A New Histology Scoring System for the Assessment of the Quality of Human Cartilage Repair: ICRS II

2010 ◽  
Vol 38 (5) ◽  
pp. 880-890 ◽  
Author(s):  
Pierre Mainil-Varlet ◽  
Boudewijn Van Damme ◽  
Dobrila Nesic ◽  
Gunnar Knutsen ◽  
Rita Kandel ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Scoring System ◽  
Human Cartilage

Arthroscopic International Cartilage Repair Society Classification System Has Only Moderate Reliability in a Porcine Cartilage Repair Model

2021 ◽  
pp. 036354652199800
Author(s):  
Jani Puhakka ◽  
Teemu Paatela ◽  
Eve Salonius ◽  
Virpi Muhonen ◽  
Anna Meller ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Scoring System ◽  
Femoral Condyle ◽  
Intraclass Correlation ◽  
Type Iii Collagen ◽  
Intrarater Reliability ◽  
Scoring Method ◽  
International Cartilage Repair Society ◽  
Made In

Background: The International Cartilage Repair Society (ICRS) score was designed for arthroscopic use to evaluate the quality of cartilage repair. Purpose: To evaluate the reliability of the ICRS scoring system using an animal cartilage repair model. Study Design: Controlled laboratory study. Methods: A chondral defect with an area of 1.5 cm2 was made in the medial femoral condyle of 18 domestic pigs. Five weeks later, 9 pigs were treated using a novel recombinant human type III collagen/polylactide scaffold, and 9 were left to heal spontaneously. After 4 months, the pigs were sacrificed, then 3 arthroscopic surgeons evaluated the medial femoral condyles via video-recorded simulated arthroscopy using the ICRS scoring system. The surgeons repeated the evaluation twice within a 9-month period using their recorded arthroscopy. Results: The porcine cartilage repair model produced cartilage repair tissue of poor to good quality. The mean ICRS total scores for all observations were 6.6 (SD, 2.6) in arthroscopy, 5.9 (SD, 2.7) in the first reevaluation, and 6.2 (SD, 2.8) in the second reevaluation. The interrater reliability with the intraclass correlation coefficient (ICC) for the ICRS total scores (ICC, 0.46-0.60) and for each individual subscore (ICC, 0.26-0.71) showed poor to moderate reliability. The intrarater reliability with the ICC also showed poor to moderate reliability for ICRS total scores (ICC, 0.52-0.59) and for each individual subscore (ICC, 0.29-0.58). A modified Bland-Altman plot for the initial arthroscopy and for the 2 reevaluations showed an evident disagreement among the observers. Conclusion: In an animal cartilage repair model, the ICRS scoring system seems to have poor to moderate reliability. Clinical Relevance: Arthroscopic assessment of cartilage repair using the ICRS scoring method has limited reliability. We need more objective methods with acceptable reliability to evaluate cartilage repair outcomes.

Quality of Life (QoL) in Children After Small Bowel Transplantation (SBTx) Using a Validated Generic Scoring System, the Euroqol EQ-5DY

2017 ◽  
Vol 101 ◽  
pp. S88
Author(s):  
Lindsay Hogg ◽  
Sarah Pugh ◽  
Girish Gupte ◽  
Jane Hartley ◽  
Rob Jobe ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Small Bowel ◽  
Scoring System ◽  
Small Bowel Transplantation

scholarly journals Novos tratamentos para a incontinência anal: injeção de silicone melhora a qualidade de vida em 35 pacientes incontinentes

2007 ◽  
Vol 27 (2) ◽  
pp. 167-173 ◽  
Author(s):  
Lucia de Oliveira ◽  
José Marcio Neves Jorge ◽  
Sonia Yusuf ◽  
Angelita Habr-Gama ◽  
Desidério Kiss ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Fecal Incontinence ◽  
Scoring System ◽  
Cleveland Clinic

