C. Lee (Sacramento, US)UC Davis Health
Presenter Of 3 Presentations
1.3.7 - Diversity, Equity & Inclusion
18.1.8 - Loose Body Versus Trochlear Biopsy MACI MOCART Scores And IKDC Reported Outcomes in Pediatric Patients
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: 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: 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.
P131 - Post-Traumatic Osteoarthritis Progression is Diminished by Early Mechanical Unloading and Anti-Inflammatory Treatment in Mice
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
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.
These data suggest that early unloading following a joint injury can diminish inflammation and can potentially have long-term benefits for joint health.
Meeting Participant Of
NextGen Committee Meeting
- K. Wong (Singapore, SG)
- Y. Lee (Singapore, SG)
- T. Lazzaretti (São Paulo, BR)
- J. Calcei (Cleveland, US)
- F. Attar (Altrincham, GB)
- L. Tirico (Sao Paulo, BR)
- T. Piontek (Poznan, PL)
- B. Di Matteo (Rozzano Milano, IT)
- R. Grabowski (Lodz, PL)
- V. Muthukumar (Chennai, IN)
- J. Chahla (Chicago, US)
- C. Lee (Sacramento, US)