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Fulltext Calcified vertical plate of the cricoid--a rare pitfall in the diagnosis of an oesophageal foreign body

Arasaratnam S, Abdullah BJJ, Fernandez V

Med J Malaysia, 1998 Sep;53(3):290-2.
PMID: 10968170

We present a case of rare pitfall in the diagnosis of an oesophageal foreign body due to the calcified vertical plate of the cricoid to highlight the need to be aware of this entity to avoid unnecessary morbidity.

Matched MeSH terms: Cartilage Diseases/diagnosis*; Cartilage Diseases/pathology; Cartilage Diseases/radiography; Cartilage Diseases/surgery
Current strategies in multiphasic scaffold design for osteochondral tissue engineering: A review

Yousefi AM, Hoque ME, Prasad RG, Uth N

J Biomed Mater Res A, 2015 Jul;103(7):2460-81.
PMID: 25345589 DOI: 10.1002/jbm.a.35356

The repair of osteochondral defects requires a tissue engineering approach that aims at mimicking the physiological properties and structure of two different tissues (cartilage and bone) using specifically designed scaffold-cell constructs. Biphasic and triphasic approaches utilize two or three different architectures, materials, or composites to produce a multilayered construct. This article gives an overview of some of the current strategies in multiphasic/gradient-based scaffold architectures and compositions for tissue engineering of osteochondral defects. In addition, the application of finite element analysis (FEA) in scaffold design and simulation of in vitro and in vivo cell growth outcomes has been briefly covered. FEA-based approaches can potentially be coupled with computer-assisted fabrication systems for controlled deposition and additive manufacturing of the simulated patterns. Finally, a summary of the existing challenges associated with the repair of osteochondral defects as well as some recommendations for future directions have been brought up in the concluding section of this article.

Matched MeSH terms: Cartilage Diseases/therapy*
Fulltext Autologous chondrocyte implantation for knee focal cartilage defects: 3 years' follow-up at the University Malaya Medical Centre

Abbas AA, Mohamad JA, Lydia AL, Selvaratnam L, Razif A, Ab-Rahim S, et al.

JUMMEC, 2014;17(1):8-13.
MyJurnal

Autologous chondrocyte implantation (ACI) is a widely accepted procedure for the treatment of large, fullthickness chondral defects involving various joints, but its use in developing countries is limited because of high cost and failure rates due to limited resources and support systems. Five patients (age

Matched MeSH terms: Cartilage Diseases
Fulltext Otitis externa complicated with chloramphenicol ear drops-induced perichondritis

Mohamad I, Johan K, Hashim H, Nik Othman N

Malays Fam Physician, 2014;9(1):28-9.
PMID: 25606295 MyJurnal

Otitis externa is a common condition of the ear. It is manifested as narrowing of the lumen owing to the edematous swelling of the ear canal lining. Perichondritis may occur independently or as a complication of the otitis externa. We report a case of perichondritis after using a topical ear drop. Changing the medication provides immediate resolution of the condition.

Matched MeSH terms: Cartilage Diseases
Fulltext Modified Harrington Procedure for Acetabular Insuficiency Due to Metastatic Malignant Disease

Faisham, W.I., Muslim, D.A.J., Bhavaraju, V.M.K., Nawaz, A.H., Zulmi, W.

Malays Orthop J, 2009;3(1):36-41.
MyJurnal

Extensive peri-acetabular osteolysis caused by malignant disease process is a major surgical challenge as conventional hip arthroplasty is not adequate. We describe a modified use of the Harrington procedure for acetabular insufficiency secondary to metastatic disease in twelve patients. The procedures include application of multiple threaded pins to bridge the acetabular columns, anti-protrusio cage and cemented acetabular cup. Eleven patients were able to walk pain free and achieved a mean Musculoskeletal Tumour Society Functional Score of 80 (range, 68 to 86).

Matched MeSH terms: Cartilage Diseases
Autologous chondrocyte transplantation in the repair of full-thickness focal cartilage damage in rabbits

Kamarul T, Selvaratnam L, Masjuddin T, Ab-Rahim S, Ng C, Chan KY, et al.

J Orthop Surg (Hong Kong), 2008 Aug;16(2):230-6.
PMID: 18725678

To compare the efficacy of autologous chondrocyte transplantation (ACT) versus non-operative measures for cartilage repair in rabbits.

Matched MeSH terms: Cartilage Diseases/pathology; Cartilage Diseases/surgery*
Fulltext Metastatic Adenocarcinoma of the Lung Mimicking Spinal Tuberculosis

Zamzuri, Z., Adham, S.Y., Shukrimi, A., Azril, M.A., Amran, R.

International Medical Journal Malaysia, 2011;10(2):33-35.
MyJurnal

Clinically, it is sometimes difﬁ cult to distinguish an infection of the spine from a metastasis. Spinal tuberculosis is common according to its endemic region and adenocarcinoma of the lung is also rising in the incidence worldwide. Similar presentations, with unknown primary, clinical ﬁ ndings and hematological investigations rarely conclude a true diagnosis. Radiologically, the hallmark of spinal infection is erosion of adjacent vertebral endplates and narrowing of the disc space with or without a paravertebral shadow. Metastasis typically does not involve the disc space with erosion of the adjacent vertebral endplates. It usually presents as a lytic/sclerotic lesion in the vertebral body or “winkle owl” sign. These distinguishing features of infection versus metastasis are not certainties. Biopsy is mandatory whenever in doubt or patient is not responded with provisional treatment. The author presents a case with so-called radiological features of spinal tuberculosis infection, which turns out to be a metastatic adenocarcinoma of the lung.

Matched MeSH terms: Cartilage Diseases
Growth kinetic study on normal and microtic chondrocytes of human auricular cartilage

Ishak MF, Aminuddin BS, Asma A, Lokman BS, Ruszymah BH, Goh BS

Med J Malaysia, 2008 Jul;63 Suppl A:117-8.
PMID: 19025013

Chondrocytes were isolated from normal and microtic human auricular cartilage after ear surgery carried out at Universiti Kebangsaan Malaysia Medical Centre. Chondrocytes were cultured and expanded until passage 4. After reached confluence, cultured chondrocytes at each passage (P1, P2, P3 and P4) were harvested and assigned for growth profile analysis. There was no significant difference in cell viability between both normal and microtic samples (p = 0.84). Both samples showed no significant differences for growth profile parameters in terms of growth rate, population doubling time and total number of cell doubling, except in passage 1, where there is significant difference in cell growth rate (p = 0.004). This preliminary data has indicated that chondrocytes from microtic cartilage has the potential to be used in the reconstruction of human pinna in the future.

Matched MeSH terms: Cartilage Diseases/pathology*
Measurement of sulphated glycosaminoglycans production after autologous 'chondrocytes-fibrin' constructs implantation in sheep knee joint

Munirah S, Samsudin OC, Chen HC, Salmah SH, Aminuddin BS, Ruszymah BH

Med J Malaysia, 2008 Jul;63 Suppl A:35-6.
PMID: 19024971

Chondrocytes were isolated from articular cartilage biopsy and were cultivated in vitro. Approximately 30 million of cultured chondrocytes per ml were incorporated with autologous plasma-derived fibrin to form three-dimensional construct. Full-thickness punch hole defects were created in lateral and medial femoral condyles. The defects were implanted either with the autologous 'chondrocytes-fibrin' construct (ACFC), autologous chondrocytes (ACI) or fibrin blank (AF). Sheep were euthanized after 12 weeks. The gross morphology of all defects treated with ACFC implantation, ACI and AF exhibited median scores which correspond to a nearly normal appearance according to the International Cartilage Repair Society (ICRS) classification. ACFC significantly enhanced cartilage repair compared to ACI and AF in accordance with the modified O'Driscoll histological scoring scale. The relative sulphated glycosaminoglycans content (%) was significantly higher (p < 0.05) in ACFC when compared to control groups; ACI vs. fibrin only vs. untreated (blank). Results showed that ACFC implantation exhibited superior cartilage-like tissue regeneration compared to ACI. If the result is applicable to the human, it possibly will improve the existing treatment approaches for cartilage restoration in orthopaedic surgery.

