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1.
Int J Mol Sci ; 25(13)2024 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-39000119

RESUMO

The purpose of this scoping review was to identify possible chondrotoxic effects caused by drugs usually used for intra-articular injections. PubMed, Scopus, Web of Science and Cochrane were searched. Inclusion criteria required randomized controlled trials written in English that evaluate the toxic effect that damages the cartilage. The literature search resulted in 185 unique articles. 133 full-text articles were screened for inclusion, of which 65 were included. Corticosteroids, with the exception of triamcinolone, along with local anaesthetics, potentially excluding ropivacaine and liposomal bupivacaine, and nonsteroidal anti-inflammatory drugs, exhibited insufficient safety profiles to warrant casual use in clinical settings. Hyaluronic acid, on the other hand, appears to demonstrate safety while also mitigating risks associated with concurrent compounds, thereby facilitating therapeutic combinations. Additionally, there remains a paucity of data regarding platelet-rich plasma, necessitating further evaluation of its potential efficacy and safety. Overall, it seems that results are significantly influenced by the dosage and frequency of injections administered, observed in both human and animal studies.


Assuntos
Ácido Hialurônico , Humanos , Injeções Intra-Articulares , Animais , Ácido Hialurônico/administração & dosagem , Ácido Hialurônico/efeitos adversos , Anestésicos Locais/administração & dosagem , Anestésicos Locais/efeitos adversos , Anestésicos Locais/toxicidade , Cartilagem Articular/efeitos dos fármacos , Cartilagem Articular/patologia , Corticosteroides/administração & dosagem , Anti-Inflamatórios não Esteroides/administração & dosagem , Anti-Inflamatórios não Esteroides/efeitos adversos
2.
Shanghai Kou Qiang Yi Xue ; 33(2): 113-116, 2024 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-39005084

RESUMO

PURPOSE: To study the damage and the expression of LC3 and p62 of condylar cartilage in fluorosis mouse. METHODS: Thirty 4-week-old male C57BL/6 mice were randomly divided into control group and the experimental group with 15 animals in each group. The control group received regular drinking water and the experimental group received a fluoride concentration of 75 mg/L drinking water for 8 weeks. The structure of condylar cartilage was observed through modified safranine O-fast green FCF cartilage stain kit. Immunohistochemistry was used to detect the expression of MMP-13, type Ⅱ collagen and LC3 and p62. Two-way analysis of variance test was conducted for analysis of semi-quantitative results of immunohistochemistry using SPSS 22.0 software package. RESULTS: Compared with the control group, the fibrocartilage layer of the experimental group became thinner, the condrocytes were smaller, and the staining became deeper.Immunohistochemistry results showed that the expression of MMP-13 and LC3 increased; the expression of type Ⅱ collagen and p62 decreased in the experimental group. CONCLUSIONS: There was degeneration of the condylar cartilage and autophagy in mice with drinking water containing 75 mg/L fluoride.


Assuntos
Autofagia , Fluorose Dentária , Metaloproteinase 13 da Matriz , Camundongos Endogâmicos C57BL , Proteínas Associadas aos Microtúbulos , Animais , Camundongos , Autofagia/efeitos dos fármacos , Metaloproteinase 13 da Matriz/metabolismo , Metaloproteinase 13 da Matriz/genética , Masculino , Proteínas Associadas aos Microtúbulos/metabolismo , Fluorose Dentária/metabolismo , Colágeno Tipo II/metabolismo , Côndilo Mandibular/metabolismo , Côndilo Mandibular/patologia , Fluoretos/toxicidade , Cartilagem Articular/metabolismo , Imuno-Histoquímica
3.
Eur Rev Med Pharmacol Sci ; 28(12): 3828-3835, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38946380

