scholarly journals The PCL Envelope Lack Sign (PELS) Is a Direct Arthroscopic Sign of Chronic Posterior Cruciate Ligament Insufficiency

2021 ◽  
Vol 11 (8) ◽  
pp. 3608
Author(s):  
Adrian Góralczyk ◽  
Marcin Mostowy ◽  
Michał Ebisz ◽  
Robert F. LaPrade ◽  
Aleksandra Sibilska ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Predictive Value ◽  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Normal Space ◽  
Control Group ◽  
Study Group ◽  
Post Injury ◽  
Diagnostic Characteristics ◽  
Posterior Knee

Purpose: To present the arthroscopic “PCL envelope lack sign” (PELS) and to calculate its diagnostic characteristics in chronic PCL insufficiency. Methods: Recordings of knee arthroscopies performed in a single clinic between April 2015 to March 2020 were retrospectively evaluated, searching for the “PCL envelope”. It was defined as a “soft tissue cuff coursing around the PCL tibial attachment, visible with the arthroscope positioned between the PCL, medial femoral condyle and posterior horn of the medial meniscus at the level of its shiny white fibers”. PELS was defined as “the PCL adhering to the proximal tibia adjacent to the medial meniscal posterior root attachment, inability to observe the normal space between the PCL and posterior tibia and no soft tissue cuff around the PCL tibial attachment”. Inclusion criteria were possibility to evaluate the PELS presence on recordings. Patients who underwent PCL reconstruction were assigned to the study group. The rest of the patients were controls. Criteria to operate on symptomatic PCL patients were at least 5 mm of posterior instability in physical examination and at least 6 months post-injury. Results: Out of 614 available recordings, 592 patients (205 females, 387 males; mean age 45.2 years, SD = 14.36, range 14–81) were included: 38 in the study group and 554 in the control group. In the study group, PELS was positive in 36 of 38 cases (94.7%). In the control group, PELS was negative in 554 PCL-efficient patients (100%). Calculated PELS sensitivity was 94.7%, specificity 100%, positive predictive value 100%, negative predictive value 99.6%. The PELS was present significantly more often in PCL-insufficient patients, p < 0.001. Conclusions: The PCL envelope lack sign was found to be a highly effective tool to arthroscopically confirm chronic PCL insufficiency, and should be considered a direct sign of chronic posterior knee instability.

Outcomes More Than 2 Years After Meniscal Repair for Longitudinal Tears of the Lateral Meniscus Combined With Anterior Cruciate Ligament Reconstruction

2021 ◽  
pp. 036354652098197
Author(s):  
Akira Tsujii ◽  
Yasukazu Yonetani ◽  
Kazutaka Kinugasa ◽  
Tomohiko Matsuo ◽  
Kenji Yoneda ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Complete Healing ◽  
Control Group ◽  
Study Group ◽  
Meniscal Extrusion ◽  
Second Look ◽  
Anterior Cruciate

Background: Meniscal function after repair of longitudinal tears of the lateral meniscus (LM) with anterior cruciate ligament reconstruction (ACLR) has not been comprehensively investigated. Purpose: To evaluate not only the clinical outcomes and radiographic findings of patients who underwent repair of longitudinal tears of the LM combined with ACLR but also the healing status of the repaired meniscus and changes in chondral status with second-look arthroscopy. Study Design: Case series; Level of evidence, 4. Methods: Among 548 patients who underwent primary anatomic ACLR at our institution between 2010 and 2017, 39 who had concomitant longitudinal tears of the LM and underwent repair were studied. During follow-up for more than 2 years, all patients were evaluated clinically (pain, range of motion, swelling, and knee instability) and with imaging (plain radiograph and magnetic resonance imaging [MRI]), and compared with a matched control group (based on age, sex, body mass index, and follow-up period) without any concomitant injuries who underwent ACLR. Measurements on MRI were recorded preoperatively, immediately after surgery, and at final follow-up, and the change in the values over time was assessed. Of the 39 patients in each group, 24 were assessed by second-look arthroscopy with hardware removal 2 years postoperatively. Results: The mean follow-up times of the study and control group were at a mean of 42.4 and 45.4 months, respectively. There were no significant differences in clinical findings, lateral joint space narrowing on radiographs, and chondral status at the lateral compartment between groups, whereas lateral and posterior meniscal extrusion on MRI progressed significantly in the study group (0.43 ± 1.0 mm vs -0.29 ± 1.1 mm, P = .003; 1.9 ± 1.9 mm vs 0.14 ± 1.1 mm, P < .0001, respectively). Second-look arthroscopy revealed complete healing in 12 patients (50%), partial healing in 9 (37.5%), and failure in 3 (12.5%) in the study group, and no new tear in the control group. Conclusion: The clinical and imaging outcomes after repair of longitudinal tears of the LM combined with anatomic ACLR were successful and comparable with those after isolated ACLR without any other injuries at 42 months postoperatively, although meniscal extrusion showed progression on coronal/sagittal MRI. Based on the MRI findings and the result that only half of patients achieved complete healing, meniscal function could not be fully restored even after repair. Although degenerative changes were not apparent, longer-term follow-up is needed.

