scholarly journals MENISCUS TRANSPLANT: IS STILL A STEP FORWARD FOR GOOD RESULTS IN CARTILAGE LESION PROGRESSION AND KNEE PAIN?

2021 ◽  
Vol 68 (1) ◽  
pp. 56-59
Author(s):  
Dan G. Cojocaru ◽  
◽  
Gheorghe Bogdan Hogea ◽  
Sorin Florescu ◽  
Jenel Marian Patrascu Jr. ◽  
...  

Meniscus injuries are the most common traumatic conditions of the knee. If until the early 2000s, menisci were considered structures of no major importance in the knee joint, subsequent studies have shown their importance in the biomechanics of the knee. Their role is not only for the natural suspension of the joint, but also for the protection of the cartilage or the achievement of the efficient and uniform circulation of the synovial fluid. Therefore, disruption of this joint balance can lead, in the absence of a well-conducted treatment, to premature knee wear. Most of the time, these meniscal tears are accompanied by associated lessions, ligaments or more severely cartilaginous lessions, creating a real challenge for the physician, specially for young pacients. There are many conservative treatments of the damaged meniscus, imagined precisely in the idea of preserving the menisci as much as possible. However, this is not always possible, especially due to the type of traumatic injury.

Author(s):  
М.М. Шамуилова ◽  
Ю.В. Седякина ◽  
Г.Ю. Кнорринг

Патология опорно-двигательного аппарата и остеоартрит в частности остаются частой причиной обращения за медицинской помощью в амбулаторном звене. Среди разных суставов самым страдающим считается коленный – на него приходится до 25% всех поражений опорно-двигательной системы, что связано с его опорной функцией и частым травматическим поражением. Рост популярности активного отдыха, развитие игровых и экстремальных видов спорта приводят к росту частоты травм коленного сустава, связочного аппарата, а также внутрисуставных повреждений. Именно травматизация признается одной из ведущих причин последующего остеоартрита. Статья предлагает краткие алгоритмы диагностики и терапии остеоартрита для применения на амбулаторно-поликлиническом этапе оказания медицинской помощи. Уделено внимание применению препаратов гиалуроновой кислоты, проведен анализ литературных данных, оценены перспективы применения подобной терапии в комплексе лечебных мероприятий. Гиалуроновая кислота является натуральным компонентом синовиальной жидкости, она служит в качестве смазки суставных поверхностей и обеспечивает ряд защитных и регуляторных эффектов. Вводимая извне гиалуроновая кислота берет на себя нагрузку, восполняя недостающие функции синовиальной жидкости, что и позволяет считать такое применение протезированием недостаточной функции сустава. Препараты гиалуроновой кислоты — быстродействующие локальные средства для улучшения функции пораженного сустава и купирования болевого синдрома, что важно для поддержания активности пациентов. Данные эффекты обусловлены реологическими особенностями гиалуроновой кислоты, которые позволяют не только улучшить смазывающие свойства и скольжение в пораженном суставе, но и обеспечивают защиту суставного хряща от ударных нагрузок. Полученная промышленным способом гиалуроновая кислота уже более 30 лет успешно применяется в лечении остеоартрита. Pathology of the musculoskeletal system and osteoarthritis, in particular, remain a frequent reason for seeking outpatient care. Among the various joints, the knee joint is considered the most affected - it accounts for up to 25% of all lesions of the musculoskeletal system, which is associated with its supporting function and frequent traumatic injury. The growing popularity of outdoor activities, the development of playing and extreme sports leads to an increase in the frequency of injuries of the knee joint, ligamentous apparatus, as well as intra-articular injuries. It is traumatization that is recognized as one of the leading causes of subsequent osteoarthritis. The article offers brief algorithms for the diagnosis and treatment of osteoarthritis for use at the outpatient stage of medical care. Attention is paid to the use of hyaluronic acid preparations, an analysis of the literature data is carried out, the prospects for the use of such therapy in a complex of therapeutic measures are assessed. Hyaluronic acid is a natural component of synovial fluid that serves as a lubricant for articular surfaces and provides a range of protective and regulatory effects. Hyaluronic acid introduced from the outside takes on the load, replenishing the missing functions of the synovial fluid, which allows us to consider such use as prosthetics of insufficient joint function. Hyaluronic acid preparations are a fast-acting local remedy to improve the function of the affected joint and relieve pain, which is important to keep patients active. These effects are due to the rheological features of hyaluronic acid, which not only improve lubricating properties and sliding in the affected joint, but also protect the articular cartilage from shock loads. The industrially obtained hyaluronic xylote has been successfully used in the treatment of osteoarthritis for more than 30 years.


