scholarly journals Clinical practice and post-operative rehabilitation after knee arthroscopy varies according to surgeon's expertise: a survey among Polish Arthroscopy Society members.

2020 ◽  
Author(s):  
Paweł Bąkowski ◽  
Kamilla Bąkowska-Żywicka ◽  
Tomasz Piontek
Keyword(s):  
Knee Arthroscopy ◽  
Full Range ◽  
Meniscal Repair ◽  
Postoperative Management ◽  
Meniscus Repair ◽  
Postoperative Treatment ◽  
Meniscus Tear ◽  
Meniscus Suture ◽  
Surgical Expertise ◽  
Almost All

Abstract Background: Meniscal repair has received increasing attention. Currently, there is a variety of arthroscopic methods of meniscus repair available. The purpose of this study was to determine a consensus in meniscus tear treatment in the environment of Polish orthopedists.Methods: 205 registered orthopedic surgeons took part in surveys. The survey consisted of 35 questions regarding general arthroscopy and postoperative management, including physician’s level of expertise, arthroscopy anesthesia, postoperative treatment, rehabilitation and procedures performed. Comparisons were made between knee arthroscopy experts (> 100 arthroscopies performed per year) and non-experts (≤ 100 cases) on aspects of patient care.Results: The most important finding of this study is an agreement in almost all aspects of knee arthroscopy approach. A consensus between polish surgeons was noticed in choosing regional anesthesia for knee arthroscopy, no need for knee braces nor knee medications, using LMW heparin as thromboprophylaxis, 1-2 days hospitalization, recommendation of rehabilitation and magnetic resonance as a diagnostic test for meniscus damage. Surgical expertise was significantly associated with the performance of meniscus sewing procedures (p = 0.009). Experts recommended starting rehabilitation already on the day of surgery (p=0.007) and more likely used objective physical tests (p=0.003). Non-expert surgeons recommended longer period from meniscus suture to a full range knee motion (p=0.001) and admitted that patient’s age does matter for meniscus repair qualification (p=0.002).Conclusions: There is a consensus in almost all issues of meniscus tear treatment in the environment of the Polish orthopedists, however the rehabilitation issues and the use of advanced meniscus repair techniques is associated with surgical expertise.

scholarly journals Clinical practice and postoperative rehabilitation after knee arthroscopy vary according to surgeons’ expertise: a survey among polish arthroscopy society members

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Paweł Bąkowski ◽  
Kamilla Bąkowska-Żywicka ◽  
Tomasz Piontek
Keyword(s):  
Knee Arthroscopy ◽  
Full Range ◽  
Postoperative Management ◽  
Meniscus Repair ◽  
Postoperative Treatment ◽  
Meniscus Tear ◽  
Postoperative Rehabilitation ◽  
Meniscus Suture ◽  
Surgical Expertise ◽  
Almost All

Abstract Background Meniscus repair is a challenging task in knee arthroscopy. Currently, there are a variety of arthroscopic methods available for meniscus repair. The purpose of this study was to determine a consensus in meniscus tear treatment in the environment of Polish orthopaedists. Methods A total of 205 registered orthopaedic surgeons participated in the surveys. The survey consisted of 35 questions regarding general arthroscopy and postoperative management, including physicians’ level of expertise, anaesthesia, postoperative treatment, rehabilitation and procedures performed. Comparisons were made between knee arthroscopy experts (> 100 arthroscopies performed per year) and non-experts (≤ 100 cases) on aspects of patient care. Results The most important finding of this study was the agreement among almost all aspects of the knee arthroscopy approach. Consensus among Polish surgeons was noticed in choosing regional anaesthesia for knee arthroscopy, the lack of need for knee braces and knee medications, the of use of LMW heparin for thromboprophylaxis, 1–2 days of hospitalization, the recommendation of rehabilitation and the use of magnetic resonance as a diagnostic test for meniscus damage. Surgical expertise was significantly associated with the performance of meniscus suture procedures (p = 0.009). Experts recommended starting rehabilitation on the day of surgery (p = 0.007) and were more likely to use objective physical tests (p = 0.003). Non-expert surgeons recommended a longer period from meniscus suture to full-range knee motion (p = 0.001) and admitted that patient age does matter for meniscus repair qualification (p = 0.002). Conclusions There is consensus among almost all issues of meniscus tear treatment in the environment of Polish orthopaedists; however, the issues of rehabilitation and the use of advanced meniscus repair techniques are associated with surgical expertise.