Is Treatment of Segond Fracture Necessary With Combined Anterior Cruciate Ligament Reconstruction?

2017 ◽  
Vol 46 (4) ◽  
pp. 832-838 ◽  
Author(s):  
Heath P. Melugin ◽  
Nick R. Johnson ◽  
Isabella T. Wu ◽  
Bruce A. Levy ◽  
Michael J. Stuart ◽  
...  
Keyword(s):  
Pivot Shift ◽  
Cruciate Ligament ◽  
Control Group ◽  
Study Group ◽  
Activity Levels ◽  
Segond Fracture ◽  
Acl Tear ◽  
Significant Difference ◽  
Ikdc Score ◽  
Grade 3

Background: There is a paucity of clinical information to guide the treatment of a combined anterior cruciate ligament (ACL) tear and Segond fracture. Purpose: To compare clinical outcomes, graft failure rates, and activity levels between patients undergoing ACL reconstruction (ACLR) with and without an untreated Segond fracture at a minimum 2-year follow-up. Study Design: Cohort study; Level of evidence, 3. Methods: This study included a group of patients with a combined ACL tear/untreated Segond fracture that was matched based on age, sex, body mass index, and graft type to a control group of patients with an ACL tear and no Segond fracture. All patients were treated with ACLR alone between the years of 2000 and 2015. The diagnosis of a Segond fracture, or bony avulsion of the anterolateral complex, was made by radiographic analysis. Data regarding the initial injury, surgical intervention, and physical examination findings were recorded. Clinical and functional outcomes were obtained using physical examination results, International Knee Documentation Committee (IKDC) subjective scores, and Tegner activity levels. Results: Twenty patients (16 male, 4 female) with a combined ACL tear/untreated Segond fracture with a mean age of 26.3 years (range, 13-44 years) were matched to a control group of 40 patients (32 male, 8 female) with an ACL tear and no Segond fracture with a mean age of 26.4 years (range, 13-47 years). The study group was followed for a mean of 59.1 months (range, 24-180 months) and the control group for a mean of 55.5 months (range, 24-120 months). The mean IKDC score was 86.5 (range, 54-100) for the study group compared with 93.0 (range, 54-100) for the control group ( P = .03). The graft rupture rate was 10% for both groups ( P = .97). The mean time to rupture was 33.0 months (range, 21-45 months) in the study group and 63.5 months (range, 39-88 months) in the control group ( P = .24). Patients in the study group had significantly more anteroposterior instability by preoperative Lachman testing than those in the control group (control group: 0 normal, 3 grade 1+, 37 grade 2+, 0 grade 3+; study group: 0 normal, 1 grade 1+, 10 grade 2+, 9 grade 3+; P = .0001). There was no significant difference between the 2 groups in regard to postoperative Lachman testing (control group: 35 normal, 3 grade 1+, 2 grade 2+, 0 grade 3+; study group: 17 normal, 3 grade 1+, 0 grade 2+, 0 grade 3+; P = .31). Patients in the study group had significantly more instability by preoperative pivot-shift testing than those in the control group (control group: 0 normal, 7 grade 1+, 33 grade 2+, 0 grade 3+; study group: 1 normal, 1 grade 1+, 11 grade 2+, 7 grade 3+; P = .0003). No significant difference was found between the 2 groups for postoperative pivot-shift testing (control group: 36 normal, 2 grade 1+, 2 grade 2+, 0 grade 3+; study group: 18 normal, 1 grade 1+, 1 grade 2+, 0 grade 3+; P = .61) or final Tegner activity level (median, 6). Conclusion: At midterm follow-up, patients undergoing ACLR with and without a Segond fracture had similar pivot-shift test results, graft failure rates, and activity levels. The IKDC score was statistically worse in the patients with a combined ACL tear/untreated Segond fracture, but the difference was less than the minimal clinically important difference for the IKDC score. These findings suggest that patients with a combined ACL tear/untreated Segond fracture can have comparable outcomes to patients with an ACL tear and no Segond fracture when treated with ACLR alone.

