Cartilage diseases

软骨疾病
  • 文章类型: Editorial
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  • 文章类型: Journal Article
    背景:探讨和比较3.0T磁共振成像(MRI)T2标测在评估髋关节置换手术中髋臼软骨退变程度的价值。
    方法:纳入26例老年股骨颈骨折患者,采用3.0TMRIT2mapping量化技术扫描。基于MRI图像,根据国际软骨修复协会(ICRS)评分,髋臼软骨退变程度分为0,1,2,3和4级.此外,8例健康志愿者作为对照组。
    结果:与健康人群相比,前部的T2弛豫值,上级,股骨颈骨折患者髋臼软骨后区明显增高(P<0.001)。在股骨颈骨折患者中,1-2级(轻度变性亚组)髋关节16例,3-4级(重度变性亚组)髋关节10例,占61.54%和38.46%,分别。此外,关节软骨前带和上带的T2松弛值与MRI分级呈正相关(P<0.05);而严重退变亚组和轻度退变亚组的关节软骨后部T2松弛值差异无统计学意义(P>0.05)。重要的是,可以通过T2映射伪彩色图像的信号变化来检测髋臼软骨退变。
    结论:3.0TMRIT2标测技术可用于确定髋臼软骨退变的程度,能有效监测病程。
    BACKGROUND: To explore and compare the values of 3.0T magnetic resonance imaging (MRI) T2 mapping in evaluating the degree of acetabular cartilage degeneration in hip replacement surgery.
    METHODS: A total of 26 elderly patients with femoral neck fractures who were scanned in 3.0T MRI T2 mapping quantification technique were included. Basing on MRI images, the degree of acetabular cartilage degeneration was classified into Grade 0, 1, 2, 3 and 4, according to the International Cartilage Repair Society (ICRS) scores. In addition, 8 healthy volunteers were included for control group.
    RESULTS: By comparison with health population, T2 relaxation values in the anterior, superior, and posterior regions of acetabular cartilage in patients with femoral neck fracture were obviously increased (P < 0.001). Among the patients with femoral neck fractures, there were 16 hip joint with Grade 1-2 (mild degeneration subgroup) and 10 hip joints with Grade 3-4 (severe degeneration subgroup), accounting for 61.54% and 38.46%, respectively. Additionally, T2 relaxation values in the anterior and superior bands of articular cartilage were positively related to the MRI-based grading (P < 0.05); while there was no significant difference of T2 relaxation values in the posterior areas of articular cartilage between severe degeneration subgroup and mild degeneration subgroup (P > 0.05). Importantly, acetabular cartilage degeneration can be detected through signal changes of T2 mapping pseudo-color images.
    CONCLUSIONS: 3.0T MRI T2 mapping technology can be used to determine the degree of acetabular cartilage degeneration, which can effectively monitor the disease course.
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  • 文章类型: Journal Article
    骨重塑是成骨细胞和破骨细胞之间的平衡。骨疾病如骨质疏松症和骨关节炎与不平衡的骨重建有关。骨骼损伤导致有限的运动功能和疼痛。神经亲素最初是在轴突中发现的,以及它的各种配体和在骨重建、血管生成中的作用,后来发现了神经性疼痛和免疫调节。Neurophilin促进成骨细胞矿化并抑制破骨细胞分化及其功能。Neuropolin-1为免疫细胞趋化和细胞因子扩散提供通道并导致疼痛。Neuropolin-1调节17型T辅助细胞(Th17)和调节性T细胞(Treg细胞)的比例,影响骨骼免疫力.血管内皮生长因子(VEGF)与神经纤毛蛋白结合并促进血管生成。3类信号蛋白(Sema3a)与VEGF竞争结合神经纤毛蛋白,减少血管生成并排斥交感神经。本文综述了神经纤毛素的结构和一般生理功能,并对神经纤毛素及其配体在骨软骨疾病中的作用进行了综述。最后,提出了基于神经纤毛素的治疗策略和未来的研究方向。
    Bone remodeling is the balance between osteoblasts and osteoclasts. Bone diseases such as osteoporosis and osteoarthritis are associated with imbalanced bone remodeling. Skeletal injury leads to limited motor function and pain. Neurophilin was initially identified in axons, and its various ligands and roles in bone remodeling, angiogenesis, neuropathic pain and immune regulation were later discovered. Neurophilin promotes osteoblast mineralization and inhibits osteoclast differentiation and its function. Neuropolin-1 provides channels for immune cell chemotaxis and cytokine diffusion and leads to pain. Neuropolin-1 regulates the proportion of T helper type 17 (Th17) and regulatory T cells (Treg cells), and affects bone immunity. Vascular endothelial growth factors (VEGF) combine with neuropilin and promote angiogenesis. Class 3 semaphorins (Sema3a) compete with VEGF to bind neuropilin, which reduces angiogenesis and rejects sympathetic nerves. This review elaborates on the structure and general physiological functions of neuropilin and summarizes the role of neuropilin and its ligands in bone and cartilage diseases. Finally, treatment strategies and future research directions based on neuropilin are proposed.
