray images of the carpal joint were taken, and geometric morphometry was performed on these images using 25 landmarks. The first principal components (PC1) represented 26.92% of the total variation, while PC2 represented 13.84%. One of the most significant shape changes with increasing PC1 occurred in the os carpi intermedium. The study found that it was statistically possible to discriminate between radiometric carpal joint images of Simmental calves in the control and arthritis groups using geometric morphometry. In newborn calves with septic arthritis, the trochlea radi was located more proximally. There was an enlargement of the os carpi intermedium and a tendency towards the os carpi ulnare in female calves with septic arthritis. These results indicate significant bone deformation due to septic arthritis. Geometric morphometric methods can be clinically useful, as demonstrated in this study. Researchers can statistically explore these shape analyses, opening new avenues for research in this field. This method not only enhances our understanding of morphological changes but also provides a framework for clinical investigations and discoveries in related areas.
Assuntos
Animais Recém-Nascidos , Artrite Infecciosa , Articulações do Carpo , Doenças dos Bovinos , Animais , Artrite Infecciosa/veterinária , Artrite Infecciosa/diagnóstico por imagem , Artrite Infecciosa/patologia , Bovinos , Feminino , Articulações do Carpo/diagnóstico por imagem , Articulações do Carpo/patologia , Masculino , Doenças dos Bovinos/patologia , Doenças dos Bovinos/diagnóstico por imagem , Radiografia/veterinária , Análise de Componente Principal , Ossos do Carpo/diagnóstico por imagem , Ossos do Carpo/patologiaRESUMO
BACKGROUND: Pisotriquetral joint (PTJ) disorders are an important cause of ulnar-sided wrist pain but are often underrecognized. Ulnar variance (UV) has been associated with several wrist pathologies. PURPOSE: To determine the effect of UV on PTJ in patients with trauma. MATERIAL AND METHODS: A total of 143 patients (77 men, 66 women; mean age=41.64 ± 18.07 years) were included. Patients with fractures, severe and high-energy trauma, arthritic conditions, avascular necrosis, congenital deformity, bone and soft-tissue tumors, suboptimal image quality, and incorrect joint position were excluded. UV and the amount of PTJ subluxation were evaluated using coronal and sagittal computed tomography images. RESULTS: PTJ subluxation was divided into five grades. A statistically significant difference was found between the presence of PTJ subluxation and sex (P = 0.045). PTJ subluxation was more common in men (46.8%) than in women (30.3%). There was no significant difference between the presence of PTJ subluxation and age (P = 0.758). The patients were also divided into three groups as positive, neutral, and negative UV. A statistically significant relationship was found between the UV and presence of PTJ subluxation (P = 0.01). PTJ subluxation was significantly less in the neutral (none=51.1%, present=48.9%; P < 0.05) and negative (none=77.8%, present=22.2%; P < 0.05) groups. CONCLUSION: PTJ subluxation was found to be less among the groups with neutral and negative UV in our study population. PTJ subluxation is more common in men while there is no relationship with age. UV and gender may be risk factors for PTJ subluxation by affecting force dynamics at the wrist joint.
Assuntos
Articulações do Carpo , Artropatias , Luxações Articulares , Masculino , Humanos , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Articulações do Carpo/patologia , Articulação do Punho/diagnóstico por imagem , Ulna/diagnóstico por imagem , Ulna/patologia , PunhoRESUMO
OBJECTIVE: Osteoarthritis (OA) is a significant health issue in humans as well as horses. Experimental models of equine carpal OA have been used to investigate OA pathogenesis and potential therapeutic candidates. A 5-scale scoring system (OARSI) for macroscopic pathological cartilage changes already exists, but there is a need for a scoring system with better differentiation of severity. The aim of this study was therefore to develop and validate such a scoring system. RESULTS: New scoring system were developed for cartilage erosions (Copenhagen Equine Total Cartilage Score, CEqTCS) along with synovial membrane pathology and osteochondral fragment healing (Copenhagen Equine Carpal Osteoarthritis Score, CEqCOAS). For the CEqTCS there was excellent intraclass agreement (ICC = 0.993; CI 0.985-0.996; p = 1.08e-31) and consistency (ICC = 0.992; CI 0.985-0.996; p = 4.61e-31), as well as excellent interclass agreement (ICC = 0.974; CI 0.948-0.987, p = 2e-22) and consistency (ICC = 0.973; CI 0.946-0.987; p = 2.77e-22), while the OARSI system had moderate (κ = 0.47) and weak (κ = 0.28) inter- and intra-class agreement, respectively. The OARSI score and the CEqTCS correlated excellently, but every OARSI grade encompassed a wide range of CEqTCS grades. The new score for assessment of equine OA provides means to a better differentiation of OA changes than the existing OARSI system.
Assuntos
Articulações do Carpo , Osteoartrite , Animais , Articulações do Carpo/patologia , Cartilagem , Cavalos , Osteoartrite/veterinária , Membrana Sinovial/patologia , Articulação do Punho/patologiaRESUMO
BACKGROUND: Carpal tunnel syndrome is the most common compression syndrome of the peripheral nerve. Transthyretin amyloidosis and dialysis-related ß2-microglobulin amyloidosis are known causes of carpal tunnel syndrome. CASE REPORT: A Japanese woman showed carpal tunnel syndrome 16 years after a domino liver transplantation (DLT) from the donor with hereditary transthyretin amyloidosis. DLT indication was congenital extrahepatic portosystemic shunt, and the patient had been put on maintenance hemodialysis because of chronic kidney disease 6 years before DLT. Moreover, the amyloid precursor protein of the patient was histologically confirmed not to be ß2-microglobulin, but transthyretin. CONCLUSIONS: The existence of amyloid was speculated when the patient who underwent DLT from hereditary transthyretin amyloidosis showed carpal tunnel syndrome. Additionally, elucidating the amyloid precursor protein when the patient has another cause of amyloidosis is necessary.
Assuntos
Neuropatias Amiloides Familiares/patologia , Síndrome do Túnel Carpal/diagnóstico , Transplante de Fígado/efeitos adversos , Neuropatias Amiloides Familiares/genética , Articulações do Carpo/patologia , Síndrome do Túnel Carpal/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Pré-Albumina/genética , Diálise Renal , Insuficiência Renal Crônica/patologia , Doadores de TecidosAssuntos
Articulações do Carpo , Amiloidose de Cadeia Leve de Imunoglobulina , Artropatias/diagnóstico , Mieloma Múltiplo/diagnóstico , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Antirreumáticos/administração & dosagem , Biópsia por Agulha Fina/métodos , Bortezomib/administração & dosagem , Articulações do Carpo/diagnóstico por imagem , Articulações do Carpo/patologia , Deterioração Clínica , Diagnóstico Diferencial , Progressão da Doença , Evolução Fatal , Feminino , Humanos , Amiloidose de Cadeia Leve de Imunoglobulina/diagnóstico , Amiloidose de Cadeia Leve de Imunoglobulina/imunologia , Amiloidose de Cadeia Leve de Imunoglobulina/fisiopatologia , Amiloidose de Cadeia Leve de Imunoglobulina/terapia , Artropatias/etiologia , Artropatias/imunologia , Artropatias/fisiopatologia , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Prednisolona/administração & dosagemRESUMO
Scapholunate ligament injuries are common and can lead to a predictable pattern of arthritis (scaphoid lunate advanced collapse wrist) if unrecognized or untreated. This article describes the relevant anatomy, biomechanics, and classification system, and provides an up-to-date literature-based review of treatment options, including acute repair and various reconstruction techniques. It also helps guide surgeons in making decisions regarding a systematic treatment algorithm for these injuries.
Assuntos
Ligamentos Articulares/lesões , Ligamentos Articulares/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Traumatismos do Punho/complicações , Artrite/epidemiologia , Artrite/etiologia , Fenômenos Biomecânicos , Articulações do Carpo/lesões , Articulações do Carpo/patologia , Articulações do Carpo/cirurgia , Humanos , Ligamentos Articulares/anatomia & histologia , Osso Semilunar/lesões , Osso Semilunar/patologia , Osso Semilunar/cirurgia , Radiografia/métodos , Amplitude de Movimento Articular , Osso Escafoide/lesões , Osso Escafoide/patologia , Osso Escafoide/cirurgia , Resultado do Tratamento , Traumatismos do Punho/diagnóstico por imagem , Traumatismos do Punho/cirurgia , Articulação do Punho/patologia , Articulação do Punho/cirurgiaRESUMO
Degenerative arthritis at the articulation of the scaphoid, trapezium, and trapezoid (STT or triscaphe joint) is a common degenerative disease of the wrist. Pain and weakness with grip strength reduction and functional limitations when performing routine daily tasks are common complaints of patients with STT arthritis. Initial conservative treatments for STT arthritis include splinting, bracing, activity modification, anti-inflammatory medication, and steroid injections for pain relief. Failure of conservative treatment is the main indication for surgery, which may include distal scaphoid excision, with or without filling of the void after excision, trapeziectomy, STT arthrodesis, or STT implant arthroplasty.
