Cartilage[JOURNAL]
Sun
200 papers
Texture Analysis of Cartilage Repair Tissue Maturation: Comparison of Two Cartilage Repair Methods and Correlation with MOCART 2.0.
Janacova V, Szomolanyi P, Sitarcikova D … +3 more , Kirner A, Trattnig S, Juras V
Cartilage · 2026 Jun · PMID 39881442 · Full text
ObjectiveThe objective of this study was to assess the maturation of matrix-associated autologous chondrocyte transplantation (MACT) grafts up to 2 years after the surgery using gray-level co-occurrence matrix (GLCM) tex...
ObjectiveThe objective of this study was to assess the maturation of matrix-associated autologous chondrocyte transplantation (MACT) grafts up to 2 years after the surgery using gray-level co-occurrence matrix (GLCM) texture analysis of quantitative T maps, compare the results with the microfracturing technique (MFX) control group, and relate these results to the morphological MOCART 2.0 score.DesignA subcohort of 37 patients from prospective, multi-center study underwent examination on a 3T MR scanner, including a T mapping sequence at 3, 12, and 24 months after surgery. Changes between the time-points in the mean T values and 20 GLCM features extracted from T maps were assessed in repair tissue, tissue adjacent to the repair site, and the reference cartilage for both procedures.ResultsSignificant correlations were found between the MOCART 2.0 and GLCM features for both surgical procedures. There were no significant differences between MACT and MFX. We identified significant intra-group changes in T and autocorrelation (3M-12M: = 0.002; 3M-24M: = 0.004), dissimilarity (3M-24M: = 0.01), homogeneity (3M-24M: = 0.013), and correlation (3M-24M: = 0.036), sum average (3M-12M: = 0.001; 3M-24M: = 0.002), and information measure (3M-24M: < 0.001) in the MACT repair tissue. MACT models revealed differences in GLCM between all combinations of ROI types at almost all time-points. In the case of MFX, the significant differences were mainly between repair and reference tissue at 12 months.ConclusionTexture analysis provides a useful extension to T mapping. Texture features are correlated to the morphological outcome and reveal differences in the process of maturation between MACT and MFX.
Hinge Position Dominance Over Osteotomy Inclination in Medial Open-Wedge High Tibial Osteotomy: A Key Factor in Posterior Tibial Slope Changes.
Bax EA, Nguyen HC, van Egmond N … +4 more , Slump CH, Kruyt MC, Custers RJH, Hekman EEG
Cartilage · 2025 Jan · PMID 39835373 · Full text
OBJECTIVE: A medial open-wedge high tibial osteotomy (MOWHTO) may increase the posterior tibial slope (PTS). The purpose of this study was to determine the effect of the osteotomy inclination angle (in the sagittal plane...
OBJECTIVE: A medial open-wedge high tibial osteotomy (MOWHTO) may increase the posterior tibial slope (PTS). The purpose of this study was to determine the effect of the osteotomy inclination angle (in the sagittal plane) in combination with different hinge positions (in the transverse plane) on the change in PTS due to a MOWHTO. METHODS: We developed a mathematical approach to determine the effect of the osteotomy inclination angle combined with different hinge positions. The change in PTS was determined for different osteotomy inclination angles, hinge positions, and intended wedge angles. Anterior-inclined, parallel, and posterior-inclined osteotomy inclination angles were simulated. Hinge positions varied between 5° anterolateral and -45° posterolateral. The wedge angles were 5°, 10°, and 15°. Moreover, 2 in silico osteotomies were performed to verify the results of the mathematical model. RESULTS: The PTS was maintained when the osteotomy cut was performed parallel to the tibial plateau with a lateral hinge position. The PTS changed when the osteotomy was not aligned in the sagittal plane, ranging between 0.0° and 0.6°. Different hinge positions, however, had a large effect on postoperative PTS change, ranging between 0.1° and 10.7°. CONCLUSIONS: Our mathematical approach showed that the hinge position has a strong effect on the PTS. The sagittal osteotomy inclination angle had little effect on the PTS. An inclination angle parallel to the medial tibial plateau combined with a lateral hinge position does not change the PTS.
Intra-Articular Administration of Ganglioside Sugars Protects Cartilage from Progressive Degeneration in an Instability OA Rabbit Model.
Hamasaki M, Onodera T, Furukawa J … +6 more , Todoh M, Sakai Y, Ebata T, Terkawi MA, Homan K, Iwasaki N
Cartilage · 2025 Jan · PMID 39810328 · Full text
OBJECTIVE: Osteoarthritis (OA) is a degenerative joint disease that has no cure, and current therapies are intended to minimize pain. There is, therefore, a need for effective pharmacologic agents that reverse or slow th...
