膝骨性关节炎模型的分期特征

目的:通过切断兔的膝前交叉韧带,观察评价其关节炎和滑膜炎不同时期的临床及病理特点,界定膝骨关节炎模型的分期。方法:实验于2004-08/2005-05在解放军南京军区南京总医院动物中心完成,取成年新西兰大白兔30只,将其右膝关节作为实验侧,作膝前交叉韧带切断,左膝关节为对照侧,只作关节囊切开。术后笼中饲养,任其自由活动。分别于造模2,4,6,8及12周时各处死6只。观察滑膜、关节液、软骨的病理特点。采用改良的Mankin骨关节炎的评分法(1～5分定为早期,6～9分为中期,10～14分为晚期)。结果∶28只兔进入结果分析。①实验侧2,4,6周可见早期骨关节炎的改变,表现为滑膜充血增生,关节渗出增多,软骨表层不平整,甲苯胺蓝染色正常或轻染,Mankin评分为2.17～3.8分。②实验侧8周可见骨关节炎中期改变,表现为滑膜增生明显,滑液少,软骨裂隙形成达表层,软骨细胞排列紊,甲苯胺蓝染色不均,Mankin评分为7.83。③实验侧12周可见骨关节炎晚期改变,表现为滑膜部分呈结节样增生,滑液少而混浊,骨赘形成,软骨下骨暴露,软骨细胞减少,甲苯胺蓝大部分失染,Mankin评分为12.2。④对照侧大部分为正常关节软骨(Mankin评分0～1分)。结论∶①兔前交叉韧带断裂后2～6周为骨性关节炎的早期改变,8周为中期,12周为晚期。②此模型能较为全面地反应骨性关节炎软骨退变从早期的代偿性增生到失代偿后软骨细胞和基质减少,软骨变软到剥脱缺失为特点的晚期改变的全过程。     

膝骨性关节炎模型的分期特征

目的：通过切断兔的膝前交叉韧带，观察评价其关节炎和滑膜炎不同时期的临床及病理特点，界定膝骨关节炎模型的分期。 方法：实验于2004-08／2005-05在解放军南京军区南京总医院动物中心完成，取成年新西兰大白兔30只，将其右膝关节作为实验侧，作膝前交叉韧带切断，左膝关节为对照侧，只作关节囊切开。术后笼中饲养，任其自由活动。分别于造模2，4，6，8及12周时各处死6只。观察滑膜、关节液、软骨的病理特点。采用改良的Mankin骨关节炎的评分法（10分定为早期，6-9分为中期，10～14分为晚期）。 结果：28只兔进入结果分析。①实验侧2，4，6周可见早期骨关节炎的改变，表现为滑膜充血增生，关节渗出增多，软骨表层不平整．甲苯胺蓝染色正常或轻染，Mankin评分为2．17-3．8分。②实验侧8周可见骨关节炎中期改变，表现为滑膜增生明显，滑液少，软骨裂隙形成达表层，软骨细胞排列紊，甲苯胺蓝染色不均，Mankin评分为7．83。③实验侧12周可见骨关节炎晚期改变，表现为滑膜部分呈结节样增生．滑液少而混浊，骨赘形成，软骨下骨暴露，软骨细胞减少。甲苯胺蓝大部分失染，Mankin评分为12．2。④对照侧大部分为正常关节软骨（Mankin评分0～1分）。 结论：①兔前交叉韧带断裂后2-6周为骨性关节炎的早期改变，8周为中期，12周为晚期。②此模型能较为全面地反应骨性关节炎软骨退变从早期的代偿性增生到失代偿后软骨细胞和基质减少，软骨变软到剥脱缺失为特点的晚期改变的全过程。     

