Diss. (sammanfattning) Umeå : Univ., 2006. / Härtill 4 uppsatser.

Thesis (M.S.)--Mississippi State University. Department of Agricultural and Biological Engineering. / Title from title screen. Includes bibliographical references.

Chronic patellar tendinopathy is a degenerative tendon disorder characterized by chronic activity-related, anterior knee pain associated with localized tenderness, swelling and impaired performance, which is a common clinical problem in athletes. The pathogenesis of patellar tendinopathy is still largely unknown, although tendon overuse is the most commonly suggested etiological factor, and treatment is usually symptomatic. / Histopathologically, the predominant feature of patellar tendinopathy is tendinosis, which is characterized by progressive tissue degeneration with a failed healing response and the absence of inflammatory cells. Hypercellularity with non-tenocyte phenotype cells and tissue metaplasia, including hyaline metaplasia, fibrocartilaginous metaplasia and bony metaplasia were observed in clinical patellar tendinopathy samples. The degeneration of patellar tendon in patellar tendinopathy is an active cell-mediated process rather than a passive degenerative process. Using a patellar tendinopathy animal model, we observed the presence of chondrocytic and osteoblastic phenotype / markers in patellar tendinopathy samples with or without ossification, which was consistent with the findings in clinical samples. Interestingly, chondrocyte makers were expressed by healing tendon cells at week 2 which became round prior to their expression in the chondrocyte-like cells at week 4. This leads us to speculate that erroneous differentiation of tendon-derived stem cells (TDSCs) identified recently in tendon tissues by our group, to chondrocyte / osteoblasts, due to alteration of mechanical and biological microenvironment during overuse, may lead to the ectopic chondro-ossification and failed healing in patellar tendinopathy. Osteo-chondrogenic BMPs, such as BMP-2, BMP-4 and BMP-7 might be possible factors regulating the osteo-chondrogenic differentiation of TDSCs in the pathogenesis of patellar tendinopathy. / In conclusion, our results have provided new insights about the pathological mechanisms of patellar tendinopathy involving the resident stem cells, osteo-chondrogenic BMPs and mechanical overloading. Erroneous differentiation of TDSCs to chondrocytes / osteoblasts due to ectopic osteo-chondrogenic BMP-2 expression, which were induced by repetitive tensile loading stimulation, might account for the chondro-ossification and failed healing in patellar tendinopathy. Re-directing of stem cells for tenogenic differentiation by blocking the ectopic expression of osteo-chondrogenic BMPs may help to promote tendon healing in patellar tendinoapthy. / In this study, we hypothesized that (1) TDSCs isolated from pathological patellar tendon of the CI model will exhibit higher osteogenic and chondrogenic differentiation potential but lower proliferative capacity compared to TDSCs isolated from healthy patellar tendon. Rat pathological tendon in our collagenase-induced failed healing animal model will harbor more TDSCs compared to healthy patellar tendon. (2) Osteo-chondrogenic BMPs, such as BMP-2, BMP-4, and BMP-7, will be expressed ectopically in both preclinical and clinical samples of patellar tendinopathy. (3) BMP-2 will promote osteo-chondrogenic differentiation and inhibit tenogenic differentiation of TDSCs in vitro. (4) Repetitive tensile loading will increase the expression of BMP-2 in TDSCs in vitro. / Our results showed that TDSCs isolated from the collagenase-induced tendinopathic patellar tendon of the animal model exhibited higher osteogenic/chondrogenic differentiation potential as well as lower proliferative capacity, supporting that there might be some defects in the TDSCs from the animal model, which might undergo osteo-chondrogenic differentiation and hence reduced the pool of TDSCs for tendon repair in the development of patellar tendinopathy. The higher clonogenicity and increased yield of TDSCs in tendinopathic patellar tendon might be caused by a compensation for the impaired differentiation potential and proliferative capacity of TDSCs. The histopathological features of our clinical patellar tendinopathy were characterized by tissue degeneration. Non-tenocyte phenotype cells and tissue metaplasia, such as chondrocyte-like cells and endochondral ossification were also observed. We observed the ectopic expression of osteo-chondrogenic BMP-2, BMP-4 and BMP-7 in both our animal model and clinical samples of patellar tendinopathy, which might trigger the erroneous differentiation of TDSCs to non-tenocytes. Indeed, we further showed that BMP-2 could promote the osteo-chondrogenic and inhibit tenogenic differentiation of TDSCs in vitro, which might provide a possible explanation for ectopic chondro-ossification and failed healing in patellar tendinopathy. In addition, our results also showed that in vitro repetitive cyclic tensile loading could increase the expression of BMP-2 in TDSCs, which might provide a possible explanation for the ectopic expression of BMP-2 in patellar tendinopathy. / This study aimed to compare the osteogenic / chondrogenic differentiation potential, proliferative capacity and yield of TDSCs isolated from rat healthy patellar tendon and pathological tendon in our collagenase-induced failed tendon healing animal model of patellar tendinopathy in vitro. The histopathological characteristics of our clinical patellar tendinopathy with or without ossification were examined. The ectopic expression of BMP-2, BMP-4, and BMP-7 in both human and rat samples of patellar tendinopathy was also examined. The effects of BMP-2 on the osteogenic, chondrogenic and tenogenic differentiation of TDSCs was further investigated in vitro. The effect of repetitive tensile loading on the expression of BMP-2 in TDSCs was studied in vitro. / Rui, Yunfeng. / Advisers: Kai Ming Chan; Po Yee Lui. / Source: Dissertation Abstracts International, Volume: 73-06, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 172-193). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

