Thirty-seven jump-landing biomechanical variables are associated with asymptomatic patellar tendon abnormality and patellar tendinopathy: A systematic review

ObjectiveTo identify studies that report three-dimensional (3D) biomechanical analysis of jump-landing tasks in relation to athletes with current patellar tendinopathy (PT), and/or asymptomatic with history of PT or patellar tendon abnormality (PTA) on diagnostic imaging.MethodsFive electronic databases were searched. Included articles were required to: (1) investigate the 3D biomechanics of a jump-landing task; (2) be cross-sectional or longitudinal in design; and (3) include participants that had symptomatic PT, were asymptomatic with a history of PT, asymptomatic with PTA on diagnostic imaging and/or asymptomatic with an unknown pathology or PT history.ResultsThirty-seven statistically significant jump-landing variables were associated with PT, history of PT and/or PTA. The only consistent variable that could be replicated between studies was knee flexion angle at initial foot-ground contact (IC) and an altered hip flexion/extension strategy during a horizontal land phase of a vertical stop-jump.ConclusionIsolated vertical landings or take-offs alone may not be sensitive enough to identify key jump-landing variables associated with PT, thus clinicians and researchers should incorporate a whole jump-landing task with a horizontal landing component. Sagital plane hip and knee kinematics in a horizontal landing phase appear to provide the most valuable information for evaluating those with PT.     

Effect of corticosteroids on articular cartilage: have animal studies said everything?

Intra‐articular (IA) corticosteroids (CS) have been used in the treatment of osteoarthritis for many years, although their effects on articular cartilage are not fully understood. To identify whether previous animal studies have provided enough evidence about the effects of CS, we undertook a systematic review that identified 35 relevant in vivo animal experimental studies between 1965 and 2014 assessing the effects of CS on either normal cartilage, or in either induced osteoarthritis (OA) or synovitis. The quality of the methodology was assessed. Deleterious effects, both structural and biochemical, have mainly been reported in rabbits and are associated with frequent administration of CS, sometimes at high dose and with systemic side effects. In dogs, four identified studies concluded that there were beneficial effects with methylprednisolone acetate (MPA) and triamcinolone hexacetonide therapy. In horses, MPA was mostly deleterious, while triamcinolone acetonide had positive effects in one study highly rated at quality assessment. However, many methodological weaknesses have been identified, such as the lack of pharmacokinetic and pharmocodynamics data and the large variation in doses between studies, the limited selection criteria at baseline, the absence of blinding, and the lack of statistics or appropriate controls for testing the effects of the vehicle of the drug. Those methodological weaknesses weaken the conclusions of numerous studies that assess beneficial or deleterious effects of CS on articular cartilage. Animal studies have not yet provided definitive data, and further research is required into the role of CS in articular pathobiology.     

血清β-Amyloid水平在膝骨关节炎发生评估中的应用价值

目的：探讨膝骨关节炎（KOA）患者血清中β-Amyloid水平与KOA发生及预后的相关性。方法：从温州医科大学附属第二医院育英儿童医院住院患者中选取56例经全膝关节置换或膝关节镜手术治疗的KOA患者为试验组和25 例非KOA患者为对照组。试验组根据X线Kellgren-Lawrence（K-L）分级方法分级，同时收集手术患者术前术后血清标本，采用双抗体夹心酶联免疫吸附法（ELISA)测定血清β-Amyloid水平后，绘制受试者工作特征（ROC）曲线评价血清β-Amyloid对KOA的预测价值，采用Spearman秩相关分析患者血清β-Amyloid水平与KOA的相关性，应用Pearson相关性分析患者手术前后血清β-Amyloid变化值与患者住院时间的相关性。结果：试验组患者血清β-Amyloid水平高于对照组（P ＜0.001）；Logistic回归分析显示β-Amyloid是KOA患病的危险因素（OR =15.122，P ＜0.05)；ROC曲线分析显示，β-Amyloid cut off值等 于0.770，曲线下面积（AUC）为0.752，95%CI =0.636～0.867，敏感度85.5%，特异度60.0%；K-L2组患者血清β-Amyloid低于K-L3/4组患者（P =0.041）；β-Amyloid的表达与KOA严重程度分级呈显著正相关（r =0.332，P =0.013）；术前KOA患者血清β-Amyloid水平高于术后（P =0.002），KOA患者手术前后血清β-Amyloid变化 值与患者住院时间呈显著负相关（r =-0.949，P ＜ 0.001）。结论：β-Amyloid是KOA患病的危险因素，血清β-Amyloid水平可能成为一种潜在的评估KOA发生及预后的生物标志物。