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Purpose: Due to a lack of consensus regarding effective treatment options in young patients, the indications of meniscal allograft transplantation (MAT) have widened to include those with substantial cartilage disease. The aim of this study was to report the long-term patient-reported outcome measures (PROMs) and allograft survival rates for patients with substantial cartilage disease., Methods: A review of the prospectively maintained database was performed. Patients with International Cartilage Repair Society 3b or above cartilage grading in either their femur or tibia were classified as having substantial cartilage disease. Postoperative International Knee Documentation Committee, Tegner, Knee Injury and Osteoarthritis Outcome Score and Lysholm were compared between those with and without substantial cartilage disease. Kaplan-Meir analysis was used to assess the survival rates. Survival was defined as revision or removal of allograft or conversion to arthroplasty., Results: Data from 422 patients were included in the analysis with 129 patients found to have full-thickness chondral lesions and 281 patients without full-thickness chondral lesions. The mean follow-up was 6.33 (SD 3.48) years for the cohort. The mean age for the entire cohort was 30 (SD 9.23). Patients in substantial cartilage disease group underwent meniscal transplantation at an older age (32 [standard deviation {SD} 8.47] years vs. 29 [SD 9.35] years [p < 0.001]). There was no significant difference in PROMs between the two groups up to 10 years postoperatively (p > 0.05). The substantial cartilage disease group had significantly lower survival rates compared to those without (80.62% vs. 94.32%)., Conclusions: MAT in the context of substantial cartilage disease was associated with an improvement in PROMs up to 10 years with no difference to the group without substantial cartilage disease. The PROMs in combination with the long-term survival rates in this study can be used to counsel patients preoperatively., Level of Evidence: Level IV., (© 2024 European Society of Sports Traumatology, Knee Surgery and Arthroscopy.)

Objectives This study aimed to investigate the relationship between ankle ligamentous injuries and osteochondral defects (OCDs) and to determine the incidence of these conditions within the Saudi Arabian population. Methods This retrospective cohort study included 215 patients (110 males and 105 females) who sought medical advice for an ankle injury at our institute from January 2017 to August 2022. The patients were divided according to age, sex, presence and type of ligamentous injury, and status of OCDs. Patients' ages were categorized into three groups: younger than 30 years (48 patients), 30-60 years (145 patients), and older than 60 years (22 patients). The patients were assessed for ligamentous ankle sprains, tears, and OCDs by reviewing their magnetic resonance imaging reports from radiology records. The exclusion criteria included ankle fracture, ankle surgery, osteoarthritis of the ankle joint, inflammatory arthritis, and congenital deformity of the ankle. The data were collected using a simple questionnaire created via Google Forms. Results Of the 24 patients with OCD, 23 had OCD of the talus. Anterior talofibular ligament (ATFL) injury was the most common injury (75 patients), whereas posterior talofibular ligament (PTFL) injury was the least common. The only significant relationship between ligamentous injury and OCD was observed between PTFL injury and OCD of the talus (P = 0.041). Conclusions In patients with an ankle injury, the most common OCDs occur at the talus, whereas the most injured ligament is the ATFL. Nevertheless, a significant relationship was observed between PTFL injury and OCD of the talus. The findings underscore the importance of considering specific ligament injuries when diagnosing and managing OCDs, especially in patients with chronic ankle pain., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Biomedical Ethics Research Committee of King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia issued approval 526-22. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Reda et al.)

Background: Tissue engineering is the application system that tries to restore damaged tissues by different approaches, such as cellular therapy, application of cell differential factors, and various materials. One of the important goals in tissue engineering is to guide stem cells directly to the desired tissue, and researchers tried to utilize different molecules as effective factors to improve this technique., Objectives: This study aims to demonstrate the effects of diacerein, a slow-acting drug for the treatment of osteoarthritis, on mesenchymal stem cell proliferation and evaluate its potential in the chondrogenesis process., Methods: Stem cells were isolated from adipose tissue, characterized by flow cytometry, and cells were treated with 10-5M diacerein for three weeks. Chondrogenic gene expression of SOX9, COL2A1, ACAN, and TGFB1 were analyzed by qRT-PCR and immunocytochemistry techniques., Results: Our results showed that diacerein increased the expression of the following genes involved in chondrogenesis: SOX9 (2.9-fold, P < 0.00), COL2A1 (2.2-fold, P < 0.00), ACAN (2.7-fold, P < 0.00), and TGFB1 (2.6-fold, P < 0.00). Immunocytochemistry results also showed increased production of collagen type II as the main protein marker for chondrocytes., Conclusions: We observed that diacerein alone could initiate and enhance chondrogenesis, and it can be used as a differentiation factor for stem cells to chondrocyte besides its ability to inhibit IL-1β. Knowing the actual function of diacerein, it could be a good candidate for the treatment of osteoarthritis., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023, Honarpardaz et al.)

