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1.
Yiying Qi Yi Du Weixu Li Xuesong Dai Tengfei Zhao Weiqi Yan 《Knee surgery, sports traumatology, arthroscopy》2014,22(6):1424-1433
Purpose
The integration of regenerated cartilage with surrounding native cartilage is a major challenge for the success of cartilage tissue-engineering strategies. The purpose of this study is to investigate whether incorporation of the power of mesenchymal stem cell (MSC) sheet to MSCs-loaded bilayer poly-(lactic-co-glycolic acid) (PLGA) scaffolds can improve the integration and repair of cartilage defects in a rabbit model.Methods
Rabbit bone marrow-derived MSCs were cultured and formed cell sheet. Full-thickness cylindrical osteochondral defects (4 mm in diameter, 3 mm in depth) were created in the patellar groove of 18 New Zealand white rabbits and the osteochondral defects were treated with PLGA scaffold (n = 6), PLGA/MSCs (n = 6) or MSC sheet-encapsulated PLGA/MSCs (n = 6). After 6 and 12 weeks, the integration and tissue response were evaluated histologically.Results
The MSC sheet-encapsulated PLGA/MCSs group showed significantly more amounts of hyaline cartilage and higher histological scores than PLGA/MSCs group and PLGA group (P < 0.05). In addition, the MSC sheet-encapsulated PLGA/MCSs group showed the best integration between the repaired cartilage and surrounding normal cartilage and subchondral bone compared to other two groups.Conclusions
The novel method of incorporation of MSC sheet to PLGA/MCSs could enhance the ability of cartilage regeneration and integration between repair cartilage and the surrounding cartilage. Transplantation of autologous MSC sheet combined with traditional strategies or cartilage debris might provide therapeutic opportunities for improving cartilage regeneration and integration in humans. 相似文献2.
Alberto Siclari Gennaro Mascaro Chiara Gentili Christian Kaps Ranieri Cancedda Eugenio Boux 《Knee surgery, sports traumatology, arthroscopy》2014,22(6):1225-1234
Purpose
The aim of our study was to analyse the clinical and histological outcome after the treatment of focal cartilage defects in non-degenerative and degenerative knees with bone marrow stimulation and subsequent covering with a cell-free resorbable polyglycolic acid–hyaluronan (PGA-HA) implant immersed with autologous platelet-rich plasma (PRP).Methods
Fifty-two patients (mean age 44 years) with focal chondral defects in radiologically confirmed non-degenerative or degenerative knees were subjected to subchondral drilling arthroscopically. Subsequently, defects were covered with the PGA-HA implant immersed with autologous PRP. At 2-year follow-up, the patients’ situation was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and compared to the pre-operative situation and 3–12-month follow-up. Biopsies (n = 4) were harvested at 18–24 months after implantation and were analysed by histology and collagen type II immune staining.Results
At 1- and 2-year follow-up, the KOOS showed clinically meaningful and significant (p < 0.05) improvement in all subcategories compared to baseline and to 3-month follow-up. There were no differences in KOOS data obtained after 2 years compared to 1 year after the treatment. Histological analysis of the biopsy tissue showed hyaline-like to hyaline cartilage repair tissue that was rich in cells with a chondrocyte morphology, proteoglycans and type II collagen.Conclusions
Covering of focal cartilage defects with the PGA-HA implant and PRP after bone marrow stimulation improves the patients’ situation and has the potential to regenerate hyaline-like cartilage.Level of evidence
Case series, Level IV. 相似文献3.
