Journal of Cartilage & Joint Preservation最新文献

{"title":"Single-stage autologous chondrocyte coimplantation on a hyaluronan scaffold for the treatment of knee cartilage lesions: a case series of 16 patients with clinical outcomes up to 5 years","authors":"Emmanouil T. Papakostas ,&nbsp;Efthymios Papasoulis ,&nbsp;Willem Cornelis de Jong ,&nbsp;Aristotelis S. Sideridis ,&nbsp;Argiris Karavelis ,&nbsp;Konstantinos Epameinontidis ,&nbsp;Ioannis P. Terzidis","doi":"10.1016/j.jcjp.2024.100170","DOIUrl":"10.1016/j.jcjp.2024.100170","url":null,"abstract":"<div><h3>Introduction</h3><p>The direct reimplantation of autologous primary articular chondrocytes in a single-stage procedure for knee cartilage lesions is a novel approach, yet to be extensively reported. This study aimed to evaluate the clinical outcomes and reinterventions over a 5-year period post-surgery.</p></div><div><h3>Methods</h3><p>A prospective case series involving 16 patients (4 female, 12 male) with single or multiple focal knee cartilage lesions was conducted. The mean age at baseline was 36.8 (±11.5) years. The mean total lesion size was 4.5 (±2.3) cm² Patients underwent surgery where articular chondrocytes and mononuclear bone marrow cells were isolated, mixed, and seeded onto a hyaluronan-based scaffold within the lesion. A structured physical therapy regimen was followed, and patients were assessed using Knee injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) Subjective questionnaires at various intervals. Overall, patient-reported outcomes improved over the first 3 years post-surgery, with slight declines thereafter.</p></div><div><h3>Results</h3><p>Significant improvements over baseline were noted for various KOOS parameters and IKDC Subjective scores at different follow-up points. Reinterventions were required for two patients, one receiving intra-articular injections with mesenchymal stromal cells and another undergoing knee washout for septic arthritis while a meniscus implant was removed. Patient satisfaction at final follow-up was generally favorable. Despite a significant intraoperative cell isolation time of approximately 1.5 hours, the procedure demonstrated safety and efficacy, with an average of ±0.9 million articular chondrocytes obtained per case.</p></div><div><h3>Conclusions</h3><p>This study underscores the potential of coimplantation of intraoperatively isolated articular chondrocytes and bone marrow cells on a hyaluronan scaffold as a promising strategy for treating symptomatic knee cartilage lesions.</p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 2","pages":"Article 100170"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667254524000064/pdfft?md5=0ab2bdba63f5a05ef4eeabbe6b271be6&pid=1-s2.0-S2667254524000064-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140271371","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":"Clinical effectiveness of various treatments for cartilage defects compared with microfracture: a network meta-analysis of randomized controlled trials","authors":"Sathish Muthu ,&nbsp;Vibhu Krishnan Viswanathan ,&nbsp;Girinivasan Chellamuthu ,&nbsp;Mohammad Thabrez","doi":"10.1016/j.jcjp.2023.100163","DOIUrl":"https://doi.org/10.1016/j.jcjp.2023.100163","url":null,"abstract":"<div><h3>Background</h3><p>Advancements have been made in the realm of cartilage-regenerative techniques in the past decades. However, their comparative advantage has not yet been fully studied.</p></div><div><h3>Objectives</h3><p>To comparatively analyze the functional, radiological and histological outcomes, and complications of various procedures available for the treatment of cartilage defects.</p></div><div><h3>Data sources</h3><p>PubMed, Embase, Web of Science, Cochrane, and Scopus.</p></div><div><h3>Study eligibility criteria, participants, and interventions</h3><p>Randomized controlled trials reporting functional, radiological, histological outcomes, or complications of various methods were utilized in the management of cartilage defects. Patients with cartilage defects. Treatment methods include microfracture (MFX), autologous chondrocyte implantation (ACI), osteochondral allograft/autograft transplantation (OAT), mosaicplasty, or acellular implants.</p></div><div><h3>Study appraisal and synthesis methods</h3><p>Cochrane’s Confidence in Network meta-analysis approach. Network meta-analysis was conducted in Stata. Random effects model was used for forest plots.