JournalTOCs

Cartilage
Journal Prestige (SJR): 0.889

Citation Impact (citeScore): 3
Number of Followers: 5

Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1947-6035 - ISSN (Online) 1947-6043
Published by Sage Publications

[1174 journals]

Rehabilitation Variability Following Osteochondral Autograft and Allograft
Transplantation of the Knee
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  Authors: Stephen G. Crowley, Anthony Pedersen, Thomas A. Fortney, Hasani W. Swindell, Bryan M. Saltzman, Charles A. Popkin, David P. Trofa
  Abstract: CARTILAGE, Volume 13, Issue 2, April-June 2022.
  ObjectiveThe aim of this study is to assess the variability of postoperative rehabilitation protocols used by orthopedic surgery residency programs for osteochondral autograft transplantation (OAT) and osteochondral allograft transplantation (OCA) of the knee.DesignOnline postoperative OAT and OCA rehabilitation protocols from US orthopedic programs and the scientific literature were reviewed. A custom scoring rubric was developed to analyze each protocol for the presence of discrete rehabilitation modalities and the timing of each intervention.ResultsA total of 16 programs (10.3%) from 155 US academic orthopedic programs published online protocols and a total of 35 protocols were analyzed. Twenty-one protocols (88%) recommended immediate postoperative bracing following OAT and 17 protocols (100%) recommended immediate postoperative bracing following OCA. The average time protocols permitted weight-bearing as tolerated (WBAT) was 5.2 weeks (range = 0-8 weeks) following OAT and 6.2 weeks (range = 0-8 weeks) following OCA. There was considerable variation in the inclusion and timing of strength, proprioception, agility, and pivoting exercises. Following OAT, 2 protocols (8%) recommended functional testing as criteria for return to sport at an average time of 12.0 weeks (range = 12-24 weeks). Following OCA, 1 protocol (6%) recommended functional testing as criteria for return to sport at an average time of 12.0 weeks (range = 12-24 weeks).ConclusionA minority of US academic orthopedic programs publish OAT and OCA rehabilitation protocols online. Among the protocols currently available, there is significant variability in the inclusion of specific rehabilitation components and timing of many modalities. Evidence-based standardization of elements of postoperative rehabilitation may help improve patient care and subsequent outcomes.
  Citation: CARTILAGE
  PubDate: 2022-06-28T09:49:06Z
  DOI: 10.1177/19476035221093071
  Issue No: Vol. 13, No. 2 (2022)
Elevated Patellofemoral and Tibiofemoral T1ρ Relaxation Times Following a
First Time Patellar Dislocation
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  Authors: John J. Elias, Mei Li, Mingrui Yang, Richard Lartey, John P. Murray, Lutul D. Farrow, Carl S. Winalski, Xiaojuan Li
  Abstract: CARTILAGE, Volume 13, Issue 2, April-June 2022.
  ObjectiveThe study was performed to evaluate cartilage within the knee following a first-time patellar dislocation, using elevated MRI-based T1ρ relaxation times as an indicator of low proteoglycan concentration. The hypothesis is that MRI-based T1ρ relaxation times for patellofemoral and tibiofemoral cartilage are significantly longer for knees being treated for patellar dislocation than for healthy control knees.DesignTwenty-one subjects being treated for a first-time, unilateral dislocation of the patella and 16 healthy controls participated in MRI-based T1ρ relaxation time mapping. Mean relaxation times were quantified for patellofemoral and tibiofemoral regions for injured knees, the contralateral knees, and healthy controls. T1ρ values for each region were compared between the 3 groups with generalized estimating equations. Linear regressions were also performed to correlate T1ρ relaxation times with time from injury.ResultsThe knees with a disloction had longer T1ρ relaxation times than the contralateral knees and control group at the medial patella and longer relaxation times than the control group at the lateral tibia (P < 0.05). T1ρ relaxation times at the medial patella also decreased with time from injury (r2 = 0.21, P = 0.037).ConclusionsCompositional changes to cartilage on the medial patella are related to traumatic impact during a dislocation. Potential exists for cartilage properties at the medial patella to improve with time. Cartilage degradation at the lateral tibia is not directly related to traumatic impact. The current baseline data are a starting point to characterize the pathway from a first-time dislocation to progressive cartilage degradation and osteoarthritis.
