Search Results (268)

Degenerative joint disease remains a leading cause of global disability, with early diagnosis posing a significant clinical challenge due to its gradual onset and symptom overlap with other musculoskeletal disorders. This review focuses on emerging diagnostic strategies by synthesizing evidence specifically from studies that integrate biochemical biomarkers, advanced imaging techniques, and machine learning models relevant to osteoarthritis. We evaluate the diagnostic utility of cartilage degradation markers (e.g., CTX-II, COMP), inflammatory cytokines (e.g., IL-1β, TNF-α), and synovial fluid microRNA profiles, and how they correlate with quantitative imaging readouts from T2-mapping MRI, ultrasound elastography, and dual-energy CT. Furthermore, we highlight recent developments in radiomics and AI-driven image interpretation to assess joint space narrowing, osteophyte formation, and subchondral bone changes with high fidelity. The integration of these datasets using multimodal learning approaches offers novel diagnostic phenotypes that stratify patients by disease stage and risk of progression. Finally, we explore the implementation of these tools in point-of-care diagnostics, including portable imaging devices and rapid biomarker assays, particularly in aging and underserved populations. By presenting a unified diagnostic pipeline, this article advances the future of early detection and personalized monitoring in joint degeneration. Full article

Current hydrogels used for cartilage tissue engineering often lack the mechanical strength and structural integrity required to mimic native human cartilage. This study addresses this limitation by developing reinforced hydrogels based on a ternary polymer blend of poly(vinyl) alcohol (PVA), gelatin (GL), and chitosan (CH), with gentamicin sulfate (GS) as an antimicrobial agent and a crosslinker. The hydrogels were produced using two crosslinking methods, the freeze/thaw and heated cycles, and reinforced with forcespun polycaprolactone (PCL) nanofiber to improve mechanical performance. Chemical characterization revealed that GS forms weak hydrogen bonds with the ternary polymers, leading to esterification with PVA, and covalent bonds are formed as the result of the free amino group (-NH₂) of chitosan that reacts with the carboxylic acid group (-COOH) of gelatin. SEM images help us to see how the hydrogels are reinforced with polycaprolactone (PCL) fibers produced via force spinning technology, while mechanical properties were evaluated via uniaxial tensile and compressive tests. Water retention measurements were performed to examine the crosslinking process’s influence on the hydrogel’s water retention, while the hydrogel surface roughness was obtained via confocal microscopy images. A constitutive model based on non-Gaussian strain energy density was introduced to predict experimental mechanical behavior data of the hydrogel, considering a non-monotonous softening function. Loading and unloading tests demonstrated that GS enhanced crosslinking without compromising water retention or biocompatibility because of the reaction between the free amino group of CH and the carboxylic group of gelatin. The PCL-reinforced PVA/GL/CH hydrogel shows strong potential for cartilage repair and tissue engineering applications. Full article

Osteoarthritis (OA) is a leading cause of disability worldwide, with its prevalence rising due to aging populations. Management ranges from conservative treatments such as weight management and pharmacologic therapy to surgical interventions such as total joint replacement. However, treating moderate knee OA remains challenging for patients unresponsive to conservative care but not yet surgical candidates. Genicular artery embolization (GAE) has emerged as a minimally invasive procedure targeting abnormal angiogenesis and inflammation in OA. This article explores GAE’s mechanism, patient-selection criteria, and effectiveness in pain reduction and functional improvement. Studies suggest that GAE has the potential to significantly improve pain and function in mild to moderate OA, with sustained benefits. Patient selection is crucial for optimal outcomes, with imaging playing a key role. While conventional MRI assesses structural damage, Dynamic Contrast-Enhanced MRI (DCE-MRI) offers superior insights by evaluating synovitis, quantifying cartilage degradation, and monitoring treatment response. Due to its strong correlation with pain scores and status as the best surrogate marker for inflammation in synovitis, DCE-MRI holds significant potential to enhance patient selection and treatment monitoring for GAE. Full article

