Journal of Cartilage & Joint Preservation最新文献

{"title":"Differences in pretreatment symptoms of patients receiving injections or surgery to treat cartilage lesions of the knee: an International Cartilage Regeneration and Joint Preservation Society Patient Registry Study","authors":"","doi":"10.1016/j.jcjp.2023.100162","DOIUrl":"10.1016/j.jcjp.2023.100162","url":null,"abstract":"<div><h3>Introduction</h3><div>Some patients with cartilage defects of the knee are known to report similar quality of life (QoL) scores to patients listed for total knee arthroplasty. However, it is unknown whether patients waiting to undergo injections for a cartilage injury perceive their symptoms and QoL to be equivalent to those awaiting surgery.</div></div><div><h3>Objectives</h3><div>Compare the pretreatment status of patients undergoing a knee injection or surgical intervention for cartilage lesions. The hypothesis was that there would be no clinical difference in scores between the 2 cohorts.</div></div><div><h3>Methods</h3><div>Anonymous data from the International Cartilage Regeneration and Joint Preservation Society Registry were exported: demographics, type of intervention, pretreatment Knee Injury and Osteoarthritis Outcome Scores (KOOS) and Visual Analog Scores (VAS). The required sample size was 273 per cohort. Statistical analyses were used to compare the scores of each cohort (α = 0.05).</div></div><div><h3>Results</h3><div>One thousand five hundred seventy-eight patients were included (993 surgeries vs 585 injections). The surgical cohort was 30 years younger than the injection cohort (<em>P</em> &lt; .0001). There were no clinically significant differences in KOOS or VAS. However, KOOS aggregate scores, KOOS pain, and VAS were statistically poorer in the injection cohort (<em>P</em> &lt; .0001; <em>P</em> = .04; <em>P</em> = .001). KOOS QoL was poorer in the surgical cohort (<em>P</em> &lt; .0001).</div></div><div><h3>Conclusions</h3><div>Our null hypothesis was accepted, as there were no clinically significant differences in the scores. Thus, both cohorts perceived their level of disability and severity of symptoms to be equivalent. Nevertheless, statistical analyses suggested that the younger surgical cohort perceived their QoL to be poorer, while pain levels were worse in the older injection cohort.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100162"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139298985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonoperative management of knee cartilage injuries—an international Delphi consensus statement","authors":"","doi":"10.1016/j.jcjp.2024.100197","DOIUrl":"10.1016/j.jcjp.2024.100197","url":null,"abstract":"<div><h3>Introduction</h3><div>Articular cartilage injuries of the knee are a complex and challenging clinical pathology.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to establish consensus statements via a Delphi process on the nonoperative management of knee cartilage injuries.</div></div><div><h3>Methods</h3><div>A consensus process on knee cartilage injuries utilizing a modified Delphi technique was conducted. Seventy-nine surgeons across 17 countries participated in these consensus statements. Eight questions were generated on the nonoperative management of knee cartilage injuries, with 3 rounds of questionnaires and final voting occurring. Consensus was defined as achieving 80% to 89% agreement, whereas strong consensus was defined as 90% to 99% agreement, and unanimous consensus was defined as 100% agreement with a proposed statement.</div></div><div><h3>Results</h3><div>Of the 8 total questions and consensus statements on nonoperative management developed from 3 rounds of voting, 1 achieved unanimous consensus, 2 achieved strong consensus, 2 achieved consensus, and 3 did not achieve consensus<em>.</em></div></div><div><h3>Conclusions</h3><div>The statements that achieved unanimous or strong consensus related to indications, contraindications, and prognostic factors for nonoperative management of knee cartilage injuries. The statements that did not achieve consensus were primarily related to the use of non–weight-bearing, injections, and biophysical stimulation in the treatment of knee cartilage injuries.