</p></div><div><h3>Results</h3><p>Three thousand one hundred ninety-three patients from 54 randomized controlled trials were included in the analysis. The mean age of included patients was 37.9 (±9.46) years. MFX-I was used as a constant comparator. Among the restorative methods, OAT-II offered significantly better functional outcome at 5 years (weighted mean difference [WMD] = 16.00, 95% confidence interval [CI] [11.66, 20.34], <em>P</em> &lt; .001) and 10 years (WMD = 16.00, 95% CI [10.42, 21.58], <em>P</em> &lt; .001), while OAT-I offered significantly better pain relief (WMD = −1.74, 95% CI [−3.45, −0.02], <em>P</em> = .042), and retained hyaline histology (odds ratio = 8.12, 95% CI [4.17, 12.07], <em>P</em> = .001) at 1 year with least-reported adverse events and failures. Among the regenerative methods, MFX-III (WMD = −10.0, 95% CI [−13.07, −6.93], <em>P</em> = .008) offered significantly better functional outcomes at 5 years, while ACI-III (odds ratio = 0.89, 95% CI [0.03, 1.76], <em>P</em> = .032) demonstrated significantly better radiological outcomes at 2 years.</p></div><div><h3>Limitations</h3><p>Heterogeneity in reporting of diverse functional outcome measures.</p></div><div><h3>Conclusions and implications of key findings</h3><p>Compared with MFX-I, OAT-II demonstrated significantly better long-term functional outcome (10 years), while ACI-III and MFX-III demonstrated significantly better functional outcomes only till midterm (5 years), and there is a paucity of long-term data on these treatment methods.</p></div><div><h3>Systematic review registration number</h3><p>CRD42022338329.</p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 2","pages":"Article 100163"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667254523000690/pdfft?md5=dd2499475cea1a5c66e2ed9b66356327&pid=1-s2.0-S2667254523000690-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141243913","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":"Next generation approaches for cartilage repair and joint preservation","authors":"Akira Tsujii ,&nbsp;Tomoki Ohori ,&nbsp;Hiroto Hanai ,&nbsp;Norimasa Nakamura","doi":"10.1016/j.jcjp.2024.100177","DOIUrl":"10.1016/j.jcjp.2024.100177","url":null,"abstract":"<div><h3>Introduction</h3><p>Articular cartilage plays an important role in the normal biological functions of joints, such as shock absorption and lubrication. Unfortunately, although cartilage is supplied with nutrients, it has a low self-healing capacity owing to the lack of direct blood supply; thus, various treatments have been used to improve the healing of cartilage tissue. Recent treatment strategies in the field of orthobiologics and biomaterials are expected to improve the healing rate of cartilage tissue.</p></div><div><h3>Objective</h3><p>To provide the latest research and clinical results related to cartilage therapy and to clarify their efficacy and expected future role.</p></div><div><h3>Methods</h3><p>A literature search was conducted in October 2023 using the keywords “cartilage therapy, next generation” and a narrative review was conducted separately for nonoperative and operative treatments.</p></div><div><h3>Results</h3><p>Orthobiologics already used in clinical practice include platelet-rich plasma- and mesenchymal stem cell-based therapies. Recent studies using exosomes derived from cell cultures have reported promising nonoperative therapies. Biomaterial-based operative therapy, which eliminates donor-site morbidity, can also be useful. In addition, a therapeutic strategy using induced pluripotent stem cells is also being promoted, and future developments are expected.</p></div><div><h3>Conclusions</h3><p>Various types of orthobiologic-based or biomaterials-based therapeutic strategies have been reported, including cell-free and stem cell-based methods; however, new methods using exosomes or induced pluripotent stem cells have not yet been applied clinically and are expected to be developed in the future. Well-designed clinical trials would reveal its true usefulness and we hope that it will be established as a treatment that can actually be offered to patients.