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Effect of low-energy shock waves in microfracture holes in the repair of articular cartilage defects in a rabbit model

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Chinese Medical Journal 2011年第9期124卷 1386-1394页

作者： WANG Qi LI Zhong-li FU Yang-mu WANG Zhi-gang WEI Min ZHAO Bin ZHANG Li ZHU Juan-li Department of Orthopedics Sports Medicine Center People's Liberation Army General Hospital Beijing 100853 China

Background Microfracture is a type of bone marrow stimulation in arthroscopic cartilage repair. However, the overall concentration of the mesenchymal stem cells is quite low and declines with age, and in the end the lesion is filled by fibrocartilage. The aim of this research was to investigate a novel method of enhancing microfracture by determining whether low-energy shock waves in microfracture holes would facilitate cartilage repair in a rabbit model.Methods Full-thickness cartilage defects were created at the medial femoral condyle of 36 mature New Zealand white rabbits without penetrating subchondral bone. The rabbits were randomly divided into three groups. In experimental group A, low-energy shock-wave therapy was performed in microfracture holes （diameter, 1 mm） at an energy flux density （EFD） of 0.095 m J/mm2 and 200 impulses by DolorClast Master （Electro Medical Systems SA, Switzerland）microprobe （diameter, 0.8 mm）. In experimental group B, microfracture was performed alone. The untreated rabbits served as a control group. At 4, 8, and 12 weeks after the operations, repair tissues at the defects were analyzed stereologically, histologically, and immunohistochemically.Results The defects were filled gradually with repair tissues in experimental groups A and B, and no repair tissues had formed in the control group at 12 weeks. Repair tissues in experimental group A contained more chondrocytes,proteoglycans, and collagen type Ⅱ than those in experimental group B. In experimental group B, fibrous tissues had formed at the defects at 8 and 12 weeks. Histological analysis of experimental group A showed a better Wakitani score （P ＜0.05） than in experimental group B at 8 and 12 weeks after the operation.Conclusions In the repair of full-thickness articular cartilage defects in rabbits, low-energy shock waves in microfracture holes facilitated the production of hyaline-like cartilage repair tissues more than microfracture alone. This model demonstrates a new method of improving microfracture and applying shock

关键词： articular cartilage repair marrow stimulation shock waves

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Elevated levels of interleukin-1β, interleukin-6, tumor necrosis factor-α and vascular endothelial growth factor in patients with knee articular cartilage injury

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World Journal of Clinical Cases 2019年第11期7卷 1262-1269页

作者： Zhen-Wei Wang Le Chen Xiao-Rui Hao Zhen-An Qu Shi-Bo Huang Xiao-Jun Ma Jian-Chuan Wang Wei-Ming Wang Department of Sports Medicine Affiliated Zhongshan Hospital of Dalian University

BACKGROUND Inflammatory cytokines play a vital role in the occurrence of osteoarticular injury and inflammation. Whether inflammation-associated factors interleukin-1β(IL- 1β), IL-6, tumor necrosis factor-α(TNF-α) and vascular endothelial growth factor (VEGF) are involved in the pathogenesis of keen articular cartilage injury remains poorly understood. AIM To measure the levels of inflammatory factors [IL-1β, IL-6, TNF-α and VEGF] in patients with knee articular cartilage injury. METHODS Fifty-five patients with knee articular cartilage injury were selected as patient groups, who were divided into three grades [mild (n = 20), moderate (n = 19) and severe (n = 16)] according to disease severity and X-ray examinations. Meanwhile, 30 healthy individuals who underwent physical examination were selected as the control group. The levels of IL-1β, IL-6, TNF-α and VEGF were measured by ELISA and immunohistochemical staining. RESULTS Compared with the control group, patient groups displayed significantly higher levels of IL-1β, IL-6, TNF-α and VEGF, and the extent of increase was directly proportional to the severity of injury (P articular cartilage injury, and are associated with the disease severity, indicating they might play an important role in the occurrence and development of knee articular cartilage injury. Furthermore, therapeutically targeting them might be a novel

关键词： Knee articular cartilage injury Interleukin-1β Interleukin-6 Tumor necrosis factor-α Vascular endothelial growth factor

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Benefits of Ilizarov automated bone distraction for nerves and articular cartilage in experimental leg lengthening

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World Journal of Orthopedics 2017年第9期8卷 688-696页

作者： Nathalia Shchudlo Tatyana Varsegova Tatyana Stupina Michael Shchudlo Marat Saifutdinov Andrey Yemanov Laboratory of Morphology FSBI Russian Ilizarov Scientific Center "Restorative Traumatology and Orthopaedics"

