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Diseased conditions of articular cartilage such as osteoarthritis (OA) are accompanied by a change in the water concentration, together with a decrease in cartilage thickness. These parameters are important indicators of the normal joint functioning. Light scattering in a heterogeneous joint tissue is a complex process and it is important to supplement its study with understanding gained from modelling. In this work we employed Monte Carlo for analysis of the relationship between changes in cartilage parameters and calculated diffuse reflectance spectra. It has been shown that water absorption peak at 980 nm is determined by both water content and cartilage thickness, while changes in diffuse reflectance spectra at 1450 nm are mostly driven only by water content. Since independent assessment of these parameters is clinically relevant, several approaches for their determination were developed. A heuristic algorithm for cartilage thickness determination and its quality metrics (R 2 = 0.96) were obtained. Several regression models were developed using the amplitudes of diffuse reflectance spectra at different wavelengths and it was shown that the use of a wide range of wavelengths (850–1700 nm) allows to determine the cartilage water concentration and its thickness with the accuracy R 2 0.96 and 0.99 while measuring at different probe-detector distances. [ABSTRACT FROM AUTHOR]

Muscle injury is defined as an overuse injury or traumatic distraction of a muscle, which is latent in any sport event, from amateur to large events. Based on previous numbers of muscle injuries and time spent to the athletes' recovery, the use of dietary functional factors intervention strategies is essential to enhance the recovery process and health. In recent years, there has been increasing evidence that biologically active peptides played an important role in sports nutrition and muscle injure recovery. Food-derived bioactive peptides were physiologically active peptides mostly derived from proteins following hydrolysis, which could be resorbed in intact form to reduce muscle damage following exercise and induce beneficial adaptions within the connective tissue. However, the complexity of the histoarchitectural considerations for skeletal muscle injuries and the repair mechanism of damaged skeletal muscle were not well known. In the following overview, the potential mechanisms and possible limitations regarding the damaged skeletal muscle metabolism were summarized, which aimed to present an overview of the nutritional strategies and recommendations after a muscular sports injury, emphasizing the use of main bioactive peptides. In addition, this review will provide implications for the studies of dietary bioactive peptides in the future. [ABSTRACT FROM AUTHOR]

Purpose Case Presentation Results Conclusion To describe the first report of third eyelid cartilage eversion in an adult American Quarter Horse mare.A 22‐year‐old American Quarter Horse mare presented to the University of Missouri Veterinary Health Center Equine Hospital for a 2‐week history of a third eyelid cartilage abnormality of the left eye with no known recent trauma. Complete ophthalmic examination revealed third eyelid cartilage eversion of the left nictitans. The abnormal scrolled cartilage was surgically excised using a handheld cautery unit and submitted for histopathologic evaluation.Histopathologic findings displayed normal third eyelid cartilage, without evidence of neoplasia or inflammation. Mucosal hyperplasia and increased vascularity of the submucosa were observed. The horse healed well after electrocautery excision and normal third eyelid conformation was restored.To the authors' knowledge, this is the first report of an acquired, presumed spontaneous, third eyelid cartilage eversion in a horse. [ABSTRACT FROM AUTHOR]

Osteoarthritis is a prevalent chronic health condition that is mostly associated with the degeneration of joint cartilage due to aging or abnormal mechanical stress in the joint. Intraarticularly injected nanoparticle‐based lubricants decrease the friction between damaged cartilage surfaces, thus preventing their further degradation; however, the effectiveness of currently used nanoparticle‐based lubricants is limited by their short retention time in the joint space. To address this challenge, cationically modified biosourced phytoglycogen nanolubricants are utilized, which electrostatically bind to the cartilage components. The conjugation of the nanoparticles with red‐emissive fluorescent carbon dots enables in vivo studies of their retention in the joint. The hytoglycogen nanoconjugates exhibit high colloidal stability in physiological conditions, provide a friction coefficient of 10−3–10−2 between the sliding surfaces under physiologically relevant pressures, strongly bind to the major cartilage surface components, and show significantly prolonged retention time in the joint in vivo, with a fourfold increase in half‐life in comparison with conventionally used hyaluronic acid injectant. These properties make these functionalized phytoglycogen nanoparticles a highly promising candidate for joint lubrication. [ABSTRACT FROM AUTHOR]

Aims: Knee osteoarthritis (KOA) is a common degenerative joint disease characterized by pain and functional limitations. Current treatments offer symptomatic relief but do not address the underlying pathology. This study explores the role of the infrapatellar fat pad (IFP) in KOA and evaluates the efficacy of its partial arthroscopic excision. Methods: A retrospective review was conducted on 37 KOA patients who underwent partial IFP excision. Pain and function were assessed using the WOMAC and VAS scores, while MRI evaluations focused on cartilage health. Results: Significant postoperative improvements were observed in both pain and functional outcomes, with substantial reductions in WOMAC and VAS scores (P < 0.001). MRI findings demonstrated notable enhancements in cartilage integrity, reflected in significantly improved WORMS scores (P < 0.001). Conclusions: Partial excision of the IFP significantly reduces pain and improves function in KOA patients, while also promoting cartilage health. These findings support the IFP's role in KOA pathology and highlight the potential benefits of targeted surgical intervention. [ABSTRACT FROM AUTHOR]

Background: Treatment of articular cartilage injury remains a challenging clinical problem in orthopedics. Chitosan-derived biomaterial could be a potential adjuvant treatment to improve cartilage repair. In the current study, we examined the effects of two potential chitosan-derived materials on cartilage regeneration of osteochondral defects in rabbits. Methods: An osteochondral defect was created over the rabbit knee and treated using three approaches: group A received no material (n = 24), group B received chitosan membranes with glucose absorption (CGA; n = 25), and group C received chitosan-glucose derivative membranes obtained via the Maillard reaction (CGMR; n = 25). Cartilage repair over the osteochondral defect was analyzed 12 weeks post-surgery via histological analysis, immunostaining, and reverse transcription-qualitative polymerase chain reaction (RT-qPCR) for type-I and type-II collagen mRNA. Results: According to histological analysis, CGMR-treated defects showed significantly improved modified O'Driscoll scoring when compared with no material- and CGA-treated defects (20.9 ± 4.3 vs. 13.00 ± 2.5 and 17.7 ± 4.6, p < 0.001). Moreover, group C exhibited higher intensity of type-II collagen immunohistochemical staining over the regenerated cartilage than groups A and B, along with increased expression of type-II collagen mRNA by RT-qPCR. Conclusions: CGMR might improve cartilage regeneration in osteochondral defects. [ABSTRACT FROM AUTHOR]

Background: Treatment of articular cartilage injury remains a challenging clinical problem in orthopedics. Chitosan-derived biomaterial could be a potential adjuvant treatment to improve cartilage repair. In the current study, we examined the effects of two potential chitosan-derived materials on cartilage regeneration of osteochondral defects in rabbits. Methods: An osteochondral defect was created over the rabbit knee and treated using three approaches: group A received no material (n = 24), group B received chitosan membranes with glucose absorption (CGA; n = 25), and group C received chitosan-glucose derivative membranes obtained via the Maillard reaction (CGMR; n = 25). Cartilage repair over the osteochondral defect was analyzed 12 weeks post-surgery via histological analysis, immunostaining, and reverse transcription-qualitative polymerase chain reaction (RT-qPCR) for type-I and type-II collagen mRNA. Results: According to histological analysis, CGMR-treated defects showed significantly improved modified O'Driscoll scoring when compared with no material- and CGA-treated defects (20.9 ± 4.3 vs. 13.00 ± 2.5 and 17.7 ± 4.6, p < 0.001). Moreover, group C exhibited higher intensity of type-II collagen immunohistochemical staining over the regenerated cartilage than groups A and B, along with increased expression of type-II collagen mRNA by RT-qPCR. Conclusions: CGMR might improve cartilage regeneration in osteochondral defects. [ABSTRACT FROM AUTHOR]