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  • 文章类型: Evaluation Study
    目的:本研究旨在探讨两种手术方法的有效性,自体髌腱移植重建和胫骨平台拔出修复,使用猪模型。主要重点是评估内侧半月板后部(MMPP)缺陷的修复能力,弯月面的整体结构完整性,以及两个手术组之间股骨和胫骨软骨的保护。总体目标是使用这些发现为临床研究提供实验指南。
    方法:选择12头猪,建立距胫骨平台插入点10mm的MMPP损伤模型。他们被随机分为三组,每组四只动物:重建(MMPP的自体肌腱移植重建),拔出修复(通过胫骨平台骨隧道缝合修复MMPP),和对照(使用正常内侧半月板作为阴性对照)。术后12周对动物实施安乐死,以评估半月板,肌腱骨愈合评估,膝关节软骨的大体观察。使用国际软骨修复学会(ICRS)分级和Mankin评分评估胫骨和股骨软骨损伤。对半月板-肌腱连接区进行组织学和免疫组织化学染色,初生半月板,和肌腱。Ishida评分用于评估重建组的再生半月板。磁共振成像(MRI)用于评估半月板愈合。
    结果:所有12头猪手术后恢复良好;所有切口均愈合,无感染,无明显并发症发生。总体观察显示,与对照组相比,重建和拔出修复组的效果更好。在胫骨软骨中,重建组有ICRSI级损伤,而拔出修复组和对照组有ICRSII级和III级损伤,分别。Mankin评分在重建组和对照组之间有明显差异;组织学染色显示,重建组再生半月板的结构与原始半月板相似。免疫组化染色显示,重建组再生半月板与原始半月板的Ⅰ型和Ⅱ型胶原染色程度类似。在重建组中,再生半月板与正常初生半月板之间的Ishida评分没有显着差异。MRI显示重建和拔除修复组的MMPP已完全愈合,而对照组尚未愈合。
    结论:自体髌腱移植重建MMPP可产生纤维软骨样再生半月板。重建和拔出修复都可以保持半月板的结构完整性,促进MMPP的愈合,延迟半月板变性,保护膝盖软骨.
    OBJECTIVE: This study was performed to investigate the effectiveness of two surgical procedures, autologous patellar tendon graft reconstruction and trans-tibial plateau pull-out repair, using a pig model. The primary focus was to assess the repair capability of medial meniscus posterior portion (MMPP) deficiency, the overall structural integrity of the meniscus, and protection of the femoral and tibial cartilage between the two surgical groups. The overall aim was to provide experimental guidelines for clinical research using these findings.
    METHODS: Twelve pigs were selected to establish a model of injury to the MMPP 10 mm from the insertion point of the tibial plateau. They were randomly divided into three groups of four animals each: reconstruction (autologous tendon graft reconstruction of the MMPP), pull-out repair (suture repair of the MMPP via a trans-tibial plateau bone tunnel), and control (use of a normal medial meniscus as the negative control). The animals were euthanized 12 weeks postoperatively for evaluation of the meniscus, assessment of tendon bone healing, and gross observation of knee joint cartilage. The tibial and femoral cartilage injuries were evaluated using the International Society for Cartilage Repair (ICRS) grade and Mankin score. Histological and immunohistochemical staining was conducted on the meniscus-tendon junction area, primary meniscus, and tendons. The Ishida score was used to evaluate the regenerated meniscus in the reconstruction group. Magnetic resonance imaging (MRI) was used to evaluate meniscal healing.
