BackgroundMeniscal tears are common knee injuries. Meniscal allograft transplantation (MAT) has been advocated to alleviate symptoms and delay osteoarthritis (OA) after meniscectomy. We investigated (1) the long-term outcome of MAT as a treatment of symptomatic meniscectomy, (2) most important factors affecting survivorship and (3) OA progression.MethodsFrom 1989 till 2013, 329 MAT were performed in 313 patients. Clinical and radiographic results and MAT survival were evaluated retrospectively. Failure was defined as conversion to knee arthroplasty (KA) or total removal of the MAT.ResultsMean age at surgery was 33 years (15–57); 60% were males. No-to-mild cartilage damage was found in 156 cases, moderate-to-severe damage in 130. Simultaneous procedures in 118 patients included cartilage procedures, osteotomy or ACL-reconstruction. At a mean follow-up of 6.8 years (0.2–24.3years), 5 patients were deceased and 48 lost (14.6%), 186 MAT were in situ (56.5%) whilst 90 (27.4%) had been removed, including 63 converted to a KA (19.2%). Cumulative allograft survivorship was 15.1% (95% CI:13.9–16.3) at 24.0 years. In patients <35 years at surgery, survival was significantly better (24.1%) compared to ≥35 years (8.0%) (p = 0.017). In knees with no-to-mild cartilage damage more allografts survived (43.0%) compared to moderate-to-severe damage (6.6%) (p = 0.003). Simultaneous osteotomy significantly deteriorated survival (0% at 24.0 years) (p = 0.010). 61% of patients underwent at least one additional surgery (1–11) for clinical symptoms after MAT. Consecutive radiographs showed significant OA progression at a mean of 3.8 years (p<0.0001). Incremental Kellgren-Lawrence grade was +1,1 grade per 1000 days (2,7yrs).ConclusionsMAT did not delay or prevent tibiofemoral OA progression. 19.2% were converted to a knee prosthesis at a mean of 10.3 years. Patients younger than 35 with no-to-mild cartilage damage may benefit from MAT for relief of symptoms (survivorship 51.9% at 20.2 years), but patients and healthcare payers and providers should be aware of the high number of surgical re-interventions.
The aim of this study is to evaluate the inflammatory effect of Coll2-1 peptide in rats and to compare the inflammatory response induced by the peptide with the one induced by bovine type II collagen or streptococcal cell wall. Methods: The Coll2-1 peptide or bovine type II collagen (CIA) or streptococcal cell wall (SCW) or saline solution were injected into female Lewis rats (n ¼ 108) (Charles River Laboratory, France). The Abstracts / Osteoarthritis and Cartilage 26 (2018) S60eS474 S120
Objective To investigate the characteristics of the anterior tibiotalar fat pad (ATFP) in the ankle joint in a population of patients 1 year after an ankle sprain and its correlation with systemic factors and local articular pathology. Design The study is a secondary analysis of an observational case-control study. We included 206 patients who were followed 6-12 months after ankle sprain. T1 MRI scans were assessed for signal intensity and area of ATFP by mapping the fat pad using dedicated imaging software (Mimics 18.0). Quantitative values of intensity and area were generated. Linear regression analysis was used to examine the association between both local and systemic factors and the ATFP. Variables with a P value <0.2 were entered in 5 stepwise multivariate models: (1) age-sex-body mass index (BMI); (2) anamnesis; (3) physical examination; (4) radiographic findings; and (5) MRI findings. Predictors in these separate models were entered in the final model. Results The final multivariate model showed a significant positive association between age ( P = 0.04; 95% confidence interval [CI] = 1.13 ± 1.06), BMI ( P = 0.05; 95% CI = 3.61 ± 3.53), and sex ( P < 0.01; 95% CI = −49.26 ± 30.04) with T1 intensity. The final model also showed a significant negative association between age ( P < 0.01; 95% CI = −0.57 ± 0.34), diffuse cartilage loss in the lateral talus ( P = 0.03; 95% CI = −0.71 ± 0.63), and Kellgren and Lawrence score in the tibiotalar joint ( P < 0.01; 95%CI = −21.61 ± 7.24) and ATFP area. A positive association was found between BMI ( P < 0.01; 95% CI = 2.25 ± 1.15) and ATFP area. Conclusion This study demonstrates a correlation between ATFP and both systemic factors and local pathology in the ankle joint.
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