多孔钽支架与磷酸三钙复合骨膜移植修复软骨缺损的比较

背景：早期实验证实骨膜含有潜在形成软骨或骨的间充质干细胞,在适当的条件下可向软骨细胞分化。目的：比较观察多孔钽支架复合骨膜移植与磷酸三钙复合骨膜移植修复软骨缺损的效果。方法：取雌性兔24只随机分为2组。建立膝关节软骨缺损模型,分别填入多孔钽支架和磷酸三钙支架,表丽覆盖预处理的反置骨膜。石膏固定2周。于12周麻醉后处死兔,观察滑膜、关节液、股骨髁软骨大体观及股骨髁软骨病理表现。采脂改良的Mankin骨关节炎的订分法。结果与结论：多孔钽组滑膜增生明显,新生软骨表层呈蓝白色,周缘欠光滑,甲苯胺蓝染包可见软骨细胞排列稍紊乱,软骨细胞数目正常,多孔钒内骨长入良好,Mankin评分为7．35分。磷酸三钙组新生软骨表层呈蓝白色,周缘欠光滑,甲苯胺龉染色可见软骨细胞排列梢袭乱,软骨细胞数目正常,磷酸二钙内骨长入可,Mankin评分为7．43分（P〉0．05）。表明多孔钽支架复合骨膜移植与磷酸三钙复合骨膜移植修复方式对软骨修复的结果无明显差别,但多孔钽支架与周刚骨组织融合优于磷酸三钙。     

骨性关节炎膝关节液总丙二醛和肿瘤坏死因子-α检测意义分析

骨性关节炎是患者关节软骨发生退行性改变为主要病理改变的一种关节疾病,其中膝关节发生上述改变较为常见,即为膝关节骨关节炎,此类患者的膝关节软骨发生了软骨变性改变、软骨被破坏、软骨下的骨质发生了反应性改变,关节边缘部分的骨质发生增生,滑膜结构也发生增生,发展到中晚期,患者的关节功能发生严重改变。为了探讨其发病机制,本文选择我院膝关节骨关节炎病患者,观察膝关节骨性关节炎的膝关节液内丙二醛和肿瘤坏死因子-a 水平改变情况,现报告如下。     

以关节不稳建立的大鼠骨关节炎模型

背景：骨性关节炎是一种复杂的多病因退变性关节疾病。早期进行骨性关节炎的防治尤其重要。但获取足量的适合研究的早期骨性关节炎的人类骨标本十分困难。目的：观察关节不稳方法建立骨关节炎模型大鼠的关节软骨组织学变化。方法：10周龄雄性SD大鼠随机分为2组：实验组切除右膝内侧半月板及内侧副韧带,对照组仅切开关节囊。于术后1,2,4,6,8周取右膝关节标本,行病理组织学检查分析大鼠骨关节炎病程的变化情况。结果与结论：①术后2,4,6,8周,实验组关节软骨退变程度呈现轻度糜烂、溃疡磨损、严重磨损、骨赘形成等病理变化。②术后1,2,4,6,8周,实验组关节软骨评分均明显高于对照组（P〈0．05）。结果显示该实验采用内侧副韧带切断＋内侧半月板切除方法成功建立了大鼠膝关节骨关节炎模型,且造模后4周内的病理、形态学改变类似于人类早期膝关节骨关节炎表现,是研究早期骨关节炎的理想模型。     

木瓜蛋白酶诱导膝关节骨关节炎模型兔滑膜病理变化与药物注射时间的关系

背景:木瓜蛋白酶诱导兔膝关节骨性关节炎的造模方法可获得稳定的退行性关节炎模型。目的:观察兔膝关节腔内注射木瓜蛋白酶诱导骨关节炎后,滑膜炎性病理改变与药物注射时间的关系。方法:将木瓜蛋白酶水溶液分别在实验开始的第1,4,7天分别注射入15只西兰大白兔右膝关节腔内,建立膝关节骨性关节炎兔模型,于首次注射后第2,4,6周分别观察膝关节滑膜大体及组织病理学变化,每个时间点5只。结果与结论:木瓜蛋白酶首次注射后第2周,兔膝关节滑膜炎性反应最严重,表现为滑膜细胞增生最明显,下层疏松纤维及血管组织明显增生,可见较多淋巴浆细胞浸润,第4,6周时炎性反应逐渐减轻。说明兔膝关节首次注射木瓜蛋白酶后2周时滑膜炎性反应最严重。     

