Post-Traumatic Osteoarthritis Assessment in Emerging and Advanced Pre-Clinical Meniscus Repair Strategies: A Review

Surgical repair of meniscus injury is intended to help alleviate pain, prevent further exacerbation of the injury, restore normal knee function, and inhibit the accelerated development of post-traumatic osteoarthritis (PTOA). Meniscus injuries that are treated poorly or left untreated are reported to significantly increase the risk of PTOA in patients. Current surgical approaches for the treatment of meniscus injuries do not eliminate the risk of accelerated PTOA development. Through recent efforts by scientists to develop innovative and more effective meniscus repair strategies, the use of biologics, allografts, and scaffolds have come into the forefront in pre-clinical investigations. However, gauging the extent to which these (and other) approaches inhibit the development of PTOA in the knee joint is often overlooked, yet an important consideration for determining the overall efficacy of potential treatments. In this review, we catalog recent advancements in pre-clinical therapies for meniscus injuries and discuss the assessment methodologies that are used for gauging the success of these treatments based on their effect on PTOA severity. Methodologies include histopathological evaluation of cartilage, radiographic evaluation of the knee, analysis of knee function, and quantification of OA predictive biomarkers. Lastly, we analyze the prevalence of these methodologies using a systemic PubMed® search for original scientific journal articles published in the last 3-years. We indexed 37 meniscus repair/replacement studies conducted in live animal models. Overall, our findings show that approximately 75% of these studies have performed at least one assessment for PTOA following meniscus injury repair. Out of this, 84% studies have reported an improvement in PTOA resulting from treatment.

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Mesenchymal stem cells in synovial fluid increase in knees with degenerative meniscus injury after arthroscopic procedures through the endogenous effects of CGRP and HGF

10.21203/rs.3.rs-42459/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Naoto Watanabe ◽

Kentaro Endo ◽

Keiichiro Komori ◽

Nobutake Ozeki ◽

Mitsuru Mizuno ◽

...

Keyword(s):

Stem Cells ◽

Mesenchymal Stem Cells ◽

Synovial Fluid ◽

Meniscal Repair ◽

Correlation Coefficients ◽

Meniscus Repair ◽

Soluble Factors ◽

Meniscus Injury ◽

Colony Number ◽

Meniscus Injuries

Abstract Background: Mesenchymal stem cells (MSCs) in synovial fluid increase after traumatic meniscus injuries. However, MSC kinetics in synovial fluid may differ for knees with degenerative meniscus injuries. Furthermore, the combination of surgical repair and synovial MSC transplantation has been found to improve clinical symptoms in patients with degenerative meniscus injury, and in this treatment, only the operation procedure without MSC transplantation might increase MSCs in synovial fluid; if so, soluble factors in synovial fluid will be involved. The purpose is this study was to examine whether MSCs exist in synovial fluid of knees with degenerative meniscus injury, to investigate whether MSCs in synovial fluid increase after harvest of synovium and meniscus repair, and to explore what soluble factors in synovial fluids affect the number of MSCs in synovial fluid.Methods: Subjects were 7 patients with degenerative meniscus injury who underwent meniscal repair and synovial MSC transplantation. Synovial fluid (Pre) was aspirated from knees before harvest of synovium and meniscus repair. After 2 weeks, synovial fluid (Post) was aspirated again before transplantation of synovial MSCs. A half volume of the synovial fluid was plated and cultured for 2 weeks to count the colony formation. The other half was used for antibody array analysis, and the correlation coefficients between the signal intensity and colony number were measured in 503 factors. Factors with high correlation coefficients were verified by migration assay.Results: While cell colonies derived from synovial fluid (Pre) were hardly observed, greater numbers of colonies from synovial fluid (Post) were demonstrated. Of the 503 factors, calcitonin gene-related peptide (CGRP) and hepatocyte growth factor (HGF) had high correlation coefficients between colony number and expression level. Both CGRP and HGF promoted migration of synovial fluid MSCs. Conclusions: MSCs in synovial fluid were hardly seen in knees with degenerated meniscus injury. They significantly increased 2 weeks after harvest of synovium and meniscus repair. Both CGRP and HGF in synovial fluid can possibly induce MSCs from synovium into synovial fluid.