OBJECTIVE: Osteoarthritis (OA) is a degenerative joint disease that has no cure, and current therapies are intended to minimize pain. There is, therefore, a need for effective pharmacologic agents that reverse or slow the progression of joint damage. We report herein on an investigation of the effects of intra-articular injections of ganglioside sugars on the progression of OA in an experimental rabbit model. DESIGN: Knee OA was induced Japanese in White rabbits by anterior cruciate ligament transection (ACLT). Ganglioside sugars at concentrations of 0.1, 0.3, and 0.9 mg/ml were then intra-articularly injected as a possible treatment for OA. Controls received intra-articular injections of saline. Knees were assessed macroscopically, histologically, and mechanically at 13 weeks after ACLT induction. RESULTS: Macroscopically, knees of the groups that received ganglioside sugars at concentrations of 0.3 and 0.9 mg/ml exhibited milder cartilage degradation compared to the controls. Consistent with these results, histological scores for these knees were significantly higher than the corresponding values for the control knees. Lectin histochemistry staining revealed that the treatment with ganglioside sugars at concentrations of 0.3 and 0.9 mg/ml was associated with a remarkable increase in the levels of GalNAc-positive chondrocytes in cartilage. Coefficient of friction testing also demonstrated that cartilages treated with ganglioside sugars had a lower coefficient of frictions than the values for the control group. CONCLUSIONS: Intra-articular injections of ganglioside sugars prevented cartilage degeneration in an OA-instability model. These results highlight the promising therapeutic potential for using ganglioside sugars in the treatment of progressive OA.
Associated Anatomic Abnormalities in Patients Undergoing Rotational Tibial Osteotomies for Patellofemoral Pathology and Implications for the Level of Correction.
Haikal M, Singh N, Issac R … +2 more , Silk G, Snow M
Cartilage · 2026 Jun · PMID 39791591 · Full text
PurposeTibial rotational deformity is a known risk factor for patellofemoral joint (PFJ) disorders. However, it is commonly associated with other abnormalities which affect the PFJ. The purpose of this study was to descr...
PurposeTibial rotational deformity is a known risk factor for patellofemoral joint (PFJ) disorders. However, it is commonly associated with other abnormalities which affect the PFJ. The purpose of this study was to describe the prevalence of associated factors known to affect PFJ in patients undergoing rotational tibial osteotomy and their implication for the correction level.MethodsAll patients with PFJ disorder, who underwent rotational tibial osteotomy between July 2009 and February 2020, were included. Patients were excluded if there were no preoperative computed tomography (CT)/magnetic resonance imaging (MRI). Scans were analyzed by 2 observers. Parameters of interest were femoral version, tibial torsion, trochlear dysplasia, lateral trochlear inclination (LTI), tibial tuberosity-trochlear groove (TT-TG) distance, Insall-Salvati (IS), and Caton Deschamps Index (CDI).ResultsThe search resulted in 80 knees, which had a mean femoral version of 21.0 ± 11.7, tibial torsion of 45.9 ± 9.1, TT-TG of 18.3 ± 5.5, and LTI of 11.4 ± 14.7. In total, 42.5% had TT-TG value of ≥ 20 mm. Patella alta/baja was found in 54% based on CDI or IS >1.2 and <0.8. High-grade trochlear dysplasia was found in 25%. In total, 29% had a tibial torsion abnormality but normal TT-TG and patella height. In total, 18% had abnormal TT-TG but normal patellar height.ConclusionBased on the associated abnormalities of patella height and tubercle lateralization, 18% of the population were suitable for supratubercle osteotomy, and 29% of patients were suitable for diaphyseal or distal tibial osteotomy. A tibial tubercle osteotomy was required in 54% of patients, making a through-tubercle approach the most appropriate option for most patients.Level of evidence:Radiological cross-sectional study.
Risk of Chondral Fracture During Implantation of Distal Femur Osteochondral Autograft Plugs: A Human Cadaveric Comparison of Four Different Donor Regions.
Massey PA, Hayward D, Bonner C … +5 more , Scalisi W, Taylor R, Vincent E, W Rutz R, F Solitro G
Cartilage · 2024 Dec · PMID 39704118 · Full text
INTRODUCTION: Distal femoral cartilage lesions can be treated using osteochondral autograft transfer (OAT). When impacting plugs into a recipient site, the cartilage may fracture. This study aimed to analyze OAT donor re...
INTRODUCTION: Distal femoral cartilage lesions can be treated using osteochondral autograft transfer (OAT). When impacting plugs into a recipient site, the cartilage may fracture. This study aimed to analyze OAT donor regions and impaction energies to identify characteristics that lead to fracture. METHODS: Fifteen cadaver femurs were used with OAT plugs harvested from the following regions: lateral and medial trochlea (LT and MT), lateral and medial intercondylar notch (LIN and MIN). Plugs were impacted into a bone surrogate block using a custom anvil-type system with pre-determined impact heights; 30, 50, 70, and 90 mm. Each plug's cartilage was examined and determined to be intact or fractured. Chi-square was used to compare the rate of chondral fracture for each region. RESULTS: In all, 221 plugs were included. The overall rate of chondral fracture was 45.7%. There was a significant difference in the rate of fracture between regions, with LIN, MIN, LT, and MT, having a fracture rate of 46.6%, 62.7%, 25.0%, and 51.9%, respectively ( = 0.001). An impact height of 30 mm resulted in a fracture rate of 17.7%. Increasing the impact height from 30 to 50 mm resulted in significantly increased chondral fracture risk ( = 0.001). CONCLUSION: Different donor regions have varying rates of chondral fracture during OAT plug impaction, with the lateral and medial trochlea being the most resistant to chondral fracture at lower forces. Increased impact energy increases risk of chondral fracture. Surgeons should maintain caution and utilize lower impact energy when inserting OAT plugs.
Prevalence and Associated Factors of Ankle Osteoarthritis in Achondroplasia: A Retrospective Radiographic Assessment of 134 Patients.