Assuntos
Articulações do Carpo/diagnóstico por imagem , Articulações do Carpo/cirurgia , Osteoartrite/diagnóstico por imagem , Osteoartrite/cirurgia , Idoso de 80 Anos ou mais , Articulações do Carpo/patologia , Gerenciamento Clínico , Humanos , Achados Incidentais , Procedimentos Ortopédicos , Osteoartrite/epidemiologia , Osso Escafoide/diagnóstico por imagem , Osso Escafoide/patologia , Trapézio/diagnóstico por imagem , Trapezoide/diagnóstico por imagem , Trapezoide/patologia , Resultado do TratamentoRESUMO
BACKGROUND: Inflammatory and degenerative activity inside the joint can be studied in vivo by analysis of synovial fluid biomarkers. In addition to pro-inflammatory mediators, several anabolic and anti-inflammatory substances are produced during the disease process. They counteract the catabolic effects of the pro-inflammatory cytokines and thus diminish the cartilage damage. The response of synovial fluid biomarkers after intra-articular hyaluronan injection, alone or in combination with other substances, has been examined only in a few equine studies. The effects of hyaluronan on some pro-inflammatory mediators, such as prostaglandin E2, have been documented but especially the effects on synovial fluid anti-inflammatory mediators are less studied. In animal models hyaluronan has been demonstrated to reduce pain via protecting nociceptive nerve endings and by blocking pain receptor channels. However, the results obtained for pain-relief of human osteoarthritis are contradictory. The aim of the study was to measure the synovial fluid IL-1ra, PDGF-BB, TGF-ß1 and TNF-α concentrations before and after surgically induced cartilage defect, and following intra-articular hyaluronan injection in horses. Eight Standardbred horses underwent bilateral arthroscopic surgeries of their intercarpal joints under general anaesthesia, and cartilage defect was created on the dorsal edge of the third carpal bone of one randomly selected intercarpal joint of each horse. Five days post-surgery, one randomly selected intercarpal joint was injected intra-articular with 3 mL HA (20 mg/mL). RESULTS: Operation type had no significant effect on the synovial fluid IL-1ra, PDGF-BB, TGF-ß1 and TNF-α concentrations but compared with baseline, synovial fluid IL-1ra and TNF-α concentrations increased. Intra-articular hyaluronan had no significant effect on the biomarker concentrations but a trend of mild improvement in the clinical signs of intra-articular inflammation was seen. CONCLUSIONS: Creation of the cartilage defect and sham-operation lead to an increase of synovial fluid IL-1ra and TNF-α concentrations but changes in concentrations of anabolic growth factors TGF-ß1 and PDGF-BB could not be documented 5 days after the arthroscopy. Intra-articular hyaluronan was well tolerated. Further research is needed to document possible treatment effects of intra-articular hyaluronan on the synovial fluid biomarkers of inflammation and cartilage metabolism.
Assuntos
Biomarcadores/análise , Articulações do Carpo/efeitos dos fármacos , Doenças das Cartilagens/diagnóstico , Doenças dos Cavalos/diagnóstico , Ácido Hialurônico/farmacologia , Líquido Sinovial/química , Animais , Biomarcadores/metabolismo , Articulações do Carpo/patologia , Articulações do Carpo/cirurgia , Doenças das Cartilagens/patologia , Doenças dos Cavalos/patologia , Cavalos , Proteína Antagonista do Receptor de Interleucina 1/análise , Fator de Necrose Tumoral alfa/análiseRESUMO
Wrist osteoarthritis (OA) is one of the most common conditions encountered by hand surgeons with limited efficacy of non-surgical treatments. The purpose of this study is to describe the Platelet-Rich Plasma (PRP) mixed-microfat biological characteristics of an experimental Advanced Therapy Medicinal Product (ATMP) needed for clinical trial authorization and describe the clinical results obtained from our first three patients 12 months after treatment (NCT03164122). Biological characterization of microfat, PRP and mixture were analysed in vitro according to validated methods. Patients with stage four OA according to the Kellgren Lawrence classification, with failure to conservative treatment and a persistent daily painful condition >40 mm according to the visual analog scale (VAS) were treated. Microfat-PRP ATMP is a product with high platelet purity, conserved viability of stromal vascular fraction cells, chondrogenic differentiation capacity in vitro and high secretion of IL-1Ra anti-inflammatory cytokine. For patients, the only side effect was pain at the adipose tissue harvesting sites. Potential efficacy was observed with a pain decrease of over 50% (per VAS score) and the achievement of minimal clinically important differences for DASH and PRWE functional scores at one year in all three patients. Microfat-PRP ATMP presented a good safety profile after an injection in wrist OA. Efficacy trials are necessary to assess whether this innovative strategy could delay the necessity to perform non-conservative surgery.
