Arthroscopy-The Journal of Arthroscopic and Related Surgery最新文献

{"title":"Culture Expansion Alters Human Bone Marrow Derived Mesenchymal Stem Cell Production of Osteoarthritis-relevant Cytokines and Growth Factors.","authors":"James E Voos, Andrew Moyal, Ryan Furdock, Arnold I Caplan, Tracey L Bonfield, Jacob G Calcei","doi":"10.1016/j.arthro.2024.10.034","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.10.034","url":null,"abstract":"<p><strong>Purpose: </strong>The purposes of this study were to characterize the human bone marrow derived mesenchymal stem cells (BM-MSCs) production of osteoarthritis-relevant cytokines and growth factors as they are purified and multiplied, a process termed culture expansion, and to compare the immunomodulatory potential of BM-MSCs based on source and medium used for culture expansion.</p><p><strong>Methods: </strong>BM-MSCs were obtained from iliac crest bone marrow aspirates of four healthy donors. These four BM-MSC cell lines underwent four rounds, or \"passages,\" of the institutional culture expansion protocol, using institutional culture media. The secretory molecules known to play a role in OA-related inflammatory immune response, cartilage degradation and patient symptoms, together called the BM-MSC \"secretome,\" were measured at each passage. Three lines of commercially available BM-MSCs from healthy donors underwent culture expansion by the same protocol, using commercial culture media. The commercial BM-MSCs secretome and the institutional BM-MSCs secretome were compared at each passage. Significance was set at p<0.05.</p><p><strong>Results: </strong>Institutional BM-MSCs produced less IL-6 at passages 3 (237±113 pg/mL) and 4 (237±113 pg/mL) compared to passages 1 (884±97 pg/mL) and 2 (1071±129 pg/mL; p<0.01). Institutional BM-MSCs produced more MIP-3α at passage 4 than at passage 1 (106±41 vs 32±7 pg/mL; p<0.01). Across passages of culture expansion, institutional BM-MSCs grown on institutional medium expressed more IL-6 (P<0.001), IL-10 (P<0.001), IL-1β (P<0.001), TNFα (P=0.004), and VEGF-C (P=0.003) than commercially available BM-MSCs grown on commercial medium.</p><p><strong>Conclusion: </strong>Culture expansion alters key molecules within the BM-MSC secretome. Additionally, differences in BM-MSC source and culture medium alter the BM-MSC secretome and its immunomodulatory potential.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Knee Anterolateral Ligament is Present in 82% of North American and 65% of European But Only in 46% of Asian Studies: A Systematic Review of Frequency and Anatomy.","authors":"Erik Hohmann, Natalie Keough, Maketo Molepo, Robert Arciero, Andreas Imhoff","doi":"10.1016/j.arthro.2024.10.029","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.10.029","url":null,"abstract":"<p><strong>Purpose: </strong>To perform an updated systematic review on the prevalence and morphological characteristics of the anterolateral ligament (ALL) in human cadaveric specimens.</p><p><strong>Methods: </strong>Medline, Embase, Scopus, and Google Scholar were searched for studies from 2012 to 2024 describing the morphology. Study quality was assessed using CASP checklist and QUACS scale. Heterogeneity was analysed with the I² statistic, funnel plot, and Q-test. Mean effect size and 95% prediction intervals were calculated. Prevalence and anatomical measurements (length, width, thickness) were analysed using mean and standard deviations.</p><p><strong>Results: </strong>Thirty studies were included. CASP identified three low-quality studies. Twelve studies met the QUACS quality threshold. The prevalence of the ALL was 61.7% (82% North America, 64.9% Europe, 45.8% Asia). The femoral insertion showed variability near the lateral femoral epicondyle and lateral collateral ligament, while the tibial insertion was midway between Gerdy's tubercle and fibular head. Histological analysis revealed 60% of studies identified ligamentous tissue similar to the ACL. The mean ALL length was 39.7 mm, width 5.5 mm, and thickness 1.5 mm, with no significant morphological differences among populations.</p><p><strong>Conclusion: </strong>This systematic review reveals that the ALL is present in 61.7%, with prevalence rates of 82% in North American studies, 65% in European studies, and 46% in Asian studies. The femoral insertion exhibited substantial variability at/around the lateral femoral epicondyle and LCL, lacking consistency. The tibial insertion was more consistently described as being located about halfway between Gerdy's tubercle and the fibular head. Histological analysis showed that 60% of the included studies identified the ALL as containing ligament-like or ligamentous tissue. The mean length of the ALL was 39.9 mm (range 31-59 mm), the mean width was 5.7 mm (range 2.2-9.0 mm), and the mean thickness was 1.5 mm (range 1.3-2.7 mm). No significant ethnic population differences were observed in the morphological measures.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synthetic Medial Meniscus Implant Demonstrates High Reoperation Rates: Patients Who Retain Implant or Require Implant Exchange SHow Improvement For Post Meniscectomy Knee Pain Is Associated With Clinical Improvement But High Reoperation Rates At 2-Years Post-Operatively.","authors":"Thomas Carter, Deryk Jones, Scott Hacker, Wayne Gersoff","doi":"10.1016/j.arthro.2024.10.033","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.10.033","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate the clinical outcomes in the use of a synthetic medial meniscus implant in patients symptomatic after medial meniscectomy and not responsive to other treatment methods. and not responded to non-operative treatment.