Characterisation of human meniscus cells

AIM: The meniscus of the human knee joint has an important function for the shock absorption, stability and power transmission from the upper to the lower leg. After meniscus injury often a partial or complete resection is necessary. Only injuries in the outer third may heal spontaneously or upon primary suture due to the vascularisation in these segments. After partial or total meniscectomy osteoarthritis of the knee joint is common in a large number of patients. The goal of our investigations was to establish meniscus cell cultures and to characterise the fibrochondrocytes (meniscus cells) in vitro. METHODS: We examined the expression of different growth factors, cytokines and proteins in human menisci from surgical preparations using immunohistochemistry and RT-PCR analysis. RESULTS: Human meniscus cells express the collagens I , II, III, and VI, the matrix metalloproteinases-1, -2, -3, -8, and -13, BMP-2, and -4, TGFbeta1, VEGF, IGF-I, and -II, FGF-2, endostatin, iNOS, vimentin, TIMP-1, and -2, aggrecan, IL-1beta, IL-6, and IL-18. Staining with the monoclonal antibody AS.02 in all examined cells confirmed their mesenchymal origin. CONCLUSION: New strategies for the treatment of meniscus damage can be derived from these results and further advances for the tissue engineering of meniscus tissue can be obtained.     

Patellar meniscus in total knee arthroplasty

Twenty-four clinically successful, autopsy retrieved porous-coated anatomic total knee arthroplasty (TKA) specimens were evaluated to determine the structure and function of the patellar meniscus. Mean implant duration was 76 months (range: 11-135 months). Histological examination showed the patellar meniscus to be composed of dense fibrous tissue with scattered regions of chronic granulomatous response to polyethylene debris. Patellar wear and polyethylene exposed patellar surface area were correlated with implant duration (r = 0.47, P = .03; r = 0.52, P = .06). Postoperative patellar tilt was also associated with patellar component wear (r = 0.64, P = .03). No other clinical measures were significantly associated with patellar wear or exposed surface area. Additional research is needed to determine what role, if any, the patellar meniscus plays in TKA outcomes.     

Fibronectin splice variation in human knee cartilage,meniscus and synovial membrane: Observations in osteoarthritic knee

Fibronectin (FN) is a widely expressed molecule that can participate in development of osteoarthritis (OA) affecting cartilage, meniscus, and synovial membrane (SM). The alternatively spliced isoforms of FN in joint tissues other than cartilage have not been extensively studied previously. The present study compares FN splice variation in patients with varying degrees of osteoarthritic change. Joint tissues were collected from asymptomatic donors and patients undergoing arthroscopic procedures. Total RNA was amplified by PCR using primers flanking alternatively spliced Extra Domain A (EDA), Extra Domain B (EDB) and Variable (V) regions. EDB⁺, EDB^? and EDA^? and V⁺ variants were present in all joint tissues, while the EDA⁺ variant was rarely detected. Expression levels of EDB⁺ and EDV⁺ variants were similar in cartilage, synovium, and meniscal tissues. Synovial expression of V⁺ FN in arthroscopy patients varied with degree of cartilage degeneration. Two V^? isoforms, previously identified in cartilage, were also present in SM and meniscus. Fibronectin splicing in meniscus and SM bears striking resemblance to that of cartilage. Expression levels of synovial V⁺ FN varied with degree of cartilage degeneration. V⁺ FN should be investigated as a potential biomarker of disease stage or progression in larger populations. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:556–562, 2015.