Objective: Cartilage and meniscus are important structures that maintain the health of the knee joint. Early detection of changes in the internal components of cartilage and meniscus before morphological changes occur is essential to prevent and delay the development of osteoarthritis (OA). This study was designed to determine the changes in the matrix composition of morphologically intact cartilage and meniscus during the acute phase of an anterior cruciate ligament (ACL) rupture, as well as the effect of different states of meniscus (intact or tear) on adjacent cartilage during the acute phase. Methods: This cross‐sectional study compared and analyzed 50 patients in the acute phase of ACL rupture who underwent surgical treatment and 66 age‐, weight‐ and height‐matched healthy volunteers from May 2022 to May 2023 at our institution. Mean T2 relaxation times and effect sizes in different regions of tibiofemoral articular cartilage and meniscus were compared between the two groups using the Mann–Whitney nonparametric t‐test, and correlations between different meniscal states and adjacent cartilage were analyzed. Results: Both in the lateral and medial compartments of the knee, T2 relaxation times were significantly higher in all subregions of cartilage and meniscus in the ACL rupture group (p < 0.05), and the site of injury was predominantly centered in the medial compartment (femur, p = 0.000; tibia, p = 0.000; anterior horn, p = 0.000). In the respective compartments, the posterior horn of the lateral meniscus showed a significant positive correlation with the mid‐cartilage of the femoral and tibial (r = 0.566, p = 0.035; r = 0.611, p = 0.02); and the posterior horn of the medial meniscus showed a significant positive correlation with the posterior tibial cartilage (r = 0.668, p = 0.018). Conclusion: During the acute phase of ACL rupture, the internal composition of the cartilage and meniscus undergoes significant changes, even if the morphology is intact. More importantly, the state of the meniscus significantly affects the internal composition of the adjacent cartilage. This is an early warning sign of OA, which should be closely monitored and carefully managed in clinical practice. [ABSTRACT FROM AUTHOR]

This study was undertaken for study of anatomical results and hearing improvement in various types of tympanoplasty using conchal cartilage. A total of 100 patients were taken for this study the patients belongs to varying age groups from 1st to 6th decade of life.Maximum patients were in between age group 21 to 30 years, 37 (37%) patients and minimum 02(2%) between age group 51 to 60 years. Out of these an overall average gain of 13.33dB in PTA(pure tone audiometry) as well as ABG(air bone gap) was seen however an overall average deficit of 32.15dB in PTA as well as 16.43dB in ABG was seen. The tympanoplasty performed were with or without any additional surgeries of mastoid like Cortical, Atticotomy, CWW, MRM.The pre and post ABG was mainstay for each of our case and final anatomical result of graft uptake. Key points: Type I Tympanoplasty had an average deficit of 15.26 in ABG. Type II Tympanoplasty had an average deficit of 12.75 dB in ABG. Type III Tympanoplasty had an average deficit of 19.42 dB in ABG. Type IV Tympanoplasty had an average deficit of 24 dB in ABG. An overall average gain of 13.33 dB in ABG was seen. An overall average deficit of 32.15 dB in PTA as well as 16.43 dB in ABG was seen. The main aim of our study is to counsel the patient that there will not be complete improvement of hearing if we have done type III and type IV tympanoplasty in advanced disease. This is also of importance for medicolegal purpose. [ABSTRACT FROM AUTHOR]

An unusually projecting human ear is known as a prominent ear, otapostasis, or bat ear. It might be both bilateral and unilateral. The scapha and antihelix of the big concha are not well formed. It is the outcome of cartilage deformity that occurred during early ear development in utero. After the child reaches five years old, the abnormality can be corrected at any time. In order to prevent psychological suffering, the procedure should ideally be performed as soon as possible. Otoplasty correction is reshaping the ear cartilage to bring the ear closer to the side of the head. The cartilage is reshaped, but the skin is left in place. Hearing remains unaffected by the operation. It is mainly done for aesthetic reasons. Although they are uncommon, the post-operative consequences from the operation include hematoma development, keloid formation, infection, and asymmetry in the ears. Otoplasty is a cosmetic operation that involves permanent sutures to alter the size, shape, or location of the ear. The main purpose of otoplasty is to treat promin auris, or bulging ears. Promin auris, the principal indication for otoplasty, is the subject of this review. The indications, contraindications, and method utilized in otoplasty are reviewed in this exercise, which also emphasizes the need of pre- and post-operative care for patients having this surgery. Otoplasty results are generally lifelong and will improve the self-confidence. The goals of otoplasties are to make the ears appear more natural in comparison to the head and help with the overall contour of the ears. Final ear surgery results will be visible after a two week recovery period, with small improvements appearing for up to 12 months post-procedure. A proper understanding of the diagnosis, indications, and surgical techniques will lead to positive outcomes in otoplasty. [ABSTRACT FROM AUTHOR]

Anterior and high septal deviation can severely affect the functional and cosmetic outcomes of a patient. Conventional septoplasty would not be sufficient in these conditions to restore the functionality and aesthetics of a nose, and the majority of the patients require L-shaped grafts for the reconstruction of the septum. In the present study, we shared our experience in using an L-strut cartilage graft in functional rhinoplasty. It is a retrospective study of 60 patients who underwent septorhinoplasty from March 2020 to January 2023 using an L-strut cartilage graft for functional and aesthetic abnormality. The functional and aesthetic outcomes have been evaluated and compared before and 12 months after the surgery. L-strut cartilage graft was used in 60 cases of functional rhinoplasty. There was a significant improvement in the functional and aesthetic outcomes in all the cases (p < 0.05). No significant intraoperative and postoperative complications were detected in any of the patients until 12 months of follow-up. L-strut cartilage graft could be a versatile graft that can be successfully utilized in patients with gross anterior/dorsal septal deviation. It provides a stable, straight midline fixation of the neoseptum, ensuring good functional and aesthetic results without major complications. [ABSTRACT FROM AUTHOR]

Background: Osteoarthritis (OA) is a prevalent degenerative joint disease characterized by chronic inflammation and progressive cartilage degradation, ultimately leading to joint dysfunction and disability. Oleocanthal (OC), a bioactive phenolic compound derived from extra virgin olive oil, has garnered significant attention due to its potent anti-inflammatory properties, which are comparable to those of non-steroidal anti-inflammatory drugs (NSAIDs). This study pioneers the investigation into the effects of OC on the Protease-Activated Receptor-2 (PAR-2) mediated inflammatory pathway in OA, aiming to validate its efficacy as a functional food-based therapeutic intervention. Methods: To simulate cartilage tissue in vitro, human bone marrow-derived mesenchymal stem cells (BMSCs) were differentiated into chondrocytes. An inflammatory OA-like environment was induced in these chondrocytes using lipopolysaccharide (LPS) to mimic the pathological conditions of OA. The therapeutic effects of OC were evaluated by treating these inflamed chondrocytes with various concentrations of OC. The study focused on assessing key inflammatory markers, catabolic enzymes, and mitochondrial function to elucidate the protective mechanisms of OC. Mitochondrial function, specifically mitochondrial membrane potential (ΔΨm), was assessed using Rhodamine 123 staining, a fluorescent dye that selectively accumulates in active mitochondria. The integrity of ΔΨm serves as an indicator of mitochondrial and bioenergetic function. Additionally, Western blotting was employed to analyze protein expression levels, while real-time polymerase chain reaction (RT-PCR) was used to quantify gene expression of inflammatory cytokines and catabolic enzymes. Flow cytometry was utilized to measure cell viability and apoptosis, providing a comprehensive evaluation of OC's therapeutic effects on chondrocytes. Results: The results demonstrated that OC significantly downregulated PAR-2 expression in a dose-dependent manner, leading to a substantial reduction in pro-inflammatory cytokines, including TNF-α, IL-1β, and MCP-1. Furthermore, OC attenuated the expression of catabolic markers such as SOX4 and ADAMTS5, which are critically involved in cartilage matrix degradation. Importantly, OC was found to preserve mitochondrial membrane potential (ΔΨm) in chondrocytes subjected to inflammatory stress, as evidenced by Rhodamine 123 staining, indicating a protective effect on cellular bioenergetics. Additionally, OC modulated the Receptor Activator of Nuclear Factor Kappa-Β Ligand (RANKL)/Receptor Activator of Nuclear Factor Kappa-Β (RANK) pathway, suggesting a broader therapeutic action against the multifactorial pathogenesis of OA. Conclusions: This study is the first to elucidate the modulatory effects of OC on the PAR-2 mediated inflammatory pathway in OA, revealing its potential as a multifaceted therapeutic agent that not only mitigates inflammation but also protects cartilage integrity. The preservation of mitochondrial function and modulation of the RANKL/RANK pathway further underscores OC's comprehensive therapeutic potential in counteracting the complex pathogenesis of OA. These findings position OC as a promising candidate for integration into nutritional interventions aimed at managing OA. However, further research is warranted to fully explore OC's therapeutic potential across different stages of OA and its long-term effects in musculoskeletal disorders. [ABSTRACT FROM AUTHOR]

