• Title/Summary/Keyword: Cartilage injury

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Pathophysiology of Articular Cartilage Injury (관절 연골 손상의 병태 생리)

  • Park, Jung-Ho
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.1
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    • pp.6-11
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    • 2005
  • Injury of articular cartilage can be classified into acute injury and chronic degenerative osteoarthritis Acute mechanical trauma on articular cartilage causes injuries that are divided into three distinct types based on the depth of injury: microdamage, chondral fracture, osteochondral fracture and each type has different potential of healing response and long-term prognosis. Articular cartilage undergoes degradation in response to a number of stimuli and eventually degenerative osteoarthritic changes will progress. The extent of initial injury to the articular cartilage is the most important factor affecting the long-term outcome of the healing response and other variables such as the size of lesion, site, age, activity level, obesity, limb alignment are also important factors. In this review, the pathophysiology that occurs within articular cartilage after different injuries and the effect of nonsurgical treatment mainly in physicochemical aspect and biological aspect will be discussed.

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Hypopharyngeal Wall Exposure within the Surgical Field : The Role of Axial Rotation of the Thyroid Cartilage during Anterior Cervical Surgery

  • Choi, Byung-Kwan;Cho, Won-Ho;Choi, Chang-Hwa;Song, Geun-Sung;Kim, Choon-Grak;Kim, Hak-Jin
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.406-411
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    • 2010
  • Objective : Esophageal/hypopharyngeal injury can be a disastrous complication of anterior cervical surgery. The amount of hypopharyngeal wall exposure within the surgical field has not been studied. The objective of this study is to evaluate the chance of hypopharyngeal wall exposure by measuring the amount of axial rotation of the thyroid cartilage (ARTC) and posterior projection of the hypopharynx (PPH). Methods : The study was prospectively designed using intraoperative ultrasonography. We measured the amount of ARTC in 27 cases. The amount of posterior projection of the hypopharynx (PPH) also was measured on pre-operative CT and compared at three different levels; the superior border of the thyroid cartilage (SBTC), cricoarytenoid joint and tip of inferior horn of the thyroid cartilage (TIHTC). The presence of air density was also checked on the same levels. Results : The angle of ARTC ranged from $-6.9^{\circ}$ to $29.7^{\circ}$, with no statistical difference between the upper and lower cervical group. The amount of PPH was increased caudally. Air densities were observed in 26 cases at the SBTC, but none at the TIHTC. Conclusion : Within the confines of the thyroid cartilage, surgeons are required to pay more attention to the status of hypopharynx/esophagus near the inferior horn of the thyroid cartilage. The hypopharynx/esophagus at the TIHTC is more likely to be exposed than at the upper and middle part of the thyroid cartilage, which may increase the risk of injury by pressure. Surgeons should be aware of the fact that the visceral component at C6-T1 surgeries also rotates as much as when the thyroid cartilage is engaged with a retractor. The esophagus at lower cervical levels warrants more careful retraction because it is not protected by the thyroid cartilage.

Protective Effects of Banggi-eum (FangchiYin) on the Articular Cartilage Injuries Induced by Monosodium Iodoacetate in Rats (방기음의 Monosodium Iodoacetate에 의한 관절연골손상 억제효과)

