Purpose To assess whether changes in knee cartilage MR-based T2 relaxation times are associated with weight loss in individuals with risk factors for knee osteoarthritis (OA) compared to controls with stable weight. Materials and Methods One hundred and twenty-seven individuals with risk factors for knee OA were studied: 62 subjects had a BMI decrease≥10% over 48-months and 65 controls had a BMI change<3%. Cartilage segmentation from 5 knee compartments at baseline and 48-month follow-up was performed, and T2 maps were generated. The association of change in T2 values over 48 months in the weight-loss group versus the control group was assessed using multiple linear regression models. Results Weight loss was associated with significantly smaller increases in cartilage T2 in the medial femoral condyle (p=0.035) and overall medial compartment (p=0.006) compared to the controls. In a subgroup analysis comparing weight-loss subjects who were obese (BMI≥30 kg/m2) and overweight (BMI 25-30 kg/m2) at baseline, obesity was associated with smaller increases in cartilage T2 values in the medial femoral condyle (p=0.022), lateral femoral condyle (p=0.015), patella (p=0.002), and globally across all compartments (p=0.002). Conclusion A decrease in BMI of ≥ 10% was associated with a slower progression of T2 values in individuals with risk factors for OA, suggesting a beneficial impact of weight loss on cartilage matrix degeneration.

Background:Many types of split-thickness skin graft (STSG) donor-site dressings are available with little consensus from the literature on the optimal dressing type. The purpose of this systematic review was to analyze the most recent outcomes regarding moist and nonmoist dressings for STSG donor sites.Methods:A comprehensive systematic review was conducted across PubMed/MEDLINE, EMBASE, and Cochrane Library databases to search for comparative studies evaluating different STSG donor-site dressings in adult subjects published between 2008 and 2017. The quality of randomized controlled trials was assessed using the Jadad scale. Data were collected on donor-site pain, rate of epithelialization, infection rate, cosmetic appearance, and cost. Meta-analysis was performed for reported pain scores.Results:A total of 41 articles were included comparing 44 dressings. Selected studies included analysis of donor-site pain (36 of 41 articles), rate of epithelialization (38 of 41), infection rate (25 of 41), cosmetic appearance (20 of 41), and cost (10 of 41). Meta-analysis revealed moist dressings result in lower pain (pooled effect size = 1.44). A majority of articles (73%) reported better reepithelialization rates with moist dressings.Conclusion:The literature on STSG donor-site dressings has not yet identified an ideal dressing. Although moist dressings provide superior outcomes with regard to pain control and wound healing, there continues to be a lack of standardization. The increasing commercial availability and marketing of novel dressings necessitates the development of standardized research protocols to design better comparison studies and assess true efficacy.

Therapeutic, IV.