Choi WS, Shin JW, Son SW … +4 more , Kim HJ, Hwang SH, Park SG, Park YH
Cartilage · 2026 Jun · PMID 39704117 · Full text
ObjectiveThe primary aim of this study is to examine the prevalence of ankle osteoarthritis in patients with achondroplasia and to assess the impact of surgical correction of lower limb alignment on this prevalence. The...
ObjectiveThe primary aim of this study is to examine the prevalence of ankle osteoarthritis in patients with achondroplasia and to assess the impact of surgical correction of lower limb alignment on this prevalence. The secondary aim is to identify radiographic parameters associated with ankle osteoarthritis.DesignThis retrospective cohort study included 134 patients (268 ankles) who visited our institution between March 2014 and February 2023. Lower limb alignment was assessed using the mechanical axis deviation, lateral distal tibial angle, anterior distal tibial angle, and talar tilt angle. Ankle osteoarthritis was evaluated using the Van Dijk Osteoarthritis score and modified Kellgren-Lawrence (K-L) scale by 2 experienced orthopedic surgeons.ResultsThe prevalence of ankle osteoarthritis in our study cohort was 29%, and that of advanced ankle osteoarthritis defined by Van Dijk Osteoarthritis scale III or modified K-L grade 4 was 0.8% (aged <40 years, 22%, and 0%; aged ≥40 years, 42% and 2%, respectively). Talar tilt angle was the only radiographic parameter that showed a significant correlation with the degree of ankle osteoarthritis (Van Dijk Osteoarthritis score, r = 0.403, < 0.001; modified K-L grade, r = 0.385, < 0.001).DiscussionThe prevalence of ankle osteoarthritis in achondroplasia is moderate, but the progression to advanced stages is uncommon. Ankle osteoarthritis in achondroplasia is strongly associated with increased talar tilt angle. This finding emphasizes caution regarding ankle osteoarthritis in achondroplasia with a nonparallel tibiotalar articular surface. Clinicians should, therefore, consider regularly assessing the talar tilt angle in patients with achondroplasia.
Return to Sport in Professional Athletes After Cartilage Restoration Surgery of the Knee: A Systematic Review and Meta-Analysis Demonstrates Gender Inequality and the Need for Improved Reporting.
Kunze KN, Uzzo RN, Thomas ZD … +3 more , Hicks J, Rodeo SA, Williams RJ
Cartilage · 2025 Dec · PMID 39688238 · Full text
ObjectiveTo synthesize the literature concerning return to sport (RTS) and related outcomes after cartilage restoration surgery of the knee in professional athletes.DesignCochrane, PubMed, and OVID/Medline databases were...
ObjectiveTo synthesize the literature concerning return to sport (RTS) and related outcomes after cartilage restoration surgery of the knee in professional athletes.DesignCochrane, PubMed, and OVID/Medline databases were queried for data pertaining to RTS after knee cartilage surgery in professional athletes. Demographic information, cartilage lesion characteristics, and RTS-specific information were extracted. Freeman-Tukey Double-Arscine Transformations with Dersimonian-Laerd random-effects estimators were constructed to quantitatively describe the cumulative incidence of RTS, while heterogeneous data described narratively.ResultsEleven studies (476 athletes; mean age 27.5 ± 2.1 years; 96.6% male) were included. Nine (81.8%) studies investigated a form of microfracture as treatment, with 6 (54.5%) performing isolated microfracture. The remaining studies investigated osteochondral allograft transplantation and mosaicplasty. More than half ( = 6; 54.5%) did not report cartilage lesion location or size. The pooled RTS rate was 84.3% (95% CI: 75.4%-91.8%) at a mean 39.9 (range, 12-104) weeks postoperatively. In 6 studies reporting competition level, a trend toward returning to a lower than pre-injury level was observed. The definition of RTS was only provided in 6 (54.5%) studies, while the criteria for RTS was only reported in 2 (18.2%) studies, suggesting limited transparency. One study reported an objective imaging assessment of reparative tissue, while none reported formal RTS testing protocols or minimum RTS timeline.ConclusionAlthough the majority of professional athletes are reported to achieve a successful RTS after cartilage restoration surgery of the knee, the literature predominantly reflects microfracture treatment. Current limitations in this literature include a substantial lack of female representation and infrequent reporting of cartilage lesion characteristics, rehabilitation and RTS criteria, and objective imaging assessments of reparative tissue.
Second-Look Needle Arthroscopy After Prior Surgical Treatment for Cartilage Lesions of the Ankle: The Amsterdam and New York City Perspectives.
Walinga AB, Butler J, Dahmen J … +4 more , Stufkens SAS, Robert G, Kennedy JG, Kerkhoffs GMMJ
Cartilage · 2026 Mar · PMID 39682041 · Full text
ObjectiveThe purpose of this prospective study was to evaluate the quality of the reparative cartilage during second-look needle arthroscopy following talar osteoperiostic grafting from the iliac crest (TOPIC) or autolog...