scholarly journals Clinical practice and postoperative rehabilitation after knee arthroscopy vary according to surgeons’ expertise: a survey among Polish Arthroscopy Society members.

2020 ◽  
Author(s):  
Paweł Bąkowski ◽  
Kamilla Bąkowska-Żywicka ◽  
Tomasz Piontek
Keyword(s):  
Knee Arthroscopy ◽  
Full Range ◽  
Postoperative Management ◽  
Meniscus Repair ◽  
Postoperative Treatment ◽  
Meniscus Tear ◽  
Postoperative Rehabilitation ◽  
Meniscus Suture ◽  
Surgical Expertise ◽  
Almost All

Abstract Background: Meniscus repair is a challenging task in knee arthroscopy. Currently, there are a variety of arthroscopic methods available for meniscus repair. The purpose of this study was to determine a consensus in meniscus tear treatment in the environment of Polish orthopaedists.Methods: A total of 205 registered orthopaedic surgeons participated in the surveys. The survey consisted of 35 questions regarding general arthroscopy and postoperative management, including physicians’ level of expertise, anaesthesia, postoperative treatment, rehabilitation and procedures performed. Comparisons were made between knee arthroscopy experts (> 100 arthroscopies performed per year) and non-experts (≤ 100 cases) on aspects of patient care.Results: The most important finding of this study was the agreement among almost all aspects of the knee arthroscopy approach. Consensus among Polish surgeons was noticed in choosing regional anaesthesia for knee arthroscopy, the lack of need for knee braces and knee medications, the of use of LMW heparin for thromboprophylaxis, 1-2 days of hospitalization, the recommendation of rehabilitation and the use of magnetic resonance as a diagnostic test for meniscus damage. Surgical expertise was significantly associated with the performance of meniscus suture procedures (p = 0.009). Experts recommended starting rehabilitation on the day of surgery (p=0.007) and were more likely to use objective physical tests (p=0.003). Non-expert surgeons recommended a longer period from meniscus suture to full-range knee motion (p=0.001) and admitted that patient age does matter for meniscus repair qualification (p=0.002).Conclusions: There is consensus among almost all issues of meniscus tear treatment in the environment of Polish orthopaedists; however, the issues of rehabilitation and the use of advanced meniscus repair techniques are associated with surgical expertise.

scholarly journals Clinical Practice and Post-Operative Rehabilitation After Knee Arthroscopy: Comparison Between Polish Experts and Non-Experts.

2020 ◽  
Author(s):  
Paweł Bąkowski ◽  
Kamilla Bąkowska-Żywicka ◽  
Tomasz Piontek
Keyword(s):  
Clinical Practice ◽  
Knee Arthroscopy ◽  
Full Range ◽  
Postoperative Management ◽  
Postoperative Treatment ◽  
Clinical Practices ◽  
Meniscus Suture ◽  
Surgical Expertise ◽  
Almost All ◽  
Suturing Techniques