    RESULTS: All 12 pigs recovered well after surgery; all incisions healed without infection, and no obvious complications occurred. Gross observation revealed superior results in the reconstruction and pull-out repair groups compared with the control group. In the tibial cartilage, the reconstruction group had ICRS grade I injury whereas the pull-out repair and control groups had ICRS grade II and III injury, respectively. The Mankin score was significantly different between the reconstruction and control groups; histological staining showed that the structure of the regenerated meniscus in the reconstruction group was similar to that of the original meniscus. Immunohistochemical staining showed that the degree of type I and II collagen staining was similar between the regenerated meniscus and the original meniscus in the reconstruction group. The Ishida score was not significantly different between the regenerated meniscus and the normal primary meniscus in the reconstruction group. MRI showed that the MMPP in the reconstruction and pull-out repair groups had fully healed, whereas that in the control group had not healed.
    CONCLUSIONS: Autologous patellar tendon graft reconstruction of the MMPP can generate a fibrocartilage-like regenerative meniscus. Both reconstruction and pull-out repair can preserve the structural integrity of the meniscus, promote healing of the MMPP, delay meniscal degeneration, and protect the knee cartilage.
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  • 文章类型: Journal Article
    关节软骨缺损受到软骨再生能力不足的挑战。Catalpol(CA),地黄的主要活性成分,可以对各种疾病发挥保护作用。然而,CA对关节软骨损伤治疗的影响尚不清楚。在这项研究中,通过手术在小鼠模型中诱导全层关节软骨缺损。用CA腹膜内注射动物4或8周。根据宏观观察的结果,显微计算机断层扫描CT(μCT),组织学和免疫组织化学染色,CA治疗可促进小鼠软骨修复,导致软骨再生,骨结构改善和基质合成代谢。具体来说,间充质干细胞(MSCs)的标志物CD90的表达增加,在软骨中观察到。此外,我们评估了CA对MSCs的迁移和软骨形成作用。向C3H10T1/2细胞中加入不同浓度的CA。结果表明,CA增强了细胞的迁移和软骨形成,而不影响增殖。总的来说,我们的发现表明CA可能通过刺激内源性MSCs治疗软骨缺损。
    Articular cartilage defect is challenged by insufficient regenerative ability of cartilage. Catalpol (CA), the primary active component of Rehmanniae Radix, could exert protective effects against various diseases. However, the impact of CA on the treatment of articular cartilage injuries is still unclear. In this study, full-thickness articular cartilage defect was induced in a mouse model via surgery. The animals were intraperitoneally injected with CA for 4 or 8 weeks. According to the results of macroscopic observation, micro-computed tomography CT (μCT), histological and immunohistochemistry staining, CA treatment could promote mouse cartilage repair, resulting in cartilage regeneration, bone structure improvement and matrix anabolism. Specifically, an increase in the expression of CD90, the marker of mesenchymal stem cells (MSCs), in the cartilage was observed. In addition, we evaluated the migratory and chondrogenic effects of CA on MSCs. Different concentration of CA was added to C3H10 T1/2 cells. The results showed that CA enhanced cell migration and chondrogenesis without affecting proliferation. Collectively, our findings indicate that CA may be effective for the treatment of cartilage defects via stimulation of endogenous MSCs.
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  • 文章类型: English Abstract
    UNASSIGNED: To discuss the application of anterior region suture of the popliteal hiatus (PH) under arthroscopy in the treatment of discoid lateral meniscus (DLM) injury with instability in the popliteal tendon region.