  Citation: CARTILAGE
  PubDate: 2022-06-09T05:47:27Z
  DOI: 10.1177/19476035221102570
  Issue No: Vol. 13, No. 2 (2022)
Incidence of (Osteo)Chondral Lesions of the Ankle in Isolated Syndesmotic
Injuries: A Systematic Review and Meta-Analysis
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  Authors: Jari Dahmen, Sohaib Jaddi, Noortje C. Hagemeijer, Bart Lubberts, Inger N. Sierevelt, Sjoerd A.S. Stufkens, Pieter d’Hooghe, John G. Kennedy, James D. F. Calder, Christopher W. DiGiovanni, Gino M. M. J. Kerkhoffs
  Abstract: CARTILAGE, Volume 13, Issue 2, April-June 2022.
  ObjectiveTo determine and compare the incidence rate of (osteo)chondral lesions of the ankle in patients with acute and chronic isolated syndesmotic injuries.DesignA literature search was conducted in the PubMed (MEDLINE) and EMBASE (Ovid) databases from 2000 to September 2021. Two authors independently screened the search results, and risk of bias was assessed using the MINORS (Methodological Index for Non-Randomized Studies) criteria. Studies on acute and chronic isolated syndesmotic injuries with pre-operative or intra-operative imaging were included. The primary outcome was the incidence rate with corresponding 95% confidence intervals (CIs) of (osteo)chondral lesions of the ankle in combined and separate groups of acute and chronic syndesmotic injuries. Secondary outcomes were anatomic distribution and mean size of the (osteo)chondral lesions.ResultsNine articles (402 syndesmotic injuries) were included in the final analysis. Overall (osteo)chondral lesion incidence was 20.7% (95% CI: 13.7%-29.9%). This rate was 22.0% (95% CI: 17.1-27.7) and 24.1% (95% CI: 15.6-35.2) for acute and chronic syndesmotic injuries, respectively. In the combined acute and chronic syndesmotic injury group, 95.4% of the lesions were located on the talar dome and 4.5% of the lesions were located on the distal tibia. (Osteo)chondral lesion size was not reported in any of the studies.ConclusionsThis meta-analysis shows that (osteo)chondral lesions of the ankle are present in 21% of the patients with isolated syndesmotic injuries. No difference in incidence rate was found between the different syndesmotic injury types and it can be concluded that the majority of lesions are located on the talar dome.PROSPERO Registration Number:CRD42020176641
  Citation: CARTILAGE
  PubDate: 2022-06-03T01:54:11Z
  DOI: 10.1177/19476035221102569
  Issue No: Vol. 13, No. 2 (2022)
Global Variation in Studies of Articular Cartilage Procedures of the Knee:
A Systematic Review
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  Authors: R. Garrett Steinmetz, J. Jared Guth, Matthew J. Matava, Matthew V. Smith, Robert H. Brophy
  Abstract: CARTILAGE, Volume 13, Issue 2, April-June 2022.
  ObjectiveThe objective of this study was to determine whether there are significant differences in terms of indications, techniques, patient variables, and objective and subjective outcome scores as a function of the geographic locale of published studies of knee articular cartilage surgery.MethodsAn electronic database search was performed of clinical studies evaluating knee articular cartilage procedures from 2000 to 2021. Studies were separated into global regions (Europe, Asia, North America, and South America) based on the study country. All cartilage-based treatments in each region were recorded. Patient age and sex, mechanism of injury, cartilage lesion size and location, follow-up time, failure rate, and knee outcome scores utilized were summarized and compared by region.ResultsA total of 2,923 studies were analyzed. Eighty level 1 and 2 studies met the inclusion criteria. The majority were from Europe (n = 60), followed by Asia (n = 11), North America (n = 7), and South America (n = 2). The majority of procedures in European and North American studies were cell-based and marrow-stimulation procedures. In Asian studies, the most common procedures were marrow-stimulation, experimental, and biologic procedures as defined by the authors. Asian countries had a higher proportion of females (P < 0.001) and an overall older patient population (P < 0.001). Regional variation was also seen in terms of lesion location, mechanism of injury, and failure rate.ConclusionMost high-level evidence for articular cartilage-based procedures of the knee comes from European countries. These studies vary by patient age and sex, anatomic location, and mechanism of injury. Global variation should be taken into consideration when interpreting and applying studies of knee articular cartilage surgery.