Abstract Background: The purpose of this study was to compare the clinical practices between polish expert and non-expert arthroscopy knee surgeons.Methods: 205 registered orthopedic surgeons took part in surveys. The survey included 35 questions regarding general arthroscopy and postoperative management, including physician’s level of expertise, arthroscopy anesthesia, postoperative treatment, rehabilitation and procedures performed. Comparisons were made between knee arthroscopy experts (> 100 arthroscopies performed per year) and non-experts (≤ 100 cases) on aspects of patient care.Results: The most important finding of this study is an agreement in almost all aspects of knee arthroscopy approach. A consensus between polish surgeons was noticed in choosing regional anesthesia for knee arthroscopy, no need for knee braces nor knee medications, using LMW heparin as thromboprophylaxis, 1-2 days hospitalization, recommendation of rehabilitation and magnetic resonance as a diagnostic test for meniscus damage. Surgical expertise was significantly associated with the performance of meniscus sewing procedures (p = 0.009). Experts recommended starting rehabilitation already on the day of surgery (p=0.007) and more likely used objective physical tests (p=0.003). Nonexpert surgeons recommended longer period from meniscus suture to a full range knee motion (p=0.001) and admitted that patient’s age does matter for meniscus repair qualification (0.002).Conclusions: Clinical practice varies among orthopeadists performing knee arthroscopy procedures, based on their level of expertise. Polish knee arthroscopy experts agreed with non-experts in the type of anesthesia during knee arthroscopy and numerous aspects of postoperative treatment. Surgical expertise was associated with the performance of advanced meniscus suturing techniques.

scholarly journals MENISCUS REPAIR VERSUS DEBRIDEMENT FOR MENISCAL TEARS IN PEDIATRIC PATIENTS – PREDICTORS FOR TREATMENT BASED ON DEMOGRAPHICS

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0016
Author(s):  
Lauren Agatstein ◽  
Alton W. Skaggs ◽  
Matthew J. Brown ◽  
Nicole Friel ◽  
Brian Haus
Keyword(s):  
Pediatric Patients ◽  
Private Insurance ◽  
Meniscal Repair ◽  
Meniscus Repair ◽  
Meniscus Tear ◽  
Children's Hospitals ◽  
Children's Hospital ◽  
Children’S Hospitals ◽  
Meniscus Tears ◽  
Children’S Hospital

BACKGROUND: Pediatric and adolescent patients with meniscus tears have a relatively high rate of healing after meniscus repair – up to greater than 80% in the literature. Despite this fact, many patients undergo meniscus debridement for treatment of their meniscus tears. In this study, we investigated the demographic factors predictive of whether a pediatric patient would receive a meniscal repair or a meniscal debridement for their meniscal tear. METHODS: The California statewide ambulatory surgery database (OSHPD) was queried for all patients under 18 years old who underwent meniscus debridement or meniscus repair from 2008-2016. The effect of age, hospital setting (adult versus pediatric hospital), injury chronicity, gender, insurance type, race, and year of service was assessed using logistic regression. RESULTS: A total of 13,906 pediatric patients had meniscal surgery during the timeframe. 83% (11,561/13,906) underwent meniscal debridement and 17% (2,345/13,906) underwent meniscal repair. Age, hospital type, nature of injury, gender, private insurance, being Hispanic, and year of service were statistically significant in predicting the odds of having meniscus repair versus meniscus debridement. Surgery at a children’s hospital increases the odds of having meniscus repair (p < 0.001). Of the 82.6% of pediatric patients (11,491/13,906) treated at non-children’s hospitals, 16% (1839) had repair and 84% underwent debridement (9,652). Of the 17.4% (2,415) treated at children’s hospitals, 21% (506) had repair and 79% (1,909) underwent debridement. As patients age, the odds of receiving a meniscus repair decrease (p < 0.001). Acute meniscus injury (p < 0.001) or private insurance (p < 0.05) increase the odds of having meniscus repair. However, females (p < 0.05) and Hispanics (p < 0.01) had decreased odds of having meniscus repair. As time between injury and surgery progressed, the odds of having meniscus repair versus meniscus debridement increased (p < 0.001). CONCLUSIONS: There is increasing evidence that pediatric patients have successful outcomes after meniscal repair surgery. The results of this study demonstrate that the majority of pediatric patients with meniscus tears undergo a meniscal debridement rather than a repair. Treatment at a children’s hospital, private insurance, and a short time frame between injury and surgery were positive predictors of meniscus repair over debridement. The results of the study may help inform patients, families, and referring physicians about what type of treatment a patient may receive for a meniscus tear, based on their demographic profile.