RESUMO

OBJECTIVE: This study investigates the biomechanical effects of graft width and chondrolabral junction (CLJ) preservation on the labral suction seal in a bovine hip model and aims to validate this model as a practical alternative for hip biomechanical research by comparing it with human cadaver studies. MATERIALS AND METHODS: Twenty hips from two-year-old male bovines were divided into two main groups: CLJ preserved (CLJ+) and CLJ excised (CLJ-). These groups were further divided into eight subgroups: Group 1 with an intact labrum; Group 2 with labrum excision preserving CLJ; Groups 3 and 4 with labral reconstruction on preserved CLJ using 4.5 mm and 9 mm grafts, respectively; Group 5 with a labral tear at 12 to 3 o'clock position without CLJ preservation; Group 6 with complete labrum excision without CLJ preservation; and Groups 7 and 8 with labral reconstruction on excised CLJ using 4.5 mm and 9 mm grafts. Mechanical tests measuring compression and distraction forces were conducted, recording force-displacement values. RESULTS: Both CLJ+ and CLJ- groups showed that labrum excision resulted in the lowest distraction forces, emphasizing labral integrity. Notably, reconstruction with 9 mm grafts improved distraction forces more than 4.5 mm grafts (p<0.001). The change in distraction forces from intact to excised stages was nearly significant between CLJ+ and CLJ- groups (Δ Intact-excised: CLJ+ vs. CLJ-: 92 N vs. 105 N, p=0.08). Distraction forces were measured at 206±27 Newtons in the CLJ preserved group and 186±24 Newtons in the resected group. CONCLUSIONS: This study demonstrates that increasing the width of the graft, despite being approximately half and a quarter of the native labrum's size, significantly enhances the distraction force in labral reconstruction within a bovine hip model. This improvement is more pronounced than the effects of preserving the CLJ, highlighting the critical role of graft size in maintaining the biomechanical integrity of the labral suction seal.


Assuntos
Articulação do Quadril , Animais , Bovinos , Masculino , Fenômenos Biomecânicos , Articulação do Quadril/cirurgia , Cartilagem Articular/cirurgia , Humanos , Modelos Animais
4.
Autoimmunity ; 57(1): 2364686, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38946534

RESUMO

BACKGROUND: Chondrocyte viability, apoptosis, and migration are closely related to cartilage injury in osteoarthritis (OA) joints. Exosomes are identified as potential therapeutic agents for OA. OBJECTIVE: This study aimed to investigate the role of exosomes derived from osteocytes in OA, particularly focusing on their effects on cartilage repair and molecular mechanisms. METHODS: An injury cell model was established by treating chondrocytes with IL-1ß. Cartilage repair was evaluated using cell counting kit-8, flow cytometry, scratch test, and Western Blot. Molecular mechanisms were analyzed using quantitative real-time PCR, bioinformatic analysis, and Western Blot. An OA mouse model was established to explore the role of exosomal DLX2 in vivo. RESULTS: Osteocyte-released exosomes promoted cell viability and migration, and inhibited apoptosis and extracellular matrix (ECM) deposition. Moreover, exosomes upregulated DLX2 expression, and knockdown of DLX2 activated the Wnt pathway. Additionally, exosomes attenuated OA in mice by transmitting DLX2. CONCLUSION: Osteocyte-derived exosomal DLX2 alleviated IL-1ß-induced cartilage repair and inactivated the Wnt pathway, thereby alleviating OA progression. The findings suggested that osteocyte-derived exosomes may hold promise as a treatment for OA.


Assuntos
Condrócitos , Exossomos , Proteínas de Homeodomínio , Osteoartrite , Osteócitos , Fatores de Transcrição , Via de Sinalização Wnt , Exossomos/metabolismo , Animais , Osteoartrite/metabolismo , Osteoartrite/patologia , Camundongos , Fatores de Transcrição/metabolismo , Proteínas de Homeodomínio/metabolismo , Proteínas de Homeodomínio/genética , Osteócitos/metabolismo , Condrócitos/metabolismo , Modelos Animais de Doenças , Humanos , Interleucina-1beta/metabolismo , Cartilagem Articular/metabolismo , Cartilagem Articular/patologia , Apoptose , Cartilagem/metabolismo , Cartilagem/patologia , Masculino , Movimento Celular , Sobrevivência Celular
5.
Anal Cell Pathol (Amst) ; 2024: 1083143, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38946863