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The Application of Natural Collagen Materials and Tissue Engineering on Repair for Exercise-Induced Meniscus Injury

Advanced Materials Research ◽

10.4028/www.scientific.net/amr.830.490 ◽

2013 ◽

Vol 830 ◽

pp. 490-494

Author(s):

Zhi Ping Wang

Keyword(s):

Tissue Engineering ◽

Materials Science ◽

Meniscus Repair ◽

Practical Application ◽

Tissue Engineering Scaffolds ◽

Meniscus Injury ◽

Meniscus Tissue ◽

Engineering Problems ◽

Mechanical Factors ◽

Exercise Induced

With the development of tissue engineering and materials science, through the research of meniscus tissue engineering to discover novel tissue engineering materials, and further accelerate the research of meniscus tissue engineering, through clinical trials and application of finding appropriate meniscus substitute, which can provide a new mode of treatment for meniscus repair. The focus of the current study including the mechanism of meniscus injury can absorb the natural collagen meniscus tissue engineering scaffolds as feasibility analysis, stress stimulation, meniscus recovery mechanical factors in 4 aspects. Research shows that it has a good application prospect and wider space for meniscus tissue engineering repair of exercise-induced meniscus injury. But in practical application, the meniscus tissue engineering scaffold construction, research on extra cellular matrix composite and its tissue compatibility, repair after tissue engineering meniscus stress stimulation and can withstand the mechanical factors the problem is still the meniscus tissue engineering problems.

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Subjective Knee Function and Risk of Failure Are Equivalent for Men and Women at 5 Years After Meniscus Repair

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2019.09.030 ◽

2020 ◽

Vol 36 (3) ◽

pp. 816-822 ◽

Cited By ~ 3

Author(s):

Joshua S. Everhart ◽

Robert A. Magnussen ◽

Parker A. Cavendish ◽

Kent Axcell ◽

Ryan Blackwell ◽

...

Keyword(s):

Meniscus Repair ◽

Knee Function ◽

Men And Women ◽

Risk Of Failure

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Correlation Between CT Images of Lateral Plateau and Lateral Meniscus Injuries in Patients With Schatzker II Tibial Plateau Fractures：A Retrospective Study

10.21203/rs.3.rs-543373/v1 ◽

2021 ◽

Author(s):

Pu Ying ◽

Lei Zhu ◽

Wenge Ding ◽

Yue Xu ◽

Xiaowei Jiang ◽

...

Keyword(s):

Tibial Plateau ◽

Lateral Meniscus ◽

Ct Images ◽

Tibial Plateau Fractures ◽

Posterior Horn ◽

Operating Point ◽

Optimal Operating ◽

Meniscus Injury ◽

Lateral Plateau ◽

Meniscus Injuries

Abstract Background: There is a great deal of controversy on whether routine MRI examination is needed for fresh fractures while the vast majority of patients with tibial plateau fractures receive preoperative X-ray and CT examinations. The purpose of the study was to analyze the exact correlation between CT images of lateral plateau and lateral meniscus injuries in Schatzker II tibial plateau fractures. Methods: Two hundred and ninety-six Schatzker II tibial plateau fracture patients from August 2012 to January 2021 in two trauma centers were enrolled for the analysis. According to the actual situation during open reduction internal fixation (ORIF) and knee arthroscopic surgery, patients were divided into meniscus injury (including rupture, incarceration, etc.) and non-meniscus injury groups. By measuring the value of both lateral plateau depression (LPD) and lateral plateau widening (LPW) of lateral tibial plateau on the coronary CT images, the correlation of which and lateral meniscus injury was analyzed. Meanwhile, the relevant receiver operating characteristic (ROC) curve was drawn to evaluate the optimal operating point of these two indicators which could predict meniscus injury. Results: Meniscus injury group mainly showed injuries involving the mid-body and posterior horn of the meniscus (98.1%, 157/160). The average LPD was 13.2 ± 3.2 mm, while the average value of the group without meniscus injury was 9.4 ± 3.2 mm. The difference was statistically significant (P < 0.05). The average LPW was 8.0 ± 1.4 mm and 6.8 ± 1.6 mm in two groups with a significant difference (P < 0.05). The optimal operating point of LPD and LPW was 7.9 mm (sensitivity-95.0%, specificity-58.8%, area under the curve (AUC-0.818) and 7.5 mm (sensitivity-70.0%, specificity-70.6%, AUC-0.724), respectively. Conclusions: The mid-body and posterior horn of lateral meniscus injury is more likely to occur in patients who had Schatzker II tibial plateau fractures when LPD > 7.9 mm and/or LPW > 7.5 mm on CT manifestations and these findings will definitely provide guidance for orthopedic surgeons in treating such injuries. During the operation, more attention should be paid to the treatment of the meniscus and full consideration is needed be taken to situations such as meniscus rupture, incarceration and other possible fracture reduction difficulties, poor vertical line, etc., in order to achieve better surgical results.

