• Journal of Veterinary Clinics
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• v.37 no.5
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• pp.261-269
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• 2020

The purpose of this study is to investigate the clinical effects of carboxymethyl chitosan (CMC) and adipose-derived mesenchymal stem cells (MSCs) on osteoarthritis (OA). Thirty New Zealand white rabbits were used as cranial cruciate ligament transection and partial meniscectomy models. The rabbits were divided into five groups (n = 6) according to the intra-articular injection materials: the control group with PBS, the HA group with hyaluronic acid, the CMC group with CMC, the MSC group with MSCs emerged in PBS, and the MSC+CMC group with CMC and MSCs. Knee thickness, extension angle, gross morphology, histopathology and immunohistochemistry were performed to evaluate the effects of CMC and MSCs on rabbit OA. On the morphologic and histologic examination, the articular surfaces of the femur and tibia were markedly damaged in control group with higher Mankin score and lower cartilage surface thickness. However, OA related cartilage defects were alleviated by the treatment of MSC and/or CMC. The expressions of apoptotic and inflammatory cytokines were decreased and cartilage extracellular matrix (ECM) related collagens I and II were enhanced by the treatment of MSC and/or CMC. In conclusion, this study showed that CMC and MSC treatments have a beneficial effects on OA via the protection of cartilage damage, the stimulation of ECM, and the inhibition of inflammatory and apoptotic reaction.

• Journal of the Korean Arthroscopy Society
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• v.13 no.2
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• pp.165-169
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• 2009

The lateral meniscus is morphologically more variable than the medial meniscus. An abnormal lateral meniscus also varies with respect to its size, shape and stability, and such variations can occur in any patient of any age. The most common variant is a discoid lateral meniscus. We recently encountered a patient with a discoid lateral meniscus for which the anterior horn of the meniscus was anomalously inserted into the anterior ACL. The patient was forty five years old women who had persistent pain for three to four years without any specific trauma history. She was preoperatively diagnosed as having discoid lateral meniscus by MRI, and was confirmed the presence of the complex tear and anomalous insertion of the anterior horn of the discoid lateral meniscus into the anterior ACL by arthroscopic examination. Arthroscopic subtotal meniscectomy was performed and the symptoms were improved after surgery.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.160-168
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• 2003

Purpose : To analyze the anterior stability and functional results after the arthroscopic ACL reconstruction and meniscectomy based on meniscus status at the time of surgery. Materials and Methods : From October 1997 to October 2002, 78 patients (male 64 female 14) were treated by arthroscopic ACL reconstruction and meniscectomy and followed more than 12 months (range, $12\~72$ months, average: 32 months). Average age was 32 years old (range, $18\~57$ years old). We divided the patients into 4 groups; Both menisci was intact (BMI, control group), lateral meniscus removed (LMR), medial meniscus removed (MMR) and both menisci removed (BMR). Anterior passive displacement (objective stability) was estimated using KT-2000 arthrometer under the loading of 15lb,20lb and 30lb and evaluated anterior drawer test, Lachman test, range of motion, thigh circumference. Functional evaluation system of IKDC, OAK and Lysholm knee score was used. Results : Average anterior displacement under the loading of 30lb were 2.47 mm, 2.96 mm, 2.96 mm and 3.57 mm in each group(BMI, LMR, MMR, BMR) and it was statistically significant difference (p<0.05). There is no statistically significant difference in average anterior displacement under the loading of 15lb and 20lb in each group but it has showed decreasing tendency in meniscal removed groups. The mean anterior displacement was within 3 mm in 21 cases, 15 cases, 24 cases and 12 cases (total 72 cases, $94\%$) under the loading of 15lb and 20 cases, 15 cases, 24 cases and 11 cases (total 70 cases, $91\%$) under the loading 20lb of in each group and postoperative knee joint stability has showed increasing tendency (p>0.05). The mean score was 94.5, 93.2, 92.2 and 90.4 points in each group and 71 cases $(91\%)$ were more than excellent or good with a OAK score and fair results were noted 4 cases in both meniscal removed group. There were 65 cases $(83\%)$ with a Lysholm knee score more than excellent or good, and IKDC grading were more than normal or nearly normal in 74 cases $(95\%)$ except 4 cases (2 cases in MMR group and 2 cases in BMR group). Conclusion : Long-term anterior stability and functional results of a successful ACL reconstruction affected by tile status of the menisci at the time of surgery and KT-2000 arthrometer was good for estimation of objective follow up.