    UNASSIGNED: The clinical data of 53 patients (56 knees) with DLM injury who met the selection criteria between March 2014 and November 2022 were retrospectively analyzed. There were 15 males and 38 females, aged 8-55 years with an average age of 36.5 years. Fourteen cases had a history of trauma, while the remaining 39 cases had no clear history of trauma. The disease duration ranged from 1 day to 6 years, with an average duration of 15.6 months. According to the Watanabe classification, there were 40 knees of complete type and 16 knees of incomplete type. The preoperative International Knee Documentation Committee (IKDC) knee joint score was 51.2±8.3, the Lysholm score was 59.6±11.2, and the visual analogue scale (VAS) score was 4.7±1.3. After the arthroscopic meniscal plasty, the instability of the popliteal tendon region meniscus was checked by probing traction. Subsequently, the Out-inside technique or a combination of Out-inside and All-inside techniques was used to suture the anterior region of the PH. The stability of the meniscus after suturing was assessed, and if necessary, further suturing using the All-inside technique at the posterior region of the PH, the posterior horn of the meniscus, and using the Out-inside technique at the anterior horn of the meniscus was performed. Postoperative complications were recorded. The effectiveness was evaluated using pre- and post-operative IKDC scores, Lysholm scores, and VAS scores.
    UNASSIGNED: After operation, knee joint pain, crepitus, and locking disappeared, with McMurray and grinding tests turning negative. All patients were followed up 12-93 months with an average of 57.5 months. There was no complication such as common peroneal nerve injury, deep vein thrombosis of the lower limbs, joint infection, or joint stiffness. At last follow-up, the IKDC knee joint score was 76.7±5.5, the Lysholm score was 94.0±4.1, and the VAS score was 1.1±0.8. The differences compared with preoperative scores were significant ( t=-22.090, P<0.001; t=-23.704, P<0.001; t=19.767, P<0.001).
    UNASSIGNED: Suturing of the anterior region of the PH is crucial in the treatment of DLM injury with instability in the popliteal tendon region.
    UNASSIGNED: 探讨关节镜下腘肌腱裂孔(popliteal hiatus,PH)前区缝合在外侧盘状半月板(discoid lateral meniscus,DLM)损伤并腘肌腱区不稳治疗中的应用。.
    UNASSIGNED: 回顾分析2014年3月—2022年11月收治且符合选择标准的53例(56膝)DLM损伤患者临床资料。男15例,女38例;年龄8~55岁,平均36.5岁。14例有外伤史,余39例无明确外伤史。病程1 d~6年,平均15.6个月。根据Watanabe分型:完全型40膝,不完全型16膝。术前国际膝关节文献委员会(IKDC)膝关节评分为(51.2±8.3)分,Lysholm评分为(59.6±11.2)分,疼痛视觉模拟评分(VAS)为(4.7±1.3)分。行关节镜下半月板成形术后,用探钩牵拉检查腘肌腱区半月板均存在不稳,进而采用Out-inside技术或Out-inside技术联合All-inside技术缝合PH前区,检查缝合后半月板稳定性,必要时再采用All-inside技术缝合PH后区、半月板后角和Out-inside技术缝合半月板前角。记录并发症发生情况;采用手术前后IKDC评分、Lysholm评分和VAS评分评价疗效。.
    UNASSIGNED: 术后膝关节疼痛、关节弹响及交锁症状消失,McMurray试验及研磨试验转为阴性。53例患者均获随访,随访时间12~93个月,平均57.5个月。无腓总神经损伤、下肢深静脉血栓形成、关节感染和关节僵硬等并发症发生。末次随访时IKDC膝关节评分为(76.7±5.5)分,Lysholm评分为(94.0±4.1)分,VAS评分为(1.1±0.8)分,与术前比较差异均有统计学意义( t=−22.090, P<0.001; t=−23.704, P<0.001; t=19.767, P<0.001)。.
    UNASSIGNED: PH前区缝合是DLM损伤并腘肌腱区不稳治疗的关键。.
