scholarly journals Effect of discoid lateral meniscus on tibiofemoral joint cartilage damage in middle-aged patients

2021 ◽  
Author(s):  
Yaxiaer Sulaiman ◽  
Qi Li ◽  
Jian Li ◽  
Gang Chen ◽  
Xin Tang
Keyword(s):  
Cartilage Damage ◽  
Meniscal Tear ◽  
Lateral Meniscus ◽  
Lateral Compartment ◽  
Medial Compartment ◽  
Cartilage Injury ◽  
Control Group ◽  
Discoid Lateral Meniscus ◽  
Middle Aged ◽  
Aged Patients

Abstract Purpose: To investigate the effect of discoid lateral meniscus (DLM) on cartilage damage of the medial and lateral compartments of the knee in middle-aged patients.Methods: We analyzed data from 44 patients (54 knees) with symptomatic discoid lateral meniscus (DLM group) and 30 patients (30 knees) with a non-discoid lateral meniscus tear (control group). All patients were over 40 years old. We compared the tibiofemoral angle (TFA) and cartilage injury rate between the two groups. We further classified DLM group patients based on dysmorphic features of the menisci (DLM type), presence/absence of meniscal tear, and symptom durations, then analyzed whether these parameters could affect the number of cartilage injuries in the knee medial and lateral compartments.Results: DLM group showed higher TFA values (2.18°±2.86°) than control group (0.84°±1.35°, P=0.002), and a higher occurrence of medial compartment cartilage damage (P=0.003). Within the DLM group, patients with cartilage damage showed higher BMI than those without cartilage damage (P=0.009 for medial compartment and P=0.001 for lateral, respectively). We found that having symptoms for more than 6 months was associated with cartilage damage in the lateral compartment (P=0.021), but not the medial compartment (P=0.858). Neither presence/absence of a meniscal tear, nor DLM type affected cartilage injury rate in either the medial or lateral compartment (P>0.05).Conclusion: Varus inclination caused by DLM could lead to cartilage injury in the medial compartment in middle-aged patients, but may not reduce the occurrence of chondral damage in the lateral compartment. Rather, lateral compartment chondral damage in patients with DLM was mainly related to symptom duration.

scholarly journals High Rate of Recurrent Meniscal Tear and Lateral Compartment Osteoarthritis in Patients Treated for Symptomatic Lateral Discoid Meniscus: A Population-Based Study

2019 ◽  
Vol 7 (7) ◽  
pp. 232596711985628 ◽  
Author(s):  
Orlando D. Sabbag ◽  
Mario Hevesi ◽  
Thomas L. Sanders ◽  
Christopher L. Camp ◽  
Diane L. Dahm ◽  
...  
Keyword(s):  
Meniscal Tear ◽  
Lateral Meniscus ◽  
Case Series ◽  
Meniscal Repair ◽  
Lateral Compartment ◽  
Hazard Ratio ◽  
High Rate ◽  
Discoid Lateral Meniscus ◽  
Discoid Meniscus ◽  
Increased Risk

Background: Little is known about the natural history of a surgically treated symptomatic lateral discoid meniscus. The goals of this study were to describe the rate and factors associated with recurrent lateral meniscal tears and progression to symptomatic lateral compartment osteoarthritis (OA) in patients surgically treated for a symptomatic lateral discoid meniscus. Hypothesis: Patients with surgically treated lateral discoid meniscus have a high incidence of meniscal retear and progression to lateral compartment OA. Study Design: Case series; Level of evidence, 4. Methods: A large geographic database was reviewed to identify and confirm patients presenting with symptomatic lateral discoid meniscus between 1998 and 2015. Charts were reviewed to document treatment and outcomes at a minimum clinical follow-up of 2 years. Results: A total of 59 patients (27 females, 32 males) with a mean age of 25.7 years (range, 4.0-66.0 years) underwent surgical management of a discoid lateral meniscus and were evaluated for a mean of 5.6 years (range, 2.0-23.7 years). Of these, 48 (82%) patients underwent partial lateral meniscectomy, with 24 patients undergoing concurrent saucerization. Eleven (18%) underwent meniscal repair. Tear-free survival following surgery was 41% at 8 years. Progression to symptomatic lateral compartment OA was 50% at 8 years. Young age (hazard ratio, 0.96; 95% CI, 0.93-0.99; P = .01) and open growth plates (hazard ratio, 3.19; 95% CI, 1.15-8.88; P = .03) were associated with increased incidence of postoperative retear. Older age at diagnosis and body mass index ≥30 kg/m2 were associated with increased risk of progression to lateral compartment OA on final radiographs. Conclusion: Patients with a surgically treated lateral discoid meniscal tear had a high rate of recurrent meniscal tear (59% at 8 years). Approximately 50% of surgically treated patients developed symptomatic lateral compartment OA at 8 years from diagnosis.