scholarly journals CONCOMITANT MENISCECTOMY RESULTS IN REDUCED RETURN TO SPORT COMPARED TO MENISCUS REPAIR IN PRIMARY PEDIATRIC ACL RECONSTRUCTION

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0007
Author(s):  
Brendan A. Williams ◽  
Maggie L. Wright ◽  
Joshua T. Bram ◽  
Kathleen J. Maguire ◽  
Neeraj M. Patel ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Pediatric Patients ◽  
Meniscal Tear ◽  
Meniscal Repair ◽  
Return To Sport ◽  
Meniscus Repair ◽  
Meniscus Tear ◽  
Initial Contact ◽  
Severity Of Injury ◽  
The Impact

Background: Meniscus repair has demonstrated favorable outcomes when performed with ACL reconstruction (ACLR). However, literature comparing meniscal tear patterns, treatments, and outcomes among pediatric patients remains limited. Purpose: The aim of this study is to evaluate the impact of surgical technique on patient outcomes, in primary pediatric ACLR with associated meniscal pathology. We secondarily examined patient factors and tear characteristics on these outcomes. Methods: This is a retrospective cohort study from 2014-2016 of pediatric ACL reconstruction patients who underwent concurrent surgical management of a meniscus tear. Predictors included patient demographics, injury mechanism, meniscal tear characteristics and surgical treatments. Clinical outcomes including return to sport (RTS), meniscus or ACL graft re-tear, and return to surgery were assessed via patient cross-sectional survey. Criteria for RTS were based on standardized postoperative rehabilitation protocols. Univariate and multivariate analyses were used to examine the relationship between studied predictors with the likelihood of RTS and other outcomes. Results: Inclusion criteria were met by 123 patients with an average follow-up time of 2.5 ± 0.7 years. RTS was achieved by 80.8% of patients while 17.1% of patients had a subsequent knee surgery within the studied timeframe. Univariate analysis of factors associated with successful RTS are shown in Table 1. While patients failing to RTS were shown to have delayed surgical intervention in univariate testing, multivariate analysis identified that patients who underwent meniscectomy were less likely to RTS than those who underwent meniscal repair (OR=2.690, 95% CI 1.044-6.930, p=0.040). Patients with an initial contact mechanism of injury were also demonstrated to be more likely to return to the OR for any reason (OR=13.443, CI 1.736-104.108, p=0.013) in multivariate modeling. Conclusion: In one of the few large cohorts of pediatric ACL reconstructions with concomitant meniscus surgery, this study adds to our understanding of a potentially modifiable factor (meniscus repair) in the surgical treatment of ACL injury with concaminant meniscus tear. Although no differences were seen in rates of meniscus or graft re-tear when comparing treatments, patients who underwent meniscal repair were more likely to return to sport than patients treated with meniscectomy. While these findings may reflect the quality of the torn meniscal tissue and severity of injury, it further emphasizes the importance of meniscal preservation not just for long term joint quality, but also for short term function in active pediatric patients. [Table: see text]

scholarly journals The predictive factors that are associated with the number of sutures used during meniscal repair

2020 ◽  
Author(s):  
Xiaoxiao Song ◽  
Dongyang Chen ◽  
Qi Xinsheng ◽  
Qing Jiang ◽  
Caiwei Xia
Keyword(s):  
Cruciate Ligament ◽  
Demographic Data ◽  
Meniscal Tear ◽  
Univariate Analysis ◽  
Meniscal Repair ◽  
Meniscus Repair ◽  
Meniscus Tear ◽  
Chi Square ◽  
Level Of Evidence ◽  
Surgical Data

