Post traumatic osteoarthritis: baseline synovial fluid biomarkers are associated with cartilage biochemistry measured using MRI one year after ACL reconstruction

Background: Osteoarthritis (OA) in the anterior cruciate ligament (ACL)–deficient knee is seen in approximately 50% of affected patients. Possible causes include biochemical or biomechanical changes. Purpose: We sought to study the correlation between inflammatory cytokines and chondral damage in ACL-deficient knees. Methods: Seventy-six male patients who underwent ACL reconstruction were enrolled in a cross-sectional study. Synovial fluid was aspirated before surgery and analyzed for levels of the inflammatory cytokines tumor necrosis factor-α, interleukin-1 (IL-1), and interleukin-6 (IL-6). At the time of ACL reconstruction, the severity of chondral damage was documented as described by the Outerbridge classification. Results: Patients with grade 2 or higher chondral damage were observed to have elevated IL-6 levels when compared to patients who had no chondral damage. Interleukin-6 levels had no correlation with the duration of injury. Conclusion: Elevated levels of IL-6 in synovial fluid were associated with chondral damage in ACL-deficient knees. Further study is warranted to determine whether inflammatory cytokines contribute to the development of OA of the knee after ACL injury.

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Across the COVID-19 Waves; Assessing Temporal Fluctuations in Perceived Stress, Post-Traumatic Symptoms, Worry, Anxiety and Civic Moral Disengagement over One Year of Pandemic

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115651 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5651

Author(s):

Alessio Gori ◽

Eleonora Topino

Keyword(s):

Perceived Stress ◽

State Anxiety ◽

Moral Disengagement ◽

Online Survey ◽

Well Being ◽

First Year ◽

Effective Interventions ◽

Post Traumatic ◽

One Year ◽

Traumatic Symptoms

This study aimed at investigating the psychological effect of the COVID-19 pandemic in Italy by analysing the trends of perceived stress, post-traumatic symptoms, state anxiety, worry, and civic moral disengagement in four different moments from March 2020 to March 2021. The study involved a total of 1827 Italian participants (30% men and 70% women; Mage = 34.72; SD = 12.40) divided into four groups to which an online survey was administered. The first group completed the survey in March 2020, the second one in August 2020, the third one in November 2020, and the fourth one in March 2021. Results highlighted significant decreases in post-traumatic symptoms and a significant increase in civic moral disengagement over the first year of the COVID-19 pandemic. The levels of perceived stress, worry, and state anxiety remained constant. The correlations between the variables at different times were also explored, as well as gender differences over the year. The COVID-19 emergency has had significant effects on the mental state of the population, with important repercussions for individual and collective well-being during but probably also after the pandemic. This study offers a clear snapshot of the psychological outcomes over one COVID-19 pandemic year, providing important information that may contribute to tailor more effective interventions for mental health.

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An Evidence-Based Systematic Review of Human Knee Post-Traumatic Osteoarthritis (PTOA): Timeline of Clinical Presentation and Disease Markers, Comparison of Knee Joint PTOA Models and Early Disease Implications

International Journal of Molecular Sciences ◽

10.3390/ijms22041996 ◽

2021 ◽

Vol 22 (4) ◽

pp. 1996 ◽

Cited By ~ 1

Author(s):

Christine M. Khella ◽

Rojiar Asgarian ◽

Judith M. Horvath ◽

Bernd Rolauffs ◽

Melanie L. Hart

Keyword(s):

Synovial Fluid ◽

Knee Joint ◽

Ex Vivo ◽

Disease Process ◽

Early Disease ◽

Knee Trauma ◽

Post Traumatic ◽

Acute Knee

Understanding the causality of the post-traumatic osteoarthritis (PTOA) disease process of the knee joint is important for diagnosing early disease and developing new and effective preventions or treatments. The aim of this review was to provide detailed clinical data on inflammatory and other biomarkers obtained from patients after acute knee trauma in order to (i) present a timeline of events that occur in the acute, subacute, and chronic post-traumatic phases and in PTOA, and (ii) to identify key factors present in the synovial fluid, serum/plasma and urine, leading to PTOA of the knee in 23–50% of individuals who had acute knee trauma. In this context, we additionally discuss methods of simulating knee trauma and inflammation in in vivo, ex vivo articular cartilage explant and in vitro chondrocyte models, and answer whether these models are representative of the clinical inflammatory stages following knee trauma. Moreover, we compare the pro-inflammatory cytokine concentrations used in such models and demonstrate that, compared to concentrations in the synovial fluid after knee trauma, they are exceedingly high. We then used the Bradford Hill Framework to present evidence that TNF-α and IL-6 cytokines are causal factors, while IL-1β and IL-17 are credible factors in inducing knee PTOA disease progresssion. Lastly, we discuss beneficial infrastructure for future studies to dissect the role of local vs. systemic inflammation in PTOA progression with an emphasis on early disease.

