Application of Embedded Smart Wearable Device Monitoring in Joint Cartilage Injury and Rehabilitation Training

Joint injuries cause varying degrees of damage to joint cartilage. The purpose of this paper is to study the application of embedded smart wearable device monitoring in articular cartilage injury and rehabilitation training. This paper studies what an embedded system is and what a smart wearable device is and also introduces the rehabilitation training method of articular cartilage injury. We cited an embedded matching cost algorithm and an improved AD-Census. The joint cartilage damage and rehabilitation training are monitored. Finally, we introduced the types of smart wearable devices and different types of application fields. The results of this paper show that, after an articular cartilage injury, the joint function significantly recovers using the staged exercise rehabilitation training based on embedded smart wearable device monitoring. We concluded that, from 2013 to 2020, smart wearable devices are very promising in the medical field. In 2020, the value will reach 20 million US dollars.

Intra- and extra-capsular ganglia at the gastrocnemius origin and association with meniscal tears and severity of osteoarthritis of the knee joint

Background The association between size of ganglia or type of ganglia (intra-articular or extra-articular) and meniscal tears or severity of the osteoarthritis (OA) is not evaluated. Purpose To evaluate the prevalence, size, and location of intra- and extra-capsular ganglia at the gastrocnemius origin and to assess their associations with meniscal injury and grades of OA. Material and Methods This study included 301 consecutive patients who had knee pain and had undergone magnetic resonance imaging (MRI) of the knee. We evaluated presence of ganglia at the gastrocnemius muscle origin site and diagnosed whether it was an intra-capsular located or mixed-capsular located (intra-capsular and extra-capsular) and then measured the diameter of each ganglion. After two weeks, we evaluated whether articular cartilage injury existed. The presence of a meniscal tear was also recorded. Results A total of 186 patients (93%) had intra- and extra-capsular ganglia. Intra-capsular ganglia were found in 183 cases (91%) and mixed-capsular ganglia were found in 16 cases (8%). In cases with intra- and extra-capsular ganglia, more meniscal tears were found ( P = 0.029). Intra-capsular ganglia showed more meniscal tears ( P = 0.021). Intra-capsular ganglia were more likely to have high-grade OA ( P = 0.043). Patients who had a meniscal tear displayed larger-sized ganglia, especially of the intra-capsular type ( P = 0.044). Conclusion Patients with intra- and extra-capsular ganglia, especially of the intra-capsular type, are more likely to have meniscal injury and more severe OA. Patients with a meniscal tear or OA are more likely to have larger intra- and extra-capsular ganglia, especially of the intra-capsular type.

How Well Does MRI Predict Chondral Lesions in Patients with Femoroacetabular Impingement? An Analysis of 545 Cases (137)

Objectives: Articular cartilage injury has been identified as a risk factor for poor outcomes following hip arthroscopy for femoroacetabular impingement syndrome (FAI). The purpose of this study was to evaluate the efficacy of magnetic resonance imaging (MRI) in detecting cartilage defects, and to identify specific MRI findings associated with cartilage injury. Methods: All patients undergoing hip arthroscopy between February 2015 and May 2017 at one institution were enrolled in a prospective cohort. Intra-articular findings were documented at the time of surgery. MRI reports were retrospectively reviewed for radiologist-reported articular cartilage, osseous or synovial abnormalities. Sensitivity and specificity of MRI findings were calculated; multivariate logistic regression analysis determined which findings were associated with high-grade chondral damage at time of arthroscopy and used to create an online risk calculator, https://orthop.washington.edu/hiprisk/. Results: Out of a total of 598 patients who underwent hip arthroscopy, 550 had MRI reports available for review (92%). Grade III and IV cartilage injuries were reported on arthroscopy in 70 patients (13%) of average age 33 ± 13 years. On univariate analyses, individual MRI findings were not found to be sensitive in detection of articular cartilage injury (mean 22%, range 1.4% – 46%), but positive findings were highly specific (mean 90%, range 76% – 99%). Multivariate analysis revealed that older age (OR 1.09 [1.06-1.11], p < .001) and osseous findings such as subchondral cyst or edema (OR 4.77 [2.51-9.05], p <.001) were most predictive of grade III and IV defects (p < .001). An example of use of the online calculator is in Figure 1. Conclusions: MRI was a specific but not sensitive tool in diagnosing articular cartilage injury. Surgeons should be aware that osseous findings such as cysts or edema are highly predictive of full-thickness cartilage loss in FAI.

Effect of Micro-/Nanoparticle Hybrid Hydrogel Platform on the Treatment of Articular Cartilage-Related Diseases

Joint diseases that mainly lead to articular cartilage injury with prolonged severe pain as well as dysfunction have remained unexplained for many years. One of the main reasons is that damaged articular cartilage is unable to repair and regenerate by itself. Furthermore, current therapy, including drug therapy and operative treatment, cannot solve the problem. Fortunately, the micro-/nanoparticle hybrid hydrogel platform provides a new strategy for the treatment of articular cartilage-related diseases, owing to its outstanding biocompatibility, high loading capability, and controlled release effect. The hybrid platform is effective for controlling symptoms of pain, inflammation and dysfunction, and cartilage repair and regeneration. In this review, we attempt to summarize recent studies on the latest development of micro-/nanoparticle hybrid hydrogel for the treatment of articular cartilage-related diseases. Furthermore, some prospects are proposed, aiming to improve the properties of the micro-/nanoparticle hybrid hydrogel platform so as to offer useful new ideas for the effective and accurate treatment of articular cartilage-related diseases.