Jinlin Wang Shiyue Li Yunxiang Zeng Ping Chen Nuofu Zhang Nanshan Zhong 《Annals of nuclear medicine》2014,28(3):276-284
Objectives
To retrospectively investigate the role of 18 F–fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for the diagnosis and therapeutic response in relapsing polychondritis (RP) patients.Methods
18F-FDG PET/CT findings were reviewed in six RP patients. The initial scans were performed for all patients, follow-up scans were performed during steroid therapy for five patients. Changes in the abnormal lesions and the maximal standard uptake value (SUVmax) were analyzed.Results
The initial PET/CT scans revealed intense FDG uptake in the cartilages for all six patients. The lesions of abnormal FDG uptake were tracheal/bronchial cartilage (n = 4), costicartilage (n = 4), nasal cartilage (n = 3), cricoid cartilage (n = 3), auricular cartilage (n = 3), arytenoid cartilage (n = 3), thyroid cartilage (n = 2), hyoid cartilage (n = 1) and mediastinum lymph node (n = 1). The mean visual score and the mean SUVmax were 2.96 ± 0.20 and 4.10 ± 0.6. The intense uptake reduced or disappeared during steroid therapy for five patients, the mean visual score and the mean SUVmax were 1.58 ± 1.4 and 1.51 ± 1.4.Conclusions
18F-FDG PET/CT enables the acquisition of both morphologic and glucose metabolic of the related cartilage structures. It plays a valuable role in assessing almost all cartilage and detecting RP, which is a better selection of a biopsy site as well as therapeutic response monitoring. 相似文献4.
M. Sauerschnig J. S. Bauer L. Kohn S. Hinterwimmer S. Landwehr K. Woertler P. M. Jungmann W. Koestler P. Niemeyer A. B. Imhoff G. M. Salzmann 《Knee surgery, sports traumatology, arthroscopy》2014,22(6):1396-1403
Purpose
To investigate whether the static knee alignment affects articular cartilage ultrastructures when measured using T2 relaxation among asymptomatic subjects.Methods
Both knee joints (n = 96) of 48 asymptomatic volunteers (26 females, 22 males; 25.4 ± 1.7 years; no history of major knee trauma or surgery) were evaluated clinically (Lysholm, Tegner) and by MRI (hip–knee–ankle angle, standard knee protocol, T2 mapping). Group (n = 4) division was as follows: neutral (<1° varus/valgus), mild varus (2°–4° varus), severe varus (>4° varus) and valgus (2°–4° valgus) deformity with n = 12 subjects/group; n = 24 knees/group. Regions of interest (ROI) for T2 assessment were placed within full-thickness cartilage across the whole joint surface and were divided respecting compartmental as well as functional joint anatomy.Results
Leg alignment was 0.7° ± 0.5° varus among neutral, 3.0° ± 0.6° varus among mild varus, 5.0° ± 1.1° varus among severe varus and 2.5° ± 0.7° valgus among valgus group subjects and thus significantly different. No differences between the groups emerged from clinical measures. No morphological pathology was detected in any knee joint. Global T2 values (42.3 ± 2.3; 37.7–47.9 ms) of ROIs placed within every knee joint per subject were not different between alignment groups or between genders, respectively.Conclusion
Static frontal plane leg malalignment does not affect cartilage ultrastructure among young, asymptomatic individuals as measured by T2 quantitative imaging.Level of evidence
Cross-sectional study, Level II-III. 相似文献5.
Leto Mailli Dimitrios K. Filippiadis Elias N. Brountzos Efthymia Alexopoulou Nikolaos Kelekis Alexios Kelekis 《Cardiovascular and interventional radiology》2013,36(1):183-191
Purpose
To compare safety and efficacy of percutaneous vertebroplasty (PVP) when treating up to three vertebrae or more than three vertebrae per session.Materials and Methods
We prospectively compared two groups of patients with symptomatic vertebral fractures who had no significant response to conservative therapy. Pathologic substrate included osteoporosis (n = 77), metastasis (n = 24), multiple myeloma (n = 13), hemangioma (n = 15), and lymphoma (n = 1). Group A patients (n = 94) underwent PVP of up to three treated vertebrae (n = 188). Group B patients (n = 36) underwent PVP with more than three treated vertebrae per session (n = 220). Decreased pain and improved mobility were recorded the day after surgery and at 12 and 24 months after surgery per clinical evaluation and the use of numeric visual scales (NVS): the Greek Brief Pain Inventory, a linear analogue self-assessment questionnaire, and a World Health Organization questionnaire.Results
Group A presented with a mean pain score of 7.9 ± 1.1 NVS units before PVP, which decreased to 2.1 ± 1.6, 2.0 ± 1.5 and 2.0 ± 1.5 NVS units the day after surgery and at 12 and 24 months after surgery, respectively. Group B presented with a mean pain score of 8.1 ± 1.3 NVS units before PVP, which decreased to 2.2 ± 1.3, 2.0 ± 1.5, and 2.1 ± 1.6 NVS units the day after surgery and at 12 and 24 months after surgery, respectively. Overall pain decrease and mobility improvement throughout the follow-up period presented no statistical significance neither between the two groups nor between different underlying aetiology. Reported cement leakages presented no statistical significance between the two groups (p = 0.365).Conclusion
PVP is an efficient and safe technique for symptomatic vertebral fractures independently of the vertebrae number treated per session. 相似文献6.