Assuntos
Tecido Adiposo/citologia , Articulações do Carpo/patologia , Transplante de Células-Tronco Mesenquimais/métodos , Osteoartrite/terapia , Transfusão de Plaquetas/métodos , Adolescente , Adulto , Idoso , Células Cultivadas , Condrócitos/citologia , Feminino , Humanos , Masculino , Transplante de Células-Tronco Mesenquimais/efeitos adversos , Células-Tronco Mesenquimais/citologia , Pessoa de Meia-Idade , Transfusão de Plaquetas/efeitos adversos , Plasma Rico em Plaquetas/citologiaRESUMO
AIM: The horse joint, due to its similarity with the human joint, is the ultimate model for translational articular cartilage repair studies. This study was designed to determine the critical size of cartilage defects in the equine carpus and serve as a benchmark for the evaluation of new cartilage treatment options. MATERIAL AND METHODS: Circular full-thickness cartilage defects with a diameter of 2, 4, and 8 mm were created in the left middle carpal joint and similar osteochondral (3.5 mm in depth) defects in the right middle carpal joint of 5 horses. Spontaneously formed repair tissue was examined macroscopically, with MR and µCT imaging, polarized light microscopy, standard histology, and immunohistochemistry at 12 months. RESULTS: Filling of 2 mm chondral defects was good (77.8 ± 8.5%), but proteoglycan depletion was evident in Safranin-O staining and gadolinium-enhanced MRI (T1Gd). Larger chondral defects showed poor filling (50.6 ± 2.7% in 4 mm and 31.9 ± 7.3% in 8 mm defects). Lesion filling in 2, 4, and 8 mm osteochondral defects was 82.3 ± 3.0%, 68.0 ± 4.6% and 70.8 ± 15.4%, respectively. Type II collagen staining was seen in 9/15 osteochondral defects but only in 1/15 chondral defects. Subchondral bone pathologies were evident in 14/15 osteochondral samples but only in 5/15 chondral samples. Although osteochondral lesions showed better neotissue quality than chondral lesions, the overall repair was deemed unsatisfactory because of the subchondral bone pathologies. CONCLUSION: We recommend classifying 4 mm as critical osteochondral lesion size and 2 mm as critical chondral lesion size for cartilage repair research in the equine carpal joint model.
Assuntos
Articulações do Carpo/patologia , Cartilagem Articular/patologia , Cavalos/anatomia & histologia , Animais , Articulações do Carpo/diagnóstico por imagem , Cartilagem Articular/diagnóstico por imagem , Imageamento por Ressonância Magnética , Microscopia de Polarização , Fatores de Tempo , Cicatrização , Microtomografia por Raio-XRESUMO
Small ruminant lentivirus (SRLV) infection manifests itself mainly with chronic progressive arthritis affecting mainly carpal joints. The data from serological and questionnaire surveys were retrospectively analyzed to determine how the dissemination of SRLV infection in the herd influenced farmer's subjective opinion on the occurrence of swelling of carpal joints (considered as a proxy of arthritis). Between 1996 and 2017 153 different Polish dairy goat herds counting at least 20 adult goats were serologically screened for CAE and their owners were asked about their opinion on the occurrence of arthritis (never, rarely, often). Of them 73 SRLV-seropositive herds, in which true seroprevalence had been estimated, were included in the analysis. The ordinal logistic regression model was developed to determine the relationship between the true within-herd seroprevalence and the probability that the farmer would observe arthritis in the herd never, rarely or often. True within-herd seroprevalence ranged from 0.2% to 100% with the median of 34.6%. Farmers declared not to have observed arthritis in 40 (54.8%) herds, to have seen it rarely in 9 (12.3%) of herds, and to have observed it often in 24 (32.9%) of herds. The model proved that the probability of observing goats with carpal arthritis in the herd was significantly linked to the true within-herd seroprevalence (OR = 1.058, CI 95% from 1.037 to 1.078; p<0.001), but this relationship was not linear and SRLV infection proved to remain unapparent to farmers even when a considerable part of the herd had already become infected. Concluding, the study shows that when the farmer realizes that goats in the herd suffer from arthritis, SRLV infection is almost certainly already widespread in the herd.
