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Radiographics : a Review Publication of... Nov 2023
Topics: Humans; Meniscus; Knee Joint; Magnetic Resonance Imaging; Menisci, Tibial; Arthroscopy
PubMed: 37883302
DOI: 10.1148/rg.230188 -
The Knee Oct 2023This study was conducted with patients with anterior and medial extrusion of the medial meniscus (MM-AE, MM-ME) to investigate the relationship of the amount of...
BACKGROUND
This study was conducted with patients with anterior and medial extrusion of the medial meniscus (MM-AE, MM-ME) to investigate the relationship of the amount of extrusion with damage to the meniscus, meniscofemoral ligament (MFL), meniscotibial ligament (MTL), presence of effusion, osteoarthritis (OA) grade and other medial stablizers. A cut-off value for significant MM-ME was also suggested.
METHODS
All patients aged 18 and above who had measurable MM extrusion on knee MRI were included. Patients with acute injury detected on knee MRI and any disease that could disrupt the anatomy were not included. The relationship between the amount of MM-AE, MM-ME and the investigated comorbidities were evaluated. The patients were divided into two: those with and without positive findings for each comorbidities. The amount of MM-AE, MM-ME were evaluated. ROC analysis was undertaken for significant differences, and cut-off values were determined.
RESULTS
There was a correlation between MM-ME and age, weight, and BMI (p < 0.001, p = 0.027, p = 0.025, respectively). The amount of MM-ME was higher in the groups with OA (p = 0.007), MTL damage (p < 0.001), MFL damage (p < 0.001), meniscus damage (p < 0.001), effusion (p < 0.001), and the amount of MM-AE was higher in the groups with OA (p = 0.042), effusion (p = 0.002). The cut-off values of MM-ME were determined to be 2.69 mm (MTL), 2.65 mm (MFL), 2.49 mm (meniscus), and 2.85 mm (OA).
CONCLUSION
OA grade, effusion, and meniscus, MTL, and MFL damage were all found to be related to the amount of MM-ME. MM-ME values 2.49-2.85 mm may indicate meniscus, MFL, MTL damage and OA.
Topics: Humans; Menisci, Tibial; Tibial Meniscus Injuries; Knee Joint; Osteoarthritis; Magnetic Resonance Imaging; Osteoarthritis, Knee
PubMed: 37672909
DOI: 10.1016/j.knee.2023.08.015 -
Arthroscopy : the Journal of... Dec 2023The 3 primary factors involved with preservation of the knee joint include joint alignment, meniscal status, and ligament stability (in particular that of the anterior...
The 3 primary factors involved with preservation of the knee joint include joint alignment, meniscal status, and ligament stability (in particular that of the anterior cruciate ligament [ACL]). These factors are interdependent and result in knee joint homeostasis when all factors are stable. When a deficiency exists in one of the factors, it will affect the others. For example, the ACL and posterior horn of the medial meniscus both act as restraints to anterior tibial translation. Thus, medial meniscal deficiency increases the risk for failure of ACL reconstruction, and chronic ACL insufficiency increases the risk for medial meniscus tears. Furthermore, all 3 of the factors of joint preservation have an impact on the articular cartilage status of the knee joint. Studies have shown that cartilage-preservation procedures do not result in optimal outcomes if there is joint malalignment, meniscal deficiency, or ligament deficiency. When evaluating patients with knee cartilage pathology, surgeons should be aware of the various factors involved in knee joint preservation and, if surgery is indicated, all factors should be addressed in order to support a successful result.
Topics: Humans; Knee Joint; Anterior Cruciate Ligament; Menisci, Tibial; Meniscus; Anterior Cruciate Ligament Reconstruction
PubMed: 37981384
DOI: 10.1016/j.arthro.2023.06.007 -
Bioactive Materials Feb 2024Osteoarthritis (OA) has emerged as a significant health concern among the elderly population, with increasing attention paid to ferroptosis-induced OA in recent years....