• Journal of the Korean Arthroscopy Society
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• v.12 no.2
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• pp.125-128
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• 2008

Purpose: The object of this study is to compare the clinical results of noraml saline and Lactated Ringer's solution in the arthroscopic meniscus surgery on the knee. Materials and Methods: The study group included 64 patients who had an medial meniscus tear and received arthroscopic partial medial meniscectomy. The group I was normal saline group, which was used as an irrigation solution during operation. The group II was Lactated Ringer's solution group. We measured the visual analogue scale, painless active knee flexion angle, and the ratio of the knee swelling at postoperative one day for all patients. Results: The visual analogue scale and the painless active knee flexion angle were no significant differences in comparing with normal saline and Lactated Ringer's solution group. The ratio of the knee swelling in Lactated Ringer's solution group was significantly less than those of noraml saline group. Conclusion: Lactated Ringer's solution has an advantage of decreasing the knee swelling in the arthroscopic meniscus surgery on the knee.

• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.2
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• pp.91-97
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• 2010

Purpose: The purpose of this study was to evaluate the results of treatment for longitudinal meniscal tear in ACL rupture patients by clinical evaluation and $2^{nd}$ look arthroscopy. Materials and Methods: Among the patients who underwent surgery due to ACL rupture and longitudinal meniscal tear between 2002~2009, 32 patients were selected for the study. The patients were devided into three groups; group 1 had repair, group 2 had partial menisectomy due to impossible to repair, group 3 had conservative treatment due to stable meniscus. Comparative retrospective analysis was applied with KT 1000 arthrometer, Lysolm' score, Tegner activity score, IKDC subjective score, and $2^{nd}$ look arthroscopy. Results: Lysolm' score, Tegner activity score, IKDC subjective score showed no statistical difference in all three groups. KT-1000 side to side difference improved from 6.2, 6.15, 6.38 before surgery to 2.56, 2.49, 2.58 after surgery in group 1, 2, and 3, respectively. In group 1, second-look arthroscopy revealed complete healing in 12 patients, incomplete healing without any clinical symptoms in 2, and healing failure in 1. In group 2, second-look arthroscopy showed partial regeneration on margin of meniscectomy. In group 3, second-look arthroscopy revealed complete healing in 2 patients, while 4 showed incomplete healing so that have repaired. Conclusion: In the study, the outcome was better when the stable longitudinal meniscal tear on posterior horn with ACL rupture had active treatment.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.2
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• pp.89-94
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• 2009

Purpose: The purpose of this study was to evaluate the factors affecting the treatment results of medial meniscus posterior horn tear. Materials and Methods: Forty seven patients who had been performed the arthroscopic surgery for medial meniscus posterior horn tear were enrolled in this study. We analyzed the clinical outcomes with Lysholm score and Tegner activity score in accordance with the factors such as patients' age, tibiofemoral angle, uptake in bone scintigraphy, surgical methods and patterns of meniscal tears, respectively. Results: The patients' age didn't affect to the results, but the preoperative tibiofemoral angle over valgus $4^{\circ}$ and the preoperative normal uptake in scintigraphic assessment showed a positive influence on the clinical outcomes. The partial meniscectomy and repair in surgical methods had no statistically significance. In addition, the pattern of meniscal tear did not have an effect on the clinical results. Conclusion: We can conclude that many factors should be considered to get satisfactory results. Among them, preoperative bone scintigraphy may be a good assessment factor for the postoperative prognosis, reflecting the condition of meniscal tear and the periarticular bone and soft tissue.

• Journal of the Korean Arthroscopy Society
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• v.14 no.1
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• pp.1-6
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• 2010

This study was undertaken to document the clinical results and technical aspects of arthroscopic repair including popliteus tendon as a post for the treatment of complex lateral meniscus in young people indicated as total meniscectomy. From June 2004 to May 2006, we prospectively studied arthroscopic repairs on 32 young people knees with symptomatic complex lateral meniscus that was treated by all inside repair technique using Popliteus tendon as a post. Clinical results were evaluated using Lysholm knee scores preoperatively and at final follow-up. 2nd look arthroscopy or MRI was taken at final follow-up. 80% of patients carried out MRI or 2nd look arthroscopy under permission. Most patients who follow up were able to return to their previous life activities with little or no limitation, and no reoperation was required after an average follow-up of 42.8 months. Mean Lysholm knee scores improved from 65.4 (range, 55 to 75) preoperatively to 93.9 (range, 79 to 100) at the final follow-up (P<.001). 80% meniscus healing was found on arthroscopic or MRI follow up. Conclusively, arthroscopic repair using Popliteus tendon as a post is effective for treating young people with complex lateral meniscus tear as a salvage procedure.

