The Detection of Arthrokinetic Biomarkers for Osteoarthritis in Partial Medial Meniscectomy Patients

2012 ◽  
Author(s):  
Chelsea Marsh ◽  
Jing Tang ◽  
Scott Tashman
Keyword(s):  
High Risk ◽  
Knee Osteoarthritis ◽  
Structural Damage ◽  
Cartilage Damage ◽  
Surface Damage ◽  
Cartilage Loss ◽  
Meniscal Injury ◽  
Meniscal Tears ◽  
Medial Meniscectomy ◽  
Injured Knee

Meniscal injury has been found to leave patients at high risk for the development of knee osteoarthritis (OA). Partial meniscectomy is often used to treat meniscal tears, and while this procedure adequately addresses pain and the restoration of function, it does not prevent the progression of OA in the injured knee. Often during arthroscopy, surgeons identify areas of “softened” cartilage, which do not always correlate with visible signs of surface damage or cartilage loss. This softening has been related to changes in the cartilage matrix, which could represent early structural damage that can lead to irreversible cartilage damage and OA.

scholarly journals Subregional effects of meniscal tears on cartilage loss over 2 years in knee osteoarthritis

2010 ◽  
Vol 70 (1) ◽  
pp. 74-79 ◽  
Author(s):  
A. Chang ◽  
K. Moisio ◽  
J. S. Chmiel ◽  
F. Eckstein ◽  
A. Guermazi ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Cartilage Loss ◽  
Meniscal Tears

scholarly journals Knee osteoarthritis risk is increased 4-6 fold after knee injury – a systematic review and meta-analysis

2019 ◽  
Vol 53 (23) ◽  
pp. 1454-1463 ◽  
Author(s):  
Erik Poulsen ◽  
Glaucia H Goncalves ◽  
Alessio Bricca ◽  
Ewa M Roos ◽  
Jonas B Thorlund ◽  
...  
Keyword(s):  
Systematic Review ◽  
Knee Osteoarthritis ◽  
Knee Injury ◽  
Meta Analysis ◽  
Acl Injury ◽  
Meniscal Injury ◽  
Knee Oa ◽  
Injured Knee ◽  
Combined Injuries

ObjectiveTo estimate knee osteoarthritis (OA) risk following anterior cruciate ligament (ACL), meniscus or combined ACL and meniscus injury.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, Embase, SPORTDiscus, CINAHL and Web of Science until November 2018.Eligibility criteria for selecting studiesProspective or retrospective studies with at least 2-year follow-up including adults with ACL injury, meniscal injury or combined injuries. Knee OA was defined by radiographs or clinical diagnosis and compared with the contralateral knee or non-injured controls.Study appraisal and synthesisRisk of bias was assessed using the SIGN50 checklist. ORs for developing knee OA were estimated using random effects meta-analysis.Results53 studies totalling ∼1 million participants were included: 185 219 participants with ACL injury, mean age 28 years, 35% females, 98% surgically reconstructed; 83 267 participants with meniscal injury, mean age 38 years, 36% females, 22% confirmed meniscectomy and 73% unknown; 725 362 participants with combined injury, mean age 31 years, 26% females, 80% treated surgically. The OR of developing knee OA were 4.2 (95% CI 2.2 to 8.0; I2=92%), 6.3 (95% CI 3.8 to 10.5; I2=95%) and 6.4 (95% CI 4.9 to 8.3; I2=62%) for patients with ACL injury, meniscal injury and combined injuries, respectively.ConclusionThe odds of developing knee OA following ACL injury are approximately four times higher compared with a non-injured knee. A meniscal injury and a combined injury affecting both the ACL and meniscus are associated with six times higher odds compared with a non-injured knee. Large inconsistency (eg, study design, follow-up period and comparator) and few high-quality studies suggest that future studies may change these estimates.Clinical relevancePatients sustaining a major knee injury have a substantially increased risk of developing knee OA, highlighting the importance of knee injury prevention programmes and secondary prevention strategies to prevent or delay knee OA development.PROSPERO registration number CRD42015016900

scholarly journals SAT0036 ULTRASOUND IN THE ASSESSMENT OF JOINT DAMAGE IN RHEUMATOID ARTHRITIS: A SYSTEMATIC LITERATURE REVIEW BY THE OMERACT ULTRASOUND WORKING GROUP

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 948-948
Author(s):  
I. Gessl ◽  
B. Wildner ◽  
P. Balint ◽  
M. A. D’agostino ◽  
P. Mandl
Keyword(s):  
Rheumatoid Arthritis ◽  
Working Group ◽  
Structural Damage ◽  
Bone Erosion ◽  
Cartilage Damage ◽  
Joint Damage ◽  
Cartilage Loss ◽  
Measurement Properties ◽  
Cochrane Library ◽  
Dominant Hand