Osteoarthritis (OA) has emerged as a significant health concern among the elderly population, with increasing attention paid to ferroptosis-induced OA in recent years. However, the prolonged use of nonsteroidal anti-inflammatory drugs or corticosteroids can lead to a series of side effects and limited therapeutic efficacy. This study aimed to employ the Mannich condensation reaction between epigallocatechin-3-gallate (EGCG) and selenomethionine (SeMet) to efficiently synthesize polyphenol-based nanodrugs in aqueous media for treating OA. Molecular biology experiments demonstrated that EGCG-based nanodrugs (ES NDs) could effectively reduce glutathione peroxidase 4 (GPX4) inactivation, abnormal Fe accumulation, and lipid peroxidation induced by oxidative stress, which ameliorated the metabolic disorder of chondrocytes and other multiple pathological processes triggered by ferroptosis. Moreover, imaging and histopathological analysis of the destabilization of the medial meniscus model in mice confirmed that ES NDs exhibiting significant therapeutic effects in relieving OA. The intra-articular delivery of ES NDs represents a promising approach for treating OA and other joint inflammatory diseases.
PubMed: 37822916
DOI: 10.1016/j.bioactmat.2023.09.020 -
Cureus Jul 2023Introduction The meniscus plays an integral role in the proper functioning of the knee joint. Located between the articular surfaces of the tibia and femur, the meniscus...
Introduction The meniscus plays an integral role in the proper functioning of the knee joint. Located between the articular surfaces of the tibia and femur, the meniscus functions to provide stability to the knee joint, even out axial load, absorb shock, and provide some lubrication to the knee joint. Accordingly, treatment of meniscal injuries aims to preserve as much meniscal tissue as possible to avoid the myriad complications that arise from its removal. This study of the all-inside technique for meniscal repair evaluates the University Hospital Southampton experience by comparing our outcomes with the available literature. Patients and methods This is a retrospective study from January 2016 to December 2020. Records of patients were obtained through the preoperative assessment clinics network and electronic notes. The endpoints of the study were defined as patients who either were discharged, experienced failure of repair, i.e., symptomatic or magnetic resonance imaging (MRI) changes, or were offered re-surgery. Results Eighty-one patients, comprising 51 males and 30 females, were included in the study, and 85 repairs were performed. A steady increase in the number of procedures was observed year on year until the outbreak of COVID-19. The mean age of patients was 24.7 years, with a range of 39 years. The medial meniscus was found to be injured more often than the lateral meniscus. The most commonly observed injury pattern was the bucket handle (BH) type. Anterior cruciate ligament (ACL) injury was found to be associated with meniscal injuries in around half of patients. The reason for this occurrence can be attributed to the ligamentous connection between the medial meniscus and the anterior cruciate ligament in the phenomenon described in the "unhappy triad." On average, three FasT-Fix sutures were required per procedure. Discussion and conclusion After a follow-up of 11 months, 11 (13.6%) treated patients were noted to have failed repair, as defined by the endpoint criteria. Age and acuity were noted to not affect outcomes, and the results suggest that males are at higher risk of failed repair than females (p<0.05).
PubMed: 37575776
DOI: 10.7759/cureus.41813 -
Journal of Inflammation Research 2023The goal of this study was to explore the expression characteristics of RNA modification-related genes, reveal immune landscapes and identify novel potential diagnostic...
The m6A/m1A/m5C-Related Methylation Modification Patterns and Immune Landscapes in Rheumatoid Arthritis and Osteoarthritis Revealed by Microarray and Single-Cell Transcriptome.
PURPOSE
The goal of this study was to explore the expression characteristics of RNA modification-related genes, reveal immune landscapes and identify novel potential diagnostic biomarkers in osteoarthritis (OA) and rheumatoid arthritis (RA) patients.
PATIENTS AND METHODS
RNA microarray and single-cell sequencing (scRNA-seq) data were downloaded from gene expression omnibus (GEO) database. Differentially expressed RNA modification-related genes were identified and then functionally annotated. Univariate logistic regression and lasso regression analysis were used to identify primary disease genes for OA and RA. Validation was done using scRNA-seq analysis and immunohistochemistry (IHC) in human knee synovial tissues and a murine destabilization of the medial meniscus (DMM) model. Through WGCNA analysis, genes associated with cell pyroptosis or autophagy in OA and RA were identified, which were then combined with differentially expressed RNA modification-related genes to construct a PPI interaction network. Furthermore, hub genes were selected for ceRNA interaction network analysis, correlation analysis with OA and RA molecular subtypes, as well as correlation analysis with 22 immune cells.
RESULTS
Six RNA modification-related genes ( and ) were identified as potential OA and RA pathogenesis biomarkers. Their expression was validated in human knee synovial tissues and a murine DMM model. Functional enrichment of differentially expressed RNA modification-related genes between RA and OA was analyzed using GO, KEGG, GSEA, and GSVA. Based on WGCNA and PPI analysis, the six hub genes related to pyroptosis and RNA modification (, and ) were identified as central nodes for ceRNA interaction, correlation with OA and RA molecular subtypes, and association with 22 immune cells.