ObjectiveThe purpose of this prospective study was to evaluate the quality of the reparative cartilage during second-look needle arthroscopy following talar osteoperiostic grafting from the iliac crest (TOPIC) or autologous osteochondral transplantation (AOT) procedure for the management of large osteochondral lesions (OCLs) of the talus.DesignProspective case series.MethodsPatients who underwent second-look needle arthroscopy following either TOPIC or AOT procedure were prospectively recruited when they needed a second look. The primary outcome was the assessment of the quality of the reparative cartilage via second-look needle arthroscopy scored by the International Cartilage Repair Society (ICRS) score. The secondary outcomes were the number and nature of needle arthroscopy interventions and complications associated with these interventions.ResultsFive patients underwent second-look needle arthroscopy following TOPIC procedure and 11 patients underwent second-look in-office needle arthroscopy following AOT. The mean ICRS in the TOPIC cohort was 9.4 ± 1.0 at a mean time of 24.4 months following the index procedure. The mean ICRS in the AOT cohort was 10.6 ± 1.3 at a mean time of 58.8 months following the index procedure. No complications were observed in either cohort.ConclusionThis study demonstrated that TOPIC and AOT lead to adequate-looking quality reparative cartilage at short-term to mid-term follow-ups. However, further studies with larger patient cohorts and longer follow-ups are warranted. Furthermore, second-look needle arthroscopy is a safe and viable minimally invasive procedure that can effectively evaluate the quality of reparative cartilage following surgical intervention for OCLs of the talus.
Long-Term Results after Autologous Matrix-Induced Chondrogenesis for Osteochondral Lesions of the Talus: A 10-Year Cohort Study.
Deiss L, Walther M, Pfahl K … +4 more , Hörterer H, Mehlhorn A, Röser A, Gottschalk O
Cartilage · 2025 Dec · PMID 39665329 · Full text
ObjectiveA gold standard surgical treatment for osteochondral lesions (OCLs) of the talus still needs to be established. Still, autologous matrix-induced chondrogenesis (AMIC) is a commonly applied 1-stage procedure that...
ObjectiveA gold standard surgical treatment for osteochondral lesions (OCLs) of the talus still needs to be established. Still, autologous matrix-induced chondrogenesis (AMIC) is a commonly applied 1-stage procedure that has achieved good short- and mid-term results. The present cohort study aimed to assess whether the long-term, 10-year results can confirm the previous findings.DesignAll patients underwent an open AMIC procedure using a collagen type I/III bilayer matrix for a talar OCL. General demographic data, preoperative magnetic resonance imaging findings, intraoperative details, and German version of the Foot Function Index (FFI-D) scores preoperatively and at 1, 5, and 10 years as well as European Foot and Ankle Society (EFAS) and American Orthopedic Foot & Ankle Society (AOFAS) scores at 10 years after surgery were analyzed. The primary outcome variable was the procedure's longitudinal effect, and several variables' influence on the outcome was tested.ResultsOf 47 consecutive patients, 18 (38%) were included. Of the 18 patients, 6 (33%) were female, and 12 (67%) were male, with a mean age of 39 ± 15 (range = 15-62) and an average body mass index (BMI) of 26 ± 5 (range = 20-38) kg/m². The mean defect size was 1.4 ± 0.9 (range = 0.2-4) cm². The FFI-D total score showed a significant decrease from preoperatively to 1 year postoperatively (56 ± 19 to 34 ± 27; = 0.001) with a further nonsignificant decrease to the 5-year (34 ± 27 to 21 ± 20; = 0.16) and 10-year follow-up (21 ± 20 to 15 ± 13; = 1.00). All the single items decreased significantly from preoperatively to the 5- and 10-year mark. Although not significant, most items improved from 5 to 10 years postoperatively. Age positively correlated with the preoperative, 5-year, and 10-year follow-up FFI-D total score.ConclusionsAMIC, as a single-step surgical intervention, is a viable long-term treatment option. Patient selection regarding symptoms and findings is vital to achieve satisfying results.
Genomic Effects of Biomechanical Loading in Adolescent Human Growth Plate Cartilage: A Pilot Study.
Zhang Z, Boggavarapu NR, Muhr LSA … +8 more , Garcia-Serrango A, Aeppli TR, Nava TS, Zhao Y, Gutierrez-Farewik EM, Kulachenko A, Sävendahl L, Zaman F
Cartilage · 2024 Dec · PMID 39655393 · Full text
OBJECTIVE: The genomic effects of biomechanical loading on human growth plate cartilage are unknown so far. To address this, we used rare human growth plate biopsies obtained from children undergoing epiphysiodesis and e...
OBJECTIVE: The genomic effects of biomechanical loading on human growth plate cartilage are unknown so far. To address this, we used rare human growth plate biopsies obtained from children undergoing epiphysiodesis and exposed them to precisely controlled mechanical loading using a microloading device. The biopsies were cultured 24 hours after mechanical loading, followed by RNA-sequencing analyses to decipher the genomic regulation. DESIGN: We conducted RNA-seq analysis of human growth plate cartilage obtained from three patients cultured and subjected to cyclical mechanical loading with peak 0.4 N with frequency 0.77 Hz during a 30-second duration, using a specialized microloading device. RESULTS: Gene ontology analysis revealed novel data showing three significantly upregulated signaling pathways, including notch, oxytocin, and tight junction, and three significantly downregulated signaling pathways, including lysosome, sphingolipid metabolism, and peroxisome proliferator-activated receptor (PPAR) in human growth plate cartilage. Moreover, we found 15 significantly regulated genes within these signaling pathways from all three patients. These genes included PSEN2, HEY1, and NCOR2 from the notch signaling; CACNB1 and PPP3R2 from the oxytocin signaling; ACTR3C, WHAMM, and ARHGEF18 from the tight junction signaling; ARSA, SMPD1, and CD68 from the lysosome signaling; ARSA and SMPD1 from the sphingolipid metabolism signaling; and SLC27A4 and AQP7 from the PPAR signaling pathway. In addition, 20 significantly upregulated genes and six significantly downregulated genes shared between two patient samples were identified. CONCLUSION: Our study provides the first-ever transcriptomic data of mechanical loading of human growth plate cartilage. These findings can potentially provide genetic targets for future investigations in physiological and pathological bone growth conditions.