RESUMO

Objectives: Osteochondral defects (OCDs) are localized areas of damaged cartilage and underlying subchondral bone that can produce pain and seriously impair joint function. Literature reports indicated that icariin (ICA) has the effect of promoting cartilage repair. However, its mechanism remains unclear. Here, we explored the effects of icariin and extracellular vesicles (EVs) from rabbit synovial-derived mesenchymal stem cells (rSMSCs) on repairing of OCDs. Materials and Methods: Rabbit primary genicular chondrocytes (rPGCs), knee skeletal muscle cells (rSMCKs), and rSMSCs, and extracellular vesicles derived from the latter two cells (rSMCK-EVs and rSMSC-EVs) were isolated and identified. The rPGCs were stimulated with ICA, rSMSC-EVs either separately or in combination. The rSMCK-EVs were used as a control. After stimulation, chondrogenic-related markers were analyzed by quantitative RT-PCR and western blotting. Cell proliferation was determined by the CCK-8 assay. The preventative effects of ICA and SMSC-EVs in vivo were determined by H&E and toluidine blue staining. Immunohistochemical analyses were performed to evaluate the levels of COL2A1 and ß-catenin in vivo. Results. In vitro, the proliferation of rPGCs was markedly increased by ICA treatment in a dose-dependent manner. When compared with ICA or rSMSC-EVs treatment alone, combined treatment with ICA and SMSC-EVs produced stronger stimulative effects on cell proliferation. Moreover, combined treatment with ICA and rSMSC-EVs promoted the expression of chondrogenic-related gene, including COL2A1, SOX-9, and RUNX2, which may be via the activation of the Wnt/ß-catenin pathway. In vivo, combined treatment with rSMSC-EVs and ICA promoted cartilage repair in joint bone defects. Results also showed that ICA or rSMSC-EVs both promoted the COL2A1 and ß-catenin protein accumulation in articular cartilage, and that was further enhanced by combined treatment with rSMSC-EVs and ICA. Conclusion: Our findings highlight the promising potential of using combined treatment with ICA and rSMSC-EVs for promoting osteochondral repair.


Assuntos
Condrócitos , Condrogênese , Vesículas Extracelulares , Flavonoides , Células-Tronco Mesenquimais , Membrana Sinovial , Via de Sinalização Wnt , Animais , Coelhos , Flavonoides/farmacologia , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais/citologia , Via de Sinalização Wnt/efeitos dos fármacos , Vesículas Extracelulares/metabolismo , Condrócitos/metabolismo , Condrócitos/efeitos dos fármacos , Membrana Sinovial/metabolismo , Membrana Sinovial/citologia , Condrogênese/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , beta Catenina/metabolismo , Cartilagem Articular/metabolismo , Cartilagem Articular/efeitos dos fármacos
6.
PLoS One ; 19(7): e0306257, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38980846

RESUMO

BACKGROUND: Marathons are the most challenging form of running, and amateur athletes may be more prone to injury due to a lack of professional knowledge and instruction in running. PURPOSE: To analyze the MRI manifestations of and factors related to knee injuries in amateur marathon runners. SUBJECTS: Data were collected from a hospital database of 105 qualified amateur marathon athletes (65 males,40 females), between May 2018 and December 2021. FIELD STRENGTH/SEQUENCE: 1.5T MR: sagittal fs-PDWI, sagittal T1WI and sagittal 3D-DESS sequence. ASSESSMENT: The MRI manifestations of knee joint injury were analyzed and evaluated by two radiologists. STATISTICAL TESTS: The inter-observer agreement on MRI readings was analyzed using the kappa coefficient, and binary logistic regression analysis was employed to identify factors associated with knee injuries. RESULTS: The overall prevalence of knee cartilage lesions, meniscus lesions and bone marrow edema among amateur marathon runners was 45.7%, 72.4%, and 49.5% respectively. Our analysis revealed that older age (OR = 1.135, P<0.001), higher BMI (OR = 1.236, P = 0.044), and slower pace (OR = 2.305, P = 0.017) were associated with increased risk of articular cartilage disease. Furthermore, older age (OR = 1.425, P<0.001) was identified as a risk factor for meniscal lesions, while older age (OR = 1.088, P = 0.002) was bone marrow edema. Notably, no significant correlation was observed between knee joint injuries of amateur marathon athletes and gender or the monthly running distance (P>0.05). CONCLUSIONS: The occurrence of knee injuries among amateur marathon athletes was highly prevalent, with the patellofemoral joint cartilage and posterior horn of medial meniscus being frequently affected areas. Moreover, age, BMI, running years and pace were significant risk factors of knee joint injury.


