• Journal of the Korean Arthroscopy Society
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• v.1 no.1
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• pp.41-46
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• 1997

The natural history of the anterior cruciate ligament(ACL)-deficient knee remains controversial. although numerous investigation have tried to ascertain the course that the knee would follow once the ACL has lost functional integrity. An extensive review of the literature performed according to symptoms. physical examinations, associated surrounding tissue injuries. returns to activity level and radiological changes in the knee joint. An active individual with a non-functioning ACL was susceptible to injury to the menisci and deteriorate the articular cartilage, followed radiographic changes. An activity levels in general also changed after injury. The most common symptom was pain. But instability varied in these individuals. Conclusively we believe that all these factors will eventually, if not initially, result in a symptomatic knee. which will result in significant limitations to the individual's desired level. So we recommend an aggressive approach in person who desired to return to a relatively active life style in young person as well as in middle aged individuals who have significant symptomatic ACL deficient knee.

• Journal of Biomedical Engineering Research
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• v.36 no.2
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• pp.43-47
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• 2015

Osteoarthritis is the most common chronic joint disease in the world. With its progression, cartilage thickness tends to diminish, which causes severe pain to human being. One way to examine the stage of osteoarthritis is to measure the cartilage thickness. When it comes to inter-subject study, however, it is not easy task to compare cartilage thickness since every human being has different cartilage structure. In this paper, we propose a method to assess cartilage defect using MRI inter-subject thickness comparison. First, we used manual segmentation method to build accurate atlas images and each segmented image was labeled as articular surface and bone-cartilage interface in order to measure the thickness. Secondly, each point in the bone-cartilage interface was assigned the measured thickness so that the thickness does not change after registration. We used affine transformation and SyGN to get deformation fields which were then applied to thickness images to have cartilage thickness atlas. In this way, it is possible to investigate pixel-by-pixel thickness comparison. Lastly, the atlas images were made according to their osteoarthritis grade which indicates the degree of its progression. The result atlas images were compared using the analysis of variance in order to verify the validity of our method. The result shows that a significant difference is existed among them with p < 0.001.

• The Korea Journal of Herbology
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• v.33 no.3
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• pp.45-53
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• 2018

Objectives : In cases of osteoarthritis, the hypofunction of the cartilage and joint leads to a limited range of joint motion, swelling, and pain, which is generally treated using pharmaceutical drugs (e.g., anti-inflammatory agents, cartilage protectants, and nonsteroidal anti-inflammatory drugs) or replacement arthroplasty. However, long-term drug treatment is associated with adverse effects on the gastrointestinal systems. The present study aimed to evaluate the ability of Giheolsotong-hwan to treat of osteoarthritis symptoms in the MIA-induced rat model based on histological analysis, and factors that are associated with inflammation and bone mineral metabolism. Methods : Giheolsotong-hwan was administered orally at doses of 200 mg/kg/day or 400 mg/kg/day for 2 weeks before direct injection of monosodium iodoacetate ($3mg/50{\mu}{\ell}$ of 0.9% saline) into the intra-articular space of the rats' right knee. The rats subsequently received the same doses of oral Giheolsotong-hwan for another 4 weeks. We evaluated the treatment effects based on serum biomarkers and histopathological analysis of the knee joints. Results : Compared to those in control rats, the Giheolsotong-hwan treatments significantly decreased the serum concentration of inflammation factors (i.e., $IL-1{\beta}$, IL-6, $TNF-{\alpha}$, $PGE_2$, and $LTB_4$), and bone degrade factors (i.e., MMP-9, CTX-II, and COMP). In addition, the Giheolsotong-hwan treatments significantly increased the concentration of glycosaminoglycans of bone defence factors, but no chage the TIMP-1. Furthermore, the Giheolsotong-hwan treatments effectively preserved the knee cartilage and proteoglycan. Conclusion : The results indicate that Giheolsotong-hwan treated osteoarthritis symptoms. Thus, Giheolsotong-hwan may be a novel oriental therapeutic option for the management of osteoarthritis.