维药买朱尼对骨关节炎大鼠模型关节软骨中基质金属蛋白酶1和基质金属蛋白酶抑制剂1的影响

背景:骨关节炎患者关节软骨的损害与基质金属蛋白酶1和基质金属蛋白酶抑制剂失平衡有关.目的:观察基质金属蛋白酶1、基质金属蛋白酶抑制剂1在关节软骨中的表达及维药买朱尼对其影响.方法:将20只SD大鼠采用改良Hulth造模法建立大鼠膝骨关节炎模型,按随机数字表法随机等分为买朱尼组和模型组,建模第2周开始分别灌胃维药买朱尼和生理盐水,连续4周.结果与结论:相比于模型组,买朱尼组大鼠膝关节软骨退变程度减轻,软骨大体评分及Mankin评分降低(P < 0.05),且膝关节软骨细胞中基质金属蛋白酶1的表达降低,基质金属蛋白酶抑制剂1的表达增加(P < 0.05).说明维药买朱尼可以通过下调基质金属蛋白酶1的表达水平、上调抑制剂的表达水平,对软骨产生保护作用.     

体外冲击波治疗兔膝骨关节炎：白细胞介素1β及基质金属蛋白酶13的表达

背景：白细胞介素1β和基质金属蛋白13能促进软骨细胞的分解代谢,抑制软骨细胞的合成修复能力,引起细胞外基质的降解,在骨关节炎的发生中有十分重要的作用。 目的：观察体外冲击波对兔膝骨关节炎软骨细胞中白细胞介素1β和基质金属蛋白酶13表达的影响。 方法：将30只新西兰兔随机分为治疗组、模型组、对照组,每组10只。治疗组和模型组均采用改良伸直位固定6周,制备兔膝骨关节炎模型。治疗组造模后给予体外冲击波治疗1次,能流密度0.1 mJ/mm2,冲击次数1000次。对照组不作任何处理。各组兔于治疗后4周处死,取膝关节液和关节软骨。苏木精-伊红染色和甲苯胺蓝染色法检测各组膝关节病理学形态改变,采用酶联免疫吸附法测定关节液白细胞介素1β水平,免疫组化法检测白细胞介素1β和基质金属蛋白酶13的表达。 结果与结论：治疗组和模型组关节液白细胞介素1β水平较对照组明显增高（P 〈0.01）,治疗结束后治疗组关节液白细胞介素1β水平较模型组下降（P 〈0.05）。治疗组和模型组软骨组织Mankin评分较对照组明显增高（P〈0.01）,治疗结束后治疗组软骨组织Mankin评分较模型组下降（P〈0.05）。治疗组和模型组软骨细胞白细胞介素1β和基质金属蛋白酶13阳性表达率较对照组明显增高（P〈0.01）,治疗结束后治疗组软骨细胞白细胞介素1β和基质金属蛋白酶13阳性表达率较模型组下降（P〈0.05）。结果可见体外冲击波能下调膝骨关节炎软骨细胞白细胞介素1β和基质金属蛋白酶13的表达,促进Ⅱ型胶原和蛋白聚糖的合成,从而对膝骨关节炎起防治作用。     

