Bisphosphonates inhibit bone resorption by affecting osteoclastic function and formation of osteoclasts from their precursor cells. Chondroclasts have the same origin and differentiation as osteoclasts. Thus, it is hypothesized that bisphosphonate can affect on cartilage metabolism. This study was aimed to elucidate effects of alendronate, a nitrogen containing bisphosphonate, on cartilage development in the tibial proximal and femoral distal epiphyseal plates in rats. Alendronate (1 mg/kg) was subcutaneously administered in growing rat pups for 10 days. Several parameters such as the number and size of chondroclasts, involved in cartilage resorption, size of secondary ossification center and thickness of cartilage cell layers were measured and analysed by histomorphometry. The size of the secondary ossification centers in the tibial proximal and femoral distal epiphysis was smaller in the alendronate treated group (p< 0.01). The number of osteoclasts in the both the ossification centers and chondroclasts beneath the epiphyseal plates was significantly decreased by alendronate treatment (p< 0.01). The size of chondroclasts was not significantly changed (p> 0.05). The thickness of proliferating cartilage layer was not changed, but by contrast, hypertrophied cartilage layer was increased in thickness by alendronate treatment. These findings suggest that bisphosphonates can affect cartilage cell metabolism in a chondroprotective way.
Alendronate ; Animals ; Bone Resorption ; Cartilage ; Diphosphonates ; Epiphyses ; Growth Plate* ; Knee Joint* ; Knee* ; Metabolism ; Nitrogen ; Osteoclasts ; Rats*

OBJECTIVE: To observe the therapeutic effects of different waves of electroacupuncture (EA) on knee osteoarthritis (KOA), and to explore the mechanism of different waves of EA on promoting cartilage repair. METHODS: Ninety- seven patients with KOA were randomly divided into a dilatational wave group (32 cases, 2 cases dropped off), a continuous wave group (32 cases, 2 cases dropped off) and a discontinuous wave group (33 cases, 3 cases dropped off). The same acupoints of Xuehai (SP 10), Liangqiu (ST 34), Dubi (ST 35) and Neixiyan (EX-LE 4) were selected in the three groups. The dilatational wave (frequency of 2 Hz/10 Hz) was used in the dilatational wave group, the continuous wave (frequency of 10 Hz) was used in the continuous wave group, and the discontinuous wave (frequency of 10 Hz) was used in the discontinuous wave group. All the needles were retained for 30 min. All the treatment was given 3 times a week (on Monday, Wednesday and Friday) for 4 weeks. Lysholm knees scoring scale (LKSS) was used to evaluate the knee joint function before and after treatment, and the content of transforming growth factor-β1 (TGF-β1) in the joint effusion before and after treatment was determined by enzyme-linked immunosorbent assay (ELISA). RESULTS: Compared before treatment, the total score and each score of LKSS were increased after treatment in the three groups (all <0.05). The improvements of total score, pain score, instability score, swelling score of LKSS in the continuous wave group and the dilatational wave group were superior to those in the discontinuous wave group (all <0.05). The content of TGF-β1 in the joint effusion in each group was increased after treatment (<0.05), and the improvement in dilatational wave group was superior to thoes in the continuous wave group and the discontinuous wave group (all <0.05). CONCLUSION The three different waves of EA could all improve the clinical symptoms of KOA, which may promote cartilage repair by increasing TGF-β1 content. The dilatational wave had the best overall effect, which can be used as a clinical optimal treatment.
Acupuncture Points ; Electroacupuncture ; Humans ; Knee Joint ; Osteoarthritis, Knee ; therapy ; Synovial Fluid ; chemistry ; Transforming Growth Factor beta1 ; analysis ; Treatment Outcome

A twenty-one year old man, who had been treated for medulloblastoma 6 years ago, complained progressive right knee joints pain and back pain. Multiple thoracic vertebral compression fracture was detected in radiography. The bone mineral density(BMD) was in osteoporotic range in duel energy X-ray absorpometry. Growth hormone deficiency and primary hypothyroidism were detected after endocrine function test. We treated him by cyclic intravenous pamidronate because he had complained severe back pain and difficulty to walk. After pamidronate therapy, the pain was decreased and the BMD was increased. No severe adverse effect was noted. This is the first case report of pamidronate therapy in patient who had osteoporotic vertebral compression fracture due to a sequela of childhood medulloblastoma.
Back Pain ; Bone Density ; Fractures, Compression ; Growth Hormone ; Humans ; Hypothyroidism ; Knee Joint ; Medulloblastoma* ; Radiography