Purpose
Our purpose was to evaluate the effectiveness of intra-articular injections of hyaluronic acid (HA) into immobilized joints for reducing rigidity and formation of joint adhesions following surgery and prolonged joint immobilization.Methods
Twenty-four New Zealand white rabbits were randomly divided into experimental (n = 12) and control groups (n = 12). A model of knee injury was created in the right hind leg, and external plaster fixation was performed for 8 weeks. The experimental and control groups received weekly intra-articular injections of 0.3 mL HA solution or normal saline, respectively, in the knee joint. The degree of adhesions, range of motion (ROM), and collagen content of the synovium of the knee joint were observed after 8 weeks.Results
At the end of 8 weeks, the experimental compared with control group had significantly higher mean ROM (70.3° ± 11.1° vs. 54.6° ± 11.2°, respectively; P = 0.002) and mean adhesion score. The experimental group compared with the control group had significantly lower mean adhesion score (2.2 ± 0.9 vs. 3.1 ± 0.7, respectively; P = 0.012) and collagen content (32.4 ± 4.7 vs. 39.0 ± 4.2 μg/mg, P = 0.001).Conclusions
In a rabbit model of knee injury, intra-articular injection of HA decreased adhesion formation and collagen content and increased ROM after prolonged immobilization. These results indicate that HA may be clinically useful to prevent adhesions and improve joint mobility in patients who require joint immobilization for up to 8 weeks. 相似文献7.
Steffen Höll Annabel Schlomberg Georg Gosheger Ralf Dieckmann Arne Streitbuerger Dino Schulz Jendrik Hardes 《Knee surgery, sports traumatology, arthroscopy》2012,20(12):2513-2518
Purpose
The aim of the present study was to assess whether using megaprostheses in revision knee arthroplasty procedures allows limb salvage with an acceptable outcome and complication rate, in comparison with other limb-saving procedures.Methods
Between 2000 and 2010, megaprosthesis implantation was required for non-oncologic indications in 20 patients (21 knees) (average age 73 years). Reconstructions involved the distal femur (n = 15), proximal tibia (n = 4), and both femur and tibia (n = 2). The indications, type, and numbers of previous operations and implants, as well as complications associated with megaprosthesis implantation, were reviewed, and the clinical and radiographic outcomes after an average follow-up period of 34 months (range 10–84 months) were evaluated.Results
The indications for megaprosthesis implantation were periprosthetic infection (n = 5), fracture (n = 9), nonunion (n = 5), and aseptic loosening (n = 2). The types of implant placed before the megaprosthetic reconstruction were a cemented rotating-hinge arthroplasty (n = 16) and a primary total knee arthroplasty (n = 5). Six patients had an additional osteosynthesis of the distal femur. An average of 3.8 operations (range 1–7) had been carried out before megaprosthesis implantation. Complications developed in 11 patients. The Knee Society Score improved significantly, from 43 (±15) to 68 (±16.8); P < 0.05.Conclusions
Megaprosthesis implantation in revision knee arthroplasty is an exceptional indication. Despite the high complication rate, the patients can be spared amputation in most cases, and rapid mobilization with full weight-bearing is possible. 相似文献8.
