There is a strong association between ACL mucoid degeneration and cartilage damage in the central and posterior MTFC, especially in patients >50 years.
Purpose
To investigate differences in joint space width (JSW) and meniscal extrusion (ME) between non-weight bearing (NWB) and weight bearing (WB) examinations of knee joints with medial compartment osteoarthritis (OA) using a cone-beam CT (CBCT) extremity imaging system.
Materials and methods
In this IRB approved prospective study, informed consent was obtained for 17 patients symptomatic for OA (11 F,6 M; 31–78 years, mean 56 years) and 18 asymptomatic controls (0 F,18 M; 29–48 years, mean 38.5 years) enrolled for CBCT exams in NWB and WB positions. Three independent observers measured medial tibiofemoral JSW and ME. Measurements were compared between NWB and WB images using paired Wilcoxon signed-rank sum test.
Results
OA subjects exhibited a statistically significant reduction in JSW between NWB and WB scans (average normalJnormalSWnormalNnormalWnormalBnormalOnormalA=2.1normalmnormalm and normalJnormalSWnormalWnormalBnormalOnormalA=1.5normalmnormalm, p = 0.016) and increase in ME (average normalMEnormalNnormalWnormalBnormalOnormalA=6.9normalmnormalm and normalMEnormalWnormalBnormalOnormalA=8.2normalmnormalm, p = 0.018)). For non-OA subjects, the change in JSW and ME between NWB and WB exams was reduced (average normalJnormalSWnormalNnormalWnormalBnormalnnormalonormalnnormalOnormalA=3.7normalmnormalm and normalJnormalSWnormalWnormalBnormalnnormalonormalnnormalOnormalA=3.4normalmnormalm; average normalMEnormalNnormalWnormalBnormalnnormalonormalnnormalOnormalA=2.6normalmnormalm and normalMEnormalWnormalBnormalnnormalonormalnnormalOnormalA=2.7normalmnormalm) and was not statistically significant. Inter-observer agreement was evaluated using Bland–Altman limits of agreement, with good agreement for all measurements (correlation coeffficient 0.89–0.98).
Conclusion
The ability to conduct NWB and WB exams in CBCT with a dose profile that is favorable in comparison to multidetector CT (MDCT) and with image quality sufficient for morphological analysis of joint space narrowing and meniscal extrusion could provide a valuable tool for OA diagnosis and treatment assessment.
These results indicate that microvascular hyperpermeability plays an important role in reperfusion injury to the spinal cord. Treatment with HES-Pz reduced the capillary permeability, neuron membrane injury, and incidence of paraplegia after reperfusion of ischemic spinal cord in a rabbit model.
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