Exploring the Efficacy of Joint Lavage in Knee Osteoarthritis: A Focus on Cytokines, Degrading Enzymes, and Oxidative Stress.
Dinç M, Cevdet Soydemir Ö
Cartilage · 2025 Dec · PMID 39651682 · Full text
Purpose/AimThis study aimed to assess the effectiveness of joint lavage in managing knee osteoarthritis (OA) by evaluating its effect on pain relief, inflammatory markers, cartilage-degrading enzymes, and oxidative stres...
Purpose/AimThis study aimed to assess the effectiveness of joint lavage in managing knee osteoarthritis (OA) by evaluating its effect on pain relief, inflammatory markers, cartilage-degrading enzymes, and oxidative stress.MethodsSeventy patients with Kellgren-Lawrence grade 2 or 3 knee OA were selected for this single-center study. Joint lavage was performed, and pain and function were measured using the visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores at baseline and 24 weeks postintervention. Synovial fluid samples were collected at baseline, before lavage, and 24 weeks postintervention. Samples were stored at -80°C and analyzed in batches to minimize variability. At the time of analysis, the samples were thawed and evaluated for levels of proinflammatory cytokines, interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α), matrix metalloproteinase-3 (MMP-3), and total oxidant status (TOS), and oxidative stress index (OSI).ResultsPostintervention, VAS, and WOMAC scores significantly decreased ( < 0.001), with 100% achieving the minimal clinically important difference (MCID). Patient acceptable symptom state (PASS) rates varied: VAS (80%), WOMAC pain (50%), function (81.4%), and total (84.3%). Cytokine levels (IL-1β, IL-6, TNF-α) and MMP-3 significantly decreased ( < 0.001), along with TOS and OSI. Baseline TNF-α, IL-6, and IL-1β levels were significantly correlated with improvements in VAS and WOMAC scores. Moderate correlations were observed between reductions in IL-6/TNF-α and improvements in VAS/WOMAC. No significant associations were found between confounders and outcomes.ConclusionsJoint lavage resulted in marked pain relief and functional improvement while significantly reducing inflammatory markers, cartilage-degrading enzymes, and oxidative stress.
Relationship Between the Subchondral Trabecular Bone Microstructure in the Hip Joint and Pain in Patients with Hip Osteoarthritis.
Kaneta H, Shoji T, Kato Y … +5 more , Shozen H, Ueki S, Morita H, Kozuma Y, Adachi N
Cartilage · 2025 Dec · PMID 39651681 · Full text
ObjectiveThis study aimed to investigate the relationship between clinical findings and the trabecular microstructure of the subchondral bone in patients with hip osteoarthritis (OA) due to developmental dysplasia of the...
ObjectiveThis study aimed to investigate the relationship between clinical findings and the trabecular microstructure of the subchondral bone in patients with hip osteoarthritis (OA) due to developmental dysplasia of the hip (DDH) using multidetector row computed tomography (MDCT).DesignA total of 63 patients (69 hips) with OA due to DDH were retrospectively reviewed, with 12 healthy controls being included for comparison. Clinical evaluation was performed using the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ). The trabecular bone microstructure was analyzed using MDCT. Regions of interest in the subchondral trabecular bones of the acetabulum and femoral head were defined in the coronal view, and various trabecular microstructural parameters were evaluated.ResultsBone volume fraction (BV/TV) and trabecular thickness (Tb.Th) exhibited a significant positive correlation with the OA stage, whereas trabecular separation (Tb.Sp) showed a negative correlation. In addition, BV/TV and Tb.Th were negatively correlated with the JHEQ total and pain scores, whereas Tb.Sp was positively correlated with the pain score in all regions.ConclusionsThis is the first study to evaluate the bone microstructure and its relationship with clinical findings in patients with hip OA due to DDH. Our findings suggest that as OA progresses, osteosclerotic changes increase in the acetabulum and femoral head; these changes are associated with worsening clinical symptoms, particularly pain. Targeting the subchondral bone may emerge as a novel treatment strategy for patients with OA due to DDH; nevertheless, further comprehensive studies are required.
Assessment of the Monocyte Subpopulations and M1/M2 Macrophage Ratio in Concentrated Bone Marrow Aspirate.
Butler JJ, Dankert JF, Keller LE … +4 more , Azam MT, Dahmen J, Kerkhoffs GMMJ, Kennedy JG
Cartilage · 2026 Mar · PMID 39651680 · Full text
ObjectiveThe purpose of this study was to determine the M1/M2 macrophage ratio in concentrated bone marrow aspirate (cBMA) in patients undergoing surgical intervention augmented with cBMA for osteochondral lesions of the...