Stefan Hinterwimmer Matthias J. Feucht Corinna Steinbrech Heiko Graichen Rüdiger von Eisenhart-Rothe 《Knee surgery, sports traumatology, arthroscopy》2014,22(6):1353-1359
Purpose
The purpose of this study was to investigate the effect of a 6-month period of intensive running followed by the participation at a marathon run on cartilage volume and thickness in knees of marathon beginners.Methods
Ten asymptomatic marathon beginners underwent a supervised 6-month training program, which was finalized by the participation at a marathon run. Three-dimensional quantitative magnetic resonance imaging was performed before the training program (baseline measurements) and 1 day after the marathon (follow-up measurements). Cartilage volume and thickness of the medial and lateral femur, medial and lateral tibia, and patella were measured using semiautomated cartilage segmentation and three dimensional data postprocessing.Results
Significant differences between baseline and follow-up measurements were observed at the lateral femur, where cartilage volume and thickness decreased by a mean of 3.2 ± 3.0 % (p = 0.012) and 1.7 ± 1.6 % (p = 0.010), respectively. No significant changes in cartilage volume and thickness were observed at the medial and lateral tibia, the medial femur, and the patella.Conclusion
Significant cartilage loss was observed at the lateral femur; however, the measured values are comparable to previously reported precision errors for quantitative cartilage measurement and thus most likely not of clinical relevance. High-impact forces during long-distance running are well tolerated even in marathon beginners and do not lead to clinical relevant cartilage loss.Level of evidence
IV. 相似文献9.
A. Marmotti M. Bruzzone D. E. Bonasia F. Castoldi R. Rossi L. Piras A. Maiello C. Realmuto G. M. Peretti 《Knee surgery, sports traumatology, arthroscopy》2012,20(12):2590-2601
Purpose
This study proposes a single-step therapeutic approach for osteochondral defects using autologous cartilage fragments loaded onto a scaffold composed of a hyaluronic acid (HA) derivative, human fibrin glue (FG) and autologous platelet-rich-plasma (PRP), in a rabbit model. The aim is to demonstrate the in vitro outgrowth of chondrocytes from cartilage fragments and the in vivo formation of a functional repair tissue.Methods
In vitro: minced articular cartilage was loaded onto two different types of scaffold (paste or membrane) according to two different HA preparations (injectable HA-derivative or HA-derivative felt). In vivo: trochlear osteochondral defects were created in 50 adult rabbits, which were then assigned to 5 different treatment groups: cartilage fragments loaded onto membrane scaffolds with FG (Group 1) or without FG (Group 2); membrane scaffolds alone with FG (Group 3) or without FG (Group 4); empty defects (Group 5). Membrane scaffolds were used “in vivo” for simpler preparation and better adhesive properties. Repair processes were evaluated histologically and by immunohistochemistry at 1, 3, and 6 months.Results
An in vitro time-dependent cell outgrowth from cartilage fragments was observed with both types of scaffolds. At 6 months, in vivo, cartilage fragment-loaded scaffolds induced significantly better repair tissue than the scaffold alone using histological scoring. Repair in Group 2 was superior to that in any of the control groups (p < 0.05).Conclusion
Autologous cartilage fragments loaded onto an HA felt/FG/PRP-scaffold provided an efficient cell source, and allowed for an improvement of the repair process of ostechondral defects in a rabbit model. Human FG, however, hampered the rabbit healing process. These results may have clinical relevance as they show the potential of a novel one-stage repair technique for osteochondral defects. 相似文献10.
Shiro Miyayama Masashi Yamashiro Masahiro Hashimoto Miki Yoshida Nanako Hashimoto Masaya Ikuno Kenichiro Okumura Osamu Matsui 《Japanese journal of radiology》2012,30(10):798-805
Purpose
To evaluate the clinical features of hepatocellular carcinoma (HCC) supplied by the left internal mammary artery (LIMA).Materials and methods
This cohort included 12 HCCs of 12 patients supplied by the LIMA. The clinical features of these tumors were analyzed.Results
The tumor diameters were 4.2 ± 4.4 cm (mean ± SD) located at the surface of segments 4 (n = 6), 3 (n = 3), 2 (n = 2), and 4–8 (n = 1), respectively. The tumor was supplied by the phrenic branch (n = 8) or musclophrenic artery (n = 4) entirely (n = 7) or partially (n = 5). Two patients with large tumors 10 and 16 cm in diameter, respectively, received no previous treatment. Ten patients had previously undergone 5.8 ± 3.7 TACE sessions including through extrahepatic collaterals. Selective TACE could not be completed in one. No TACE-related complications developed. Of 11 embolized tumors, six did not recur at 8.8 ± 4.6 months and five recurred 4.4 ± 2.6 months later.Conclusion
The clinical features of HCC supplied by the LIMA can be divided into two categories, untreated large tumors and small tumors receiving multiple TACE sessions at the subcapsular area of the left hepatic lobe. 相似文献11.