Surgical treatment for the pediatric anterior cruciate ligament (ACL) avulsion fracture consists of arthroscopic treatment and open surgery. Recently, arthroscopic treatment has been commonly performed rather than open surgery because of less post-operative pain and faster rehabilitation. In arthroscopic treatment, K-wire and cannulated cancellous screws are the main instruments used for fixation of avulsion fracture, but these instruments have the risk of causing damage to the growth plate and an additional surgery to remove the fixation is needed. In spite of the technical difficulty, the suture anchor is used to overcome the risk of damage to the growth plate and the need for an additional surgery. The authors report good results using bio-absorbable suture anchor in arthroscopic treatment for pediatric ACL avulsion fracture.
Anterior Cruciate Ligament ; Arthroscopy ; Child ; Fracture Fixation ; Growth Plate ; Humans ; Knee Joint ; Suture Anchors ; Sutures

Platelet-derived growth factor(PDGF) is known to accelerate soft tissue fracture and periodontal bone healing, but little information is available for characterizing the healing of articualr cartilage. This study was designed to demonstrate the regeneration potential of pasteurized autogeneous osteochondral graft when PDFG was applied locally in vivo. Eighteen rabbits in two groups were used in the experiment. The free osteochondral fragment(1x1x1 cm) were taken from distal femur. The fragment were pasteurized in 65degrees C for 5 minutes. In experimental group(group II), the fragment were soaked in 0.25 mg/ml of recombinant human PDGF mixed 5 ml normal saline and reimplanted to the resected site, and followed with local administration of 0.25 mg/ml PDGF to knee joint. In control group(group I), the pasteurized fragment were reimplanted in the resected site without any treatments. The histologic characteristics of the transplanted autografts for three rabbits in each group were observed at 3, 5 and 7 weeks postoperatively. The results were as follows; Group II revealed the more favorable regeneration of articular cartilage, less arthritic changes and more mature arrangement of chondrocytes than group I. Even thought the cartilage is avascular and the regeneration capacity of pasteurized cartilage is severely limited, the regeneration of grafted articular cartilage is thought to be accellerated by increased newly formed blood vessels and soft tissues due to the diffusion of PDGF on grafted cartilage, and probably also by differentiation of mesenchymal cells in the initial stage of experiment. The results of this study suggest that local administration of PDGF could be used for the treatment of posttraumatic or degenerative arthritis and various cartilage damages.
Autografts ; Blood Vessels ; Cartilage ; Cartilage, Articular ; Chondrocytes ; Diffusion ; Femur ; Humans ; Knee Joint ; Osteoarthritis ; Platelet-Derived Growth Factor* ; Rabbits* ; Regeneration* ; Transplants*

It is well-known that the infection of bone and joints could produce the shortening by destroying the articuiar cartilage and growth plate, or the lengthening hy increased hlood circulation to the epiphyseal and metaphyseal regions of long bone. Since 1985, we have treated total l7 cases of children s pyogenic or tuberculous children s knee with early arthrotomy and continuous irrigation etc. and followed their long hone growth for average 53 months after surgical intervention. Five patients (group I ) were early treated within 2 weeks and twelve patients(group 3 ) were delayed to treat their knees for more than 2 weeks of symptom development. Total 11 patients out of 17 cases(64.7%) (2 cases of group 1 pyogenic arthritis, and 1 case of group l and 8 cases of group II tuberculous arthritis) revealed growth acceleration. Femoral lengthening was much more greater than that of tibial growth, and the size of patella, distal femoral and proximal tibial epiphysis which were measured by computerized digitizer were also significantly larger than that of opposite knee. The total limb length was increased hy average 7mm in 6 months, l4mm in 1 year and 3mm in 2 years after operation. These results suggest the pyogenic and tuberculous arthritis in children s knee should he treated as early as possible after symptoms developed, and followed them to trace their limh inequality for at least 2 years after surgery. That means the early arthrotomy for tuberculous knee or even in pyogenic arthritis can preserve normal articular cartilage and can also prevent the early epiphyseal closure hy infection. and can get the limh lengthening by increased blood circulation around the knee joint.
Acceleration ; Arthritis ; Blood Circulation ; Cartilage ; Cartilage, Articular ; Child* ; Epiphyses ; Extremities ; Growth Plate ; Humans ; Joints ; Knee Joint* ; Knee* ; Lower Extremity* ; Patella ; Socioeconomic Factors

The posterior cruciate ligament plays as basic stabilizer of the knee. Therefore the knee becomes unstable when tibial insertion of the posterior cruciate ligament is avulsed. The diagnosis may be delsyed or missed because of surgeon's 1sck of awareness or rare condition. The authors treated seven cases of avulsion fracture of posterior cruciate ligsment at the tibial attachment ares ranged from ten to thirty-two years. There were five male and two female. The results were as follows : 1. The cause of all seven cases injury was traffic accident. 2. The physical findings were seven positive posterior drawer test, seven cases of abrasion or laceration over the anterior proximal tibial surface and antero-medial surfsce of the knee joint. 3. The associated injury was comminuted fracture of the tibia and femur (1 case), rupture of collateral ligsment and comminuted fracture of the tibia (1 case) and zygomatic fracture (1 case). 4. The treatment methods were four cancellous fixation, one K-wire fixation after epiphyseal plate fusion but each one pull out wire and dexon suture before epiphyseal plate fusion. 5. The motion of knee joint was within normal limit and no instsbility was inspected at the three months after reduction.
Accidents, Traffic ; Diagnosis ; Female ; Femur ; Fractures, Comminuted ; Growth Plate ; Humans ; Knee Joint ; Knee ; Lacerations ; Male ; Posterior Cruciate Ligament ; Rupture ; Sutures ; Tibia ; Zygomatic Fractures