A human laryngeal model, incorporating all the cartilages and the intrinsic muscles, was reconstructed based on MRI data. The vocal fold was represented as a multilayer structure with detailed inner components. The activation levels of the thyroarytenoid (TA) and cricothyroid (CT) muscles were systematically varied from zero to full activation allowing for the analysis of their interaction and influence on vocal fold dynamics and glottal flow. The finite element method was employed to calculate the vocal fold dynamics, while the one-dimensional Bernoulli equation was utilized to calculate the glottal flow. The analysis was focused on the muscle influence on the fundamental frequency (fo). We found that while CT and TA activation increased the fo in most of the conditions, TA activation resulted in a frequency drop when it was moderately activated. We show that this frequency drop was associated with the sudden increase of the vertical motion when the vibration transited from involving the whole tissue to mainly in the cover layer. The transition of the vibration pattern was caused by the increased body-cover stiffness ratio that resulted from TA activation. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate whether trans-thyroid cartilage nerve monitoring for thyroid surgeries is as effective and safe as endotracheal tube monitoring. Methods: Fifty-one thyroidectomies (38 hemithyroidectomies and 13 total thyroidectomies, analyzed as two separate hemi-thyroidectomies) were included. Patients undergoing surgery from 6/2020 to 8/2021 were monitored simultaneously with the NIM® Nerve Monitoring System TriVantage™ Electromyography (EMG) endotracheal tube and EMG trans-thyroid cartilage. Electrophysiological responses of 64 vagus and recurrent laryngeal nerves were obtained. Peri-operative evaluation and 12-month post-operative follow-up were conducted to examine nerve function. Wilcoxon signed-rank and Spearman coefficient tests were used to determine whether there were differences between the methods. Results: The average initial amplitude measured with the trans-thyroid cartilage method was higher in the recurrent laryngeal and vagus nerves (p = 0.002, p = 0.003, respectively). The mean difference in EMG amplitude from start to end of surgery for 10 damaged nerves (7 temporary and 3 permanent) differed from intact nerves in both methods and nerves (p < 0.05 for all). Among intact recurrent laryngeal nerves, 20.4% had 20–80% decrease in amplitude in endotracheal tube electrodes and 16.7% in trans-thyroid cartilage electrodes (p = 0.92). All cases with stable EMG signals or with increased EMG amplitude (with both types of electrodes and with both nerves) had normal post-operative vocal function. No significant difference was found between the two methods when measuring the vagus and recurrent laryngeal nerves. No complications occurred when using trans-thyroid cartilage electrodes. Conclusions: Trans-thyroid cartilage nerve monitoring for thyroid surgeries is as effective and safe as the current standard monitoring using an endotracheal tube. Lay Summary: During thyroid surgery, patients are monitored to avoid damaging nerves near the vocal cords. This study compared monitoring through a throat tube with the easier method of monitoring outside of the throat to see if it is as effective and safe. No major difference was found between the two methods and there were no problems. [ABSTRACT FROM AUTHOR]

To provide a better understanding of the contribution of specific constituents (i.e. proteoglycan, collagen, fluid) to the mechanical behavior of the superficial zone of articular cartilage, a complex biological tissue with several time-dependent properties, a finite element model was developed. Optimization was then used to fit the model to microindentation experiments. We used this model to compare superficial zone material properties of mature human vs. immature bovine articular cartilage. Non-linearity and stiffness of the fiber-reinforced component of the model differed between human and bovine tissue. This may be due to the more complex collagen architecture in mature tissue and is of interest to investigate in future work. [ABSTRACT FROM AUTHOR]

Background: The xiphoid process (XP) in animals such as sheep and rats are well known to have cartilage called xiphoidal cartilage (XC). In humans, the cartilage in the xiphoid process is considered an anatomical variant and is not well understood. The aim of this study was to investigate the morphology of the XP. Methods: A total of twenty embalmed European descendant cadaveric sterna (aged 52 to 98 years) were used. Transilluminated XPs and midsagittal sections of XPs were used to examine the bone and cartilage. Subsequently, a sagittally-sectioned XP was harvested for histology and stained with Masson's trichrome. The results of the transillumination and histological examinations were compared qualitatively. Results: The dark area visible in transilluminated XPs was consistent with the bony part in the midsagittal XP sections, which contained bone marrow; the bright area was consistent with the cartilage part in the midsagittal XP sections. This was all demonstrated histologically. Most of the XPs (85%) had some portion of cartilage. The XP was classified into four types based on its proportions of bone and cartilage: Type I, no ossification (< 1/3 ossification) 45%; Type II, minor ossification (1/3 − 1/2 ossification) 20%; Type III, major ossification (1/2–2/3 ossification) 20%; Type IV, complete ossification (> 2/3 ossification) 15%. Most of the XPs (85%) had bone and cartilage, which could have been overlooked in studies using skeletons or CT. Conclusion: Previous studies probably underestimated or overestimated the size of the XP. The XC needs to be considered as normal anatomy. [ABSTRACT FROM AUTHOR]

Purpose: The current supraomohyoid neck dissection (SOHND) is performed above the omohyoid muscle to dissect levels I, II, and III in the levels of cervical lymph nodes. However, the anatomical boundary between levels III and IV is the inferior border of the cricoid cartilage. We investigated the anatomical relationship between the omohyoid muscle and cricoid cartilage using contrast-enhanced CT (CE-CT) images to assess the validity of the current SOHND. Methods: CE-CT images of the head and neck regions in patients were reviewed. The patients were divided into two groups: "malignant tumors" and "others". The vertebral levels corresponding to the positions of anatomical structures such as the intersection of the omohyoid muscle and internal jugular vein (OM-IJ), and the inferior border of the cricoid cartilage (CC), were recorded. Results: The OM-IJ was located around the seventh cervical to the first thoracic vertebra. There was a significant difference between the malignant tumor and others groups in females (p = 0.036). The CC was located around the sixth to seventh cervical vertebrae. There was a significant sex difference in each group (malignant tumor: p < 0.0001; others: p = 0.008). Both sexes tended to have lower OM-IJ than CC, and females had significantly lower OM-IJ than males. Conclusion: This study provides clear anatomical evidence showing the difference between the SOHND dissection area and levels I, II, and III. It could be considered that in most cases SOHND invades level IV, not just levels I, II, and III, especially in female patients. [ABSTRACT FROM AUTHOR]

Literature regarding the feasibility of inexperienced surgeons using needle arthroscopy is limited. The present study aimed to clarify the feasibility of performing ankle needle arthroscopy for inexperienced surgeons. Diagnostic needle arthroscopy was performed for 10 cadaveric ankles by two surgeons with different levels of experience in ankle arthroscopy (inexperienced and expert surgeons). The visibility of arthroscopy was assessed based on a 15-point checklist and compared between surgeons. In addition, iatrogenic articular cartilage injury created by the inexperienced surgeon was investigated. The number of visible points was significantly larger for the expert surgeon than for the inexperienced surgeon (14.1 ± 1.0 vs. 13.7 ± 1.0, P = 0.035). The location of cartilage injury was greatest on the medial talar dome when viewing from the anteromedial portal at a rate of 30%. Ankle needle arthroscopy may be an option for surgeons in the future, however, differences in surgeon experience may impact effective visualization. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the long-term clinical efficacy of first-generation autologous chondrocyte implantation (ACI) technique for osteochondral lesions of the ankle joint. Eleven patients with symptomatic OLTs underwent ACI from December 1997 to October 2002. A total of 9 patients (5 men, 4 women, age 25.2 ± 6.3) were evaluated at baseline and at 1, 3, 10 years, and at final follow-up of minimum 20 years with AOFAS ankle-hindfoot score, NRS for pain, and with the Tegner score. The AOFAS score improved significantly from the baseline value of 40.4 ± 19.8 to 82.7 ± 12.9 at the final follow-up (p < 0.0005). The NRS for pain improved significantly from 7.8 ± 0.7 at baseline to 4.8 ± 2.1 at the final follow-up (p < 0.0005). Moreover, the Tegner score underwent a modification from the pre-operative median value of 1 (range: 1–3) and from a pre-injury value of 5 (range: 3–7) to 3 (range: 2–4) at the final follow-up (p < 0.0005). ACI has proven to be an effective treatment option for patients suffering from OLTs, leading to a long-lasting clinical improvement even beyond 20 years of follow-up. Level IV [ABSTRACT FROM AUTHOR]