Demonstrar através do índice de incontinência e de um instrumento de qualidade de vida, o benefício da utilização do silicone como substância de preenchimento para o tratamento da incontinência anal. 35 pacientes incontinentes foram avaliados através do índice de incontinência (Cleveland Clinic Florida Scoring System-CCFSS) e instrumento de qualidade de vida (Fecal Incontinence Quality of Life-FIQL), antes e após injeção ambulatorial trans-esfincteriana de silicone. Os critérios de inclusão foram: incontinência anal associada a defeito simples do esfíncter interno ou associado a pequeno defeito do esfíncter externo em quadrante anterior. A escala de qualidade de vida avaliada inclui quatro domínios: depressão, estilo de vida, comportamento e constrangimento. Após 3 meses de tratamento, todos os pacientes foram reavaliados através do índice de incontinência e instrumento de qualidade de vida. Os resultados foram analisados estatisticamente através do programa GraphPd Instat. 28 mulheres e 7 homens com idade média de 60,3 (19-80) anos foram submetidos a injeção de silicone para o tratamento de incontinência anal. O índice médio de incontinência, antes e após a injeção, foi de 11,3 e 4,3 (p<0.001). Em relação às alterações na escala de qualidade de vida, notamos significantes alterações em todos os domínios estudados antes e após a injeção: (1) estilo de vida p<0,0001;(2)comportamento p<0,0001;(3) depressão p<0,0001; (4) constrangimento p<0,0001. Em casos selecionados, a injeção trans-esfincteriana de silicone proporciona uma melhora do quadro de incontinência anal, observada pela mudança significativa dos parâmetros do índice de incontinência e instrumento de qualidade de vida.

scholarly journals PSS58 A SCORING SYSTEM FOR QUALITY OF CARE EVALUATION. A COMMUNITY-BASED STUDY OF CHRONIC LEG ULCERS IN NORTH GERMANY

2008 ◽  
Vol 11 (6) ◽  
pp. A627
Author(s):  
M Augustin ◽  
L Grams ◽  
K Herberger ◽  
N Franzke ◽  
S Debus ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Scoring System ◽  
Leg Ulcers ◽  
Community Based ◽  
North Germany ◽  
Care Evaluation ◽  
Chronic Leg Ulcers

scholarly journals A Prospective, Randomized, Open-Label, Multicenter, Phase III Noninferiority Trial to Compare the Clinical Efficacy of Matrix-Associated Autologous Chondrocyte Implantation With Spheroid Technology Versus Arthroscopic Microfracture for Cartilage Defects of the Knee

2019 ◽  
Vol 7 (7) ◽  
pp. 232596711985444 ◽  
Author(s):  
Philipp Niemeyer ◽  
Volker Laute ◽  
Wolfgang Zinser ◽  
Christoph Becher ◽  
Thomas Kolombe ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Cartilage Repair ◽  
Daily Living ◽  
Autologous Chondrocyte Implantation ◽  
Statistical Hypothesis ◽  
Cartilage Defects ◽  
Koos Score ◽  
Chondrocyte Implantation ◽  
Autologous Chondrocyte