  Citation: CARTILAGE
  PubDate: 2022-05-17T06:06:51Z
  DOI: 10.1177/19476035221098169
  Issue No: Vol. 13, No. 2 (2022)
The Role of Interleukin-4 and Interleukin-10 in Osteoarthritic Joint
Disease: A Systematic Narrative Review
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  Authors: E.M. van Helvoort, E. van der Heijden, J.A.G. van Roon, N. Eijkelkamp, S.C. Mastbergen
  Abstract: CARTILAGE, Volume 13, Issue 2, April-June 2022.
  ObjectiveA fusion protein of interleukin-4 and interleukin-10 (IL4-10 FP) was developed as a disease-modifying osteoarthritis drug (DMOAD), and chondroprotection, anti-inflammation, and analgesia have been suggested. To better understand the mechanisms behind its potential as DMOAD, this systematic narrative review aims to assess the potential of IL-4, IL-10 and the combination of IL-4 and IL-10 for the treatment of osteoarthritis. It describes the chondroprotective, anti-inflammatory, and analgesic effects of IL-4, IL-10, and IL4-10 FP.DesignPubMed and Embase were searched for publications that were published from 1990 until May 21, 2021 (moment of search). Key search terms were: Osteoarthritis, Interleukin-4, and Interleukin-10. This yielded 2,479 hits, of which 43 were included in this review.ResultsIL-4 and IL-10 showed mainly protective effects on osteoarthritic cartilage in vitro and in vivo, as did IL4-10 FP. Both cytokines showed anti-inflammatory effects, but also proinflammatory effects. Only in vitro IL4-10 FP showed purely anti-inflammatory effects, indicating that proinflammatory effects of one cytokine can be counteracted by the other when given as a combination. Only a few studies investigated the analgesic effects of IL-4, IL-10 or IL4-10 FP. In vitro, IL-4 and IL4-10 FP were able to decrease pain mediators. In vivo, IL-4, IL-10, and IL4-10 FP were able to reduce pain.ConclusionsIn conclusion, this review describes overlapping, but also different modes of action for the DMOAD effects of IL-4 and IL-10, giving an explanation for the synergistic effects found when applied as combination, as is the case for IL4-10 FP.
  Citation: CARTILAGE
  PubDate: 2022-05-13T05:12:47Z
  DOI: 10.1177/19476035221098167
  Issue No: Vol. 13, No. 2 (2022)
Early Emergent and Progressive Aberrant Subchondral Bone Remodeling
Coupled with Aggravated Cartilage Degeneration in Developmental Dysplasia
of the Hip
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  Authors: Teng Ye, Feng Xue, Hai Hu, Zihao He, Minqi Wang, Zhifeng Yu, Bizeng Zhao, Linyang Chu
  Abstract: CARTILAGE, Volume 13, Issue 2, April-June 2022.
  ObjectiveDevelopmental dysplasia of the hip (DDH) is the most common skeletal development in children and could result in secondary osteoarthritis. This study aims to clarify the alternations of subchondral trabecular bone remodeling and microstructural properties during the development of DDH, and the potential influence of these alternations on the overlying cartilage degeneration and DDH progression.DesignTraditional straight-leg swaddling method was adopted to establish DDH model in newborn Sprague Dawley rats. Hip joint specimens from normal or DDH rats were used. Typical features of DDH in radiological examination were observed by x-ray analysis. Micro–computed tomography analysis was applied to evaluate the microstructural properties of subchondral bone at postnatal weeks 2, 4, and 6. Histological and immunohistochemical analyses were adopted to appraise subchondral bone remodeling activity and cartilage degeneration. The associations among subchondral bone, articular cartilage, and DDH severity were analyzed via multiple linear regression analysis.ResultsCompared with control group, the subchondral bone in DDH group displayed a gradual trend of deteriorated microstructure and worsening biomechanical properties along with aberrant bone remodeling, which might be responsible for the inhibition of stress transmission from the articular cartilage to the subchondral bone and thus leading to the cartilage degeneration and accelerated DDH progression.ConclusionsOur findings indicate that alternations of subchondral trabecular bone in a time-dependent manner could contribute to the DDH progression and the amelioration on subchondral bone might be a favorable therapeutic candidate for DDH.
