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Supplemental material, Revised_Supplemental_table for Biomechanical Changes of Repair Tissue after Autologous Chondrocyte Implantation at Long-Term Follow-Up by Teemu Paatela, Anna Vasara, Heikki Nurmi, Hannu Kautiainen, Jukka S. Jurvelin and Ilkka Kiviranta in CARTILAGE

Aim: The horse joint, due to its similarity with the human joint, is the ultimate model for translational articular cartilage repair studies. This study was designed to determine the critical size of cartilage defects in the equine carpus and serve as a benchmark for the evaluation of new cartilage treatment options. Material and Methods: Circular full-thickness cartilage defects with a diameter of 2, 4, and 8 mm were created in the left middle carpal joint and similar osteochondral (3.5 mm in depth) defects in the right middle carpal joint of 5 horses. Spontaneously formed repair tissue was examined macroscopically, with MR and mu CT imaging, polarized light microscopy, standard histology, and immunohistochemistry at 12 months. Results: Filling of 2 mm chondral defects was good (77.8 +/- 8.5%), but proteoglycan depletion was evident in Safranin-O staining and gadolinium-enhanced MRI (T-1Gd). Larger chondral defects showed poor filling (50.6 +/- 2.7% in 4 mm and 31.9 +/- 7.3% in 8 mm defects). Lesion filling in 2, 4, and 8 mm osteochondral defects was 82.3 +/- 3.0%, 68.0 +/- 4.6% and 70.8 +/- 15.4%, respectively. Type II collagen staining was seen in 9/15 osteochondral defects but only in 1/15 chondral defects. Subchondral bone pathologies were evident in 14/15 osteochondral samples but only in 5/15 chondral samples. Although osteochondral lesions showed better neotissue quality than chondral lesions, the overall repair was deemed unsatisfactory because of the subchondral bone pathologies. Conclusion: We recommend classifying 4 mm as critical osteochondral lesion size and 2 mm as critical chondral lesion size for cartilage repair research in the equine carpal joint model.

The back-translation of the Finnish version of the KOOS questionnaire “KOOS KNEE QUESTIONNAIRE”. (PDF 87 kb)

Referral to a specialist has a significant influence on management of the patient and costs associated with the treatments. However, development and research of the process by which patients are referred has been almost neglected. Expectations considering the purpose, contents, and timing of the referral of the consulting physician and the consultant do not always meet. A structured, electronic consultation letter was developed to respond this need. Functionality and interactivity are the key elements of the referral, including (1) an electronic referral letter to a specialist, (2) interactive education in clinical examination and management of shoulder disorders, and (3) an instrument of clinical examination and documentation of shoulder disorders.

Although the positive health benefits of physical activity (PA) are well established, most of the evidence is linked with one of the sub-domains of PA, which is leisure-time physical activity (LTPA). The other domains besides LTPA (performed during free time) are occupational physical activity (OPA) (performed while working), transportation physical activity (TPA) (purpose to go somewhere), household physical activity (HPA) (engaging in housework), and sitting (such as while at work, at home, or studying). The role of the different domains of PA and their relations to different indicators of health or functioning, such as health-related quality-of-life (HRQoL) and work ability, have been minimally examined and are poorly understood. The aim of this study was to examine how different sub-domains of PA relate to HRQoL or work ability in different work requirements among the Finnish male population between 20 and 40 years of age. Data were obtained from 5000 male participants (born in 1969, 1974, 1979, 1984, or 1989) that were randomly selected from the population register as a population sample. Self-reported questions and questionnaires were used in the studies. Out of all domains of PA, LTPA was the only one that was positively related to mental and physical aspects of HRQoL or work ability. Furthermore, the results indicate that different domains were related differently between physical or mental aspects of HRQoL. More accurately, relatively high LTPA was related to better quality-of-life in both mental and physical aspects of HRQoL, whereas OPA was negatively related to physical health indicators and higher daily sitting was negatively related to mental-health indicators. Moreover, this study indicates the importance of LTPA among workers, particularly those with higher work-related physical strain, to endure the demands of daily work chores. Although the results of this study indicate that higher LTPA is related to better work ability in workers without depressive symptoms, the workers with depressive symptoms may need more than exercise to improve work ability, particularly if their job description included higher physical or mental demands. In addition, the findings reveal that regardless of whether the work is mainly physical or mental, LTPA could possibly compensate for the negative relations associated with lower work ability. Tutkimusnäyttöä fyysisen aktiivisuuden (physical activity, PA) terveyttä edistävistä ja ylläpitävistä hyödyistä on runsaasti, mutta suurin osa näytöstä liittyy vapaa-ajalla tapahtuvan fyysisen aktiivisuuden (leisure-time physical activity, LTPA) mittaamiseen. Muita PA:n osa-alueita ovat työssä (occupational physical acitivity, OPA), siirtymisissä (transportation physical activity, TPA) ja kotitaloustöissä tapahtuva fyysinen aktiivisuus (household physical activity (HPA). PA:n osa-alueiden roolia ja suhdetta erilaisiin terveyden tai toiminnan indikaattoreihin, kuten terveyteen liittyvään elämänlaatuun (health-related quality of life, HRQoL) ja työkykyyn on tutkittu vähemmän, minkä vuoksi näitä yhteyksiä tunnetaan myös heikommin. Tämän tutkimuksen tavoitteena oli tutkia miten 20-40-vuotiailla suomalaisilla miehillä PA:n eri osa-alueet vaikuttavat elämänlaatuun tai työkykyyn työn eri kuormituksissa. Tutkimusaineistona oli väestörekisteristä satunnaisotannalla valitut 5000 miehestä, jotka jaettiin 1000 miehen ikäkohortteihin syntymävuosien (1969, 1974, 1979, 1984 ja 1989) mukaan. Tutkittavien liikunnallista aktiviteettia, työkykyä ja henkilökohtaisia taustatietoja selvitettiin kyselylomaketutkimuksella. Kaikista PA:n osa-alueista LTPA oli ainoa, jolla oli positiivinen yhteys HRQoL:n tai työkyvyn henkisiin ja fyysisiin osatekijöihin. Tarkemmin ilmaistuna suhteellisen korkealla LTPA:lla oli yhteys parempaan elämänlaatuun HRQoL:n henkisissä ja fyysisissä osatekijöissä, kun taas OPA:lla oli negatiivinen yhteys HRQoL:n fyysisen terveyden indikaattoreihin. Lisäksi korkeampi päivittäinen istumisaika yhdistyi negatiivisesti HRQoL:n henkisen terveyden indikaattoreihin. Tutkimuksen tulokset korostavat LTPA:n tärkeyttä, etenkin työntekijöillä, joiden työ on fyysisesti raskasta. Tulokset myös osoittavat, että korkeammalla LTPA:lla oli mahdollisesti yhteys parempaan työkykyyn henkilöillä, joilla ei ollut masennusoireita, mutta masennusoireista kärsivät saattavat tarvita muutakin kuin liikuntaa työkyvyn parantamiseksi, etenkin jos heidän työnkuvaansa sisältyi reilusti fyysisiä tai henkisiä vaatimuksia. Lisäksi tulokset osoittavat, että riippumatta siitä, oliko työ enemmän fyysistä tai henkistä, korkeampi LTPA mahdollisesti vähentää huonommasta työkyvystä aiheutuvia negatiivisia assosiaatioita.