• Journal of the Korean Arthroscopy Society
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• v.3 no.1
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• pp.62-65
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• 1999

A new method for arthroscopic resection of the inferior leaf for the horizontal tear in the anterior horn of the meniscus extending deep toward the capsule was developed. Resection of this tear is difficult-perhaps more so than any other meniscal tear. At arthroscopy, a small incision on the meniscotibial ligament of the anterior horn was made after the deep horizontal tear was carefully debrided. A retrograde punch was introduced through the incision and underneath the inferior leaf of the anterior meniscus. The inferior leaf of the anterior horn was resected by the punch without difficulty. This simple technique minimizes the risk of superior leaf injury and can be used for a horizontal tear in the anterior horn as well as the mid horn with sweeping motion of the retrograde punch.

• IMMUNE NETWORK
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• v.24 no.2
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• pp.17.1-17.16
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• 2024

We have reported that anterior cruciate ligament (ACL) injury leads to the differential dysregulation of the complement system in the synovium as compared to meniscus tear (MT) and proposed this as a mechanism for a greater post-injury prevalence of post traumatic osteoarthritis (PTOA). To explore additional roles of complement proteins and regulators, we determined the presence of decay-accelerating factor (DAF), C5b, and membrane attack complexes (MACs, C5b-9) in discarded surgical synovial tissue (DSST) collected during arthroscopic ACL reconstructive surgery, MT-related meniscectomy, osteoarthritis (OA)-related knee replacement surgery and normal controls. Multiplexed immunohistochemistry was used to detect and quantify complement proteins. To explore the involvement of body mass index (BMI), after these 2 injuries, we examined correlations among DAF, C5b, MAC and BMI. Using these approaches, we found that synovial cells after ACL injury expressed a significantly lower level of DAF as compared to MT (p<0.049). In contrast, C5b staining synovial cells were significantly higher after ACL injury (p<0.0009) and in OA DSST (p<0.039) compared to MT. Interestingly, there were significantly positive correlations between DAF & C5b (r=0.75, p<0.018) and DAF & C5b (r=0.64 p<0.022) after ACL injury and MT, respectively. The data support that DAF, which should normally dampen C5b deposition due to its regulatory activities on C3/C5 convertases, does not appear to exhibit that function in inflamed synovia following either ACL injury or MT. Ineffective DAF regulation may be an additional mechanism by which relatively uncontrolled complement activation damages tissue in these injury states.

• Journal of Veterinary Clinics
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• v.26 no.2
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• pp.144-149
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• 2009

Chondrocytes and synovial fluid derived markers are used to monitor for osteoarthritis(OA). Specific inhibitors, known as tissue inhibitors of metalloproteinases(TIMP), regulate the proteolytic activity of matrix metalloproteinases(MMP). This study investigated whether MMP and TIMP levels were altered in synovial fluid and cartilage following the experimental induction of OA in canines. Twenty mature beagle dogs underwent a unilateral surgical transection of the cranial cruciate ligament and the medial collateral ligament as well as a medial meniscectomy. Matrix metalloproteinase-2 and MMP-9 levels were assayed using Western blot and TIMP-2 levels were measured with enzyme-linked immunosorbent assays four weeks after OA induction. Increased MMP-2 expression was observed in chondrocytes isolated from cartilage following OA induction, but MMP-9 expression decreased. Matrix metalloproteinase-2 and MMP-9 levels in synovial fluid from the OA induced joint significantly increased compared to those of the sham group. Tissue inhibitors of metalloproteinase-2 concentrations were higher in chondrocytes from the OA cartilage, yet TIMP-2 remained lower in the synovial fluid of OA. This suggests the elevated release of MMP-9 over MMP-2 into the synovial fluid following the cartilage degradation-related death of chondrocytes after OA. Osteoarthritis can be further deteriorated by increased MMP activity in the synovial fluid because TIMP-2 exist low concentration into the extracellular matrix. As a result, MMP activity, particularly MMP-9 activity, can be useful as a biomarker in diagnosing and monitoring the early stages of canine OA.