Matched MeSH terms: Cartilage Diseases/therapy*
The comparison between the different generations of autologous chondrocyte implantation with other treatment modalities: a systematic review of clinical trials

Samsudin EZ, Kamarul T

Knee Surg Sports Traumatol Arthrosc, 2016 Dec;24(12):3912-3926.
PMID: 26003481

PURPOSE: This paper aims to review the current evidence for autologous chondrocyte implantation (ACI) generations relative to other treatment modalities, different cell delivery methods and different cell source application.
METHODS: Literature search was performed to identify all level I and II studies reporting the clinical and structural outcome of any ACI generation in human knees using the following medical electronic databases: PubMed, EMBASE, Cochrane Library, CINAHL, SPORTDiscus and NICE healthcare database. The level of evidence, sample size calculation and risk of bias were determined for all included studies to enable quality assessment.
RESULTS: Twenty studies were included in the analysis, reporting on a total of 1094 patients. Of the 20 studies, 13 compared ACI with other treatment modalities, seven compared different ACI cell delivery methods, and one compared different cell source for implantation. Studies included were heterogeneous in baseline design, preventing meta-analysis. Data showed a trend towards similar outcomes when comparing ACI generations with other repair techniques and when comparing different cell delivery methods and cell source selection. Majority of the studies (80 %) were level II evidence, and overall the quality of studies can be rated as average to low, with the absence of power analysis in 65 % studies.
CONCLUSION: At present, there are insufficient data to conclude any superiority of ACI techniques. Considering its two-stage operation and cost, it may be appropriate to reserve ACI for patients with larger defects or those who have had inadequate response to other repair procedures until hard evidence enables specific clinical recommendations be made.
LEVEL OF EVIDENCE: II.

Matched MeSH terms: Cartilage Diseases/therapy*
Inflammation of the external ear in acute chikungunya infection: Experience from the outbreak in Johor Bahru, Malaysia, 2008

Javelle E, Tiong TH, Leparc-Goffart I, Savini H, Simon F

J Clin Virol, 2014 Apr;59(4):270-3.
PMID: 24556566 DOI: 10.1016/j.jcv.2014.01.011

The re-emerging invalidating chikungunya disease has recently extended to temperate areas. Other alphaviruses can also present with febrile arthalgias. Dengue virus transmitted by the same species of mosquitoes may cocirculate, leading to dual infections and concurrent epidemics. Although these diseases share similar clinical features, their prognoses considerably differ. Prominent and prolonged articular disorders are more consistent with chikungunya virus, whereas haemorrhages make the gravity of dengue infection. Specific symptoms are required, especially when diagnostic tests are not available or performable at a large scale. Indeed, early clinical suspicion of a vector-borne disease is crucial to isolate the first cases in the course of an outbreak, and discrimination between arboviruses help to optimal management of patients. No specific chikungunya clinical sign has been yet reported. We highlight here the high prevalence (about 25%) of acute ear redness in infected people during the 2008 chikungunya outbreak in Jahor Bahru in Malaysia. Nine consenting patients are more precisely described. Ear chondritis could be sensitive diagnostic criterion of the acute stage of chikungunya, every physician - even in occidental non endemic areas - should be aware of.

Matched MeSH terms: Cartilage Diseases/diagnosis; Cartilage Diseases/pathology
Fulltext The effect of water extracts of Euphorbia hirta on cartilage degeneration in arthritic rats

Lee KH, Chen YS, Judson JP, Chakravarthi S, Sim YM, Er HM

Malays J Pathol, 2008 Dec;30(2):95-102.
PMID: 19291918 MyJurnal

The effect of water extracts of Euphorbia hirta on the histological features and expressions of matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) in the rat articular cartilage was investigated. Arthritis was induced in rats using Freund's Complete Adjuvant containing heat-killed M. tuberculosis, and treated with water extracts of E. hirta. Paraffin tissue sections of the arthritic joints were evaluated. The extent of cartilage degeneration was found to be greatest in rats treated with the highest dosage of E. hirta, followed by rats in the untreated group. Rats treated with the intermediary and low dosages of Euphorbia hirta showed improved histology. MMP-13 levels were found to be decreased with decreasing dosages of E. hirta. TIMP-1 levels were found to increase with decreasing dosages of E. hirta. MMP-3 levels fluctuated without any appreciable pattern. Low dosages of E. hirta seem to be beneficial in reducing cartilage degeneration in cases of arthritis.

