Pattern of joint damage in persons with knee osteoarthritis and concomitant ACL tears.

OBJECTIVE: The aim of this study was to evaluate the morphological changes of the lateral meniscus in end-stage lateral compartment osteoarthritis (OA) of the knee. METHODS: One hundred fifty-eight knee joints from 133 patients that subsequently underwent total knee joint arthroplasty from January 2008 to December 2009 were enrolled. There were 26 men and 107 women. Their ages ranged from 56 to 81 (mean 67.4 + 6.5 years). All study participants had complete obliteration of the lateral joint space identified by weight-bearing radiography. Meniscal position was assessed by measuring meniscal subluxation and meniscal height. The meniscal morphology was assessed using a modification of the whole-organ magnetic resonance imaging score (WORMS). The frequency of different meniscal morphology and their respective positions was calculated. RESULTS: The predominant type (42.4%, 53.8% and 52.5% in the anterior horn, mid-body and posterior horn, respectively) of abnormal meniscal morphology was a complete maceration/destruction or complete resection. The anterior horn of non-macerated lateral meniscus was more subluxed than that of the non-macerated medial meniscus in patients with lateral OA. CONCLUSION: This study suggests that the lateral meniscus in persons with end-stage lateral OA are mostly macerated or destroyed. Also, unlike isolated end-staged medial compartment OA, the anterior horn of the lateral meniscus in isolated end-stage lateral OA is commonly affected. Copyright 2011 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved

Pattern of joint damage in persons with knee osteoarthritis and concomitant ACL tears.

OBJECTIVE: The aim of this study was to evaluate the morphological changes of the lateral meniscus in end-stage lateral compartment osteoarthritis (OA) of the knee. METHODS: One hundred fifty-eight knee joints from 133 patients that subsequently underwent total knee joint arthroplasty from January 2008 to December 2009 were enrolled. There were 26 men and 107 women. Their ages ranged from 56 to 81 (mean 67.4 + 6.5 years). All study participants had complete obliteration of the lateral joint space identified by weight-bearing radiography. Meniscal position was assessed by measuring meniscal subluxation and meniscal height. The meniscal morphology was assessed using a modification of the whole-organ magnetic resonance imaging score (WORMS). The frequency of different meniscal morphology and their respective positions was calculated. RESULTS: The predominant type (42.4%, 53.8% and 52.5% in the anterior horn, mid-body and posterior horn, respectively) of abnormal meniscal morphology was a complete maceration/destruction or complete resection. The anterior horn of non-macerated lateral meniscus was more subluxed than that of the non-macerated medial meniscus in patients with lateral OA. CONCLUSION: This study suggests that the lateral meniscus in persons with end-stage lateral OA are mostly macerated or destroyed. Also, unlike isolated end-staged medial compartment OA, the anterior horn of the lateral meniscus in isolated end-stage lateral OA is commonly affected. Copyright 2011 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved

Side Differences of Thigh Muscle Cross-Sectional Areas and Maximal Isometric Muscle Force in Bilateral Knees with the Same Radiographic Disease Stage, but Unilateral Frequent Pain – Data from the Osteoarthritis Initiative

Objective To determine whether anatomical thigh muscle cross-sectional areas (MCSAs) and strength differ between osteoarthritis (OA) knees with frequent pain compared with contra-lateral knees without pain, and to examine the correlation between MCSAs and strength in painful vs painless knees. Methods Forty-eight subjects (31 women; 17 men; age 45–78 years) were drawn from 4,796 Osteoarthritis Initiative (OAI) participants, in whom both knees displayed the same radiographic stage (KLG2 or 3), one with frequent pain (most days of the month within the past 12 months) and the contra-lateral one without pain. Axial MR images were used to determine MCSAs of extensors, flexors and adductors at 35% femoral length (distal to proximal) and in two adjacent 5 mm images. Maximal isometric extensor and flexor forces were used as provided from the OAI database. Results Painful knees showed 5.2% lower extensor MCSAs (P = 0.00003; paired t-test), and 7.8% lower maximal extensor muscle forces (P = 0.003) than contra-lateral painless knees. There were no significant differences in flexor forces, or flexor and adductor MCSAs (P > 0.39). Correlations between force and MCSAs were similar in painful and painless OA knees (0.44 < r < 0.66). Conclusions Knees with frequent pain demonstrate lower MCSAs and force of the quadriceps (but not of other thigh muscles) compared with contra-lateral knees without knee pain with the same radiographic stage. Frequent pain does not appear to affect the correlations between MCSAs and strength in OA knees. The findings suggest that quadriceps strengthening exercise may be useful in treating symptomatic knee OA

