JaLCDOI 10.18926/AMO/56864
FullText URL 73_3_223.pdf
Author Sugiu, Kazuhisa| Furumatsu, Takayuki| Kodama, Yuya| Kamatsuki, Yusuke| Okazaki, Yoshiki| Okazaki, Yuki| Hiranaka, Takaaki| Ozaki, Toshifumi|
Abstract Anterior cruciate ligament (ACL) reconstruction (ACLR) after ACL rupture improves the instability of the knee joint and decreases mechanical stress to the meniscus and articular cartilage. However, there are reports that post-traumatic osteoarthritis (PTOA) is observed over time following ACLR. In this study, we assessed changes in cartilage lesions by arthroscopic findings following anatomical double-bundle ACLR and at post-operative second-look arthroscopy about 14 months later. We retrospectively evaluated 37 knees in cases with patients <40 years of age who had undergone an anatomical double-bundle ACL reconstruction <1 year after ACL rupture injury from March 2012 to December 2016. Clinical results and arthroscopic cartilage/meniscal lesion were evaluated and compared between a cartilage lesion-detected group and intact-cartilage group. Surgery improved anteroposterior laxity and other clinical measures; however, cartilage lesions were detected at 11 sites during ACLR and at 54 sites at second-look arthroscopy. The periods from injury to second-look arthroscopy and from ACLR to second-look arthroscopy were significantly longer in the cartilage-lesion group (n=23) than in the intact-cartilage group (n=14). Conversely, 96% of meniscal damage observed during ACLR was cured at the time of second-look arthroscopy. Knee articular cartilage lesions after ACL rupture cannot be completely suppressed, even using the anatomical ACL reconstruction technique. This study suggested that articular cartilage lesions can progress to a level that can be confirmed arthroscopically at approximately 17 months after ACL injury. Therefore, in ACLR patients, the possibility of developing knee articular cartilage lesions and PTOA should be considered.
Keywords anterior cruciate ligament reconstruction post-traumatic osteoarthritis meniscal lesion cartilage lesions second-look arthroscopy
Amo Type Original Article
Published Date 2019-06
Publication Title Acta Medica Okayama
Volume volume73
Issue issue3
Publisher Okayama University Medical School
Start Page 223
End Page 228
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2019 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 31235969
JaLCDOI 10.18926/AMO/56248
FullText URL 72_5_499.pdf
Author Kodama, Yuya| Furumatsu, Takayuki| Maehara, Ami| Ozaki, Toshifumi|
Abstract Cell clusters, or groups of cells sharing a single chondron-like structure, are frequently found in degenerated areas of the osteoarthritic (OA) meniscus. However, little is known about these meniscal clusters in humans. The aim of our study was to determine the composition of the extracellular matrix deposition around cell clusters in human OA menisci. Twenty-six menisci were obtained through total knee arthroplasty from patients with OA knee joints. The specimens were subjected to safranin O staining and immunostaining for Sry-type HMG box 9 (SOX9), type II collagen, and aggrecan. Their signal density after staining was assessed using ImageJ software. Five regions of interest were analyzed within each tissue sample. The SOX9, type II collagen, and aggrecan densities were considerably higher in cluster areas than in intact superficial layers of the meniscus. In addition, a substantial difference was detected between cluster areas and degenerative areas without cell clusters. We demonstrated that cell clusters localized near fissures and clefts showed remarkable uniformity in menisci exposed to a broad range of injuries. In addition, the chondrogenic proteins SOX9, type II collagen, and aggrecan were highly expressed in these tissues.
Keywords cell cluster meniscus osteoarthritis Sry-type HMG box 9 type II collagen
Amo Type Original Article
Published Date 2018-10
Publication Title Acta Medica Okayama
Volume volume72
Issue issue5
Publisher Okayama University Medical School
Start Page 499
End Page 506
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2018 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 30369607
JaLCDOI 10.18926/AMO/56247
FullText URL 72_5_493.pdf
Author Okazaki, Yuki| Furumatsu, Takayuki| Masuda, Shin| Miyazawa, Shinichi| Kodama, Yuya| Kamatsuki, Yusuke| Hino, Tomohito| Okazaki, Yoshiki| Ozaki, Toshifumi|
Abstract Medial meniscus (MM) posterior root tear (PRT) results in joint overloading and degenerative changes in the knee. MM root repair is recommended to prevent subsequent cartilage degeneration following MMPRT. Favorable clinical outcomes have been reported after transtibial pullout repair of MMPRT. However, it is unclear whether pullout repair can cause compositional change in the MM posterior segment. We examined this question in 14 patients who underwent MMPRT pullout repair. Magnetic resonance imaging examinations were performed preoperatively and 3 months postoperatively at 10° knee flexion. The region-of-interest was marked along the MM posterior segment edge. Intra-meniscal signal intensity (IMSI) was expressed as the signal intensity ratio of the repaired MM to the intact lateral meniscus, which was used as a control. MMPRT pullout repair reduced IMSI from 1 to 0.915±0.096 (range, 0.760-1.074) 3 months postoperatively (p=0.006, power=0.90). Meniscal degeneration causes high proton density-weighted imaging signal intensity of the meniscal body. In our study, MMPRT pullout repair reduced IMSI contrary to other tears. This technique may decrease the MM posterior segment signal intensity by restoring the hoop tension mechanism. Measuring IMSI may be useful to assess the effect of MMPRT pullout repair on meniscal healing.
Keywords medial meniscus posterior root tear magnetic resonance imaging signal intensity arthroscopic surgery
Amo Type Original Article
Published Date 2018-10
Publication Title Acta Medica Okayama
Volume volume72
Issue issue5
Publisher Okayama University Medical School
Start Page 493
End Page 498
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2018 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 30369606
JaLCDOI 10.18926/AMO/55439
FullText URL 71_5_413.pdf
Author Furumatsu, Takayuki| Kodama, Yuya| Kamatsuki, Yusuke| Hino, Tomohito| Ozaki, Toshifumi|
Abstract Extrusion of the medial meniscus (MM) is associated with knee joint pain in osteoarthritic knees. The relationships among MM radial/oblique tears, MM extrusion (MME), and the effect of arthroscopic meniscal repair are not established. Here we evaluated the effects of arthroscopic all-inside MM repair on MME and the clinical outcomes in patients with radially oriented MM tears and mildly osteoarthritic knees. Twenty patients with a symptomatic radial or oblique tear of the MM posterior segment, MME ≥2.5 mm, and mildly osteoarthritic knees were treated using FasT-Fix 360 All-inside Meniscal Suture devices. We used magnetic resonance imaging (MRI) to measure the patients’ MM body width (MMBW), absolute MME, and relative MME. The Japanese Knee Injury and Osteoarthritis Outcome Score, Lysholm, Tegner, IKDC Subjective Knee Evaluation, and Visual Analogue Scale scores were obtained. Arthroscopic all-inside MM repair prevented increases of absolute and relative MME. The preoperative and 3- and 12-month MRI-based MMBW values were similar. Over a 24-month follow-up after the MM repairs, the clinical scores showed significant improvements. Our results suggest that all-inside meniscal repairs would be useful in preventing the progression of MME in patients suffering from symptomatic MM radial/oblique tears associated with mildly osteoarthritic knees.
Keywords medial meniscus radial/oblique tear meniscal repair meniscal extrusion osteoarthritic knee
Amo Type Original Article
Published Date 2017-10
Publication Title Acta Medica Okayama
Volume volume71
Issue issue5
Publisher Okayama University Medical School
Start Page 413
End Page 418
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29042699