These results suggest that MACI provides a suitable midterm treatment option for articular cartilage defects in the knee. Long-term follow-up is essential to confirm whether the repair tissue has the durability required to maintain long-term patient quality of life.

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BackgroundSoft tissue and bone sarcoma represent a broad spectrum of different pathology and genetic variance. Current chemotherapy regimens are derived from randomised trials and represent empirical treatment. Chemosensitivity testing and whole exome sequencing (WES) may offer personalized chemotherapy treatment based on genetic mutations.MethodsA pilot, prospective, non-randomised control experimental study was conducted. Twelve patients with metastatic bone or soft tissue sarcoma that had failed first line chemotherapy treatment were enrolled for this study. Human tissue taken at surgical biopsy under general anaesthetic was divided between two arms of the trial. Subsections of the tumour were used for WES and the remainder was implanted subcutaneously in immunodeficient mice (PDX). Results of WES were analysed using a bioinformatics pipeline to identify mutations conferring susceptibility to kinase inhibitors and common chemotherapeutic agents. PDX models exhibiting successful growth underwent WES of the tumour and subsequent chemosensitivity testing.ResultsWES was successful in all 12 patients, with successful establishment PDX tumours models in seven patients. WES identified potential actionable therapeutics in all patients. Significant variation in predicted therapeutics was demonstrated between three PDX samples and their matched tumour samples.ConclusionAnalysis of WES of fresh tumour specimens via a bioinformatics pipeline may identify potential actionable chemotherapy agents. Further research into this field may lead to the development of personalized cancer therapy for sarcoma.Electronic supplementary materialThe online version of this article (10.1186/s13569-018-0090-1) contains supplementary material, which is available to authorized users.

The observed improvements in lean body mass and cholesterol profile promote the implementation of a resistance exercise intervention in this population.

PurposeTo report 10‐year outcomes and survivorship in patients undergoing bicompartmental knee arthroplasty (BCKA) using the Journey‐Deuce prosthesis in a consecutive prospective case series. MethodsBetween November 2006 and November 2009, 41 patients with a mean age of 69.6 years (range 51–86) underwent 51 bicompartmental knee arthroplasties with the Journey‐Deuce knee prosthesis. All patients presented with symptomatic medial and patellofemoral compartment osteoarthritis, with intact cruciate ligaments and a preserved lateral compartment on plain radiographs and Magnetic Resonance Imaging. Clinical assessment was undertaken pre‐surgery and at 1, 2, 5 and 10 years post‐surgery using the Oxford Knee Score (OKS), EuroQol Group 5‐Dimension self‐reported questionnaire (EQ‐5D) and maximal active range of motion (ROM). Results30 patients (37 knees) were followed‐up at a mean time of 11.4 years (SD 1.1; range 10.5–14.0). Eight patients (ten knees) were deceased and three could not be contacted at final review. No major component revision was performed. Pre‐operative OKS 25.4 (SD 5.2; range 15–40), knee flexion 116.4° (SD 10.3°; range 100°–140°) and EQ‐5D 70.5 (SD 19.9; range 25–95). 10‐year OKS 43.5 (SD 4.1; range 32–48), knee flexion 127.3° (SD 11.1°; range 105°–144°) and EQ‐5D 77.4 (SD 9.3; range 60–100). The OKS (p < 0.0001), EQ‐5D (p = 0.024) and active knee flexion ROM (p < 0.0001) all significantly improved from pre‐surgery to 1‐year post‐surgery, with no further significant changes in these scores between any post‐operative time period up until 10 years. 32% (7/22) of tibial and 45% (10/22) of femoral components showed progressive radiolucencies between 2 and 5‐year and 10‐year follow‐up. ConclusionsThis is the largest cohort of patients having undergone BCKA (with the Journey‐Deuce prosthesis) with longest follow‐up described in the literature. At 10 years, patients presented with significantly improved clinical outcomes, comparable to other surgical arthroplasty options. No major component revision was performed. Progressive radiolucencies were noted in 32% of tibial and 45% of femoral components without corresponding clinical signs of loosening. Level of evidenceLevel III.