     

Arthroscopic meniscus repair in the ACL-deficient knee

Between 1985 and 1995, 45 patients underwent closed meniscus repair. There were 30 men and 15 women with a mean age of 32.5 years. In 23 patients, the anterior cruciate ligament was intact (group 1) whereas it was deficient in 22 patients (group 2). All patients were managed with the same postoperative program of partial weight bearing, immediate motion and rehabilitation of the knee. Five patients had a failed meniscal repair and underwent a repeat arthroscopy and a partial meniscectomy. These patients were considered as failures and excluded from the final scoring. After a mean follow-up of more than 9 years, all patients were subjected to a clinical examination using the Hospital for Special Surgery (HSS) knee rating system. Seven patients in group 2 had episodes of frequent giving way and had their anterior cruciate ligament (ACL) reconstructed 6 and 7 years after the initial meniscus repair. None of the other patients had any clinical symptoms or signs of a meniscal tear. In group 1, 20 patients and in group 2, 14 patients, all had a satisfactory knee score. Even though the failure rate of meniscus repair may be greater in an unstable knee, it is concluded that meniscal repair is not contraindicated in a knee with a deficient ACL.

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Résumé Entre 1985 et 1995 45 malades ont eu une réparation méniscale à foyer fermé. Il y avait 30 hommes et 15 femmes à lâge moyen de 32,5 ans. Chez 23 malades le ligament croisé antérieur (LCA) était intact (Groupe 1), alors quil était défectueux chez 22 malades (Groupe 2). Tous les malades ont eu le même programme postopératoire avec appui partiel, mobilisation immédiate et rééducation du genou. Cinq malades ont présentés un échec et ont subi une arthroscopie secondaire avec méniscectomie partielle. Ces malades ont été considérés comme échecs et ont exclu du dernier marquage de points. Après une moyenne de suivi de plus de neuf ans tous les malades ont été soumis à un examen clinique qui utilise le score HSS pour lestimation du genou. Sept malades du groupe 2 ont eu de fréquent épisodes de dérobement et ont eu leur LCA reconstruit 6 et 7 ans après la réparation du ménisque. Aucun des autres malades navait de symptôme clinique ou de signe dune déchirure méniscale. Vingt malades du groupe 1 et 14 malades du groupe 2 avaient tous un score du genou satisfaisant. Bien que le taux déchec de réparation du ménisque puisse être plus grand dans un genou instable, notre conclusion est que la réparation du ménisque nest pas contre-indiquée sur un genou avec un LCA défectueux.

     

Gene expression profiles of the meniscus avascular phenotype: A guide for meniscus tissue engineering

Avascular (Avas) meniscus regeneration remains a challenge, which is partly a consequence of our limited knowledge of the cells that maintain this tissue region. In this study, we utilized microarrays to characterize gene expression profiles of intact human Avas meniscus tissue and of cells following culture expansion. Using these data, we examined various 3D culture conditions to redifferentiate Avas cells toward the tissue phenotype. RNA was isolated from either the tissue directly or following cell isolation and 2 weeks in monolayer culture. RNA was hybridized on human genome arrays. Differentially expressed (DE) genes were identified by ranking analysis. DAVID pathway analysis was performed and visualized using STRING analysis. Quantitative PCR (qPCR) on additional donor menisci (tissues and cells) were used to validate array data. Avas cells cultured in 3D were subjected to qPCR to compare with the array‐generated data. A total of 387 genes were DE based on differentiation state (>3‐fold change; p < 0.01). In Avas‐cultured cells, the upregulated pathways included focal adhesion, ECM‐receptor interaction, regulation of actin cytoskeleton, and PDGF Signaling. In 3D‐cultured Avas cells, TGFβ1 or combinations of TGFβ1 and BMP6 were most effective to promote an Avas tissue phenotype. THBS2 and THBS4 expression levels were identified as a means to denote meniscus cell phenotype status. We identified the key gene expression profiles, new markers and pathways involved in characterizing the Avas meniscus phenotype in the native state and during in vitro dedifferentiation and redifferentiation. These data served to screen 3D conditions to generate meniscus‐like neotissues. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1947–1958, 2018.

     

The value of meniscus sonography of the knee joint

In each of 73 patients with acute knee injuries, both menisci were examined by means of 7.5-MHz sector-scan sonography before arthroscopy was performed. In 87% of the cases the sonographic and arthroscopic diagnoses were identical. The results were better for the lateral meniscus. Overall, the sensitivity was 80% and the specificity, 90%. False-positive and false-negative results each accounted for 6%. In this series there was no correlation between the accuracy of the sonographic diagnosis and the type of meniscal lesion or its location within the meniscus.     