Tomasz L. Nosewicz Mikel L. Reilingh Martin Wolny C. Niek van Dijk Georg N. Duda Hanna Schell 《Knee surgery, sports traumatology, arthroscopy》2014,22(6):1445-1451
Purpose
The influence of basal graft support combined to early loading following an osteochondral autograft procedure is unclear. It was hypothesized that bottomed grafts may allow for early mobilization by preventing graft subsidence and leading to better healing.Methods
Osteochondral autografts were press fitted in the femoral condyles of 24 sheep (one graft per animal). In the unbottomed group (n = 12), a gap of 2 mm was created between graft and recipient bone base. In the bottomed group (n = 12), the graft firmly rested on recipient bone. Animals were allowed immediate postoperative weightbearing. Healing times were 3 and 6 months per group (n = 6 per subgroup). After killing, histological and histomorphometric analyses were performed.Results
Unbottomed grafts at 3 months showed significantly more graft subsidence (P = 0.024), significantly less mineralized bone (P = 0.028) and significantly worse cartilage and subchondral bone plate healing (P = 0.034) when compared to bottomed grafts. At 6 months, no differences were seen. Compared to the native situation, unbottomed grafts showed significantly more graft subsidence (P = 0.024), whereas bottomed grafts did not. Cystic lesions were seen in both groups. Osteoclasts were closely related to the degree of bone remodelling.Conclusion
In the animal model, in the case of early loading, bottomed osteochondral autografts have less chance of graft subsidence. Evident subsidence negatively influences the histological healing process. In the osteochondral autograft procedure, full graft support should be aimed for. This may allow for early mobilization, diminish graft subsidence and improve long-term integration. 相似文献12.
Karl F. Schüttler Hanno Schenker Christina Theisen Markus D. Schofer Alan Getgood Philip P. Roessler Johannes Struewer Marga B. Rominger Turgay Efe 《Knee surgery, sports traumatology, arthroscopy》2014,22(6):1270-1276
Purpose
Articular cartilage defects of the knee are a common condition for which several repair techniques have been described. The aim of the present study was to assess medium-term results of a one-step procedure using a cell-free collagen type I matrix.Methods
Fifteen patients with articular cartilage defects of the knee were treated with an 11-mm-diameter cell-free collagen type 1 matrix implant. The matrices were implanted in a press-fit manner into the defect after careful debridement down to the subchondral bone but without penetration of this margin. Follow-up examinations were carried out at 6 weeks, 6 months, and at 12, 24, 36, and 48 months after implantation. Clinical assessment included the visual analogue scale (VAS), the Tegner activity scale, and the International Knee Documentation Committee (IKDC) score. Radiological assessment for graft attachment and tissue regeneration was performed using the magnetic observation of cartilage repair tissue (MOCART) score.Results
A total of 15 patients (males: n = 6 and females: n = 9) with a mean age of 26.4 years (range 19–40) were treated. The mean VAS improved significantly when compared to the preoperative values (P < 0.05). Six weeks after implantation, IKDC values were slightly lower than the preoperative values (n.s.), but increased significantly at final follow-up (P < 0.05). At 24 months, there were no significant differences in the median Tegner score between the post-operative values and the preoperative values (n.s.). However, after 36 months, a significant improvement was noted that lasted at least up to 48 months (P < 0.05). The MOCART score improved consistently up to 4 years after implantation, with significant improvements already observed after 12 months (P < 0.05). No correlation between the clinical scores and the MOCART score could be perceived.Conclusion
The present study showed that the use of cell-free collagen type I matrix implants led to a significant and durable improvement in all the clinical and imaging scores investigated 4 years after implantation.Level of evidence