This study developed composite hydrogel scaffolds from chitosan (CS), silk fibroin (SF), and Aloe vera (AV) gel extract for cartilage tissue engineering. SF extracted from Nang-Laai silkworm cocoons showed high protein content (86.8%), while AV extract contained characteristic polysaccharides. Scaffolds with varying CS/SF/AV ratios were fabricated and evaluated for physicochemical and biological properties. Among all formulations, CS40/SF/AV (3.00%wt CS, 2.70%wt SF, 0.075%wt AV) exhibited superior porosity (72.23 ± 4.85%), pore size (79.57 ± 3.68 μm), and compressive strength, both in dry (6.67 ± 1.44 MPa) and wet states. It also showed controlled swelling (270%) and a stable degradation profile (55–57% over 21 days). FTIR and XRD confirmed successful component integration and semi-crystalline structure. In vitro, CS40/SF/AV supported chondrocyte adhesion, proliferation, and morphology retention over 28 days. Fluorescence imaging showed uniform cell distribution across the scaffold. These results highlight the CS40/SF/AV scaffold as a promising, biocompatible platform with optimal mechanical and structural properties for cartilage regeneration, offering potential for further in vivo applications. Full article

Developing a functional tissue-engineered articular cartilage remains a challenge to improving clinical treatment of cartilage injury and joint-related degenerative disease. The dynamic self-regenerating cartilage (dSRC) approach presented here encourages autologous chondrocytes to generate their own matrix rather than imposing a matrix upon them. dSRC constructs were grown for 12 weeks under hypoxic conditions in reciprocating motion. Biochemical composition was evaluated, specifically water, collagen, and proteoglycan content. Speckle rHEologicAl micRoscopy (SHEAR) was utilized for spatially resolved evaluation of the shear modulus in engineered cartilage. Histological and immunohistochemical analyses of dSRC were also performed. The maturation of the dSRC matrix results in collagen and glycosaminoglycan (GAG) levels around 50% of those in native cartilage. SHEAR images demonstrate an increase in shear modulus of the matrix to ~20% that of native cartilage after 12 weeks. Histological support for excellent collagen and GAG production was evident, and immunohistochemistry showed a high preference for hyaline-like type II collagen in the neomatrix. A decrease in chondrocyte density occurred from an initial hypercellular matrix to that approaching native cartilage by 12 weeks. While this maturation of dSRC in vitro should not be construed as an absolute prediction of in vivo performance, these results are encouraging, representing a potential new cartilage repair and regeneration approach. Full article

The Arhgap29 gene encodes Rho-GTPase-activating protein 29 (Arhgap29), which plays a crucial role in embryonic tissue development. Mutations in the Arhgap29 gene are significantly associated with non-syndromic cleft lip and palate (NSCL/P). Our study demonstrated that the deletion of Arhgap29 leads to syndromic cleft lip and palate (SCL/P) characteristics in mice, where, in addition to cleft palate, the mice exhibit craniofacial and systemic skeletal abnormalities. However, the mechanisms underlying these skeletal abnormalities remain unclear. Through micro-CT imaging, histological analysis, and transcriptomic methods, we discovered that the knockout of Arhgap29 delays the fusion of Meckel’s cartilage, widens cranial sutures, reduces bone quality, and alters the expression of osteoblasts and osteoclasts in the mandible. Digit defects, including ectrodactyly and impaired endochondral ossification, were also observed. Immunohistochemical analysis demonstrated the expression of Arhgap29 in both osteoblasts and osteoclasts, indicating its dual role in maintaining matrix homeostasis and regulating bone resorption equilibrium. Transcriptomic analysis revealed disrupted calcium and MAPK signaling pathways, while in vitro studies demonstrated impaired osteogenesis in Arhgap29-deficient calvarial cells, mirroring the in vivo defects. Furthermore, spatial transcriptomics linked the loss of Arhgap29 to defective bone differentiation and protein synthesis. Our findings underscore the critical role of Arhgap29 in the development of the mandible and digits, suggesting its potential as a pathogenic gene associated with syndromic cleft lip and palate (SCL/P). Full article

Orthopedics is undergoing a transformative shift driven by personalized medical technologies that enhance precision, efficiency, and patient outcomes. Virtual surgical planning, robotic assistance, and real-time 3D navigation have revolutionized procedures like total knee arthroplasty and hip replacement, offering unparalleled accuracy and reducing recovery times. Integrating artificial intelligence, advanced imaging, and 3D-printed patient-specific implants further elevates surgical precision, minimizes intraoperative complications, and supports individualized care. In sports orthopedics, wearable sensors and motion analysis technologies are revolutionizing diagnostics, injury prevention, and rehabilitation, enabling real-time decision-making and improved patient safety. Health-tracking devices are advancing recovery and supporting preventative care, transforming athletic performance management. Concurrently, breakthroughs in biologics, biomaterials, and bioprinting are reshaping treatments for cartilage defects, ligament injuries, osteoporosis, and meniscal damage. These innovations are poised to establish new benchmarks for regenerative medicine in orthopedics. By combining cutting-edge technologies with interdisciplinary collaboration, the field is redefining surgical standards, optimizing patient care, and paving the way for a highly personalized and efficient future. Full article