跑步运动对大鼠不稳定膝关节软骨的影响

目的研究跑步运动对大鼠不稳定膝关节软骨的影响。 方法将20只切断膝关节前交叉韧带的8周龄SD大鼠按随机数字表法分为自由活动组（对照组）和跑步训练组（实验组）,每组10只大鼠,2组再根据处死取材时间分为造模成功3周和6周各2个亚组,每个亚组5只大鼠。实验组按15m/min强度进行跑步训练,每天训练1h;对照组自由活动,不接受任何干预。于造模成功3周和6周后采用苏木精-伊红（HE）、甲苯胺蓝及免疫组化染色、透射电镜等方法分别观察和比较2组大鼠膝关节的软骨厚度、Mankin评分、蛋白多糖含量、软骨基质Ⅱ型胶原含量及软骨形态结构。 结果造模成功6周后,2组大鼠关节软骨的厚度和Mankin评分与组内造模成功3周后比较,差异均有统计学意义（P<0.05）;造模成功3周和6周后,实验组软骨厚度分别为（154±13）μm和（131±15）μm,Mankin评分分别为（9.93±1.36）分和（11.23±1.57）分,分别与对照组同时间点比较,差异均有统计学意义（P<0.05）。造模成功6周后,2组大鼠膝关节软骨甲苯胺蓝染色阳性光密度与组内造模成功3周后比较,差异有统计学意义（P<0.05）;造模成功3周和6周后,实验组甲苯胺蓝染色阳性光密度分别与对照组同时间点比较,差异均有统计学意义（P<0.05）。造模成功6周后,2组大鼠膝关节软骨Ⅱ型胶原纤维免疫组化染色阳性光密度与组内造模成功3周后比较,差异有统计学意义（P<0.05）;造模成功3周和6周后,实验组Ⅱ型胶原纤维免疫组化染色阳性光密度分别与对照组同时间点比较,差异均有统计学意义（P<0.05）。造模成功3周后,实验组透射电镜显示软骨细胞减少,软骨表面有部分断裂;造模成功6周后,实验组透射电镜可见软骨表面多处有破损,软骨细胞坏死。 结论跑步运动对不稳定膝关节软骨具有破坏效应,可加重关节损伤和软骨基质的破坏,加速软骨细胞的退行性变。     

体外冲击波对大鼠膝骨性关节炎中基质金属蛋白酶-1、3、13表达的影响

目的:观察体外冲击波(ESW)对大鼠膝骨性关节炎(OA)中基质金属蛋白酶-1、3、13表达的影响,探讨ESW治疗膝骨性关节炎的可能机制.方法:将18只SD大鼠随机分为ESW组、模型组、对照组,每组6只.ESW组和模型组采用单侧后肢跟腱切除法建立膝OA模型,对照组不作任何处理.治疗组造模术后4周造模成功立即给予ESW治疗1次,能量1.5bar,冲击次数1000次.各组大鼠分别于治疗后4周处死,取各组软骨予以HE和甲苯胺蓝染色,免疫组化行MMP-1、3、13分析,观察软骨Mankin评分的改变,MMP-1、3、13表达的变化.结果:HE和甲苯胺蓝染色结果采用Mankin评分在ESW组、模型组高于对照组,差异有显著性意义(P＜0.01),ESW组低于模型组比较,差异有显著性意义(P＜0.01);软骨免疫组化MMP-1、3、13测定,ESW组、模型组低于对照组,差异均有显著性意义(P＜0.01),ESW组高于模型组,差异有显著性意义(P＜0.05).结论:体外冲击波通过减少骨性关节炎软骨细胞中MMP-1、3、13的表达,进而减少对Ⅱ型胶原和氨基多糖等细胞外基质的降解,从而延缓骨性关节炎的发展.     