AIM To determine peculiarities of tissue responses to manual and automated Ilizarov bone distraction in nerves and articular cartilage.METHODS Twenty-nine dogs were divided in two experimental groups: Group M-leg lengthening with manual distraction(1 mm/d in 4 steps), Group A-automated distraction(1 mm/d in 60 steps) and intact group. Animals were euthanized at the end of distraction, at 30 th day of fixation in apparatus and 30 d after the fixator removal. M-responses in gastrocnemius and tibialis anterior muscles were recorded, numerical histology of peronealand tibialis nerves and knee cartilage semi-thin sections, scanning electron microscopy and X-ray electron probe microanalysis were performed.RESULTS Better restoration of M-response amplitudes in leg muscles was noted in A-group. Fibrosis of epineurium with adipocytes loss in peroneal nerve, subperineurial edema and fibrosis of endoneurium in some fascicles of both nerves were noted only in M-group, shares of nerve fibers with atrophic and degenerative changes were bigger in M-group than in A-group. At the end of experiment morphometric parameters of nerve fibers in peroneal nerve were comparable with intact nerve only in A-group. Quantitative parameters of articular cartilage(thickness, volumetric densities of chondrocytes, percentages of isogenic clusters and empty cellular lacunas, contents of sulfur and calcium) were badly changed in M-group and less changed in A-group.CONCLUSION Automated Ilizarov distraction is more safe method of orthopedic leg lengthening than manual distraction in points of nervous fibers survival and articular cartilage arthrotic changes.

关键词： Limb lengthening articular cartilage Nerve Histomorphometry Dog

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T2 mapping in the quantitative evaluation of articular cartilage changes in children with hemophilia: A pilot study

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Pediatric Investigation 2018年第4期2卷 242-247页

作者： Ningning Zhang Yanqiu Lv Yue Liu Guangheng Yin Di Hu Runhui Wu Yun Peng Department of Radiology Beijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina Department of Hemotology Beijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina

Importance: Joint disease affects more than 90% of severe hemophiliacs. Early diagnosis is critical in preventing hemophilic arthritis. Magnetic resonance imaging (MRI) enables visualization of early arthropathic changes and plays an important role in treatment. Objective: To evaluate the role of T2 mapping in detecting early cartilage lesions in the knee and ankle joints of children with hemophilic arthropathy. Methods: Target joints of 15 male patients with clinically confirmed moderate or severe hemophilia were evaluated with MRI. In addition to routine MRI protocols (T1WI, T2_FFE, T2_SPAIR, PDW_TSE), T2 mapping was used to evaluate the articular cartilage of target joints. results: The mean T2 value of the distal femoral cartilage was 46.72 ± 10.94 ms, which is higher than the reported age-matched normal value (40.27 ± 3.50 ms). The mean T2 value of the proximal tibial cartilage was 45.60 ± 8.82 ms, which is higher than the reported normal value (31.15 ± 1.86 ms). Four examined joints (two ankles, two knees) showed normal morphology with no abnormal signal on routine MR sequences. However, T2 mapping showed locally increased T2 values in the cartilage, along with uneven color scales. Interpretation: The quantitative assessment method of T2 mapping might be helpful to early diagnosis for articular cartilage lesions. It might be a potential tool for early assessment of cartilage changes and quantification of lesion's severity for hemophilia joint.

关键词： Magnetic resonance imaging articular cartilage Hemophilia

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Effectiveness of bee venom acupuncture for patients suffering from periarthritis humeroscapularis

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中医杂志:英文版 2023年第4期43卷 795-800页

作者： Minh Duc Nguyen Thanh Van Tran Quoc Vinh Nguyen Cay Doan Ha Linh Vu Phuong Dang Senior Specialist Clinic National Hospital of AcupunctureHanoi 1000Vietnam Department of Senior Specialist National Hospital of Acupuncture Hanoi 1000Vietnam Department of Senior Specialist Military Institute of Traditional MedicineHanoi 1000Vietnam Department of minimally invasive spine National Hospital of AcupunctureHanoi 1000Vietnam Department of Medicine Dai Nam UniversityHanoi 1000Vietnam