ObjectiveThe purpose of this study was to determine the M1/M2 macrophage ratio in concentrated bone marrow aspirate (cBMA) in patients undergoing surgical intervention augmented with cBMA for osteochondral lesions of the talus (OLTs).DesignSamples of peripheral blood (PB), bone marrow aspirate (BMA), and cBMA were collected during the procedure. The samples were analyzed by automated cell counting and multicolor fluorescence-activated cell sorting with specific antibodies recognizing monocytes (CD14+ CD16+) and the M1 (CD86+) and M2 (CD163+CD206+) populations within that monocyte population. Cytokine concentrations within the samples were evaluated with enzyme-linked immunosorbent assay (ELISA). The composition of cBMA was compared between 2 commercially available BMA concentration systems.ResultsThirty-eight patients with a mean age of 43.2 ± 10.1 years old undergoing a surgical procedure for the treatment of OLTs involving the use of cBMA were included. cBMA had a mean fold increase of 4.7 for all white blood cells, 6.1 for monocytes, 7.9 for lymphocytes, 2.4 for neutrophils, and 9.6 for platelets when compared to BMA. The mean M1/M2 ratio for PB, BMA, and cBMA was 15.2 ± 12.0, 20.8 ± 13.3, and 22.1 ± 16.0, respectively. There was a statistically significant higher concentration of interleukin-1 receptor antagonist (IL-1Ra) in the cBMA sample (8243.3 ± 14,837.4 pg/mL) compared to both BMA (3143.0 ± 2218.5 pg/mL) and PB (1847.5 ± 1520.4 pg/mL) samples. The IL-1Ra/IL-1β ratio for PB, BMA, and cBMA was 790.6 ± 581.9, 764.7 ± 675.2, and 235.7 ± 192.1, respectively. There was no difference in the cBMA M1/M2 ratio (19.0 ± 11.1 vs 24.0 ± 18.3) between the Magellan (Isto Biologics, Hopkinton, Massachusetts) and Angel systems (Arthrex Inc, Naples, Florida).ConclusionThis prospective study found that the M1/M2 ratio in cBMA was 22.1 ± 16.0, with significant patient to patient variation observed. Overall, there was no statistically significant difference in the M1/M2 ratio across PB, BMA, and cBMA samples. This is the first study to characterize the macrophage subpopulation within cBMA, which may have significant clinical implications in future studies.
Comparison of Early-Stage Knee Osteoarthritis Induced by Medial Meniscus Tear Versus Tibial Osteotomy in the Rat Model.
Thever Y, Shen Xuanrong M, Rong Chuin T … +1 more , Bin Abd Razak HR
Cartilage · 2024 Dec · PMID 39633532 · Full text
OBJECTIVE: Medial meniscus tear (MMT) is a common method to induce osteoarthritis in rats, but mimics secondary osteoarthritis. A novel method of carrying out a medial wedge closing tibial osteotomy (TO) has been recentl...
OBJECTIVE: Medial meniscus tear (MMT) is a common method to induce osteoarthritis in rats, but mimics secondary osteoarthritis. A novel method of carrying out a medial wedge closing tibial osteotomy (TO) has been recently developed to induce primary osteoarthritis. This study aims to validate it, compared to MMT. METHODS: Twenty rats were divided equally into 2 groups. Outcome measures such as histology graded according to Osteoarthritis Research Society International (OARSI) guidelines and computed tomography (CT) scans were analyzed at 6 weeks post-operatively. Observational gait analysis and serum biomarkers such as C-terminal cross-linked telopeptides of type II collagen (CTX-II) and -1 beta (IL-1β) were collected at 2-weekly intervals up to 6 weeks post-operatively. RESULTS: Serum CTX-II and IL-1β levels did not reveal a statistically significant difference across all time points between the 2 groups. CT grading was significantly more severe (2.80 ± 1.10 vs 1.40 ± 0.548, = 0.0389) in the MMT group compared to the TO group. In addition, histological gradings such as calcified cartilage score (2.10 ± 1.91 vs 0.00 ± 0.00, < 0.01) and cartilage degeneration score (4.80 ± 5.18 vs 0.00 ± 0.00, < 0.01) revealed significantly more severe osteoarthritis in the MMT compared to TO group. Synovial membrane score did not reveal a statistically significant difference (1.10 ± 0.994 vs 1.00 ± 0.00, = 1.00). CONCLUSION: TO is a novel method in inducing primary osteoarthritis in the rat model compared to MMT between the 6 and 12 weeks' time frame.
Attenuating Cartilage Degeneration in a Low Mechanical Compression Rat Model Through Intra-Articular Injections of Allogeneic Bone Marrow-Derived Mesenchymal Stem Cells.
Tai C, Ito A, Zhao Z … +2 more , Kuroki H, Aoyama T
Cartilage · 2024 Nov · PMID 39611391 · Full text
OBJECTIVE: Mechanical stimulation significantly contributes to posttraumatic osteoarthritis (PTOA), a condition that impedes patient recovery following intra-articular injury. Effective treatment options for compression-...
OBJECTIVE: Mechanical stimulation significantly contributes to posttraumatic osteoarthritis (PTOA), a condition that impedes patient recovery following intra-articular injury. Effective treatment options for compression-induced injuries are limited. Bone marrow-derived mesenchymal stem cell (BMSC) implantation has emerged as a potential therapeutic breakthrough for joint diseases. The aim of this study was to attenuate the progression of PTOA induced by cyclic loading and demonstrate the potential effectiveness of BMSCs in a rat model of low mechanical compression. DESIGN: Using a rat model of compression-induced articular cartilage injury, assessments were conducted 2, 4, and 8 weeks after cyclic compressive loading. The expression of matrix metallopeptidase 13, transforming growth factor-beta 3 (TGF-β3), insulin-like growth factor 1 (IGF-1), and cleaved caspase-3 was evaluated through immunohistochemistry to investigate the mechanistic aspects underlying the prevention of compression-induced injury following BMSCs treatment. RESULTS: Intra-articular injections of BMSCs significantly improved scores in the OARSI (Osteoarthritis Research Society International) Osteoarthritis Cartilage Histopathology Assessment System and Histological-Histochemical Grading System. This treatment showed positive outcomes in maintaining high relative cell density and reducing proteoglycan loss after cyclic compression-induced injury. The expression patterns of IGF-1 and TGF-β3 provide valuable insights into the presence and distribution of these growth factors in healthy and injured cartilage. CONCLUSIONS: These findings highlight the efficacy of BMSCs treatment in attenuating the advancement of compression-induced injuries, albeit within a limited timeframe.
