Expression von Signal- und Adhäsionsmolekülen in humanen dermalen mikrovaskulären Endothelzellen nach mechanischer Stimulation der Zellen

In vitro wurde eine mechanische Stimulation humaner dermaler mikrovaskulärer Endothelzellen zur Überprüfung der Aktivierung von Signal- und Adhäsionsmolekülen durchgeführt. Dabei wurden zwei mechanische Stimulationsmethoden verglichen. Zum einen wurden mit einer Anlage zyklische mechanische Kräfte auf die Integrinrezeptoren der Zellen ausgeübt, zum anderen wurden mit dem STREX Cell Strain Instrument die gesamte Zellen gestreckt. Die Aktivierung der Moleküle Erk, Akt und Src sowie von VE-Cadherin, Connexin43 und Caveolin-1 aufgrund mechanischer Kräfte wurden analysiert

Over-optimistic patient expectations of recovery and leisure activities after arthroscopic meniscus surgery

Background and purpose — Patients’ expectations of outcomes following arthroscopic meniscus surgery are largely unknown. We investigated patients’ expectations concerning recovery and participation in leisure-time activities after arthroscopic meniscus surgery and the postoperative fulfillment of these. Patients and methods — The study sample consisted of 491 consecutively recruited patients (mean age 50 (SD 13) years, 55% men) who were assigned for arthroscopy on suspicion of meniscus injury and later verified by arthroscopy. Before surgery, patients completed questionnaires regarding their expectations of recovery time and postoperative participation in leisure activities. 3 months after surgery, the patients completed questionnaires on their actual level of leisure activity and their degree of satisfaction with their current knee function. We analyzed differences between the expected outcome and the actual outcome, and between fulfilled/exceeded expectations and satisfaction with knee function. Results — 478 patients (97%) completed the follow-up. 91% had expected to be fully recovered within 3 months. We found differences between patients’ preoperative expectations of participation in leisure activities postoperatively and their actual participation in these, with 59% having unfulfilled expectations (p < 0.001). Satisfaction with current knee function was associated with expectations of leisure activities being fulfilled/exceeded. Interpretation — In general, patients undergoing arthroscopic meniscus surgery were too optimistic regarding their recovery time and postoperative participation in leisure activities. This highlights the need for shared decision making which should include giving the patient information on realistic expectations of recovery time and regarding participation in leisure-time activities after meniscal surgery

Changes in knee joint load indices from before to 12 months after arthroscopic partial meniscectomy:a prospective cohort study

Patients undergoing arthroscopic partial meniscectomy (APM) are at increased risk of knee osteoarthritis (OA). Meniscal damage and/or surgery may alter knee joint loading to increase OA risk. We investigated changes in knee joint loading following medial APM surgery, compared with the contra-lateral leg

Knee Arthroscopy Cohort Southern Denmark (KACS):protocol for a prospective cohort study

BACKGROUND: Meniscus surgery is a high-volume surgery carried out on 1 million patients annually in the USA. The procedure is conducted on an outpatient basis and the patients leave the hospital a few hours after surgery. A critical oversight of previous studies is their failure to account for the type of meniscal tears. Meniscus tears can be categorised as traumatic or non-traumatic. Traumatic tears (TT) are usually observed in younger, more active individuals in an otherwise ‘healthy’ meniscus and joint. Non-traumatic tears (NTT) (ie, degenerative tears) are typically observed in the middle-aged (35–55 years) and older population but the aetiology is largely unclear. Knowledge about the potential difference of the effect of arthroscopic meniscus surgery on patient symptoms between patients with traumatic and NTT is sparse. Furthermore, little is known about the natural time course of patient perceived pain, function and quality of life after meniscus surgery and factors affecting these outcomes. The aim of this prospective cohort study is to investigate the natural time course of patient-reported outcomes in patients undergoing meniscus surgery, with particular emphasis on the role of type of symptom onset. METHODS/DESIGN: This prospective cohort study enrol patients assigned for meniscus surgery. At the baseline (PRE surgery), patient characteristics are assessed using an email-based questionnaire also comprising several validated questionnaires assessing general health, knee-specific characteristics and patient's expectations of the surgery. Follow-up will be conducted at 12 and 52 weeks after meniscus surgery. The major outcomes will be differences in changes, from before to 52 weeks after surgery, in each of the five domains on the Knee injury and Osteoarthritis Outcome Score (KOOS) between patients undergoing surgery for traumatic compared with non-traumatic meniscus tears. DISSEMINATION: The study findings will be disseminated in peer-reviewed journals and presented at national and international conferences. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Identifier: NCT01871272