Assuntos
Anticorpos Antivirais/sangue , Artrite/veterinária , Articulações do Carpo/virologia , Fazendeiros/psicologia , Doenças das Cabras/epidemiologia , Cabras/virologia , Infecções por Lentivirus/veterinária , Criação de Animais Domésticos , Animais , Artrite/epidemiologia , Artrite/patologia , Artrite/virologia , Articulações do Carpo/imunologia , Articulações do Carpo/patologia , Feminino , Doenças das Cabras/imunologia , Doenças das Cabras/patologia , Doenças das Cabras/virologia , Lentivirus/patogenicidade , Lentivirus/fisiologia , Infecções por Lentivirus/epidemiologia , Infecções por Lentivirus/patologia , Infecções por Lentivirus/virologia , Modelos Logísticos , Masculino , Polônia/epidemiologia , Estudos Soroepidemiológicos , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: Gene therapy holds great promise for the treatment of osteoarthritis (OA) because a single intraarticular injection can lead to long-term expression of therapeutic proteins within the joint. This study was undertaken to investigate the use of a helper-dependent adenovirus (HDAd)-mediated intraarticular gene therapy approach for long-term expression of interleukin-1 receptor antagonist (IL-1Ra) as sustained symptomatic and disease-modifying therapy for OA. METHODS: In mouse models of OA, efficacy of HDAd-IL-1Ra was evaluated by histologic analysis, micro-computed tomography (micro-CT), and hot plate analysis. In a horse OA model, safety and efficacy of HDAd-IL-1Ra were evaluated by blood chemistry, analyses of synovial fluid, synovial membrane, and cartilage, and gross pathology and lameness assessments. RESULTS: In skeletally immature mice, HDAd-IL-1Ra prevented development of cartilage damage, osteophytes, and synovitis. In skeletally immature and mature mice, treatment with HDAd-interleukin-1 receptor antagonist post-OA induction resulted in improved-albeit not significantly-cartilage status assessed histologically and significantly increased cartilage volume, cartilage surface, and bone surface covered by cartilage as assessed by micro-CT. Fewer osteophytes were observed in HDAd-IL-1Ra-treated skeletally immature mice. Synovitis was not affected in skeletally immature or mature mice. HDAd-IL-1Ra protected against disease-induced thermal hyperalgesia in skeletally mature mice. In the horse OA model, HDAd-IL-1Ra therapy significantly improved lameness parameters, indicating efficient symptomatic treatment. Moreover, macroscopically and histologically assessed cartilage and synovial membrane parameters were significantly improved, suggesting disease-modifying efficacy. CONCLUSION: These data from OA models in small and large animals demonstrated safe symptomatic and disease-modifying treatment with an HDAd-expressing IL-1Ra. Furthermore, this study establishes HDAd as a vector for joint gene therapy.
Assuntos
Artrite Experimental/terapia , Cartilagem Articular/patologia , Terapia Genética/métodos , Proteína Antagonista do Receptor de Interleucina 1/genética , Osteoartrite/terapia , Osteófito/patologia , Joelho de Quadrúpedes/patologia , Sinovite/patologia , Adenoviridae , Animais , Articulações do Carpo/diagnóstico por imagem , Articulações do Carpo/metabolismo , Articulações do Carpo/patologia , Cartilagem Articular/diagnóstico por imagem , Cartilagem Articular/metabolismo , Modelos Animais de Doenças , Membro Anterior , Cavalos , Proteína Antagonista do Receptor de Interleucina 1/metabolismo , Ligamentos Articulares/cirurgia , Camundongos , Osteoartrite/metabolismo , Osteófito/diagnóstico por imagem , Osteófito/metabolismo , Joelho de Quadrúpedes/diagnóstico por imagem , Joelho de Quadrúpedes/metabolismo , Líquido Sinovial/metabolismo , Membrana Sinovial/metabolismo , Sinovite/diagnóstico por imagem , Sinovite/metabolismo , Microtomografia por Raio-XRESUMO
