Whole joint MRI assessment of surgical cartilage repair of the knee: Cartilage Repair OsteoArthritis Knee Score (CROAKS)

AbstractRoutine use of biological therapies is in its early stages. Techniques involve stem cells, platelet preparations, recombinant growth factors and autologous conditioned serum, often combined with surgery. The objective of this case analysis was to document effects of intra-articular autologous conditioned serum injections in outpatients with knee pain associated with meniscal defects. Autologous conditioned serum was prepared from patients’ blood by centrifugal separation from cellular components using a specialized device (EOT®II, Orthokine). Outpatients (n=47) with heterogeneous knee meniscus lesions (76.6% traumatic knee injury) were injected once weekly (average 5.2 applications). Average age was 48.6 years (range 21–79). Oxford Knee Score and structural changes with the MRI Boston Leeds Osteoarthritis Knee Score were documented at baseline and 6 months. All analyses were performed retrospectively.In 83% patients, surgery was avoided during the 6-month observation period. Oxford Knee Score improved significantly from 29.1–44.3 (p<0.001; best possible score=48). Structural findings on MRI, measured by Boston Leeds Osteoarthritis Knee Score, showed significant improvement at 6 months (0.82–0.71, p<0.001). This retrospective study implies that intra-articular autologous conditioned serum injection may be an effective treatment option for knee pain associated with meniscal lesions. Controlled studies of autologous conditioned serum treatment for meniscal lesions are advocated.

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Calpain is involved in C-terminal truncation of human aggrecan

Biochemical Journal ◽

10.1042/bj20100591 ◽

2010 ◽

Vol 430 (3) ◽

pp. 531-538 ◽

Cited By ~ 19

Author(s):

André Struglics ◽

Maria Hansson

Keyword(s):

Synovial Fluid ◽

Keratan Sulfate ◽

Kinetic Studies ◽

Minor Role ◽

Cleavage Sites ◽

Knee Cartilage ◽

Normal Cartilage ◽

Osteoarthritis Knee ◽

Specific Order ◽

A Minor

Mature aggrecan is generally C-terminally truncated at several sites in the CS (chondroitin sulfate) region. Aggrecanases and MMPs (matrix metalloproteinases) have been suggested to be responsible for this digestion. To identify whether calpain, a common intracellular protease, has a specific role in the proteolysis of aggrecan we developed neoepitope antibodies (anti-PGVA, anti-GDLS and anti-EDLS) against calpain cleavage sites and used Western blot analysis to identify calpain-generated fragments in normal and OA (osteoarthritis) knee cartilage and SF (synovial fluid) samples. Our results showed that human aggrecan contains six calpain cleavage sites: one in the IGD (interglobular domain), one in the KS (keratan sulfate) region, two in the CS1 and two in the CS2 region. Kinetic studies of calpain proteolysis against aggrecan showed that the aggrecan molecule was cleaved in a specific order where cuts in CS1 was the most preferred and cuts in KS region was the second most preferred cleavage. OA and normal cartilage contained low amounts of a calpain-generated G1–PGVA fragment (0.5–2%) compared with aggrecanase-generated G1–TEGE (71–76%) and MMP-generated G1–IPEN (23–29%) fragments. Significant amounts of calpain-generated GDLS and EDLS fragments were found in OA and normal cartilage, and a ARGS–EDLS fragment was detected in arthritic SF samples. The results of the present study indicate that calpains are involved in the C-terminal truncation of aggrecan and might have a minor role in arthritic diseases.

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Activation of the phosphatidylcholine to lysophosphatidylcholine pathway is associated with osteoarthritis knee cartilage volume loss over time: data from a 2-year multicentre clinical trial

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2019.02.675 ◽

2019 ◽

Vol 27 ◽

pp. S288

Author(s):

G. Zhai ◽

J.-P. Pelletier ◽

M. Liu ◽

D. Aitken ◽

E. Randell ◽

...

Keyword(s):

Clinical Trial ◽

Cartilage Volume ◽

Volume Loss ◽

Knee Cartilage ◽

Time Data ◽

Multicentre Clinical Trial ◽

Osteoarthritis Knee ◽

Cartilage Volume Loss ◽

Over Time

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Meta-Analysis and Evidence Base for the Efficacy of Autologous Bone Marrow Mesenchymal Stem Cells in Knee Cartilage Repair: Methodological Guidelines and Quality Assessment

Stem Cells International ◽

10.1155/2019/3826054 ◽

2019 ◽

Vol 2019 ◽

pp. 1-15 ◽

Cited By ~ 6

Author(s):

Mohamed E. Awad ◽

Khaled A. Hussein ◽

Inas Helwa ◽

Mohamed F. Abdelsamid ◽

Alexandra Aguilar-Perez ◽

...

Keyword(s):

Stem Cells ◽

Bone Marrow ◽

Mesenchymal Stem Cells ◽

Cartilage Repair ◽

Meta Analysis ◽

Autologous Bone Marrow ◽

Knee Cartilage ◽

Marrow Mesenchymal Stem Cells ◽

Autologous Bone ◽

Coleman Methodology Score

The aim of this study is to review all the published clinical trials on autologous bone marrow mesenchymal stem cells (BM-MSCs) in the repair of cartilage lesions of the knee. We performed a comprehensive search in three electronic databases: PubMed, Medline via Ovid, and Web of Science. A systematic review was conducted according to the guidelines of PRISMA protocol and the Cochrane Handbook for Systematic Reviews of Interventions. The modified Coleman methodology score was used to assess the quality of the included studies. Meta-analysis was conducted to estimate the effect size for Pain and function change after receiving BM-MSCs. Thirty-three studies—including 724 patients of mean age 44.2 years—were eligible. 50.7% of the included patients received cultured BM-MSCs for knee cartilage repair. There was improvement in the MINORS quality score over time with a positive correlation with the publication year. Meta-analysis indicated better improvement and statistical significance in the Visual Analog Scale for Pain, IKDC Function, Tegner Activity Scale, and Lysholm Knee Score after administration of noncultured BM-MSCs when compared to evaluation before the treatment. Meanwhile, there was a clear methodological defect in most studies with an average modified Coleman methodology score (MCMS) of 55. BM-MSCs revealed a clinically relevant improvement in pain, function, and histological regeneration.

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