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Across the COVID-19 Waves; Assessing Temporal Fluctuations in Perceived Stress, Post-Traumatic Symptoms, Worry, Anxiety and Civic-Moral Disengagement Over One Year of Pandemic

SSRN Electronic Journal ◽

10.2139/ssrn.3825512 ◽

2021 ◽

Author(s):

Alessio Gori ◽

Eleonora Topino

Keyword(s):

Perceived Stress ◽

Moral Disengagement ◽

Temporal Fluctuations ◽

Post Traumatic ◽

One Year ◽

Traumatic Symptoms

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One-year clinical outcomes following theta burst stimulation for post-traumatic stress disorder

Neuropsychopharmacology ◽

10.1038/s41386-019-0584-4 ◽

2019 ◽

Vol 45 (6) ◽

pp. 940-946 ◽

Cited By ~ 4

Author(s):

Nicholas J. Petrosino ◽

Mascha van ’t Wout-Frank ◽

Emily Aiken ◽

Hannah R. Swearingen ◽

Jennifer Barredo ◽

...

Keyword(s):

Transcranial Magnetic Stimulation ◽

Clinical Outcomes ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Magnetic Stimulation ◽

Stress Disorder ◽

Post Traumatic Stress ◽

Post Traumatic ◽

One Year ◽

Theta Burst

AbstractTheta burst transcranial magnetic stimulation (TBS) is a potential new treatment for post-traumatic stress disorder (PTSD). We previously reported active intermittent TBS (iTBS) was associated with superior clinical outcomes for up to 1-month, in a sample of fifty veterans with PTSD, using a crossover design. In that study, participants randomized to the active group received a total of 4-weeks of active iTBS, or 2-weeks if randomized to sham. Results were superior with greater exposure to active iTBS, which raised the question of whether observed effects persisted over the longer-term. This study reviewed naturalistic outcomes up to 1-year from study endpoint, to test the hypothesis that greater exposure to active iTBS would be associated with superior outcomes. The primary outcome measure was clinical relapse, defined as any serious adverse event (e.g., suicide, psychiatric hospitalization, etc.,) or need for retreatment with repetitive transcranial magnetic stimulation (rTMS). Forty-six (92%) of the initial study’s intent-to-treat participants were included. Mean age was 51.0 ± 12.3 years and seven (15.2%) were female. The group originally randomized to active iTBS (4-weeks active iTBS) demonstrated superior outcomes at one year compared to those originally randomized to sham (2-weeks active iTBS); log-rank ChiSq = 5.871, df = 1, p = 0.015; OR = 3.50, 95% CI = 1.04–11.79. Mean days to relapse were 296.0 ± 22.1 in the 4-week group, and 182.0 ± 31.9 in the 2-week group. When used, rTMS retreatment was generally effective. Exploratory neuroimaging revealed default mode network connectivity was predictive of 1-year outcomes (corrected p < 0.05). In summary, greater accumulated exposure to active iTBS demonstrated clinically meaningful improvements in the year following stimulation, and default mode connectivity could be used to predict longer-term outcomes.

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Functional evaluation of patients treated with osteochondral allograft transplantation for post-traumatic ankle arthritis: One year follow-up

Gait & Posture ◽

10.1016/j.gaitpost.2013.04.020 ◽

2013 ◽

Vol 38 (4) ◽

pp. 945-950 ◽

Cited By ~ 6

Author(s):

L. Berti ◽

F. Vannini ◽

G. Lullini ◽

P. Caravaggi ◽

A. Leardini ◽

...