A Randomized Clinical Trial to Evaluate Attached Hamstring Anterior Cruciate Ligament Graft Maturity With Magnetic Resonance Imaging

2018 ◽  
Vol 46 (5) ◽  
pp. 1143-1149 ◽  
Author(s):  
Shaohua Liu ◽  
Hong Li ◽  
Hongyue Tao ◽  
Yaying Sun ◽  
Shiyi Chen ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Signal Intensity ◽  
Cruciate Ligament ◽  
Hamstring Tendon ◽  
Control Group ◽  
Study Group ◽  
Tibial Insertion ◽  
Significant Difference ◽  
The Difference ◽  
Anterior Cruciate

Background: The hamstring tendons are commonly harvested for anterior cruciate ligament (ACL) reconstruction with detachment of the tibial insertion. Retaining the insertion may help to preserve vascularity and viability of the graft and bypass the stages of avascular necrosis and revascularization, which might be beneficial to graft maturity. Purpose: To investigate and compare graft maturity by magnetic resonance imaging (MRI) after ACL reconstruction with preservation or detachment of hamstring tendon tibial insertion at up to 2 years. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: Forty-five patients (age range, 18-45 years) undergoing isolated ACL reconstruction with hamstring tendon were enrolled and randomized to 2 groups. The tibial insertion of the hamstring tendon was preserved in the study group (n = 21) and detached in the control group (n = 24). Patients had follow-up at 3, 6, 12, and 24 months, which consisted of the following: (1) clinical examination and (2) MRI evaluation of graft signal intensity based on signal/noise quotient (SNQ) values. Finally, 18 patients in the study group and 19 in the control group received full follow-up evaluation (ie, at all 4 time points). Results: All knees acquired full range of motion at 24 months without significant laxity. At each time point, the KT-1000 arthrometer revealed no significant difference between groups; the clinical scores significantly improved in both groups, although the difference between groups was not significant. In the control group, the SNQ value increased from 3 months, peaked at 6 months, and then decreased (3 months, 21.4 ± 12.7; 6 months, 25.6 ± 12; 12 months, 18.3 ± 7.7; 24 months, 15.3 ± 6.3). However, the insertion-preserved graft in the study group maintained relatively lower and unchanged signal intensity throughout all time points (3 months, 15.0 ± 11.2; 6 months, 14.9 ± 6.3; 12 months, 12.6 ± 7.0; 24 months, 14.6 ± 7.0). Between groups, there was no significant difference at 3 or 24 months ( P = .11 and .75, respectively), while the SNQ values were significantly lower in the study group versus the control group at 6 and 12 months ( P = .002 and .02, respectively). Conclusion: The insertion-detached hamstring tendon grafts underwent a significantly increasing change in signal intensity during the first 2 years after ACL reconstruction, while the insertion-preserved grafts kept a relatively lower and unchanged signal intensity. The difference was most significant at 6 and 12 months postoperatively.

