Gender Disparity between Absolute versus Relative Size of Condylar Chondral Defects: An MRI Analysis

2018 ◽  
Vol 32 (05) ◽  
pp. 448-453 ◽  
Author(s):  
Daniel Berman ◽  
Kelly Rogers ◽  
Justin Griffin ◽  
Kevin Bonner
Keyword(s):  
Articular Cartilage ◽  
Relative Size ◽  
Gender Disparity ◽  
Defect Size ◽  
Cartilage Defects ◽  
Lateral Condyle ◽  
Female Patients ◽  
Chondral Defects ◽  
Significant Difference ◽  
Males And Females

AbstractSurgical repair of articular cartilage defects in the knee currently utilizes surgical algorithms based on absolute defect size. These algorithms, which have not been validated, are currently utilized not only by surgeons but also by insurance carriers for justification of reimbursement policy. However, current algorithms do not account for morphological differences between individual patients and defect size relative to condylar dimension. We hypothesized that a significant difference in relative defect size compared with condylar dimension may exist between individuals. A 3T magnetic resonance imaging from 220 skeletally mature patients, 110 males and 110 females, were analyzed. Exclusion criteria included degenerative arthritis, anatomical defects, poor image quality, and genetic abnormalities such as dwarfism. Utilizing a radiological curved measurement probe, the femoral condylar articular width was obtained for both the medial and lateral condyles. The mean condylar width from a reproducible anatomic location representing the maximal condylar dimension was measured. Statistical analysis was performed using a two-sample t-test. The lateral condyle articular cartilage width (mm) for males and females was 31.62 ± 3.54 and 26.53 ± 3.70, respectively (p < 0.0001). The medical condyle articular cartilage width was 27.26 ± 4.42 and 23.05 ± 4.11 (p < 0.00001). There was a width variation up to 22.66 mm between male patients and 22.10 mm between female patients. Differences up to 28.26 mm were found between males and females. A condylar defect measuring 10 mm represents as little as 24.29% of a condyle in some males versus as much as 77.46% in smaller females. Existing surgical algorithms for condylar chondral defects apply absolute size to patients regardless of individual condylar variations. Our study suggests the relative sizes of the defect vary significantly from male to female patients as well as within the same gender. Future studies may investigate clinical outcomes utilizing surgical algorithms that take into account these differences.

scholarly journals Autologous Matrix-Induced Chondrogenesis for Treatment of Focal Cartilage Defects in the Knee: A Follow-up Study

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098187
Author(s):  
Justus Gille ◽  
Ellen Reiss ◽  
Moritz Freitag ◽  
Jan Schagemann ◽  
Matthias Steinwachs ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Demographic Data ◽  
Case Series ◽  
Defect Size ◽  
Lysholm Score ◽  
Outcome Analysis ◽  
Cartilage Defects ◽  
Chondral Defects ◽  
The Mean

Background: Autologous matrix-induced chondrogenesis (AMIC) is a well-established treatment for full-thickness cartilage defects. Purpose: To evaluate the long-term clinical outcomes of AMIC for the treatment of chondral lesions of the knee. Study Design: Case series; Level of evidence, 4. Methods: A multisite prospective registry recorded demographic data and outcomes for patients who underwent repair of chondral defects. In total, 131 patients were included in the study. Lysholm, Knee injury and Osteoarthritis Outcome Score (KOOS), and visual analog scale (VAS) score for pain were used for outcome analysis. Across all patients, the mean ± SD age of patients was 36.6 ± 11.7 years. The mean body weight was 80.0 ± 16.8 kg, mean height was 176.3 ± 7.9 cm, and mean defect size was 3.3 ± 1.8 cm2. Defects were classified as Outerbridge grade III or IV. A repeated-measures analysis of variance was used to compare outcomes across all time points. Results: The median follow-up time for the patients in this cohort was 4.56 ± 2.92 years. Significant improvement ( P < .001) in all scores was observed at 1 to 2 years after AMIC, and improved values were noted up to 7 years postoperatively. Among all patients, the mean preoperative Lysholm score was 46.9 ± 19.6. At the 1-year follow-up, a significantly higher mean Lysholm score was noted, with maintenance of the favorable outcomes at 7-year follow-up. The KOOS also showed a significant improvement of postoperative values compared with preoperative data. The mean VAS had significantly decreased during the 7-year follow-up. Age, sex, and defect size did not have a significant effect on the outcomes. Conclusion: AMIC is an effective method of treating chondral defects of the knee and leads to reliably favorable results up to 7 years postoperatively.

scholarly journals Particulate Juvenile Articular Cartilage vs Osteochondral Allograft for Patellar Cartilage Defects: A Matched Cohort Analysis

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0051
Author(s):  
Niv Marom ◽  
Francesca Coxe ◽  
Dean Wang ◽  
Riley Williams ◽  
Gabriella Ode
Keyword(s):  
Patient Reported Outcomes ◽  
Cohort Analysis ◽  
Osteochondral Allograft ◽  
Cartilage Defects ◽  
Matched Cohort ◽  
Chondral Defects ◽  
Sf 36 ◽  
Cartilage Restoration ◽  
Significant Difference ◽  
Patient Reported

Objectives: Management of full-thickness cartilage defects of the patella remains a significant clinical challenge. Osteochondral allograft transplantation (OCA) is a reliable cartilage restoration procedure for large chondral defects of the knee. OCA reports good long-term outcomes for condylar defects but limited literature on outcomes of patellar defects. Since 2007, particulated juvenile articular cartilage (PJAC) has been used as an alternative method of cartilage restoration. PJAC has demonstrated promising early clinical outcomes, however, no studies have directly compared the clinical and patient reported outcomes of PJAC and OCA for management of full thickness chondral defects of the patella. Methods: Prospective data was collected for patients within our institutional cartilage registry who underwent OCA or PJAC using DeNovo NT (Zimmer-Biomet) for management of grade 4 cartilage defects of the patella. OCA patients were matched to PJAC patients by age, sex and BMI. Patient characteristics and minimum 2-year patient reported outcomes (PROMs) (Knee Outcome Survey-Activities of Daily Living (KOS-ADL) score, International Knee Documentation Committee (IKDC) score, Short Form 36 (SF-36) pain rating, and Marx Activity Rating Scale) and self-reported general overall knee condition were reported. Results: There were 28 patients eligible for analysis (14 OCA, 14 PJAC). Demographics of the two groups are outlined in Table 1. The mean age of the entire cohort was 38.4 +/- 11.4 years with a mean BMI of 24.6 +/- 3.1. One patient in each group had bipolar transplantation (patella and trochlea). OCA patients had more previous surgeries (1.4 vs 0.4) (p<0.01) and significantly larger chondral defects (4.6 cm2 vs. 2.5 cm2) (p<0.01) than PJAC patients. Patient reported outcomes are reported in Figure 1. IKDC, KOS-ADL and SF-36-Pain scores improved by 17, 16 and 14 points for OCA compared to 17, 11, and 23 points for PJAC at last follow-up (average 3.5 years) (p>0.05). Both groups met the published MCID for IKDC (17 pts) and KOS-ADL (10 pts) for osteochondral grafts. There was no significant difference between OCA and PJAC for all postoperative PROMs. The reoperation rate for OCA and PJAC was 36% and 50% respectively (p>0.05). There were 4 graft failures in the PJAC group (29%) and 1 failure in the OCA group (6%) (p>0.05). The failed OCA underwent manipulation and lysis of adhesions for post-operative stiffness at 7 months and arthroscopic synovectomy for synovitis at 8 months after OCA. The four failed PJAC patients underwent revision to OCA (at 8 months), chondroplasty of the graft (at 10 and 26 months), and revision to TKA (at 78 months). Reoperations are further described in Table 2. Conclusion: In a matched cohort analysis, both PJAC and OCA demonstrated significant clinical improvement in patient reported outcomes with no significant difference between the two groups at mean 3.5 years. Larger investigational studies are needed to determine optimal indications for use of PJAC versus OCA for management of focal cartilage defects of the patella. [Table: see text][Table: see text]

Cardiac Iron Loading Measured by Multislice Multiecho T2* MRI and Cardiac Disease In Male and Female Patients with Thalassemia Major

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4268-4268
Author(s):  
Alessia Pepe ◽  
Maria Marsella ◽  
Antonella Meloni ◽  
Valeria Caldarelli ◽  
Maria Chiara Dell'Amico ◽  
...  
Keyword(s):  
Iron Overload ◽  
Cardiac Disease ◽  
Chelation Therapy ◽  
Thalassemia Major ◽  
Myocardial Iron ◽  
Heart Dysfunction ◽  
Female Patients ◽  
Cardiac Iron ◽  
Significant Difference ◽  
Males And Females