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Deep Learning-Based Image Feature with Arthroscopy-Aided Early Diagnosis and Treatment of Meniscus Injury of Knee Joint

Journal of Healthcare Engineering ◽

10.1155/2021/2254594 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Zijian Li ◽

Shiyou Ren ◽

Xintao Zhang ◽

Lu Bai ◽

Changqing Jiang ◽

...

Keyword(s):

Deep Learning ◽

Knee Joint ◽

Knee Function ◽

Partial Resection ◽

Knee Meniscus ◽

Meniscus Injury ◽

Secondary Resection ◽

Network Algorithm ◽

Meniscus Suture ◽

Mri Image

The aim of this study is to explore the clinical effect of deep learning-based MRI-assisted arthroscopy in the early treatment of knee meniscus sports injury. Based on convolutional neural network algorithm, Adam algorithm was introduced to optimize it, and the magnetic resonance imaging (MRI) image super-resolution reconstruction model (SRCNN) was established. Peak signal-to-noise ratio (PSNR) and structural similarity (SSIM) were compared between SRCNN and other algorithms. Sixty patients with meniscus injury of knee joint were studied. Arthroscopic surgery was performed according to the patients’ actual type of injury, and knee scores were evaluated for all patients. Then, postoperative scores and MRI results were analyzed. The results showed that the PSNR and SSIM values of the SRCNN algorithm were (42.19 ± 4.37) dB and 0.9951, respectively, which were significantly higher than those of other algorithms ( P < 0.05). Among patients with meniscus injury, 17 cases (28.33%) were treated with meniscus suture, 39 cases (65.00%) underwent secondary resection, 3 cases (5.00%) underwent partial resection, and 1 case (1.67%) underwent full resection. After meniscus suture, secondary resection, partial resection, and total resection, the knee function scores of patients after treatment were (83.17 ± 8.63), (80.06 ± 7.96), (84.34 ± 7.74), and (85.52 ± 5.97), respectively. There was no great difference in knee function scores after different methods of treatment ( P > 0.05), and there were considerable differences compared with those before treatment ( P < 0.01). Compared with the results of arthroscopy, there was no significant difference in the grading of meniscus injury by MRI ( P > 0.05). To sum up, the SRCNN algorithm based on the deep convolutional network algorithm improved the MRI image quality and the diagnosis of knee meniscus injuries. Arthroscopic knee surgery had good results and had great clinical application and promotion value.

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Artificial Intelligence in Repairing Meniscus Injury in Football Sports with Perovskite Nanobiomaterials

Journal of Healthcare Engineering ◽

10.1155/2021/4324138 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Wei Wang

Keyword(s):