Abstract PurposeTo investigate factors associated with the consumption of a large number of sutures during arthroscopic meniscus repair procedures.MethodsAll patients who received meniscal repair, with or without concomitant anterior cruciate ligament (ACL) reconstruction, in our hospital from January 2015 to December 2019 were included in the current study. Demographic data (sex, age, body mass index (BMI), and injury-to-surgery interval) and surgical data (the site of the tear, side of the meniscus, presence of an ACL rupture or not and the number of sutures) were retrospectively collected from our medical records. The number of sutures was divided into two groups (1–2 sutures versus > 2 sutures). The stitching process was implemented through an all-inside technique using a meniscal repair device (Fast-Fix; Smith & Nephew). According to the length and stability of the meniscal tear, one to seven sutures were used. Univariate analysis consisted of chi-square tests. Multivariate logistic regression was then performed to adjust for confounding factors.ResultsA total of 242 patients, including 168 males and 57 females, was finally included. In the univariate analysis, we found that those patients who underwent meniscus repair within one month after meniscus tear were more likely to need fewer sutures than those who underwent surgery more than one month after injury (70/110 versus 59/115, p = 0.062). In total, 75/109 (68.8%) lateral meniscal tears were repaired with fewer sutures than medial (34/72, 47.2%) and bilateral meniscus injuries (20/44, 45.4%; p = 0.003). In the multivariate analysis, we found that the duration of injury (OR, 2.06; 95% CI, 1.16–3.64, p = 0.013), presence of an ACL injury (OR, 3.76; 95% CI, 1.97–7.21, p < 0.001) and the side of the meniscus (OR, 0.31; 95% CI, 0.14–0.65, p = 0.002) were associated with the number of sutures used during meniscal repair procedures.ConclusionsPatients who underwent meniscal repair within one month after meniscus tear, especially lateral menisci tears, were more likely to need fewer sutures.Study DesignCase-control study; level of evidence, 3.

scholarly journals The predictive factors that are associated with the number of sutures used during meniscal repair

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Xiaoxiao Song ◽  
Dongyang Chen ◽  
Xinsheng Qi ◽  
Qing Jiang ◽  
Caiwei Xia
Keyword(s):  
Cruciate Ligament ◽  
Demographic Data ◽  
Meniscal Tear ◽  
Univariate Analysis ◽  
Meniscal Repair ◽  
Meniscus Repair ◽  
Meniscus Tear ◽  
Chi Square ◽  
Level Of Evidence ◽  
Surgical Data

Abstract Purpose To investigate factors associated with the consumption of a large number of sutures during arthroscopic meniscus repair procedures. Methods All patients who received meniscal repair, with or without concomitant anterior cruciate ligament (ACL) reconstruction, in our hospital from January 2015 to December 2019 were included in the current study. Demographic data (sex, age, body mass index (BMI), and injury-to-surgery interval) and surgical data (the site of the tear, side of the meniscus, presence of an ACL rupture or not and the number of sutures) were retrospectively collected from our medical records. The number of sutures was divided into two groups (1–2 sutures versus > 2 sutures). The stitching process was implemented through an all-inside technique using a meniscal repair device (Fast-Fix; Smith & Nephew). According to the length and stability of the meniscal tear, one to seven sutures were used. Univariate analysis consisted of chi-square tests. Multivariate logistic regression was then performed to adjust for confounding factors. Results A total of 242 patients, including 168 males and 57 females, was finally included. In the univariate analysis, we found that those patients who underwent meniscus repair within one month after meniscus tear were more likely to need fewer sutures than those who underwent surgery more than one month after injury (70/110 versus 59/115, p=0.062). In total, 75/109 (68.8%) lateral meniscal tears were repaired with fewer sutures than medial (34/72, 47.2%) and bilateral meniscus injuries (20/44, 45.4%; p=0.003). In the multivariate analysis, we found that the duration of injury (OR, 2.06; 95% CI, 1.16–3.64, p=0.013), presence of an ACL injury (OR, 3.76; 95% CI, 1.97–7.21, p< 0.001) and the side of the meniscus (OR, 0.31; 95% CI, 0.14–0.65, p=0.002) were associated with the number of sutures used during meniscal repair procedures. Conclusions Patients who underwent meniscal repair within one month after meniscus tear, especially lateral menisci tears, were more likely to need fewer sutures. Study design Case-control study; level of evidence, 3.