Background:Mesenchymal stem/stromal cells (MSCs) are non-hematopoietic, plastic-adherent, and self-renewing cells capable of in vitro trilineage differentiation into fat, bone, and cartilage tissue. Suggestively, MSCs have additional plasticity, as demonstrated by their ability to differentiate in vitro into myocytes, neuron-like cells, and hepatocytes. MSCs are ideal for therapeutic application owing to their numerous advantages; they exhibit limited growth and differentiation abilities, leading to heterogeneous cell populations with inconsistent functions. However, highly purified MSCs, namely, rapidly expanding clones (RECs) that are isolated by single-cell sorting, display uniform functionality. RECs have the potential to offer many benefits, such as transplantable cells for treating several disorders of bone, heart, peripheral nerves, brain, and other organs. This study aimed to assess the effects of RECs on the pheochromocytoma (PC12) cell line, a well-known neuronal cell model.Methods: PC12 cells were cultured under the following conditions: co-culture with RECs, treatment with REC-derived conditioned medium (CM), or co-culture with RECs using Transwell inserts for 7 days. The cells were stained with anti-βIII-tubulin antibody; the lengths of neurites were measured by image analysis. Results: Regarding the co-culture with RECs, PC12’s outgrowth was significantly increased. The RECs expressed nerve growth factor (NGF), a neurotrophic factor that could act on PC12 cells to trigger cellular differentiation.Conclusions: Our findings suggest that RECs via direct culture, intercellular communication in Transwell culture, and RECs CM promoted PC12 cell survival and outgrowth via NGF signaling. Full article

Knee osteoarthritis (KOA) is a highly prevalent muscoloskeletal joint disorder affecting a significant portion of the population worldwide. Accurate predictions of KOA progression can assist clinicians in drawing preventive strategies for patients. In this paper, we present an integrated approach based on hypergraph convolutional networks (HGCNs) for longitudinal predictions of KOA grades and progressions from MRI images. We propose two novel models, namely, the C_Shape.Net and the predictor network. The C_Shape.Net operates on a hypergraph of volumetric nodes, especially designed to represent the surface and volumetric features of the cartilage. It encompasses deep HGCN convolutions, graph pooling, and readout operations in a hierarchy of layers, providing, at the output, expressive 3D shape descriptors of the cartilage volume. The predictor is a spatio-temporal HGCN network (ST_HGCN), following the sequence-to-sequence learning scheme. Concretely, it transforms sequences of knee representations at the historical stage into sequences of KOA predictions at the prediction stage. The predictor includes spatial HGCN convolutions, attention-based temporal fusion of feature embeddings at multiple layers, and a transformer module that generates longitudinal predictions at follow-up times. We present comprehensive experiments on the Osteoarthritis Initiative (OAI) cohort to evaluate the performance of our methodology for various tasks, including node classification, longitudinal KL grading, and progression. The basic finding of the experiments is that the larger the depth of the historical stage, the higher the accuracy of the obtained predictions in all tasks. For the maximum historic depth of four years, our method yielded an average balanced accuracy (BA) of 85.94% in KOA grading, and accuracies of 91.89% (+1), 88.11% (+2), 84.35% (+3), and 79.41% (+4) for the four consecutive follow-up visits. Under the same setting, we also achieved an average value of Area Under Curve (AUC) of 0.94 for the prediction of progression incidence, and follow-up AUC values of 0.81 (+1), 0.77 (+2), 0.73 (+3), and 0.68 (+4), respectively. Full article