  • Jung, Hae-Chang;Jeong, Su-Hyeon;Seo, Il-Bok
    • Journal of Korean Medicine Rehabilitation
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    • v.24 no.3
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    • pp.39-50
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    • 2014
  • Objectives The objective of this study is to investigate the protective effects of Banggi-eum (FangchiYin) on the articular cartilage injuries in rat model of osteoarthritis. Methods Articular cartilage injury was induced by injection of monosodium iodoacetate (MIA) (0.25 mg) into both knee joint cavities of rats. Rats were divided into control group (n=8) and Banggi-eum (FangchiYin) group (n=8), which was taken extracts of Banggi-eum (FangchiYin) by orally for 20 days. At the end of the experiment (20 days after MIA injection), gross and histopathological examinations on the articular structures of knee joints were performed. Proteoglycan (PG) content in articular cartilages was analyzed by safranin O staining method. And also, tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) and interleukin-$1{\beta}$ (IL-$1{\beta}$) contents in synovial fluid were measured by ELISA method. Results 1. Grossly, the degree of articular cartilage injury in the Banggi-eum (FangchiYin) group was alleviated compared with the control group. 2. PG content in articular cartilage of the Banggi-eum (FangchiYin) group was increased significantly compared with the control group. 3. Histopathologically, osteoarthritic score of the Banggi-eum (FangchiYin) group was decreased significantly compared with the control group. 4. TNF-${\alpha}$ and IL-$1{\beta}$ content in synovial fluid of the Banggi-eum (FangchiYin) group was increased compared with the control group. But there was no significance. Conclusions On the basis of these results, we suggest that Banggi-eum (FangchiYin) have inhibiting effects on the progression of articular cartilage injury in MIA-induced osteoarthritis model.

Current Update of Cartilage Regeneration Using Stem Cells in Osteoarthritis (골관절염에서 줄기세포를 이용한 연골 재생의 최신 지견)

  • Seon, Jong-Keun;Choi, Ik-Sun;Ko, Jee-Wook
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.478-489
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    • 2019
  • Osteoarthritis is a disease characterized by the progression of articular cartilage erosion, that increases pain during joint motion and reduces the ability to withstand mechanical stress, which in turn limits joint mobility and function. Damage to articular cartilage due to trauma or degenerative injury is considered a major cause of arthritis. Numerous studies and attempts have been made to regenerate articular cartilage. In the case of partial degenerative cartilage changes, microfracture and autologous chondrocyte implantation have been proposed as surgical treatment methods, but they have disadvantages such as insufficient mutual binding to the host cells, inaccurate cell delivery, and deterioration of healthy cartilage. Stem cell-based therapies have been developed to compensate for this. This review summarizes the drawbacks and consequences of various cartilage regeneration methods and describes the various attempts to treat cartilage damage. In addition, this review will discuss cartilage regeneration, particularly mesenchymal stem cell engineering-based therapies, and explore how to treat future cartilage regeneration using mesenchymal stem cells.

Bony Fragment Excision Followed by Multiple Drilling and Fragment Fixation Using Bio-absorbable Pins for Bilateral Osteochondral Fracture of the Lateral Talar Dome: A Case Report (양측 족관절에 발생한 외측 거골원개 골연골의 골절에 대한 골편제거 후 다발성 천공술 및 생흡수성 핀을 이용한 골편고정: 증례 보고)

  • Lee, Yong Jae;Suh, Jin Soo;Choi, Jun Young
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.4
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    • pp.201-207
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    • 2019
  • An osteochondral fracture is considered to be an injury involving the cartilage and subchondral bone. Acute traumatic osteochondral fractures can be related to joint instability because abnormal joint motion causes shearing and rotatory stress. Acute osteochondral fractures are frequently missed or misdiagnosed as a pure soft tissue injury. Thus, surgeons' proactive attention is highly required as articular cartilage has limited potential for self-repair and these lesions may develop osteoarthritis. In order to minimize the progression of post-traumatic osteoarthritis, it is important to properly identify and treat osteochondral fractures. Yet, little is known about the operative management of acute osteochondral fractures of the talus. We report here on a case of a middle-aged male with acute osteochondral fractures of the bilateral lateral talar dome. We applied different operative methods on each side with regard to fragment size and stability. A favorable clinical outcome was obtained at 18 months follow-up.