• Journal of Physiology & Pathology in Korean Medicine
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• v.27 no.2
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• pp.212-224
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• 2013

This study intends to clarify how Sayeok-tang(here in after reffered to SYT) affect C57BL/10 mice whose osteoarthritis was induced by papain. Osteoarthritis was induced by injecting papain in the knee joint of 3 groups(n=6) of mice. Normal group was non-treatment group and was not injected papain, whereas control mice were orally administered with $200{\mu}{\ell}$ of physiological saline. Positive comparison group was medicated with 100 mg/kg of Joins$^{(R)}$ mixed with $200{\mu}{\ell}$ of physiological saline. Experimental group was medicated with 400 mg/kg of SYT mixed with $200{\mu}{\ell}$ of physiological saline. Both Positive and experimental comparison groups were orally medicated once per day for 4 weeks. After the experiment, the functions of liver and kidney, inflammation cytokine values within serum, degree of revelation for inflammation cytokine genes, immune cells within blood, metabolism of arachidonic acid and amount of cartilage were measured and histopathological changes in the knee joint structures were observed. As results, SYT had no significant effect on the liver and kidney functions. Interleukin-$1{\beta}$(IL-$1{\beta}$), interleukin-6(IL-6), monocyte chemo attractant protein-1(MCP-1) and tumor necrosis factor-${\alpha}$(TNF-${\alpha}$) were significantly decreased. Inflammation cytokines in joints were all significantly decreased. Prostaglandin $E_2(PGE_2)$, thromboxane $B_2(TXB_2)$ were significantly decreased. Destruction of cartilage on micro computed tomography(CT)-arthrography was meaningfully decreased. In terms of histopathology, infiltration of inflammation, proliferation of synovial membrane, subsidence of cartilage and bone due to penetration of excessive formation of synovial cell and destruction of cartilage were small. Based on all results mentioned above, Sayeok-tang(SYT) is believed to be meaningful for suppressing the progress of osteoarthritis and its treatments because of its anti-inflammatory effects and alleviation of pain with histopathological effective efficacy.

• Archives of Plastic Surgery
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• v.35 no.6
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• pp.637-644
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• 2008

Purpose: The survival of bone marrow derived stem cell was reported several times. But the survival of adipose tissue derived stem cells(hASCs) was not mentioned on. We studied the adipose tissue derived stem cell's survival and effect on articular cartilage in rabbits. Methods: Osteoarthritis was induced in twenty New Zealand white rabbits by intraarticular injection of monosodium iodoacetate(MIA). After four weeks, hASCs were also injected into the knee joints space without any vehicle, but the control group received phosphate buffered saline only. The histologic grade of articular cartilage was measured in 4 and 8 weeks after the transplantation of hASC and the viability of injected stem cells measured by Fluorescent in situ Hybridization (FISH) examination. Results: After 4 and 8 weeks from hASCs transplantation, histologic grade was not significantly difference between two groups(p>0.05), and the Y chromosome of the transplanted hASCs was not detected in articular cartilage. Conclusion: We found that direct injection of hASC in joint space didn't work on damaged articular cartilage repair.

• Journal of Korean Medicine Rehabilitation
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• v.29 no.2
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• pp.101-113
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• 2019

Objectives Bogol-tang has clinically been used to protect joint cartilage and to treat osteoarthritis. Our objective was to study the protective effect of Bogol-tang extract (BGT) in functional impairment, behavioral disorders, cartilage loss and pathological changes in a monoiodoacetate (MIA)-induced murine osteoarthritis (OA) model and interleukin (IL)-$1{\beta}$ -treated primary rat chondrocytes. Methods Mouse knee joints were injected with MIA, a chemical that inhibits glycolysis and causes joint inflammation and matrix loss. MIA-OA induced mice orally administered BGT or acetaminophen (AAP) for 18 days by daily. Primary rat chondrocytes were pretreated with BGT or dexamethasone (DEX) and followed by co-incubation with IL-$1{\beta}$ (10 ng/mL). Results In MIA-OA mice model, BGT led to delayed response on hot plate analysis, and suppressed the cartilage loss and damages in joint tissues. BGT suppressed the elevated levels of inflammatory mediators, nitrite and $PGE_2$, the gene expression of matrix degrading enzymes, and extracellular-signal-regulated kinases 1/2 and c-JunN-terminal kinase phosphorylation in IL-$1{\beta}$-treated primary rat chondrocytes. Conclusions Our results suggest that BGT improve the knee joint function and delay the cartilage damages by anti-nociceptive, anti-inflammatory and ant-catabolic effects, which indicate BGT could be a potential candidate for osteoarthritis treatment.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.14 no.2
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• pp.34-40
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• 2008

Purpose: We defined osteoarthritis of the knee as knee pain and crepitus in over 40 years old. The usual clinical manifestation include pain, stiffness, crepitus and loss of function. Methods: We studied 40 cases of the degenerative arthritis of knee clinically. The body mass index(BMI, weight(kg)/height($m^2$) was used as a measure of obesity. Pain self assessment scale by Million Index in according to age, occupation, BMI. Results: Gender by pain self assessment scale was 6.5 in male and 6.6 in female(P<0.05). The prevalence rates obese was 40%. Occupation by pain self assessment scale was 7.0 in Sitting and 5.7 in Standing(P<0.05). Prevalence was increased with age by pain self assessment scale in aged 40-69 years. Conclusion: It has been known that the obesity is one of the predispsing factors of the primary degenerative arthritis of knee. A flexion weight bearing view of the knee obtained at $30^{\circ}$ to $40^{\circ}$ of the joint flexion may be more sensitive in assessing damages to hyaline cartilage because the knee flexion is an important component of the stance phase.

• Journal of the Institute of Electronics Engineers of Korea SP
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• v.47 no.6
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• pp.75-81
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• 2010

The segmentation of cartilage is crucial for the diagnose and treatment of osteoarthritis (OA), and has mostly been done manually by an expert, requiring a considerable amount of time and effort due to the thin shape and vague boundaries of the cartilage in MR (magnetic resonance) images. In this paper, we propose a fully automatic method to segment cartilage in a knee joint on MR images. The proposed method is based on a small number of manually segmented images as the training set and comprised of an initial per patch segmentation process and a global refinement process on the cumulative per patch results. Each patch for per patch segmentation is positioned by classifying the bone-cartilage interface on the pre-segmented bone surface. Next, the shape and intensity priors are constructed for each patch based on information extracted from reference patches in the training set. The ratio of influence between the shape and intensity priors is adaptively determined per patch. Each patch is segmented by graph cuts, where energy is defined based on constructed priors. Finally, global refinement is conducted on the global cartilage using the results of per patch segmentation as the shape prior. Experimental evaluation shows that the proposed framework provide accurate and clinically useful segmentation results.

• IMMUNE NETWORK
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• v.14 no.1
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• pp.45-53
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• 2014

Osteoarthritis (OA) is a degenerative joint disease characterized by a progressive loss of cartilage. And, increased oxidative stress plays a relevant role in the pathogenesis of OA. Ursodeoxycholic acid (UDCA) is a used drug for liver diseases known for its free radical-scavenging property. The objectives of this study were to investigate the in vivo effects of UDCA on pain severity and cartilage degeneration using an experimental OA model and to explore its mode of actions. OA was induced in rats by intra-articular injection of monosodium iodoacetate (MIA) to the knee. Oral administration UDCA was initiated on the day of MIA injection. Limb nociception was assessed by measuring the paw withdrawal latency and threshold. Samples were analyzed macroscopically and histologically. Immunohistochemistry was used to investigate the expression of interleukin-$1{\beta}$ (IL-$1{\beta}$), IL-6, nitrotyrosine and inducible nitric oxide synthase (iNOS) in knee joints. UDCA showed an antinociceptive property and attenuated cartilage degeneration. OA rats given oral UDCA significantly exhibited a decreased number of osteoclasts in subchondral bone legion compared with the vehicle-treated OA group. UDCA reduced the expression of IL-$1{\beta}$, IL-6, nitrotyrosine and iNOS in articular cartilage. UDCA treatment significantly attenuated the mRNA expression of matrix metalloproteinase-3 (MMP-3), -13, and ADAMTS5 in IL-$1{\beta}$-stimulated human OA chondrocytes. These results show the inhibitory effects of UDCA on pain production and cartilage degeneration in experimentally induced OA. The chondroprotective properties of UDCA were achieved by suppressing oxidative damage and inhibiting catabolic factors that are implicated in the pathogenesis of cartilage damage in OA.

• Journal of the Korean Arthroscopy Society
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• v.3 no.1
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• pp.51-53
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• 1999

A four-year-old boy with knee pain who had an obscure history showed radiopaque material in the radiograph of the medial side of the knee joint. We successfully treated removal of a piece of glass by arthroscope followed by debridement of erosive cartilage and torn meniscus.