</p><p><strong>Methods: </strong>This single-arm, multicenter, prospective study enrolled subjects between ages 30-75 with post-meniscectomy pain. Changes from baseline to 24-months were measured in the pain subscale of the knee injury and osteoarthritis outcome score (KOOS) and in KOOS overall (average of all five subscales) in patients that had received a medial meniscus implant. Success was a 20-point improvement at 24-months, reoperation rates, and implant failures were recorded. VAS, IKDC, and WOMET scores were also measured.</p><p><strong>Results: </strong>Of the 115 treated patients 3 (2.6%) were either lost to follow-up or missed the 24-month visit, 48 (43%) patients had at least one subsequent surgery, 12 (10.7%) had the implant permanently removed. Of the remaining 100 patients, the mean KOOS pain improved 28.4 points at 24 months (P <0.001), and mean KOOS overall improved 28.3 points (P < 0.001). Seventy-six percent of subjects had mean scores for KOOS pain above the minimal clinically important difference (MCID) threshold, and 72% of subjects met or exceeded this threshold for KOOS overall. There were 29 patients (25.9%) who underwent implant exchange. The 24-month clinical outcomes were similar between subjects who had an implant exchange and patients who did not have any subsequent implant procedure (P < 0.2).</p><p><strong>Conclusion: </strong>The synthetic medial meniscus demonstrates high reoperation and failure rates. Patients who retained the implant or required implant exchange showed significantly improved pain, function, and quality of life at 24-month follow-up in patients symptomatic following partial medial meniscectomy and failed non-operative management. The high reoperation rate is a concern, and further evaluation is needed to determine any contributing factors.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author Reply to Editorial Comment \"Autologous Minced Repair of Knee Cartilage Is Safely and Effectively Performed Using Arthroscopic Techniques\".","authors":"Jannik Frings, Anke Baranowsky, Johannes Keller, Matthias Krause","doi":"10.1016/j.arthro.2024.10.028","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.10.028","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Steeper Slope of the Medial Tibial Plateau, Greater Varus Alignment, and Narrower Intercondylar Distance and Notch Width Increase Risk for Medial Meniscus Posterior Root Tears: A Systematic Review.","authors":"Jacob F Oeding, Michael C Dean, Mario Hevesi, Jorge Chahla, Aaron J Krych","doi":"10.1016/j.arthro.2024.10.031","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.10.031","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the available literature on the relationship between knee bony morphology and medial meniscus posterior root tears (MMPRTs) to determine which underlying tibiofemoral morphologic risk factors may predispose the development of MMPRTs.</p><p><strong>Methods: </strong>Embase, MEDLINE, and PubMed databases were searched to identify all relevant human clinical studies investigating knee morphologic features and MMPRTs. Shape features were compared between control groups and patients with MMPRTs. The methodological index for non-randomized studies (MINORS) instrument was utilized to assess the methodological quality of included studies.</p><p><strong>Results: </strong>Thirteen level III evidence studies and one level IV evidence study were included in this review (n=2,181), with 895 patients in the MMPRT group and 1,286 in the control group. Tibial morphology features associated with an increased risk for MMPRTs included an increased medial tibial slope (six studies), increased tibial torsion (one study), increased medial meniscal slope (one study), and shallower medial tibial plateau concavity (one study). Varus mechanical alignment was found to increase the risk for MMPRTs (four studies). Femoral morphology features associated with an increased risk for MMPRTs included an A-type intercondylar notch (one study), increased medial femoral condyle (MFC) angle (one study), narrower intercondylar distance (one study), narrower intercondylar notch width (one study), shorter MFC distal offset distance (one study), increased MFC width (one study), increased MFC to medial tibial condyle width ratio (one study), greater distance between the medial tibial eminence and MFC (one study), and smaller femoral offset ratios of both the medial and lateral condyles (one study).</p><p><strong>Conclusion: </strong>Multiple tibiofemoral shape features, including a steeper slope of the medial tibial plateau, greater varus alignment, and a narrower intercondylar distance and notch width, were found to be predictive factors for MMPRTs.</p><p><strong>Level of evidence: </strong>Level IV (Systematic review of Level III and IV studies).</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress Views should be Standard of Care for all ACL Deficient Knees with Asymmetric Varus Laxity on Examination.","authors":"Taylor A Johnson, Brendan J Kosko, Bruce A Levy","doi":"10.1016/j.arthro.2024.10.030","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.10.030","url":null,"abstract":"<p><p>A small degree of increased varus laxity in acute anterior cruciate ligament (ACL) disrupted knees can often be felt on initial examination. Why this occurs is not always clear and is usually felt to be related to some degree of fibular collateral ligament (FCL) injury. However, there may be another structure that demands our attention in an ACL-deficient knee with more laxity than isolated ACL injuries, but less laxity than combined ACL and FCL injuries. That structure is the anterolateral complex (ALC), including the anterolateral ligament (ALL), the iliotibial band, and quite importantly, Kaplan's fibers.