Altered cartilage mechanics and histology in knee osteoarthritis: relation to clinical assessment (ICRS Grade)

Kleemann, Ralf U.; Krocker, D.; Cedraro, A.; Tuischer, Jens; Duda, Georg N.

doi:10.1016/j.joca.2005.06.008

Cited by 246 publications

(195 citation statements)

References 34 publications

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“…Once triggered, degeneration is marked by a vicious circle of increasing structural changes that are not homogenous across the joint, but usually extend out from a localized area. 8 In line with this theory, Kleemann et al found substantial statistical variation in histological Mankin scores in relation to the Outerbridge grade, 19 which supports the present study's findings of a close relation between degeneration and variation.…”

Section: Discussionsupporting

confidence: 90%

Three‐dimensional imaging and analysis of human cartilage degeneration using Optical Coherence Tomography

Nebelung

Brill

Marx

et al. 2015

Journal Orthopaedic Research

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Optical Coherence Tomography (OCT) is an evolving imaging technology allowing non-destructive imaging of cartilage tissue at near-histological resolution. This study investigated the diagnostic value of real time 3-D OCT in comparison to conventional 2-D OCT in the comprehensive grading of human cartilage degeneration. Fifty-three human osteochondral samples were obtained from eight total knee arthroplasties. OCT imaging was performed by either obtaining a single two-dimensional cross-sectional image (2-D OCT) or by collecting 100 consecutive parallel 2-D OCT images to generate a volumetric data set of 8 Â 8 mm (3-D OCT). OCT images were assessed qualitatively according to a modified version of the DJD classification and quantitatively by algorithm-based evaluation of surface irregularity, tissue homogeneity, and signal attenuation. Samples were graded according to the Outerbridge classification and statistically analyzed by one-way ANOVA, Kruskal Wallis and Tukey's or Dunn's post-hoc tests. Overall, the generation of 3-D volumetric datasets and their multiple reconstructions such as rendering, surface topography, parametric, and cross-sectional views proved to be of potential diagnostic value. With increasing distance to the mid-sagittal plane and increasing degeneration, score deviations increased, too. In conclusion, 3-D imaging of cartilage with image analysis algorithms adds considerable potential diagnostic value to conventional OCT diagnostics. ß

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Section: Discussionsupporting

confidence: 90%

Three‐dimensional imaging and analysis of human cartilage degeneration using Optical Coherence Tomography

Nebelung

Brill

Marx

et al. 2015

Journal Orthopaedic Research

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“…However, in this case, the concentration of the external bath solution was decreased from 0.15 to 0.125 M to mimic cartilage swelling observed in the physiological situation. Both computational parameters for OA progression and cartilage after full joint immobilization were obtained from the literature [49][50][51][52][53]. The related results were compared with those obtained for healthy tissue.…”

Section: Numerical Applicationsmentioning

confidence: 99%

Altered swelling and ion fluxes in articular cartilage as a biomarker in osteoarthritis and joint immobilization: a computational analysis

Manzano

Doblaré

et al. 2015

J. R. Soc. Interface.

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In healthy cartilage, mechano-electrochemical phenomena act together to maintain tissue homeostasis. Osteoarthritis (OA) and degenerative diseases disrupt this biological equilibrium by causing structural deterioration and subsequent dysfunction of the tissue. Swelling and ion flux alteration as well as abnormal ion distribution are proposed as primary indicators of tissue degradation. In this paper, we present an extension of a previous three-dimensional computational model of the cartilage behaviour developed by the authors to simulate the contribution of the main tissue components in its behaviour. The model considers the mechano-electrochemical events as concurrent phenomena in a three-dimensional environment. This model has been extended here to include the effect of repulsion of negative charges attached to proteoglycans. Moreover, we have studied the fluctuation of these charges owning to proteoglycan variations in healthy and pathological articular cartilage. In this sense, standard patterns of healthy and degraded tissue behaviour can be obtained which could be a helpful diagnostic tool. By introducing measured properties of unhealthy cartilage into the computational model, the severity of tissue degeneration can be predicted avoiding complex tissue extraction and subsequent in vitro analysis. In this work, the model has been applied to monitor and analyse cartilage behaviour at different stages of OA and in both short (four, six and eight weeks) and long-term (11 weeks) fully immobilized joints. Simulation results showed marked differences in the corresponding swelling phenomena, in outgoing cation fluxes and in cation distributions. Furthermore, long-term immobilized patients display similar swelling as well as fluxes and distribution of cations to patients in the early stages of OA, thus, preventive treatments are highly recommended to avoid tissue deterioration.

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“…The severity of cartilage injury was classified into the following 5 grades according to the International Cartilage Repair Society (ICRS) classification 10) : Grade 0, normal; Grade 1, softening and fissure of cartilage; Grade 2, cartilage defect of less than 50%; Grade 3, cartilage defect of more than 50% ; and Grade 4, defect extending to the subcartilaginous bone. In this study, severe cartilage injury was classified as Grade 3 or 4, and the number of such injuries was calculated.…”

Section: Distribution and Severity Of Cartilage Injury In The Radial mentioning

confidence: 99%

“…The severity of cartilage injury was classified according to the ICRS system, 10) as was the radial notch of the ulna. Similarly, severe cartilage injury was classified as Grade 3 or 4, and the number of such injuries was calculated.…”

Section: Distribution and Severity Of Cartilage Injury In The Articulmentioning

confidence: 99%

Anatomical Study of the Contact Area and Degenerative Change of the Proximal Radioulnar Joint During Forearm Rotation

Nishimura

Tanaka

Arai

et al. 2015

J St. Marianna Univ

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Although the articular circumference of the radial head is known to affect lateral stability of the elbow joint, no studies have reported an association between the radial head and radial notch of the ulna, which form the joint. The objective of this study was to investigate, from an anatomical perspective, the association of contact between the radial head and radial notch of the ulna in the proximal radioulnar joint (PRUJ) with development of cartilage injury during pronation and supination of the forearm. Forty-nine elbows from 26 cadavers were included for systemic anatomical study. After the articular circumference of the radial head and the radial notch of the ulna were divided into 4 and 9 regions, respectively, the presence or absence and severity of cartilage injury were determined. The contact area between the radial head and radial notch of the ulna was 50% smaller with the forearm at the pronated position than at the supinated position. Cartilage injury was observed in the medial region of the articular circumference of the radial head and the distal regions of the radial notch of the ulna. These regions corresponded to the contact area of the PRUJ with the elbow joint extended and the forearm pronated. In this condition, the elbow joint becomes most unstable. The elbow joint lateral support complex is likely to be impinged in the humeroradial joint with the elbow joint extended and the forearm pronated, suggesting that repeated impingement might induce cartilage injury.

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Altered cartilage mechanics and histology in knee osteoarthritis: relation to clinical assessment (ICRS Grade)

Cited by 246 publications

References 34 publications

Three‐dimensional imaging and analysis of human cartilage degeneration using Optical Coherence Tomography

Three‐dimensional imaging and analysis of human cartilage degeneration using Optical Coherence Tomography

Altered swelling and ion fluxes in articular cartilage as a biomarker in osteoarthritis and joint immobilization: a computational analysis

Anatomical Study of the Contact Area and Degenerative Change of the Proximal Radioulnar Joint During Forearm Rotation

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