Abstract Abstract 4268 Introduction. Heart disease remains the main cause of mortality in thalassemia major patients. Female patients with thalassemia major have a proved lower prevalence of cardiac complications than males and survive longer. It has been suggested that females have a better compliance than males, and therefore accumulate less iron in crucial organs like the heart (Borgna-Pignatti C et al, Haematologica 2004). The aim of our study was to verify if the decreased prevalence of cardiac disease in females could be attributed to lesser iron accumulation in their hearts as measured by multislice multiecho T2* Magnetic Resonance Imaging (MRI) technique. Methods. We performed a retrospective review of the MRI results and of clinical data about the thalassemia major patients enrolled in the Myocardial Iron Overload in Thalassemia (MIOT) project. The MIOT is a network where MRI is performed using standardized and validated procedures and the MRI and thalassemia centers are linked by a web-based network, configured to collect patients' clinical and diagnostic data (Meloni A et al, Int J Med Inform 2009). Myocardial iron concentrations were measured by T2* multislice multiecho technique (Pepe A et al, JMRI 2006).Biventricular function parameters were quantitatively evaluated by cine images. Results. Seven hundred and seventy six thalassemia patients (370 males) were present in the MIOT database having undergone at least one MRI exam. The prevalence of cardiac disease (heart dysfunction and/or arrhythmias requiring medications) was significantly higher in males than in females (males 28% vs females 17%; P<0.0001). The analysis of different chelation treatments did not demonstrate a significant difference between patients with and without cardiac disease (P=0.59), nor between sexes (P=0.46). In addition, there was no difference in the reported compliance to chelation therapy between males and females (P=0.52). Global heart T2* values were significantly lower in both males and females with heart dysfunction (males: 20 ± 15 ms; females: 18 ± 12 ms), compared to those without dysfunction (males: 29 ± 11 ms; females: 27 ± 13 ms) (P<0.0001), but no difference was observed according to sex (Figure 1A). Global heart T2* values were not significantly lower in patients with arrhythmias compared to those without arrhythmias, nor was there a significant difference between sexes (Figure 1B). Conclusions. The confirmed higher prevalence of cardiac disease in males with thalassemia major was not correlated to a worse compliance to chelation therapy or to an higher cardiac iron burden. Increased survival of female thalassemia major patients seems to not be attributed to lower cardiac iron overload. It can be hypothesized that females tolerate iron toxicity better, possibly as an effect of reduced sensitivity to chronic oxidative stress. Disclosures: No relevant conflicts of interest to declare.

Gender-related outcomes of chimney EVAR within the PERICLES registry

Vascular ◽  
2018 ◽  
Vol 26 (6) ◽  
pp. 641-646 ◽  
Author(s):  
G Torsello ◽  
MV Usai ◽  
S Scali ◽  
P Kubilis ◽  
FJ Veith ◽  
...  
Keyword(s):  
Graft Patency ◽  
Rank Test ◽  
Female Group ◽  
Fisher Exact Test ◽  
Type I ◽  
Exact Test ◽  
Female Patients ◽  
Chimney Technique ◽  
Significant Difference ◽  
Males And Females

Objective Gender-related differences in outcomes in complex endovascular aortic repair have not been profoundly investigated. Use of low profile abdominal devices as in chimney endovascular repair may be beneficial for female patients with pararenal pathologies. With the chimney technique, there is no need for large introduction sheaths. This could be an advantage in case of smaller in diameter iliac access especially in combination with stenosis or elongation. Aim of the present study was to compare the perioperative and mid-term outcomes between males and females patients treated with the chimney/snorkel technique for pararenal aortic pathologies. Methods The PERICLES registry collected the world wide experience with the chimney technique. According to the gender, patients were classified in two cohorts. Primary endpoints were freedom from occlusion of the chimney grafts and reintervention. Secondary endpoints included access site complications and need for surgical or interventional revision, Endoleak Type I rate, 30-day overall complications and mortality. Univariate comparison P-values were generated using either the likelihood ratio χ2 test, the Fisher exact test, the Wilcoxon rank sum test, or the log rank test. Kaplan–Meier curves estimated the outcomes in the long run. Results A total of 412 patients underwent Ch-EVAR, 71 (17%) females and 341 (83%) males with a mean age for both groups being 74 years were included in the present study. After 36 months of mean follow-up, no statistically significant difference was observed between the two cohorts regarding re-interventions ( P= .44). Freedom from occlusion rates at 36 months did not differed between the two groups (females 84% vs. 80% for males ( P= .033). For patients receiving more than one chimney stent, the odds of having a complication did not differ between males and females (M:F OR = 2.0, 95% CI: 0.6–6.4, P = 0.228); 30-day mortality was 0% in the female group, instead five male patients died within one month. ( P = 0.59). The incidence of acute renal failure was low in both groups without statistical difference: 2 (3.1%) vs. 13 (4.6%) 58 ( P = 1.00). Neither patient received an endoconduit to insert the abdominal device. Conclusions No statistically significant difference regarding the freedom from reintervention and chimney graft patency was observed between the two genders. The results highlight the beneficial use of the chimney technique in female patients who can have potentially higher risk of access complications.