关节镜治疗膝关节半月板损伤

<正>本院2001年3月至2008年6月应用关节镜技术治疗膝关节半月板损伤77例,效果良好。现报道如下。1临床资料1.1一般资料:男性35例,女性42例;年龄15～64岁,平均38岁。左膝半月板损伤45例,右膝22例,双膝5例。病程最短7天,最长2年。术前77例经MRI     

Abnormal band of the lateral meniscus of the knee

Summary: We report 2 cases of an abnormal band of the lateral meniscus of the knee joint. A 23-year-old man complained of mechanical symptoms in both knees and an arthroscopic procedure was performed. We found meniscal abnormalities in the both knees. A 20-year-old man sustained a posterior cruciate ligament injury. In the course of an arthroscopy for his torn posterior cruciate ligament, an abnormal band of the lateral meniscus was seen. It was characteristic that the upper abnormal band was loose and serpentine and connected at the posterior horn and the middle segment of the lower normal lateral meniscus. Arthroscopic resection of abnormal bands successfully eliminated the symptoms. Because of its characteristic appearance and bilaterality, it was evident that this abnormal band was a congenital anomaly.Arthroscopy: The Journal of Arthroscopic and Related surgery, Vol 16, No 6 (September), 2000: E11     

膝关节骨性关节炎半月板退变情况分析

目的：观察半月板在膝关节骨性关节炎中的退变情况，探索半月板退变与膝关节骨性关节炎临床表现的关系。方法：对43例行关节清理术的膝关节半月板进行观察，根据半月板的退变程度，将其分为三型：粗糙型、磨损型和破裂型。比较各类型退变出现关节间隙压痛、关节交锁、Mc Murray试验（＋）、Apley试验（＋）的比率进行统计学分析。结果：43膝83个半月板中有66个出现退变，占79．5％。粗糙型34个，占51．5％；磨损型23个，占34．8％；破裂型9个，占13．6％。各型合并半月板松弛者14个，占21．2％。比较三种类型中的4个指标，差异无显著性意义（P＞0．05）。结论：膝关节骨性关节炎普遍存在半月板退变，由于缺乏典型的临床表现，在临床检查中不易发现，手术中要避免遗漏对半月板的探查和处理。     

MR对膝关节半月板撕裂诊断价值的Meta分析

目的通过Meta分析探讨MR对膝关节半月板撕裂的诊断价值及高低场强MR设备对诊断价值的影响。方法检索Medline、Web of Science、万方中文科技期刊数据库、CNKI中国知网数据库,筛选有关MR对膝关节半月板撕裂诊断的研究文献,检索时间均由建库至2013-01。采用Metadisc 1.4软件对数据进行分析,计算合并敏感度(SE)、特异度(SP)、诊断比值比(DOR)、阳性似然比(LR)、阴性LR及95%CI;异质性采用I2检验分析,绘制汇总受试者工作特征曲线(SROC),并计算曲线下面积(AUC)。采用Review Manager 5软件绘制漏斗图评价纳入文献的发表性偏倚。结果共纳入11篇文献,合计1 058例。Meta分析结果显示:MR对膝关节内侧半月板撕裂诊断的合并SE为0.87,SP为0.92,DOR为89.57,阳性LR为10.78,阴性LR为0.14,AUC为0.959 0;MR对膝关节外侧半月板撕裂诊断的合并SE为0.79,SP为0.93,DOR为50.17,阳性LR为10.18,阴性LR为0.23,AUC为0.958 9。对于低场强(1 T)的MR,内侧半月板MR诊断的AUC为0.973 5,外侧半月板MR诊断的AUC为0.947 4;对于高场强(≥1 T)的MR,内侧半月板MR诊断的AUC为0.956 2,外侧半月板MR诊断的AUC为0.975 4。结论 MR对于膝关节半月板撕裂有较高的诊断价值,高场强和低场强的MR对半月板撕裂的诊断准确性无明显差别。