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor regarding \"Arthroscopic Shaver-based Harvest of Minced Cartilage Results in Reduced Chondrocyte Viability and Reduced Quality of Cartilaginous Repair Tissue Compared With Open Harvest and Conventional Fragmentation.\"","authors":"Sebastian Gebhardt, Alexander Zimmerer, Peter Balcarek, Georgi I Wassilew, Janosch Schoon","doi":"10.1016/j.arthro.2024.10.026","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.10.026","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Autologous Minced Repair of Knee Cartilage Is Safely and Effectively Performed Using Arthroscopic Techniques\".","authors":"Jannik Frings, Anke Baranowsky, Johannes Keller, Matthias Krause","doi":"10.1016/j.arthro.2024.10.027","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.10.027","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic Disadvantage Is Associated With Delays in Anterior Cruciate Ligament Reconstruction and Greater Rates of Concomitant Meniscectomies.","authors":"Richard N Puzzitiello, Leanne T Ludwick, Osemwengie Enabulele, Matthew J Salzler","doi":"10.1016/j.arthro.2024.10.019","DOIUrl":"10.1016/j.arthro.2024.10.019","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the association between patients' neighborhood level of socioeconomic disadvantage according to their Area Deprivation Index (ADI) and (1) delays between anterior cruciate ligament (ACL) injury and anterior cruciate ligament reconstruction (ACLR), and (2) concomitant knee injuries at the time of treatment.</p><p><strong>Methods: </strong>This was a retrospective study of consecutive patients aged 18 years or older who underwent an ACLR at a single academic institution between 2015 and 2021. Each patient's home address was mapped to obtain their ADI to determine their level of socioeconomic disadvantage. Patients were categorized by their ADI score into 3 groups: least disadvantaged (ADI scores 0-3), middle group (ADI scores 4-6), and most disadvantaged (ADI scores 7-10). Time-to-event multivariable Cox proportional-hazard analysis was used to assess the association between ADI groups and delays in ACLR while controlling for relevant demographic, clinical, and surgical variables. Additional multivariable logistic regression analyses assessed this relationship using clinically relevant time thresholds of 12 weeks and 6 months between the time of injury and ACLR.</p><p><strong>Results: </strong>We identified 383 patients for inclusion. Patients in the most disadvantaged group had an increased incidence of concomitant meniscectomies performed at the time of ACLR for irreparable tears (51.5% vs 34.8% [least disadvantaged], P = .04). Multivariate analysis revealed patients in the most disadvantaged group were at significant risk of delayed ACLR (hazard ratio, 1.36; 95% confidence interval [CI], 1.02-1.86; P = .04), with a 2.24 times risk of delays >12 weeks (95% CI, 1.13-4.44, P = .02), and a 2.36 times risk of delays >6 months (95% CI, 1.2-4.65, P = .01). Non-White race was similarly associated with significant risk of ACLR delays >3 (odds ratio, 2.02; 95% CI, 1.22-3.33; P = .006) and 6 months (OR, 1.77; 95% CI, 1.06-2.95; P = .03).</p><p><strong>Conclusions: </strong>Socioeconomically disadvantaged and non-White patients who sustain ACL tears are at a greater risk of delays in the time of injury to ACLR and for undergoing a concomitant meniscectomy.</p><p><strong>Level of evidence: </strong>Level IV, retrospective case series.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Commentary: Arthroscopic Treatment of Mild Hip Dysplasia Can Result in Excellent Outcome and Avoid More Invasive Periacetabular Osteotomy.","authors":"Benjamin G Domb, Isabella A Wallace, Nils Becker","doi":"10.1016/j.arthro.2024.10.023","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.10.023","url":null,"abstract":"<p><p>Several mechanisms either support or decrease stability of the hip joint. Primary stability of the hip comes from bony coverage of the femoral head, influenced by acetabular version and femoral antetorsion. In addition, soft tissue structures such as the acetabular labrum, the ligamentum teres, and the hip capsule play a significant role in maintaining joint stability. Untreated hip instability may lead to pathological force transmission between the acetabular socket and femoral head, and subluxation resulting in osteoarthritis. Historically, pelvic and/or femoral osteotomies have been performed to increase hip stability and prevent joint degeneration. However, osteotomies do not address soft tissue instability or lesions of intra-articular structures, which could explain symptoms following bony correction. Furthermore, the rate of combined pathologies resulting in hip instability and femoroacetabular impingement syndrome (FAIS) is high. Modern hip arthroscopy enables reconstruction and stabilization of soft tissue structures and the correction of bony pathologies caused by FAIS. Minimally invasive procedures can help avoid overtreatment and unnecessary risks associated with more invasive osteotomies. However, in cases of ongoing symptoms after arthroscopic treatment for mild instability, or for patients with severe dysplasia, concomitant PAO and arthroscopy can combine bony correction of a PAO with intra-articular therapies of hip arthroscopy.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}