Excessive Preoperative Anterior Tibial Subluxation in Extension Is Associated With Inferior Knee Stability After Anatomic Anterior Cruciate Ligament Reconstruction

2020 ◽  
Vol 48 (3) ◽  
pp. 573-580 ◽  
Author(s):  
Guan-yang Song ◽  
Hui Zhang ◽  
Jin Zhang ◽  
Zhi-jun Zhang ◽  
Tong Zheng ◽  
...  
Keyword(s):  
Pivot Shift ◽  
Cruciate Ligament ◽  
Pivot Shift Test ◽  
Control Group ◽  
Study Group ◽  
Knee Stability ◽  
Anterior Tibial ◽  
Kt 1000 ◽  
Anterior Cruciate

Background: Anterior tibial subluxation (ATS) in extension after anterior cruciate ligament (ACL) injury highlights an increased anterior position of the tibia relative to the femur. Recent studies demonstrated that subluxation is sometimes irreducible and the normal tibiofemoral relationship is not restored by ACL reconstruction (ACLR), which raises concerns regarding clinical outcomes after ACLR. Hypothesis: Excessive preoperative ATS in extension is associated with inferior knee stability after anatomic ACLR. Study Design: Cohort study; Level of evidence, 3. Methods: From March 2016 to January 2017, a total of 487 consecutive patients with clinically diagnosed noncontact ACL injuries who underwent primary anatomic ACLR were retrospectively analyzed. Of these patients, 430 met the criteria for inclusion in this study. Anterior subluxation of the lateral and medial compartments (ASLC and ASMC) in extension relative to the femoral condyles was measured on preoperative magnetic resonance imaging. Twenty patients (study group) who demonstrated excessive (>10 mm) ASLC and ASMC in extension were matched 1:2 to 40 participants (control group) who showed minimal or no (<3 mm) ASLC and ASMC in extension. The amount of ASLC and ASMC in extension relative to the femoral condyles at 2 years postoperatively was the primary outcome. Moreover, the Lysholm score, IKDC grade (International Knee Documentation Committee), and stability assessments (pivot-shift test and KT-1000 arthrometer side-to-side difference) were evaluated preoperatively and at the last follow-up visit. Results: The preoperative mean ASLC and ASMC in extension of the study group were both significantly larger than those of the control group (study group vs control group: ASLC, 13.5 mm vs 1.2 mm; ASMC, 12.4 mm vs 1.0 mm; P < .05). Moreover, patients in the study group showed significantly larger posterior tibial slope than the patients in the control group (17.8°± 2.5° vs 9.5°± 1.5°; P < .05). At the final follow-up visit, the mean ASLC and ASMC of the study group were 8.1 mm and 7.3 mm, which were significantly larger than those of the control group (ASLC, 0.9 mm; ASMC, 0.7 mm; P < .05). In addition, the study group showed inferior knee stability when compared with the control group in terms of both the pivot-shift test (study group vs control group: 2 grade 2, 10 grade 1, and 8 grade 0 vs 1 grade 1 and 39 grade 0; P < .05) and the KT-1000 arthrometer side-to-side difference (study group vs control group: 4.4 ± 1.2 mm vs 1.5 ± 0.6 mm; P < .05). Furthermore, the study group showed significantly lower mean Lysholm score (study group vs control group: 80.3 ± 6.3 vs 93.3 ± 4.3, P < .05) and IKDC grading results (study group vs control group: 3 grade C, 16 grade B, and 1 grade A vs 3 grade B and 37 grade A; P < .05) as compared with the control group. Conclusion: In this short-term study, the excessive (>10 mm) preoperative ATS in extension after ACL injury was associated with inferior knee stability after anatomic ACLR.

scholarly journals Prognostic Utility of Coronary Computed Tomographic Angiography: A 5-Year Follow-Up in Type 2 Diabetes Patients with Suspected Coronary Artery Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Daliang Liu ◽  
Huijuan Jia ◽  
Yucun Fu ◽  
Wen He ◽  
Daqing Ma
Keyword(s):  
Computed Tomography ◽  
Type 2 Diabetes ◽  
Coronary Artery ◽  
Predictive Value ◽  
Coronary Computed Tomography Angiography ◽  
Control Group ◽  
Study Group ◽  
Coronary Events