Open-wedge high tibial osteotomy in patients with discoid lateral meniscus

2021 ◽  
Vol 29 (2) ◽  
pp. 230949902110173
Author(s):  
Hee-June Kim ◽  
Ji-Yeon Shin ◽  
Hyun-Joo Lee ◽  
Chul-Hee Jung ◽  
Kyeong-Hyeon Park ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Lateral Meniscus ◽  
Lateral Compartment ◽  
Clinical Results ◽  
Discoid Lateral Meniscus ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Factors Affecting ◽  
The Mean ◽  
Open Wedge Hto

Background: There are concerns about the progression of the lateral osteoarthritis (OA) should be taken into account when high tibial osteotomy (HTO) is performed in patients with discoid lateral meniscus (LM). This study evaluated the clinical results of HTO in patients with discoid LM and elucidated factors affecting the results. Methods: This study evaluated 32 female patients with varus deformity and medial OA. Patients with discoid LM (8 patients) or without discoid LM (24 patients) underwent open-wedge HTO. The mean age was 53.5 years and the mean follow-up period was 35 months. Clinical results, including the Hospital for Special Surgery (HSS) score, Knee Society knee score (KS) and function score (FS), were evaluated. The progression of OA in the lateral compartment was also evaluated. Finally, we evaluated the factors affecting the clinical results and OA progression in the lateral compartment. Results: Between two groups, all clinical scores were not different (p = 0.964, 0.963, and 0.559, respectively). Three of eight patients (37.5%) in the discoid group developed OA in the lateral compartment, whereas 2 of 24 patients (8.3%) in the control group developed such; however, this was not significantly different (p = 0.085). In discoid group, patients with undercorrection has higher KS relative to patients with acceptable correction (p = 0.044). Other clinical results and OA change in the lateral compartment were not affected by evaluated factors. Conclusions: Patients who underwent open-wedge HTO showed the satisfactory clinical results and lateral OA progression regardless of the presence or absence discoid LM. However, when discoid LM was present, patients with undercorrection showed higher KS in comparison with patients with acceptable correction.

Age-associated features of the development of fibrosis and inflamaging in patients with arterial hypertension and ischemic stroke

2022 ◽  
pp. 879-884
Author(s):  
О.А. Осипова ◽  
Е.В. Гостева ◽  
О.Н. Белоусова ◽  
Н.И. Жернакова ◽  
Н.И. Клюшников ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Elderly Patients ◽  
Arterial Hypertension ◽  
Old Age ◽  
Control Group ◽  
Cerebral Stroke ◽  
Middle Aged ◽  
Aged Patients ◽  
Tnf Α ◽  
Immune Inflammation