Objective: Subcutaneous fat tissue thickness (SFTT) is a representative marker of obesity. This study was performed to determine the relationship between SFTT and chondromalacia patella (CP) through routine 1.5-Tesla magnetic resonance imaging (MRI) of the knee., Methods: In this retrospective cross-sectional study, 440 knee MRI scans were re-examined and divided into those with and without CP. A 1.5-Tesla MRI machine with a standard knee coil was used. Prepatellar SFTT (PSFTT) and medial SFTT (MSFTT) were measured on each MRI scan. PSFTT and MSFTT were compared between patients with and without CP., Results: Both the PSFTT and MSFTT values were significantly higher in patients with than without CP. Women had significantly higher PSFTT and MSFTT values than men. A statistically significant correlation was found between the PSFTT and MSFTT values and the CP grades., Conclusions: The results of this study indicate an association between SFTT and CP. A positive correlation was also found between SFTT and CP severity.

Background: Acute and chronic cartilage injuries are often encountered in professional and recreational athletes. They can compromise the athlete's performance and career and are considered a potential risk factor for early joint degeneration., Objectives: Incidence of cartilage injury in athletes, understanding of cartilage composition, injury mechanism and suitable diagnostic imaging are summarized and established therapeutic procedures, postoperative imaging including detection of relevant complications and assessment of reasonable indications for follow-up examinations are described., Methods: Original research and review articles were analyzed., Results: Cartilage injury can mimic meniscal or ligamentous injury and cannot be ruled out by clinical examination alone. Magnetic resonance imaging (MRI) is the method of choice to (1) detect (sensitivity 87-93%, specificity 94-99%) and grade cartilage lesions to facilitate choice of therapy and (2) to exclude concomitant injuries that require treatment to improve the prognosis of the chosen cartilage therapy. Postoperatively MRI allows noninvasive assessment of the repaired cartilage tissue and is an appropriate method to detect therapeutically relevant complications., Conclusions: Knowledge of mechanisms and appearance of cartilage injuries, current cartilage repair techniques and their imaging is crucial for the medical care of athletes., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Background: To evaluate the clinical outcomes and second-look arthroscopic findings after intra-articular adipose-derived regenerative cell (ADRC) injection as treatment for knee osteoarthritis (OA)., Methods: ADRCs were administered to 11 patients (19 knees; mean age, 61.7 years) with knee OA. Subcutaneous adipose tissue was harvested by liposuction from both thighs, and arthroscopic lavage was performed, followed by ADRC injection (mean dose, 1.40 × 10 7 cells) into the synovial fluid. Outcome measures included the Knee Injury and Osteoarthritis Outcome Score, Lysholm score, and visual analog scale score. Arthroscopic examinations were performed to assess the International Cartilage Repair Society cartilage injury grade preoperatively and overall repair postoperatively. Noninvasive assessments were performed at baseline and at 1-, 3-, and 6-month follow-ups; arthroscopic assessments were performed at baseline and at 6 months., Results: All outcome measures significantly improved after treatment. This improvement was evident 1 month after treatment and was sustained until the 6-month follow-up. Data from second-look arthroscopy showed better repair in low-grade cartilage lesions than in lesions with a greater degree of damage. No patients demonstrated worsening of Kellgren-Lawrence grade, and none underwent total knee arthroplasty during this period., Conclusions: Clinical outcomes were improved in patients with knee OA after ADRC administration. Cartilage regeneration was more effective in smaller damaged lesions than in bigger lesions., Competing Interests: CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported., (Copyright © 2022 by The Korean Orthopaedic Association.)