</p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 2","pages":"Article 100177"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667254524000131/pdfft?md5=85113d48ce0fb021c8a85190649ab302&pid=1-s2.0-S2667254524000131-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140270690","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":"Age-related surgical management of chondral and osteochondral lesions","authors":"Tiago Lazzaretti Fernandes ,&nbsp;Joao P.C. SantAnna ,&nbsp;Mario Sergio Boff ,&nbsp;Caio Gomes Tabet ,&nbsp;Betina B. Hinckel ,&nbsp;Seth L. Sherman ,&nbsp;Christian Lattermann","doi":"10.1016/j.jcjp.2024.100172","DOIUrl":"10.1016/j.jcjp.2024.100172","url":null,"abstract":"<div><h3>Introduction</h3><p>Cartilage lesions and osteoarthritis are very prevalent and imply a significant clinical and economic burden.</p></div><div><h3>Objectives</h3><p>To review treatments for cartilage lesions in a time life sequence and its particularities.</p></div><div><h3>Methods</h3><p>We performed a broad PUBMED database review with a sensitive systematized strategy without restriction to article date or type.</p></div><div><h3>Results</h3><p>This review brings us to the aspects of chondral and osteochondral lesions throughout the different age groups of patients. Focusing mainly on surgical treatment, we present here the most widely used techniques. To facilitate discussion, patients have been divided into 3 groups: children and adolescents with open physes, adults until the fifth decade, and adult patients over the fifth decade. For open physes patients, their capacity for healing is of important consideration in both conservative and operative management. In those with closed physes, most patients are treated surgically. While marrow stimulation is the most common cartilage treatment procedure, there is a growing use of other techniques such as osteochondral autograft transplantation and osteochondral allograft transplantation. Patients over 50 years old commonly present with more severe chondral lesions, which influences the treatment decision-making process.</p></div><div><h3>Conclusion</h3><p>When attempting to optimize cartilage restoration in these 3 groups, it is important to weigh the physiologic age, the extent of the cartilage lesion, and the stage of the degenerative and osteoarthritic processes.</p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 2","pages":"Article 100172"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667254524000088/pdfft?md5=2dd24cdfcb80a06eb6812c8f815a3bc8&pid=1-s2.0-S2667254524000088-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140268944","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":"New horizons in cartilage repair: update on treatment trends and outcomes","authors":"José Rafael García ,&nbsp;Alexander J. Acuña ,&nbsp;Juan Bernardo Villareal ,&nbsp;Rodrigo Saad Berreta ,&nbsp;Salvador Gonzalez Ayala ,&nbsp;Laura del Baño-Barragán ,&nbsp;Felicitas Allende ,&nbsp;Jorge Chahla","doi":"10.1016/j.jcjp.2024.100179","DOIUrl":"10.1016/j.jcjp.2024.100179","url":null,"abstract":"<div><h3>Introduction</h3><p>Articular cartilage plays a crucial role in preserving the knee joint's structural integrity. Damage can manifest as focal chondral defects or progressive osteoarthritis. Treatment options for knee cartilage damage are multifaceted, encompassing surgical and nonsurgical interventions to repair defects, alleviate symptoms, restore function, and slow disease progression.</p></div><div><h3>Objectives</h3><p>Gain insight and summarize the latest available evidence of knee joint preservation techniques.</p></div><div><h3>Methods</h3><p>The indications, outcomes, and biological characteristics of operative and nonoperative knee cartilage repair and joint preservation therapies were summarized.</p></div><div><h3>Results</h3><p>Osteochondral autologous transplantation and osteochondral allograft transplantation offer durable solutions with excellent long-term outcomes. Autologous chondrocyte implantation and matrix-induced autologous chondrocyte implantation are advanced, cell-based therapies effective for larger defects, especially in younger, active individuals. Non-operative therapies such as hyaluronic acid provide symptomatic relief for knee osteoarthritis. Bone marrow aspirate concentrate and platelet-rich plasma show efficacy in alleviating symptoms and improving joint function, presenting a minimally invasive approach with promising results for knee preservation and cartilage repair.