scholarly journals Evaluation of articular cartilage injury using computed tomography with axial traction in ankle joint

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0036
Author(s):  
Tomoyuki Nakasa ◽  
Yasunari Ikuta ◽  
Masahiro Yoshikawa ◽  
Yusuke Tsuyuguchi ◽  
Yuki Ota ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Sensitivity And Specificity ◽  
Subchondral Bone ◽  
Ct Images ◽  
Cartilage Injury ◽  
Cartilage Layer ◽  
Arthroscopic Findings ◽  
Cartilage Injuries ◽  
Axial Traction ◽  
Articular Cartilage Injuries

Category: Ankle Introduction/Purpose: Although chondral or osteochondral injuries are usually assessed by MRI, its accuracy is reportedly low because of the relatively thin cartilage layer and its close apposition to the cartilage talus and tibial plafond. The subchondral bone plays a role in cartilage metabolism, therefore the evaluation of subchondral bone is crucial for cartilage treatment. A method which enables the simultaneous evaluation of cartilage and subchondral bone is useful for the treatment of cartilage injury. The purpose of this study was to assess the feasibility of CT imaging with axial traction for the diagnosis of articular cartilage injuries. Methods: Chondral lesion in 18 ankles of 17 patients were evaluated. These 18 ankles consisted of 11 ankles of osteochondral lesion of the talar dome (OLT), 5 ankles of osteoarthritis of ankle joints and 2 ankles of anterior impingement syndrome. Twelve males and 5 women were included, with a mean age of 33.7 years (range, 15 -70 years). An ankle distractor foot strap was placed on the ankle with 30 degrees flexion of the knee joint, and a traction force of 80 N was applied during CT scanning. Gray scale CT images were allocated colors to make it easier to evaluate the cartilage layer. The international Cartilage Repair Society (ICRS) grades on CT were compared with those in arthroscopic findings. Results: The respective sensitivity and specificity of CT imaging with traction compared to ICRS grading were 74.4%, and 96.3%. The level of agreement of the ICRS grading between CT images and arthroscopic findings showed moderate (kappa coefficient; 0.547). The diagnosis of grade 3 or 4 lesions had 80.0% sensitivity. Axial traction to CT enabled the delineation of the cartilage surface including chondral thinning, defect and cartilage separation more visible (Figure 1). Conclusion: CT with axial traction could obtain acceptable levels of sensitivity and specificity for the evaluation of articular cartilage injuries in addition to the assessment of subchondral bone.

Evaluation of Articular Cartilage Injury Using Computed Tomography With Axial Traction in the Ankle Joint

2018 ◽  
Vol 39 (9) ◽  
pp. 1120-1127 ◽  
Author(s):  
Tomoyuki Nakasa ◽  
Yasunari Ikuta ◽  
Mikiya Sawa ◽  
Masahiro Yoshikawa ◽  
Yusuke Tsuyuguchi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Articular Cartilage ◽  
Sensitivity And Specificity ◽  
Subchondral Bone ◽  
Ct Images ◽  
Cartilage Layer ◽  
Arthroscopic Findings ◽  
Cartilage Injuries ◽  
Axial Traction ◽  
Articular Cartilage Injuries

Background: Although chondral or osteochondral injuries are usually assessed by magnetic resonance imaging, its accuracy can be low, presumably related to the relatively thin cartilage layer and the close apposition of the cartilage of the talus and tibial plafond. We hypothesized that axial traction could provide a contrast between the articular cartilage and joint cavity, and it enabled the simultaneous evaluation of cartilage and subchondral bone. The purpose of this study was to assess the feasibility of using computed tomography (CT) imaging with axial traction for the diagnosis of articular cartilage injuries. Methods: Chondral lesions in 18 ankles were evaluated by CT with axial traction using a tensioning device and ankle strap for enlargement of the joint space of the ankle. CT was done in 3-mm slices and programmed for gray scale, and then CT images were allocated colors to make it easier to evaluate the cartilage layer. The International Cartilage Repair Society (ICRS) grades on CT were compared with those on arthroscopic findings. Results: The respective sensitivity and specificity of CT imaging with traction using ICRS grading were 74.4%, and 96.3%. The level of agreement of the ICRS grading between CT images and arthroscopic findings was moderate (kappa coefficient, 0.547). Adding axial traction to CT increased the delineation of the cartilage surface, including chondral thinning, chondral defect, and cartilage separation. Conclusions: CT with axial traction produced acceptable levels of sensitivity and specificity for the evaluation of articular cartilage injuries, in addition to the assessment of subchondral bone. Level of Evidence: Level III, comparative case series.

Treatment of Articular Cartilage Injuries in the Knee

2009 ◽  
Author(s):  
Tony Wanich
Keyword(s):  
Extracellular Matrix ◽  
Articular Cartilage ◽  
Thin Layer ◽  
Subchondral Bone ◽  
Articular Surface ◽  
Low Friction ◽  
Cartilage Injuries ◽  
Articular Cartilage Injuries

Articular cartilage is a unique biphasic tissue composed of chondrocytes surrounded by extracellular matrix (ECM). This thin layer of tissue covers the articular surface of diarthroidal joints and provides a durable, low friction interface which also helps to reduce the load transmitted to the underlying subchondral bone.

scholarly journals The treatment of articular cartilage injuries with mesenchymal stem cells in different animal species

2021 ◽  
Vol 11 (1) ◽  
pp. 128-134
Author(s):  
Ilnur Ganiev ◽  
Natalia Alexandrova ◽  
Alexander Aimaletdinov ◽  
Catrin Rutland ◽  
Albina Malanyeva ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Veterinary Medicine ◽  
Articular Cartilage ◽  
Companion Animals ◽  
Experimental Studies ◽  
Experimental Models ◽  
Cartilage Injury ◽  
Cartilage Injuries ◽  
Articular Cartilage Injuries