IV. 相似文献13.
Giuseppe Filardo Elizaveta Kon Alessandro Di Martino Francesco Perdisa Maurizio Busacca Francesco Tentoni Federica Balboni Maurilio Marcacci 《Knee surgery, sports traumatology, arthroscopy》2014,22(6):1337-1344
Purpose
Subchondral bone edema is a common finding after cartilage treatment, but its interpretation is still debated. The aim of this study is to analyse the presence of edema after matrix-assisted autologous chondrocyte transplantation (MACT) for knee cartilage lesions at different follow-up times and its correlation with the clinical outcome.Methods
Two hundred and forty-eight magnetic resonance imagings (MRIs) of patients treated with a hyaluronic acid-based MACT for lesions of the knee articular surface were considered. The MRIs belonged to 116 patients (mean age at surgery 28.6 ± 10.3 years, average defect size 2.4 ± 1.0 cm2), 57 affected by degenerative cartilage lesions, 27 traumatic and 32 were osteochondritis dissecans (OCD). MRI follow-up was performed from 6 to 108 months after treatment. Other than its presence or absence, the subchondral bone edema was evaluated using a 3-level grading considering extension and hyperintensity, and with the WORMS score edema classification. The IKDC subjective score was collected at the time of every MRI.Results
An analysis of the entire MRI group showed that edema is not constantly present through the follow-up, but presents a particular and well-defined trend. Edema was present within the first 2 years and was then markedly reduced or disappeared at 2 and 3 years (p = 0.044). Afterwards the level of edema increased again (p < 0.0005) and remained steadily present at medium/long-term follow-up. Patellar lesions presented significantly lower edema (p = 0.012), whereas OCD lesions presented more edema at all follow-up (p = 0.002) and a different trend, with an increasing level of edema over time. No correlation was found between edema and clinical outcome.Conclusions
Edema after MACT is present during the first phases of cartilage maturation up to 2 years of follow-up, and then tends to disappear. However, after a few years, it tends to reappear. Less edema was found in the patella, whereas more edema was found in the OCD, where subchondral bone is primarily involved. Interestingly, the presence of edema was not correlated with a poorer clinical outcome. Whether this might be a prognostic factor at longer follow-up remains to be determined, but our results give some indication on what to expect on both MRI edema and clinical outcome after MACT.Level of evidence
Case series, Level IV. 相似文献14.
C. J. Borba-Pinheiro N. M. A. Figueiredo M. C. G. A. Carvalho A. J. Drigo C. S. Pernambuco F. P. Jesus E. H. M. Dantas 《Sport Sciences for Health》2012,8(2-3):87-93
Background
The osteoporosis is a bone disease that causes bone fragility with increased risks of fractures and negative consequences on human mobility.Objective
The study sought to examine the effects of adapted Judo training (AJT) on bone mineral density (BMD), balance and quality of life (QoL) in postmenopausal women taking alendronate.Methods
Eighteen female volunteers participated in this study. The volunteers were separated into two groups: AJT (n = 11; 52.2 ± 5.3 years) and control group (CG) (n = 7; 53.8 ± 4.4 years). The following evaluation instruments were used: dual-energy X-ray absorptiometry (which measured the lumbar L2–L4, femoral neck and trochanter), the “Osteoporosis Assessment Questionnaire” (OPAQ) and a static balance test with visual control. The study period was 12 months. The fitness training involved traditional Judo class methodology. Repeated measures ANOVA and Kruskal–Wallis tests were used along with normality tests of the data.Results
The data show significant differences in the AJT group for the BMD of the lumbar L2–L4 (Δ% = +0.052 %, p = 0.013), balance (Δ% = +3.9 %, p = 0.004) and the OPAQ functions (p < 0.05) including to the total score range (Δ% = +16.8 %, p = 0.001).Conclusion
The results suggest the AJT as an alternative physical activity is effective for the lumbar BMD, balance and QoL. However, the AJT needs more studies to be recommended for postmenopausal women with low BMD. 相似文献15.
