It has been found that obese people have a higher proportion in suffering from osteoarthritis (OA),not only in the weight-bearing joints like knee and hip joints,even in non-weight-bearing joints such as hand joints.O...It has been found that obese people have a higher proportion in suffering from osteoarthritis (OA),not only in the weight-bearing joints like knee and hip joints,even in non-weight-bearing joints such as hand joints.One of the reasons is because the large amount of adipose tissue secretes some factors,which can promote the occurrence of arthritis.As an important structure of the knee joint,the infrapatellar fat pad (IPFP) is actually a piece of adipose tissue.The aim of this review is to offer a comprehensive view of the anatomy and physiological characteristics of IPFP and its relationship with the pathological process of OA,indicating the important function of IPFP in OA.At the same time,with the development of adipose derived stem cells in the treatment of OA,owing to its special advantages,the IPFP is becoming a kind of important,minimally invasive fat stem cell source,providing a new approach for the treatment of OA.We hope that this review will offer an overview of all published data regarding the IPFP and will indicate novel directions for future research.展开更多
Infrapatellar fat pad strain is a common disease and is referred to the chronic cumu-lative lesion of the knee joint, manifested mainly as arthralgia. The author treated 100 cases ofthis disease by noedling Neixiyan(E...Infrapatellar fat pad strain is a common disease and is referred to the chronic cumu-lative lesion of the knee joint, manifested mainly as arthralgia. The author treated 100 cases ofthis disease by noedling Neixiyan(EX-LE 4), Waixiyan and Zusanli (ST 36) and other 38 caseswith combined therapies of acupuncture(of the same three points) and infrared radiation, achiev- ing cure rates of 68% and 71. 1 %, and total effective rates of 93.0% and 92.1% respectively.Comparison between the two groups in cure rate shows no statistical difference (P】0. 05).展开更多
Intra-articular injection of mesenchymal stem cells(MSCs)is a promising strategy for osteoarthritis(OA)treatment.However,more and more studies reveal that the injected MSCs have poor adhesion,migration,and survival in...Intra-articular injection of mesenchymal stem cells(MSCs)is a promising strategy for osteoarthritis(OA)treatment.However,more and more studies reveal that the injected MSCs have poor adhesion,migration,and survival in the joint cavity.A recent study shows that tropoelastin(TE)regulates adhesion,proliferation and phenotypic maintenance of MSCs as a soluble additive,indicating that TE could promote MSCs-homing in regenerative medicine.In this study,we used TE as injection medium,and compared it with classic media in MSCs intra-articular injection such as normal saline(NS),hyaluronic acid(HA),and platelet-rich plasma(PRP).We found that TE could effectively improve adhesion,migration,chondrogenic differentiation of infrapatellar fat pad MSCs(IPFP-MSCs)and enhance matrix synthesis of osteoarthritic chondrocytes(OACs)in indirect-coculture system.Moreover,TE could significantly enhance IPFP-MSCs adhesion via activation of integrin β1,ERK1/2 and vinculin(VCL)in vitro.In addition,intra-articular injection of TE-IPFP MSCs suspension resulted in a short-term increase in survival rate of IPFP-MSCs and better histology scores of rat joint tissues.Inhibition of integrin β1 or ERK1/2 attenuated the protective effect of TE-IPFP MSCs suspension in vivo.In conclusion,TE promotes performance of IPFP-MSCs and protects knee cartilage from damage in OA through enhancement of cell adhesion and activation of integrin β1/ERK/VCL pathway.Our findings may provide new insights in MSCs intra-articular injection for OA treatment.展开更多
