Bilateral osteochondral defects of the patellae in an 11-year-old girl

Osteochondral defect or osteochondritis dissecans (OCD) of the knee usually affects young, active populations. It is a challenging diagnosis as patients typically present with poorly localised activity-related pain, which is non-specific and covers many differentials. We present an active 11-year-old girl with bilateral osteochondral defects of the patellae: a rare clinical disorder which was affecting her sporting activities. She had a 12-month history of bilateral anterior knee pain before the diagnosis was achieved with appropriate imaging. Her pain significantly improved with activity modification and physiotherapy. Follow-up will require outpatient clinic assessment and imaging to determine if non-operative management continues to be successful or surgery may be required. This case report emphasises the importance of appropriate high index of suspicion when managing patients with non-specific knee pain. It also demonstrates the importance of judicious use of imaging to avoid a missed or delayed diagnosis

Tibial osteotomy as a mechanical model of primary osteoarthritis in rats

This study has presented the first purely biomechanical surgical model of osteoarthritis (OA) in rats, which could be more representative of the human primary disease than intra-articular techniques published previously. A surgical tibial osteotomy (TO) was used to induce degenerative cartilage changes in the medial knee of Sprague-Dawley rats. The presence of osteoarthritic changes in the medial knee compartment of the operated animals was evaluated histologically and through analysis of serum carboxy-terminal telepeptides of type II collagen (CTX-II). In-vivo biomechanical analyses were carried out using a musculoskeletal model of the rat hindlimb to evaluate the loading conditions in the knee pre and post-surgically. Qualitative and quantitative medial cartilage degeneration consistent with OA was found in the knees of the operated animals alongside elevated CTX-II levels and increased tibial compressive loading. The potential avoidance of joint inflammation post-surgically, the maintenance of internal joint biomechanics and the ability to quantify the alterations in joint loading should make this model of OA a better candidate for modeling primary forms of the disease in humans

Development of an experimental method for well-controlled blast induced traumatic limb fracture in rats

Heterotopic ossification (HO) is a consequence of traumatic bone and tissue damage, which occurs in 65% of military casualties with blast-associated amputations. However, the mechanisms behind blast-induced HO remain unclear. Animal models are used to study blast-induced HO, but developing such models is challenging, particularly in how to use a pure blast wave (primary blast) to induce limb fracture that then requires an amputation. Several studies, including our recent study, have developed platforms to induce limb fractures in rats with blast loading or a mixture of blast and impact loading. However, these models are limited by the survivability of the animal and repeatability of the model. In this study, we developed an improved platform, aiming to improve the animal's survivability and injury repeatability as well as focusing on primary blast only. The platform exposed only one limb of the rat to a blast wave while providing proper protection to the rest of the rat's body. We obtained very consistent fracture outcome in the tibia (location and pattern) in cadaveric rats with a large range of size and weight. Importantly, the rats did not obviously move during the test, where movement is a potential cause of uncontrolled injury. We further conducted parametric studies by varying the features of the design of the platform. These factors, such as how the limb is fixed and how the cavity through which the limb is placed is sealed, significantly affect the resulting injury. This platform and test setups enable well-controlled limb fracture induced directly by pure blast wave, which is the fundamental step towards a complete in vivo animal model for blast-induced HO induced by primary blast alone, excluding secondary and tertiary blast injury. In addition, the platform design and the findings presented here, particularly regarding the proper protection of the animal, have implications for future studies investigating localized blast injuries, such as blast induced brain and lung injuries