Assuntos
Atletas , Traumatismos do Joelho , Imageamento por Ressonância Magnética , Corrida de Maratona , Humanos , Masculino , Feminino , Imageamento por Ressonância Magnética/métodos , Traumatismos do Joelho/diagnóstico por imagem , Adulto , Corrida de Maratona/lesões , Pessoa de Meia-Idade , Fatores de Risco , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/patologia , Cartilagem Articular/diagnóstico por imagem , Cartilagem Articular/lesões , Cartilagem Articular/patologia , Corrida/lesões
7.
Int J Mol Sci ; 25(13)2024 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-39000568

RESUMO

Osteoarthritis (OA) is the most common joint disease, causing symptoms such as joint pain, swelling, and deformity, which severely affect patients' quality of life. Despite advances in medical treatment, OA management remains challenging, necessitating the development of safe and effective drugs. Quercetin (QUE), a natural flavonoid widely found in fruits and vegetables, shows promise due to its broad range of pharmacological effects, particularly in various degenerative diseases. However, its role in preventing OA progression and its underlying mechanisms remain unclear. In this study, we demonstrated that QUE has a protective effect against OA development both in vivo and in vitro, and we elucidated the underlying molecular mechanisms. In vitro, QUE inhibited the expression of IL-1ß-induced chondrocyte matrix metalloproteinases (MMP3 and MMP13) and inflammatory mediators such as INOS and COX-2. It also promoted the expression of collagen II, thereby preventing the extracellular matrix (ECM). Mechanistically, QUE exerts its protective effect on chondrocytes by activating the SIRT1/Nrf-2/HO-1 and inhibiting chondrocyte ferroptosis. Similarly, in an OA rat model induced by anterior cruciate ligament transection (ACLT), QUE treatment improved articular cartilage damage, reduced joint pain, and normalized abnormal subchondral bone remodeling. QUE also reduced serum IL-1ß, TNF-α, MMP3, CTX-II, and COMP, thereby slowing the progression of OA. QUE exerts chondroprotective effects by inhibiting chondrocyte oxidative damage and ferroptosis through the SIRT1/Nrf-2/HO-1 pathway, effectively alleviating OA progression in rats.


Assuntos
Cartilagem Articular , Condrócitos , Modelos Animais de Doenças , Ferroptose , Fator 2 Relacionado a NF-E2 , Osteoartrite , Quercetina , Sirtuína 1 , Animais , Sirtuína 1/metabolismo , Osteoartrite/tratamento farmacológico , Osteoartrite/metabolismo , Osteoartrite/patologia , Ratos , Quercetina/farmacologia , Quercetina/uso terapêutico , Fator 2 Relacionado a NF-E2/metabolismo , Condrócitos/efeitos dos fármacos , Condrócitos/metabolismo , Ferroptose/efeitos dos fármacos , Cartilagem Articular/efeitos dos fármacos , Cartilagem Articular/patologia , Cartilagem Articular/metabolismo , Masculino , Transdução de Sinais/efeitos dos fármacos , Ratos Sprague-Dawley , Interleucina-1beta/metabolismo , Heme Oxigenase (Desciclizante)/metabolismo
8.
Sci Rep ; 14(1): 15902, 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38987563

RESUMO

Raman spectroscopy is a rapid method for analysing the molecular composition of biological material. However, noise contamination in the spectral data necessitates careful pre-processing prior to analysis. Here we propose an end-to-end Convolutional Neural Network to automatically learn an optimal combination of pre-processing strategies, for the classification of Raman spectra of superficial and deep layers of cartilage harvested from 45 Osteoarthritis and 19 Osteoporosis (Healthy controls) patients. Using 6-fold cross-validation, the Multi-Convolutional Neural Network achieves comparable or improved classification accuracy against the best-performing Convolutional Neural Network applied to either the raw or pre-processed spectra. We utilised Integrated Gradients to identify the contributing features (Raman signatures) in the network decision process, showing they are biologically relevant. Using these features, we compared Artificial Neural Networks, Decision Trees and Support Vector Machines for the feature selection task. Results show that training on fewer than 3 and 300 features, respectively, for the disease classification and layer assignment task provide performance comparable to the best-performing CNN-based network applied to the full dataset. Our approach, incorporating multi-channel input and Integrated Gradients, can potentially facilitate the clinical translation of Raman spectroscopy-based diagnosis without the need for laborious manual pre-processing and feature selection.