While articular cartilage changes are considered to be one of the initial events in the pathological cascade leading to osteoarthritis, these changes remain difficult to detect using conventional diagnostic imaging modalities such as plain radiography. The aim of this prospective, experimental, methods comparison study was to compare the sensitivity of magnetic resonance imaging (MRI), magnetic resonance arthrography, computed tomography (CT), and CT arthrography in the detection of artificially induced articular cartilage defects in the equine carpal joints. Defects were created in the antebrachiocarpal and middle carpal joint using curettage by a board-certified equine surgeon. Normal articular cartilage thickness varied from a maximum of 1.22 mm at the level of the distal aspect of the radius to a minimum of 0.17 mm in the proximal articular surface of the third carpal bone. Regarding cartilaginous defect measurements the remaining cartilaginous bed range from a maximum of 0.776 mm in the partial thickness defects, and 0 mm (defect reaches the subchondral bone) when total thickness defect were made. Computed tomography and magnetic resonance imaging were performed followed by CT arthrography and magnetic resonance arthrography after antebrachiocarpal and middle carpal intraarticular contrast administration. All images were reviewed by two board-certified veterinary radiologists, both of whom were blinded to the location, presence of, and thickness of the cartilage defects. A total number of 72 lesions in nine limbs were created. Mean sensitivity for localizing cartilage defects varied between imaging modalities with CT arthrography showing the best sensitivity (69.9%), followed by magnetic resonance arthrography (53.5%), MRI (33.3%), and CT (18.1%) respectively. The addition of contrast arthrography in both magnetic resonance and CT improved the rate of cartilage lesion detection although no statistical significance was found. Computed tomographic arthrography displayed the best sensitivity for detecting articular cartilage defects in the equine antebrachiocarpal and middle-carpal joints, compared to magnetic resonance arthrography, MRI, and CT.
Assuntos
Artrografia/veterinária , Articulações do Carpo/diagnóstico por imagem , Doenças das Cartilagens/veterinária , Cartilagem Articular/diagnóstico por imagem , Doenças dos Cavalos/diagnóstico por imagem , Imageamento por Ressonância Magnética/veterinária , Tomografia Computadorizada por Raios X/veterinária , Animais , Cadáver , Articulações do Carpo/patologia , Doenças das Cartilagens/diagnóstico por imagem , Doenças das Cartilagens/patologia , Cartilagem Articular/patologia , Cavalos , Estudos ProspectivosRESUMO
BACKGROUND AND OBJECTIVE: Carpal fusions are useful for treating specific carpal disorders, maximizing postoperative wrist motion, hand strength, reducing pain and instability of the joint. The surgeon selects the appropriate treatment by considering the degree of stability, the chronicity of the injury, functional demands of the patient and former patient's outcomes as well. However there are not many studies regarding the load distribution provided by the treatment. So, the purpose of this study is to analyze the load distribution through the wrist joint with an arthrodesis treatment and compare the results with a normal wrist. METHOD: To this end the rigid body spring model (RBSM) method was used on a three-dimensional model of the wrist joint. The cartilage and ligaments were simulated as springs acting under compression and tension, respectively, while the bones were considered as rigid bodies. To simulate the arthrodesis, the fused bones were considered as a single rigid body. RESULTS: The changes on the load distribution for each arthrodesis agree with the treatment objective, reducing load transmission through a specific articular surface. For example, for SLAC/SNAC II most of the treatments reduced the load transmitted through the radioscaphoid fossae, almost by 8%. However, the capitolunate (CL) arthrodesis was the treatment that managed to keep the load transmitted through the radiolunate joint closer to normal conditions. Also, in treatments where the scaphoid was excised (3-corner, 4-corner and capitolunate arthrodesis), the joint surface between the lunate surface compensates by doubling the transmitted force to the radius. CONCLUSIONS: The common arthrodesis for treating SLAC/SNAC II-III, reduces, in fact, the load on the radioscaphoid joint. Alternative treatments that reduce load distribution on the radiocarpal joint should be three corner and capitolunate arthrodesis for treating SLAC/SNAC-II; and for SLAC/SNAC-III four corners with scaphoid excision. On Kienbock's disease. Scaphocapitate (SC) arthrodesis is more effective on reducing the load transmission through the radiolunate and ulnolunate joints. All arthrodesis treatment should consider changes on the load transmission, and also bones' fusion rates and pain reduction on patient's outcomes.