Artificial Intelligence ◽

Healing Rate ◽

Age Of Onset ◽

Rapid Development ◽

Biological Characteristics ◽

Special Equipment ◽

Meniscus Injury ◽

Artificial Intelligence Technology ◽

Meniscus Injuries ◽

Support Phase

Knee meniscus injuries are more likely to occur in young adults in clinical practice, and their lower age of onset and greater impact on joint function after injury also put forward higher requirements for the treatment and rehabilitation of meniscus injuries. With the rapid development of artificial intelligence technology and arthroscopic minimally invasive technology, arthroscopic meniscus plasty and perovskite nanobiomaterial repair have gradually replaced the previous open meniscus surgery of the knee joint and has become the main method of meniscus injury treatment, and the perovskite nanobiomaterial repair technique that incorporates artificial intelligence technology is also gradually being applied. Therefore, this article studies the role of perovskite nanobiomaterials in the repair of meniscus injuries in football sports and analyzes the biological characteristics of the inner and outer meniscus to provide help to improve the healing rate of meniscus injuries. The study selected six male meniscus-injured patients (meniscus injuries caused by football sports) and obtained six injured menisci. The same cross section of the same part of the meniscus was analyzed inside and outside the meniscus. At the same time, a meniscal injury step was performed on the patient. The biological characteristics of perovskite nano-biomaterials in the repair of meniscus injuries in football sports were compared and analyzed, and the patient's gait before and after surgery was also compared. Experiments have shown that the percentage of the postoperative support phase of the affected limb is significantly higher than that before surgery ( P < 0.05 ), the percentage of the postoperative support phase and flatfoot phase decreased compared with that before surgery, and the gait cycle parameters of both lower extremities improved after surgery, obviously ( P < 0.05 ). It explains that the arthroscopic repair of perovskite nanobiomaterials combined with the artificial intelligence technology to repair the meniscus anterior angle injury is simple and does not require special equipment, has fewer complications, is safe and reliable, and has a high clinical healing rate and a high patient satisfaction rate after surgery. The curative effect is significant; artificial intelligence technology and the application of perovskite nanobiomaterials provide more possibilities for meniscus repair.

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Radium-223 Treatment of Patients with Metastatic Castration Resistant Prostate Cancer: Biomarkers for Stratification and Response Evaluation

Cancers ◽

10.3390/cancers13174346 ◽

2021 ◽

Vol 13 (17) ◽

pp. 4346

Author(s):

Kim van der Zande ◽

Wim J. G. Oyen ◽

Wilbert Zwart ◽

Andries M. Bergman

Keyword(s):

Prostate Cancer ◽

Predictive Biomarkers ◽

Radiographic Evaluation ◽

Castration Resistant Prostate Cancer ◽

Treatment Benefit ◽

Castration Resistant ◽

Radium 223 ◽

Related Quality ◽

Health Related ◽

Psa Response

Radium-223 dichloride ([223Ra]RaCl2; Ra-223) is a targeted alpha-emitting radiopharmaceutical which results in an overall survival and health related quality of life (HRQoL) benefit in symptomatic patients with metastatic castration resistant prostate cancer (mCRPC) and predominantly bone metastasis. Although effective, options to select patients who will derive treatment benefit and to monitor and predict treatment outcomes are limited. PSA response and radiographic evaluation are commonly used in mCRPC treatment assessment but are not informative in Ra-223 treated patients. Consequently, there is a clear need for predictive and prognostic tools. In this review, we discuss the physiology of bone metastases and the mechanism of action and efficacy of Ra-223 treatment, as well as offering an outline of current innovative prognostic and predictive biomarkers.

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Surgical treatment for Pipkin type IV femoral head fracture

Journal of Orthopaedic Surgery ◽

10.1177/2309499016684970 ◽

2017 ◽

Vol 25 (1) ◽

pp. 230949901668497 ◽

Cited By ~ 3

Author(s):

Yi-Hsun Yu ◽

Yung-Heng Hsu ◽

Ying-Chao Chou ◽

I-Chuan Tseng ◽

Chun-Yi Su ◽

...

Keyword(s):