  Citation: CARTILAGE
  PubDate: 2022-05-13T05:09:48Z
  DOI: 10.1177/19476035221098165
  Issue No: Vol. 13, No. 2 (2022)
Extracellular Vesicles from Hypoxic Pretreated Urine-Derived Stem Cells
Enhance the Proliferation and Migration of Chondrocytes by Delivering
miR-26a-5p
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  Authors: Sha Wan, Dingsu Bao, Jia Li, Kefu Lin, Qi Huang, Qiang Li, Lang Li
  Abstract: CARTILAGE, Volume 13, Issue 2, April-June 2022.
  ObjectiveStem-cell therapy is a promising treatment for cartilage defects. The newly identified urine-derived stem cells (USCs), which have multipotency and sufficient proliferative ability, are promising candidates for several tissue engineering therapies. In this study, we investigated the role of USC extracellular vehicles (EVs) in promoting the proliferation and migration of chondrocytes.DesignUSCs were characterized by measuring induced multipotent differentiation and flow cytometry analysis of surface marker expression. The EVs were isolated from USCs under normoxic conditions (nor-EVs) and hypoxic conditions (hypo-EVs). Transmission electron microscopy and western blot analysis characterized the EVs. The chondrocytes were cultured in the USC-EVs. CCK-8 assay and EdU staining detected the proliferation of chondrocytes, and transwell assay detected their migration. miR-26a-5p expression in EVs was detected by quantitative real-time polymerase chain reaction (qRT-PCR). The target relationship of miR-26a-5p and phosphatase and tensin homolog (PTEN) was predicted and confirmed. The roles of EVs-miR-26a-5p and PTEN on the proliferation and migration of chondrocytes were also investigated.ResultsHypo-EVs showed a superior effect in promoting the proliferation and migration of chondrocytes than nor-EVs. Mechanistically, USC-EVs delivered miR-26a-5p into chondrocytes to overexpress miR-26a-5p. PTEN was identified as an miR-26a-5p target in chondrocytes. The effects of EVs-miR-26a-5p on promoting the proliferation and migration of chondrocytes were mediated by its regulation of PTEN.ConclusionOur study suggested that hypoxic USC-EVs may represent a promising strategy for osteoarthritis by promoting the proliferation and migration of chondrocytes via miR-26a-5p transfer.
  Citation: CARTILAGE
  PubDate: 2022-05-12T09:44:35Z
  DOI: 10.1177/19476035221077401
  Issue No: Vol. 13, No. 2 (2022)
The Current Status of Clinical Trials on Biologics for Cartilage Repair
and Osteoarthritis Treatment: An Analysis of ClinicalTrials.gov Data
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  Authors: Zijun Zhang, Lew Schon
  Abstract: CARTILAGE, Volume 13, Issue 2, April-June 2022.
  ObjectiveBiologics are increasingly used for cartilage repair and osteoarthritis (OA) treatment. This study aimed to provide an overview of the clinical trials conducted on this subject.DesignTwo-word combinations of two sets of key words “cartilage”; “joint”; “osteoarthritis” and “biologics”; “stem cells”; “cell implantation” were used to search the database of ClinicalTrials.gov and supplemented with searches of PubMed and EMbase. The registered trials were analyzed for clinical conditions, completion status, phases, and investigated biologics. Recently completed trials with posted/published results were summarized.ResultsFrom 2000 to 2022, a total of 365 clinical trials were registered at ClinicalTrials.gov to use biologics for cartilage repair and OA treatment. Since 2006, the number of registered trials accelerated at an annual rate of 16.4%. Of the 265 trials designated with a phase, 72% were early Phase 1, Phase 1, and Phase 2. Chondrocytes and platelet-rich plasma (PRP) were studied in nearly equal number of early- and late-stage trials. Mesenchymal stem/stromal cells (MSCs) were the most commonly investigated biologics (38%) and mostly derived from bone marrow and adipose tissue (70%). In last 5 years, 32 of the 72 completed trials posted/published results, among which seven Phase 3 trials investigated chondrocytes, PRP, bone marrow aspirate concentrate, hyaluronic acid, collagen membrane, and albumin.ConclusionsThere was a rapid increase in the number of registered clinical trials in recent years, using a variety of biologics for cartilage repair and OA treatment. Majority of the biologics still require late-stage trials to validate their clinical effectiveness.