Matched MeSH terms: Cartilage Diseases/etiology; Cartilage Diseases/pathology*
Fulltext Gelatin Microsphere for Cartilage Tissue Engineering: Current and Future Strategies

Sulaiman SB, Idrus RBH, Hwei NM

Polymers (Basel), 2020 Oct 19;12(10).
PMID: 33086577 DOI: 10.3390/polym12102404

The gelatin microsphere (GM) provides an attractive option for tissue engineering due to its versatility, as reported by various studies. This review presents the history, characteristics of, and the multiple approaches to, the production of GM, and in particular, the water in oil emulsification technique. Thereafter, the application of GM as a drug delivery system for cartilage diseases is introduced. The review then focusses on the emerging application of GM as a carrier for cells and biologics, and biologics delivery within a cartilage construct. The influence of GM on chondrocytes in terms of promoting chondrocyte proliferation and chondrogenic differentiation is highlighted. Furthermore, GM seeded with cells has been shown to have a high tendency to form aggregates; hence the concept of using GM seeded with cells as the building block for the formation of a complex tissue construct. Despite the advancement in GM research, some issues must still be addressed, particularly the improvement of GM's ability to home to defect sites. As such, the strategy of intraarticular injection of GM seeded with antibody-coated cells is proposed. By addressing this in future studies, a better-targeted delivery system, that would result in more effective intervention, can be achieved.

Matched MeSH terms: Cartilage Diseases
Fulltext Osteochondromyxoma of Talus

Balakrishnan, Yogambigai, Nor Hasnina Mohd Hassan, Wan Najwa Zaini Wan Mohamed

Borneo Journal of Medical Sciences, 2019;13(3):65-70.
MyJurnal

Osteochondromyxoma is a rare bone tumour. Bone tumours of the talus are also uncommon, and accounts to be between 8% to 23% in tumours of the foot. A 28-year-old man presented with chronic right ankle pain. He had underlying left knee ligament and meniscal injury. Special examination tests for ligament injury were negative. Magnetic Resonance Imaging (MRI) revealed a benign bone lesion of talus with reactive oedema of sinus tarsi. Excision of lesion was done and subsequent histopathological examination confirmed the diagnosis of ostechondromyxoma.

Matched MeSH terms: Cartilage Diseases
Adult Langerhans cell histiocytosis: An unusual cause of referred knee pain

Swarna Nantha Y, Yeoh MH, Sharif SM

Malays Fam Physician, 2019;14(3):60-64.
PMID: 32175042

Langerhans cell histiocytosis (LCH) in adults is rare and regarded as an 'orphan disease.' The systemic symptoms of LCH can mimic many other undifferentiated diseases seen at the primary care level. Failure to diagnose and delays in referral are common pitfalls in the management of this disease. We present a case of a 34-year-old woman with referred knee pain who was eventually diagnosed with multi-system LCH 4 years after the initial presentation. The mean age of presentation of LCH symptoms in adults is 33. Bone lesions are the frequent presentation of LCH in this age group. Endocrine involvement in LCH is seen in the form of diabetes insipidus (DI), which remains the most common extraskeletal presentation of LCH in adults. In the case discussed here, a definitive diagnosis of LCH was established through tissue biopsy. The spectrum of undifferentiated symptoms underscores the difficulty and delay in making a diagnosis associated with the condition. Most GPs not only face the predicament of initial recognition but also fail to merge presenting symptoms to form a purposeful referral of this elusive disease to a tertiary care unit.

Matched MeSH terms: Cartilage Diseases
A clinical update and global economic burden of rheumatoid arthritis

Fazal SA, Khan M, Nishi SE, Alam F, Zarin N, Bari MT, et al.

Endocr Metab Immune Disord Drug Targets, 2018 Feb 13;18(2):98-109.
PMID: 29141572 DOI: 10.2174/1871530317666171114122417

BACKGROUND AND OBJECTIVE: Rheumatoid arthritis (RA) is a predominant inflammatory autoimmune disorder. The incidence and prevalence of RA is increasing with considerable morbidity and mortality worldwide. The pathophysiology of RA has become clearer due to many significant research outputs during the last two decades. Many inflammatory cytokines involved in RA pathophysiology and the presence of autoantibodies are being used as potential biomarkers via the use of effective diagnostic techniques for the early diagnosis of RA. Currently, several disease-modifying anti-rheumatic drugs are being prescribed targeting RA pathophysiology, which have shown significant contributions in improving the disease outcomes.