Acute cartilage injuries, such as intra-articular fractures and blunt impacts, frequently result in chondrocyte death and extracellular matrix (ECM) degradation, significantly elevating the risk of post-traumatic osteoarthritis (PTOA). Despite advances in treatment, no effective therapies currently exist to fully cure PTOA or halt its progression. This study explores the protective effects of the dietary fatty acid eicosapentaenoic acid (EPA) on human primary chondrocytes (HPCs) and cartilage explants exposed to mechanical overload and blunt trauma. HPCs were isolated and subjected to mechanical stretching using BioFlex six-well culture plates, while cartilage explants were subjected to impact loading via a customized drop tower. EPA was incorporated into the culture medium, followed by assays to evaluate cell viability, calcium (Ca²⁺) influx, apoptosis, reactive oxygen species (ROS) levels, and collagen type II alpha (Col-2a) expression. EPA treatment markedly decreased chondrocyte mechanical sensitivity, as demonstrated by enhanced cell viability and reduced lactate dehydrogenase (LDH) release. Furthermore, EPA inhibited Piezo1 activation, leading to lower intracellular Ca²⁺ concentrations, decreased apoptosis, and diminished ROS levels. In cartilage explants, EPA improved chondrocyte viability, minimized structural damage, and sustained higher Col-2a expression compared to the blunt trauma group. These results indicate that EPA effectively shields chondrocytes and cartilage explants from mechanical overload-induced damage by inhibiting Piezo1 activation and mitigating Ca²⁺ influx, apoptosis, and oxidative stress. The findings suggest that EPA supplementation could offer a promising strategy for preventing PTOA progression following acute cartilage injuries. Further research is warranted to assess the clinical applications of EPA and confirm its efficacy in larger animal models and human trials. [ABSTRACT FROM AUTHOR]

Introduction Materials and Methods Results Conclusion Foot‐related lameness is common in Standardbred and Thoroughbred racehorses. Magnetic resonance imaging (MRI) provides information on both the soft tissue and osseous structures of the distal extremity. The aim of this study was to determine whether abnormalities identified on distal limb MRI differed between these two racehorse populations.The records of Standardbred and Thoroughbred racehorse distal extremity MRI examinations conducted at Camden Equine Centre and Ballarat Veterinary Practice between 2013 and 2023 were retrieved. Horses were included if pain causing lameness had been localised to the foot using perineural or intra‐articular analgesia. MRI abnormalities of the structures within the distal extremity were recorded and comparisons made between the two groups.There was a significant difference in the rate of occurrence of certain MRI abnormalities between the Thoroughbred and Standardbred racehorse populations, including distal phalangeal fractures, proximal phalangeal short tau inversion recovery (STIR) hyperintensity (distal aspect), the presence and severity of ungular cartilage ossification, abnormalities of the navicular bone distal border synovial invaginations/vascular channels and navicular bone distal border fragments. The presence of distal extremity STIR hyperintensity and fractures was significantly higher in Standardbred compared to Thoroughbred racehorses when these findings were grouped and considered in combination.There were many similarities in the distal extremity MRI abnormalities identified in lame Australian Standardbred and Thoroughbred racehorses. However, distal phalangeal fractures, ungular cartilage ossification and distal extremity STIR hyperintensity were identified in significantly more in Standardbred than Thoroughbred racehorses. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusion Level of Evidence Similar to the anterior cruciate ligament, the femoral footprint of the posterior cruciate ligament (PCL) is composed of different fibre areas, possibly having distinct biomechanical functions. The aim of this study was to determine the role of different fibre areas of the femoral footprint of the PCL in restraining posterior tibial translation (PTT).A sequential cutting study was performed on eight fresh‐frozen human knee specimens, utilizing a six‐degrees‐of‐freedom robotic test setup. The femoral attachment of the PCL was divided into 15 areas, which were sequentially cut from the bone in a randomized sequence. After determining the native knee kinematics, a displacement‐controlled protocol was performed replaying the native motion, while constantly measuring the force. The reduction of the restraining force presented the percentage contribution of each cut, according to the principle of superposition.The PCL was found to contribute 29 ± 16% in 0°, 51 ± 24% in 30°, 60 ± 22% in 60° and 55 ± 18% in 90°, to restricting a PTT. The fibre areas contributing the most were located at the proximal border of the PCL footprint, away from the cartilage, and directly adjacent to the medial intercondylar ridge (p < 0.05). Of these, one fibre area showed the highest contribution at all flexion angles. This area was located at the posterior half of the medial intercondylar ridge. No clear assignment of the areas to either the anterolateral or posteromedial bundle was possible.An area towards the proximal and posterior part of the femoral PCL footprint was found to significantly restrain a posterior tibial force. Based on the data of this testing setup, a PCL graft positioned at the identified area may best mimic the part of the native PCL, which bears the most load in resisting a PTT force.No evidence level (laboratory study). [ABSTRACT FROM AUTHOR]

BACKGROUND: Disturbances in bone metabolism have a significant association with ferroptosis in steroid-induced osteonecrosis of the femoral head (SONFH). Furthermore, the pathologic process of SONFH is characterized by the presence of cartilage damage and degeneration. However, the specific regulatory targets and the relationship between ferroptosis and cartilage concerning SONFH remain unclear. OBJECTIVE: To employ bioinformatics and machine learning techniques to identify specific genes associated with ferroptosis that target cartilage and to investigate the correlation between ferroptosis and cartilage, thereby providing novel ideas and methodologies for the study and treatment of SONFH. METHODS: Disease datasets pertinent to the study and ferroptosis-related genes were retrieved from the GEO and FerrDb databases. Subsequently, the disease datasets were normalized and differential analysis using the R language to identify ferroptosis-related differential genes (Fe-DEGs). We conducted Gene Ontology (GO) functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathway enrichment analysis of Fe-DEGs. Furthermore, ferroptosis-related signature genes were filtered based on the protein-protein interaction network of Fe-DEGs and machine learning methods. Finally, the rabbits were divided into normal and model groups. The normal group was given the same dose of saline to simulate the modeling drug, and the animal model of SONFH in rabbits was constructed by injection of modified horse serum combined with methylprednisolone. After successful modeling, the expression of signature gene was verified between different groups, and the phenotype of ferroptosis in cartilage was analyzed. RESULTS AND CONCLUSION: Through the normalization and differential analysis of the dataset, a total of 1 315 differentially expressed genes were identified. Additionally, 379 ferroptosis-related genes were obtained from the FerrDb database. After intersecting both gene sets, 19 Fe-DEGs were obtained. The GO analysis revealed that Fe-DEGs were mainly involved in biological processes such as cell migration and cellular response to oxidative stress, cellular components such as kinase complexes, amino acid complexes, and cytoplasmic membranes, as well as molecular functions such as kinase activity, receptor activity, and protein binding. The KEGG analysis revealed that Fe-DEGs were mainly enriched in the FoxO signaling pathway, vascular endothelial growth factor signaling pathway, and FcγR-mediated phagocytosis. Constructing a protein-protein interaction network and using machine learning, we identified the ferroptosis-related signature gene, CA9. The gene set enrichment analysis of the signature gene CA9 revealed an upregulated expression in biological processes such as fatty acid metabolism and O-GlcNAc glycosylation modification, while being inhibited in terms of neural activity and ligand-receptor interactions. RT-PCR and western blot results showed that compared with the normal group, the expressions of ACSL4 and CA9 at mRNA and protein levels were significantly higher in the model group (P < 0.05), while the expressions of SLC7A11 and GPX4 at mRNA and protein levels were significantly lower in the model group (P < 0.05), coinciding with the expression levels of the signature genes in the dataset. These findings indicate that the cartilage of SONFH is closely related to ferroptosis, and targeting the signature gene may provide certain ideas and directions for the study and treatment of SONFH. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusion Level of Evidence Different cartilage repair techniques are widely used to regenerate cartilage, such as autologous chondrocyte implantation (ACI), osteochondral autograft transfer, microfracturing and minced cartilage. Defect size is a key parameter for selecting the best procedure to repair cartilage. However, the defect's size is not related to the patient's total cartilage surface. This is because assessing the femoral cartilage surface area is time‐consuming and therefore unsuitable in the daily clinical routine. It has been proposed that the femur's total cartilage area correlates positively with the transepicondylar distance (TEA).The knees of 40 subjects were analysed. Their average age was 30.1 ± 8.6 years. Twenty‐four female and 16 male subjects were examined. Their mean body height was 176.2 ± 8.8 cm. MRI scans were performed via 3‐Tesla MRI. These data were postprocessed and quantified using the browser‐based, customizable SATORI platform (Fraunhofer MEVIS). This software computed the femoral cartilage surface area (FeCA), the patella cartilage surface area (PCA), the TEA and the patella length.Body height reveals a good correlation (r = 0.722, p < 0.001) with the distal femur's cartilage area surface. However, regression analysis shows only moderate dependence (R2: 0.514). A very good correlation (r = 0.830, p < 0.001) was observed between the TEA distance and the total cartilage surface area of the distal femur. The regression analysis yields a good value (R2: 0.684). The cranio‐caudal length of the patella was chosen as a suitably measurable two‐dimensional parameter for correlation analysis with the patella's total cartilage surface area. Those results yield a poor correlation (r = 0.577, p < 0.001) between the two parameters, and regression analysis reveals a low value (R2: 0.384).The TEA is a reliable parameter for estimating the femur's cartilage area using MRI. A simple determination of this parameter allows the estimation of the femur's total cartilage area as well as the surface‐corrected defect size (SCDS) in daily routine.Level II [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusions Level of evidence This study aimed to evaluate which preoperative patient, injury or clinical factors were associated with the anterior cruciate ligament (ACL) remnant volume in patients undergoing ACL surgery. It was hypothesized that the main factors determining an insufficient ACL remnant volume at the time of surgery were younger age and longer time to surgery.A retrospective analysis from the Francophone Arthroscopic Society's registry was conducted, including 1565 patients with an ACL lesion underdoing a primary ACL surgery (reconstruction or repair) between June 2020 and June 2023. Patients were excluded in case of revision surgery and incomplete data. Preoperative factors—including patient demographics, delay to surgery, preoperative laxity and the presence of meniscal tears or cartilage lesions—were analysed to determine their influence on ACL remnant volume (estimated by the surgeon as the percentage of residual volume). Univariate, multivariate and receiver operating characteristic curve analyses were performed to explore these relationships.Multivariate analyses demonstrated that younger age (<20 years and 20–30 years compared to ≥40, p = 0.02), higher time from injury to surgery (≥12 months compared to <3 months, p = 0.01) and the presence of a medial (p = 0.01) or a lateral meniscal tear (p = 0.02) were significant predictors of an ACL remnant volume ≤ 50%.Younger age (under 30 years of age), a time from injury to surgery above 12 months and the presence of medial and lateral meniscal tears are associated with higher odds of observing a smaller ACL remnant volume at the time of the ACL surgery. These factors should be considered when planning ACL remnant preservation techniques.Level III. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate a non‐resorbable implant for the focal repair of chondral defects in eight adult horses with 12‐month follow‐up. The bi‐layered construct composed of a polycarbonate‐urethane‐urea biomaterial which was printed in 3D fashion onto a bone anchor was implanted into surgically created osteochondral defects into the femoropatellar joints of eight horses. The analysis of post‐mortem outcomes were compared to defects treated with microfracture in the same animal on the contralateral femoropatellar jointfemoropatellar joint. The overall macroscopic scoring after 12 months yielded higher scores in the OCI‐treated stifles compared to MF treatment (p = 0.09) with better quality and filling of the defect. Histology revealed good anchorage of repair tissue growing into the 3D structure of the implant and histopathology scoring for adjacent native cartilage showed no difference between groups. MRI and micro‐CT showed overall less sclerotic reactions in the surrounding bone in the implant group and no foreign body reaction was detected. Biomechanical analysis of the repair tissue revealed a significantly higher peak modulus (p < 0.05) in the implant group (0.74 ± 0.45) compared to the microfracture control group (0.15 ± 0.11). Dynamic loading yielded higher values for the repair tissue overgrowing the implant group (0.23 ± 0.17) compared to the microfracture control (0.06 ± 0.06) (p < 0.05). The bi‐layered osteochondral implant provided a safe implant for focal repair of full‐thickness osteochondral defects, as no adverse reaction was seen within the joints and the level of degeneration of adjacent cartilage to the repair site was not different compared to that seen in defects treated with microfracture after 12 months. [ABSTRACT FROM AUTHOR]