OBJECTIVE: To discuss bone development trend in the knee joint of Tibetan teenagers in Sichuan province and to effectively update the database for estimating the living age of Tibetan teenagers in terms of bone age of the knee joint. METHODS: Radiographs including epiphysis of distal femur, proximal tibia and proximal fibula were taken from 483 Tibetan male and female teenagers aged from 14 to 19 years old in Aba prefecture of Sichuan province in order to observe epiphyseal growth situation. The descriptive data of the epiphyseal closure ages of these teenagers' knee joints were statistically analyzed by SPSS 16.0 software. RESULTS: The distal femur epiphyseal closure occurred earliest, while the proximal fibula epiphyseal closure occurred latest. The epiphyseal growth of knee joints of females occurred about one year earlier than that of males. CONCLUSION The forensic information and data related to Tibetan teenagers' bone age identification should be updated regularly. These results provide potential value for the practice of forensic medicine, anthropology and clinical medicine.
Adolescent ; Age Determination by Skeleton/methods* ; Bone Development/physiology* ; China/ethnology* ; Epiphyses/growth & development* ; Female ; Femur/growth & development* ; Humans ; Knee Joint/growth & development* ; Male ; Sex Characteristics ; Tibia/growth & development* ; X-Ray Film ; Young Adult

This study was performed to identify the chronological changes of the knee angle or the tibiofemoral angles in normal healthy Korean children. Full-length anteroposterior view standing radiographs of 818 limbs of 452 Korean children were analyzed. The overall patterns of the chronological changes in the knee angle were similar to those described previously in western or Asian children, but the knee angle development was delayed, i.e., genu varum before 1 yr, neutral at 1.5 yr, increasing genu valgum with maximum a value of 7.8 degrees at 4 yr, followed by a gradual decrease to approximately 5-6 degrees of genu valgum of the adult level at 7 to 8 yr of age. These normative data on chronological changes of knee angles should be taken into consideration when evaluating lower limb alignment in children.
Adolescent ; Child ; Child Development ; Child, Preschool ; Female ; Femur/anatomy & histology ; Humans ; Infant ; Knee Joint/anatomy & histology/*growth & development ; Male ; Retrospective Studies ; Tibia/anatomy & histology

OBJECTIVETo investigate the effect of eletroacupuncture with close-to-bone needling treatment on expression of Sox9, vascular endothelial growth factor (VEGF) and type X collagen (ColX) in impaired cartilage of rabbits with knee osteoarthritis (KOA) and explore its possible mechanisms.

METHODSForty New Zealand rabbits were randomized equally into normal control group, KOA model group, eletroacupuncture with close-to-bone needling group (CN group), and normal thrust needing group (NTN group). In the latter 3 groups, KOA was induced by Hulth-Telhag treatment and evaluated with X-ray examination, and 6 weeks after the modeling, eletroacupuncture for 20 min was administered in CN and NTN groups at the acupoints "Zusanli", "Waixiyan", "Neixiyan", "Liangqiu" and "Yinlingquan" in the left knee joints once daily for 5 days as a treatment cycle. After 5 treatment cycles, the rabbits were examined for behavioral changes, cartilage morphology, and Mankin scores; The protein and mRNA expressions of S0x9, VEGF, and ColX were examined using Westen blotting, immunohistochemistry, and RT-PCR as appropriate.

RESULTSThe rabbits in the model, CN and NTN groups showed significant changes in behaviors and cartilage histomorphology after the modeling and after the treatments. HE staining showed that cartilage injury was repaired and tended to recovery in CN and NTN groups. The cartilage pathologies was severer in the model group than in the normal control, CN and NTN groups (P<0.01); Sox9 protein increased and VEGF mRNA level decreased in CN and NTN groups after treatment as compared with those in the model group (P<0.01).

CONCLUSIONEletroacupuncture with close-to-bone needling can effectively improve KOA in rabbits probably by enhancing Sox9 and reducing VEGF and ColX expressions in the cartilage to inhibit hypertrophic differentiation of the chondrocytes, maintain chondrogenic phenotype and repair cartilage cells.

Acupuncture Points ; Animals ; Cartilage, Articular ; metabolism ; pathology ; Cell Differentiation ; Chondrocytes ; cytology ; Chondrogenesis ; Collagen Type X ; metabolism ; Electroacupuncture ; Knee Joint ; physiopathology ; Osteoarthritis, Knee ; therapy ; Rabbits ; SOX9 Transcription Factor ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism