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Hernandez PA, Bradford JC, Brahmachary P, Ulman S, Robinson JL, June RK, Cucchiarini M. Unraveling sex-specific risks of knee osteoarthritis before menopause: Do sex differences start early in life? Osteoarthritis Cartilage 2024:S1063-4584(24)01172-5. [PMID: 38703811 DOI: 10.1016/j.joca.2024.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 03/15/2024] [Accepted: 04/24/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVE Sufficient evidence within the past two decades have shown that osteoarthritis (OA) has a sex-specific component. However, efforts to reveal the biological causes of this disparity have emerged more gradually. In this narrative review, we discuss anatomical differences within the knee, incidence of injuries in youth sports, and metabolic factors that present early in life (childhood and early adulthood) that can contribute to a higher risk of OA in females. DESIGN We compiled clinical data from multiple tissues within the knee joint-since OA is a whole joint disorder-aiming to reveal relevant factors behind the sex differences from different perspectives. RESULTS The data gathered in this review indicate that sex differences in articular cartilage, meniscus, and anterior cruciate ligament are detected as early as childhood and are not only explained by sex hormones. Aiming to unveil the biological causes of the uneven sex-specific risks for knee OA, we review the current knowledge of sex differences mostly in young, but also including old populations, from the perspective of (i) human anatomy in both healthy and pathological conditions, (ii) physical activity and response to injury, and (iii) metabolic signatures. CONCLUSIONS We propose that to close the gap in health disparities, and specifically regarding OA, we should address sex-specific anatomic, biologic, and metabolic factors at early stages in life, as a way to prevent the higher severity and incidence of OA in women later in life.
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Affiliation(s)
- Paula A Hernandez
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA; Department of Biomedical Engineering, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
| | | | - Priyanka Brahmachary
- Department of Mechanical & Industrial Engineering, Montana State University, Bozeman, MT 59717, USA.
| | - Sophia Ulman
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA; Movement Science Laboratory, Scottish Rite for Children, Frisco, TX 75034, USA.
| | - Jennifer L Robinson
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA; Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA 98195, USA; Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA 98109, USA.
| | - Ronald K June
- Department of Mechanical & Industrial Engineering, Montana State University, Bozeman, MT 59717, USA.
| | - Magali Cucchiarini
- Center of Experimental Orthopaedics, Saarland University Medical Center, Homburg/Saar D-66421, Germany.
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Mazy D, Chung-Tze-Cheong C, Ma Z, Huo R, Lamer S, Li J, Nault ML. Tough gel adhesive is an effective method for meniscal repair in a bovine cadaveric study. J Exp Orthop 2023; 10:139. [PMID: 38095758 PMCID: PMC10721589 DOI: 10.1186/s40634-023-00691-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/13/2023] [Indexed: 12/17/2023] Open
Abstract
PURPOSE To test tough gel adhesives to repair meniscus tears under relevant loading conditions and determine if they have adequate biomechanical properties to repair meniscus tears in a bovine cadaveric study. METHODS Cyclic compression tests on 24 dissected bovine knees were performed. The tough gel adhesive was used either as an adhesive patch or as a coating bonded onto commercially available surgical sutures. Forty-eight menisci were tested in this study; 24 complete radial tears and 24 bucket-handle tears. After preconditioning, the specimens underwent 100 cycles of compression, (800 N/0.5 Hz) on an Instron© machine and the size of the gaps measured. One third of the menisci were repaired with pristine sutures, one third with adhesive patches, and one third with sutures coated in adhesive gel. The size of the gaps was compared after 100 and 500 cycles of compression. RESULTS The mean gap measured at the tear site without treatment was 6.46 mm (± 1.41 mm) for radial tears and 1.92 mm (± 0.65 mm) for bucket-handle tears. After treatment and 500 cycles of compression, the mean gap was 1.63 mm (± 1.41 mm) for pristine sutures, 1.50 mm (± 1.16 mm) for adhesive sutures and 2.06 mm (± 1.53 mm) for adhesive gel patches. There was no significant difference between treatments regardless of the type of tear. Also, the gaps for radial tears increased significantly with the number of compression cycles applied (p > 0.001). CONCLUSION From a biomechanical standpoint, the tough adhesive gel patch is as effective as suturing. In addition, it would allow the repair of non-suturable tears and thus broaden the indications for meniscus repair. LEVEL OF EVIDENCE Controlled laboratory study.
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Affiliation(s)
- David Mazy
- University of Montreal, 2900 Boul. Edouard-Montpetit, Montréal, QC, H3T 1J4, Canada
- CHU Sainte-Justine, 3175 Chemin de La Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada
| | - Christopher Chung-Tze-Cheong
- Department of Mechanical Engineering, McGill University, 817 Sherbrooke Street West Montreal, Quebec, H3A 0C3, Canada
| | - Zhenwei Ma
- Department of Mechanical Engineering, McGill University, 817 Sherbrooke Street West Montreal, Quebec, H3A 0C3, Canada
| | - Ran Huo
- Department of Mechanical Engineering, McGill University, 817 Sherbrooke Street West Montreal, Quebec, H3A 0C3, Canada
| | - Stephanie Lamer
- University of Montreal, 2900 Boul. Edouard-Montpetit, Montréal, QC, H3T 1J4, Canada
| | - Jianyu Li
- Department of Mechanical Engineering, McGill University, 817 Sherbrooke Street West Montreal, Quebec, H3A 0C3, Canada.
- Department of Biomedical Engineering, McGill University, 3775 Rue University Montréal, Montreal, QC, H3A 2B4, Canada.
- Department of Surgery, McGill University, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada.
| | - Marie-Lyne Nault
- University of Montreal, 2900 Boul. Edouard-Montpetit, Montréal, QC, H3T 1J4, Canada.
- CHU Sainte-Justine, 3175 Chemin de La Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada.
- Department of Orthopedic Surgery, CIUSSS Hôpital du Sacré-Coeur de Montréal (HSCM), 5400 Boul. Gouin Ouest, Montreal, QC, H4J 1C5, Canada.
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Deng GH. Causal relationship between obesity and meniscal injuries: Two-sample Mendelian randomization. Medicine (Baltimore) 2023; 102:e36510. [PMID: 38050236 PMCID: PMC10695575 DOI: 10.1097/md.0000000000036510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 11/16/2023] [Indexed: 12/06/2023] Open
Abstract
To investigate the causal relationship between obesity and meniscal injuries using Mendelian randomization (MR). Genetic loci independently associated with obesity and meniscal injuries in people of European origin were selected as instrumental variables using pooled data from genome-wide association studies. Three MR analyses, MR-Egger, weighted median and inverse variance weighting, were used to investigate the causal relationship between obesity and meniscal injuries. The results were tested for robustness by heterogeneity and multiplicity tests, and sensitivity analyses were performed using the "leave-one-out" method. The inverse variance weighting results showed an OR (95% CI) of 1.13 (1.04-1.22), P = .003, indicating a causal relationship between obesity and the occurrence of meniscal injuries. And no heterogeneity and multiplicity were found by the test and sensitivity analysis also showed robust results. In this study, genetic data were analyzed and explored using 2-sample MR analysis, and the results showed that obesity is a risk factor for meniscal injuries.
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