Background/Objectives: Long-standing groin pain is a severe issue for athletes, often associated with the cleft sign on magnetic resonance imaging (MRI) scans, yet its underlying causes are poorly understood. The purpose of this study is to histologically examine the pubic plate structure in cadavers with and without the cleft sign on MRI, shedding light on the pathology behind the cleft sign. Methods: Three fresh human pelvic cadavers underwent 3.0T MRI to detect the cleft sign before histological dissection of pubic plates. Pubic plate tissues were fixed in formalin, decalcified, and processed. Of the two cleft sign-negative specimens, one was cut into sagittal sections, and the other was cut into coronal sections for histology. For the cleft sign positive specimen, a sagittal section was cut. Moreover, 5 µm thick sections were cut at different axial levels for each orientation. Sections were subjected to Safranin O, Alcian blue, and Herovici's staining or hematoxylin and eosin staining. Results: MRI confirmed that one specimen had a cleft sign in the inferior region on both sides of the pubis and that two specimens had no cleft sign. Both sagittal and coronal sections showed the presence of a cartilage structure continuing from the pubic symphysis to 3 mm laterally within the pubic plate. In the specimen with a positive cleft sign, cartilage damage within the pubic symphysis and pubic plate was identified as revealed by Safranin O staining, Herovici's staining, and H&E staining. Conclusions: This study elucidated the existence of a cartilage component extending from the pubic symphysis to the pubic plate. The cleft sign in MRI correlated with a disruption in the cartilage component in histology within this specific area. [ABSTRACT FROM AUTHOR]

Background: Osteoarthritis (OA) is a complex disease marked by the degradation of articular cartilage. Objective: This study aimed to explore the relationship between cartilage volume/thickness and clinical outcomes in knee OA patients treated with intra-articular injections over one year. Methods: Twenty-four patients with mild-to-moderate OA were retrospectively analyzed using knee MRI. OA features were assessed semiquantitatively with the Whole-Organ Magnetic Resonance Imaging Score (WORMS), while cartilage thickness and volume in the medial femoral condyle (MFC) and medial tibial plateau (MTP) were measured. T1ρ and T2 values for MFC cartilage were also recorded. Clinical outcomes were evaluated using the Korean Western Ontario and McMaster Universities (K-WOMAC) and Knee Injury Osteoarthritis Outcomes (KOOS) scores. Spearman's rank test assessed the associations between imaging changes and clinical outcomes. Results: The baseline MTP and MFC cartilage thickness and MTP cartilage volume showed significant correlations with clinical outcomes. Additionally, less progressive cartilage loss in the medial femorotibial joint (MFTJ) and overall joint was linked to a better clinical response over 12 months. Conclusions: In conclusion, thicker baseline MFTJ cartilage and minimal cartilage loss were associated with favorable clinical outcomes in knee OA patients receiving intra-articular injections. [ABSTRACT FROM AUTHOR]

Cartilage repair remains a major challenge in human orthopedic medicine, necessitating the application of innovative strategies to overcome existing technical and clinical limitations. Adhesive hydrogels have emerged as promising candidates for cartilage repair promotion and tissue engineering, offering key advantages such as enhanced tissue integration and therapeutic potential. This comprehensive review navigates the landscape of adhesive hydrogels in cartilage repair, discussing identified challenges, shortcomings of current treatment options, and unique advantages of adhesive hydrogel products and scaffolds. While emphasizing the critical need for in situ lateral integration with surrounding tissues, we dissect current limitations and outline future perspectives for hydrogel scaffolds in cartilage repair. Moreover, we examine the clinical translation pathway and regulatory considerations specific to adhesive hydrogels. Overall, this review synthesizes the existing insights and knowledge gaps and highlights directions for future research regarding adhesive hydrogel-based devices in advancing cartilage tissue engineering. [ABSTRACT FROM AUTHOR]

Endochondral ossification is the process by which cartilage is mineralized into bone, and is essential for the development of long bones. Osteocalcin (OCN), a protein abundant in bone matrix, also exhibits high expression in chondrocytes, especially hypertrophic chondrocytes, while its role in endochondral ossification remains unclear. Utilizing a new CRISPR/Cas9-mediated bglap–bglap2 deficiency (OCNem) mouse model generated in our laboratory, we provide the first evidence of OCN's regulatory function in chondrocyte differentiation and endochondral ossification. The OCNem mice exhibited significant delays in primary and secondary ossification centers compared to wild-type mice, along with increased cartilage length in growth plates and hypertrophic zones during neonatal and adolescent stages. These anomalies indicated that OCN deficiency disturbed endochondral ossification during embryonic and postnatal periods. Mechanism wise, OCN deficiency was found to increase chondrocyte differentiation and postpone vascularization process. Furthermore, bone marrow mesenchymal stromal cells (BMSCs) from OCNem mice demonstrated an increased capacity for chondrogenic differentiation. Transcriptional network analysis implicated that BMP and TGF-β signaling pathways were highly affected in OCNem BMSCs, which is closely associated with cartilage development and maintenance. This elucidation of OCN's function in chondrocyte differentiation and endochondral ossification contributes to a more comprehensive understanding of its impact on skeletal development and homeostasis. [ABSTRACT FROM AUTHOR]