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  • 文章类型: English Abstract
    盘状半月板是一种常见的先天性半月板畸形,主要在亚洲人中普遍存在,通常发生在盘状半月板外侧。无症状盘状半月板患者通常采用观察、避免损伤等保守方法治疗,而有症状和流泪的患者需要手术治疗。关节镜下开式联合半月板部分切除术和半月板修复是最常见的手术方法。,早期到中期报告都很好。影响预后的因素是患者的手术年龄、随访时间和手术类型。一些患者会出现并发症,如术后膝关节疼痛延长,早期骨关节炎,再撕裂和剥离骨软骨炎。术后膝关节长期疼痛的发生率较高,剥脱性骨软骨炎的发生率最低。外侧半月板的保留是再次手术的主要原因。
    The discoid meniscus is a common congenital meniscal malformation that is prevalent mainly in Asians and often occurs in the lateral discoid meniscus. Patients with asymptomatic discoid meniscus are usually treated by conservative methods such as observation and injury avoidance, while patients with symptoms and tears need to be treated surgically. Arthroscopic saucerization combined with partial meniscectomy and meniscus repair is the most common surgical approach., and early to mid-term reports are good. The prognostic factors are the patient\'s age at surgery、follow-up time and type of surgery. Some patients experience complications such as prolonged postoperative knee pain, early osteoarthritis, retears and Osteochondritis dissecans. The incidence of prolonged postoperative knee pain was higher and the incidence of Osteochondritis dissecans was the lowest. Retears of the lateral meniscus is the main reason for reoperation.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    软骨相关疾病,如发育不良的软骨发育不良是一种罕见的遗传性疾病,会影响新生儿,导致软骨发育异常和骨骼生长受限。然而,由于受控药物递送的局限性,软骨发育不良的有效治疗策略的开发仍然面临重大挑战,生物相容性,和纳米药物的生物降解性。
    构建了基于硅纳米颗粒(MON)的可生物降解的镁掺杂的硅基纳米平台。简而言之,使用MPTMS用巯基修饰MON以形成MOS。通过“溶解-再生长”方法掺入Mg2离子,实现了MOS的进一步工程,导致MMOS。Ica被有效地加载到MMOS通道中,并将HA锚定在MOS的表面以获得MMOS-Ica@HA纳米平台。此外,使用体外细胞实验和体内斑马鱼胚胎模型来评估纳米平台对软骨分化或形成的影响以及治疗软骨发育不良的效率。
    一系列表征测试,包括TEM,SEM,DLS,XPS,EDX,和BET分析验证了MOS-Ica@HA纳米平台的成功制备。制备的纳米平台表现出优异的分散性和可控的药物释放行为。细胞毒性评价揭示了MOS-Ica@HA由于Ica的持续和可控释放而具有良好的生物相容性。重要的是,MOS-Ica@HA中Ica和Mg成分的存在通过Smad5/HIF-1α信号通路显著促进BMSCs的软骨分化。体外和体内实验证实,纳米平台通过促进软骨分化和形成来改善软骨发育不良。
    研究结果表明,开发的可生物降解的MMOS-Ica@HA纳米平台具有可接受的载药量和受控的药物释放在软骨发育不良治疗中的潜在应用,这表明了治疗软骨发育不良的有希望的方法。
    UNASSIGNED: Cartilage-related diseases, such as hypoplastic chondrodysplasia a rare genetic disorder that affects newborns, causing abnormal cartilage development and restricted skeletal growth. However, the development of effective treatment strategies for chondrodysplasia still faces significant challenges due to limitations in the controlled drug delivery, biocompatibility, and biodegradability of nanomedicines.
    UNASSIGNED: A biodegradable magnesium doped-silicon based-nanoplatforms based on silicon nanoparticles (MON) was constructed. Briefly, the MON was modified with sulfhydryl groups using MPTMS to form MOS. Further engineering of MOS was achieved by incorporating Mg2+ ions through the \"dissolution-regrowth\" method, resulting in MMOS. Ica was effectively loaded into the MMOS channels, and HA was anchored on the surface of MOS to obtain MMOS-Ica@HA nanoplatforms. Additionally, in vitro cell experiments and in vivo zebrafish embryo models were used to evaluate the effect of the nanoplatforms on cartilage differentiation or formation and the efficiency of treating chondrodysplasia.