目的基于磁共振mDIXON-Quant技术分析膝骨关节炎(knee osteoarthritis,KOA)髌下脂肪垫质子密度脂肪分数(proton density fat fraction,PDFF)改变,及其与KOA严重程度的相关性。材料与方法前瞻性招募44例KOA患者,共计对70例膝关节进行磁...目的基于磁共振mDIXON-Quant技术分析膝骨关节炎(knee osteoarthritis,KOA)髌下脂肪垫质子密度脂肪分数(proton density fat fraction,PDFF)改变,及其与KOA严重程度的相关性。材料与方法前瞻性招募44例KOA患者,共计对70例膝关节进行磁共振常规序列及mDIXON-Quant序列扫描,测量KOA患者髌下脂肪垫PDFF。膝关节采用全器官磁共振评分(whole-organ magnetic resonance imaging score,WORMS)评估受试KOA严重程度。分析各膝髌下脂肪垫PDFF与WORMS 11个特征独立评分及总评分的相关性。结果髌下脂肪垫PDFF与膝关节WORMS总评分、关节软骨完整性、边缘骨赘、关节面下骨磨损、关节面下骨髓异常、关节面下骨囊肿、内外侧半月板完整性、关节内游离体、关节周围囊肿/滑囊炎、前后交叉韧带完整性、滑膜炎/积液(r=-0.94、-0.85、-0.83、-0.80、-0.72、-0.52、-0.54、-0.39、-0.27、-0.27、-0.24,P均<0.05)WORMS评分均呈负相关性;与内外侧副韧带完整性(r=0.27,P=0.826)WORMS评分无显著相关性。观察者间一致性非常好ICC=0.793(P<0.001),95%可信区间为(0.667~0.875)。结论磁共振mDIXON-Quant技术可以定量评估KOA患者髌下脂肪垫PDFF改变,髌下脂肪垫PDFF随着KOA严重程度进展而下降。髌下脂肪垫PDFF可以作为反映KOA严重程度的客观评价指标。展开更多
目的观察健步通络熏蒸液治疗膝关节骨性关节炎(knee osteoarthritis,KOA)的疗效,探讨髌下脂肪垫CT扫描在治疗前后的变化及其与疗效的相关性。方法将105例KOA门诊患者随机分为3组,治疗组35例给予健步通络熏蒸液熏洗,30 min/次,每日1次,1...目的观察健步通络熏蒸液治疗膝关节骨性关节炎(knee osteoarthritis,KOA)的疗效,探讨髌下脂肪垫CT扫描在治疗前后的变化及其与疗效的相关性。方法将105例KOA门诊患者随机分为3组,治疗组35例给予健步通络熏蒸液熏洗,30 min/次,每日1次,10次为1个疗程,共连续治疗3个疗程。对照组35例给予玻璃酸钠关节内注射,每次3 mL,1次/6日,共5次。联合组35例给予健步通络熏蒸液熏洗配合玻璃酸钠关节内注射,治疗方法同前两组。3组皆治疗30天。观察临床疗效及治疗前后髌下脂肪垫CT扫描变化,分析其相关性。结果治疗后联合组总有效率(88.57%,31/35)优于对照组(74.29%,26/35)和治疗组(80.00%,28/35),差异有统计学意义(P<0.05);且联合组美国特种外科医院(hospital for special surgery,HSS)膝关节功能评分优于对照组与治疗组(P<0.05)。治疗组与联合组治疗前后髌下脂肪垫的前后径、内外径、上下径均有缩小,密度均有降低(P<0.05);且联合组和治疗组优于对照组(P<0.05)。结论 CT扫描髌下脂肪垫治疗前后的变化主要存在于有中医药治疗的组内,说明CT扫描变化只与能改变髌下脂肪垫理化性质的疗效有关;而中医药治疗是全面、均衡地调节各组织功能与结构,因此,CT可作为中医药治疗各疾病临床疗效观察的较好检查手段。展开更多
文摘It has been found that obese people have a higher proportion in suffering from osteoarthritis (OA),not only in the weight-bearing joints like knee and hip joints,even in non-weight-bearing joints such as hand joints.One of the reasons is because the large amount of adipose tissue secretes some factors,which can promote the occurrence of arthritis.As an important structure of the knee joint,the infrapatellar fat pad (IPFP) is actually a piece of adipose tissue.The aim of this review is to offer a comprehensive view of the anatomy and physiological characteristics of IPFP and its relationship with the pathological process of OA,indicating the important function of IPFP in OA.At the same time,with the development of adipose derived stem cells in the treatment of OA,owing to its special advantages,the IPFP is becoming a kind of important,minimally invasive fat stem cell source,providing a new approach for the treatment of OA.We hope that this review will offer an overview of all published data regarding the IPFP and will indicate novel directions for future research.
文摘Infrapatellar fat pad strain is a common disease and is referred to the chronic cumu-lative lesion of the knee joint, manifested mainly as arthralgia. The author treated 100 cases ofthis disease by noedling Neixiyan(EX-LE 4), Waixiyan and Zusanli (ST 36) and other 38 caseswith combined therapies of acupuncture(of the same three points) and infrared radiation, achiev- ing cure rates of 68% and 71. 1 %, and total effective rates of 93.0% and 92.1% respectively.Comparison between the two groups in cure rate shows no statistical difference (P】0. 05).
基金supported by CHONGQING TALENTS PROJECT(4246ZJ1)Science and technology projects of Chongqing Education Commission(KJQN202000427).