Le développement du membre passe par des étapes complexes de polarisation, dans les axes dorso-ventral et antéro-postérieur, qui ont lieu en parallèle de la croissance proximo-distale du bourgeon. Le déterminisme génétique de ces étapes est encore imparfaitement connu. Il implique des facteurs de transcription dont l’expression est temporo-spatiale spécifique, compliquant leur identification. L’étude de cohortes homogènes de patients porteurs d’anomalies développementales des membres est l’un des moyens d’identifier de nouveaux mécanismes impliqués dans leur modélisation. A cet effet, nous avons étudié des patients atteints de Syndrome Nail-Patella correspondant à un défaut de polarisation dorso-ventrale ; une grande famille de polydactylie préaxiale syndromique et une série de patients atteints de Syndrome de Nager comme modèles d’étude de la polarisation antéro-postérieure ; et enfin une cohorte de patients présentant des pieds et mains fendus correspondant à un défaut de la signalisation proximo-distale. Ces travaux nous ont permis de souligner le rôle crucial de la régulation d’expression génique dans la modélisation du bourgeon de membre et plus généralement dans le développement embryonnaire. / Limb development requires complex patterning along dorso-ventral, antero-posterior and proximo-distal axes. The molecular mechanisms underlying these stages are not fully delineated yet. Identification of the transcription factors involved is challenging because of their spatio-temporally restricted expression during limb bud development. Analysis of carefully selected series of patients affected with limb malformations is a clue to identify new mechanisms involved in this patterning. For this purpose, we studied several families presnsenting with Nail-Patella Syndrome corresponding to a disorder of dorso-ventral polarization; a large family affected with syndromic preaxial polydactyly and a series of Nager Syndrome cases as models of antero-posterior polarization; eventually, a cohort of patients affected with split hand/foot malformations corresponding to a defect in the signalisation center of proximo-distal growth and differenciation. This work has led us to emphasize the crucial role of gene expression regulation during limb bud patterning and more generally during embryological development.

