Osteoarthritis (OA) is one of the most common causes of disability around the globe, especially in aging populations. The main symptoms of OA are pain and loss of motion and function of the affected joint. Hyaline cartilage has limited ability for regeneration due to its avascularity, lack of nerve endings, and very slow metabolism. Total joint replacement (TJR) has to date been used as the treatment of end-stage disease. Various joint-sparing alternatives, including conservative and surgical treatment, have been proposed in the literature; however, no treatment to date has been fully successful in restoring hyaline cartilage. The mechanical and frictional properties of the cartilage are of paramount importance in terms of cartilage resistance to continuous loading. OA causes numerous changes in the macro- and microstructure of cartilage, affecting its mechanical properties. Increased friction and reduced load-bearing capability of the cartilage accelerate further degradation of tissue by exerting increased loads on the healthy surrounding tissues. Cartilage repair techniques aim to restore function and reduce pain in the affected joint. Numerous studies have investigated the biological aspects of OA progression and cartilage repair techniques. However, the mechanical properties of cartilage repair techniques are of vital importance and must be addressed too. This review, therefore, addresses the mechanical and frictional properties of articular cartilage and its changes during OA, and it summarizes the mechanical outcomes of cartilage repair techniques.
The application of 3D printing in bone grafts is gaining in importance and is becoming more and more popular. The choice of the method has a direct impact on the preparation of the patient for surgery, the probability of rejection of the transplant, and many other complications. The aim of the article is to discuss methods of bone grafting and to compare these methods. This review of literature is based on a selective literature search of the PubMed and Web of Science databases from 2001 to 2022 using the search terms "bone graft", "bone transplant", and "3D printing". In addition, we also reviewed non-medical literature related to materials used for 3D printing. There are several methods of bone grafting, such as a demineralized bone matrix, cancellous allograft, nonvascular cortical allograft, osteoarticular allograft, osteochondral allograft, vascularized allograft, and an autogenic transplant using a bone substitute. Currently, autogenous grafting, which involves removing the patient's bone from an area of low aesthetic importance, is referred to as the gold standard. 3D printing enables using a variety of materials. 3D technology is being applied to bone tissue engineering much more often. It allows for the treatment of bone defects thanks to the creation of a porous scaffold with adequate mechanical strength and favorable macro-and microstructures. Bone tissue engineering is an innovative approach that can be used to repair multiple bone defects in the process of transplantation. In this process, biomaterials are a very important factor in supporting regenerative cells and the regeneration of tissue. We have years of research ahead of us; however, it is certain that 3D printing is the future of transplant medicine.
Articular cartilage (AC) plays an important role in the biomechanics of synovial joints. Its task is to enable smooth movement and transfer of mechanical loads with minimised friction. AC is characterised by unique mechanical properties resulting from its complex structure, in which the dominant components are type II collagen, proteoglycans and water. Healthy articular cartilage shows elasticity in compression, viscoelastic properties, and the ability to relax stresses under the influence of cyclic loads. In response to different loading modes, it shows anisotropic and non-uniform behaviour, which translates into its cushioning and protective function for the subchondral bone. Significant changes occur in the structure and mechanical properties of cartilage with age as a result of mechanical overload or degenerative diseases, such as osteoarthritis. This results in a deterioration of the cushioning and mechanical function, which leads to progressive degradation of joint tissues. Understanding the mechanical properties of AC is crucial for developing effective diagnostic methods. Analysis of changes in mechanical properties contributes to the early detection of pathological changes. The aim of this paper is to review the current state of knowledge regarding the structure and biomechanical properties of articular cartilage, and to analyse conventional and alternative diagnostic methods in the context of their suitability for assessing the state of AC, particularly in the early stages of degenerative processes.
Plastic overconsumption has emerged as a major environmental pollutant, with degraded micro- and nanoplastic (MNP) particles being consumed by a vast variety of species. MNPs, particles < 5 mm, contain endocrine-disrupting chemicals (EDCs), which can bind to hormone receptors and disrupt the proper endocrinological function of a variety of organs. This review explores the toxicological impact of MNPs on the hypothalamus, pituitary gland, thyroid, pineal body, ovaries, and testes, as well as the effects of the endocrinological regulatory axes, including the hypothalamic–pituitary–gonadal (HPG), hypothalamic–pituitary–thyroid (HPT), and hypothalamic–pituitary–adrenal (HPA) axes. The disruption of these hormonal feedback systems leads to reproductive dysfunction, neurotoxicity, cytotoxicity, immunotoxicity, and metabolic disorders. The gonads are particularly susceptible, with studies demonstrating oxidative stress, cellular apoptosis, and infertility due to MNP exposure. Given the widespread presence of MNPs and their impact on human health, further research is critical to understand their long-term effects and develop strategies to reduce exposure.
Purpose: This study evaluated the diagnostic accuracy of physical examination and magnetic resonance imaging (MRI) in knee injuries. Methods: Ninety-six patients at a regional hospital were included in the study. Each participant underwent a physical examination in which menisci and ACL were evaluated. Knee joint MRI was collected from each patient. Physical examination and MRI scans were then compared with knee arthroscopy findings as a golden standard for meniscal and ligamentous lesions. The data were analyzed and specificity and sensitivity were calculated and correlated on receiver operating characteristics (ROC) curves. Results: Knee arthroscopy diagnosed 32 total ACL ruptures, 45 medial meniscus and 17 lateral meniscus lesions. Three patients were diagnosed with bilateral meniscal lesions. The highest sensitivities were the McMurray test (87.5%) for medial meniscus (MM) and the Thessaly test (70%) for lateral meniscus (LM). The most sensitive ACL test was Lachman (84.5%), whereas, the pivot shift and Lelli tests were the most specific (98.5%). MRI was highly sensitive for MM (96%) with specificity of 52%. MRI showed lower sensitivity (70%) and higher specificity (85.5%) for LM. The specificity of MRI for ACL rupture was 92%, with sensitivity only 75%. Conclusion: McMurray and Apley tests for meniscal lesions seem the most appropriate in daily practice. A combination of lever signs, pivot shifts (PSs) and Lachman tests showed the best sensitivity and specificity in detecting ACL deficiency, and was superior to MRI.
This paper presents the results of a preliminary study on simplified diagnosis of osteoarthritis of the knee joint based on generated vibroacoustic processes. The analysis was based on acoustic signals recorded in a group of 50 people, half of whom were healthy, and the other half - people with previously confirmed degenerative changes. Selected discriminants of the signals were determined and statistical analysis was performed to allow selection of optimal discriminants used at a later stage as input to the classifier. The best results of classification using artificial neural networks (ANN) of RBF (Radial Basis Function) and MLP (Multilevel Perceptron) types are presented. For the problem involving the classification of cases into one of two groups HC (Healthy Control) and OA (Osteoarthritis) an accuracy of 0.9 was obtained, with a sensitivity of 0.885 and a specificity of 0.917. It is shown that vibroacoustic diagnostics has great potential in the non-invasive assessment of damage to joint structures of the knee.