Keyword(s):

Osteochondral Allograft ◽

Functional Evaluation ◽

Ankle Arthritis ◽

Allograft Transplantation ◽

Post Traumatic ◽

One Year

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Cefsulodin Treatment for Serious Pseudomonas aeruginosa Infections

Journal of International Medical Research ◽

10.1177/030006058601400504 ◽

1986 ◽

Vol 14 (5) ◽

pp. 242-253 ◽

Cited By ~ 2

Author(s):

A Routman ◽

W Van Manen ◽

R Haddad ◽

B Pollock ◽

B Holmes ◽

...

Keyword(s):

Pseudomonas Aeruginosa ◽

Respiratory Tract Infections ◽

Adverse Reactions ◽

Severe Trauma ◽

Lower Respiratory Tract Infections ◽

Alcohol And Drugs ◽

Post Traumatic ◽

Satisfactory Clinical Response ◽

One Year ◽

Tract Infections

Cefsulodin, a narrow-spectrum cephalosporin with excellent antipseudomonal activity was used to treat 48 patients with 51 Pseudomonas aeruginosa infections. These included osteomyelitis, infected prostheses, post-operative and post-traumatic superficial wounds, decubitus and stasis ulcers, lower respiratory tract infections and infections of the urinary tract. Many of the patients were compromised by underlying debilitating conditions such as severe trauma, diabetes mellitus, vascular impairment, and abuse of alcohol and drugs. In cases of polymicrobial infections, a concomitant non-antipseudomonal antibiotic was sometimes administered. Cefsulodin was administered intravenously to 47 patients and by intramuscular injections to one individual. The dosage ranged from 0.5 to 2.0 g every six hr and duration of therapy was from 4 to 70 days. A satisfactory clinical response was observed in 88% of the patients. P. aeruginosa was eradicated from 76% of the infection sites. Failures, which included relapse within one year, were generally associated with prior severe trauma or vascular impairment in cases of osteomyelitis. Reinfections and superinfections developed in 12 individuals. Adverse reactions reported for two patients were nausea and vomiting. A third patient had transient increases in alkaline phosphatase and SGOT. These data indicate that cefsulodin is an effective and safe antibiotic in various types of P. aeruginosa infections.

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The Associated Meniscal Tears and Associated Risk Factors in Concomitant ACL Injuries of the Knee: A Retrospective Analysis

Birat Journal of Health Sciences ◽

10.3126/bjhs.v5i1.29639 ◽

2020 ◽

Vol 5 (1) ◽

pp. 981-985

Author(s):

Rosan Prasad Shah Kalawar ◽

Pashupati Chaudhary ◽

Raju Rijal ◽

Bishnu Pokharel

Keyword(s):

Risk Factors ◽

Acl Reconstruction ◽

Injury Risk ◽

Meniscus Tear ◽

Acl Injuries ◽

Arthroscopic Findings ◽

History Of ◽

Post Traumatic ◽

Associated Risk Factors ◽

Primary Acl Reconstruction

Introduction: The pattern of meniscus tear has significant impact onsubsequent rehabilitation and functional outcome as theyare usually associated with ACL injury.Knowledge about associated meniscus tear helps to identifypatients in the early post-traumatic phase. Objectives: To study meniscus tear patterns and associationbetween different tear patterns of meniscus in ACLinjured subjects and to identify potential demographic andother associated risk factors. Methodology: Routine arthroscopic findings database of 54 patientsoperated for primary ACL reconstruction from January 2017to December 2018 was used to study associated tear of meniscus. Based on arthroscopic evaluation, cases weregrouped into meniscus having no tear, minor tear and majortear. Major tear included complete radial tears, root tearsand unstable longitudinal tears including bucket-handletears. Result: Totalarthroscopycasesinthestudydurationwere124.Ofthose,43% (n=54) underwent ACL reconstruction (ACLR) for tornACL. Among the patients who underwent ACLR, 58% had notear, 26%hadminortears, and16%hadmajortears ofthemeniscus. Therewere significant differencesbetweenthree groups for gender, age groupsandmechanism of injury. Risk factors formajortearsweremalegenderandage<30years.Minorandmajortears were associated with a contact injury. Conclusion: Male, age <30 years and history of contact injury havehigh risks for having an associated meniscus tear. Earlyreferral to magnetic resonance imaging and/or arthroscopyis recommended to allow meniscus repair in a timelymanner.

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