В статье рассмотрены вопросы развития фиброза и иммунного воспаления у больных артериальной гипертензией (АГ) с острым ишемическим инсультом (ИИ) в пожилом возрасте. Цель исследования - изучение возраст-ассоциированных особенностей концентрации маркеров фиброза (металлопротеиназы-9, тканевого ингибитора матриксных металлопротеиназ-1, их соотношения ММП-9/ТИМП-1), иммунного воспаления (TNF-α, IL-1β, INF-γ) у больных АГ с ИИ. В исследование были включены 86 больных АГ II степени, из которых 42 человека - среднего возраста (53±5 лет) и 44 - пожилого (66±5 лет), контрольную группу составили 22 пациента пожилого возраста с АГ без ИИ в анамнезе. Критерии включения - пациенты с АГ, поступившие в стационар в остром периоде первого церебрального инсульта. Установлено, что у пожилых больных АГ с ИИ показатели инфламэйджинга и маркеры фиброза были достоверно выше, чем у лиц среднего возраста. Уровень IL-1β был выше на 31,7 % (р<0,01), TNF-α - на 55,7 % (р<0,001), INF-γ - на 36,6 % (р<0,01), уровень ММП-9 - на 46,4 % (р<0,01), ТИМП-1 - на 21,2 % (р<0,01), ММП-9/ТИМП-1 - на 19,6 % (р<0,01) в пожилом возрасте по сравнению с больными среднего возраста с АГ и острым ИИ. Таким образом, установлено, что больные АГ с ИИ имеют нарушения процессов инфламейджинга, синтеза и деградации внеклеточного матрикса, особенно выраженные в пожилом возрасте. The article deals with the development of fibrosis and immune inflammation in patients with arterial hypertension and acute ischemic stroke in old age. The aim of the study was to study age-associated features of the concentration of fibrosis markers (metalloproteinase-9, tissue inhibitor of matrix metalloproteinases-1, their ratio MMP-9/TIMP-1), immune inflammation (TNF-α, IL-1β, INF-γ) in patients with arterial hypertension and ischemic stroke (AI). The study included 86 patients with arterial hypertension (AH) of the 2nd degree, of which 42 were middle-aged (53±5 years) and 44 elderly (66±5 years). The control group consisted of 22 elderly patients with AH without a history of AI. The criteria for inclusion in the study are patients with hypertension who were admitted to the hospital in the acute period of the first cerebral stroke. It was found that in elderly patients with hypertension with AI, the indicators of inflamaging and fibrosis markers were significantly higher than in middle-aged people. The level of IL-1β was 31,7 % higher (p<0,01), TNF-α by 55,7 % (p<0,001), INF-γ by 36,6 % (p<0,01), the level of MMP-9 was 46,4 % higher (p<0,01), TIMP-1 by 21,2 % (p<0,01), MMP-9/TIMP-1 by 19,6 % (p<0,01) in the elderly compared to middle-aged patients with hypertension and acute AI. Thus, it was found that patients with arterial hypertension and ischemic stroke have violations of the processes of inflamaging, synthesis and degradation of the extracellular matrix, especially pronounced in old age.

Meniscal tear morphology independently affects pain relief following arthroscopic partial meniscectomy in middle-aged patients

2018 ◽  
Vol 27 (8) ◽  
pp. 2460-2467 ◽  
Author(s):  
Masayuki Kamimura ◽  
Jutaro Umehara ◽  
Atsushi Takahashi ◽  
Yu Mori ◽  
Daisuke Chiba ◽  
...  
Keyword(s):  
Pain Relief ◽  
Meniscal Tear ◽  
Partial Meniscectomy ◽  
Middle Aged ◽  
Arthroscopic Partial Meniscectomy ◽  
Aged Patients

scholarly journals Visual and previsual MRI-criteria for early diagnosis of cerebral small vessels disease in middle-aged patients: clinical and neuroimaging correlations

2021 ◽  
Vol 29 (3) ◽  
pp. 89-100
Author(s):  
О.V. Semonova ◽  
L.А. Myronyak ◽  
І.І. Glazovska ◽  
M.F. Ivanova ◽  
О.А. Krasyuk
Keyword(s):  
Early Diagnosis ◽  
Cerebrovascular Disorders ◽  
Total Duration ◽  
Multiparametric Mri ◽  
Control Group ◽  
Perivascular Spaces ◽  
Middle Aged ◽  
Aged Patients ◽  
Small Vessels ◽  
Visual Spatial