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100197"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141024080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to ‘Noninferiority meta-analysis of autologous vs allogeneic osteochondral transplantation for the treatment of osteochondral defects of the knee confounded by defect size differences’ [J Cartil Joint Preserv 3 (2023) 100130]","authors":"","doi":"10.1016/j.jcjp.2024.100183","DOIUrl":"10.1016/j.jcjp.2024.100183","url":null,"abstract":"","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100183"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140778555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of knee cartilage injuries—an international Delphi consensus statement","authors":"","doi":"10.1016/j.jcjp.2024.100196","DOIUrl":"10.1016/j.jcjp.2024.100196","url":null,"abstract":"<div><h3>Introduction</h3><div>Articular cartilage injuries of the knee are a complex and challenging clinical pathology.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to establish consensus statements via a Delphi process on the diagnosis of knee cartilage injuries.</div></div><div><h3>Methods</h3><div>A consensus process on knee cartilage injuries utilizing a modified Delphi technique was conducted. Seventy-nine surgeons across 17 countries participated in these consensus statements. Eleven questions were generated on the diagnosis of knee cartilage injuries, with 3 rounds of questionnaires and final voting occurring. Consensus was defined as achieving 80% to 89% agreement, whereas strong consensus was defined as 90% to 99% agreement, and unanimous consensus was defined as 100% agreement with a proposed statement.</div></div><div><h3>Results</h3><div>Of the 11 total questions and consensus statements regarding the diagnosis of knee cartilage injuries developed from 3 rounds of voting, 0 achieved unanimous consensus, 8 achieved strong consensus, and 3 achieved consensus.</div></div><div><h3>Conclusions</h3><div>The majority of the statements regarding diagnosis achieved strong consensus, which related to aspects of the physical exam and history, imaging and documentation, and assessment of concomitant injury or bony malalignment that aid in surgical decision-making. The statements that did not achieve strong consensus were determining when a lesion is symptomatic, documentation of imaging, and when a diagnostic arthroscopy is indicated.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100196"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141028127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographs demonstrate poor accuracy for evaluation of postoperative osseous integration of osteochondral allografts in the knee","authors":"Navya Dandu ,&nbsp;Tristan Elias ,&nbsp;Erik Haneberg ,&nbsp;Andrew Phillips ,&nbsp;Corey M. Beals ,&nbsp;Christopher M. Brusalis ,&nbsp;Daniel Kaplan ,&nbsp;Nicholas A. Trasolini ,&nbsp;Mario Hevesi ,&nbsp;Brian J. Cole ,&nbsp;Adam B. Yanke","doi":"10.1016/j.jcjp.2024.100209","DOIUrl":"10.1016/j.jcjp.2024.100209","url":null,"abstract":"<div><h3>Introduction</h3><div>This study evaluates the inter-rater reliability and accuracy of radiographs in assessing healing of osteochondral allografts (OCA) in the knee compared with computed tomography (CT) imaging is currently unknown.</div></div><div><h3>Methods</h3><div>A retrospective review patients who underwent OCA transplantation with postoperative knee radiographs obtained at three and six months, and CT scans obtained at six months was conducted. Three board-eligible orthopaedic surgeons independently graded postoperative radiographs, utilizing the grading scale established by Oladeji et al (2017), and the CT scans utilizing the grading scale established by Gelber et al (2021). Their consensus measurements served as a comparative gold standard.</div></div><div><h3>Results</h3><div>Among 44 prospectively imaged grafts, 13 (29.5%) had radiographs at three months and 28 (63.6%) had radiographs available for evaluation at six months. Assessment of radiographic integration demonstrated low reliability (Intraclass correlation coefficient (ICC): -0.02 to 0.14). On CT scan, this improved to fair reliability (κ = 0.29, <em>P</em> &lt; .001). However, Spearman rho between CT and x-ray (XR) grading demonstrated poor correlation (ρ = −0.23, <em>P</em> = .04). Among six-month postoperative radiographs, accuracy of cyst identification was negatively correlated to greater degree of cystic changes from 90.9% (30/33 correct; no cystic changes) to 19.4% (7/36 correct; small cystic changes) and 33.3% (5/15 correct; large cystic changes). Overall true positive cyst detection rates on radiographs were 27.8% to 46.7%.</div></div><div><h3>Conclusions</h3><div>Radiographs demonstrate poor inter-rater reliability and accuracy in evaluation of healing after OCA transplantation of the knee. There was a high rate of missed cystic changes on radiographic analysis and poor correlation with CT scan findings.