Background and Objectives: The superior thyroid artery (STA) typically has its origin inferiorly to the greater hyoid horn (GHHB) either from the external carotid artery (ECA) or from the carotid bifurcation (CB) or the common carotid artery (CCA). We aimed to determine the topographic variants of the STA related to the GHHB and the artery of origin and to check their bilateral symmetry. Materials and Methods: Determinations were performed in a sample of 85 archived angio CT adult cases, comprising 53 men and 32 women. The origins of the STAs from the CCA/CB/ECA were classified as types A–C. We defined the vertical topographies of the STA as follows in relation to the GHHB: type 1 (infrahyoid), type 2 (hyoid), and type 3 (suprahyoid). Subtypes of the STA course were added: “a”, lateral to the GHHB; “b”, medial; and “c”, posterior to it. Unilateral combinations of types and bilateral associations of these were established. Results: In 170 carotid axes, we detected STA type A in 8.82%, type B in 28.82%, and type C in 60% of cases. It was absent in 2.35% of the cases. The infrahyoid type 1 of STA was found in 47.06% of cases. The hyoid type 2 was found in 20.59% (2a), 0.59% (2b), and 4.71% (2c). The suprahyoid type 3 was found in 21.18% (3a), 0% (3b), and 3.53% (3c). Thirteen unilateral combinations of types were found. The most prevalent ones were C1 (27.71%), C3a (17.47%), and B1 (15.66%). We established thirty-seven bilateral associations of unilateral combinations of types. The cases with asymmetrical bilateral associations of unilateral combinations of types prevailed. A lowered hyoid bone overlapping the thyroid cartilage was found in one of these cases. The prevailing associations were C1-C1 (bilateral infrahyoid origin of the STA from the ECA, 13/85, 15.29%), C3a-C3a (suprahyoid origins of the STAs from the ECAs and lateral courses over the GHHB, 9/85, 10.58%) and C1-B1 (infrahyoid origins from the ECA and CB, 8/85, 9.41%). Conclusions: The vertical topography of the STA is highly variable and hardly predictable but can be examined in imaging studies. The GHHB may be of use to identify and manage the artery. The STA is rarely absent. Full article

Background and Objectives: Chondral and osteochondral lesions can lead to osteoarthritis if untreated, making accurate assessment of cartilage repair outcomes essential for optimizing treatment strategies. The objective of this study was to compare MOCART and MOCART 2.0 and to evaluate the clinical utility of both across different surgical cartilage repair techniques and various time points. Material and Methods: This study included 111 patients (age: 35 ± 10, 35% female) who underwent cartilage repair surgery of the knee between September 2015 and March 2022. A total of 188 postoperative magnetic resonance images were evaluated using MOCART and MOCART 2.0. The correlations between both scores, as well as to the change in Patient-Reported Outcome Measures (PROMs), were determined. Results: MOCART 2.0 scores (66 ± 13) were significantly higher than MOCART scores (58 ± 13, p < 0.001). Positive correlation was observed between scoring systems (r = 0.837, p < 0.001). There was no significant correlation between MOCART or MOCART 2.0 scores and the change in PROMs. Noticeably, there was a statistically significant correlation between both MOCART and MOCART 2.0 in the AutoCart subgroup across multiple timepoints for the change in PROMs. Conclusions: Based on radiographic–clinical outcome discordance, clinicians should not rely solely on MOCART or MOCART 2.0 scores when evaluating cartilage repair success but instead prioritize patient-reported functional improvements while using imaging as a complementary assessment tool. Full article

The proper function and longevity of the knee joint are ensured by the knee menisci. Their susceptibility to damage and injury is one of the main risk factors for rapid cartilage loss and the development of osteoarthritis. The vascularization pattern and nutritional status of a torn meniscus determine its potential for healing and the success of meniscus surgery. Blood supply is a crucial factor in assessing healing potential. Knee cartilage volume loss and its modification often result from meniscal damage or excision, leading to osteoarthritis. Modern methods for preserving meniscal tissue are currently the treatment of choice. Magnetic resonance imaging (MRI) is the gold standard for assessing meniscus lesions. It provides a comprehensive evaluation of tear stability and progression risk. Additionally, it offers high sensitivity and specificity. Arthrography combined with computed tomography (CT) can be used for patients who are unable to undergo MRI. Other methods, such as X-ray and ultrasound, are not useful for the typical diagnosis of meniscal lesions. Minimally invasive surgery has become the gold standard for both treatment and diagnosis. Modern techniques, such as all-inside compression sutures and other suturing techniques, are also considered. In contrast, in the past, open total meniscectomy was routinely performed as the gold standard, based on the mistaken belief that the menisci were functionless. Currently, new treatment methods for meniscal lesions are being explored, including mesenchymal stem cells, synthetic implants, and platelet-rich plasma (PRP). The crucial role of the menisci in knee biomechanics drives the development of modern solutions focused on preserving meniscal tissue. Full article