Objectives.To analyze the predictive value of coronary computed tomography angiography on acute coronary artery events in patients with type 2 diabetes.Methods.Coronary computed tomography angiography was performed in 250 type 2 diabetic patients. After a follow-up for 5 years, 145 patients were excluded as they did not have any coronary events. The remaining 95 patients were divided into study group and control group. According to their density and shape, the coronary artery plaques were classified into 3 types and 4 types, respectively.Results.There is no statistically significant difference in the degree of stenosis between two groups. The proportion of calcified plaques in the study group was lower than in the control group. The proportion of mixed-calcified plaques in the study group was higher than in the other. Type III plaques have a 76.2% sensitivity and negative predictive value was 64.5% for acute coronary events; type IV plaques have a sensitivity of 52.6% and positive predictive value of 63% for chronic coronary events.Conclusions.CCTA may be used as a non-invasive modality for evaluating and predicting vulnerable coronary atherosclerosis plaques in patients with type 2 diabetes.

scholarly journals Morphometric parameters as risk factors for anterior cruciate ligament injuries: A MRI case-control study

2014 ◽  
Vol 71 (3) ◽  
pp. 271-276 ◽  
Author(s):  
Lazar Stijak ◽  
Marko Bumbasirevic ◽  
Marko Kadija ◽  
Gordana Stankovic ◽  
Richard Herzog ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Control Group ◽  
Study Group ◽  
Matched Pairs ◽  
Intercondylar Notch ◽  
Anterior Cruciate Ligament Injuries ◽  
Magnetic Resonance Imaging Mri ◽  
Anterior Cruciate

Background/Aim. The anterior cruciate ligament (ACL) is the most frequently injured ligament of the knee, representing 50% of all knee injuries. The aim of this study was to determine the differences in the morphometry of knee injury patients with an intact and a ruptured anterior cruciate ligament. Methods. The study included 33 matched pairs of patients divided into two groups: the study group with the diagnosis of anterior cruciate ligament rupture, and the control group with the diagnosis of patellofemoral pain but no anterior cruciate ligament lesion. The patients were matched on the basis of 4 attributes: age, sex, type of lesion (whether it was profession- related), and whether the lesion was left- or right-sided. Measurements were carried out using magnetic resonance imaging (MRI). Results. The anterior and posterior edges of the anterior cruciate ligament in the control group were highly significantly smaller (p < 0.01; in both cases). The control group showed a statistically significantly larger width of the anterior cruciate ligament (p < 0.05). A significant correlation between the width of the anterior cruciate ligament and the width (p < 0.01) and height (p < 0.05) of the intercondylar notch was found to exist in the control group, but not in the study group (p > 0.05). The patients in the control group showed a shorter but wider anterior cruciate ligament in comparison to their matched pairs. The control group of patients was also characterized by the correlation between the width of the intercondylar notch and the width of the anterior cruciate ligament, which was not the case in the study group. Conclusions. According to the results of our study we can say that a narrow intercondylar notch contains a proportionally thin anterior cruciate ligament, but we cannot say that this factor necessarily leads to rupture of the anterior cruciate ligament.

scholarly journals Utilidad diagnóstica de la relación plaquetas/linfocitos en embarazadas con preeclampsia

2021 ◽  
Vol 81 (01) ◽  
pp. 5-12
Author(s):  
Eduardo Reyna-Villasmil ◽  
◽  
Jorly Mejía-Montilla ◽  
Nadia Reyna-Villasmil ◽  
Duly Torres-Cepeda ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Predictive Value ◽  
Control Group ◽  
Study Group ◽  
Diagnostic Efficacy ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
A Value ◽  
Group A ◽  
Group B