Background:Autologous chondrocyte implantation (ACI) and microfracture are established treatments for large, full-thickness cartilage defects, but there is still a need to expand the clinical and health economic knowledge of these procedures.Purpose:To confirm the noninferiority of ACI compared with microfracture.Study Design:Randomized controlled trial; Level of evidence, 2.Methods:Patients were randomized to be treated with matrix-associated ACI using spheroid technology (n = 52) or microfracture (n = 50). Both procedures followed standard methods. Patients were assessed by the Knee injury and Osteoarthritis Outcome Score (KOOS), MOCART (magnetic resonance observation of cartilage repair tissue) scoring system, Bern score, modified Lysholm score, International Cartilage Repair Society (ICRS) rating (histological and immunochemical scoring after rebiopsy 24 months after implantation), and International Knee Documentation Committee (IKDC) examination form. The main assessments were conducted 24 months after study treatment.Results:In the primary intention-to-treat analysis, the overall KOOS score for both ACI and microfracture yielded a statistically significant improvement relative to baseline. According to the between-group analysis, ACI passed the test of noninferiority compared with microfracture; thus, the primary goal of the study was achieved. The KOOS subscores yielded the same qualitative results as the overall KOOS score (ie, for each of these, noninferiority was demonstrated), and in 1 case (Activities of Daily Living subscore), the threshold for superiority was passed. The subgroup analyses did not yield any clear evidence of an association between treatment effect and any of the categories investigated (age, diagnosis, defect localization, sex). A histological analysis of biopsies from 16 patients (ACI: n = 9; microfracture: n = 7) suggested a better quality of repair in the patients treated with ACI.Conclusion:The efficacy of both ACI and microfracture was demonstrated with respect to both functional outcomes and morphological repair. The primary analysis confirmed the statistical hypothesis of the noninferiority of ACI, even for relatively small cartilage defects (1-4 cm2) treated in this study, the indication for which microfracture is generally accepted as the standard of care. ACI showed significant superiority in the KOOS subscores of Activities of Daily Living at 24 months and Knee-related Quality of Life at 12 months.Registration:NCT01222559 ( ClinicalTrials.gov identifier).

A comparison of the effects of joint immobilisation, twice-daily passive motion, and voluntary motion on articular cartilage healing in sheep

2002 ◽  
Vol 15 (01) ◽  
pp. 23-29 ◽  
Author(s):  
K. Frame ◽  
H. M. Burbidge ◽  
K. Thompson ◽  
E. C. Firth ◽  
W. J. Bruce
Keyword(s):  
Articular Cartilage ◽  
Range Of Motion ◽  
Cartilage Repair ◽  
Articular Cartilage Repair ◽  
Cartilage Healing ◽  
Joint Range Of Motion ◽  
Cell Counts ◽  
Voluntary Motion ◽  
Joint Range

SummaryIn this study, articulated transarticular external skeletal fixators were used to examine the effects of joint immobilisation, twice-daily passive range-of-motion exercises, and voluntary motion on articular cartilage healing and other joint parameters. Abaxial articular cartilage lesions demonstrated superior cartilage healing to axial lesions. Twice-daily passive range of motion exercises failed to improve the quality of articular cartilage repair when compared with joint immobilisation. Voluntary motion resulted in superior articular cartilage repair tissue with maintenance of near normal cartilage architecture, proteoglycan staining, synovial fluid cell counts and specific gravity, and joint range-of-motion.

Development of a scoring system to judge the scientific quality of information from case‐control and cohort studies of nutrition and disease

1995 ◽  
Vol 24 (3) ◽  
pp. 231-239 ◽  
Author(s):  
Barrie M. Margetts ◽  
Rachel L. Thompson ◽  
Tim Key ◽  
Stephen Duffy ◽  
Michael Nelson ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Scoring System ◽  
Case Control ◽  
Scientific Quality ◽  
Quality Of Information

First-in-Human Pilot Study of Implantation of a Scaffold-Free Tissue-Engineered Construct Generated From Autologous Synovial Mesenchymal Stem Cells for Repair of Knee Chondral Lesions

2018 ◽  
Vol 46 (10) ◽  
pp. 2384-2393 ◽  
Author(s):  
Kazunori Shimomura ◽  
Yukihiko Yasui ◽  
Kota Koizumi ◽  
Ryota Chijimatsu ◽  
David A. Hart ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Magnetic Resonance ◽  
Cartilage Repair ◽  
Femoral Condyle ◽  
Chondral Lesions ◽  
Repair Tissue ◽  
Biopsy Specimens ◽  
Implantation Procedure