Semih Akkaya Nuray Akkaya Levent Ozcakar Alper Kılıç Fusun Sahin Nilgun Simsir Atalay Fusun Ardic 《Knee surgery, sports traumatology, arthroscopy》2013,21(5):1104-1110
Purpose
To assess the distal femoral cartilage after unilateral arthroscopic partial meniscectomy and to explore the relationship between cartilage thickness and various disease-/surgery-related parameters.Methods
Eighty-nine patients (42 M, 47 F) who had undergone arthroscopic partial meniscectomy surgery were evaluated. Ultrasonographic distal femoral cartilage thicknesses were measured with a 5–13-MHz linear probe (General Electric, Logiq P5) on mid-points of the lateral condyle, intercondylar notch and medial condyle of operated and non-operated knees by a physician blinded to patients’ data. Demographic features, duration after surgery, type of meniscal tear and site of meniscectomy were recorded.Results
Mean age of the patients was 51.8 ± 12.8 years (range 18–88). Mean body mass index was 29.4 ± 4.4 kg/m2 (range 18–38). Overall, in patients with degenerative meniscal tears, femoral cartilage thicknesses pertaining to all the three measured sites (lateral, intercondylar and medial) were found to be decreased in the operated knees when compared with those of the non-operated knees (p = 0.004, p = 0.003, p = 0.041, respectively), whereas in patients with non-degenerative tears, this decrease was significant only in the intercondylar area (p = 0.038). When patients were grouped according to the duration (months) after their surgery (≤36, 37–48 and ≥49), cartilage thickness was similar between both knees in the first group, decreased at the lateral condyle (p = 0.008) and intercondylar area (p = 0.049) in the second group and decreased at all three sites (lateral, intercondylar and medial) in the third group (p = 0.015, p = 0.005 and p = 0.008, respectively).Conclusion
These findings would be considered as unfavourable with respect to weight-bearing, and thus, conservative measures to support relevant joints would strongly be kept in mind during clinical practice. Lastly, ultrasonography may be a convenient alternative imaging method for the evaluation of short- and medium-term cartilage loss in patients with arthroscopic partial meniscectomy.Levels of evidence
III. 相似文献16.
Darra T. Murphy Jeffrey R. Korzan Hugue A. Ouellette David M. Liu Paul W. Clarkson Peter L. Munk 《Cardiovascular and interventional radiology》2013,36(2):531-535
Purpose
This technical note describes the novel use of a curved, steerable needle to access symptomatic osseous lesions in the pelvis and sacrum for palliative percutaneous treatment that would otherwise be difficult to treat using conventional straight needles.Materials and Methods
Seven patients with lytic bone lesions were treated. One patient had multiple myeloma; the remaining had metastatic disease: breast carcinoma (n = 2), colorectal carcinoma (n = 1), renal cell carcinoma (n = 1), squamous cell carcinoma (n = 1), and leiomyosarcoma (n = 1). Five of the seven patients had lesions in the posterior acetabulum, and the two other patients had lesions in the sacrum. Four of the seven patients received radiofrequency ablation followed by cementoplasty; three patients received cementation alone. We used a novel needle designed for vertebroplasty, which has an articulating tip allowing it to be guided into lytic bone lesions located in difficult-to-access regions of the pelvis and sacrum.Results
All patients were successfully treated with cementoplasty either with or without thermal ablation. No serious adverse events were reported. The needle was difficult to withdraw in two patients.Conclusion
Steerable curved needles can be successfully used to treat lytic osseous metastases with cementoplasty when lesions are located in sites that may be difficult to reach using conventional straight needles. 相似文献17.
Shoaib Rafi Sarat M. Piduru Bassel El-Rayes John S. Kauh David A. Kooby Juan M. Sarmiento Hyun S. Kim 《Cardiovascular and interventional radiology》2013,36(2):440-448
Purpose
To assess the overall survival, efficacy, and safety of radioembolization with yttrium-90 (Y90) for unresectable standard-chemorefractory intrahepatic cholangiocarcinoma (ICC).Methods
Patients with unresectable standard-chemorefractory ICC treated with Y90 were studied. Survival was calculated from the date of first Y90 procedure. Tumor response was assessed with the Response Evaluation Criteria in Solid Tumors criteria on follow-up computed tomography or magnetic resonance imaging scans. National Cancer Institute Common Terminology Criteria (NCI CTCAE), version 3, were used for complications. Statistical analysis was performed by the Kaplan–Meier estimator by the log rank test.Results
Nineteen patients underwent a total of 24 resin-based Y90 treatments. Median survival from the time of diagnosis and first Y90 procedure was 752 ± 193 [95 % confidence interval (CI) 374–1130] and 345 ± 128 (95 % CI 95–595) days, respectively. Median survival with Eastern Cooperative Oncology Group (ECOG) performance status 1 (n = 15) and ECOG performance status 2 (n = 4) was 450 ± 190 (95 % CI 78–822) and 345 ± 227 (95 % CI 0–790) days, respectively (p = .214). Patients with extrahepatic metastasis (n = 11) had a median survival of 404 ± 309 (95 % CI 0–1010) days versus 345 ± 117 (95 % CI 115–575) days for patients without metastasis (n = 8) (p = .491). No mortality was reported within 30 days from first Y90 radioembolization. One patient developed grade 3 thrombocytopenia as assessed by NCI CTCAE. Fatigue and transient abdominal pain were observed in 4 (21 %) and 6 (32 %) patients, respectively.Conclusion
Y90 radioembolization is effective for unresectable standard-chemorefractory ICC. 相似文献18.