A Comprehensive Analysis of SE-lncRNA/mRNA Differential Expression Profiles During Chondrogenic Differentiation of Human Bone Marrow Mesenchymal Stem Cells

Objective: Articular cartilage injury is common and difficult to treat clinically because of the characteristics of the cartilage. Bone marrow-derived mesenchymal stem cell (BMSC)-mediated cartilage regeneration is a promising therapy for treating articular cartilage injury. BMSC differentiation is controlled by numerous molecules and signaling pathways in the microenvironment at both the transcriptional and post-transcriptional levels. However, the possible function of super enhancer long non-coding RNAs (SE-lncRNAs) in the chondrogenic differentiation of BMSCs is still unclear. Our intention was to explore the expression profile of SE-lncRNAs and potential target genes regulated by SE-lncRNAs during chondrogenic differentiation in BMSCs.Materials and Methods: In this study, we conducted a human Super-Enhancer LncRNA Microarray to investigate the differential expression profile of SE-lncRNAs and mRNAs during chondrogenic differentiation of BMSCs. Subsequent bioinformatic analysis was performed to clarify the important signaling pathways, SE-lncRNAs, and mRNAs associated with SE-lncRNAs regulating the chondrogenic differentiation of BMSCs.Results: A total of 77 SE-lncRNAs were identified, of which 47 were upregulated and 30 were downregulated during chondrogenic differentiation. A total of 308 mRNAs were identified, of which 245 were upregulated and 63 were downregulated. Some pathways, such as focal adhesion, extracellular matrix (ECM)–receptor interaction, transforming growth factor-β (TGF-β) signaling pathway, and PI3K–Akt signaling pathway, were identified as the key pathways that may be implicated in the chondrogenic differentiation of BMSCs. Moreover, five potentially core regulatory mRNAs (PMEPA1, ENC1, TES, CDK6, and ADIRF) and 37 SE-lncRNAs in chondrogenic differentiation were identified by bioinformatic analysis.Conclusion: We assessed the differential expression levels of SE-lncRNAs and mRNAs, along with the chondrogenic differentiation of BMSCs. By analyzing the interactions and co-expression, we identified the core SE-lncRNAs and mRNAs acting as regulators of the chondrogenic differentiation potential of BMSCs. Our study also provided novel insights into the mechanism of BMSC chondrogenic and cartilage regeneration.

Application Value of Magnetic Resonance Arthrography of the Shoulder in Nursing and Diagnosis of Patients with Shoulder Joint Injury

Supraspinatus tendon injury is a common clinical shoulder joint disease and is one of the most common causes of shoulder pain and dysfunction. Supraspinatus tendon injury will lead to articular cartilage injury and degeneration, then cause joint disease, seriously affect the quality of life of patients, and bring a huge burden to the family and society. This paper mainly studies and evaluates the application value of special signs of shoulder joint and indirect MR imaging in the diagnosis of supraspinatus tendon injury. Through a series of special examinations for the diagnosis of supraspinatus tendon injury in 90 patients, including zero degree abduction resistance test, arm drop test, Jobe test, Neer sign, and Hawkins sign, all patients in the study underwent indirect magnetic resonance imaging of the shoulder joint. Finally, arthroscopic examination results were used as the “gold standard” to evaluate and analyze the diagnosis. The results showed that among the special signs, the specificity of the falling-arm test was the highest (72.2%) in the diagnosis of full-thickness supraspinatus tendon injury. Hawkins sign had the highest sensitivity (84.0%). In the diagnosis of partial supraspinatus tendon injury, the specificity of the Jobe test was the highest, which was 66.6%. The Neer sign had the highest sensitivity of 50.0%. In the diagnosis of full-thickness supraspinatus tendon injury, there was no significant difference in sensitivity between indirect MRI and Hawkins sign, but the diagnostic specificity of indirect MRI was higher than that of special sign examination. In the diagnosis of partial supraspinatus tendon injury, the sensitivity and specificity of indirect MR imaging are higher than those of special sign examination.

Potential of Exosomes for Diagnosis and Treatment of Joint Disease: Towards a Point-of-Care Therapy for Osteoarthritis of the Knee

In the knee joint, articular cartilage injury can often lead to osteoarthritis of the knee (OAK). Currently, no point-of-care treatment can completely address OAK symptoms and regenerate articular cartilage to restore original functions. While various cell-based therapies are being developed to address OAK, exosomes containing various components derived from their cells of origin have attracted attention as a cell-free alternative. The potential for exosomes as a novel point-of-care treatment for OAK has been studied extensively, especially in the context of intra-articular treatments. Specific exosomal microRNAs have been identified as possibly effective in treating cartilage defects. Additionally, exosomes have been studied as biomarkers through their differences in body fluid composition between joint disease patients and healthy subjects. Exosomes themselves can be utilized as a drug delivery system through their manipulation and encapsulation of specific contents to be delivered to specific cells. Through the combination of exosomes with tissue engineering, novel sustained release drug delivery systems are being developed. On the other hand, many of the functions and activities of exosomes are unknown and challenges remain for clinical applications. In this review, the possibilities of intra-articular treatments utilizing exosomes and the challenges in using exosomes in therapy are discussed.