Joint Loading Factors of Articular Cartilage Structure in Healthy and ACL-Injured Knees

Articular cartilage structure and chondrocyte health are sensitive and reliant on dynamic joint loading during activities. The risk of osteoarthritis (OA) is high after anterior cruciate ligament (ACL) injury, but mechanisms underlying its development are poorly understood. The overall goals of this work were 1) to determine the association between measures of individual and cumulative knee joint loading with T2 relaxation times in the knee cartilage of young individuals without injury and 2) to determine if these same knee joint loading factors are associated with cartilage T2 relaxation time one month after ACL injury. The central hypotheses was that lower measures of knee joint loading would be associated with higher (worse) T2 relaxation time throughout the articular cartilage of knees with and without ACL injury. Individuals without a history of knee injury and with an acute ACL injury in the past month served as participants for this study. Participants completed magnetic resonance imaging with T2 mapping, biomechanical gait analysis, and one week of accelerometry during daily living to measure T2 relaxation time, knee joint angles and moments, and daily physical activity levels, respectively. Individual loading factors and cumulative knee joint loading were correlated with higher T2 relaxation times in the articular cartilage of uninjured knees. Altered knee joint adduction moment impulse, less knee flexion excursion, and higher daily physical activity were associated with prolonged T2 relaxation time one month after ACL injury. Gait biomechanics and daily PA may be modifiable targets to alter OA development acutely after ACL injury

From joint anatomy to clinical outcomes in osteoarthritis and cartilage repair: summary of the fifth annual osteoarthritis imaging workshop

SummaryObjectiveThis white paper constitutes an overview of presentations and discussions from the fifth Annual Workshop on Imaging in Osteoarthritis (OA) held in Salzburg June eighth to eleventh 2011.DesignThis workshop brought together the communities of basic OA researchers, orthopedists and rheumatologists, imaging scientists, instrument manufacturers, and pharmaceutical representatives to focus on three overlapping themes of joint anatomy, cartilage repair and clinical validation of imaging biomarkers.ResultsThe workshop was held on the campus of the Paracelsus Medical University in Salzburg, Austria from June 8–11, 2011; 133 attendees participated, representing 17 countries. The meeting was successful in facilitating discussion, raising awareness and consolidating knowledge about application of imaging in OA research studies and cartilage repair.ConclusionsThe OA research communities need to work alongside the regulatory, pharmaceutical, and MRI industries to support the new ideas and engage in the positive reinforcement of resources to further the new studies. A number of new initiatives were discussed to further break down obstacles to clinical trial utility of imaging biomarkers

Knee joint unloading and daily physical activity associate with cartilage T2 relaxation times 1 month after ACL injury

Osteoarthritis (OA) is prevalent after anterior cruciate ligament (ACL) injury, but mechanismsunderlying its development are poorly understood. The purpose of this study was to determine if gait biomechanics and daily physical activity (PA) associate with cartilage T2 relaxation times, a marker of collagen organization and water content, 1 month after ACL injury. Twenty-seven participants (15–35 years old) without chondral lesions completed magnetic resonance imaging, three-dimensional gait analysis, and 1 week of PA accelerometry. Interlimb differences and ratios were calculated for gait biomechanics and T2 relaxation times, respectively. Multiple linear regression models adjusted for age, sex, and concomitant meniscus injury were used to determine the association between gait biomechanics and PA with T2 relaxation times, respectively. Altered knee adduction moment (KAM) impulse, less knee flexion excursion (kEXC) and higher daily step counts accounted for 35.8%–65.8% of T2 relaxation time variation in the weightbearing and posterior cartilage of the medial and lateral compartment (all p ≤.011). KAM impulse was the strongest factor for T2 relaxation times in all models (all p ≤.001). Lower KAM impulse associated with longer T2 relaxation times in the injured medial compartment (β = −.720 to −.901) and shorter T2 relaxation in the lateral compartment (β =.713 to.956). At 1 month after ACL injury, altered KAM impulse, less kEXC, and higher PA associated with longer T2 relaxation times, which may indicate poorer cartilage health. Statement of Clinical Significance: Gait biomechanics and daily PA are modifiable targets that may improve cartilage health acutely after ACL injury and slow progression to OA