Oliver Dudeck 《Cardiovascular and interventional radiology》2014,37(4):1041-1046
Purpose
To assess the potential of a steerable microcatheter in a comparative preclinical trial.Methods
A total of 100 small target vessels of the lower limbs with a maximum diameter of 3 mm were prospectively randomized to catheterize with either the preshaped torqueable Direxion? (J tip shape; Boston Scientific, Natick, MA) or a similarly steam-shaped Renegade? microcatheter (Boston Scientific) in a porcine model. Catheterization was first performed in combination with a microguidewire and afterwards without.Results
No significant differences were found for the mean vessel diameter in the Direxion (1.53 ± 0.44 mm; n = 50) or Renegade (1.62 ± 0.43 mm; n = 50; p = 0.35) group. Guidewire-assisted catheterization was successful in all target vessels, whereas access was achieved in most cases with the guidewire alone. However, when it became necessary to steer the Direxion actively, this was regarded as key to obtain vessel access in three of four target vessels (75 %). Vessel catheterization without guidewire was significantly more successful with the Direxion (88 %; n = 44) compared with the Renegade (32 %; n = 16; p < 0.0001). In addition, this catheterization technique was also significantly faster with the Direxion compared with guidewire-assisted vessel catheterization with the Renegade (16.1 ± 14.4 sec compared with 27.1 ± 24.7 sec; p = 0.011).Conclusions
The Direxion microcatheter demonstrated unique steerability characteristics, which makes it a promising new tool especially for complex coaxial endovascular procedures. 相似文献19.
Stefano Zaffagnini Rebecca Luciana Russo Giulio Maria Marcheggiani Muccioli Maurilio Marcacci 《Knee surgery, sports traumatology, arthroscopy》2013,21(4):851-858
Purpose
The purpose of this randomized double blind controlled study was to investigate if the vision of contemporary art video according to the Videoinsight® method could produce better short-term clinical and subjective outcomes after anterior cruciate ligament (ACL) reconstruction.Methods
One-hundred and six patients treated with single-bundle ACL reconstruction plus extra-articular tenodesis were enrolled in this study and randomly assigned to Group A (53 patients) and Group B (53 patients). Group A received one art video that was established to produce positive and therapeutic “insight”, while Group B received one art video with an “insight” unfavourable to the psychological recovery. All patients were instructed to watch the video 3 times a week for the first 2 months during the execution of the same rehabilitative protocol. Patients were evaluated pre-operatively and 3 months after surgery with Tegner, subjective International Knee Documentation Committee (IKDC), physical and mental SF-36 scores and Tampa Scale of Kinesiophobia (TSK). Time to crutches discharge was collected at final follow-up as well.Results
Five patients were lost to follow-up and 101 patients (Group A: 51 patients; Group B: 50 patients) were available at mean 3.0 ± 0.2 months follow-up. Age at surgery was 33.0 ± 17.0 years. The two groups were homogeneous regarding pre-operative demographic data, meniscal lesions and clinical outcomes. Significant improvements were observed in Group A compared to Group B at final follow-up for subjective IKDC (82.0 ± 13.8 vs. 71.0 ± 19.7, p = 0.0470), TKS (28.1 ± 6.0 vs. 32.0 ± 5.8, p = 0.0141) and time to crutches discharge (20.9 ± 5.0 vs. 26.5 ± 8.2 days, p = 0.0012). A positive significant correlation between TSK and time to crutches discharge (r = 0.35, p = 0.0121) was observed.Conclusions
The Videoinsight® method combined to adequate rehabilitation could be an effective tool in order to improve short-term clinical and functional outcomes in patients who underwent ACL reconstruction.Level of evidence
I. 相似文献20.
J. García-Medina 《Cardiovascular and interventional radiology》2013,36(6):1658-1663