CONCLUSION
Our research revealed the significance of RNA modification-related genes in the development of OA and RA pathogenesis, thereby providing a novel research direction for understanding the mechanisms, diagnosis, and treatment of OA and RA.
PubMed: 37933335
DOI: 10.2147/JIR.S431076 -
Knee Surgery, Sports Traumatology,... May 2024The demographic and radiological risk factors of subchondral insufficiency fractures of the knee (SIFK) continue to be a subject of debate. The purpose of this study was...
PURPOSE
The demographic and radiological risk factors of subchondral insufficiency fractures of the knee (SIFK) continue to be a subject of debate. The purpose of this study was to associate patient-specific factors with SIFK in a large cohort of patients.
METHODS
Inclusion criteria consisted of patients with SIFK as verified on magnetic resonance imaging (MRI). All radiographs and MRIs were reviewed to assess characteristics such as meniscus tear presence and type, subchondral oedema presence and location, location of SIFK, mechanical limb alignment, osteoarthritis as assessed by Kellgren-Lawrence grade and ligamentous injury. A total of 253 patients (253 knees) were included, with 171 being female. The average body mass index (BMI) was 32.1 ± 7.0 kg/m.
RESULTS
SIFK was more common in patients with medial meniscus tears (77.1%, 195/253) rather than tears of the lateral meniscus (14.6%, 37/253) (p < 0.001). Medial meniscus root and radial tears of the posterior horn were present in 71.1% (180/253) of patients. Ninety-one percent (164/180) of medial meniscus posterior root and radial tears had an extrusion ≥3.0 mm. Eighty-one percent (119/147) of patients with SIFK on the medial femoral condyle and 86.8% (105/121) of patients with SIFK on the medial tibial plateau had a medial meniscus tear. Varus knees had a significantly increased rate of SIFK on the medial femoral condyle in comparison to valgus knees (p = 0.016).
CONCLUSION
In this large cohort of patients with SIFK, there was a high association with medial meniscus root and radial tears of the posterior horn, meniscus extrusion ≥3.0 mm as well as higher age, female gender and higher BMI. Additionally, there was a particularly strong association of medial compartment SIFK with medial meniscus tears. As SIFK is frequently undiagnosed, identifying patient-specific demographic and radiological risk factors will help achieve a prompt diagnosis.
LEVEL OF EVIDENCE
Level IV.
PubMed: 38769782
DOI: 10.1002/ksa.12271 -
Bioengineering (Basel, Switzerland) May 2024(1) Background: Bone bruises in acute anterior cruciate ligament (ACL) injuries are closely linked to the occurrence of simultaneous meniscal and cartilage damage.... (Review)
Review
(1) Background: Bone bruises in acute anterior cruciate ligament (ACL) injuries are closely linked to the occurrence of simultaneous meniscal and cartilage damage. Despite the frequent occurrence of associated injuries including bone bruises, meniscus, and cartilage damage in patients with ACL injuries, a systematic review of the relationships between the presence of bone bruises and the extent of meniscus and cartilage injuries has yet to be conducted. (2) Methods: Multiple comprehensive databases, including MEDLINE, EMBASE, and the Cochrane Library, were searched for studies that evaluated the relationship between bone bruises and meniscus or cartilage injuries following ACL injuries. Study selection, data extraction, and meta-analysis were performed. The Methodological Index for Non-Randomized Studies (MINORS) was used for quality assessments, and Review Manager 5.3 was used for data analysis. (3) Results: Data were extracted from 22 studies encompassing a total of 2891 patients with ACL injuries. Among the included studies, six studies investigated the relationships between bone bruises and medial meniscus (MM) or lateral meniscus (LM) injuries, while three studies investigated the relationships between bone bruises and cartilage injuries. There were no significant correlations between the presence of bone bruises and MM injuries (relative risk (RR) = 1.32; = 0.61). A quantitative analysis indicated that individuals with bone bruises had a 2.71-fold higher likelihood of sustaining LM injuries than those without bone bruises (RR = 2.71; = 0.0003). The analysis confirmed a significant relationship between bone bruises and cartilage injuries (RR = 6.18; = 0.003). (4) Conclusions: Bone bruises occur most frequently in the lateral compartment. Bone bruises resulting from ACL injuries are related to accompanying LM injuries and cartilage injuries. Knowing these associations and the frequency of injuries may allow orthopedic surgeons to promptly address ACL-related meniscus and cartilage injuries on MRI results and in future clinical practice.
