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This study was aimed at investigating the use of ultrasound parameters obtained non-invasively through soft tissue (ST) to evaluate degeneration in cartilage and subchondral bone (SB) in the human knee. We developed a 3-D ultrasound system and introduced the ratio parameters Rcb and RcbT to suppress the attenuation effect in the ST or in both the ST and cartilage. As reference measurements, the grade for cartilage by visual judgment (Gsum) and ultrasound parameters for the cartilage and the SB were directly evaluated under arthroscopy. Rcb correlated significantly with Gsum (rs = -0.63) and with the corresponding parameter obtained directly under arthroscopy (r = 0.55). RcbT also correlated significantly with Gsum (rs = -0.46) but was not superior to Rcb. Rcb is considered to be an efficient parameter that reflects the total degeneration in both the cartilage and SB, including the information on cartilage thickness. [ABSTRACT FROM AUTHOR]

Background: We previously developed a surface-controlled water-dispersible form of curcumin that we called Theracurmin®. The area under the blood concentration-time curve (AUC) of Theracurmin in humans was 27-fold higher than that of curcumin powder. Previously, we reported on the anti-inflammatory effects of Theracurmin for knee osteoarthritis. Hypothesis/Purpose: We determined the clinical effects of orally administered Theracurmin in patients with knee osteoarthritis over a 6-month period. Study Design: Open prospective study. Methods: Fifty patients Kellgren-Lawrence grade II, III, or IV knee osteoarthritis who were above 40 years old were enrolled in this clinical study. Theracurmin containing 180 mg/day of curcumin was administered orally every day for 6 months. To monitor for adverse events, blood biochemistry analyses were performed before and after 6 months of each intervention. The patients' knee symptoms were evaluated at 0, 1, 2, 3, 4, 5, and 6 months based on the Japanese Knee Osteoarthritis Measure, the knee pain visual analog scale, and the knee scoring system of the Japanese Orthopedic Association. Results: Five cases dropped out during the study, but no cases dropped out because of major problems. No major side effects were observed with Theracurmin treatment, including the blood biochemistry analysis results. The effective group included 34 cases (75.6%), while the not-effective group included 11 cases. Conclusion: This study demonstrates the safety and good efficacy of Theracurmin for various types of knee osteoarthritis. Theracurmin shows great potential for the treatment of human knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Background: We previously developed a surface-controlled water-dispersible form of curcumin and named it Theracurmin (Theracurmin; Theravalues, Tokyo, Japan). The area under the blood concentration-time curve of Theracurmin in humans was 27-fold higher than that of curcumin powder. We determined the clinical effects of orally administered Theracurmin in patients with knee osteoarthritis during 8 weeks of treatment. Methods: Fifty patients with knee osteoarthritis of Kellgren-Lawrence grade II or III and who were aged more than 40 years were enrolled in this randomized, double-blind, placebo-controlled, prospective clinical study. Placebo or Theracurmin containing 180 mg/day of curcumin was administered orally every day for 8 weeks. To monitor adverse events, blood biochemistry analyses were performed before and after 8 weeks of each intervention. The patients' knee symptoms were evaluated at 0, 2, 4, 6, and 8 weeks by the Japanese Knee Osteoarthritis Measure, the knee pain visual analog scale (VAS), the knee scoring system of the Japanese Orthopedic Association, and the need for nonsteroidal anti-inflammatory drugs. Results: At 8 weeks after treatment initiation, knee pain VAS scores were significantly lower in the Theracurmin group than in the placebo group, except in the patients with initial VAS scores of 0.15 or less. Theracurmin lowered the celecoxib dependence significantly more than placebo. No major side effects were observed with Theracurmin treatment. Conclusion: Theracurmin shows modest potential for the treatment of human knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Background: Autologous osteochondral mosaicplasty for osteochondritis dissecans of the capitellum is being used increasingly in adolescent patients. Little research has been published on the material properties of living human cartilage of the elbow and knee. Hypothesis: The cartilage of the osteochondritis dissecans lesion is detected as degenerated by ultrasound. The material properties of the cartilage of the intact part of.the elbow are not different from those of the intact knee except in thickness. Study Design: Descriptive laboratory study. Methods: The authors studied 10 young male athletes with osteochondritis dissecans of the capitellum who underwent mosaicplasty. An acoustic probe was used for measurement, and the wavelet transform method was used. Three parameters were used: signal intensity (index of cartilage stiffness), signal duration (index of roughness), and signal interval (index of thickness). Results: The cartilage of the osteochondritis dissecans lesion had lower signal intensity than did the intact part of the capitellum. The cartilage of the radial head opposite the capitellum had significantly lower signal intensity and higher signal duration than did other sites. The signal intensity of the radial head was significantly higher in early-stage patients than in late-stage patients, although the macroscopic view was almost all intact. The signal intensity of the plug was decreased significantly after grafting. Conclusion: The osteochondritis dissecans lesion had lower signal intensity than did the intact part of the capitellum. Although the macroscopic view looked intact, the radial head cartilage was degenerated as measured acoustically. Clinical Relevance: Not only the cartilage of the capitellum but the cartilage of the radial head are acoustically degenerated in osteochondritis dissecans patients. Plugs might be damaged in the transplanting procedure, and further follow-up is necessary. [ABSTRACT FROM AUTHOR]

We aimed to quantitatively investigate the relationship between amplitude-based pulse-echo ultrasound parameters and early degeneration of the knee articular cartilage. Twenty samples from six human femoral condyles judged as grade 0 or 1 according to International Cartilage Repair Society grading were assessed using a 15-MHz pulsed-ultrasound 3-D scanning system ex vivo. Surface roughness (Rq), average collagen content (A1) and collagen orientation (A12) in the superficial zone of the cartilage were measured via laser microscopy and Fourier transform infrared imaging spectroscopy. Multiple regression analysis with a linear mixed-effects model (LMM) revealed that a time-domain reflection coefficient at the cartilage surface (Rc) had a significant coefficient of determination with Rq and A12 (RLMMm2=0.79); however, Rc did not correlate with A1. Concerning the collagen characteristic in the superficial zone, Rc was found to be a sensitive indicator reflecting collagen disorganization, not collagen content, for the early degeneration samples. [ABSTRACT FROM AUTHOR]

The article discusses the procedure of autogenous bone-cartilage transplantation. Among the measures for cartilage repair include marrow stimulation, correction osteotomy and chondrocyte or stem cell transplantation. An overview of the indications and contraindications of autogenous bone-cartilage transplantation is provided, along with technical data about osteonecrosis of the knee, and complications and rehabilitation of the procedure.