半月板损伤后生物力学和生物学变化的相互作用

IF 5.7 2区 医学 Q1 RHEUMATOLOGY
Current Rheumatology Reports Pub Date : 2023-02-01 Epub Date: 2022-12-07 DOI:10.1007/s11926-022-01093-3
Patrick X Bradley, Karl N Thomas, Avery L Kratzer, Allison C Robinson, Jocelyn R Wittstein, Louis E DeFrate, Amy L McNulty
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引用次数: 0

摘要

审查目的:半月板损伤通常会导致关节退化和创伤后骨关节炎(PTOA)的发生。因此,本综述旨在概述目前对半月板损伤后生物力学和生物学反响的理解,以及这些变化如何影响半月板修复和 PTOA 的发展。此外,我们还指出了必须进一步研究的关键知识缺口,以改善半月板愈合并预防 PTOA:半月板损伤后,关节中的多个组织经常发生生物力学和生物学改变。从生物力学角度看,半月板撕裂会削弱半月板在关节中传递负荷的能力,使软骨更容易受到应变增加的影响。从生物学角度看,受伤后的环境通常表现为促炎细胞因子、分解酶和免疫细胞的增加。这些多方面的变化相互作用,形成了一种不利于组织修复的环境,并导致 PTOA 的发生。此外,与 OA 相关的退行性变化可能会造成反馈循环,对半月板的愈合能力产生负面影响。在了解受伤后关节的生物和生物力学变化、它们之间的相互作用以及它们如何影响愈合和 PTOA 的发展方面,我们已经取得了长足的进步。然而,为了改进临床治疗,促进半月板愈合并预防 PTOA 的发生,迫切需要了解损伤后关节的生理变化。特别是,需要对半月板损伤后患者体内发生的时间性生物力学和生物学变化以及这些变化如何导致 PTOA 的发生进行体内特征描述。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The Interplay of Biomechanical and Biological Changes Following Meniscus Injury.

The Interplay of Biomechanical and Biological Changes Following Meniscus Injury.

Purpose of review: Meniscus injury often leads to joint degeneration and post-traumatic osteoarthritis (PTOA) development. Therefore, the purpose of this review is to outline the current understanding of biomechanical and biological repercussions following meniscus injury and how these changes impact meniscus repair and PTOA development. Moreover, we identify key gaps in knowledge that must be further investigated to improve meniscus healing and prevent PTOA.

Recent findings: Following meniscus injury, both biomechanical and biological alterations frequently occur in multiple tissues in the joint. Biomechanically, meniscus tears compromise the ability of the meniscus to transfer load in the joint, making the cartilage more vulnerable to increased strain. Biologically, the post-injury environment is often characterized by an increase in pro-inflammatory cytokines, catabolic enzymes, and immune cells. These multi-faceted changes have a significant interplay and result in an environment that opposes tissue repair and contributes to PTOA development. Additionally, degenerative changes associated with OA may cause a feedback cycle, negatively impacting the healing capacity of the meniscus. Strides have been made towards understanding post-injury biological and biomechanical changes in the joint, their interplay, and how they affect healing and PTOA development. However, in order to improve clinical treatments to promote meniscus healing and prevent PTOA development, there is an urgent need to understand the physiologic changes in the joint following injury. In particular, work is needed on the in vivo characterization of the temporal biomechanical and biological changes that occur in patients following meniscus injury and how these changes contribute to PTOA development.

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来源期刊
CiteScore
11.20
自引率
0.00%
发文量
41
期刊介绍: This journal aims to review the most important, recently published research in the field of rheumatology. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care and prevention of rheumatologic conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas such as the many forms of arthritis, osteoporosis and metabolic bone disease, and systemic lupus erythematosus. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also occasionally provided.
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