(1) Background: Osteoarthritis is a degenerative disease of the whole joint marked by cartilage–bone interface (CBI) remodeling, but methods to monitor subtle changes in mineralization are lacking. We optimized a non-destructive ultrasound imaging method to monitor incremental shifts in mineralization, using brief decalcification as a mimetic of CBI remodeling. (2) Methods: We used a 35-MHz transducer to scan 3 mm diameter bovine osteochondral explants wrapped with parafilm to produce surface-directed decalcification and dedicated 3D-printed holders to maintain sample orientation. Customized MATLAB codes and a matched pair design were used for quantitative hypothesis testing. (3) Results: Optimal scan precision was obtained when the High-Frequency Ultrasound (HFUS) focal distance was trained at the CBI. HFUS cartilage thickness increased by 53 ± 21 µm or 97 ± 28 µm after three or seven hours of ethylene diamine tetra-acetic acid (EDTA) (but not PBS), respectively, and was highly correlated with histological cartilage thickness (R = 0.98). The en face CBI backscatter pattern was irregular and shifted after the EDTA-displacement of the mineral front. Collective data suggested that the −10 dB echogenic CBI signal originated from the mineral front and varied topographically with undulating mineral thickness. (4) Conclusions: This imaging approach could be used to monitor tidemark remodeling in live explant cultures, toward identifying new treatments that inhibit tidemark advancement and slow osteoarthritis progression. Full article

The meniscus is a C-shaped connective tissue with a cartilage-like structure in the knee joint. This study proposes an innovative method based on You Only Look Once (YOLO) series models and ensemble methods for meniscus segmentation from knee magnetic resonance imaging (MRI) images to improve segmentation performance and evaluate generalization capability. In this study, five different segmentation models were trained, and masks were created from the YOLO series. These masks are combined with pixel-based voting, weighted multiple voting, and dynamic weighted multiple voting optimized by grid search. Tests were conducted on internal and external sets and various metrics. The dynamic weighted multiple voting method optimized with grid search performed the best on both the test set (DSC: 0.8976 ± 0.0071, PPV: 0.8561 ± 0.0121, Sensitivity: 0.9467 ± 0.0077) and the external set (DSC: 0.9004 ± 0.0064, PPV: 0.8876 ± 0.0134, Sensitivity: 0.9200 ± 0.0119). The proposed ensemble methods offer high accuracy, reliability, and generalization capability for meniscus segmentation. Full article

This narrative review provides an overview of the various diagnostic tools used to assess cartilage health, with a focus on early detection, nutrition intervention, and management of osteoarthritis. Early detection of cartilage damage is crucial for effective patient management. Traditional diagnostic tools like radiography and conventional magnetic resonance imaging (MRI) sequences are more suited to detecting late-stage structural changes. This paper highlights advanced imaging techniques, including sodium MRI, T2 mapping, T1ρ imaging, and delayed gadolinium-enhanced MRI of cartilage, which provide valuable biochemical information about cartilage composition, particularly the glycosaminoglycan content and its potential links to nutrition-related factors influencing cartilage health. Cartilage degradation is often linked with inflammation and measurable via markers like CRP and IL-6 which, although not specific to cartilage breakdown, offer insights into the inflammation affecting cartilage. In addition to imaging techniques, biochemical markers, such as collagen breakdown products and aggrecan fragments, which reflect metabolic changes in cartilage, are discussed. Emerging tools like optical coherence tomography and hybrid positron emission tomography–magnetic resonance imaging (PET-MRI) are also explored, offering high-resolution imaging and combined metabolic and structural insights, respectively. Finally, wearable technology and biosensors for real-time monitoring of osteoarthritis progression, as well as the role of artificial intelligence in enhancing diagnostic accuracy through pattern recognition in imaging data are addressed. While these advanced diagnostic tools hold great potential for early detection and monitoring of osteoarthritis, challenges remain in clinical translation, including validation in larger populations and integration into existing clinical workflows and personalized treatment strategies for cartilage-related diseases. Full article