The existing in vitro and in vivo models for studying osteoarthritis have significant limitations in replicating the complexity of joint tissues. This research aims to validate a Tissue-On-a-Chip system for osteoarthritis research. Osteochondral tissues obtained from knee replacement surgeries of patients with osteoarthritis were cultured in an Organ-On-a-Chip system. This system was designed to supply oxygen and glucose to the cartilage from the bone. The distribution of oxygen and glucose was evaluated by fluorescence using Image-iT Green Hypoxia and 2-NBDG, respectively. Cytotoxicity was measured using lactate dehydrogenase (LDH) levels in chip cultures compared to plate cultures (12 tissues per method). Glycosaminoglycans (GAGs), alkaline phosphatase (ALP), Coll2-1, and procollagen type II N-terminal propeptide (PIINP) were measured in the perfused medium of the Tissue-On-a-Chip over a period of 70 days. Fluorescence of Image-iT Green Hypoxia was observed only in the cartilage area, while 2-NBDG was distributed throughout the tissue. An increase in LDH levels was noted in the plate cultures on day 24 and in the Tissue-On-a-Chip cultures on day 63. Compared to the start of the culture, GAG content increased on day 52, while ALP showed variations. A notable increase in GAG, ALP, and Coll2-1 levels was observed on day 59. PIINP levels remained stable throughout the experiment. The validated osteochondral Tissue-On-a-Chip system can replicate the joint microenvironment, with hypoxic conditions in cartilage and normoxic conditions in bone. Tissue survival and component stability were maintained for approximately two months. This platform is a useful tool for evaluating new drugs and represents a viable alternative to animal models. [ABSTRACT FROM AUTHOR]

Articular cartilage damage and wear can result in cartilage degeneration, ultimately culminating in osteoarthritis. Current surgical interventions offer limited capacity for cartilage tissue regeneration and offer only temporary alleviation of symptoms. Tissue engineering strategies are increasingly recognized as promising modalities for cartilage restoration. Currently, various biological scaffolds utilizing tissue engineering materials are extensively employed in both fundamental and clinical investigations of cartilage repair. In order to optimize the cartilage repair ability of tissue engineering scaffolds, researchers not only optimize the structure and properties of scaffolds from the perspective of materials science and manufacturing technology to enhance their histocompatibility, but also adopt strategies such as loading cells, cytokines, and drugs to promote cartilage formation. This review provides an overview of contemporary tissue engineering strategies employed in cartilage repair, as well as a synthesis of existing preclinical and clinical research. Furthermore, the obstacles faced in the translation of tissue engineering strategies to clinical practice are discussed, offering valuable guidance for researchers seeking to address these challenges. [ABSTRACT FROM AUTHOR]

The repair and regeneration of cartilage is a challenge for scientists and clinical surgery. Achieving cell adhesion and regeneration, anti‐inflammatory, lubrication, targeted drug delivery and controlled release simultaneously in cartilage treatment are the goals of researchers. Polymer composites and hybrids have the potential to realize above functions in cartilage tissue engineering. This review refers to cartilage injuries, current clinical techniques, and their benefits and limitations, focusing on the most relevant and state of art of advanced polymers for cartilage tissue engineering. The frontier applications of multifunctional polymer composites and hybrids in cartilage tissue engineering are discussed in depth, including polymer scaffold, polymer bio‐lubricant, and zwitterionic polymer for drug delivery and sustained drug release. A summary of comprehensive properties of polymers such as processability, mechanical properties, biocompatibility, biodegradability, hydrophilicity, cytotoxicity, etc., and their mechanisms are analyzed. Furthermore, some key challenges and outstanding concerns on polymer‐based materials for cartilage tissue engineering are presented followed by future perspectives. Highlights: The state of art of advanced polymers for cartilage tissue engineering.The advanced bionic property and mechanism of polymer composites and hybrids.Polymers for scaffold, biolubricant, drug delivery, sustained drug release.Future perspectives on polymer composites, hybrids‐based cartilage materials. [ABSTRACT FROM AUTHOR]

Introduction High-rate non-penetrating blunt impacts to the thorax, such as from impacts to protective equipment, can lead to a wide range of thoracic injuries. These injuries can include rib fractures, lung contusions, and abdominal organ contusions. Ovine animals have been used to study such impacts, in a variety of ways, including in silico. To properly model these impacts in silico, it is imperative that the tissues impacted are properly characterized. The objective of this study is to characterize and validate two tissues impacted that are adjacent to the point of impact—costal cartilage and hide. Heretofore, these materials have not been characterized for use in computational models despite their nearly immediate engagement in the high-rate, non-penetrating loading environment. Materials and Methods Ovine costal cartilage and hide samples were procured from a local abattoir following USDA regulations. Costal cartilage samples were then cut into ASTM D638 Type V tensile coupons and compressive disks for testing. The cartilage tensile coupons were tested at 150 ε/s, and the compressive samples were tested at −150 ε/s. Identical coupons and disks were then simulated in LS-Dyna using a hyperelastic material model based on test data and experimental boundary conditions. Hide samples were shaved and cut into ASTM D638 Type V tensile coupons and validated in silico using identical boundary conditions and an Ogden rubber model based on test data. Results The structural responses of costal cartilage and hide are presented and exhibit typical behavior for biological specimens. The respective model fits in LS-Dyna were a hyperelastic- based "simplified rubber" for the costal cartilage and an Ogden rubber for the hide. The costal cartilage had a mean failure strain of 0.094 ± 0.040 in tension and −0.1755 ± 0.0642 in compression. The costal cartilage was also noted to have an order-of-magnitude difference in the stresses observed experimentally between the tensile and compressive experiments. Hide had a mean failure strain of 0.2358 ± 0.1362. The energies for all three simulations showed material stability. Conclusions Overall, we successfully characterized the mechanical behavior of the hide and costal cartilage in an ovine model. The data are intended for use in computational analogs of the ovine model for testing non-penetrating blunt impact in silico. To improve upon these models, rate sensitivity should be included, which will require additional mechanical testing. [ABSTRACT FROM AUTHOR]

Cartilage, a critical tissue for joint function, often degenerates due to osteoarthritis (OA), rheumatoid arthritis (RA), and trauma. Recent research underscores necroptosis, a regulated form of necrosis, as a key player in cartilage degradation. Unlike apoptosis, necroptosis triggers robust inflammatory responses, exacerbating tissue damage. Key mediators such as receptor-interacting serine/threonine-protein kinase-1 (RIPK1), receptor-interacting serine/threonine-protein kinase-3(RIPK3), and mixed lineage kinase domain-like (MLKL) are pivotal in this process. Studies reveal necroptosis contributes significantly to OA and RA pathophysiology, where elevated RIPK3 and associated proteins drive cartilage degradation. Targeting necroptotic pathways shows promise; inhibitors like Necrostatin-1 (Nec-1), GSK'872, and Necrosulfonamide (NSA) reduce necroptotic cell death, offering potential therapeutic avenues. Additionally, autophagy's role in mitigating necroptosis-induced damage highlights the need for comprehensive strategies addressing multiple pathways. Despite these insights, further research is essential to fully understand necroptosis' mechanisms and develop effective treatments. This review synthesizes current knowledge on necroptosis in cartilage degeneration, aiming to inform novel therapeutic approaches for OA, RA, and trauma. [ABSTRACT FROM AUTHOR]

Desbuquois dysplasia type 1 (DBQD1) is a recessive chondrodysplasia caused by mutations in the CANT1 gene, encoding for the Golgi Calcium-Activated Nucleotidase 1 (CANT1). The enzyme hydrolyzes UDP, the by-product of glycosyltransferase reactions, but it might play other roles in different cell types. Using a Cant1 knock-out mouse, we demonstrated that CANT1 is crucial for glycosaminoglycan (GAG) synthesis; however, its impact on the biochemical properties of cartilage proteoglycans remains unknown. Thus, in this work, we characterized decorin and aggrecan from primary chondrocyte cultures and cartilage biopsies of mutant mice at post-natal day 4 by Western blots and further investigated their distribution in the cartilage extracellular matrix (ECM) by immunohistochemistry. We demonstrated that the GAG synthesis defect caused by CANT1 impairment led to the synthesis and secretion of proteoglycans with shorter GAG chains compared with wild-type animals. However, this alteration did not result in the synthesis and secretion of decorin and aggrecan in the unglycanated form. Interestingly, the defect was not cartilage-specific since also skin decorin showed a reduced hydrodynamic size. Finally, immunohistochemical studies in epiphyseal sections of mutant mice demonstrated that the proteoglycan structural defect moderately affected decorin distribution in the ECM. [ABSTRACT FROM AUTHOR]