Progressive movement-related valgus knee impairments: clinical examination,classification, and treatment

Abstract

This paper introduces a clinical examination, classification and therapeutic treatment system for patients with progressive valgus knee malalignment. A literature review was performed on the development of progressive lateral compartment tibiofemoral joint osteoarthritis from progressive valgus knee malalignment. Classification categories include: primary valgus (osteochondral frontal plane tibiofemoral joint malalignment), double valgus (osteochondral frontal plane tibiofemoral joint malalignment and increased medial compartment separation associated with medial collateral ligament deficiency), and triple valgus (osteochondral frontal plane tibiofemoral joint malalignment, increased medial compartment separation associated with medial collateral ligament deficiency, and genu recurvatum). From this information, a clinical examination and therapeutic treatment system is proposed to aid in preventing or minimising the effects of disabilities associated with this condition. This system will better enable physicians and rehabilitation clinicians to provide effective care for patients who display progressive valgus knee malalignment and will enable researchers to evaluate treatment efficacy with well-designed clinical research studies.     

Wear patterns on tibial plateau from varus osteoarthritic knees

BACKGROUND: The knowledge of cartilage wear patterns at the medial tibial plateau is important to understand the main causes of arthritis in varus knees. The most important factors influencing knee arthritis in fact seem to be the severity of the degenerative changes determined by the lower limb mechanical axis and the abnormal knee joint kinematics which frequently results from dysfunction of the anterior cruciate ligament. METHODS: We studied the wear patterns of cartilage damage in 70 medial tibial plateaus resected at operation during total knee arthroplasty indicated for varus osteoarthritic knee. Anterior cruciate ligament and medial meniscus integrity was assessed intra-operatively. Calibrated digital images were used to measure the wear patterns with a standard software tool. The medial compartment of the tibial plateau was divided into six zones, and the amount of cartilage and bone destruction in each zone was classified into two grades. FINDINGS: The wear pattern was found to be highly dependent upon knee varus deformity (Mann Whitney P<0.001) and anterior cruciate ligament integrity (Friedman P<0.0005). Anterior cruciate ligament was found intact in 35.7% of the cases. Wear patterns on intact anterior cruciate ligament knees occurred in the central to medial aspect of the tibial plateau. Anterior cruciate ligament deficient knees had significantly larger wear patterns anteriorly and posteriorly in the most medial region of the medial plateau. INTERPRETATION: These observations suggest altered joint mechanics exist in anterior cruciate ligament deficient varus knees, which would worsen cartilage degeneration and osteoarthritis progression.     

骨性关节炎动物模型内侧副韧带的应力松弛

背景:韧带和其他生物软组织一样,具有黏弹性特性,其应力松弛和蠕变黏弹性特性是为适应人的生理功能需要而存在的。研究说明骨性关节炎对韧带力学性能具有一定影响。目的:比较正常和骨性关节炎动物模型内侧副韧带的应力松弛流变特性,确定骨性关节炎对内侧副韧带应力松弛特性的影响。方法:以闭合关节刻痕法复制骨性关节炎动物模型,取正常和骨性关节炎动物模型大鼠膝关节内侧副韧带各10个试样,进行应力松弛实验。应力松弛实验的应变增加速度为5%/s。设定实验时间为7200s,采集100个数据,观察应力松弛数据和曲线、应力与时间的变化规律,以一元线性回归分析的方法处理实验数据。结果与结论:正常组和病态组试样应力松弛最初600s变化较快,之后应力缓慢下降,正常组7200s应力松弛量0.47MPa,病态组7200s应力松弛量0.29MPa。模型组7200s应力松弛量显著低于正常组(P<0.05),且应力松弛曲线是以对数关系变化的。说明骨性关节炎时可以使膝关节对内侧副韧带应力松弛量降低,对膝关节应力松弛特性具有一定影响。     