Meniscus Injury Induces Patellofemoral Osteoarthritis Development Mediated by Synovitis and Gait Kinematics: A Preclinical Study.
Nakahata A, Ito A, Nakahara R … +1 more , Kuroki H
Cartilage · 2024 Nov · PMID 39567862 · Full text
OBJECTIVE: To investigate whether meniscal injury leads to the development of patellofemoral (PF) osteoarthritis (PFOA) and to explore how synovitis and gait kinematics mediate this relationship. METHODS: Fifty-four male...
OBJECTIVE: To investigate whether meniscal injury leads to the development of patellofemoral (PF) osteoarthritis (PFOA) and to explore how synovitis and gait kinematics mediate this relationship. METHODS: Fifty-four male Wistar rats (12 weeks old) were randomly assigned to the control, sham, or destabilized medial meniscus (DMM) groups. The rats were subjected to gait analysis to assess the kinematic changes at 2, 4, and 8 weeks postoperatively. Subsequently, the rats were euthanized, and their right knees were harvested for histological analysis. RESULTS: The Osteoarthritis Research Society International (OARSI) and modified Mankin (MM) scores in the DMM group were significantly higher than those in the control and sham groups at week 2 and significantly higher than those in the control group at week 4. The OARSI and MM scores in the sham group were significantly higher than those in the control group at weeks 2 and 4. The association between the DMM and OARSI scores was significantly mediated by the synovitis score and knee flexion angle at foot contact (proportion mediated: 58% and 10%, respectively). The association between the sham and OARSI scores was significantly mediated by the synovitis score and knee flexion angle (proportion mediated: 24% and 24%, respectively). CONCLUSIONS: DMM surgery induced articular cartilage damage in the PF joint. Synovitis and the knee flexion angle significantly mediated the association between DMM or sham surgery and PFOA development.
TNF-α Regulated Bidirectional Interaction Between Bone Marrow Mesenchymal Stem Cells and Articular Chondrocytes.
Huang Y, Zuo F, Wu J … +1 more , Wu S
Cartilage · 2024 Nov · PMID 39567501 · Full text
BACKGROUND: Articular chondrocytes (ACs) secrete a variety of extracellular matrix components to maintain the functions of articular cartilage. Degeneration of ACs leads to the degeneration of articular cartilage and con...
BACKGROUND: Articular chondrocytes (ACs) secrete a variety of extracellular matrix components to maintain the functions of articular cartilage. Degeneration of ACs leads to the degeneration of articular cartilage and consequently to osteoarthritis. The secretion of bone marrow mesenchymal stem cells (BMSCs) is capable of protecting ACs from degeneration, and thus BMSCs are widely applied to treat osteoarthritis. OBJECTIVE: This study aims to explore whether BMSCs and ACs will affect the functions of each other through their secretions in the context of osteoarthritis. DESIGN: BMSCs and ACs isolated from rabbits were identified using flow cytometry and immunocytochemistry. Conditioned medium of BMSCs and ACs treated with 0, 5, 10, 20, and 40 ng/ml of tumor necrosis factor-alpha (TNF-α) were collected and used to treat ACs and BMSCs, respectively. The viabilities of ACs and BMSCs treated with condition medium were assessed using a Cell Count Kit-8 (CCK-8) kit. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR), immunoblotting, and enzyme-linked immunosorbent assay (ELISA) methods were employed to evaluate the relative expression levels of genes and proteins, as well as the cytokine concentrations in the supernatant. RESULTS: Immunofluorescence and flow cytometry results indicated that the purity of isolated cells exceeded 95%. CCK-8 analysis showed that 6 hours of treatment with a conditioned medium did not affect the viability of BMSCs and ACs. However, treatment for 12 hours or longer significantly increased the viability of BMSCs ( < 0.05) and significantly decreased the viability of ACs ( < 0.01). RT-qPCR results demonstrated that the relative expression levels of (1.15-3.91), (1.06-2.84), (BMSCs: 0.94-2.54; ACs: 1.03-2.64), (BMSCs: 0.98-2.78; ACs: 0.96-3.71), (BMSCs: 1.08-5.91; ACs: 0.90-4.20), and (BMSCs: 0.93-2.82; ACs: 0.89-2.25) genes in conditioned medium-treated BMSCs and ACs were dose-dependently elevated ( < 0.001) by TNF-α treatment. Immunoblotting analysis revealed that the expression levels of RUNX2 (0.53-0.86) and ALP (0.49-0.85) proteins were also dose-dependently elevated ( < 0.001) by TNF-α treatment. ELISA results showed similar TNF-α dose-dependent increases ( < 0.001) in the supernatant concentrations of pro-inflammatory cytokines TNF-α (BMSCs: 36.90 ± 0.75 to 199.38 pg/ml; ACs: 29.76 to 293.99 pg/ml), interleukin (IL)-6 (BMSCs: 4.96-48.24 pg/ml; ACs: 6.12-38.15 pg/ml), IL-17 (BMSCs: 3.06-28.99 pg/ml; ACs: 3.08-28.51 pg/ml), as well as the anti-inflammatory cytokine IL-10 (BMSCs: 6.34-65.02 pg/ml; ACs: 5.30-34.85 pg/ml). CONCLUSION: Together, these results indicate a TNF-α-regulated bidirectional interaction between BMSCs and ACs, deepening our understanding of the pathogenesis of osteoarthritis and aiding in its prevention and treatment.