Objective: To establish the diagnostic utility of the platelet-lymphocyte ratio in pregnant women with preeclampsia. Methods: A case-control study was carried out at the Hospital Central “Dr. Urquinaona” Maracaibo, Venezuela. A total of 180 pregnant women were selected. Ninety preeclamptic women were included as the study group (group A) and a control group selected for their age and body mass index similar to the study group, which consisted of 90 healthy normotensive pregnant women (group B). The general characteristics, platelet-lymphocyte ratio values and diagnostic efficacy were determined. Results: Group A patients presented lower platelet and lymphocyte values compared to group B patients (p <0.001). However, no statistically significant differences were found in platelet-lymphocyte ratio between group A patients (115.2 ± 32.7) and group B patients (122.3 ± 23.8; p = 0, 0971). A cut-off value of the platelets-lymphocyte ratio of 117 presented a value below the curve of 0.57, the sensitivity of 47.8%, the specificity of 50.0%, the positive predictive value of 48.9%, and the negative predictive value of 52.2%, with a diagnostic accuracy of 48.9%. Conclusion: Platelet-lymphocyte ratio is not a useful tool in the diagnosis of preeclampsia, since patients with the syndrome present similar values to normotensive pregnant women. Keywords: Platelet-lymphocyte ratio, Preeclampsia, Diagnosis, Pregnancy.

scholarly journals Insall–Salvati index is associated with anterior cruciate ligament tears in men: A Case-controlled study

2022 ◽  
Vol 30 (1) ◽  
pp. 230949902110696
Author(s):  
Necip GÜVEN ◽  
Sezai ÖZKAN ◽  
Tulin TURKOZU ◽  
Adem YOKUS ◽  
Cihan ADANAS ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Controlled Study ◽  
Control Group ◽  
Anterior Tibial Translation ◽  
Study Group ◽  
Significant Difference ◽  
Anterior Cruciate ◽  
And Control ◽  
Tibial Translation

Purpose Many factors in the etiology of anterior cruciate ligament (ACL) tears, predisposing factors related to knee morphology have also been reported. This study aimed to determine whether the Insall–Salvati (IS) index, which measures patella height, is a predisposing risk factor for ACL tears. Methods The IS index, patellar length (PL), and patellar tendon length (PTL) values of patients (study group) that underwent arthroscopic reconstruction for ACL tears obtained by preoperative magnetic resonance imaging (MRI) were compared with the index values in the preoperative MRIs of patients that underwent knee arthroscopy for reasons besides ACL tears. In addition, the anterior tibial translation (ATT) of both groups was also measured and compared on MRI images. The MRI findings of the subjects included in both study groups were arthroscopically confirmed. Results The mean ages of the study group (n = 120) and control group (n = 90) were 29.1 ± 8.2 years and 31.8 ± 9.8 years, respectively. There was a statistically significant difference between the study and control groups in terms of the PL and PTL values ( p = 0.016 and p = 0.001, respectively). The IS index was statistically significantly higher in the study group with ACL tears ( p = 0.009). The ATT was 8.61 ± 4.68 mm in the study group and 3.80 ± 1.92 mm in the control group. The ATT results of both groups were evaluated, and it was found that the study group was significantly higher than the control group ( p = 0.001) Conclusions As a result of our current study, we observed higher IS index values in patients with ACL tears than in patients without ACL tears. It should be kept in mind that patella alta, which is associated with a high IS index as one of the factors of knee morphology associated with ACL tears, may play a role in the etiology of ACL tears.

Advantages of an Attached Semitendinosus Tendon Graft in Anterior Cruciate Ligament Reconstruction in a Rabbit Model

2018 ◽  
Vol 46 (13) ◽  
pp. 3227-3236 ◽  
Author(s):  
Shaohua Liu ◽  
Yaying Sun ◽  
Fang Wan ◽  
Zheci Ding ◽  
Shiyi Chen ◽  
...  
Keyword(s):  
Bone Healing ◽  
Cruciate Ligament ◽  
Tendon Graft ◽  
Semitendinosus Tendon ◽  
Control Group ◽  
Study Group ◽  
Micro Ct ◽  
Tibial Insertion ◽  
Anterior Cruciate ◽  
Biomechanical Strength