2021 ◽  
Vol 22 (4) ◽  
pp. 1996 ◽  
Author(s):  
Christine M. Khella ◽  
Rojiar Asgarian ◽  
Judith M. Horvath ◽  
Bernd Rolauffs ◽  
Melanie L. Hart

Understanding the causality of the post-traumatic osteoarthritis (PTOA) disease process of the knee joint is important for diagnosing early disease and developing new and effective preventions or treatments. The aim of this review was to provide detailed clinical data on inflammatory and other biomarkers obtained from patients after acute knee trauma in order to (i) present a timeline of events that occur in the acute, subacute, and chronic post-traumatic phases and in PTOA, and (ii) to identify key factors present in the synovial fluid, serum/plasma and urine, leading to PTOA of the knee in 23–50% of individuals who had acute knee trauma. In this context, we additionally discuss methods of simulating knee trauma and inflammation in in vivo, ex vivo articular cartilage explant and in vitro chondrocyte models, and answer whether these models are representative of the clinical inflammatory stages following knee trauma. Moreover, we compare the pro-inflammatory cytokine concentrations used in such models and demonstrate that, compared to concentrations in the synovial fluid after knee trauma, they are exceedingly high. We then used the Bradford Hill Framework to present evidence that TNF-α and IL-6 cytokines are causal factors, while IL-1β and IL-17 are credible factors in inducing knee PTOA disease progresssion. Lastly, we discuss beneficial infrastructure for future studies to dissect the role of local vs. systemic inflammation in PTOA progression with an emphasis on early disease.


2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Alexander Franz ◽  
Laura Joseph ◽  
Constantin Mayer ◽  
Jan-Frieder Harmsen ◽  
Holger Schrumpf ◽  
...  

Osteoarthritis (OA) is the most frequently diagnosed joint disorder worldwide with increasing prevalence and crucial impact on the quality of life of affected patients through chronic pain, decreasing mobility and invalidity. Although some risk factors, such as age, obesity and previous joint injury are well established, the exact pathogenesis of OA on a cellular and molecular level remains less understood. Today, the role of nitrosative and oxidative stress has not been investigated conclusively in the pathogenesis of OA yet. Therefore, the objective of this study was to identify biological substances for oxidative and nitrosative stress, which mirror the degenerative processes in an osteoarthritic joint. 69 patients suffering from a diagnosed knee pain participated in this study. Based on the orthopedic diagnosis, patients were classified into an osteoarthritis group (OAG, n=24) or in one of two control groups (meniscopathy, CG1, n=11; anterior cruciate ligament rupture, CG2, n=34). Independently from the study protocol, all patients underwent an invasive surgical intervention which was used to collect samples from the synovial membrane, synovial fluid and human serum. Synovial biopsies were analyzed histopathologically for synovitis (Krenn-Score) and immunohistochemically for detection of end products of oxidative (8-isoprostane F2α) and nitrosative (3-nitrotyrosine) stress. Additionally, the fluid samples were analyzed for 8-isoprostane F2α and 3-nitrotyrosine by competitive ELISA method. The analyzation of inflammation in synovial biopsies revealed a slight synovitis in all three investigated groups. Detectable concentrations of 3-nitrotyrosine were reported in all three investigated groups without showing any significant differences between the synovial biopsies, fluid or human serum. In contrast, significant increased concentrations of 8-isoprostane F2α were detected in OAG compared to both control groups. Furthermore, our data showed a significant correlation between the histopathological synovitis and oxidative stress in OAG (r=0.728, P<0.01). There were no significant differences between the concentrations of 8-isoprostane F2α in synovial fluid and human serum. The findings of the current study support the hypothesis that oxidative and nitrosative stress are components of the multi-factory pathophysiological formation of OA. It seems reasonable that an inflammatory process in the synovial membrane triggers the generation of oxidative and nitrosative acting substances which can lead to a further degradation of the articular cartilage. Based on correlations between the observed degree of inflammation and investigated biomarkers, especially 8-isoprostane F2α seems to be a novel candidate biomarker for OA. However, due to the finding that also both control groups showed increased concentrations of selected biomarkers, future studies have to validate the diagnostic potential of these biomarkers in OA and in related conditions of the knee joint.


2014 ◽  
Vol 15 (5) ◽  
pp. 7250-7265 ◽  
Author(s):  
Congming Zhang ◽  
Xiaochun Wei ◽  
Chongwei Chen ◽  
Kun Cao ◽  
Yongping Li ◽  
...  

2016 ◽  
Vol 45 (6) ◽  
pp. 827-831 ◽  
Author(s):  
D. W. Wen ◽  
T. J. Tan ◽  
S. Rasheed

2012 ◽  
Vol 7 (1) ◽  
pp. 183-186 ◽  
Author(s):  
SHAO-LAN ZHANG ◽  
HONG-QI LIU ◽  
XIAO-ZU XU ◽  
JUAN ZHI ◽  
JIAO-JIAO GENG ◽  
...  

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