Background:The detection of damage in patients with rheumatoid arthritis (RA) is crucial for monitoring of therapy targets as well as for early diagnosis. Conventional radiography (CR) is commonly used to detect structural damage, in the form of bone erosions or loss of hyaline cartilage. Over the last years, musculoskeletal ultrasound (MSUS) was shown to be a sensitive and reliable method to detect erosion and cartilage loss as well as damage to soft tissue structures.Objectives:To identify and synthesize the evidence for the use and measurement properties of MSUS in assessing structural damage in patients with RA.Methods:A systematic literature search (SLR) of the PubMed, Embase and Cochrane Library was performed. Original articles were included that were published in English until 01/01/2019, reporting MSUS of bone erosion, cartilage loss or damage and tendon damage, and the measurement properties of MSUS according to the OMERACT Filter 2.1.Results:Of the 1.266 identified articles 79 were finally included, most of which reported on cross-sectional studies. The majority of the studies used the OMERACT definitions for ultrasonographic pathology. Among these, erosions were assessed in 72 (91.1%), cartilage damage in 12 (15.2%), tendons in 4 (5.1%) studies and enthesophytes in a single (1.3%) study. Erosions were rated by binary grading in 56 (77.8%) studies and by semiquantitative scoring in 27 (37.5%) studies. Global or sum scores were calculated in only 9 (12.5%) studies. Among 23 studies assessing erosions both by US and CR, only 1/23 (4.3%) study found a higher sensitivity of CR as compared to MSUS. Among studies assessing tendons, 3 (75%) used a semiquantitative score and one scored tendon rupture as being present or absent. Cartilage damage was graded in binary fashion, quantitatively by measuring cartilage thickness or semi-quantitatively. Hand joints were the most frequently evaluated joints (58, 73.4%). The overwhelming majority of studies assessed structural damage bilaterally (68, 86.1%), with 5 (6.3%) studies assessing only the dominant hand, 5 (6.3%) studies evaluating the clinically more affected side and 1 (1.3%) study assessing only the right hand. Validity, reliability and responsiveness were assessed in only 8 (10.1%), 10 (12.7%) and 4 (5.1%) studies respectively. Feasibility was not considered in any of the studies.Conclusion:While the results of this SLR suggest that US is a sensitive and feasible tool to detect damage in RA, they also highlight the need for further research and validation. Findings of this SLR will inform the next steps of the Working Group in developing an ultrasound score for assessing structural damage in patients with RA.Disclosure of Interests:None declared

scholarly journals DELAY TO ACL RECONSTRUCTION IN PEDIATRIC AND ADOLESCENT PATIENTS IS ASSOCIATED WITH A LINEAR INCREASE IN THE RISK OF MEDIAL MENISCAL TEARS

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0004
Author(s):  
David A. Kolin ◽  
Brody Dawkins ◽  
Joshua Park ◽  
Peter D. Fabricant ◽  
Allison Gilmore ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Meniscal Tear ◽  
Lateral Meniscus ◽  
Linear Increase ◽  
Meniscal Injury ◽  
Meniscal Tears ◽  
Increased Risk ◽  
Text Figure ◽  
Time From Injury

Background: Anterior cruciate ligament (ACL) tears are frequently associated with meniscal tears. Previous studies have shown that secondary meniscal tears—occurring after the initial ACL injury—are associated with greater delays from injury to ACL reconstruction (ACLR), but frequently use dichotomous categories of acute versus delayed ACLR. Purpose: As meniscal damage is likely accrued constantly over time, we investigated the variability of concurrent meniscal injuries as a function of time from injury to ACLR in a pediatric and adolescent population. Methods: We performed a retrospective review of all patients ≤18 years who underwent an ACLR between 2014 and 2018 at one of two tertiary academic hospitals. Outliers were excluded if time from injury to ACLR was greater than 78 weeks. Records were reviewed to assess patients’ dates of injury and surgery. The prevalence of concurrent medial and/or lateral meniscal injury was evaluated at the time of surgery for each patient. Adjusted relative risks (ARRs) of meniscal injury were calculated using Poisson regression models adjusted for age, sex, and body-mass index. Logistic regression was used to model the predicted probability of medial meniscal tears. Results: 546 patients met inclusion criteria. The mean age of participants was 15.3 years (S.D., 1.6), and 277 (50.7%) patients were male. Overall, 344 (63.0%) patients had a meniscal tear. 169 (49.1%) tears occurred at the medial meniscus, and 257 (74.7%) occurred at the lateral meniscus (Table 1). Compared to females, males had a greater risk of lateral meniscal injury (ARR, 1.46; 95% CI, 1.20-1.77) but not medial meniscal injury (ARR, 1.01; 95% CI, 0.77-1.31) (Figure 1). When considering all meniscal tears, time from injury to ACLR was not associated with increased risk of a tear (ARR, 1.01; 95% CI, 1.00-1.01). However, for medial meniscal tears, there was a significant association between time from injury to ACLR, in weeks, and meniscal tears (ARR, 1.02; 95% CI, 1.01-1.03, P = 0.003). A ten-week delay was associated with a 20% increased risk of medial meniscal injury (Figure 2). Conclusion: In pediatric and adolescent ACLR patients, the risk of any meniscal injury was not associated with delay from injury to surgery. However, the risk of medial meniscal injury increased by 2% each week from injury to surgery. [Table: see text][Figure: see text][Figure: see text]