Background: The semitendinosus tendon graft with an intact tibial insertion has a sustainable blood supply and might be beneficial for graft maturation after anterior cruciate ligament reconstruction (ACLR); however, its potential advantages for graft tendon-bone healing is still unclear. Hypothesis: Intact tibial insertion of the hamstring tendon can preserve enough blood supply to keep the harvested tendon alive, which can improve tendon-bone healing and the biomechanical strength of the graft. Study Design: Controlled laboratory study. Methods: Sixty-four healthy New Zealand White rabbits underwent unilateral ACLR with a semitendinosus tendon autograft after random enrollment into 2 groups (study group, n = 32 rabbits with semitendinosus tendon–preserved tibial insertions; control group, n = 32 rabbits with free semitendinosus tendons). At weeks 3, 6, 12, and 24, 8 rabbits in each group were sacrificed to evaluate tendon-bone healing by histologic staining, micro–computed tomography (micro-CT) examination, and biomechanical test. Results: The grafts in the study group maintained a similar cell count with no signs of necrosis or hypocellularity across all time points, but the grafts in the control group underwent a characteristic stage of necrosis at weeks 3 and 6. Sharpey-like fibers were observed from postoperative 3 weeks at the tendon-bone interface in the study group, and a normal insertion-like structure was formed at week 12, which became more mature at week 24. In the control group, however, Sharpey-like fibers could not be observed until week 12, and a normal transition through cartilage from bone to tendon was not observed at any time point. Histologic scores of the tendon-bone interface in the study group were significantly higher than those in the control group at week 6 ( P = .04), week 12 ( P < .001), and week 24 ( P = .04). As compared with the control group via micro-CT, the study group had a significantly smaller bone tunnel area at week 6 ( P = .01) and larger bone volume/total volume at week 3 ( P = .0026) and week 6 ( P = .01). Also, the study group had a significantly higher failure load at weeks 12 and 24 (both P = .03) and a significantly higher stiffness at week 24 ( P < .001) versus the control group. Conclusion: The semitendinosus tendon graft with an intact tibial insertion in ACLR would bypass the graft avascular necrosis stage, which improves tendon-bone healing and biomechanical strength. Clinical Relevance: An alive graft in ACLR could improve tendon-bone healing and the biomechanical strength of the graft, which might be beneficial to early and intensive rehabilitation after ACLR.

scholarly journals Clinical-Grade Human Embryonic Stem Cell-Derived Mesenchymal Stromal Cells Ameliorate the Progression of Osteoarthritis in a Rat Model

Molecules ◽  
2021 ◽  
Vol 26 (3) ◽  
pp. 604
Author(s):  
Dan Xing ◽  
Kai Wang ◽  
Jun Wu ◽  
Yu Zhao ◽  
Wei Liu ◽  
...  
Keyword(s):  
Stem Cell ◽  
Single Dose ◽  
Embryonic Stem Cell ◽  
Rat Model ◽  
Therapeutic Potential ◽  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Embryonic Stem ◽  
Control Group ◽  
Repeated Doses

Mesenchymalstem cell (MSC)-based therapy is being increasingly explored in preclinical and clinical studies as a regenerative method for treating osteoarthritis (OA). However, the use of primary MSCs is hampered by a number of limitations, including donor heterogeneity and inconsistent cell quality. Here, we tested the therapeutic potential of embryonic stem cell-derived MSCs (ES-MSCs) in anOA rat model. ES-MSCs were generated and identified by morphology, trilineage differentiation and flow cytometry. Sprague Dawley rats were treated with either a single dose (106 cells/rat) of ES-MSCs or with three doses spaced one week apart for each dose, starting at four weeks after anterior cruciate ligament transectionto induce OA. Cartilage quality was evaluated at 6 and 10 weeks after treatment with behavioral analysis, macroscopic examination, and histology. At sixweeks after treatment, the groups treated with both single and repeated doses of ES-MSCs had significantly better modified Mankin scores and International Cartilage Repair Society (ICRS) macroscopic scores in the femoral condyle compared to the control group. At 10 weeks after treatment, the repeated doses group had a significantly better ICRS macroscopic scores in the femoral condyle compared to the single dose and control groups. Histological analysis also showed more proteoglycan and less cartilage loss, along with lower Mankin scores in the repeated doses group. In conclusion, treatment with multiple injections of ES-MSCs can ameliorate OA in a rat model. TheES-MSCs have potential to be considered as a regenerative therapy for OA, and can provide an infinite cellular source.

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