Nutritional epigenomics is exceptionally important because it describes the complex interactions among food compounds and epigenome modifications. Phytonutrients or bioactive compounds, which are secondary metabolites of plants, can protect against osteoarthritis by suppressing the expression of inflammatory and catabolic mediators, modulating epigenetic changes in DNA methylation, and the histone or chromatin remodelling of key inflammatory genes and noncoding RNAs. The combination of natural epigenetic modulators is crucial because of their additive and synergistic effects, safety and therapeutic efficacy, and lower adverse effects than conventional pharmacology in the treatment of osteoarthritis. In this review, we have summarized the chondroprotective properties of bioactive compounds used for the management, treatment, or prevention of osteoarthritis in both human and animal studies. However, further research is needed into bioactive compounds used as epigenetic modulators in osteoarthritis, in order to determine their potential value for future clinical applications in osteoarthritic patients as well as their relation with the genomic and nutritional environment, in order to personalize food and nutrition together with disease prevention. [ABSTRACT FROM AUTHOR]

Multiple osteochondromas (MO) is an autosomal dominant disorder and the most common genetic skeletal dysplasia, characterized by the growth of bone outgrowths capped by cartilage, called osteochondromas. Most MO cases are caused by mutations in the exostosin-1 (EXT1) and exostosin-2 (EXT2) genes. Only 5% of MO-causative variants are represented by single or multiple exon deletions; to date, no pathogenic large duplication has been described in the literature. In the present study, we describe the novel in-tandem intragenic duplication c.(1128_1202)_(1284+29_1344)dup involving exon 4 of EXT1 (NM_000127.2), detected in a three-generation family with MO. The variant has been detected by MLPA (multiplex ligation-dependent probe amplification) and then confirmed with qPCR (quantitative PCR). Our finding expands the spectrum of MO-causing variants describing a pathogenic large duplication, underlying the importance of quantitative analysis in patients with negative sequencing. [ABSTRACT FROM AUTHOR]

Ewing-like sarcomas (ELS) are round cell mesenchymal neoplasms that are highly aggressive to bone and/or soft tissue. However, they rarely occur in the nose, with no reported such cases in the medical literature to date. Here, we reported the case of a two-year-old Chinese boy who presented with a mass in the left nasal cavity. Surprisingly, the final histopathological diagnosis of the nasal mass was determined to be a subtype of ELS, BCOR -rearranged sarcoma. Therefore, we retrospectively analyzed the clinical data of this case and reviewed the relevant literature on ELS and BCOR -rearranged sarcoma. The purpose of this article is to provide new insights into the clinical characteristics of children with BCOR -rearranged Ewing-like sarcoma and to improve the understanding of this disease. [ABSTRACT FROM AUTHOR]

Recent evidence indicates that the damaged regions in osteoarthritis are accompanied by the accumulation of iron ions. Ferroptosis, as an iron‐dependent form of cell death, holds significant implications in osteoarthritis. Melatonin, a natural product with strong scavenging abilities against reactive oxygen species and lipid peroxidation, plays a crucial role in the treatment of osteoarthritis. This study aims to demonstrate the existence of ferroptosis in osteoarthritis and explore the specific mechanism of melatonin in suppressing ferroptosis and alleviating osteoarthritis. Our findings reveal that melatonin reverses inflammation‐induced oxidative stress and lipid peroxidation while promoting the expression of extracellular matrix components in chondrocytes, safeguarding the cells. Our research has revealed that NADPH oxidase 4 (NOX4) serves as a crucial molecule in the ferroptosis process of osteoarthritis. Specifically, NOX4 is located on mitochondria in chondrocytes, which can induce disorders in mitochondrial energy metabolism and dysfunction, thereby intensifying oxidative stress and lipid peroxidation. LC‐MS analysis further uncovered that GRP78 is a downstream binding protein of NOX4. NOX4 induces ferroptosis by weakening GRP78's protective effect on GPX4 and reducing its expression. Melatonin can inhibit the upregulation of NOX4 on mitochondria and mitigate mitochondrial dysfunction, effectively suppressing ferroptosis and alleviating osteoarthritis. This suggests that melatonin therapy represents a promising new approach for the treatment of osteoarthritis. [ABSTRACT FROM AUTHOR]

Objective To investigate the efficacy of autologous costal cartilage cortex as a nasal tip support and modification graft in improving the nasal tip morphology. Methods From March 2021 to June 2022, 89 patients who underwent rhinoplasty with a focus on nasal tip shaping were enrolled. CT scans were used as an auxiliary examination, and costal cartilage was harvested. The cortical layer of the costal cartilage was shaped into "plate-like" and "cap-like" grafts to sculpt the nasal tip morphology, while expanded polytetrafluoroethylene (ePTFE) or silicone implants were used to elevate the nasal dorsum. Photometric methods were employed to obtain the patients' nasofacial parameters, which were then compared before and after surgery to observe patient satisfaction and the occurrence of complications. Results All 89 patients were followed up for 6 to 24 months, with an average of 9 months. Postoperatively, there were no intranasal occupations or graft protrusions. Patients reported no foreign body sensation in the external nasal valve upon self-examination, and the nasal tip was able to move laterally. The nasal tip exhibited distinct tip-defining points, a full lower lateral cartilage lobule, and no complications such as cartilage visibility, exposure, or infection. Two patients experienced deviation of the nasal columella and asymmetrical nostrils due to unaddressed septal deviation. Measurement results showed significant improvements in postoperative nasal length, nasal tip rotation, nasofrontal angle, and nasal tip projection, with statistically significant differences compared to preoperative values (P<0.05). Conclusion The application of autologous costal cartilage cortex as a nasal tip support and modifying graft to improve nasal tip morphology is a good surgical technique. The shaped nasal tip is soft and movable without affecting the airway, making it worthy of clinical application. [ABSTRACT FROM AUTHOR]

Objective To evaluate the clinical effect of costal cartilage sculpted polygonal nasal tip graft in rhinoplasty. Methods From June 2016 to December 2021, 368 patients with poor nasal tip shape underwent rhinoplasty with costal cartilage sculpted polygonal nasal tip graft. Postoperative complications, incision scar, nasal tip protrusion, nasal tip morphology improvement, and overall satisfaction were evaluated. Results All 368 patients were followed up for 12 to 46 months, and the nasal tip protrusion and shape of the patients improved well. Five patients showed a slight downward rotation of the nasal tip 12 to 19 months postoperation, and 4 patients showed a cartilaginous appearance of the nasal tip 12 to 16 months postoperation, which was improved after the second rhinoplasty. No flap necrosis, infection, delayed incision healing, or other complications occurred, no obvious incision scar formation and nasal tip skewed. Postoperative overall satisfaction was high, including 312 very satisfied cases, 45 satisfied cases, and 11 general cases, the satisfaction rate was 97.0%. Conclusion The application of costal cartilage sculpted polygonal nasal tip grafts in rhinoplasty has the following advantages. The graft is conformed to the anatomical and aesthetic characteristics of the nasal tip, can effectively reduce the height of the nasal tip strut, reduce the incidence of skewness, and reduce the tension of the alar cartilage and mucosa. The postoperative effect is good, the overall satisfaction of patients is high, and it is worthy of clinical popularization and application. [ABSTRACT FROM AUTHOR]

Articular cartilage receives nutrients and oxygen from the synovial fluid to maintain homeostasis. However, compared to tissues with abundant blood flow, articular cartilage is exposed to a hypoxic environment (i.e., physioxia) and has an enhanced hypoxic stress response. Hypoxia-inducible factors (HIFs) play a pivotal role in this physioxic environment. In normoxic conditions, HIFs are downregulated, whereas in physioxic conditions, they are upregulated. The HIF-α family comprises three members: HIF-1α, HIF-2α, and HIF-3α. Each member has a distinct function in articular cartilage. In osteoarthritis, which is primarily caused by degeneration of articular cartilage, HIF-1α is upregulated in chondrocytes and is believed to protect articular cartilage by acting anabolically on it. Conversely, in contrast to HIF-1α, HIF-2α exerts a catabolic influence on articular cartilage. It may therefore be possible to develop a new treatment for OA by controlling the expression of HIF-1α and HIF-2α with drugs or by altering the oxygen environment in the joints. [ABSTRACT FROM AUTHOR]