scholarly journals Relationship between abnormalities detected by magnetic resonance imaging and knee symptoms in early knee osteoarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Seiya Ota ◽  
Eiji Sasaki ◽  
Shizuka Sasaki ◽  
Daisuke Chiba ◽  
Yuka Kimura ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Knee Osteoarthritis ◽  
Cartilage Damage ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Radiographic Evidence ◽  
Cross Sectional ◽  
Meniscal Lesions ◽  
Magnetic Resonance Imaging Mri

AbstractWe investigated the prevalence of magnetic resonance imaging (MRI) findings and their relationship with knee symptoms in women without radiographic evidence of knee osteoarthritis (KOA). This cross-sectional cohort study included 359 Japanese women without radiographic evidence of KOA (Kellgren‒Lawrence grade < 2). All participants underwent T2-weighted fat-suppressed MRI of their knees. Structural abnormalities (cartilage damage, bone marrow lesions [BMLs], subchondral cysts, bone attrition, osteophytes, meniscal lesions, and synovitis) were scored according to the whole-organ MRI score method. Knee symptoms were evaluated using the Knee Injury and Osteoarthritis Outcome Score. Participants were divided into early and non-KOA groups based on early KOA classification criteria. Logistic regression analysis was performed to evaluate the relationship between MRI abnormalities and knee symptoms. Cartilage damage was the most common abnormality (43.5%). The prevalences of cartilage damage, BMLs, subchondral cysts, bone attrition, meniscal lesions, and synovitis were higher in patients with early KOA than in those without. Synovitis (odds ratio [OR] 2.254, P = 0.002) and meniscal lesions (OR 1.479, P = 0.031) were positively associated with the presence of early KOA. Synovitis was most strongly associated with knee pain and might be a therapeutic target in patients with early KOA.

scholarly journals Presence of MRI-detected joint effusion and synovitis increases the risk of cartilage loss in knees without osteoarthritis at 30-month follow-up: the MOST study

2011 ◽  
Vol 70 (10) ◽  
pp. 1804-1809 ◽  
Author(s):  
Frank W Roemer ◽  
Ali Guermazi ◽  
David T Felson ◽  
Jingbo Niu ◽  
Michael C Nevitt ◽  
...  
Keyword(s):  
Cartilage Damage ◽  
Multivariable Analysis ◽  
Cartilage Loss ◽  
Joint Effusion ◽  
Proton Density ◽  
Osteoarthritis Of The Knee ◽  
Radiographic Osteoarthritis ◽  
Baseline Visit ◽  
Increased Risk

ObjectiveTo evaluate if two different measures of synovial activation, baseline Hoffa synovitis and effusion synovitis, assessed by MRI, predict cartilage loss in the tibiofemoral joint at 30 months follow-up in subjects with neither cartilage damage nor tibiofemoral radiographic osteoarthritis of the knee.MethodsNon-contrast-enhanced MRI was performed using proton density-weighted fat-suppressed sequences in the axial and sagittal planes and a short tau inversion recovery sequence in the coronal plane. Hoffa synovitis, effusion synovitis and cartilage status were assessed semiquantitatively according to the WORMS scoring system. Included were knees that had neither radiographic osteoarthritis nor MRI-detected tibiofemoral cartilage damage at the baseline visit. The presence of Hoffa synovitis was defined as any grade ≥2 (range 0–3) and effusion synovitis as any grade ≥2 (range 0–3). Logistic regression was performed to examine the relation of the presence of either measure to the risk of cartilage loss at 30 months adjusting for other potential confounders.ResultsOf 514 knees included in the analysis, the prevalence of Hoffa synovitis and effusion synovitis at the baseline visit was 8.4% and 10.3%, respectively. In the multivariable analysis, baseline effusion synovitis was associated with an increased risk of cartilage loss. No such association was observed for baseline Hoffa synovitis.ConclusionsBaseline effusion synovitis, but not Hoffa synovitis, predicted cartilage loss. The findings suggest that effusion synovitis, a reflection of inflammatory activity including joint effusion and synovitic thickening, may play a role in the future development of cartilage lesions in knees without osteoarthritis.

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