Cartilage Matrix Degeneration Occurs within the First Year after ACLR and Is Associated with Impaired Clinical Outcome

Objective Anterior cruciate ligament reconstruction (ACLR) has not been shown to decrease the risk for development of post-traumatic osteoarthritis. Magnetic resonance imaging (MRI) T2 mapping can be used to assess cartilage compositional changes. This study tests whether (1) worse cartilage arthroscopic status at ACLR is reflected by higher cartilage T2 values in matched study regions 6 weeks and 1 year after ACLR, and (2) increasing cartilage T2 values between 6 weeks and 1 year after ACLR are associated with worsening patient-reported outcomes. Design Twenty-two participants with ACLR and 26 controls underwent 3T MRI. T2 values in medial and lateral femoral and tibial cartilage were measured at 6 weeks and 1 year after ACLR and compared with arthroscopic grades, Knee injury and Osteoarthritis Outcome Scores (KOOS), and control T2 values. Results Most (59%-86%) cartilage study regions examined by arthroscopy demonstrated intact articular surfaces. Average T2 value increased in 3 of 4 study regions between 6 weeks and 1 year after ACLR ( P = .001-.011). T2 value increased ( P < .013) even for participants whose cartilage had intact articular surfaces at ACLR. Participants with ACLR who showed greater increases in cartilage T2 values had less improvement to KOOS Quality of Life ( P = .009, ρ = −0.62). Discussion Cartilage status assessed arthroscopically at ACLR and by MRI T2 maps 6 weeks later was healthier than cartilage status assessed by MRI T2 maps at 1-year follow-up. Progressive T2 elevations were observed over the first year after ACLR even in patients with arthroscopically intact cartilage at the time of surgery and were associated with reduced improvement in knee quality of life suggesting preosteoarthritis.

Analysis of differences in vibroacoustic signals between healthy and osteoarthritic knees using EMD algorithm and statistical analysis

The knee joint is the largest and one of the most vulnerable and most frequently damaged joints in the human body. It is characterized by a complex structure. All articular surfaces are covered with hyaline cartilage. This cartilage has minimal regenerative capacity. Under the influence of cyclical micro-injuries, inflammatory mediators, prolonged excessive pressure or immobility, and thus disturbance of tissue nutrition, the cartilage becomes susceptible to damage and is easily covered with villi, cracks and abrasion. As a result, this translates into changes in the friction and lubrication processes within the joint and may affect the generated vibroacoustic processes. In this study, the signals recorded in a group of 28 volunteers were analysed, 15 of them were healthy people (HC) and 13 were people diagnosed with osteoarthritis (OA) qualified for surgery. The study aims to check the usefulness of the EMD (Empirical Mode Decomposition) algorithm in the filtration procedures of vibroacoustic signals. This algorithm is most often used in the analysis of signals that are most often nonlinear and non-stationary. Selected statistical indicators, such as RMS, VMS, variance and energy, were determined for the signals constituting the sum of the IMFs (Intrinsic Mode Functions) 1-8, having a normal distribution in the assessment of damage to the articular cartilage of the knee joint. Statistical analysis was performed for the values of individual indicators obtained. The vibroacoustic signals were recorded using CM-01B contact microphones placed in the central part of the medial and lateral joint fissure for movement in the range of 90°–0°–90° in closed kinetic chains (CKC) in the control group (HC) and the group of patients diagnosed with osteoarthritis (OA).

Accurate and semi-automated reassociation of intermixed human skeletal remains recovered from bioarchaeological and forensic contexts

Commingled remains describes the situation of intermixed skeletal elements, an extremely common occurrence in contemporary forensic cases, archaeological mass graves, as well as fossil hominin assemblages. Given that reliable identification is typically impossible for commingled contexts, a plethora of previous studies has focused on the development of refined methods for reassociating the bones of each individual skeleton. Here, a novel virtual approach for quantifying the degree of three-dimensional shape compatibility between two adjoining bone articular surfaces is put forth. Additionally, the integrability of this method with traditional osteometric techniques is evaluated. We focus on the paradigm of the hip joint, whose articulating bone elements (the femur and the innominate bone) are crucial for reconstructing the biological profile of unidentified human remains. The results demonstrate that this new semi-automated methodology is highly accurate both for large commingled assemblages (such as those resulting from mass disasters or burials) as well as smaller-scale contexts (such as those resulting from secondary burials).

How to Report: Hip MRI

Writing a good magnetic resonance imaging (MRI) hip report requires a sound understanding of hip anatomy, imaging, and related pathologies. The structures of the hip most prone to pathology are the articular surfaces, labrum, subchondral bone, and gluteal tendons. Particular attention should be paid to abnormal hip morphology that is relatively common and can manifest as internal or external hip derangement. It is essential to appreciate and report the specific features of each pathology that carry clinical significance to aid patient management. This article is aimed at trainee radiologists and those less experienced with reporting hip MRI, focusing on the essential features to comment on and providing examples of terminology to use and MR images to illustrate these features.