One of the major problems observed in veterinary practice is articular cartilage injuries in animals. In terms of agriculture, it leads to their culling from the herd, even if they are highly productive animals. With companion animals, owners usually have to decide between euthanasia or long-term sometimes lifelong treatment of the injury by a veterinarian. The use of mesenchymal stem cells (MSCs) for the treatment of cartilage injury in veterinary medicine is based on the good results observed in preclinical studies, where large animals have been used as experimental models to study the regenerative activity of MSCs. According to the literature, MSCs in veterinary medicine have been used to treat cartilage injury of dogs and horses, whereas sheep and goats are generally models for reproducing the disease in preclinical experimental studies.

scholarly journals Use of Particulated Juvenile Articular Cartilage Allograft for Osteochondral Lesions of the Wrist

Hand ◽  
2016 ◽  
Vol 12 (5) ◽  
pp. NP62-NP67 ◽  
Author(s):  
Daniel E. Hess ◽  
Brian C. Werner ◽  
D. Nicole Deal
Keyword(s):  
Articular Cartilage ◽  
Case Reports ◽  
New Technology ◽  
Full Range ◽  
Osteochondral Lesions ◽  
Appropriate Treatment ◽  
Cartilage Injuries ◽  
Articular Cartilage Injuries ◽  
Outerbridge Grade ◽  
Active Patients

Background: Articular cartilage injuries are a common injury among young, active patients, and the most appropriate treatment for these injuries remains controversial. A promising new technology in the treatment of high-grade cartilage injuries is particulated juvenile articular cartilage (PJAC) allograft (DeNovo NT, Zimmer, Warsaw, Indiana). This has been shown to be successful in multiple joints including the knee, talus, and elbow. No studies or case reports exist in supporting or discouraging its use in injuries of the wrist, in specific, the scaphoid. Methods: The use of PJAC allograft is described for the treatment of an active 21-year-old male with an Outerbridge Grade IV chondral lesion on the proximal pole of his right scaphoid and right distal radius scaphoid facet who had failed conservative management. The patient was followed clinically and radiographically for 21 months. Results: The patient had return to full sport (jujutsu) and full range-of-motion, both of which represented an improvement from his preoperative exam. Radiographically, the chondral lucency seen had decreased in size and was almost completely absent on radiographs after 21 months. Conclusions: The results of this case suggest that PJAC can be used safely and effectively in the wrist thereby potentially broadening the indications for its use.

scholarly journals Relationship between osteophyte and arthroscopic findings in osteoarthritis of ankle

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0027
Author(s):  
Munekazu Kanemitsu ◽  
Tomoyuki Nakasa ◽  
Mikiya Sawa ◽  
Masahiro Yoshikawa ◽  
Yusuke Tsuyuguchi ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Weight Bearing ◽  
Arthroscopic Surgery ◽  
Joint Space ◽  
Cartilage Injury ◽  
Radiographic Findings ◽  
Tibiotalar Joint ◽  
Arthroscopic Findings ◽  
Articular Cartilage Injury ◽  
Mortise View

Category: Ankle Introduction/Purpose: Mortise view weight-bearing radiograph is widely used for the diagnosis of osteoarthritis of ankle. Thickness of the articular cartilage cannot be accurately evaluated in the evaluation of joint space from weight-bearing radiograph, because lateral tibiotalar joint space is maintained in valgus type osteoarthritis in some cases. There are few reports on the relation between osteophyte and the articular cartilage injury. We considered that it might be possible to estimate the cartilage injury more accurately by examining osteophytes. The purpose of this study is to analyze the relationship between the location and grade of osteophytes in weight-bearing radiograph and cartilage injury in arthroscopic findings was analyzed. Methods: Twenty-one anklets of 21 patients consisted of 10 males and 10 females, with mean age of 61.4 years (31-79 years), who underwent arthroscopic surgery for osteoarthritis in our department were included. Weight-bearing radiograph were taken before surgery. Location and grade of osteophytes were evaluated using Ankle and Hindfoot Radiographic Osteoarthritis Scoring reported by Kraus et al. Arthroscopic findings were evaluated with International Cartilage Repair Society (ICRS) Grade at a total of 20 sites (9 areas of tibia and talar in tibiotalar joint, medial malleolus and lateral malleolus). The correlation between radiographic findings and arthroscopic findings were analyzed. Results: In Mortise view, strong correlations were found between lateral tibial osteophyte grade and ICRS grade of the center (talus R = 0.69, tibia R = 0.76), the central lateral (tibia R = 0.79), the posterior center (talus R = 0.72, tibia R = 0.74) and the posterior lateral of the tibiotalar joint (talus R = 0.63, tibia R = 0.76). There are moderate correlations between distal fibular osteophyte grade and ICRS grade of the medial inner (tibia R = 0.74) and the posterior medial of the tibiotalar joint (talus R = 0.61, tibia = 0.63). In lateral view, there are moderate correlations between posterior talar osteophyte grade and ICRS grade at the center of the tibiotalar joint (talus R = 0.61, tibia R = 0.60). Conclusion: From this study, there was a strong correlation between location and grade osteophyte and the articular cartilage injury. Osteoarthritis progression is caused by degeneration of the cartilage because of the joint instability, and osteophytes were formed by traction force or impaction. This study showed that local cartilage injury is thought to be related to osteophytes. By evaluating the location and size of osteophytes, the articular cartilage injury might be predicted accurately before arthroscopic surgery.

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