Assuntos
Artrodese , Articulações do Carpo/cirurgia , Articulações do Carpo/patologia , Humanos , Modelos TeóricosRESUMO
UNLABELLED: The role of osteoclasts in osteochondral degeneration in osteoarthritis (OA) has rarely been investigated in spontaneous disease or animal models of OA. OBJECTIVE: The objectives of the current study were to investigate osteoclast density and location in post-traumatic OA (PTOA) and control specimens from racehorses. METHOD: Cores were harvested from a site in the equine third carpal bone, that undergoes repetitive, high intensity loading. Histological and immunohistochemical (Cathepsin K and Receptor-activator of Nuclear Factor kappa-ß ligand (RANKL)) stained sections were scored (global and subregional) and the osteoclast density calculated. The cartilage histological scores were compared with osteoclast density and RANKL scores. RESULTS: There was a greater density of osteoclasts in PTOA samples and they were preferentially located in the subchondral bone plate. RANKL scores positively correlated to the scores of cartilage degeneration and the osteoclast density. The relationship between hyaline articular cartilage RANKL score and osteoclast density was stronger than that of the subchondral bone RANKL score suggesting that cartilage RANKL may have a role in recruiting osteoclasts. The RANKL score in the articular calcified cartilage correlated with the number of microcracks also suggesting that osteoclasts recruited by RANKL may contribute to calcified cartilage degeneration in PTOA. CONCLUSION: Our results support the hypothesis that osteoclasts are recruited during the progression of spontaneous equine carpal PTOA by cartilage RANKL, contributing to calcified cartilage microcracks and focal subchondral bone loss.
Assuntos
Ossos do Carpo/patologia , Articulações do Carpo/patologia , Doenças dos Cavalos/patologia , Osteoartrite/patologia , Osteoartrite/veterinária , Osteoclastos/patologia , Animais , Calcinose/metabolismo , Calcinose/patologia , Ossos do Carpo/metabolismo , Articulações do Carpo/lesões , Doenças das Cartilagens/etiologia , Doenças das Cartilagens/metabolismo , Doenças das Cartilagens/patologia , Doenças das Cartilagens/veterinária , Cartilagem Articular/metabolismo , Cartilagem Articular/patologia , Contagem de Células , Movimento Celular/fisiologia , Cavalos , Masculino , Osteoartrite/etiologia , Osteoartrite/metabolismo , Osteoclastos/fisiologia , Ligante RANK/metabolismo , Ligante RANK/fisiologiaRESUMO
A hatch-year Swainson's Hawk (Buteo swainsoni) recovered from Modoc County, California, US, on 12 August 2012 had malformations of the rear limbs consisting of bilateral polymelia and syndactyly. We describe the malformations and evaluate potential causes. Postmortem examination revealed varus rotation of both femurs and abnormal appendages originating from the distal medial surface of the tibiotarsi with two nonfunctional digits on the right leg and one digit on the left leg. There was syndactyly between digits III and IV of both feet. Avian pox viral dermatitis was present on the skin of the ventral abdomen. A definitive cause of the skeletal malformations was not identified.
Assuntos
Falcões/anormalidades , Membro Posterior/anormalidades , Sindactilia/veterinária , Animais , Articulações do Carpo/lesões , Articulações do Carpo/patologia , Plumas/lesões , Plumas/patologia , Feminino , Sindactilia/patologiaRESUMO
Carpal instability is a complex and heterogeneous clinical condition. Management requires accurate identification of structural injury with an understanding of the resultant movement (kinematic) and load transfer (kinetic) failure. Static imaging techniques, such as plain film radiography, stress views, ultrasound, magnetic resonance, MR arthrography and computerized tomography arthrography, may accurately depict major wrist ligamentous injury. Dynamic ultrasound and videofluoroscopy may demonstrate dynamic instability and kinematic dysfunction. There is a growing evidence base for the diagnostic accuracy of these techniques in detecting intrinsic ligament tears, but there are limitations. Evidence of their efficacy and relevance in detection of non-dissociative carpal instability and extrinsic ligament tears is weak. Further research into the accuracy of existing imaging modalities is still required. Novel techniques, including four-dimensional computerized tomography and magnetic resonance, can evaluate both cross-sectional and functional carpal anatomy. This is a narrative review of level-III studies evaluating the role of imaging in carpal instability.