  Citation: CARTILAGE
  PubDate: 2022-05-12T06:47:34Z
  DOI: 10.1177/19476035221093065
  Issue No: Vol. 13, No. 2 (2022)
Single-Dose Intra-Cartilage Delivery of Kartogenin Using a Cationic
Multi-Arm Avidin Nanocarrier Suppresses Cytokine-Induced
Osteoarthritis-Related Catabolism
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  Authors: Tengfei He, Irfhan Shaw, Armin Vedadghavami, Ambika G. Bajpayee
  Abstract: CARTILAGE, Volume 13, Issue 2, April-June 2022.
  ObjectiveKartogenin (KGN) has proven as a both chondrogenic and chondroprotective drug for osteoarthritis (OA) therapy. However, being a small hydrophobic molecule, KGN suffers from rapid joint clearance and inability to penetrate cartilage to reach chondrocytes following intra-articular administration. As such multiple high doses are needed that can lead to off-target effects including stimulation and tissue outgrowth. Here we design charge-based cartilage targeting formulation of KGN by using a multi-arm cationic nano-construct of Avidin (mAv) that can rapidly penetrate into cartilage in high concentrations owing to weak-reversible electrostatic binding interactions with negatively charged aggrecan-glycosaminoglycans (GAGs) and form an extended-release drug depot such that its therapeutic benefit can be reaped in just a single dose.DesignWe synthesized 2 novel formulations, one with a releasable ester linker (mAv-OH-KGN, release half-life ~58 h) that enables sustained KGN release over 2 weeks and another with a non-releasable amide linker (mAv-NH-KGN) that relies on mAv’s ability to be uptaken and endocytosed by chondrocytes for drug delivery. Their effectiveness in suppressing cytokine-induced catabolism was evaluated in vitro using cartilage explant culture model.ResultsA single 100 μM dose of cartilage homing mAv-KGN was significantly more effective in suppressing cytokine-induced GAG loss, cell death, inflammatory response and in rescuing cell metabolism than a single dose of free KGN; multiple doses of free KGN were needed to match this therapeutic response.ConclusionmAv mediated delivery of KGN is promising and can facilitate clinical translation of KGN for OA treatment with only a single dose.
  Citation: CARTILAGE
  PubDate: 2022-04-30T11:28:54Z
  DOI: 10.1177/19476035221093072
  Issue No: Vol. 13, No. 2 (2022)
A Pre-Clinical Animal Study for Zonal Articular Cartilage Regeneration
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  Authors: Ching Ann Tee, Zheng Yang, Yingnan Wu, Xiafei Ren, Maciej Baranski, Daryl Jimian Lin, Afizah Hassan, Jongyoon Han, Eng Hin Lee
  Abstract: CARTILAGE, Volume 13, Issue 2, April-June 2022.
  ObjectiveThe zonal properties of articular cartilage critically contribute to the mechanical support and lubrication of the tissue. Current treatments for articular cartilage have yet to regenerate this zonal architecture, thus compromising the functional efficacy of the repaired tissue and leading to tissue degeneration in the long term. In this study, the efficacy of zonal cartilage regeneration through bilayered implantation of expanded autologous zonal chondrocytes was investigated in a porcine chondral defect model.DesignAutologous chondrocytes extracted from articular cartilage in the non-weight bearing trochlea region of the knee were subjected to an expansion-sorting strategy, integrating dynamic microcarrier (dMC) culture, and spiral microchannel size-based zonal chondrocyte separation. Zonal chondrocytes were then implanted as bilayered fibrin hydrogel construct in a porcine knee chondral defect model. Repair efficacy was compared with implantation with cell-free fibrin hydrogel and full thickness (FT) cartilage-derived heterogenous chondrocytes. Cartilage repair was evaluated 6 months after implantation.ResultsSufficient numbers of zonal chondrocytes for implantation were generated from the non-weight bearing cartilage. Six-month repair outcomes showed that bilayered implantation of dMC-expanded zonal chondrocytes resulted in substantial recapitulation of zonal architecture, including chondrocyte arrangement, specific Proteoglycan 4 distribution, and collagen alignment, that was accompanied by healthier underlying subchondral bone.ConclusionThese results demonstrate that with appropriate expansion and isolation of zonal chondrocytes, the strategy of stratified zonal chondrocyte implantation represents a significant advancement to Autologous Chondrocyte Implantation-based cartilage regeneration, with the potential to improve the long-term integrity of the regenerated tissues.