    UNASSIGNED: A series of characterization tests including TEM, SEM, DLS, XPS, EDX, and BET analysis validate the successful preparation of MOS-Ica@HA nanoplatforms. The prepared nanoplatforms show excellent dispersion and controllable drug release behavior. The cytotoxicity evaluation reveals the good biocompatibility of MOS-Ica@HA due to the sustained and controllable release of Ica. Importantly, the presence of Ica and Mg component in MOS-Ica@HA significantly promote chondrogenic differentiation of BMSCs via the Smad5/HIF-1α signaling pathway. In vitro and in vivo experiments confirmed that the nanoplatforms improved chondrodysplasia by promoting cartilage differentiation and formation.
    UNASSIGNED: The findings suggest the potential application of the developed biodegradable MMOS-Ica@HA nanoplatforms with acceptable drug loading capacity and controlled drug release in chondrodysplasia treatment, which indicates a promising approach for the treatment of chondrodysplasia.
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  • 文章类型: Journal Article
    骨关节炎(OA)是一种常见的关节疾病,以软骨退化而闻名,由于其高残疾率,给个人和社会带来了沉重负担。然而,由于软骨再生的潜在机制不明确,目前临床治疗软骨缺损的方法仍不尽人意.组织工程水凝胶已成为软骨修复中的一种有吸引力的方法。最近的研究表明,干细胞可以感知水凝胶的机械强度,从而调节他们的分化命运。在这项研究中,我们提出了具有可控表面刚度的双网络DNA-丝素蛋白(SF)水凝胶的开创性构建。超分子网络,通过DNA碱基配对形成的,通过约束和聚集SF分子诱导β-折叠结构的发展。随后,SF通过辣根过氧化物酶(HRP)介导的酶反应交联,形成第二个网络。实验结果表明,双网络DNA-SF水凝胶的表面刚度与DNA含量呈正相关。有趣的是,观察到具有中等表面硬度的双网络DNA-SF水凝胶在促进骨髓间充质干细胞(BMSCs)的迁移及其软骨分化方面表现出最高的有效性。转录组测序进一步证实,双网络DNA-SF水凝胶主要通过上调Wnt和TGF-β信号通路同时加速胶原蛋白II合成来增强BMSCs的软骨分化。此外,体内研究表明,具有中等表面刚度的双网络DNA-SF水凝胶可显着加速软骨再生。总之,双网络DNA-SF水凝胶代表了软骨再生的一种有前途和新颖的治疗策略。
    Osteoarthritis (OA) is a common joint disease known for cartilage degeneration, leading to a substantial burden on individuals and society due to its high disability rate. However, current clinical treatments for cartilage defects remain unsatisfactory due to the unclear mechanisms underlying cartilage regeneration. Tissue engineering hydrogels have emerged as an attractive approach in cartilage repair. Recent research studies have indicated that stem cells can sense the mechanical strength of hydrogels, thereby regulating their differentiation fate. In this study, we present the groundbreaking construction of dual-network DNA-silk fibroin (SF) hydrogels with controllable surface rigidity. The supramolecular networks, formed through DNA base-pairing, induce the development of β-sheet structures by constraining and aggregating SF molecules. Subsequently, SF was cross-linked via horseradish peroxidase (HRP)-mediated enzyme reactions to form the second network. Experimental results demonstrated a positive correlation between the surface rigidity of dual-network DNA-SF hydrogels and the DNA content. Interestingly, it was observed that dual-network DNA-SF hydrogels with moderate surface rigidity exhibited the highest effectiveness in facilitating the migration of bone marrow mesenchymal stem cells (BMSCs) and their chondrogenic differentiation. Transcriptome sequencing further confirmed that dual-network DNA-SF hydrogels primarily enhanced chondrogenic differentiation of BMSCs by upregulating the Wnt and TGF-β signaling pathways while accelerating collagen II synthesis. Furthermore, in vivo studies revealed that dual-network DNA-SF hydrogels with moderate surface rigidity significantly accelerated cartilage regeneration. In summary, the dual-network DNA-SF hydrogels represent a promising and novel therapeutic strategy for cartilage regeneration.
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