C. Lee (Sacramento, US)

UC Davis Health
Dr. Cassandra A. Lee is an Orthopaedic Surgeon with subspecialty certification in sports medicine. She is the Chief of the Sports Medicine Service and an Associate Professor of Orthopaedics at the University of California Davis Health System. She currently serves as team physician for collegiate and professional teams including the University of California at Davis Aggies and the Sacramento Republic FC. Dr. Lee earned her Bachelor of Arts degree with Summa Cum Laude distinction and Doctor of Medicine degree at Boston University. She completed her residency training at Wake Forest University and sports medicine fellowship at Washington University in St. Louis; serving as team physician for the Washington University Bears; St. Louis Rams; and St. Louis Blues. Dr. Lee was awarded the ICRS -Zimmer scholarship Program in 2013 and the Lars Petersen Travelling Fellowship in 2017. Her clinical interests are in sports related shoulder and knee injuries with an emphasis on joint preservation of the knee. Her research interests are in ligament engineering and management and modulation of post-traumatic osteoarthritis.

Presenter Of 3 Presentations

Extended Abstract (for invited Faculty only) Basic Science

1.3.7 - Diversity, Equity & Inclusion

Presentation Topic
Basic Science
Date
12.04.2022
Lecture Time
12:28 - 12:38
Room
Bellevue
Session Type
Special Session
Disclosure
Grant/Research support - NIAMS/NIH, United States Department of Defense Consultant/Speakers Bureau - Smith and Nephew, Vericel
Podium Presentation Cartilage /Cell Transplantation

18.1.8 - Loose Body Versus Trochlear Biopsy MACI MOCART Scores And IKDC Reported Outcomes in Pediatric Patients

Presentation Topic
Cartilage /Cell Transplantation
Date
14.04.2022
Lecture Time
15:09 - 15:18
Room
Bellevue
Session Type
Free Papers
Disclosure
No Significant Commercial Relationship

Abstract

Purpose

Background/Purpose: The goal of this study was to compare radiographic and patient reported outcomes at a minimum of two-years post matrix-induced chondrocyte implantation (MACI) between standard intercondylar region biopsy and osteochondral loose body biopsy.

Methods and Materials

Methods: A retrospective study was performed on all pediatric ACI procedures from 2014 to 2017 at a single institution. Patients were split into two groups: one group had cartilage derived from a standard intercondylar biopsy (n=9), and the other group had cartilage derived from osteochondral loose bodies found withing the ipsilateral knee (n=10). At a minimum one-year post-implantation, MRIs of the operative knee were performed and three individual orthopaedic surgeons used the MOCART 2.0 knee score to assess the cartilage. Interclass correlation coefficients (ICC) were calculated between the two groups. International Knee Documentation Committee (IKDC) scores were determined at a minimum two-years after implantation. Differences between outcomes were compared using a Wilcoxon rank-sum test.

Results

Results: The ICC between examiners for the MOCART scoring was excellent at 0.94. With regards to the MOCART score, the loose body group had an insignificant 17-point lower median score at 63 (IQR 59-89) compared to the intercondylar group at 80 (IQR 65-09) (p=0.151). With regards to the IKDC, the loose body group had an insignificant 2-point lower median score at 82 (IQR 65-95) compared to the intercondylar group at 84 (IQR 53-99) (p=0.902).

Conclusion

Conclusion: These results demonstrate that osteochondral loose bodies can be used as viable biopsies in MACI with no difference in functional and radiographic outcomes at two-years post-implantation. This may limit short and long term donor site morbidity.

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Poster Osteoarthritis

P131 - Post-Traumatic Osteoarthritis Progression is Diminished by Early Mechanical Unloading and Anti-Inflammatory Treatment in Mice

Presentation Topic
Osteoarthritis
Date
13.04.2022
Lecture Time
09:30 - 09:30
Room
Exhibition Foyer
Session Name
7.3 - Poster Viewing / Coffee Break / Exhibition
Session Type
Poster Session
Disclosure
Grant/Research Support - NIAMS/NIH

Abstract

Purpose

Post-traumatic osteoarthritis (PTOA) is a degenerative joint disease that is initiated by a traumatic joint injury. Current treatments during the early phase (<7 days) post-injury aim to reduce pain and inflammation through rest (unloading) and non-steroidal anti-inflammatory drug (NSAID) treatment, but how those early phase interventions impact long-term PTOA progression is unknown. We hypothesized that early unloading and NSAID treatment would both diminish joint inflammation and slow PTOA progression

Methods and Materials

In this study, we use a noninvasive anterior cruciate ligament rupture (ACL-R) mouse model to investigate whether PTOA progression can be slowed with early phase hindlimb unloading (HLU) and/or daily celecoxib (CXB) treatment following ACL-R. Inflammatory protease activity was evaluated using in vivo fluorescence imaging, osteophyte formation and epiphyseal trabecular bone microstructure were quantified using micro-computed tomography, and synovitis and PTOA progression were examined using whole-joint histology at 0, 7, 14, 21, and 28 days post-injury

Results

Hindlimb unloading significantly reduced protease activity and synovitis in injured joints during the unloading period, but these returned to control levels during subsequent reloading. Similarly, trabecular bone volume was partially preserved in injured limbs with HLU, but returned to control values with reloading. Mineralized osteophyte volume was significantly reduced at 21 and 28 days post-injury by both HLU and CXB, but there was not a synergistic effect of these treatments. Similarly, HLU delayed PTOA progression in injured knee joints.

Conclusion

These data suggest that early unloading following a joint injury can diminish inflammation and can potentially have long-term benefits for joint health.

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