Femoral Head ◽

Functional Results ◽

Surgical Approaches ◽

Consecutive Series ◽

Radiological Outcome ◽

Femoral Head Fracture ◽

Type Iv ◽

Post Traumatic ◽

The Mean

Purpose: Pipkin type IV femoral head (FH) fracture was thought as poor prognosis. There were several surgical approaches and treatments for this difficult fracture. However, there was no one treatment superior to another. We reviewed a serious of patients with Pipkin type IV FH fracture underwent surgery via a modified Gibson approach. Methods: We reviewed a consecutive series of nine patients with Pipkin type IV FH fracture under surgery via a modified Gibson approach between 2012 and 2013. The surgical procedure was completely described, and the radiological outcome and the functional outcome were also reviewed. Results: The mean follow-up duration was 17 (12–30) months. The mean Merle d’Aubigne score was 16 (8–19). Seven patients had anatomical reductions, and two had imperfect reductions by Matta’s grading. There was no early posttraumatic osteoarthritis during the follow-up period. One patient with early post-traumatic osteonecrosis 3 months after index surgery underwent total hip arthroplasty. Conclusions: Through this surgery approach to fix the FH and the acetabulum, the radiological and the functional results were satisfactory. We still need more patients with prospective study to find an optimal surgical approach for Pipkin type IV FH fracture.

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The Alignment of Solution-Focused Brief Counseling in Helping to Achieve Resilience

Islamic Guidance and Counseling Journal ◽

10.25217/igcj.v3i2.860 ◽

2020 ◽

Vol 3 (2) ◽

pp. 100-107

Author(s):

Wiwin Hendriani ◽

Mulawarman Mulawarman

Keyword(s):

Scientific Journal ◽

Relevant Literature ◽

Journal Articles ◽

Brief Counseling ◽

Psychological Conditions ◽

Intervention Process ◽

Individual Resilience ◽

Post Traumatic ◽

Conceptual Explanation ◽

Solution Focused

This review of the literature aims to explain why Solution-Focused Brief Counseling (SFBC) is appropriate as an approach in helping individuals achieve resilience, after experiencing certain traumatic events. This study was motivated by the need for a conceptual explanation of what approaches can be recommended so that recovery of post-traumatic psychological conditions and the achievement of resilience can be carried out with more efficient and effective processes. The method used in this study was comparative analysis, involving a variety of relevant literature to identify alignment concepts between SFBC and resilience. The intended literature includes reference books, reputable scientific journal articles, and various information from credible sources. The results of the study show that there are points of similarity in the two theories, both in terms of basic assumptions and concepts related to the intervention process which confirms the relevance and accuracy of the use of SFBC in helping individuals achieve post-traumatic resilience. This study can then be used as a scientific foothold for the application of SFBC in an effort to increase individual resilience in various contexts.

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Surgical treatment for terrible triad injury of the elbow with anteromedial coronoid fracture through a combined surgical approach

Journal of International Medical Research ◽

10.1177/0300060518771263 ◽

2018 ◽

Vol 46 (8) ◽

pp. 3053-3064 ◽

Cited By ~ 1

Author(s):

Guanyi Liu ◽

Jingen Hu ◽

Weihu Ma ◽

Ming Li ◽

Rongming Xu ◽

...

Keyword(s):

Surgical Treatment ◽

Surgical Approach ◽

Lateral Collateral Ligament ◽

Surgical Approaches ◽

Terrible Triad ◽

Coronoid Fracture ◽

Flexion Extension ◽

Post Traumatic ◽

Coronoid Fractures ◽

The Mean

Summary Objective To report the results of the surgical treatment of terrible triad injury with anteromedial coronoid fracture through a combined surgical approach. Methods This retrospective study evaluated data from patients who underwent surgery to repair terrible triad injuries and anteromedial coronoid fractures. Surgical treatment involved radial head repair or replacement, medial and lateral collateral ligament repair, and coronoid fracture fixation through combined approaches. Evaluations were performed using the Mayo Elbow Performance Score (MEPS) and anteroposterior and lateral radiographs of the elbow. Results Twenty-two patients (15 males, seven females; mean ± SD age, 47.5 ± 11.4 years) were enrolled in this study. Fracture union and concentric reduction of both the ulnotrochlear and radiocapitellar articulations were achieved in all patients. The mean ± SD follow-up was 31.6 ± 11.9 months. The mean ± SD arc of flexion–extension was 110.3° ± 26.3° and arc of forearm rotation was 139.5° ± 17.1°. The mean ± SD MEPS was 88.1 ± 12.2 points, with results classified as excellent in eight elbows, good in ten, and fair in four. Six patients had radiographic signs of post-traumatic arthritis. Three patients required secondary surgeries. Conclusion Combined surgical approaches can be considered for the treatment of terrible triad injuries in association with anteromedial coronoid fractures.

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