Assuntos
Aprendizado Profundo , Redes Neurais de Computação , Osteoartrite , Análise Espectral Raman , Humanos , Análise Espectral Raman/métodos , Osteoartrite/classificação , Osteoartrite/diagnóstico , Feminino , Masculino , Cartilagem Articular/patologia , Pessoa de Meia-Idade , Idoso , Osteoporose/diagnóstico , Máquina de Vetores de Suporte
9.
Sports Med Arthrosc Rev ; 32(2): 60-67, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38978199

RESUMO

Cartilage injuries can present in a diverse setting of anatomic locations, with varying severity, and can impact athletes of all ages and competition levels. Moreover, the timing of when an injury presents introduces an additional dimension to treatment decision-making. Frequently, the level of competition, in conjunction with career trajectory and short-term and long-term athlete goals, will dictate whether a temporary or definitive treatment strategy is ideal. Although indicating the correct therapeutic regimen may prove challenging, understanding the athlete-specific considerations can be essential to meeting the goals of the athlete and other stakeholders involved in the athlete's career. The purpose of this review is to comprehensively present the deliberations a treating physician must consider in managing cartilage injuries within a spectrum of athletic levels ranging from youth to professional levels, with a secondary focus on the presentation of temporizing treatment strategies and associated outcomes.


Assuntos
Traumatismos em Atletas , Cartilagem Articular , Humanos , Traumatismos em Atletas/terapia , Cartilagem Articular/lesões , Atletas
10.
Sports Med Arthrosc Rev ; 32(2): 68-74, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38978200

RESUMO

Articular cartilage defects in the knee are common in athletes who have a variety of loading demands across the knee. Athletes of different sports may have different baseline risk of injury. The most studied sports in terms of prevalence and treatment of cartilage injuries include soccer (football), American football, and basketball. At this time, the authors do not specifically treat patients by their sport; however, return to sports timing may be earlier in sports with fewer demands on the knee based on the rehabilitation protocol. If conservative management is unsuccessful, the authors typically perform a staging arthroscopy with chondroplasty, followed by osteochondral allograft transplantation with possible additional concomitant procedures, such as osteotomies or meniscal transplants. Athletes in a variety of sports and at high levels of competition can successfully return to sports with the appropriate considerations and treatment.


Assuntos
Artroscopia , Traumatismos em Atletas , Cartilagem Articular , Humanos , Cartilagem Articular/lesões , Cartilagem Articular/cirurgia , Traumatismos em Atletas/terapia , Traumatismos em Atletas/cirurgia , Artroscopia/métodos , Volta ao Esporte , Traumatismos do Joelho/cirurgia
12.
Sports Med Arthrosc Rev ; 32(2): 95-103, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38978203

RESUMO

Chondral defects in the athlete's hip are a relatively common occurrence, often presenting with debilitating pain and activity limitation. Preoperative identification of cartilage defects is challenging and there are many different modalities for treatment. Nonsurgical interventions, including activity modification, physical therapy, and injections, play a vital role, especially in less severe cases and as adjuncts to surgical intervention. Treating surgeons must be familiar with the cartilage restoration procedures available, including debridement, microfracture, and various implantation and transplantation options. Safe and effective management of cartilage defects is imperative to an athlete's return to sport. It is also imperative that surgeons are aware of all these various treatment options to determine what modality is best for their patients. This review serves to outline these options, cover the published literature, and provide general guidelines for surgeons when they encounter chondral defects in the office and the operating room.


Assuntos
Traumatismos em Atletas , Cartilagem Articular , Humanos , Cartilagem Articular/lesões , Cartilagem Articular/cirurgia , Traumatismos em Atletas/terapia , Traumatismos em Atletas/cirurgia , Desbridamento , Artroplastia Subcondral , Lesões do Quadril/cirurgia , Lesões do Quadril/terapia , Atletas , Volta ao Esporte
13.
Sports Med Arthrosc Rev ; 32(2): 104-112, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38978204

RESUMO

Cartilage injuries of the hand and wrist can be debilitating in the athlete. Diagnosis is difficult given the broad spectrum of presenting symptomatology. History and physical examination is crucial to achieve the correct diagnosis, and advanced imaging can offer helpful assistance to the clinician as well. TFCC injuries and ulnar impaction syndrome are among the most common conditions in athletes with hand and wrist pain. Treatment of these injuries is initially nonoperative, but elite athletes may elect to bypass nonoperative treatment in favor of earlier return to sport. Surgical treatment varies but can include open and arthroscopic methods. The clinician should tailor treatment plans to each athlete based on level of competition, type of sport, and individual preferences and goals.