Anterior Cruciate Ligament Reconstruction and Concomitant Focal Cartilage Lesions: A Systematic Review and Meta-Analysis of Prognosis after Surgical Treatment.
Jevremovic D, Årøen A, Thomas OMT … +3 more , Berge HM, Khan AA, Ulstein S
Cartilage · 2024 Nov · PMID 39564754 · Full text
OBJECTIVE: To synthesize available evidence on the impact of concomitant focal cartilage lesions and their surgical treatment on clinical outcomes in the setting of anterior cruciate ligament (ACL)-reconstruction at shor...
OBJECTIVE: To synthesize available evidence on the impact of concomitant focal cartilage lesions and their surgical treatment on clinical outcomes in the setting of anterior cruciate ligament (ACL)-reconstruction at short (6-36 months) and midterm (3-8 years) follow-up. DESIGN: Original level 1 or 2 studies comparing any patient-reported or objective outcomes in ACL-reconstructed patients (1) with and without concomitant focal cartilage lesion(s) or (2) after any type of cartilage surgical treatment were considered for inclusion. Systematic searches were conducted in MEDLINE via Ovid, Cochrane Library, EMBASE via OvidSP, and Web of Science. RESULTS: In meta-analysis performed across 6 studies (n=8,789 patients), we discovered with very low certainty, the correlation of concomitant any-thickness cartilage lesions and worse Patient-Reported Outcome Measure scores (PROMS) at cumulative short to mid, (pooled standardized mean difference (psmd) = -0.36; 95% confidence interval (CI) -0.62 to -0.10), short (psmd = -0.43; 95% CI = -0.94 to 0.08), and midterm (psmd = -0.22; 95% CI -0.43 to 0.00). Full-thickness lesions predicted worse PROMS with moderate certainty at cumulative short-midterm (psmd = -0.32; 95% CI = -0.41 to -0.23) and low certainty at both short (psmd = -0.45; 95% CI -0.83 to -0.07) and midterm (psmd = -0.30; 95% CI -0.38 to -0.22). In 4 studies for each outcome, mixed results were reported on osteoarthritis (OA) and reoperation rates. CONCLUSIONS: As the main finding, concomitant full-thickness cartilage lesions in ACL-reconstructed patients are a predictor of worse PROMS in the cumulative short to midterm. Correlations of any-thickness lesions or different cartilage treatments with short- or midterm PROMS, OA, or reoperation rates were either with very low certainty, unmeasured, or with mixed results.
EUROVISCO Consensus Guidelines for the Use of Hyaluronic Acid Viscosupplementation in Knee Osteoarthritis Based on Patient Characteristics.
Conrozier T, Raman R, Diraçoglu D … +9 more , Montfort J, Bard H, Baron D, Goncalves B, Richette P, Migliore A, Chevalier X, Brittberg M, Henrotin Y
Cartilage · 2025 Dec · PMID 39564753 · Full text
ObjectivesViscosupplementation with hyaluronic acid (HA) is a commonly used intra-articular treatment for osteoarthritis (OA). We performed a Delphi consensus process to formulate guidelines for the use of intra-articula...
ObjectivesViscosupplementation with hyaluronic acid (HA) is a commonly used intra-articular treatment for osteoarthritis (OA). We performed a Delphi consensus process to formulate guidelines for the use of intra-articular hyaluronic acid (IAHA) knee injection according to the patient's characteristics.MethodsThe EUROVISCO group consists of 12 members who had expertise in clinical and/or research in the field of OA and IAHA treatment. This group drafted issues through an iterative process and subsequently voted according to a Delphi process on their level of agreement (LoA) on these recommendations. The scores were pooled to generate a median agreement score for each recommendation. The strength of the recommendation (SOR) was classified as strong if the median agreement score was ≥8. The level of consensus (LOC) was also obtained. The level of evidence was given for each recommendation.Results:A total of 34 statements were evaluated by the expert group. A unanimous or high LoA was obtained in 16. IAHA can be considered irrespective of the age in patients with symptomatic knee OA. It can be used in patients with diabetes and/or moderate to severe obesity. It can also be used in knee OA patients with a history of gout, meniscocalcinosis and with mild-to-moderate varus/valgus malalignment. The group recommended against the use of VS in pregnant women and in OA flare.ConclusionIn summary, the working group provided strong recommendations for the use of IAHA injection that will facilitate individualized treatment decision algorithms in the management of knee OA.
Regression to the Mean: Statistical Bias Can Mislead Interpretation in Cartilage and Osteoarthritis Clinics and Research.
Emanuel KS, Dahmen J, Sierevelt IN … +2 more , Brittberg M, Kerkhoffs GMMJ
Cartilage · 2025 Dec · PMID 39529243 · Full text
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