Brain and Human Body Modelling 2021

This open access book describes modern applications of computational human modelling to advance neurology, cancer treatment, and radio-frequency studies including regulatory, safety, and wireless communication fields. Readers working on any application that may expose human subjects to electromagnetic radiation will benefit from this book’s coverage of the latest models and techniques available to assess a given technology’s safety and efficacy in a timely and efficient manner. This is an Open Access book

Cultivate Quantitative Magnetic Resonance Imaging Methods to Measure Markers of Health and Translate to Large Scale Cohort Studies

Magnetic Resonance Imaging (MRI) is an indispensable tool in healthcare and research, with a growing demand for its services. The appeal of MRI stems from its non-ionizing radiation nature, ability to generate high-resolution images of internal organs and structures without invasive procedures, and capacity to provide quantitative assessments of tissue properties such as ectopic fat, body composition, and organ volume. All without long term side effects. Nine published papers are submitted which show the cultivation of quantitative measures of ectopic fat within the liver and pancreas using MRI, and the process of validating whole-body composition and organ volume measurements. All these techniques have been translated into large-scale studies to improve health measurements in large population cohorts. Translating this work into large-scale studies, including the use of artificial intelligence, is included. Additionally, an evaluation accompanies these published studies, appraising the evolution of these quantitative MRI techniques from the conception to their application in large cohort studies. Finally, this appraisal provides a summary of future work on crowdsourcing of ground truth training data to facilitate its use in wider applications of artificial intelligence.In conclusion, this body of work presents a portfolio of evidence to fulfil the requirements of a PhD by published works at the University of Salford

Mapping the Impact and Plasticity of Cortical-Cardiovascular Interactions in Vascular Disease Using Structural and Functional MRI

There is growing interest in the role of vascular disease in accelerating age-related decline in cerebrovascular structural and functional integrity. Since an increased number of older adults are surviving chronic diseases, of which cardiovascular disease (CVD) is prevalent, there is an urgent need to understand relationships between cardiovascular dysfunction and brain health. It is unclear if CVD puts the brains of older adults, already experiencing natural brain aging, at greater risk for degeneration. In this thesis, the role of CVD in accelerating brain aging is explored. Because physical activity is known to provide neuroprotective benefits to brains of older adults, the role of physical activity in mediating disease effects were also explored. Using novel neuroimaging techniques, measures of gray matter volume and cerebrovascular hemodynamics were compared between groups of coronary artery disease patients and age-matched controls, to describe regional effects of CVD on the brain. In a sub-set of patients, imaging measures were repeated after completion of a 6-month exercise training, part of a cardiac rehabilitation program, to examine exercise effects. Differences in cerebrovascular hemodynamics were measured as changes in resting cerebral blood flow (CBF) and changes in cerebrovascular reactivity (CVR) to hypercapnia (6% CO2) using a non-invasive perfusion magnetic resonance imaging technique, arterial spin labelling (ASL). We found decreased brain volume, CBF and CVR in several regions of the brains of coronary artery disease patients compared to age-matched healthy controls. The reductions in CBF and CVR were independent of underlying brain atrophy, suggesting that changes in cerebrovascular function could precede changes in brain structure. In addition, increase in brain volume and CBF were observed in some regions of the brain after exercise training, indicating that cardiac rehabilitation programs may have neurorehabiliation effects as well. Since, CBF measured with ASL is not the [gold] standard measure of functional brain activity, we examined the regional correlation of ASL-CBF to glucose consumption rates (CMRglc) measured with positron emission tomography (PET), a widely acceptable marker of brain functional activity. Simultaneous measurements of ASL-CBF and PET-CMRglc were performed in a separate study in a group of older adults with no neurological impairment. Across brain regions, ASL-CBF correlated well with PET-CMRglc, but variations in regional coupling were found and demonstrate the role of certain brain regions in maintaining higher level of functional organization compared to other regions. In general, the results of the thesis demonstrate the impact of CVD on brain health, and the neurorehabiliation capacity of cardiac rehabilitation. The work presented also highlights the ability of novel non-invasive neuroimaging techniques in detecting and monitoring subtle but robust changes in the aging human brain