The Basic Science of Human Knee Menisci

Fox, Allison M.; Bedi, Asheesh; Rodeo, Scott A.

doi:10.1177/1941738111429419

Cited by 478 publications

(310 citation statements)

References 138 publications

(186 reference statements)

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“…This finding, in combination with our finding that C-PC lines exhibit higher expression of type I collagen than mature chondrocytes, became our primary motivation for testing the efficacy of C-PCs in meniscus tissue repair. Type I collagen is the primary building block of the meniscal extracellular matrix network and accounts for approximately 90% of its dry weight [31]. …”

Section: Discussionmentioning

confidence: 99%

Human Cartilage-Derived Progenitors Resist Terminal Differentiation and Require CXCR4 Activation to Successfully Bridge Meniscus Tissue Tears

et al. 2018

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Meniscus injuries are among the most common orthopaedic injuries. Tears in the inner one-third of the meniscus heal poorly and present a significant clinical challenge. In this study, we hypothesized that progenitor cells from healthy human articular cartilage (C-PCs) may be more suitable than bone-marrow mesenchymal stem cells (BM-MSCs) to mediate bridging and reintegration of fibrocartilage tissue tears in meniscus. C-PCs were isolated from healthy human articular cartilage based on their expression of mesenchymal stem/progenitor marker ALCAM (CD166). Our findings revealed that healthy human C-PCs are CD166+, CD90+, CD54+, CD106- cells with multi-lineage differentiation potential and elevated basal expression of chondrogenesis marker SOX-9. We show that, similar to BM-MSCs, C-PCs are responsive to the chemokine stromal cell derived factor-1 (SDF-1) and they can successfully migrate to the area of meniscal tissue damage promoting collagen bridging across inner meniscal tears. In contrast to BM-MSCs, C-PCs maintaining reduced expression of cellular hypertrophy marker collagen X in monolayer culture and in an ex-plant organ culture model of meniscus repair. Treatment of C-PCs with SDF-1/CXCR4 pathway inhibitor AMD3100 disrupted cell localization to area of injury and prevented meniscus tissue bridging thereby indicating that the SDF-1/CXCR4 axis is an important mediator of this repair process. This study suggests that C-PCs from healthy human cartilage may potentially be a useful tool for fibrocartilage tissue repair/regeneration because they resist cellular hypertrophy and mobilize in response to chemokine signaling.

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Section: Discussionmentioning

confidence: 99%

Human Cartilage-Derived Progenitors Resist Terminal Differentiation and Require CXCR4 Activation to Successfully Bridge Meniscus Tissue Tears

et al. 2018

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“…Water, constituting 72% of the wet weight in mature meniscus, contributes to hydraulic pressures (HP) by binding with proteoglycans to overcome the friction drag of forcing fluid flow through the meniscus (Fox et al , 2012; Herwig et al , 1984). Collagen, another major matrix component, constitutes up to 22% of the wet weight in the meniscus, primarily for type I collagen (Eyre and Wu, 1983; Herwig et al , 1984; McDevitt and Webber, 1990).…”

Section: Matrix Microenvironmentmentioning

confidence: 99%

“…As the major proteoglycan in human menisci, aggrecan largely contributes to the viscoelastic compressive properties by binding with chondroitin sulfate and keratan sulfate of glycosaminoglycan (GAG) (Herwig et al , 1984). Regarding glycoproteins, fibronectin, constituting 8–13% of the dry weight in the meniscus, takes part in tissue repair, embryogenesis, and cell migration/adhesion (Fox et al , 2012). Elastin, which accounts for less than 0.6% of the dry weight in the meniscus (Höpker et al , 1986), most likely interacts directly with collagen to provide resiliency to the tissue (Fithian et al , 1990).…”

Section: Matrix Microenvironmentmentioning

confidence: 99%

Meniscus, articular cartilage and nucleus pulposus: a comparative review of cartilage-like tissues in anatomy, development and function

et al. 2017

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The degradation of cartilage in the human body is impacted by aging, disease, genetic predisposition, and continued insults resulting from daily activity. The burden of cartilage defects (osteoarthritis, rheumatoid arthritis, intervertebral disc damage, knee replacement surgeries, etc.) is daunting in light of substantial economic and social stresses. This review strives to broaden the scope of regenerative medicine and tissue engineering approaches used for cartilage repair by comparing and contrasting the anatomical and functional nature of the meniscus, articular cartilage (AC), and nucleus pulposus (NP). Many review papers have provided detailed evaluations of these cartilages and cartilage-like tissues individually, but none have comprehensively examined the parallels and inconsistencies in signaling, genetic expression, and extracellular matrix (ECM) composition between tissues. For the first time, this review outlines the importance of understanding these three tissues as unique entities, providing a comparative analysis of anatomy, ultrastructure, biochemistry, and function for each tissue. This novel approach highlights the similarities and differences between tissues, progressing research toward an understanding of what defines each tissue as distinctive. The goal of this paper is to provide researchers with the fundamental knowledge to correctly engineer the meniscus, AC, and NP without inadvertently developing the wrong tissue function or biochemistry.