OBJECTIVE:To evaluate the efficacy of bee venom acupuncture in humeroscapularis(PHS)patients.METHODS:One hundred and twenty patients diagnosed with PHS were assigned into four groups:BV1(0.01 mg/kg),BV2(0.005 mg/kg),BV3(0.0025 mg/kg),and control group(vitamin B1 plus novocain 3%injection)with 15 d of treatment.The outcomes of the study including visual analogue scale(VAS)score andβ-endorphin,inflammatory cytokines including interleukin-10(IL-10),IL-1βand tumor necrosis factorα(TNF-α)and shoulder function score were assessed at baseline,after 10 and 15 d of treatment.RESULTS:All four groups reported statistically significant improvement in VAS score,motion range,and shoulder function score(P<0.01),only the BV3 group showed significant increase of anti-inflammatory(IL-10)and decrease of pro-inflammatory(IL-1β,TNF-α)cytokines after treatment(P<0.05).The BV3 group presented a significant difference between all outcomes compared to the control and other groups.CONCLUSION:BV3 groups showed better recovery including reduced pain,improved motor function and normalized inflammatory cytokines than current therapy used in Vietnam and other groups.

关键词： periarthritis humeroscapularis bee venom acupuncture visual analogue scale range of motion articular shoulder function score inflammatory cytokines

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Mesenchymal stem cells as a potent cell source for articular cartilage regeneration

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World Journal of Stem Cells 2014年第3期6卷 344-354页

作者： Mohamadreza Baghaban Eslaminejad Elham Malakooty Poor Department of Stem Cells Developmental Biology atCell Science Research Center Royan Institute for Stem Cell Bi-ology and Technology ACECR

Since articular cartilage possesses only a weak capac-ity for repair, its regeneration potential is considered one of the most important challenges for orthopedic surgeons. The treatment options, such as marrow stimulation techniques, fail to induce a repair tissue with the same functional and mechanical properties of native hyaline cartilage. Osteochondral transplantation is considered an effective treatment option but is as-sociated with some disadvantages, including donor-site morbidity, tissue supply limitation, unsuitable mechani-cal properties and thickness of the obtained tissue. Although autologous chondrocyte implantation results in reasonable repair, it requires a two-step surgical pro-cedure. Moreover, chondrocytes expanded in culture gradually undergo dedifferentiation, so lose morpho-logical features and specialized functions. In the search for alternative cells, scientists have found mesenchymal stem cells(MSCs) to be an appropriate cellular mate-rial for articular cartilage repair. These cells were origi-nally isolated from bone marrow samples and further investigations have revealed the presence of the cells in many other tissues. Furthermore, chondrogenic dif-ferentiation is an inherent property of MSCs noticedat the time of the cell discovery. MSCs are known to exhibit homing potential to the damaged site at which they differentiate into the tissue cells or secrete a wide spectrum of bioactive factors with regenerative proper-ties. Moreover, these cells possess a considerable im-munomodulatory potential that make them the general donor for therapeutic applications. All of these topics will be discussed in this review.

关键词： Mesenchymal stem cells Regeneration articular cartilage Cell therapy

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Influence of bone morphogenetic protein on articular cartilage regeneration following periosteal grafting

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Journal of Biomedical Science and Engineering 2013年第1期6卷 25-30页

作者： Yimin Zhang Xin Jiang Yongzhi Guo Orthopedic Department Weifang People’s Hospital Weifang China

Background: Autologous periosteal grafting is used as treatment for articular cartilage defect. Objective: To study the effect of bone morphogenetic protein (BMP) on articular cartilage regeneration following periosteal grafting. Methods: 16 healthy 15 week-old New Zealand white rabbits of both sexes (32 knees) were randomly divided into experimental group (group A) and control group (group B). A4.0 mmdiameter full-thickness articular cartilage defect was created in the femoral intercondylar fossa in all rabbits. Following this, a4.0 mmdiameter section of the periosteum was harvested from the anteromedial part of the upper tibial bone. In group A (eight rabbits, 16 knees), the cartilage defect was covered with periosteum, into which 20 μg BMP and 20% Pluronic were injected. In group B (eight rabbits, 16 knees), the cartilage defect was covered with periosteum, into which the same dosage of 0.9% NS (Normal saline) and 20% Pluronic were injected. All rabbits were sacrificed at 4, 8, and 12 weeks postoperatively, the cartilage defect areas were examined macroscopically and microscopically, and the morphology of the chondrocytes and collagen fibers were examined by scanning electron microscopy. Results: The filling of the defects with regenerated tissue was observed in both the group. The most notable improvement was that the cartilage regeneration in group A was obviously superior to that in group B, with the total histological score in group A significantly higher. Conclusion: BMP is an effective factor that could promote regeneration of articular cartilage and lead to successful cartilaginous resurfacing following periosteal

关键词： Bone Morphogenetic Protein (BMP) articular Cartilage Regeneration Periosteal Grafting

