Anterior cruciate ligament resection and medial meniscectomy result in multifocal cartilage degenerations

Damage to the meniscus and the anterior cruciate ligament alters the pattern of loading in the knee joint and frequently leads to cartilage degeneration and osteoarthritis. This study aimed to evaluate the area of greatest impact after traumatic osteoarthritic induction at the knee joint in sheep model. Osteoarthritis was induced unilaterally at the right hind knee of six sheep by surgical resection of the anterior cruciate ligament and medial meniscus. After 3 weeks recovery period, sheep were exercised once daily by running a 100 meters distance on a hard surface for 3 weeks. Gross and histological assessments were done. Six regions examined were; the patella, patella femoral groove, medial femoral condyle, lateral femoral condyle, medial tibia plateau and lateral tibia plateau. Their mean International Cartilage Repair Society grading was: 2.5±0.42, 3.3±0.17, 2.25±0.38, 1.33±0.25, 2±0.37 and 1.5±0.22 respectively. The control from all samples scored zero at the above regions. The lesions at various regions were significantly higher compared to the control (p < 0.05). Patella femoral groove was significantly higher compare to all other regions except for Patella. Lateral femoral condyle was the least (p < 0.05). Histological staining revealed defined osteoarthritic changes. Total excision of medial meniscus and anterior cruciate ligament followed by exercise regime induced osteoarthritis in the affected knee joint. The changes in pattern of degeneration, affected patella femoral groove the most; followed by the patella and medial femoral condyle, then medial tibia plateau, lateral tibia plateau and lastly the lateral femoral condyle

Improved functional recovery of osteoarthritic knee joint after treatment with chondrogenically induced multipotent cells

The aim of this study was to quantify the functional improvements of osteoarthritic (OA) knee joints after treatment with chondrogenically induced pluripotent stem cells. OA was induced in the right knee joints by the resection of the anterior cruciate ligament and medial meniscus. Nine sheep were divided equally into 3 groups. Two treatment groups received either autologous chondrogenically induced adipose-derived stem cells (ADSCs) or bone marrow stem cells (BMSCs), while the control group received basal medium. Electromyography evaluations (EMGs) were conducted at week 0 (pre-OA), 8 (post-OA) and 24 (post-treatment), and compared to ascertain recovery in joint function. Multifocal subchondral lesions were developed after OA inductions and the treatment groups demonstrated the presence of regenerated neocartilages, evidenced by the presence of PKH26 tracking dye. Post-treatment EMGs showed that the controls retained significant reductions in amplitude compared to the pre-OA values, whereas ADSCs and BMSCs samples had no further significant reductions in amplitude post treatments (p<0.05). ADSCs and BMSCs treated knee joints had structural regeneration of cartilage; confirmed by PKH26 dye. The EMG analysis provided evidence of functional recovery associated to the structural regenerations

Strides towards the realization of cure for cartilage defects and osteoarthritis: the limitation and regulatory challenges

Despite remarkable mechanical durability and strength, hyaline cartilage has very limited capacity for self-repair when injured and over time, may degenerate to osteoarthritis. We evaluated the most significant mile stones attained, in the pursuit of cure for cartilage defects and osteoarthritis. The basic treatment options include: Natural or physical therapy, medications, nutritional supplements, nutriceuticals and chondroprotective agents. Next are repairs and replacements, which include surgical procedures: Debridement/chondroplasty, microfracturing, mosaicplasty, periosteum transplantation, osteochondral autografting and allografting, high tibial osteotomy and total knee arthroplasty. But, current trend has shifted from repair, replacement, to most recently regeneration. Regenerations include the cell and gene therapies. While cell therapy involves the use of cells isolated from different tissues to cause regeneration of cartilage; gene therapy involves the selection of appropriate gene and optimal vector to incorporate cDNA. There has been much positivity reported with big animal models, which has led to several ongoing clinical trials. Translations of these findings hold high promises, though not without inherent regulatory hurdles. Considering the initial success rates, there are increasing hopes of realizing these treatments from bench to bedsides. Significant improvements in the treatment of cartilage degenerations and osteoarthritis have been made so far, but no gold standard delineated

Application of stem cells in tissue engineering for defense medicine

Abstract The dynamic nature of modern warfare, including threats and injuries faced by soldiers, necessitates the development of countermeasures that address a wide variety of injuries. Tissue engineering has emerged as a field with the potential to provide contemporary solutions. In this review, discussions focus on the applications of stem cells in tissue engineering to address health risks frequently faced by combatants at war. Human development depends intimately on stem cells, the mysterious precursor to every kind of cell in the body that, with proper instruction, can grow and differentiate into any new tissue or organ. Recent reports have suggested the greater therapeutic effects of the anti-inflammatory, trophic, paracrine and immune-modulatory functions associated with these cells, which induce them to restore normal healing and tissue regeneration by modulating immune reactions, regulating inflammation, and suppressing fibrosis. Therefore, the use of stem cells holds significant promise for the treatment of many battlefield injuries and their complications. These applications include the treatment of injuries to the skin, sensory organs, nervous system tissues, the musculoskeletal system, circulatory/pulmonary tissues and genitals/testicles and of acute radiation syndrome and the development of novel biosensors. The new research developments in these areas suggest that solutions are being developed to reduce critical consequences of wounds and exposures suffered in warfare. Current military applications of stem cell-based therapies are already saving the lives of soldiers who would have died in previous conflicts. Injuries that would have resulted in deaths previously now result in wounds today; similarly, today’s permanent wounds may be reduced to tomorrow’s bad memories with further advances in stem cell-based therapies