Inflammation models are widely used in the in vitro investigation of new therapeutic approaches for osteoarthritis. TNFα (tumor necrosis factor alpha) plays an important role in the inflammatory process. Current inflammation models lack uniformity and make comparisons difficult. Therefore, this study aimed to systematically investigate whether the effects of TNFα are concentration-dependent and whether chondrocyte expansion has an effect on the inflammatory model. Bovine chondrocytes were enzymatically isolated, expanded to passages 1–3, and transferred into a 3D pellet culture. Chondrocyte pellets were stimulated with recombinant bovine TNFα at different concentrations for 48 h to induce inflammation. Gene expression of anabolic (collagen 2, aggrecan, cartilage oligomeric protein (COMP)), catabolic (matrix metalloproteinases (MMP3, MMP13)), dedifferentiation (collagen 1) markers, inflammation markers (interleukin-6 (IL-6), nuclear factor kappa B (NFkB), cyclooxygenase-2 (COX), prostaglandin-E-synthase-2 (PTGES2)), and the apoptosis marker caspase 3 was determined. At the protein level, concentrations of IL-6, nitric oxide (NO), and sulfated glycosaminoglycans (GAG) were evaluated. Statistical analysis was performed using the independent t-test, and significance was defined as p < 0.05. In general, TNFα caused a decrease in anabolic markers and an increase in the expression of catabolic and inflammatory markers. There was a concentration-dependent threshold of 10 ng/mL to induce significant inflammatory effects. Most of the markers analyzed showed TNFα concentration-dependent effects (COMP, PRG4, AGN, Col1, MMP3, and NFkB). There was a statistical influence of selected gene expression markers from different passages on the TNFα chondrocyte inflammation model, including Col2, MMP13, IL-6, NFkB, COX2, and PTGES2. Considering the expression of collagen 2 and MMP3, passage 3 chondrocytes showed a higher sensitivity to TNFα stimulation compared to passages 1 and 2. On the other hand, MMP13, IL-6, NFkB, and caspase 3 gene expression were lower in P3 chondrocytes compared to the other passages. On the protein level, inflammatory effects showed a similar pattern, with cytokine effects starting at 10 ng/mL and differences between the passages. TNFα had a detrimental effect on cartilage, with a clear threshold observed at 10 ng/mL. Although TNFα effects showed concentration-dependent patterns, this was not consistent for all markers. The selected passage showed a clear influence, especially on inflammation markers. Further experiments were warranted to explore the effects of TNFα concentration and passage in long-term stimulation. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to prospectively investigate the progression of cartilage thinning in patients with symptomatic rotator cuff tears using MRI. Methods: Two hundred twenty-five consecutive patients with symptomatic rotator cuff tears visited our institute between 2009 and 2019. Of these, 28 shoulders of 27 patients (mean age, 65 years) who underwent at least two magnetic resonance imaging (MRI) examinations were prospectively enrolled. They all received conservative treatment. The mean follow-up was 67 months. Changes in cartilage thickness and the combined cartilage and subchondral bone thickness at the initial and final MRI were measured using a RadiAnt DICOM-viewer (Medixant, Poznan, Poland). The cartilage thickness of the humeral head was measured in the oblique coronal and sagittal images. The glenoid cartilage was measured in the axial and oblique coronal images. Results: At an average period of 5 years, 12 of 28 shoulders (42%) showed more than a 30% decrease in cartilage thickness in the humeral head. The glenoid showed cartilage thinning in only one shoulder (4%). In the humeral head, progressive cartilage thinning was seen mainly in the anterior and posterior parts of the humeral head in the sagittal plane. In the glenoid, progressive cartilage thinning was seen on the entire surface except the posterior area. There was no significant difference in cartilage thickness between the first and final follow-ups for both the humeral head and the glenoid. Conclusions: A total of 12 of 28 shoulders (42%) showed more than a 30% decrease in cartilage thickness in the humeral head, which was mainly observed in the anterior and posterior areas of the humeral head. [ABSTRACT FROM AUTHOR]

Purpose: To describe the clinical outcomes of patients who underwent surgical repair through an anterior approach that involved interposition a posterior cartilage for Type III or Type IV laryngotracheoesophageal cleft (LTEC). Methods: A chart view was performed on patients with Type III or Type IV LTEC between May 2017 and May 2022. Demographic features and surgical outcomes were collected and analyzed. Results: Seven patients were finally included. Five patients were diagnosed with Type III LTEC and two patients were diagnosed with Type IV LTEC. All but one patients survived and thrived. Four patients were able to successfully extubate with acceptable voice, and two patients were tracheostomized. Five patients were deemed safe for all consistencies food and one was safe for thickened food. After a mean follow-up of 49 months (18–83 months), neither complications nor recurrences were observed. Conclusion: An anterior laryngofissure approach to the cleft repair with a posterior cartilage grafting is an effective and safe treatment for Type III or IV LTEC, which enables closure of LTEC and reconstruction of cricoid plate in order to avoid tracheoesophageal fistula formation or subglottic stenosis postoperatively. Severe tracheomalacia and GERD are two main causes for surgical failure. [ABSTRACT FROM AUTHOR]

Background Chronic Otitis Media (COM) is one of the leading causes of hearing loss in the world. Tympanoplasty is the surgical treatment to repair the defective tympanic membrane in such patients. Aim To compare the healing and graft uptake using temporalis fascia versus cartilage perichondrium grafts in tympanoplasty type-1. Method A prospective randomized comparative cohort trial was conducted in the Department of Otorhinolaryngology at a Private Medical College in South India in the year 2020. This study compared the effect of two graft materials, tragal cartilage perichondrium and temporalis fascia, in tympanoplasty and evaluated the post-operative healing, among 60 patients randomized into 2 groups. Results 93% cases belonging to the cartilage perichondrium graft group had formation of neotympanum compared to only 53% cases in Temporalis fascia group. Statistically significant difference between the two groups in terms of formation of neotympanum suggests cartilage perichondrium was better in the aspect of healing and graft uptake. Conclusion Results of this study conclude that tragal cartilage perichondrium is significantly better than temporalis fascia in terms of graft uptake in cases of Type I Tympanoplasty. [ABSTRACT FROM AUTHOR]

Full-endoscopic lumbar interbody fusion (FELIF) is a critical yet challenging procedure. However, extensive analyses of discectomy and cartilage endplate preparation techniques are limited. This can be attributed to the lack of universal protocols owing to diverse surgical practices and equipment preferences. Therefore, this narrative review presents a comprehensive overview of discectomy and cartilage endplate preparation techniques in FELIF. A literature search of the PubMed, Embase, and Google Scholar databases in December 2023 retrieved 490 studies, of which 53 met the predefined inclusion criteria, and 1373 patients were included in the analyses. Spinal endoscopic disc and cartilage endplate removal can be categorized into 2 main types: removal under direct endoscopic visualization and removal under radiographic guidance with the protection of a working sheath following the endoscope's removal. Removal under direct visualization ensures the safety and precision of the procedure. Radiographic guidance can enhance the efficiency of the removal process. Specially designed instruments can be utilized through the narrow working channels of spinal endoscopes for the scraping surgery. Moreover, many traditional spinal endoscopic instruments, through specific techniques and manipulations, can also aid in cartilage removal. The approaches and techniques vary significantly among physicians, but overall, these instruments and techniques aim to achieve a safe and efficient disc-scraping outcome. Thus, this review may offer a comprehensive guidance to surgeons in selecting the most efficient practices for FELIF. Uniform procedural protocols are needed to ensure broader adoption and standardized practice. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this retrospective review was to determine the prevalence of osteochondral lesions (OCLs) of the lateral talar dome in patients with anterior ankle impingement with an associated hypertrophic distal fascicle of the anterior tibio‐fibular ligament. Methods: Retrospective chart review identified 40 patients who underwent anterior ankle arthroscopy for the management of anterior ankle impingement. Clinical outcomes assessed included pre‐ and postoperative foot and ankle outcome score (FAOS), visual analogue scale (VAS), complications, failures, secondary surgical procedures, return‐to‐work data and return‐to‐sport data. Results: Thirty‐two patients with a mean follow‐up time of 29.3 ± 10.4 months were included. The hypertrophic distal fascicle of the anterior tibio‐fibular ligament was hypertrophic in 29 patients (90.6%), with a mean thickness of 2.5 ± 0.4 mm on MRI. There were 22 OCLs of the lateral talar dome (75.9%) with an associated hypertrophic distal fascicle of the anterior tibio‐fibular ligament visualized during arthroscopy. The international cartilage repair society gradings of the lesions included 3 (13.6%) grade I lesions, 15 (68.1%) grade II lesions, 3 (13.6%) grade III lesions, and 1 (4.6%) grade IV lesion. There was a statistically significant improvement in mean FAOS and VAS scores from preoperative to postoperative (p < 0.001). No cases of syndesmotic instability were observed following resection of hypertrophic distal fascicle of the anterior tibio‐fibular ligament. Conclusion: This retrospective case series demonstrated that a hypertrophic distal fascicle of the anterior tibio‐fibular ligament was associated with an OCL of the lateral talar dome identified during arthroscopic evaluation. In addition, preoperative MRI demonstrated poor sensitivity for the detection of these OCLs. Heightened awareness is warranted for potential lateral talar dome OCLs in patients presenting with anterolateral ankle impingement with a hypertrophic ATiFLdf identified on preoperative MRI in the absence of an associated OCLs. Level of Evidence: Level IV, Retrospective case series. [ABSTRACT FROM AUTHOR]