Assuntos
Articulações do Carpo , Diagnóstico por Imagem/métodos , Instabilidade Articular , Articulação do Punho , Articulações do Carpo/diagnóstico por imagem , Articulações do Carpo/patologia , Humanos , Imageamento Tridimensional , Instabilidade Articular/diagnóstico por imagem , Instabilidade Articular/patologia , Radiografia , Ultrassonografia , Articulação do Punho/diagnóstico por imagem , Articulação do Punho/patologiaRESUMO
The effect of the lunate type on carpal collapse in cases of scaphoid nonunion has not been thoroughly investigated. The purpose of the present study was to determine whether any association exists or not between the capitate-triquetrum distance and occurrence of carpal collapse in cases of scaphoid nonunion. In a retrospective study, 76 patients with scaphoid nonunion formed two groups based on the capitate-triquetrum distance: forty-three patients with distance of less than 5 mm and 33 patients with distance of 5 mm or more. The two groups were comparable with respect to sex distribution, age, dominant hand involvement, manual labor, nonunion location and time from injury to final x-rays. Six patients (13.9%) in the capitate-triquetrum<5 mm group and 13 patients (39.4%) in the capitate-triquetrum≥5 mm group had no signs of collapse, with significant difference (p<0.05). Capitate-triquetrum distance could contribute in the decision making process for cases of scaphoid nonunion without straightforward indication for surgical intervention.
Assuntos
Capitato/patologia , Articulações do Carpo/diagnóstico por imagem , Articulações do Carpo/patologia , Piramidal/patologia , Capitato/diagnóstico por imagem , Humanos , Radiografia , Estudos Retrospectivos , Piramidal/diagnóstico por imagemRESUMO
PURPOSE: To determine whether specific anatomic lesions of the scapholunate supporting structures are associated with the grades of scapholunate instability according to the Geissler classification. METHODS: Six fresh frozen cadaveric limbs underwent serial arthroscopic sectioning of the scapholunate supporting ligaments. To simulate a progressive scapholunate injury based on the current literature, sectioning occurred as follows: volar scapholunate interosseous ligament (SLIL), membranous SLIL, dorsal SLIL, radioscaphocapitate, long radiolunate, dorsal radiocarpal, dorsal intercarpal, and scaphotrapeziotrapezoid ligaments. We performed arthroscopic examination of the radiocarpal and midcarpal joints after each ligamentous sectioning and recorded the appearance of the scapholunate interval. RESULTS: There was a progressive increase in Geissler grade with sequential sectioning of the scapholunate supporting ligaments. In all specimens, Geissler grade 2 injury was associated with sectioning of intrinsic ligaments only. Geissler grade 3 injury first appeared with sectioning through the dorsal SLIL and continued through sectioning of the volar extrinsic ligaments. Geissler grade 4 injury did not occur until the dorsal extrinsic ligaments were sectioned. Statistical analysis indicated a linear relationship between ligament sectioned and Geissler grade, with deeper sections associated with a higher Geissler grade. CONCLUSIONS: In this cadaveric model, arthroscopically determined Geissler grade was associated with specific anatomic lesions of the scapholunate supporting ligaments. Sequential sectioning of the ligaments showed a progressive increase in Geissler grade. CLINICAL RELEVANCE: Knowledge of the association of Geissler grade with pathoanatomy may aid the surgeon in deciding which reconstructive method is best.
Assuntos
Artroscopia , Articulações do Carpo/patologia , Instabilidade Articular/classificação , Ligamentos Articulares/lesões , Cadáver , Humanos , Instabilidade Articular/patologia , Ligamentos Articulares/patologia , Osso Semilunar/patologia , Osso Escafoide/patologiaRESUMO
A gene therapeutic approach to treat osteoarthritis (OA) appears to be on the horizon for millions of people who suffer from this disease. Previously we described optimization of a scAAVIL-1ra gene therapeutic vector and initially tested this in an equine model verifying long-term intrasynovial IL-1ra protein at therapeutic levels. Using this vector, we carried out a dosing trial in six horses to verify protein levels and establish a dose that would express relevant levels of therapeutic protein for extended periods of time (8 months). A novel arthroscopic procedure used to detect green fluorescence protein (GFP) fluorescence intrasynovially confirmed successful transduction of the scAAVGFP vector in both the synovial and cartilage tissues. No evidence of intra-articular toxicity was detected. Immune responses to vector revealed development of neutralizing antibodies (Nabs) within 2 weeks of administration, which persisted for the duration of the study but did not lower protein expression intra-articularly. Re-dosing with a different serotype to attain therapeutic levels of protein confirmed establishment of successful transduction. This is the first study in an equine model to establish a dosing/redosing protocol, as well as examine the Nab response to capsid and supports further clinical investigation to determine the clinical efficacy of scAAVIL-1ra to treat OA.