</p></div><div><h3>Conclusion</h3><p>The use of minimally invasive and nonsurgical interventions in addressing focal cartilage defects, osteoarthritis, and overall joint preservation has yielded varied results. Although recent literature has exhibited encouraging findings, the existing body of high-level evidence remains limited. The emerging evidence inspires optimism for the future, as medical practitioners shift focus to the next wave of knee cartilage repair and joint preservation methodologies. However, comprehensive research is essential to establish conclusive insights into outcomes, safety profiles, and comparative effectiveness among the diverse available treatments.</p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 2","pages":"Article 100179"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667254524000155/pdfft?md5=d6c72f884cbda0978c38e9cee6a7a14f&pid=1-s2.0-S2667254524000155-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140275975","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":"Assessing acellular scaffold viability with T2-weighted relaxation time value imaging: imaging variables and early clinical associations at 6 months following patellofemoral cartilage repair","authors":"Zachariah Gene Wing Ow ,&nbsp;Dean Wang ,&nbsp;Edmund Jia Xi Zhang ,&nbsp;Hamid Rahmatullah Bin Abd Razak ,&nbsp;Steven Bak Siew Wong ,&nbsp;Jamie Xiu Mei Ho ,&nbsp;Keng Lin Wong","doi":"10.1016/j.jcjp.2024.100185","DOIUrl":"10.1016/j.jcjp.2024.100185","url":null,"abstract":"<div><p>This study aims to describe novel magnetic resonance imaging (MRI) imaging characteristics using T2-weighted relaxation time values (T2RVs) for evaluating acellular graft status following cartilage repair, addressing the limitations identified in current imaging techniques. Nine patients (11 lesions) underwent cartilage repair procedures for patellofemoral cartilage lesions. Visual Analog Scales for pain and Tegner scores for function were the primary clinical outcomes measures, with clinical failure defined as nil improvement of either score at follow-up. Radiological outcomes were MRI variables centered around evaluating 2 main domains—graft viability and integration, with individual imaging characteristics being identified based on these 2 domains. At 6 postoperative months, clinical success was observed in 89% (8) of the patients. On average, Visual Analog Scales decreased by 2.6 and Tegner improved by 1.9 points, respectively, with just 1 patient experiencing no pain relief or functional improvement at follow-up. To evaluate the viability and integration of the implanted grafts, several pertinent magnetic resonance variables were utilized, namely T2RV distribution and range, graft surface, matrix and edge characteristics, as well as subchondral bone characteristics. The singular graft failure identified on MRI displayed unique characteristics not identified on the other grafts—that of heterogeneously high T2RV signals within the graft with a discontinuous matrix. T2RV imaging offers a noninvasive method for evaluating cartilage graft viability and integration, potentially improving postoperative monitoring and patient outcomes. Despite promising results, limitations such as sample size and lack of long-term follow-up data need to be addressed in future studies.</p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 2","pages":"Article 100185"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667254524000210/pdfft?md5=5250e469df7c5d322847f271db43413e&pid=1-s2.0-S2667254524000210-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140772705","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":"Gait characteristics of patients with symptomatic cartilage lesions of the knee","authors":"Gwenllian F. Tawy ,&nbsp;Beatrice Timme ,&nbsp;Michael J. McNicholas ,&nbsp;Leela C. Biant","doi":"10.1016/j.jcjp.2024.100175","DOIUrl":"10.1016/j.jcjp.2024.100175","url":null,"abstract":"<div><h3>Introduction</h3><p>Little is known about the impact of articular cartilage lesions on knee joint biomechanics.</p></div><div><h3>Objectives</h3><p>This investigation aimed to determine the gait characteristics of patients with symptomatic articular cartilage defects of the knee.</p></div><div><h3>Methods</h3><p>Gait analyses were performed at a regional joint preservation center. Assessments were completed on a treadmill with a 15-camera 3D motion-capture system. Participants walked for 2 minutes at a self-selected speed at 0° inclination. The resulting kinematic and spatiotemporal parameters were averaged across 20 consecutive gait cycles. Paired <em>t</em> tests or Wilcoxon ranked tests were performed on the data to compare biomechanical parameters between knees (α = 0.05).