PubMed: 38790382
DOI: 10.3390/bioengineering11050515 -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... Jul 2023To review the research progress of meniscus repair in recent years, in order to provide help for the clinical decision-making of meniscus injury treatment. (Review)
Review
OBJECTIVE
To review the research progress of meniscus repair in recent years, in order to provide help for the clinical decision-making of meniscus injury treatment.
METHODS
The domestic and foreign literature related to meniscal repair in recent years was extensively reviewed to summarize the reasons for the prevalence of meniscal repair, surgical indications, various repair methods and long-term effectiveness, the need to deal with mechanical structural abnormalities, biological enhancement repair technology, rehabilitation treatment, and so on.
RESULTS
In order to delay the occurrence of osteoarthritis, the best treatment of meniscus has undergone an important change from partial meniscectomy to meniscal repair, and the indications for meniscal repair have been expanding. The mid- and long-term effectiveness of different meniscal repair methods are ideal. During meniscus repair, the abnormality of lower limb force line and meniscus protrusion should be corrected at the same time. There are controversies about the biological enhancement technology to promote meniscus healing and rehabilitation programs, which need further study.
CONCLUSION
Meniscal repair can restore the normal mechanical conduction of lower limbs and reduce the incidence of traumatic osteoarthritis, but the poor blood supply and healing ability of meniscal tissue bring difficulties to meniscal repair. Further development of new biological enhanced repair technology and individualized rehabilitation program and verification of its effectiveness will be an important research direction.
Topics: Humans; Menisci, Tibial; Knee Joint; Meniscectomy; Lower Extremity; Osteoarthritis
PubMed: 37460187
DOI: 10.7507/1002-1892.202302103 -
Orthopaedic Journal of Sports Medicine Sep 2023Medial meniscus root tears (RTs) are associated with the development and worsening of knee osteoarthritis (OA), but little is known about their progression when compared...
BACKGROUND
Medial meniscus root tears (RTs) are associated with the development and worsening of knee osteoarthritis (OA), but little is known about their progression when compared with meniscal tears that spare the root (nonroot tears; NRTs).
PURPOSE
To compare radiographic worsening of OA in knees with RTs versus NRTs and to identify factors associated with radiographic worsening of OA in knees with RTs.
STUDY DESIGN
Cohort study; Level of evidence, 3.
METHODS
Using the Osteoarthritis Initiative database, we included knees with medial meniscus RTs and NRTs present at the baseline visit (baseline tears) and new RTs and NRTs observed at 12- to 48-month annual follow-up visits (incident tears). Worsening of radiographic OA was defined for baseline tears as an increase in Kellgren-Lawrence grade (KLG) during the subsequent 12 months of follow-up; for incident tears, worsening was defined as either concurrent (increase in KLG over the 12 months preceding tear appearance on magnetic resonance imaging) or subsequent (increase in KLG during the 12 months after tear appearance). Odds ratios (ORs), adjusted for covariates, were calculated for the association of worsening by type of tear.
RESULTS
Included were 39 knees with baseline RTs, 633 knees with baseline NRTs, 33 knees with incident RTs, and 234 knees with incident NRTs. Radiographic OA worsening subsequent to meniscal tear identification was no different for baseline RTs (15%) or baseline NRTs (14%; adjusted OR, 1.34; 95% CI, 0.52-3.47), nor did subsequent worsening differ for incident RTs (19%) versus incident NRTs (18%; adjusted OR, 0.52; 95% CI, 0.15-1.83). Concurrent radiographic OA worsening was seen at a significantly higher rate for incident RTs (64%) versus incident NRTs (21%; adjusted OR, 3.00; 95% CI, 1.21-7.47). Incident RTs in knees without radiographic OA (KLG 0-1) before the tear had a high rate of worsening (94%, n = 16) and were more likely to worsen than those in knees with radiographic OA (KLG ≥2) present before the tear.
CONCLUSION
Compared with NRTs, incident RTs were associated with a significantly increased risk of worsening radiographic OA over a 12-month period concurrent with the appearance of the tear. Incident RTs in knees without radiographic OA at baseline had a high rate of worsening.
PubMed: 37711506
DOI: 10.1177/23259671231195894