内侧半月板半脱位与膝关节损伤的MRI评价

目的：通过分析伴有内侧半月板半脱位的膝关节MRI影像学改变,探讨内侧半月板半脱位与膝关节损伤的关系。方法：回顾性分析77例内侧半月板半脱位的膝关节MRI表现。结果：①韧带损伤：26例前交叉韧带断裂（4例完全断裂、22例部分断裂）,与关节镜诊断完全符合率为88.8%;26例后交叉韧带断裂（3例完全断裂、23例部分断裂）,与关节镜诊断完全符合率为95%;17例内侧副韧带损伤（1例Ⅲ级损伤、13例Ⅱ级损伤、3例Ⅰ级损伤）;13例外侧副韧带损伤（8例Ⅱ级损伤,5例Ⅰ级损伤）;与关节镜诊断完全符合率为90%。②半月板损伤：73例内侧半月板损伤（50例Ⅲ度损伤、13例Ⅱ度损伤、10例Ⅰ度损伤）;30例外侧半月板损伤（10例Ⅲ度损伤、8例Ⅱ度损伤、12例Ⅰ度损伤）;MRI对半月板诊断结果与关节镜诊断完全符合率为90.5%;46例内侧半月板后根部损伤,与关节镜诊断完全符合率为92.21%。③软骨损伤：68例软骨损伤（1例4级损伤,21例3级损伤,46例2级损伤）;与关节镜诊断完全符合率为73%。④骨质增生：40例骨赘形成。结论：半月板半脱位是膝关节韧带损伤、半月板损伤、软骨损伤及骨质增生的重要间接征象。重视MRI内侧半月板半脱位,对于上述膝关节损伤的检出具有重要意义,能够有效防止膝关节骨性关节病的发生与发展。     

Early morphometric and anisotropic change in periarticular cancellous bone in a model of experimental knee osteoarthritis quantified using microcomputed tomography

OBJECTIVE: To quantify early stage microstructural changes of periarticular cancellous bone in a canine anterior cruciate ligament transection model for experimental osteoarthritis. DESIGN: Unilateral transection of the anterior cruciate ligament was performed in 10 animals. Bone structure changes were quantified in five animals at 3-week post-transection and five animals at 12-week post-transection. An additional two non-operated animals were used as controls. BACKGROUND: Changes in trabecular architecture of the periarticular cancellous bone in early stage post-traumatic osteoarthritis is not well understood. Previous studies have found alterations in bone mineral density in experimental osteoarthritis suggesting adaptation of the trabecular structure. Early change of the periarticular bone following a ligament injury may contribute to the long-term development of osteoarthritis. METHODS:++. Bone cores from the medial condyles of the femoral and tibial pairs were scanned with a three-dimensional microtomographic system. Structural indices were quantified including bone volume ratio, bone surface ratio, trabecular thickness, trabecular separation, trabecular number, as well as structural anisotropy determined by the mean-intercept-length method.Results. Significant structural changes were observed at 3-week post-transection, and were more prominent at 12-week post-transection. These changes were accompanied by decreasing anisotropy. CONCLUSIONS: Periarticular cancellous bone microstructure is significantly altered in experimental osteoarthritis. These changes occurred as early as 3-week post-transection, and were large at 12-week post-transection. RELEVANCE: The pathogenesis of post-traumatic osteoarthritis is poorly understood, but it is clear that this disease involves the entire organ system of the joint, including the cartilages, synovium, ligaments, and bones. This study focuses on the changes that occur in the bones during the early stages following a joint injury, and contributes to a better overall understanding of the disease aetiology.     

骨性关节炎动物模型内侧副韧带的应力松弛

背景：韧带和其他生物软组织一样,具有黏弹性特性,其应力松弛和蠕变黏弹性特性是为适应人的生理功能需要而存在的。研究说明骨性关节炎对韧带力学性能具有一定影响。目的：比较正常和骨性关节炎动物模型内侧副韧带的应力松弛流变特性,确定骨性关节炎对内侧副韧带应力松弛特性的影响。方法：以闭合关节刻痕法复制骨性关节炎动物模型,取正常和骨性关节炎动物模型大鼠膝关节内侧副韧带各10个试样,进行应力松弛实验。应力松弛实验的应变增加速度为5%/s。设定实验时间为7200s,采集100个数据,观察应力松弛数据和曲线、应力与时间的变化规律,以一元线性回归分析的方法处理实验数据。结果与结论：正常组和病态组试样应力松弛最初600s变化较快,之后应力缓慢下降,正常组7200s应力松弛量0.47MPa,病态组7200s应力松弛量0.29MPa。模型组7200s应力松弛量显著低于正常组（P〈0.05）,且应力松弛曲线是以对数关系变化的。说明骨性关节炎时可以使膝关节对内侧副韧带应力松弛量降低,对膝关节应力松弛特性具有一定影响。     