Rats Display Sexual Dimorphism in Phosphorylation of Brain Tau with Age

2021 ◽  
pp. 1-15
Author(s):  
Jiahui Niu ◽  
Khalid Iqbal ◽  
Fei Liu ◽  
Wen Hu
Keyword(s):  
Sexual Dimorphism ◽  
Older Women ◽  
Brain Regions ◽  
Gender Disparity ◽  
Female Rats ◽  
Tau Pathology ◽  
Western Blots ◽  
Total Tau ◽  
Significant Difference ◽  
Males And Females

Background: Women have a two-fold higher risk than men to Alzheimer’s disease (AD) at midlife. Larger brain tau burden was consistently shown in older women than age-matched men. The biological basis for this gender disparity remains elusive. Objective: We sought to know whether tau expression and phosphorylation physiologically differ between males and females. Methods: We used western blots and immunohistochemistry to compare the levels of total tau and phosphorylated tau in the hippocampus and entorhinal cortex (EC) between sexes in Wistar rats at 40 days, and 8 and 20 months of age. Results: We detected no statistically significant difference in total tau, 3R-tau, and 4R-tau between sexes. However, female rats exhibited lower levels of tau unphosphorylated at the Tau-1 site at 40 days of age. At 8 months of age, females showed higher levels of tau phosphorylated at Ser190, Ser387, and Ser395 (Ser199, Ser396, and Ser404 of human tau, respectively) than males in EC. At 20 months of age, both brain regions of female rats consistently showed higher levels than males of tau phosphorylated at Ser253, Ser387, PHF-1 (Ser387/395), and Ser413 sites, which correspond to Ser262, Ser396, Ser396/404, and Ser422 of human tau, respectively. Conclusion: Rats of both sexes have comparable levels of total tau, 3R-tau, and 4R-tau, whereas females exhibit higher levels of tau phosphorylated at multiple sites that are implicated in AD tau pathology, indicating a sexual dimorphism of tau phosphorylation that may potentially underlie the disparity in brain tau burden and risk for AD between sexes.

scholarly journals Treatment of Unicompartmental Cartilage Defects of the Knee with Unicompartmental Knee Arthroplasty, Patellofemoral Partial Knee Arthroplasty or Focal Resurfacing

Life ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 394
Author(s):  
Bernhard Springer ◽  
Friedrich Boettner
Keyword(s):  
Articular Cartilage ◽  
Conservative Treatment ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Treatment Options ◽  
Cartilage Defects ◽  
Osteoarthritis Of The Knee ◽  
Chondral Defects ◽  
Focal Resurfacing ◽  
Partial Knee Replacement

Focal chondral defects are common lesions of the articular cartilage. They are predominantly found on the medial femoral condyle and often progress to osteoarthritis of the knee. Various conservative treatment options are available. The conservative treatment might reduce pain and delay the progress of degenerative processes. However, restoration of the articular cartilage cannot be accomplished. If the conservative treatment fails unicompartmental arthroplasty, patellofemoral joint replacement or focal resurfacing are reasonable options to postpone total knee arthroplasty. A careful patient selection before surgery is crucial for all three treatment options. The following overview reports indications and outcomes of medial partial knee replacement, patellofemoral partial knee replacement, and focal resurfacing treatment options for focal chondral defects.

Gender Disparity in Employment and Wages in Rural Labour Market in Odisha: Some Survey Findings and Empirical Analysis

2021 ◽  
Keyword(s):  
Labour Market ◽  
Empirical Analysis ◽  
Agricultural Development ◽  
Gender Disparity ◽  
Female Labour ◽  
Agricultural Work ◽  
Positive Difference ◽  
Significant Difference ◽  
Males And Females ◽  
Gender Based

Gender disparity prevails through various attributes, including gender specificity of agricultural operations, discriminating women in terms of wages, and system of wage payments. This paper employed a t-test to investigate the degree of gender disparity in the rural labour market in Cuttack district of Odisha, covering one irrigated village, Bahalpada, and a non-irrigated village Erancha with a sample of 50 female labourers, 20 male labourers, and ten employers from each village, where irrigation was used as the indicator of agricultural development. The results indicated no significant difference in the days of work available to males and females in farm activities in the irrigated village Bahalpada; however, there was a significant positive difference in male-female labour days in agricultural work non-irrigated village Erancha. Despite non-significant differences in days of employment in farm activities, the gender-based wage differentials persisted and were more pronounced in the non-irrigated village than in irrigated villages.