</p></div><div><h3>Results</h3><p>Patients (<em>n</em> = 30) walked at an average speed of 3.0 ± 0.7 km/h with a cadence of 60.4 ± 16.2 steps/min. Step lengths were comparable between limbs (<em>P</em> = .595). Maximum flexion during swing did not differ between knees (<em>P</em> = .507), but were lower than previously reported healthy adults. In the frontal plane, both knees remained in adduction throughout the gait cycle (<em>P</em> = .385). The maximal adduction reported in both knees were greater than previously reported for healthy adults. Maximal internal-external rotation patterns were comparable in stance (<em>P</em> = .475) and swing (<em>P</em> = .762) and to previous literature.</p></div><div><h3>Conclusions</h3><p>Gait characteristics were generally comparable between injured and contralateral knees of patients with symptomatic cartilage lesions of the knee. However, some parameters of gait in the sagittal and frontal plane were pathological when compared to previously published data from healthy adults.</p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 2","pages":"Article 100175"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667254524000118/pdfft?md5=cbf98f47cf2e8000246b63da29d8efa0&pid=1-s2.0-S2667254524000118-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140277520","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":"Acellular scaffolds, cellular therapy and next generation approaches for knee cartilage repair","authors":"Pedro Debieux ,&nbsp;Enzo Salviato Mameri ,&nbsp;Giovanna Medina ,&nbsp;Keng Lin Wong ,&nbsp;Camila Cohen Keleka","doi":"10.1016/j.jcjp.2024.100180","DOIUrl":"10.1016/j.jcjp.2024.100180","url":null,"abstract":"<div><h3>Introduction</h3><p>Full-thickness knee cartilage defects are a potential source of significant morbidity for patients and incur an increased risk for early degenerative joint disease. Recent decades have seen several advancements in the field of cartilage repair, among which osteochondral allograft transplantation and autologous chondrocyte implantation stand out as the options with the most durable and effective results. There are several limitations, however, to the current generation of cartilage repair options, spanning from cost and availability-related issues to the inherent implications of 2-stage surgery, and potentially limited capacity for tissue regeneration.</p></div><div><h3>Objectives</h3><p>The present review aims to offer an overview of next-generation approaches for cartilage repair, providing the rationale and available evidence for novel acellular scaffolds, cell-based therapies, mesenchymal stem cells, extra-cellularextracellular vesicles (exosomes), allogenic therapies, and gene therapies.</p></div><div><h3>Methods</h3><p>This article reviews current literature regarding innovations in the repair of chondral and osteochondral injuries.</p></div><div><h3>Results</h3><p>Emerging approaches the so-called next generation of cartilage repair are numerous and aim to harness the optimal biological environment and structural support needed to potentially enhance clinical outcomes.</p></div><div><h3>Conclusion</h3><p>The next generation of care for cartilage injuries aims to enhance the quality of scaffolds, cell types, cell viability, and integration with the receptor; and to introduce new technologies such as three dimensional bioprinting scaffolds, acellular and gene therapies.</p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 2","pages":"Article 100180"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667254524000167/pdfft?md5=204fa1e72c13991bae7ff3934ac164fb&pid=1-s2.0-S2667254524000167-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140788311","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":"Gene therapies for osteoarthritis: progress and prospects","authors":"Anais Defois ,&nbsp;Nina Bon ,&nbsp;Mathieu Mével ,&nbsp;David Deniaud ,&nbsp;Yves Maugars ,&nbsp;Jérôme Guicheux ,&nbsp;Oumeya Adjali ,&nbsp;Claire Vinatier","doi":"10.1016/j.jcjp.2024.100186","DOIUrl":"10.1016/j.jcjp.2024.100186","url":null,"abstract":"<div><h3>Introduction</h3><p>Osteoarthritis (OA), the most common form of joint disease, affects more than 500 million people worldwide. This painful and debilitating disease imposes a huge socioeconomic cost worldwide. Despite years of promising research, no etiological drug has been successfully introduced into daily clinical practice. In this context, gene therapy (GT) is emerging as a tool capable of meeting an increasingly specialized medical need. Five GT drugs for OA are currently under clinical evaluation, demonstrating the relevance of this tool. However, the widespread use of GT is still limited by considerations of safety, long-term efficacy, controlled and specific targeting, and the presence of neutralizing immune responses. Cartilage, a tissue of interest to target in OA, is a complex tissue to penetrates with the various GT vectors.