Assuntos
Artroscopia , Traumatismos em Atletas , Cartilagem Articular , Traumatismos da Mão , Traumatismos do Punho , Humanos , Traumatismos do Punho/terapia , Traumatismos do Punho/cirurgia , Traumatismos do Punho/diagnóstico , Traumatismos do Punho/diagnóstico por imagem , Traumatismos em Atletas/terapia , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/cirurgia , Traumatismos da Mão/terapia , Traumatismos da Mão/cirurgia , Traumatismos da Mão/diagnóstico , Artroscopia/métodos , Cartilagem Articular/lesões , Cartilagem Articular/cirurgia , Volta ao Esporte , Exame Físico
14.
Sports Med Arthrosc Rev ; 32(2): 113-118, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38978205

RESUMO

Articular cartilage lesions are a common injury that have become increasingly treatable with joint preservation procedures. Well-documented allograft and cellular treatments for these lesions are detailed elsewhere in this volume. This article discusses three new unique options for addressing these defects taking three different paths to address these complex injuries. Agili-C is an existing FDA- and EMEA-approved option using an acellular aragonite-based scaffold to treat both chondral and osteochondral lesions, with or without concurrent arthritis. Cartistem is a stem-cell-based product composed of culture-expanded allogeneic human umbilical cord blood-derived mesenchymal stem cells and hyaluronic acid hydrogel, which is in its final clinical trial stages in the United States, but already has regulatory approval in Korea. IMPACT and RECLAIM studies have shown the safety and efficacy of a new one-stage procedure utilizing autologous chondrons combined with allogeneic mesenchymal stem cells (MSCs) that can provide another effective single-stage treatment option.


Assuntos
Cartilagem Articular , Transplante de Células-Tronco Mesenquimais , Alicerces Teciduais , Humanos , Cartilagem Articular/lesões , Cartilagem Articular/cirurgia , Transplante Autólogo , Condrócitos/transplante , Traumatismos do Joelho/terapia , Traumatismos do Joelho/cirurgia
15.
Sports Med Arthrosc Rev ; 32(2): 75-86, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38978201

RESUMO

Cartilage lesions of the knee are a challenging problem, especially for active individuals and athletes who desire a return to high-load activities. They occur both through chronic repetitive loading of the knee joint or through acute traumatic injury and represent a major cause of pain and time lost from sport. They can arise as isolated lesions or in association with concomitant knee pathology. Management of these defects ultimately requires a sound understanding of their pathophysiologic underpinnings to help guide treatment. Team physicians should maintain a high index of suspicion for underlying cartilage lesions in any patient presenting with a knee effusion, whether painful or not. A thorough workup should include a complete history and physical examination. MRI is the most sensitive and specific imaging modality to assess these lesions and can provide intricate detail not only of the structure and composition of cartilage, but also of the surrounding physiological environment in the joint. Treatment of these lesions consists of both conservative or supportive measures, as well as surgical interventions designed to restore or regenerate healthy cartilage. Because of the poor inherent capacity for healing associated with hyaline cartilage, the vast majority of symptomatic lesions will ultimately require surgery. Surgical treatment options range from simple arthroscopic debridement to large osteochondral reconstructions. Operative decision-making is based on numerous patient- and defect-related factors and requires open lines of communication between the athlete, the surgeon, and the rest of the treatment team. Ultimately, a positive outcome is based on the creation of a durable, resistant repair that allows the athlete to return to pain-free sporting activities.