scholarly journals How Consistent are the MRI Findings and the Clinical Outcomes after Meniscus Repair?

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0013
Author(s):  
Hasan Bombaci ◽  
Fatih Cetinkaya ◽  
Kaan Meric
Keyword(s):  
Clinical Outcomes ◽  
Meniscal Repair ◽  
Meniscus Repair ◽  
Lysholm Score ◽  
Activity Score ◽  
Meniscus Tear ◽  
Mri Findings ◽  
Mri Examination ◽  
The Mean

Objectives: The meniscal repair is a preferred treatment whenever possible after meniscus tear. There are reports in the literature that MRI assessment is not useful to evaluate healing of the meniscus after repair. However, we have not found any study which compares the clinical outcomes of meniscus repair according to the MRI findings. The purpose of this study was to compare the MRI features and the clinical outcomes after meniscus repair. Methods: 32 patients underwent meniscus repair between January 2011 and June 2013. Twenty three of them accepted a control MRI examination at last follow-up visit. One patient was more than 130 kg in weight so it was not possible to perform MRI examination in our institution. Therefore, twenty-two patients (17 male, 5 female) were included in this study. The mean age was 31.81 (18-48). Preoperative clinical and radiological findings were obtained from the hospital registry. At last follow-up, the clinical examination and MRI assessment were performed. The results were compared statistically with the ANOVA method. Results: MRI assessment, obtained at the last follow-up, was performed blindly by the radiology specialist and senior surgeon and any conflicts between the two assessments were settled by using the preoperative MRI findings. In 10 patients (45.45%), the MRI examination revealed normal/nearly normal meniscal signal alteration, in three (13.64%), incomplete tear and in nine (40.91%), a vertical/complex tear signal located in the previously torn meniscus area. Post-operatively the mean Lysholm score was 91.40±10.57 and Tegner activity score, 4.59±1.62. Also, the Lysholm score (91.5±12.44, 94.33±5.50 and 90.33±10.34, respectively) and Tegner activity score (4.2±1.87, 6±1.00 and 4.5±1.33, respectively) were evaluated in each group separately, however the difference was not statistically significant (p>0.05). Conclusion: In the present study, there was no correlation between the MRI signals and clinical outcomes. The Lysholm score was found to be over 90 in 20 of the 22 knees in this series. In conclusion, the findings reveal that the meniscus fulfills its function as normal or nearly normal even though the MRI findings fail to prove healing, in the mean 19. 5 months’ period postoperatively.

scholarly journals Which factors are associated with the prevalence of meniscal repair?

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Xiaoxiao Song ◽  
Dongyang Chen ◽  
Xinsheng Qi ◽  
Qing Jiang ◽  
Caiwei Xia
Keyword(s):  
Cruciate Ligament ◽  
Demographic Data ◽  
Meniscal Tear ◽  
Univariate Analysis ◽  
Lateral Meniscus ◽  
Meniscal Repair ◽  
Acl Injury ◽  
Partial Meniscectomy ◽  
Meniscus Tear ◽  
Confounding Factors