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100209"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141697612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Welcome to the third issue of JCJP 2024","authors":"Miranda Manfre,&nbsp;Rachel M. Frank","doi":"10.1016/j.jcjp.2024.100214","DOIUrl":"10.1016/j.jcjp.2024.100214","url":null,"abstract":"","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100214"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concomitant procedures for knee cartilage injuries—an international Delphi consensus statement","authors":"","doi":"10.1016/j.jcjp.2024.100198","DOIUrl":"10.1016/j.jcjp.2024.100198","url":null,"abstract":"<div><h3>Introduction</h3><div>Articular cartilage injuries of the knee are a complex and challenging clinical pathology.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to establish consensus statements via a Delphi process on concomitant procedures for knee cartilage injuries.</div></div><div><h3>Methods</h3><div>A consensus process on knee cartilage injuries utilizing a modified Delphi technique was conducted. Seventy-nine surgeons across 17 countries participated in these consensus statements. Twelve questions were generated on concomitant procedures, with 3 rounds of questionnaires and final voting occurring. Consensus was defined as achieving 80% to 89% agreement, whereas strong consensus was defined as 90% to 99% agreement, and unanimous consensus was defined as 100% agreement with a proposed statement.</div></div><div><h3>Results</h3><div>Of the 12 total questions and consensus statements on concomitant procedures developed from 3 rounds of voting, 0 achieved unanimous consensus, 5 achieved strong consensus, 5 achieved consensus, and 2 did not achieve consensus.</div></div><div><h3>Conclusions</h3><div>The statements achieving consensus were primarily related to the tibiofemoral joint, meniscal insufficiency, and ligamentous stability. Concomitant procedures, including osteotomy, meniscal repair or transplantation, and ligamentous repair or reconstruction, should be performed with cartilage procedures for the most optimal outcome. The statements that did not reach consensus were related to the patellofemoral joint and unloading osteotomies in patients with normal alignment.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100198"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141039390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of Periostin as a biomarker of anterior cruciate ligament injury and potential therapeutic target to alleviate post-traumatic cartilage degeneration","authors":"","doi":"10.1016/j.jcjp.2024.100176","DOIUrl":"10.1016/j.jcjp.2024.100176","url":null,"abstract":"<div><h3>Introduction</h3><div>Periostin, a matricellular protein, has emerged as a potential biomarker for anterior cruciate ligament (ACL) injury and has been associated with cartilage degeneration and the development of post-traumatic osteoarthritis (PTOA).</div></div><div><h3>Objectives</h3><div>This review aims to comprehensively examine and synthesize the existing literature concerning the role of Periostin in the aftermath of ACL injury, particularly its involvement in subsequent cartilage degradation processes within the knee joint.</div></div><div><h3>Methods</h3><div>Conducting a scoping review, we systematically searched Medline, Scopus, and Embase, focusing on human and animal studies investigating Periostin in the context of ACL injury or PTOA.</div></div><div><h3>Results</h3><div>Analysis of Periostin expression in human synovial fluid and ACL tissue reveals distinctive temporal profiles, with peak levels observed at a minimum of 1-month post-ACL injury. In vitro data suggests that injured ACL tissue promotes Periostin expression in human chondrocytes. Animal studies demonstrate that recombinant Periostin application leads to increased cartilage degeneration, potentially mediated by enhanced Wnt signaling and MMP-13 expression. Conversely, Periostin knockdown studies indicate a mitigating effect on cartilage degradation.</div></div><div><h3>Conclusions</h3><div>Periostin exhibits robust associations with biomarkers of cartilage degeneration in humans and progression of osteoarthritis in animals. However, the precise impact of Periostin in the context of ACL injury and its potential causal relationship with the onset of PTOA remain uncertain.