DISCUSSION: Even though innovations in treatment strategies and monitoring are helping the patients to achieve early and sustained clinical and radiographic remission, the high cost of drugs and limited health care budgets are restricting the easy access of RA treatment. Both direct and indirect high cost of treatment are creating economic burden for the patients and affecting their quality of life.

CONCLUSION: The aim of this review is to describe the updated concept of RA pathophysiology and highlight current diagnostic tools used for the early detection as well as prognosis - targeting several biomarkers of RA. Additionally, we explored the updated treatment options with side effects besides discussing the global economic burden.

Matched MeSH terms: Cartilage Diseases/etiology; Cartilage Diseases/immunology; Cartilage Diseases/prevention & control
Fulltext Strides towards the realization of cure for cartilage defects and osteoarthritis: the limitation and regulatory challenges

Ude Chinedu Cletus, Azizi Miskon, Ruszymah Idrus

Sains Malaysiana, 2018;47(11):2757-2767.

Despite remarkable mechanical durability and strength, hyaline cartilage has very limited capacity for self-repair when injured and over time, may degenerate to osteoarthritis. We evaluated the most significant mile stones attained, in the pursuit of cure for cartilage defects and osteoarthritis. The basic treatment options include: Natural or physical therapy, medications, nutritional supplements, nutriceuticals and chondroprotective agents. Next are repairs and replacements, which include surgical procedures: Debridement/chondroplasty, microfracturing, mosaicplasty, periosteum transplantation, osteochondral autografting and allografting, high tibial osteotomy and total knee arthroplasty. But, current trend has shifted from repair, replacement, to most recently regeneration. Regenerations include the cell and gene therapies. While cell therapy involves the use of cells isolated from different tissues to cause regeneration of cartilage; gene therapy involves the selection of appropriate gene and optimal vector to incorporate cDNA. There has been much positivity reported with big animal models, which has led to several ongoing clinical trials. Translations of these findings hold high promises, though not without inherent regulatory hurdles. Considering the initial success rates, there are increasing hopes of realizing these treatments from bench to bedsides. Significant improvements in the treatment of cartilage degenerations and osteoarthritis have been made so far, but no gold standard delineated.

Matched MeSH terms: Cartilage Diseases
Platelet rich concentrate enhances mesenchymal stem cells capacity to repair focal cartilage injury in rabbits

Samuel S, Ahmad RE, Ramasamy TS, Manan F, Kamarul T

Injury, 2018 Apr;49(4):775-783.
PMID: 29503013 DOI: 10.1016/j.injury.2018.02.020

BACKGROUND: It has been previously suggested that the use of regenerative promoters, which include bone marrow-derived mesenchymal stem cells (MSCs) or natural growth factors supplement such as platelet-rich concentrate (PRC) could promote cartilage regeneration. However, the notion that the concurrent use of both promoters may provide a synergistic effect that improves the repair outcome of focal cartilage injury has not been previously demonstrated. This study was thus conducted to determine whether the concomitant use of PRC could further enhance the reparative potential of MSCs encapsulated in alginate transplanted into focal cartilage injury in rabbits.
METHODS: Artifically created full thickness cartilage defects were made on the weight-bearing region of medial femoral condyles in bilateral knees of New Zealand White rabbits (N = 30). After one month, the right knee was treated with either i) PRC (n = 10), ii) MSCs (n = 10), or, iii) a combination of PRC and MSCs (PRC + MSC) (n = 10), all encapsulated in alginate. The left knee remained untreated (control). Rabbits were sacrificed at 3 and 6 months after treatment. Cartilage tissue regeneration was accessed using ICRS morphologic scoring, histologic grading by O'Driscoll scoring, immunohistochemical staining and quantitative analysis of glycosaminoglycans (GAG) per total protein content.
RESULTS: At 3 months, transplantation using PRC alone was equally effective as MSCs in inducing the repair of cartilage defects. However, PRC + MSC resulted in significantly higher ICRS and O'Driscoll scores (p 

Matched MeSH terms: Cartilage Diseases

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