Background: Articular cartilage has limited healing capacity, owing in part to poor vascularity and innervation. Once injured, it cannot be repaired, typically leading to high risk for developing osteoarthritis. Thus, cell-based and/or tissue-engineered approaches have been investigated; however, no approach has yet achieved safety and regenerative repair capacity via a simple implantation procedure. Purpose: To assess the safety and efficacy of using a scaffold-free tissue-engineered construct (TEC) derived from autologous synovial membrane mesenchymal stem cells (MSCs) for effective cartilage repair. Study Design: Case series; Level of evidence, 4. Methods: Five patients with symptomatic knee chondral lesions (1.5-3.0 cm2) on the medial femoral condyle, lateral femoral condyle, or femoral groove were included. Synovial MSCs were isolated from arthroscopic biopsy specimens and cultured to develop a TEC that matched the lesion size. The TECs were then implanted into chondral defects without fixation and assessed up to 24 months postoperatively. The primary outcome was the safety of the procedure. Secondary outcomes were self-assessed clinical scores, arthroscopy, tissue biopsy, and magnetic resonance image–based estimation of morphologic and compositional quality of the repair tissue. Results: No adverse events were recorded, and self-assessed clinical scores for pain, symptoms, activities of daily living, sports activity, and quality of life were significantly improved at 24 months after surgery. Secure defect filling was confirmed by second-look arthroscopy and magnetic resonance imaging in all cases. Histology of biopsy specimens indicated repair tissue approaching the composition and structure of hyaline cartilage. Conclusion: Autologous scaffold-free TEC derived from synovial MSCs may be used for regenerative cartilage repair via a sutureless and simple implantation procedure. Registration: 000008266 (UMIN Clinical Trials Registry number).

scholarly journals Microfracture Versus Drilling of Articular Cartilage Defects: A Systematic Review of the Basic Science Evidence

2020 ◽  
Vol 8 (8) ◽  
pp. 232596712094531 ◽  
Author(s):  
Matthew J. Kraeutler ◽  
Gianna M. Aliberti ◽  
Anthony J. Scillia ◽  
Eric C. McCarty ◽  
Mary K. Mulcahey
Keyword(s):  
Systematic Review ◽  
Articular Cartilage ◽  
Cartilage Repair ◽  
Basic Science ◽  
Science Studies ◽  
Cartilage Regeneration ◽  
Cartilage Defects ◽  
Repair Tissue ◽  
Marrow Stimulation

Background: Microfracture (MFx) is one of the most common techniques used for the treatment of articular cartilage defects, although recently there has been a trend toward the use of drilling rather than MFx for the treatment of these defects. Purpose: To perform a systematic review of basic science studies to determine the effect of microfracture versus drilling for articular cartilage repair. Study Design: Systematic review. Methods: A systematic review was performed by searching PubMed, the Cochrane Library, and EMBASE to identify basic science studies comparing outcomes of MFx versus drilling. The search phrase used was microfracture AND (drilling OR microdrilling). Inclusion criteria were basic science studies that directly compared the effect of MFx versus drilling on subchondral bone, bone marrow stimulation, and cartilage regeneration. Results: A total of 7 studies met the inclusion criteria and were included in this systematic review. Of these, 4 studies were performed in rabbits, 1 study in sheep, and 2 studies in humans. All of the included studies investigated cartilage repair in the knee. In the animal studies, microfracture produced fractured and compacted bone and led to increased osteocyte necrosis compared with drilling. Deep drilling (6 mm) was superior to both shallow drilling (2 mm) and MFx in terms of increased subchondral hematoma with greater access to marrow stroma, improved cartilage repair, and increased mineralized bone. However, the overall quality of cartilage repair tissue was poor regardless of marrow stimulation technique. In 2 studies that investigated repair tissue after MFx and/or drilling in human patients with osteoarthritis and cartilage defects, the investigators found that cartilage repair tissue did not achieve the quality of normal hyaline articular cartilage. Conclusion: In the limited basic science studies that are available, deep drilling of cartilage defects in the knee resulted in improved biological features compared with MFx, including less damage to the subchondral bone and greater access to marrow stroma. Regardless of marrow stimulation technique, the overall quality of cartilage regeneration was poor and did not achieve the characteristics of native hyaline cartilage. Overall, there is a general lack of basic science literature comparing microfracture versus drilling for focal chondral defects.

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