Erratum to: Gender Disparity between Absolute versus Relative Size of Condylar Chondral Defects: An MRI Analysis

2018 ◽  
Vol 32 (05) ◽  
pp. e1-e1
Author(s):  
Daniel Berman ◽  
Kelly Rogers ◽  
Justin Griffin ◽  
Kevin Bonner
Keyword(s):  
Relative Size ◽  
Gender Disparity ◽  
Chondral Defects

scholarly journals Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures for Chondral Defects of the Talar Shoulder: A Five-Year Follow-Up Prospective Cohort Study

Life ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 244
Author(s):  
Filippo Migliorini ◽  
Jörg Eschweiler ◽  
Nicola Maffulli ◽  
Hanno Schenker ◽  
Arne Driessen ◽  
...  
Keyword(s):  
Defect Size ◽  
Cartilage Defects ◽  
Type I ◽  
Foot And Ankle ◽  
Chondral Defects ◽  
Prior Surgery ◽  
The Mean ◽  
Length Of Hospitalization ◽  
Tegner Activity Scale

Introduction: Many procedures are available to manage cartilage defects of the talus, including microfracturing (MFx) and Autologous Matrix Induced Chondrogenesis (AMIC). Whether AMIC or MFx are equivalent for borderline sized defects of the talar shoulder is unclear. Thus, the present study compared the efficacy of primary isolated AMIC versus MFx for borderline sized focal unipolar chondral defects of the talar shoulder at midterm follow-up. Methods: Patients undergoing primary isolated AMIC or MFx for focal unipolar borderline sized chondral defects of the talar shoulder were recruited prospectively. For those patients who underwent AMIC, a type I/III collagen resorbable membrane was used. The outcomes of interest were: Visual Analogic Scale (VAS), Tegner Activity Scale, American Orthopedic Foot and Ankle Score (AOFAS). The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) was assessed by a blinded radiologist, who had not been involved in the clinical management of the patients. Data concerning complication rate and additional procedures were also collected. Results: The mean follow-up was 43.5 months. The mean age of the 70 patients at operation was 32.0 years, with a mean defect size of 2.7 cm2. The mean length of hospitalization was shorter in the MFx cohort (p = 0.01). No difference was found between the two cohorts in terms of length of prior surgery symptoms and follow-up, mean age and BMI, sex and side, and defect size. At a mean follow-up of 43.5 months, the AOFAS (p = 0.03), VAS (p = 0.003), and Tegner (p = 0.01) scores were greater in the AMIC group. No difference was found in the MOCART score (p = 0.08). The AMIC group evidenced lower rates of reoperation (p = 0.008) and failure (p = 0.003). Conclusion: At midterm follow-up, AMIC provides better results compared to MFx.

Cartilage Restoration: Microfracture and Osteochondral Autograft Transplantation

2018 ◽  
Vol 31 (03) ◽  
pp. 231-238 ◽  
Author(s):  
Michael Redondo ◽  
Adam Beer ◽  
Adam Yanke
Keyword(s):  
Articular Cartilage ◽  
Weight Bearing ◽  
Symptomatic Relief ◽  
Autologous Transplantation ◽  
Cartilage Defects ◽  
Osteochondral Autograft ◽  
Cartilage Lesions ◽  
Chondral Defects ◽  
Osteochondral Autograft Transplantation ◽  
Cartilage Restoration

AbstractThe treatment of patellofemoral cartilage defects presents several distinct challenges when compared with cartilage restoration techniques used for other compartments of the knee due to the unique anatomy and distribution of forces. The etiologies of patellofemoral articular cartilage lesions include acute traumatic instability injuries, such as dislocation and subluxation, osteochondritis dissecans, and chronic degenerative changes. Regardless of the etiology, untreated patellofemoral cartilage lesions can contribute to activity-limiting anterior knee pain. The goal of patellofemoral cartilage restoration procedures is to impart symptomatic relief and improve quality of life by repairing the articular cartilage surface and any comorbid malalignment or maltracking.Microfracture and osteochondral autograft transplantation (OAT) are two cartilage restoration procedures to consider when treating full-thickness patellofemoral chondral defects. Considered by some experts to be the gold standard therapy, microfracture is one of the most common procedures used for cartilage restoration. The technique involves the perforation of the subchondral bone plate for the release of marrow elements, filling the defect with a fibrocartilage clot repair. Though less commonly used, OAT allows defect replacement with native hyaline cartilage via autologous transplantation from a non-weight bearing area. The purpose of this article is to discuss the indication, technical considerations, and outcomes of microfracture and OAT when used for treating chondral lesions of the patellofemoral joint.

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