The authors present a new method for fixation of meniscus bucket-handle lesions. This technique is based on the development of a Biofix self-reinforced polylactic acid tack and an application system. The main goal of this technique has been to eliminate or at least reduce the risk of neurovascular injury during meniscus fixation and to simplify the fixation procedure. Additional skin incisions and exposure of the knee joint capsule are superfluous. The steps in the development of this technique are outlined and the surgical technique and preliminary results described.

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In a prospectively randomized study including 68 patients, the results of inside-out horizontal meniscus suturing were compared to meniscus repair using the meniscus arrow. 96% of the patients underwent re-arthroscopy after 3-4 months. Only lesions in the red/red or red/white areas were included. Patients were treated with a hinged brace for 9 weeks. 30 patients had an isolated bucket-handle lesion. In 19 cases the repair was done in conjunction with an ACL reconstruction and in 19 cases the repair was performed in an ACL-insufficient knee. The two groups were comparable. Operating time in the arrow group was one half that of the suture group. Of 65 re-arthroscopies, 91% of the patients had healed or partially healed in the arrow group compared to 75% in the suture group (P = 0.11). In only 50% of the non-healed cases was this clinically suspected prior to control arthroscopy. The difference between healing in ACL-reconstructed and ACL-insufficient knees was not significant. Two patients in the suture group had a deep infection. There were no serious neurovascular injuries. Five patients in the suture group and two patients in the arrow group had symptoms in the saphenous nerve area. All patients had some synovial irritation at control arthroscopy but no severe reactions to suture or arrows were seen. Short-term results with meniscus arrows, based on healing and evaluated by second-look arthroscopy, seem promising.

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Purpose: An increasing number of castration-resistant prostate cancer (CRPC) tumors exhibit neuroendocrine (NE) features. NE prostate cancer (NEPC) has poor prognosis, and its development is poorly understood.Experimental Design: We applied mass spectrometrybased proteomics to a unique set of 17 prostate cancer patient-derived xenografts (PDX) to characterize the effects of castration in vivo, and the proteome differences between NEPC and prostate adenocarcinomas. Genome-wide profiling of REST-occupied regions in prostate cancer cells was correlated to the expression changes in vivo to investigate the role of the transcriptional repressor REST in castration-induced NEPC differentiation.Results: An average of 4,881 proteins were identified and quantified from each PDX. Proteins related to neurogenesis, cell-cycle regulation, and DNA repair were found upregulated and elevated in NEPC, while the reduced levels of proteins involved in mitochondrial functions suggested a prevalent glycolytic metabolism of NEPC tumors. Integration of the REST chromatin bound regions with expression changes indicated a direct role of REST in regulating neuronal gene expression in prostate cancer cells. Mechanistically, depletion of REST led to cell-cycle arrest in G 1 , which could be rescued by p53 knockdown. Finally, the expression of the REST-regulated gene secretagogin (SCGN) correlated with an increased risk of suffering disease relapse after radical prostatectomy.Conclusions: This study presents the first deep characterization of the proteome of NEPC and suggests that concomitant inhibition of REST and the p53 pathway would promote NEPC. We also identify SCGN as a novel prognostic marker in prostate cancer.