Nobutake Ozeki1, Takeshi Muneta2, Kenichi Kawabata2, Hideyuki Koga2, Yusuke Nakagawa3, Ryusuke Saito2, Mio Udo2, Katsuaki Yanagisawa2, Toshiyuki Ohara2, Tomoyuki Mochizuki4, Kunikazu Tsuji5, Tomoyuki Saito6, Ichiro Sekiya7. 1. Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Japan; Department of Orthopaedic Surgery, Yokohama City University, Japan. 2. Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Japan. 3. Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Japan; Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Japan. 4. Department of Joint Reconstruction, Graduate School, Tokyo Medical and Dental University, Japan. 5. Department of Cartilage Regeneration, Graduate School, Tokyo Medical and Dental University, Japan. 6. Department of Orthopaedic Surgery, Yokohama City University, Japan. 7. Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Japan. Electronic address: sekiya.arm@tmd.ac.jp.
Abstract
BACKGROUND: Meniscus extrusion often observed in knee osteoarthritis has a strong correlation with the progression of cartilage degeneration and symptom in the patients. We recently reported a novel procedure "arthroscopic centralization" in which the capsule was sutured to the edge of the tibial plateau to reduce meniscus extrusion in the human knee. However, there is no animal model to study the efficacy of this procedure. The purposes of this study were [1] to establish a model of centralization for the extruded medial meniscus in a rat model; and [2] to investigate the chondroprotective effect of this procedure. METHODS: Medial meniscus extrusion was induced by the release of the anterior synovial capsule and the transection of the meniscotibial ligament. Centralization was performed by the pulled-out suture technique. Alternatively, control rats had only the medial meniscus extrusion surgery. Medial meniscus extrusion was evaluated by micro-CT and macroscopic findings. Cartilage degeneration of the medial tibial plateau was evaluated macroscopically and histologically. RESULTS: By micro-CT analysis, the medial meniscus extrusion was significantly improved in the centralization group in comparison to the extrusion group throughout the study. Both macroscopically and histologically, the cartilage lesion of the medial tibial plateau was prevented in the centralization group but was apparent in the control group. CONCLUSIONS: We developed medial meniscus extrusion in a rat model, and centralization of the extruded medial meniscus by the pull-out suture technique improved the medial meniscus extrusion and delayed cartilage degeneration, though the effect was limited. Centralization is a promising treatment to prevent the progression of osteoarthritis.
BACKGROUND: Meniscus extrusion often observed in knee osteoarthritis has a strong correlation with the progression of cartilage degeneration and symptom in the patients. We recently reported a novel procedure "arthroscopic centralization" in which the capsule was sutured to the edge of the tibial plateau to reduce meniscus extrusion in the human knee. However, there is no animal model to study the efficacy of this procedure. The purposes of this study were [1] to establish a model of centralization for the extruded medial meniscus in a rat model; and [2] to investigate the chondroprotective effect of this procedure. METHODS: Medial meniscus extrusion was induced by the release of the anterior synovial capsule and the transection of the meniscotibial ligament. Centralization was performed by the pulled-out suture technique. Alternatively, control rats had only the medial meniscus extrusion surgery. Medial meniscus extrusion was evaluated by micro-CT and macroscopic findings. Cartilage degeneration of the medial tibial plateau was evaluated macroscopically and histologically. RESULTS: By micro-CT analysis, the medial meniscus extrusion was significantly improved in the centralization group in comparison to the extrusion group throughout the study. Both macroscopically and histologically, the cartilage lesion of the medial tibial plateau was prevented in the centralization group but was apparent in the control group. CONCLUSIONS: We developed medial meniscus extrusion in a rat model, and centralization of the extruded medial meniscus by the pull-out suture technique improved the medial meniscus extrusion and delayed cartilage degeneration, though the effect was limited. Centralization is a promising treatment to prevent the progression of osteoarthritis.
Authors: Daniel J Kaplan; David Bloom; Erin F Alaia; William R Walter; Robert J Meislin; Eric J Strauss; Laith M Jazrawi; Michael J Alaia Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-10-15 Impact factor: 4.342
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