Background. The urgency of cerebral small vessel disease (cSVD) in modern neurology is considered mainly in terms of the development of vascular dementia and early diagnosis of Alzheimer’s disease. Minimal changes in MRI images and indistinct cognitive disorders in SNAMA-type cSVD (sporadic non-amyloid microangiopathy) last for a long time until they manifest as acute cerebrovascular disorders and/or significant mental deficits. However, clinical and neuroimaging criteria for early diagnosis of the disease have not been established yet, and the nature of the correlations between the indicators of neuropsychological and multiparametric MRI studies has not been clarified. Purpose – to develop criteria for early diagnosis of SNAMA cerebrovascular disease in middle-aged patients using neuropsychological studies and high-field multiparametric MRI. Materials and methods. The study enrolled 34 middle-aged patients (52.5 ± 10.8) with hypertension of stage 1–2, stage I–II and cSVD (women – 11 (32.4%), men – 23 (67.6%)). The control group (19 healthy individuals) was identical in age, gender and total duration of education. MRI (3T) was performed in the following modes: T1-2WI, DWI, 3D Brain FLAIR SHC, 3D tra, VEN BOLD, DTI medium iso SENSE. Neuropsychological studies were performed using the MoSA questionnaire evaluating the EIS, VIS, AIS, LIS, MIS, OIS domains. Results and discussion. We developed and introduced a modified scoring system for determining the severity of the burden of cerebral small vessels disease (BcSVDearly) in clinical practice. Among the early visual MRI markers, the expansion of the perivascular spaces was dominated in 27 (79.4%) of participants. A minor increase in Σ BcSVDearly to 6–7 points was found in 10 (29.4%) patients. The age norm (0–4 points) corresponded to the indicators of Σ BcSVDearly 23 out of 34 (67.6%) in the main group. Additional evidence of the disease was obtained by DTI MRI. The most significant decrease in FA was recorded in belt fibers (Δ: up to – 31.4%) and semioval centers (Δ: up to – 33.6%), the largest increase in MD was recorded in hooked bundles (Δ: up to 24.4%); right prefrontal, orbitofrontal and parietal areas (Δ up to 28.0%). According to the MoSA scale, moderate cognitive impairment was detected in 29 of 34 (85.3%) patients with a significant decrease in scores in the domains of EIS, VIS, LIS and AIS (p <0.001). The severity of early clinical manifestations of cSVD (non-amnestic polydomain moderate disorders of attention, speech, visual-spatial and executive cognitive functions) has been found to be moderately / markedly correlated with THMS, MD (positive) and FA (negative).Conclusions. We determined early visual signs of cSVD associated with arterial hypertension: dilated perivascular spaces, hyperintensity of the periventricular deep white matter of the brain, decrease by 9–33.6% of FA coefficient and increase by 20.8% – 28.0% MD. Moderate correlations between neuropsychological and neuroimaging studies have been demonstrated.

Effects of Qigong on Blood Pressure, Blood Pressure Determinants and Ventilatory Function in Middle-Aged Patients with Essential Hypertension

2003 ◽  
Vol 31 (03) ◽  
pp. 489-497 ◽  
Author(s):  
Myung Suk Lee ◽  
Myeong Soo Lee ◽  
Euy-Soon Choi ◽  
Hun-Taeg Chung
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Control Group ◽  
Middle Aged ◽  
Aged Patients ◽  
Urinary Catecholamines ◽  
Baseline Values ◽  
Sympathetic Nervous

This study was designed to measure changes in blood pressure (BP), urinary catecholamines and ventilatory functions of patients with mild essential hypertension after 10 weeks of Qigong (Shuxinpingxuegong). Fifty-eight patients volunteered to participate in this study and were randomly divided into either a Qigong group (n = 29), or a control group (n = 29). Systolic blood pressure and diastolic blood pressure decreased significantly in the Qigong group such that both became significantly lower after 10 weeks in the Qigong than in the control group. Also, there was a significant reduction of norepinephrine, metanephrine and epinephrine compared to baseline values in the Qigong group. The ventilatory functions, forced vital capacity and forced expiratory volume per sec, were increased in the Qigong group but not the control. These results suggest that Qigong may stabilize the sympathetic nervous system is effective in modulating levels of urinary catecholamines and BP positively, and in improving ventilatory functions in mildly hypertensive middle-aged patients.

scholarly journals Middle-aged patients with an MRI-verified medial meniscal tear report symptoms commonly associated with knee osteoarthritis

2017 ◽  
Vol 88 (6) ◽  
pp. 664-669 ◽  
Author(s):  
Kristoffer B Hare ◽  
L Stefan Lohmander ◽  
Nina Jullum Kise ◽  
May Arna Risberg ◽  
Ewa M Roos
Keyword(s):  
Knee Osteoarthritis ◽  
Meniscal Tear ◽  
Middle Aged ◽  
Aged Patients ◽  
Medial Meniscal Tear