Abstract Purpose To investigate the potential factors associated with the prevalence of meniscal repair Methods Patients who received partial meniscectomy or meniscal repair in our institution from Jan 2015 to Dec 2019 were included in current study. The inclusion criteria were (1) meniscus tear treated using meniscectomy or repair, (2) with or without concomitant anterior cruciate ligament reconstruction, (3) not multiligamentous injury. Demographic data, including sex, age, body mass index (BMI), injury-to-surgery interval and intra-articular factors such as the location of injury, medial or lateral, ACL rupture or not and the option of procedure (partial meniscectomy or repair) were documented from medical records. Univariate analysis consisted of chi-square. Multivariate logistic regression was then performed to adjust for confounding factors. Results 592 patients including 399 males and 193 females with a mean age of 28.7 years (range from 10 to 75 years) were included in current study. In the univariate analysis, male (p = 0.002), patients aged 40 years or younger (p < 0.001), increased weight (p = 0.010), Posterior meniscus torn (0.011), concurrent ACL ruputure (p < 0.001), lateral meniscus (p = 0.039) and early surgery (p < 0.001) were all associated with the prevalence of meniscal repair. However, After adjusting for confounding factors, we found that age (OR, 0.35; 95% CI, 0.17 - 0.68, p = 0.002), ACL injury (OR, 3.76; 95% CI, 1.97 – 7.21, p < 0.001), side of menisci (OR, 3.29; 95% CI, 1.43 – 7.55, p = 0.005), site of tear (OR, 0.15; 95% CI, 0.07 – 0.32, p < 0.001), and duration of injury (OR, 0.46; 95% CI, 0.28 – 0.82, p = 0.008) were associated with the prevalence of meniscus repair. Conclusions Meniscal tear in aged patients especially those with concomitant ACL injury is likely to be repaired. Additionally, in order to increase the prevalence of repair and slow down progression of OA, the surgical procedure should be performed within two weeks after meniscus tear especially when the tear is located at lateral meniscal posterior. Study design Case-control study; level of evidence, 3.

scholarly journals Two Populations of Glucocorticoid Receptor-Binding Sites in the Male Rat Hippocampal Genome

Endocrinology ◽  
2013 ◽  
Vol 154 (5) ◽  
pp. 1832-1844 ◽  
Author(s):  
J. Annelies E. Polman ◽  
E. Ronald de Kloet ◽  
Nicole A. Datson
Keyword(s):  
Receptor Binding ◽  
Binding Sites ◽  
Glucocorticoid Receptors ◽  
Full Range ◽  
Male Rat ◽  
Motif Analysis ◽  
Wide Range ◽  
Neuronal Processes ◽  
Almost All

Abstract In the present study, genomic binding sites of glucocorticoid receptors (GR) were identified in vivo in the rat hippocampus applying chromatin immunoprecipitation followed by next-generation sequencing. We identified 2470 significant GR-binding sites (GBS) and were able to confirm GR binding to a random selection of these GBS covering a wide range of P values. Analysis of the genomic distribution of the significant GBS revealed a high prevalence of intragenic GBS. Gene ontology clusters involved in neuronal plasticity and other essential neuronal processes were overrepresented among the genes harboring a GBS or located in the vicinity of a GBS. Male adrenalectomized rats were challenged with increasing doses of the GR agonist corticosterone (CORT) ranging from 3 to 3000 μg/kg, resulting in clear differences in the GR-binding profile to individual GBS. Two groups of GBS could be distinguished: a low-CORT group that displayed GR binding across the full range of CORT concentrations, and a second high-CORT group that displayed significant GR binding only after administering the highest concentration of CORT. All validated GBS, in both the low-CORT and high-CORT groups, displayed mineralocorticoid receptor binding, which remained relatively constant from 30 μg/kg CORT upward. Motif analysis revealed that almost all GBS contained a glucocorticoid response element resembling the consensus motif in literature. In addition, motifs corresponding with new potential GR-interacting proteins were identified, such as zinc finger and BTB domain containing 3 (Zbtb3) and CUP (CG11181 gene product from transcript CG11181-RB), which may be involved in GR-dependent transactivation and transrepression, respectively. In conclusion, our results highlight the existence of 2 populations of GBS in the rat hippocampal genome.

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