Medial femoral trochlea flap reconstruction versus proximal row carpectomy for Kienböck’s disease: a morphometric comparison

Surgical options for advanced Kienböck’s disease include proximal row carpectomy or lunate reconstruction with a medial femoral trochlea osteochondral flap. This study compares morphology of the proximal capitate and the medial femoral trochlear surfaces to the proximal lunate using three-dimensional geometric morphometric analysis. Virtual articular surfaces were extracted from MRI studies of ten healthy volunteers. Distances between corresponding points on the proximal lunate and proximal capitate or medial femoral trochlear surfaces were measured. In seven subjects, mean inter-surface distance for the medial femoral trochlea–proximal lunate pair was significantly lower than the proximal capitate–proximal lunate pairing. In three subjects, mean proximal capitate–proximal lunate distance was significantly lower. We conclude that the medial femoral trochlear flap was anatomically closer to the shape of the proximal lunate in the majority of the examined subjects. However, we found that in three out of ten cases, the proximal capitate was a better match.

Morphometric evaluation of features of remodeling of chondrocites of joint surfaces of temporomandibular joint of experimental animals in hyperglycemia

Aim: to study morphometrically the peculiarities of remodeling of chondrocytes of the articular surfaces of the temporomandibular joint in hyperglycemia.Materials and methods: Quantitative morphological methods were used to study diameters of chondrocytes and their nuclei, nuclear-cytoplasmic relationship in these cells, relative volume of damaged chondrocytes, intercellular-chondrocytic relationship in mature chondrocytes of the articular surfaces of the temporomandibular joint of 45 laboratory mature white male rats with simulated diabetes.Results: A comprehensive analysis of the morphometric parameters presented in the article showed that they did not differ in the articular surfaces of the temporal fossa and mandibular head of the intact temporomandibular joint. The expressed structural changes of chondrocytes were revealed at a monthly and a two-month diabetic arthropathy of this joint.Conclusions: Proceeded studies and obtained results suggest that prolonged hyperglycemia leads to diabetic arthropathy of the TMJ, which is characterized by atrophy of chondrocytes, violation of nuclear-cytoplasmic relationships, an increase in the relative volume of damaged chondrocytes and volume of intercellular substance. The detected changes in quantitative morphological parameters depended on the duration of hyperglycemia and dominated in the cartilaginous tissue of the articular surface of the mandibular head.

Tabetic Arthropathy

Tabetic Arthropathy (TA) defines bone- and joint-destructive processes associated with neurosensory deficits due to syphilis infection. It occurs at the late stages of the disease, and affects 10% of patients with Tabes Dorsalis. The mean age at diagnosis is 60 years with a predilection for male patients. TA became less common thanks to the early diagnosis of syphilis infection, but its management remains complicated given the severity of injuries and the lack of specific treatment. TA can affect every joint, mainly the knees. Patients usually present with a single painless and swollen joint. Deformities are seen in advanced stages. Plain radiographs and CT findings include subchondral sclerosis, osteophytosis, subluxation, and soft tissue swelling. MRI shows articular destruction with irregularities of articular surfaces, deformation, and intraarticular effusion. It also helps differentiate neuropathic osteoarthropathy from other articular diseases as infection, osteonecrosis, and psoriatic arthritis (Figure 1 and 2).

MORPHOMETRIC STUDY OF MEDIAL AND LATERAL CONDYLE OF THE TIBIA IN NORTH INDIAN POPULATION

SUMMARY: Total and unicompartmental joints replacements have become the main standard for the treatment of degenerative disorders and osteoarthritis of the knee. In total knee arthroplasty less than half an inch (9 mm) of the tibial and femoral articular surfaces are removed from the ends of bones and replace the metal and plastic prosthesis. There by the dimensions of each condyle are requisite for designing prosthesis required for knee arthroplasty. Fifty (25 right & 25 left) adult fully ossied dry tibias were taken from the Department of Anatomy and morphometric measurements of medial and lateral condyle were taken by using a Vernier caliper. Statistical analysis of the parameters was done. Present study, the mean anteroposterior, the transverse diameter of medial and lateral condyles of tibia were 45.71±3.17, 29.75±2.95, and 39.71±3.09, 30.24±2.45 mm respectively. The mean mediolateral length of total tibia and the mean circumference of the upper tibia were 69.35±5.08 and 191.49±14.85 mm respectively. The results of this study will be helpful for anatomists, anthropologists, and orthopedics in cases of unicompartmental knee arthroplasty, complete knee arthroplasty procedures, and meniscal transplantation.