  Citation: CARTILAGE
  PubDate: 2022-04-21T02:00:39Z
  DOI: 10.1177/19476035221093063
  Issue No: Vol. 13, No. 2 (2022)
Validating a Semi-Automated Technique for Segmenting Femoral Articular
Cartilage on Ultrasound Images
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  Authors: Matthew S. Harkey, Nicholas Michel, Christopher Kuenze, Ryan Fajardo, Matt Salzler, Jeffrey B. Driban, Ilker Hacihaliloglu
  Abstract: CARTILAGE, Volume 13, Issue 2, April-June 2022.
  ObjectiveTo validate a semi-automated technique to segment ultrasound-assessed femoral cartilage without compromising segmentation accuracy to a traditional manual segmentation technique in participants with an anterior cruciate ligament injury (ACL).DesignWe recruited 27 participants with a primary unilateral ACL injury at a pre-operative clinic visit. One investigator performed a transverse suprapatellar ultrasound scan with the participant’s ACL injured knee in maximum flexion. Three femoral cartilage ultrasound images were recorded. A single expert reader manually segmented the femoral cartilage cross-sectional area in each image. In addition, we created a semi-automatic program to segment the cartilage using a random walker-based method. We quantified the average cartilage thickness and echo-intensity for the manual and semi-automated segmentations. Intraclass correlation coefficients (ICC2,k) and Bland-Altman plots were used to validate the semi-automated technique to the manual segmentation for assessing average cartilage thickness and echo-intensity. A dice correlation coefficient was used to quantify the overlap between the segmentations created with the semi-automated and manual techniques.ResultsFor average cartilage thickness, there was excellent reliability (ICC2,k = 0.99) and a small mean difference (+0.8%) between the manual and semi-automated segmentations. For average echo-intensity, there was excellent reliability (ICC2,k = 0.97) and a small mean difference (−2.5%) between the manual and semi-automated segmentations. The average dice correlation coefficient between the manual segmentation and semi-automated segmentation was 0.90, indicating high overlap between techniques.ConclusionsOur novel semi-automated segmentation technique is a valid method that requires less technical expertise and time than manual segmentation in patients after ACL injury.
  Citation: CARTILAGE
  PubDate: 2022-04-19T12:27:47Z
  DOI: 10.1177/19476035221093069
  Issue No: Vol. 13, No. 2 (2022)
Low-Intensity Pulsed Ultrasound Enhances the Efficacy of Bone
Marrow–Derived MSCs in Osteoarthritis Cartilage Repair by Regulating
Autophagy-Mediated Exosome Release
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  Authors: Peng Xia, Qi Wang, Jiulong Song, Xiaoju Wang, Xinwei Wang, Qiang Lin, Kai Cheng, Anliang Chen, Xueping Li
  Abstract: CARTILAGE, Volume 13, Issue 2, April-June 2022.
  ObjectiveThe present study explored whether low-intensity pulsed ultrasound (LIPUS) enhances the therapeutic efficacy of mesenchymal stem cells (MSCs) in osteoarthritis (OA) cartilage repair by regulating autophagy-mediated exosome release.DesignMSCs were isolated from the rat bone marrow and treated with rapamycin, 3-methyladenine, or LIPUS. The mechanism of the LIPUS-stimulated exosome release by MSCs was analyzed by inhibiting autophagy. In addition, the MSCs were co-cultured with OA chondrocytes and stimulated by LIPUS, with or without exosome release inhibitor intervention. The exosome release was detected through transmission electron microscopy (TEM), nanoparticle tracking analysis, and biomarker expression analysis. Autophagy was analyzed through TEM, autophagy-related gene expression analysis, and immunofluorescence analysis in vitro. Furthermore, a rat knee OA model was constructed and treated with MSCs, GW4869, and LIPUS. The cartilage repair was assessed through histopathological analysis and extracellular matrix protein expression analysis.ResultsThe in vitro results indicated that LIPUS promoted MSC exosome release by activating autophagy. The in vivo results demonstrated that LIPUS significantly enhanced the positive effects of MSCs on OA cartilage. These effects were significantly blocked by GW4869, an inhibitor of exosome release.ConclusionsLIPUS can enhance the therapeutic efficacy of MSCs in OA cartilage repair, and the underlying mechanism is related to the increase in autophagy-mediated exosome release.
  Citation: CARTILAGE
  PubDate: 2022-04-19T12:23:26Z
  DOI: 10.1177/19476035221093060
  Issue No: Vol. 13, No. 2 (2022)