Since loss of meniscus is correlated with an increasing risk for osteoarthritis, meniscal scaffolds are proposed as new strategies. Development of a suitable scaffold has to take into account differing meniscus thickness, exposure to compressive and tensile forces combined with high porosity and biocompatibility of the material. After physical testing of three flat scaffolds composed of different modified polyglycolic acid (PGA) fibers, a three‐dimensional meniscus‐shaped PGA‐hyaluronan implant was generated. Micro‐computed tomography showed 90% porosity in the outer area with 50% in the inner area of the implant. Biocompatibility and expression of meniscus typical cartilaginous genes were shown for human meniscus cells cultivated in the implant with 10% human serum or 5% platelet‐rich plasma for 14 days in vitro. The proof‐of‐concept study in sheep demonstrated proteoglycan‐ and collagen type I‐rich repair tissue formation in partial meniscectomy combined with a meniscus‐shaped PGA‐hyaluronan implant after 6 months. In contrast, the control showed nearly no repair tissue formation. Thus, meniscus‐shaped PGA‐hyaluronan implants might be a suitable therapeutic approach to support repair tissue formation in partial meniscectomy.

Aim:The aim of our study was to assess the therapeutic effects of platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC) in an animal knee lesion complex associating a large osteochondral defect and meniscal defect resulted from partial meniscectomy, a clinical situation that occurs quite often in orthopedic practice. Materials and Methods: Twenty-one male rabbits were included in the study, and all underwent initial surgery on the right knee to create the osteochondral defect on the internal femoral condyle, and remove the anterior horn of the internal meniscus, simulating a clinical situation. Rabbits were separated in three study groups: control, PRP group, in which three PRP injections were administered, and BMAC group, in which one single BMAC injection was administered. At the end of the six months follow-up period, knees were harvested and further analyzed using confocal microscopy and three-dimensional (3D) reconstruction of the articular surface. Results: Therapeutic groups had better results concerning articular surface remodeling and joint degeneration indicators in comparison to trauma group. Conclusions: Our results suggest that using post-operative regenerative therapies does improve final results concerning surface contact remodeling that was investigated using confocal microscopy and should be considered a valid treatment adjuvant in managing patients with this type of lesion complex, as it improves global joint outcome.

Brodie’s abscess is a rare form of sub-acute osteomyelitis that implies the collection of pus inside bone tissue. The present paper presents an extremely rare case of Brodie’s abscess located in the distal femur in a young male patient who refused medical care for three years and presented directly with spontaneous fistula and septic complications. Laboratory tests also suggested chronic septic alterations. Complex imaging investigations including X-ray (RX), computer tomography (CT) and Magnetic Resonance imaging (MRI) confirmed the diagnosis with characteristic aspects, such as the penumbra sign on the T1 weighted MRI image. Management included aggressive debridement, defect reconstruction, and long-term specific antibiotics according to culture harvested intra-operatively. Evolution was positive with inflammatory blood tests returning to physiological values within four weeks and patient full recovery within six months, without any physical deficits. The novelty aspect found in this case presentation is represented by the long-term natural evolution of this pathology, and the fact that even in these conditions, the Brodie’s abscess did not evolve into a ‘malignant’ septic condition, but remained rather benign until the spontaneous fistula prompted the patient to seek medical care.

Surgical indication of joint preserving alternative procedures, remain extremely rare worldwide in comparison to total hip arthroplasty. The aim of our study was to map the femoral head in regard to quality of the articular surface using confocal microscopy, and to bring more arguments that would encourage orthopedic surgeons to take into consideration procedures that preserve the femoral head and joint in young patients, as opposed to direct total arthroplasty of the hip. Furthermore we believe that new procedures could be described in order to reach these two main goals: sparing the femoral head and, of course, better function of the hip. Our results show that while the superior pole of the femoral head presents completely deteriorated cartilage and contact surface, other areas of the femoral head present relatively good quality cartilage, whereas the inferior pole of the femoral head which is non-weightbearing has unaltered surface anatomy. In conclusion, we do encourage for further research in the direction of femoral head sparing procedures of the hip, in order to improve function and delay total hip arthroplasty in carefully selected patients.

Achilles tendon disorders, chronic degenerative tendon disorders (tendinopathy) are a frequent pathology in the Orthopaedic ward and quite difficult to treat. The autors present the case of a number of 25 patients (18 females and 7 male), with mean age of 37.2 years,a group of young and active patients, with chronic unilateral Achilles tendinopathy (at least 6 months of symptoms) refractary to conservative treatment, including physical rest and physical theraphy. All study patients have no surgical treatment performed at the Achilles tendons, or any corticosteroids infiltrations in this region. Patients were treated with 3 PRP injections at one week interval. The patient were evaluated clinically and with the ultrasound at baseline, at 1 month and at 6 months, further results will be evaluated at 1 year and early after that. Scores used for evaluation were: Visual Analog Scale (VAS) and VISA A score. The study group that included 25 patients male and females were evaluated using the VAS score and the VISA A questionnaire referring to Achilles tendinopathy, pain symptoms and functionality. Results were assessed at 1 month and at 6 months, both scores improved significantly, and also the ultrasound imaging findings. The majority of the patients were symptoms free after the 3 step PRP local infiltrations showing stable results at 6 months, while 5 of the patients showed no clinical improvement of symptoms. The overall findings in our study show that repeated PRP injections for Achilles tendinopathy obtained good results in term of clinical symptom improvement and alo stable results in time at the 6 months evaluation. On this study group discussiond reffer mainly to the small gropup of patients, only 25, and to the short term follow up period, 6 months, with future data to be analysed at 12 months and 24 months on this study group.