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2006 18, xvii, 157, 14 leaves, Annexures A-K / The aim of this study was to assess the inter-examiner reliability of motion palpation of the patella, in both pathological (osteoarthritis) as well as functional (patellofemoral pain syndrome) conditions, in order to assess the validity of this assessment tool, which is commonly used as a method in identifying restricted patella motion.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2008. / There are mechanical loads applied to the patella tendon in almost all sporting activities and as a result is commonly injured (Peterson and Renström, 2003:321). Patellar tendinopathy is a common chronic tendinopathy (Hamilton and Purdman, 2004) and occurs commonly in athletes who impose rapid eccentric loading of the knee extensor mechanism (Norris, 2004:246). Deep Transverse Friction Massage (DTFM) and soft tissue mobilization are the two most common forms of manual therapy used to treat patellar tendinopathy (Rees et al., 2006). DTFM is considered the most effective treatment for patellar tendinopathy (Brunker and Khan, 2002:487). It is theorised that DTFM causes the softening of scar tissue and the breakdown of adhesions, promoting the realignment of disrupted connective tissue fibrils within the affected tendon (Stasinopoulos and Johnson, 2007). Graston Instrument Assisted Soft Tissue Mobilization (GIASTM) consists of a set of stainless steel instruments (Carey 2003:2) and is an advanced form of soft tissue mobilization used in detecting and releasing scar tissue, adhesions and fascial restrictions (Carey, 2003:7). The controlled microtrauma created by these instruments is hypothesised to create a localised inflammatory response (Hammer, 2004) in a similar mechanism to that of DTFM. The aim of this study was to determine the relative effectiveness of GIASTM versus DTFM in treating patellar tendinopathy. The study included a total of twenty-six knees among twenty-one patients. Patients were placed randomly into either the GIASTM group or the DTFM group. Each patient received a total of twelve treatments over a three month period. Algometer and inclinometer readings were recorded at set intervals and compromised objective measures. Two questionnaires and a numerical pain rating scale (NRS) were administered at set intervals and compromised subjective measures. SPSS version 13.0 (SPSS Inc., Chicago, Illinois, USA) was used to analyse the data. Repeated measures ANOVA was used to examine changes in quantitative outcomes over the time points (intragroup analysis) and a treatment effect (intergroup analysis). To control for the partial pairing in the intergroup analysis, a variable which classified each subject as paired (both left and right knee used in study) or non-paired (only used once in study) was used as a factor in the model. Correlations between the intragroup changes in the various outcome variables were assessed using Pearson’s correlation coefficients. Statistical analysis of both objective and subjective data revealed significant improvements for most outcome measures in the study. Findings imply that GIASTM is as effective as DTFM in treating patellar tendinopathy.

ACL injury has been shown to have long-lasting and severe consequences on the different structures of the knee such as the articular cartilage and meniscus. Cartilage thickness changes in particular are indicative of osteoarthritic changes in the tibiofemoral joint. While there has been significant research focused on cartilage changes of the tibia and femur, there has been little work looking at patellar cartilage. The following goals were set forth for this study. First, to establish a robust coordinate system to accurately determine the location and orientation of the patella. Secondly, to determine the effects of ACL injury on patellar cartilage thickness. Twenty-one individuals (10 males, 11 females) were studied. All individuals had suffered first time ACL injuries to one of their knees. MRI data from both the healthy and injured knees were collected an average of 4 ± 0.9 years. Using MRI data, the bone and cartilage surfaces were manually segmented and imported into MATLAB for study. Differences in cartilage thickness values between the healthy and unhealthy knees within individuals was the primary measure of analysis. Analysis revealed a total of 9 square millimeters of cartilage surface area that were statistically significant. Four square millimeters of significant difference were found in males in the medial superior compartment, (mean thickness difference = -0.381 mm, with SD = 0.084mm, indicating thinning). Five square millimeters of significant difference were found in females in the medial inferior compartment (mean thickness difference = 0.551 mm, SD = 0.015mm, indicating thickening). This suggests regional and sex related cartilage thickness changes occur following ACL injury, surgery, and 4 year follow-up.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2006. / The aim of this study was to assess the inter-examiner reliability of motion palpation of the patella, in both pathological (osteoarthritis) as well as functional (patellofemoral pain syndrome) conditions, in order to assess the validity of this assessment tool, which is commonly used as a method in identifying restricted patella motion. / M

Author: Bc. Petra Mertová Title: The effect of kinesiotape application on rheological properties of the knee joint with chondromalacia patellae Problem definition: Chondromalacia patellae is a very frequent diagnosis related to knee injuries. Diagnosing chondromalacia is very difficult. Knee arthroscopy is the best method for evaluating the cartilage condition, however this technique is invasive. Kinesiotaping is a therapeutic method extensively used to affect knee pain. Patellar taping is an effective method in improving symptoms resulting from patellofemoral joint problems, nevertheless the evaluation of its effect has not yet been objectively investigated. Aim of the thesis: The aim of this study is firstly to discover the possibility to noninvasively detect chondromalacia patellae using the method of biorheometry and secondly to discover the impact of kinesiotaping on rheological properties of the knee joint with chondromalacia patellae. Method: The designed experiment was performed as a pilot case study using the method of biorheometry. The history of the patient was monitored using a questionnaire and by a clinical examination of the knee joint. Two questionnaires were created to evaluate the functional state of the knee joint. Measurements were done on a special device called biorheometer....