The Effects of Home-Based Self-Care Education on Blood Pressure and Self-Care Behaviors among Middle-Aged Patients with Primary Hypertension in Iran: A Randomized Clinical Controlled Trial

2021 ◽  
pp. 108482232110127
Author(s):  
Sara Hazrati Gonbad ◽  
Masoumeh Zakerimoghadam ◽  
Shahzad Pashaeypoor ◽  
Shima Haghani
Keyword(s):  
Blood Pressure ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Care ◽  
Primary Hypertension ◽  
Control Group ◽  
Middle Aged ◽  
Aged Patients ◽  
Care Education ◽  
Home Based

Self-care education (SCE) through home visit is one of the methods with potential effects on self-care. This study aimed to evaluate the effects of home-based SCE on blood pressure and self-care behaviors among middle-aged patients with primary hypertension in Iran. This randomized controlled trial was conducted on 110 middle-aged patients with hypertension recruited from public healthcare centers in the south of Tehran, Iran in September 2019. After convenience sampling, Participants were simple randomly allocated to control and intervention groups. Intervention group received a 2-month home-based SCE while control group received routine care services. Before and 2 months after the intervention, self-care behaviors were assessed using the Hypertension Self-Care Activity Level Effects (H-SCALE). Data were analyzed using the SPSS software (v. 16.0) at a significance level of less than .05. After 2 months, the posttest mean scores of self-care behaviors in medication adherence (17.42 ± 1.03 vs 14.49 ± 1.01, p = .04), physical activity (8.16 ± 0.39 vs 6.47 ± 0.52, p = .01), low-salt diet (52.51 ± 3.8 vs 35.36 ± 3.47, p = .001), and blood pressure control (3.47 ± 0.22 vs 2.42 ± 1.89, p = .001), in the intervention group were significantly greater than the control group. However, there were no significant between-group differences respecting the posttest mean scores of the weight management ( p = .06) and smoking cessation ( p = .2). Also, the mean blood pressure between the 2 groups changed after the intervention, but this difference was not statistically significant. This study suggests the effectiveness of home-based SCE in significantly improving self-care behaviors among patients with hypertension. But more studies are needed to measure the effectiveness of intervention on blood pressure. IRCT code: IRCT20190623043985N1. Registered 06/30/2019, https://fa.irct.ir/trial/40351 .

scholarly journals Age-Dependent Occurrence and Progression of White Matter Hyperintensities in Patients With Systemic Lupus Erythematosus

2021 ◽  
Author(s):  
Eri Sano ◽  
Shimon Ishida ◽  
Tohru Takeuchi ◽  
Yoshifumi Nakaya ◽  
Shigeki Arawaka
Keyword(s):  
White Matter ◽  
Lupus Erythematosus ◽  
White Matter Hyperintensities ◽  
Brain Magnetic Resonance Imaging ◽  
Control Group ◽  
Middle Aged ◽  
Aged Patients ◽  
Deterioration Rate ◽  
The Difference ◽  
Fazekas Scale

Abstract To elucidate the process of white matter hyperintensities (WMH) deterioration in SLE, we here report the occurrence of WMH on brain magnetic resonance imaging (MRI) by age group and the WMH deterioration rate in patients with SLE. Age-adjusted ratios of periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) in the SLE group (n = 142) were higher than those in the control group (n = 216, p = 0.003 and p < 0.0001, respectively). The difference was remarkable in middle-aged patients (≥40 and <60 years) (p < 0.0001 for PVH and DWMH). In middle-aged patients with SLE, WMH were associated with factors related to atherosclerosis, including hypertension (OR, 4.0; 95% CI, 1.1–15.8 for PVH and OR, 4.5; 95% CI, 1.1–18.5 for DWMH) and dyslipidemia (OR, 22.2; 95% CI, 1.6–300.5 for PVH). In Kaplan–Meier analysis, the overall rate of one grade WMH deterioration on the Fazekas scale was 8.2% per year after a 15-year follow-up (<60 years, n = 68). WMH in middle-aged patients declined more rapidly than younger patients. Our study reveals that middle-aged patients with SLE pose a risk for developing WMH because of atherosclerotic changes and also can have progressively worsening WMH.

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