Assuntos
Traumatismos em Atletas , Cartilagem Articular , Traumatismos do Joelho , Imageamento por Ressonância Magnética , Humanos , Cartilagem Articular/lesões , Cartilagem Articular/cirurgia , Traumatismos em Atletas/cirurgia , Traumatismos em Atletas/terapia , Traumatismos em Atletas/diagnóstico , Traumatismos do Joelho/cirurgia , Artroscopia/métodos , Desbridamento , Atletas
16.
Sports Med Arthrosc Rev ; 32(2): 87-94, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38978202

RESUMO

Articular cartilage defects in the glenohumeral joint may be found in laborers, the elderly, and young athletes, among others. Various factors can contribute to cartilage damage, including prior surgery, trauma, avascular necrosis, inflammatory arthritis, joint instability, and osteoarthritis. There is a wide variety of treatment options, from conservative treatment, injections, and surgical options, including arthroscopic debridement, microfracture, osteochondral autograft transfer, osteochondral graft transplantation, autologous chondrocyte implantation, and the newly emerging techniques such as biologic augmentation. There is a challenge to determine the optimal treatment options, especially for young athletes, due to limited outcomes in the literature. However, there are many options which are viable to address osteochondral defects of the glenohumeral joint.


Assuntos
Artroscopia , Traumatismos em Atletas , Cartilagem Articular , Humanos , Cartilagem Articular/lesões , Cartilagem Articular/cirurgia , Artroscopia/métodos , Traumatismos em Atletas/cirurgia , Traumatismos em Atletas/terapia , Articulação do Ombro/cirurgia , Condrócitos/transplante , Transplante Ósseo/métodos , Desbridamento , Transplante Autólogo , Lesões do Ombro , Atletas
17.
Commun Biol ; 7(1): 828, 2024 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-38972919

RESUMO

Crystallization of monosodium urate monohydrate (MSU) leads to painful gouty arthritis. Despite extensive research it is still unknown how this pathological biomineralization occurs, which hampers its prevention. Here we show how inflammatory MSU crystals form after a non-inflammatory amorphous precursor (AMSU) that nucleates heterogeneously on collagen fibrils from damaged articular cartilage of gout patients. This non-classical crystallization route imprints a nanogranular structure to biogenic acicular MSU crystals, which have smaller unit cell volume, lower microstrain, and higher crystallinity than synthetic MSU. These distinctive biosignatures are consistent with the template-promoted crystallization of biotic MSU crystals after AMSU at low supersaturation, and their slow growth over long periods of time (possibly years) in hyperuricemic gout patients. Our results help to better understand gout pathophysiology, underline the role of cartilage damage in promoting MSU crystallization, and suggest that there is a time-window to treat potential gouty patients before a critical amount of MSU has slowly formed as to trigger a gout flare.


Assuntos
Cristalização , Gota , Ácido Úrico , Ácido Úrico/metabolismo , Humanos , Gota/metabolismo , Gota/patologia , Biomineralização , Cartilagem Articular/metabolismo , Cartilagem Articular/patologia , Artrite Gotosa/metabolismo , Artrite Gotosa/patologia
18.
Biochem Biophys Res Commun ; 726: 150229, 2024 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-38908346

RESUMO

OBJECTIVE: Mesenchymal stem cells (MSCs) can treat osteoarthritis (OA), but their therapeutic efficacy is poor to date due to low migration efficiency. This study aimed to determine whether ultrasound-targeted microbubble destruction (UTMD) could ameliorate cartilage repair efficiency through facilitating the migration of MSCs via hypoxia-inducible factor-1α (HIF-1α)-mediated glycolysis regulatory pathway in OA model rats. METHODS: OA rats were treated with MSCs alone or in combination with UTMD, respectively, for 4 weeks. Cartilage histopathology, MSCs migration efficiency, von Frey fiber thresholds, and the expression levels of collagen II and MMP-13 were measured. Further, MSCs were extracted from the bone marrow of rats, cocultured with osteoarthritic chondrocytes, transfected to siRNA-HIF-1α, and subjected to UTMD for 4 days. Glucose consumption, lactate production, and cell migration efficiency were assessed. The protein expression levels of HIF-1α, HK2, PKM2, and GLUT1 were measured, respectively. RESULTS: In OA rat model, NC-MSCs + UTMD improved migration efficiency, increased collagen II expression, decreased MMP-13 expression, and delayed osteoarthritis progression. Silencing HIF-1α attenuated the effects induced by UTMD. In vitro, UTMD led to increases in MSC activity and migration, glucose consumption, lactate production, and the protein expression of HIF-1α, HK2, PKM2, and GLUT1 expression, all of which were reversed upon HIF-1α silencing. CONCLUSION: UTMD enhances MSCs migration and improves cartilage repair efficiency through the HIF-1α-mediated glycolytic regulatory pathway, providing a novel therapy strategy for knee osteoarthritis.