膝骨关节炎模型内侧副韧带的生物力学特性

背景:膝骨关节炎多由力学和理化因素导致软骨基质退变而引起。目前对发病的理化因素和软骨基质的退变研究较多,力学研究较少。目的:观察兔膝骨关节炎模型内侧副韧带拉伸力学性质的改变。方法:左后肢伸直位石膏固定制动法建立兔模型。在BoseElectroForce3300疲劳试验机上对正常对照组和模型组各6个试样进行拉伸实验。拉伸实验的速度为5mm/min,计算机每0.1s自动记录一个数据,直到将试样拉断。结果与结论:正常对照组最大应力为(17.92±3.18)MPa,最大应变为(10.7±2.07)%,最大位移为(2.76±0.37)mm,弹性模量(316.19±74.55)MPa;模型组最大应力为(11.34±1.05)MPa,最大应变为(7.97±1.65)%,最大位移为(2.08±0.31)mm,弹性模量(279.77±33.91)MPa。正常对照组各项拉伸性能指标显著大于模型组(P<0.05)。提示膝骨关节炎对膝关节韧带的生物力学特性具有一定影响。     

American Society of Biomechanics Clinical Biomechanics Award 2015: MRI assessments of cartilage mechanics,morphology and composition following reconstruction of the anterior cruciate ligament

BackgroundThe pathogenesis of osteoarthritis following anterior cruciate ligament (ACL) reconstruction is currently unknown. The study purpose was to leverage recent advances in quantitative and dynamic MRI to test the hypothesis that abnormal joint mechanics within four years of reconstruction is accompanied by evidence of early compositional changes in cartilage.MethodsStatic MR imaging was performed bilaterally on eleven subjects with an ACL reconstruction (1–4 years post-surgery) and on twelve healthy subjects to obtain tibial cartilage thickness maps. Quantitative imaging (mcDESPOT) was performed unilaterally on all subjects to assess the fraction of bound water in the tibial plateau cartilage. Finally, volumetric dynamic imaging was performed to assess cartilage contact patterns during an active knee flexion–extension task. A repeated-measures ANOVA was used to test for the effects of surgical reconstruction and location on cartilage thickness, bound water fractions, and contact across the medial and lateral tibia plateaus.FindingsNo significant differences in cartilage thickness were found between groups. However, there was a significant reduction in the fraction of water bound by proteoglycan in the ACL reconstructed knees, most notably along the anterior portion of the medial plateau and the weight-bearing lateral plateau. During movement, reconstructed knees exhibited greater contact along the medial spine in the medial plateau and along the posterior aspect of the lateral plateau, when compared with their healthy contralateral knees and healthy controls.InterpretationThis study provides evidence that abnormal mechanics in anterior cruciate ligament reconstructed knees are present coincidently with early biomarkers of cartilage degeneration.     

Therapie einer übersehenen iatrogenen „Stener-like lesion“ des medialen Kollateralbands nach Arthroskopie

This article reports the case of a female patient with advanced osteoarthritis of the medial knee compartment, who suffered from an iatrogenic rupture of the medial collateral ligament (MCL) during arthroscopic medial partial meniscectomy. Subsequently, the cause was overlooked despite persisting pain and valgus instability. A magnetic resonance imaging (MRI) carried out in the course of the treatment revealed an extended MCL, comparable with a Stener lesion, running superficially over the tendons of the pes anserinus. A secondary open repair of the MCL led to a satisfactory restoration of stability and a pain-free knee.