Spontaneously Healed Thyroid Cartilage Fracture with Displacement: Report of a Case (전위를 동반한 갑상연골 골절의 자연 치유 치험 1례)

  • Ryu, Hyun-Ho;Lee, Byung-Kook;Jeung, Kyung-Woon
    • Journal of Trauma and Injury
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    • v.23 no.1
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    • pp.53-55
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    • 2010
  • A thyroid cartilage fracture is a rare entity and can be overlooked easily. Such cases are difficult to diagnose, and assessment and treatment guidelines are difficult to determine. CT of the neck region may be useful when acute airway intervention is not required or when more information regarding the neck's anatomy is required for management decisions. We describe a case of a thyroid cartilage fracture with displacement. In the emergency department (ED), neck CT and fiberoptic nasopharyngoscopy were used to assess the status of the patient's (a male) vocal chords immediately. He remained unable to phonate continuously. After an immediate assessment, we decided to use steroid and conservative therapy. The patient had a good recovery and was without symptoms one month after injury. There is no question that early surgical repair of neck injuries affords the best results for airway and voice patency in most cases however, we suspect that surgical repair is not needed in all cases. Early recognition and an accurate therapy plan for a thyroid fracture with displacement are essential. Therefore, the emergency physician's immediate and careful decision based on endoscopy and neck CT is important for the patient's long-term recovery.

Effect of Bee Venom Herb-acupuncture on the Repair of Articular Full-thickness Defect in Rat (흰쥐 퇴행성 관절염모델을 이용한 봉독약침의 치료효과)

  • Zhao, Mei-Ai;Hahm, Dae-Hyun;Lee, Seung-Ki;Choi, Sun-Mi;Kim, Gun-Ho;Shim, In-Sop;Kang, Sung-Keel;Lee, Hye-Jung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.3
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    • pp.618-622
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    • 2005
  • Articular cartilage is an important target for studying the arthritic diseases. To verify the therapeutic effects of bee venom herb-acupuncture in vivo, 3${\mu}$l of diluted solution of bee venom for herb-acupuncture were injected into articular cavity once a day during 3 months after making full-thickness defects in rat articular cartilage. Histological examination and immunohistochemistry indicated that the chondrocyte-like tissue was formed during the repair process of cartilage injury, and the expression of a cartilage-specific protein, collagen type II, were significantly activated. It means that the expression of the gene encoding type I collagen was down-regulated, whereas those of collagen type II were up-regulated. Histological examination by hematoxylin-eosin staining indicated that the cells regained their original round morphology. In addition, a homogeneous distribution of articular cartilage extracellular matrices was detected around the cells. These results suggested that bee venom herb-acupuncture was very effective on the recovery of articular chondrocyte phenotype.

A Case Report of Focal Ossification of the Auricular Cartilage (귀 연골조직에서 발생한 부분적 골화)

  • Suh, Hyeun Woo;Kim, Hyo Seong;Ha, Ki Young;Han, Eun Mee;Kim, Boo Yeong
    • Archives of Craniofacial Surgery
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    • v.12 no.1
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    • pp.58-62
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    • 2011
  • Purpose: The focal ossification of auricular cartilage is an unusual clinical entity in which the ear becomes partially or totally rigid and immalleable. This condition may result from cold injury, local trauma, inflammation, or various systemic diseases. Patients may feel mild discomfort, but there are usually no other serious symptoms. We present a case of focal ossification of auricular cartilage in which the cause is unknown. Methods: A healthy 58-year-old man presented with a 2-year history of hard mass of right posterior auricular area. He denied any precipitating historical events like cold injury and inflammation. Routine testing did not demonstrate systemic abnormalities. Ultrasonographic examination revealed a $22{\times}10{\times}11mm$ sized heterogenous isoechoic mass showing an acoustic shadow. Results: Excisional biopsy was performed under local anesthesia. Histological examination revealed the ossification with deposition of trabecular bone in normal elastic cartilage. The patient was healed without any problems and satisfied with the result. Conclusion: We report clinical experience of focal ossification of auricular cartilage, which is quite a rare clinical entity. It should be considered that there is the possibility of ossification of cartilage when it meets the benign mass of the ear.