</p></div><div><h3>Methods</h3><p>This manuscript reviews current clinical trials involving DNA-based GT for OA and suggests ways to improve recombinant adenoviral and adeno-associated viral vectors, including capsid engineering and transgene sequence optimization to achieve long-term expression of a given transgene exclusively in the target joint tissue, including cartilage.</p></div><div><h3>Results</h3><p>This review then highlights that the use of hybrid serotypes and/or chemical modifications of capsids are promising for improved tissue targeting. In addition, the choice of promoter and type of vectorized nucleic acid (single- or double-stranded DNA) appears to be critical for efficient transgene expression.</p></div><div><h3>Conclusion</h3><p>Finally, the combination of increasing knowledge about biocompatible materials and viral vectors should also be a way to improve transduction efficiency, increase the stability of transgene expression, and allow escape from neutralizing antibodies.</p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 2","pages":"Article 100186"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667254524000222/pdfft?md5=ddc6a80ea4c466f5a8e0b03c1abd6dff&pid=1-s2.0-S2667254524000222-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140788026","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":"Body mass index and sex and their effect on patient-reported outcomes following cartilage repair: an insight from the International Cartilage Regeneration and Joint Preservation Society Patient Registry","authors":"Gwenllian F. Tawy ,&nbsp;Reza Ojaghi ,&nbsp;Michael J. McNicholas","doi":"10.1016/j.jcjp.2024.100165","DOIUrl":"10.1016/j.jcjp.2024.100165","url":null,"abstract":"<div><h3>Introduction</h3><p>Chondral injuries in the knee, whether isolated or accompanying other injuries are found in as many as 60% of arthroscopic examinations. Although current research has identified negative outcomes for patients with a body mass index (BMI) &gt;30<!--> <!-->kg/m² undergoing chondral repair, our understanding of the relationship between presurgery BMI and postoperative patient-reported outcomes across all BMI categories remains lacking.</p></div><div><h3>Objectives</h3><p>Through the International Cartilage Regeneration and Joint Preservation Society (ICRS) Patient Registry, this study aimed to explore this relationship, taking into account sex variations.</p></div><div><h3>Methods</h3><p>The ICRS Patient Registry was used to extract the data for this study. The outcomes in focus were the Knee Osteoarthritis Outcome Score (KOOS) and EQ-5D scores. Pearson and Spearman correlation methods were applied and the level of significance was set as <span><math><mi>α</mi></math></span> <!-->= 0.05.</p></div><div><h3>Results</h3><p>Of 3194 Registry patients at the time of data extraction, 1757 had undergone a surgical procedure, and 336 of these had complete KOOS or EQ-5D scores available for 6-week, 6-month, and 1-year postoperation. Analyses revealed that neither male (average BMI – 28.2 kg/m²) nor female (average BMI – 25.3 kg/m²) data sets indicated a correlation between BMI and the patient-reported outcomes.</p></div><div><h3>Conclusions</h3><p>BMI, irrespective of sex, is not correlated with patient-reported outcomes in patients enrolled in the ICRS Registry with a BMI &lt;30 kg/m². Although BMIs in the overweight classification were not associated with poorer outcomes than BMIs in the normal classification, the current literature continues to support the notion that a BMI &gt;30 kg/m² is linked to poor cartilage repair and failure.</p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"4 2","pages":"Article 100165"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667254524000015/pdfft?md5=bb700722f65c469f6a4413658742c995&pid=1-s2.0-S2667254524000015-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139827680","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}