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“…The inferior surfaces of the menisci are flat to match the tibial plateau. 6 The 'red zone' is heavily vascularised, the 'red-white zone' constitutes the central third of the meniscal body and has limited vascularity, and the 'white zone' is located in the inner third of the body of the meniscus and has no vascular supply.…”

Section: Fundingmentioning

confidence: 99%

“…4 The peripheral red zone is a thick, convex structure attached to the joint capsule whereas the inner white zone tapers to a thin edge. 6 To allow effective articulation with the convex femoral condyles the superior surface of the menisci are concave. The inferior surfaces of the menisci are flat to match the tibial plateau.…”

Section: Fundingmentioning

confidence: 99%

Diagnostic accuracy of the Thessaly test, standardised clinical history and other clinical examination tests (Apley’s, McMurray’s and joint line tenderness) for meniscal tears in comparison with magnetic resonance imaging diagnosis

Blyth

Anthony

Francq³

et al. 2015

Health Technol Assess

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BackgroundReliable non-invasive diagnosis of meniscal tears is difficult. Magnetic resonance imaging (MRI) is often used but is expensive and incidental findings are problematic. There are a number of physical examination tests for the diagnosis of meniscal tears that are simple, cheap and non-invasive.ObjectivesTo determine the diagnostic accuracy of the Thessaly test and to determine if the Thessaly test (alone or in combination with other physical tests) can obviate the need for further investigation by MRI or arthroscopy for patients with a suspected meniscal tear.DesignSingle-centre prospective diagnostic accuracy study.SettingAlthough the study was performed in a secondary care setting, it was designed to replicate the results that would have been achieved in a primary care setting.ParticipantsTwo cohorts of patients were recruited: patients with knee pathology (n = 292) and a control cohort with no knee pathology (n = 75).Main outcome measuresSensitivity, specificity and diagnostic accuracy of the Thessaly test in determining the presence of meniscal tears.MethodsParticipants were assessed by both a primary care clinician and a musculoskeletal clinician. Both clinicians performed the Thessaly test, McMurray’s test, Apley’s test, joint line tenderness test and took a standardised clinical history from the patient.ResultsThe Thessaly test had a sensitivity of 0.66, a specificity of 0.39 and a diagnostic accuracy of 54% when utilised by primary care clinicians. This compared with a sensitivity of 0.62, a specificity of 0.55 and diagnostic accuracy of 59% when used by musculoskeletal clinicians. The diagnostics accuracy of the other tests when used by primary care clinicians was 54% for McMurray’s test, 53% for Apley’s test, 54% for the joint line tenderness test and 55% for clinical history. For primary care clinicians, age and past history of osteoarthritis were both significant predictors of MRI diagnosis of meniscal tears. For musculoskeletal clinicians age and a positive diagnosis of meniscal tears on clinical history taking were significant predictors of MRI diagnosis. No physical tests were significant predictors of MRI diagnosis in our multivariate models. The specificity of MRI diagnosis was tested in subgroup of patients who went on to have a knee arthroscopy and was found to be low [0.53 (95% confidence interval 0.28 to 0.77)], although the sensitivity was 1.0.ConclusionsThe Thessaly test was no better at diagnosing meniscal tears than other established physical tests. The sensitivity, specificity and diagnostic accuracy of all physical tests was too low to be of routine clinical value as an alternative to MRI. Caution needs to be exercised in the indiscriminate use of MRI scanning in the identification of meniscal tears in the diagnosis of the painful knee, due to the low specificity seen in the presence of concomitant knee pathology. Further research is required to determine the true diagnostic accuracy and cost-effectiveness of MRI for the detection of meniscal tears.Trial registrationCurrent Controlled Trial ISRCTN43527822.FundingThe National Institute for Health Research Health Technology Assessment programme.

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The Basic Science of Human Knee Menisci

Cited by 478 publications

References 138 publications

Human Cartilage-Derived Progenitors Resist Terminal Differentiation and Require CXCR4 Activation to Successfully Bridge Meniscus Tissue Tears

Human Cartilage-Derived Progenitors Resist Terminal Differentiation and Require CXCR4 Activation to Successfully Bridge Meniscus Tissue Tears

Meniscus, articular cartilage and nucleus pulposus: a comparative review of cartilage-like tissues in anatomy, development and function

Diagnostic accuracy of the Thessaly test, standardised clinical history and other clinical examination tests (Apley’s, McMurray’s and joint line tenderness) for meniscal tears in comparison with magnetic resonance imaging diagnosis

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