Assuntos
Movimento Celular , Glicólise , Subunidade alfa do Fator 1 Induzível por Hipóxia , Células-Tronco Mesenquimais , Microbolhas , Osteoartrite , Ratos Sprague-Dawley , Animais , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais/citologia , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Subunidade alfa do Fator 1 Induzível por Hipóxia/genética , Ratos , Osteoartrite/metabolismo , Osteoartrite/terapia , Osteoartrite/patologia , Transplante de Células-Tronco Mesenquimais/métodos , Masculino , Ondas Ultrassônicas , Cartilagem Articular/metabolismo , Cartilagem Articular/patologia , Condrócitos/metabolismo , Células Cultivadas
19.
J Orthop Surg Res ; 19(1): 373, 2024 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-38915104

RESUMO

PURPOSE: The objective of this study was to provide a comprehensive review of the existing literature regarding the treatment of osteochondral lesions of the talus (OLT) using autologous matrix-induced chondrogenesis (AMIC), while also discussing the mid-long term functional outcomes, complications, and surgical failure rate. METHODS: We searched Embase, PubMed, and Web of Science for studies on OLT treated with AMIC with an average follow-up of at least 2 years. Publication information, patient data, functional scores, surgical failure rate, and complications were extracted. RESULTS: A total of 15 studies were screened and included, with 12 case series selected for meta-analysis and 3 non-randomized controlled studies chosen for descriptive analysis. The improvements in the Visual Analog Scale (VAS), the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot, and Tegner scores at the last follow-up were (SMD = - 2.825, 95% CI - 3.343 to - 2.306, P < 0.001), (SMD = 2.73, 95% CI 1.60 to 3.86, P < 0.001), (SMD = 0.85, 95% CI 0.5 to 1.2, P < 0.001) respectively compared to preoperative values. The surgery failure rate was 11% (95% CI 8-15%), with a total of 12 patients experiencing complications. CONCLUSION: The use of AMIC demonstrates a positive impact on pain management, functional improvement, and mobility enhancement in patients with OLT. It is worth noting that the choice of stent for AMIC, patient age, and OLT size can influence the ultimate clinical outcomes. This study provides evidences supporting the safety and efficacy of AMIC as a viable treatment option in real-world medical practice.


Assuntos
Condrogênese , Tálus , Transplante Autólogo , Humanos , Tálus/cirurgia , Condrogênese/fisiologia , Transplante Autólogo/métodos , Resultado do Tratamento , Fatores de Tempo , Cartilagem Articular/cirurgia
20.
Int J Mol Sci ; 25(11)2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38891793

RESUMO

Joint-resident chondrogenic precursor cells have become a significant therapeutic option due to the lack of regenerative capacity in articular cartilage. Progenitor cells are located in the superficial zone of the articular cartilage, producing lubricin/Prg4 to decrease friction of cartilage surfaces during joint movement. Prg4-positive progenitors are crucial in maintaining the joint's structure and functionality. The disappearance of progenitor cells leads to changes in articular hyaline cartilage over time, subchondral bone abnormalities, and the formation of ectopic ossification. Genetic labeling cell technology has been the main tool used to characterize Prg4-expressing progenitor cells of articular cartilage in vivo through drug injection at different time points. This technology allows for the determination of the origin of progenitor cells and the tracking of their progeny during joint development and cartilage damage. We endeavored to highlight the currently known information about the Prg4-producing cell population in the joint to underline the significance of the role of these cells in the development of articular cartilage and its homeostasis. This review focuses on superficial progenitors in the joint, how they contribute to postnatal articular cartilage formation, their capacity for regeneration, and the consequences of Prg4 deficiency in these cells. We have accumulated information about the Prg4+ cell population of articular cartilage obtained through various elegantly designed experiments using transgenic technologies to identify potential opportunities for further research.


Assuntos
Cartilagem Articular , Proteoglicanas , Células-Tronco , Cartilagem Articular/metabolismo , Cartilagem Articular/citologia , Animais , Humanos , Células-Tronco/metabolismo , Células-Tronco/citologia , Proteoglicanas/metabolismo , Condrogênese , Condrócitos/metabolismo , Condrócitos/citologia , Diferenciação Celular , Regeneração
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