文摘Intra-articular injection of mesenchymal stem cells(MSCs)is a promising strategy for osteoarthritis(OA)treatment.However,more and more studies reveal that the injected MSCs have poor adhesion,migration,and survival in the joint cavity.A recent study shows that tropoelastin(TE)regulates adhesion,proliferation and phenotypic maintenance of MSCs as a soluble additive,indicating that TE could promote MSCs-homing in regenerative medicine.In this study,we used TE as injection medium,and compared it with classic media in MSCs intra-articular injection such as normal saline(NS),hyaluronic acid(HA),and platelet-rich plasma(PRP).We found that TE could effectively improve adhesion,migration,chondrogenic differentiation of infrapatellar fat pad MSCs(IPFP-MSCs)and enhance matrix synthesis of osteoarthritic chondrocytes(OACs)in indirect-coculture system.Moreover,TE could significantly enhance IPFP-MSCs adhesion via activation of integrin β1,ERK1/2 and vinculin(VCL)in vitro.In addition,intra-articular injection of TE-IPFP MSCs suspension resulted in a short-term increase in survival rate of IPFP-MSCs and better histology scores of rat joint tissues.Inhibition of integrin β1 or ERK1/2 attenuated the protective effect of TE-IPFP MSCs suspension in vivo.In conclusion,TE promotes performance of IPFP-MSCs and protects knee cartilage from damage in OA through enhancement of cell adhesion and activation of integrin β1/ERK/VCL pathway.Our findings may provide new insights in MSCs intra-articular injection for OA treatment.
文摘目的基于磁共振mDIXON-Quant技术分析膝骨关节炎(knee osteoarthritis,KOA)髌下脂肪垫质子密度脂肪分数(proton density fat fraction,PDFF)改变,及其与KOA严重程度的相关性。材料与方法前瞻性招募44例KOA患者,共计对70例膝关节进行磁共振常规序列及mDIXON-Quant序列扫描,测量KOA患者髌下脂肪垫PDFF。膝关节采用全器官磁共振评分(whole-organ magnetic resonance imaging score,WORMS)评估受试KOA严重程度。分析各膝髌下脂肪垫PDFF与WORMS 11个特征独立评分及总评分的相关性。结果髌下脂肪垫PDFF与膝关节WORMS总评分、关节软骨完整性、边缘骨赘、关节面下骨磨损、关节面下骨髓异常、关节面下骨囊肿、内外侧半月板完整性、关节内游离体、关节周围囊肿/滑囊炎、前后交叉韧带完整性、滑膜炎/积液(r=-0.94、-0.85、-0.83、-0.80、-0.72、-0.52、-0.54、-0.39、-0.27、-0.27、-0.24,P均<0.05)WORMS评分均呈负相关性;与内外侧副韧带完整性(r=0.27,P=0.826)WORMS评分无显著相关性。观察者间一致性非常好ICC=0.793(P<0.001),95%可信区间为(0.667~0.875)。结论磁共振mDIXON-Quant技术可以定量评估KOA患者髌下脂肪垫PDFF改变,髌下脂肪垫PDFF随着KOA严重程度进展而下降。髌下脂肪垫PDFF可以作为反映KOA严重程度的客观评价指标。
文摘目的观察健步通络熏蒸液治疗膝关节骨性关节炎(knee osteoarthritis,KOA)的疗效,探讨髌下脂肪垫CT扫描在治疗前后的变化及其与疗效的相关性。方法将105例KOA门诊患者随机分为3组,治疗组35例给予健步通络熏蒸液熏洗,30 min/次,每日1次,10次为1个疗程,共连续治疗3个疗程。对照组35例给予玻璃酸钠关节内注射,每次3 mL,1次/6日,共5次。联合组35例给予健步通络熏蒸液熏洗配合玻璃酸钠关节内注射,治疗方法同前两组。3组皆治疗30天。观察临床疗效及治疗前后髌下脂肪垫CT扫描变化,分析其相关性。结果治疗后联合组总有效率(88.57%,31/35)优于对照组(74.29%,26/35)和治疗组(80.00%,28/35),差异有统计学意义(P<0.05);且联合组美国特种外科医院(hospital for special surgery,HSS)膝关节功能评分优于对照组与治疗组(P<0.05)。治疗组与联合组治疗前后髌下脂肪垫的前后径、内外径、上下径均有缩小,密度均有降低(P<0.05);且联合组和治疗组优于对照组(P<0.05)。结论 CT扫描髌下脂肪垫治疗前后的变化主要存在于有中医药治疗的组内,说明CT扫描变化只与能改变髌下脂肪垫理化性质的疗效有关;而中医药治疗是全面、均衡地调节各组织功能与结构,因此,CT可作为中医药治疗各疾病临床疗效观察的较好检查手段。