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100176"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140273379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regenerative capacity of morselized cartilage in vitro and in an osteochondral defect model","authors":"","doi":"10.1016/j.jcjp.2024.100182","DOIUrl":"10.1016/j.jcjp.2024.100182","url":null,"abstract":"<div><h3>Introduction</h3><div>Numerous treatment modalities for focal articular cartilage defects exist. However, the use of consistent and reproducible minced cartilage morsels to heal these lesions, especially with a scaffold, has not been investigated.</div></div><div><h3>Objectives</h3><div>To investigate the effect of consistently sized minced cartilage morsels on the healing of focal articular cartilage defects.</div></div><div><h3>Methods</h3><div>Cartilage was harvested and morselized into 0.5, 1.0, and 5.0 mm diameters, and cultured. Cell viability and chondrogenic gene expression were analyzed. Minced cartilage morsels of 0.5 mm were harvested and used to produce the implant paste. The NC paste was filled into a rabbit articular cartilage defect, and histology was used to assess cartilage repair.</div></div><div><h3>Results</h3><div>Chondrocyte viability of the morsels was highly maintained. Chondrogenic and proliferative genes like ACAN, COL2, COMP, PCNA, SOX9, and PRG4 all increased expression to a varying degree as morsel size decreased. Morsels of 0.5 mm exhibited the highest chondrogenic potential. Also, NC paste containing 0.5 mm morsels resulted in complete defect closure unlike marrow stimulation alone. Safranin-O staining demonstrated superior cartilage formation in the defect area.</div></div><div><h3>Conclusions</h3><div>Smaller consistent morsel size was found to be linked to increased chondrogenic potential. However, since PRG4 expression was highest in 1 mm morsels and MMP-13 gene expression was significantly decreased in only 0.5 mm morsels, this demonstrates the need to adjust morsel size to optimize gene expression of interest. NC paste mixed with 0.5 mm morsels produced the greatest regenerative capacity. Exploring the regenerative potential of unique hydrogels and chondron morsel sizes is warranted.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100182"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140403400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-based machine learning algorithm to predict failure following cartilage procedures in the knee","authors":"","doi":"10.1016/j.jcjp.2023.100161","DOIUrl":"10.1016/j.jcjp.2023.100161","url":null,"abstract":"<div><h3>Introduction</h3><div>Clinical decision-making is highly based on expert opinion. Machine learning is increasingly used to develop patient-specific risk prediction analysis to improve patient selection prior to surgery.</div></div><div><h3>Objectives</h3><div>To develop machine learning algorithms to predict failure of surgical procedures that address cartilage defects of the knee and detect variables associated with failure.</div></div><div><h3>Methods</h3><div>An institutional database was queried for cartilage procedures performed between 2000 and 2018. Failure was defined as revision cartilage surgery or knee arthroplasty. One hundred and one preoperative and intraoperative features were evaluated as potential predictors. Four machine learning algorithms were trained and internally validated.</div></div><div><h3>Results</h3><div>One thousand and ninety-one patients with a minimum follow-up of 2 years were included and underwent chondroplasty (<em>n</em> = 560; 51%), osteochondral allograft transplantation (<em>n</em> = 306; 28%), microfracture (<em>n</em> = 150; 14%), autologous chondrocyte implantation (<em>n</em> = 39; 4%), or osteochondral autograft transplantation (<em>n</em> = 36; 3%). The Random Forest algorithm was the best-performing algorithm, with an area under the curve of 0.765 and a Brier score of 0.135. The most important features for predicting failure were symptom duration, age, body mass index, lesion grade, and total lesion area. Local Interpretable Model-agnostic Explanations analysis provided patient-specific comparisons for the risk of failure of an individual patient being assigned various types of cartilage procedures.</div></div><div><h3>Conclusions</h3><div>Machine learning algorithms were accurate in predicting the risk of failure following cartilage procedures of the knee, with the most important features in descending order being symptom duration, age, body mass index, lesion grade, and total lesion area. Machine learning algorithms may be used to compare the risk of failure of specific patient-procedure combinations in the treatment of cartilage defects of the knee.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 3","pages":"Article 100161"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139292621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}