O objetivo deste trabalho foi avaliar a membrana de celulose bacteriana associada a células mesenquimais, que foram inoculadas juntamente com derivado do ácido hialurônico, hylano G-F 20, em patelas lesadas de suínos. Foram utilizados 12 suínos (24 joelhos) submetidos à raspagem das superfícies articulares das patelas até osso esponjoso; joelhos esquerdos sem tratamento, grupo controle (GC). Joelhos direitos, grupo tratado (GT), tiveram membranas de celulose bacteriana fixadas às superfícies de suas patelas, sendo que as mesmas foram preparadas com inoculação de células mesenquimais, ósseas e cartilaginosas, provenientes das raspagens das superfícies, lavadas em solução fisiológica 0,9%, filtradas e diluídas em 5 ml de solução fisiológica à 0,9% e posteriormente acrescentados 2 ml de hylano G-F 20. Colhidos 5 ml dessa papa que teve contido o volume de 16,35 x \'10 POT.8\' células na sua totalidade, e foram infiltrados na membrana de celulose revestindo a patela, obedecendo a distribuição de 3,27 x \'10 POT.8\' por 1,2 \'CM POT.3\'. Após 2, 4 e 6 meses os animais foram sacrificados para avaliações macroscópicas e histológicas. As superfícies patelares apresentaram aspecto de neoformação de cartilagem aos dois meses; essas membranas evoluíram para tecido fibroso de altíssima resistência, com densidade de fibras conjuntivas aumentando proporcionalmente ao tempo de cirurgia, quatro ou seis meses conforme as células do infiltrado tiveram alterações morfológicas para fibroblastos Ao mesmo tempo, parte do volume dessas células sofreu processo de degeneração e morte celular, semelhante ao mecanismo de apoptose celular. Dessa forma, ofereceu substratos para as células remanescentes, colaborando para a neoformação desse tecido conjuntivo. Não ocorreram processos inflamatórios ou agressão às cartilagens em contigüidade à membrana. Pelo contrário, em relação ao grupo controle não tratado, a membrana de celulose bacteriana utilizada segundo a metodologia aplicada, atuou com uma barreira protetora para agressões maiores à cartilagem da fossa intercondilar do fêmur que manteve a integridade de seus contornos articulares. Desta forma, segundo a metodologia utilizada, concluímos que a membrana de celulose bacteriana apresentou biocompatibilidade para uso articular, hábil para agregar condrócitos e fibroblastos. / The goal of this work was to evaluate the bacterial cellulose membrane associated with mesenchymal cells, which were inoculated with hyaluronic acid derivative, G-F 20 hylano in patelas injured pigs. 12 pigs were used (24 knees) submitted to the scraping of the articular surfaces of spongy bone patelas up; knees left without treatment, group controller (GC). Knees rights, treated group (GT), bacterial cellulose membranes had fixed on their surfaces patelas, being that they were prepared with inoculation of mesenchymal cells, bone and cartilage from sweeps of surfaces, washed in 0.9% saline solution, filtered and diluted in 5 ml of saline solution to 0.9% and subsequently added 2 ml hylano G-F 20. Collected 5 ml that Pope had contained the volume 16.35 x \'10 POT.8\' cells in its entirety, and were infiltrated in the membrane of cellulose coating the patella, obeying distribution 3.27 x \'10 POT.8\' per 1.2 \'CM POT.3\'. After 2, 4 and 6 months the animals were sacrificed to macroscopic and histological evaluations. The surfaces patellar components submitted aspect of neoplasm of cartilage to two months; These membranes evolved into fibrous tissue resistance of high density fibrous tears increasing in proportion to the time of surgery, four or six months as had infiltrated cells for morphological changes while fibroblasts, part of the volume of these cells suffered process of degeneration and cell death, similar to the mechanism of cellular apoptosis. This way, offered substrates for the remaining cells, collaborating for this connective tissue neoplasm. There were no inflammatory processes or aggression on cartilage in adjacency to the membrane. On the contrary, compared to the untreated control group, the bacterial cellulose membrane used according to the methodology applied, served with a protective barrier for larger aggressions of cartilage of the femur intercondilar trench that maintained the integrity of its articular contours. This way, according to the methodology, we found that the bacterial cellulose membrane biocompatibility presented for use articulate, skilled to aggregate condrócitos and fibroblasts.