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Osteoarthritis and articular Cartilage: Biomechanics and Novel Treatment Paradigms

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Advances in Aging Research 2014年第4期3卷 297-309页

作者： Ray Marks School of Health & Behavioral Sciences York College City University of New York New York USA

Background: Osteoarthritis is a widespread highly painful disabling age-related disease with no known cure. Although novel strategies for ameliorating osteoarthritic damage abound, it is likely that none will be successful over time if the entire spectrum of the disease and the effects of joint biomechanics on joint tissues are not carefully considered. Objectives: 1) To detail the structure of healthy articular cartilage, the key tissue affected by osteoarthritis. 2) To detail what aspects of cartilage damage best characterize osteoarthritis. 3) To consider the role of biomechanical factors in developing solutions to treat osteoarthritic joint damage. Methods: Literature sources from 1980 onwards that have contributed to our knowledge of the topics relevant to this paper were accessed and retrieved. The data were categorized into four predominant themes and conclusions about the state of our knowledge and future directives were formulated. Conclusions: Osteoarthritis prevalence remains high, and a cure appears elusive. A rich body of data has helped us to better understand the key tissue involved, and suggests a repair process might be feasible, if the basic collective information on the role of biomechanics in mediating or moderating articular cartilage integrity and function is forthcoming.

关键词： articular Cartilage Biomechanics Osteoarthritis Prevention Treatment

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CLINICAL OBSERVATION ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE PLUS MANUAL REPOSITION FOR TREATMENT OF ACUTE LUMBAR VERTEBRAL articular DYSKINESIA

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World Journal of Acupuncture-Moxibustion 2003年第4期13卷 41-44页

作者： LUO Jun-fan(骆钧梵) The Second Affiliated Hospital of Jinan University Shenzhen Municipal People''s Hospital Shenzhen 518020 China

Objective: To observe the therapeutic effect of acupuncture plus manual reposition for treatment of acute lumbar vertebral articular dyskinesia for choosing a better remedy. Methods: 66 cases of acute lumbar vertebral articular dyskinesia were randomly divided into acupuncture plus manual reposition group (treatment group, n=33) and routine manual reposition group (control group, n=33). Yaotong point was punctured, when, the patient was asked to move his or her waist simultaneously. Results: After one session of treatment, of the two 33 cases in treatment and control groups, 28 (84.85%) and 20 (60.61%) were cured, 4 (12.12%) and 9 (27.27%) were improved, and 1 (3.03%) and 4 (12.12%) failed in the treatment. The therapeutic effect of treatment group was significantly superior to that of control group (Particular dyskinesia.

关键词： Acute lumbar,vertebral articular dyskinesia,Acupuncture therapy, Manual reposition

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A Novel Biomaterial for Cartilage Repair Generated by Self-Assembly: Creation of a Self-Organized articular Cartilage-Like Tissue

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Journal of Biomaterials and Nanobiotechnology 2012年第2期3卷 125-129页

作者： Kazuo Yudoh Rie Karasawa Institute of Medical Science St. Marianna University School of Medicine Kawasaki Japan Institute of Medical Science St. Marianna University School of Medicine Kawasaki Japan.

Recently, attention has been drawn to tissue engineering and other novel techniques aimed at reconstruction of the joint. Regarding articular cartilage tissue engineering, three-dimensional materials created in vitro by cultivation of autologous chondrocytes or mesenchymal stem cells with a collagen gel have been implanted to replace defective parts of the articular cartilage in limited cases with the diseases such as trauma or arthritis. However, several passages of chondrocyte culture are required to obtain a sufficient number of cells for tissue engineering. Additionally, several other problems arise including dedifferentiation of chondrocytes during cell culture, which need to be solved from a viewpoint of cellular resources. The purpose of our study is to create a novel biomaterial possessing functions and structures comparable to native hyaline articular cartilage by utilizing the physicochemical properties of the cartilage matrix components themselves, in other words, employing a self-assembly technique instead of using chondrocytes to produce cartilage matrices eventually leading to articular cartilage tissue formation. We verified the conditions and accuracy of the self-organization process and analyzed the resulting micro structure using electron beam microscopy in order to study the technique involved in the self-organization which would be applicable to creation of cartilage-like tissue. We demonstrated that self-assembly of several cartilage components including type II collagen, proteoglycan and hyaluronic acid could construct self-assembled cartilage-like tissues characterized by nano composite structures comparable to human articular cartilage and by low friction coefficients as small as those of native cartilage.

关键词： Self Assembly articular Cartilage Tissue Engineering Chondrocyte

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