Objective: The T2 value of lumbar cartilage endplates was measured using the T2 mapping imaging technique, aiming to explore the correlation between the T2 value and Pfirrmann grading of intervertebral discs., Methods: A total of 130 patients with lumbar spine MR examination due to persistent low back pain were enrolled, including 71 men and 59 women (age: 21-63 years). Lumbar Modic changes and Schmorl nodules were recognized by conventional T1WI and T2WI images in 49 patients, and these patients were excluded from the study. A total of 81 patients were enrolled in this study, including 45 men (45.16 ± 12.20 years) and 36 women (43.33 ± 11.27 years). Pfirrmann (Pm) grading of each lumbar disc was performed based on conventional T2WI median sagittal images and the position of cartilage endplates (CEP) was determined by IDEAL-SPGR images. Meanwhile, the T2 mapping technique was used to obtain T2 values of cartilage endplates. The T2 values of CEP corresponding to different Pm grade discs were compared, and the correlation between the T2 value and the Pm grade of intervertebral discs was analyzed., Results: The T2 values of cephalic and caudal CEP of L 1-2 in Pm grades I-II, Pm grades III, and Pm grades IV-V were 61.96 ± 5.89 ms, 54.45 ± 3.29 ms, 42.47 ± 3.69 ms and 64.35 ± 5.93 ms, 55.28 ± 3.97 ms, 44.75 ± 2.12 ms, respectively. For cephalic and caudal CEP of L 2-3 , the T2 values in Pm grades I-II, Pm grades III, and Pm grades IV-V were 62.96 ± 6.93 ms, 55.19 ± 4.02 ms, 48.67 ± 4.56 ms and 65.51 ± 6.49 ms, 57.16 ± 5.55 ms, 52.05 ± 4.20 ms, respectively. The T2 values of cephalic and caudal CEP from L 3-4 to L 5 -S 1 in Pm grades I-II, Pm grades III, and Pm grades IV-V were (63.72 ± 5.76 ms, 53.96 ± 6.52 ms, 48.05 ± 5.00 ms), (65.46 ± 6.37 ms, 55.70 ± 7.50 ms, 48.10 ± 3.27 ms); (66.34 ± 7.68 ms, 56.76 ± 9.48 ms, 47.80 ± 4.33 ms), (64.44 ± 4.65 ms, 59.30 ± 8.80 ms, 47.30 ± 5.78 ms), (65.32 ± 5.11 ms, 55.33 ± 6.65 ms, 48.18 ± 5.37 ms), and (63.47 ± 4.92 ms, 50.32 ± 8.86 ms, 44.77 ± 4.69 ms), respectively. There were significant differences in T2 values of cartilage endplates between the Pm grades I-II, III, and IV-V of intervertebral discs (P = 0.000). T2 values corresponding to Pm I-II grades were higher than those in Pm III grade, while T2 values in Pm grades IV-V were lowest. The T2 value of the L 4-5 , L 5 -S 1 segment endplates was highly correlated with the Pm grades (r = -0.711, -0.721, -0.796, -0.745; P = 0.000) and that of L 1-2 , L 2-3 endplates were moderately correlated (r = -0.542, -0.562, -0.637, -0.612; P = 0.000)., Conclusion: The T2 values of cartilage endplates revealed varying degrees of degeneration of intervertebral discs, and more severe degeneration corresponded to lower T2 values. Measurement of changes in the T2 value through cartilage endplates can be useful for the diagnosis of early intervertebral disc degeneration and the prevention of disc degeneration., (© 2020 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.)

Background: This study aimed to assess a novel ultrasound (US) scanning approach in evaluating knee femoral cartilaginous defects, compared with magnetic resonance imaging (MRI, commonly used for knee imaging) and arthroscopy (gold standard)., Methods: Sixty-four consecutive patients (65 knees) were prospectively evaluated between April 2010 and July 2011., Results: The overall sensitivity (62.2 and 69.4%), specificity (92.9 and 90.5%), accuracy (75.4 and 78.5%), and adjusted positive (88.7 and 90.4%) and negative predictive (69.5 and 73.3%) were similar for both radiologists (weighted κ = 0.76). Furthermore, agreement between grading by US and MRI was substantial (weighted κ = 0.61)., Conclusions: In conclusion, the novel US scanning approach allows similar diagnostic performance compared to routine MRI for knee cartilage defects. US is more accessible, easier to perform, and less expensive than MRI, with potential advantages of easier initial screening and assessment of cartilage defects.