Objectives To evaluate the main symptoms of knee osteoarthritis (OA) and tissue structure changes after a single dose bone marrow-derived mononuclear cell (BM MNC) intra articular injection. Case series study. Patients with knee OA Kellgren Lawrence (K-L) grade II and III received 1 injection of BM MNC. The clinical results were analyzed with the Knee injury and Osteoarthritis Outcome Score (KOOS) and Knee Society Score (KSS) before, 3, 6, and 12 months after injection. Radiological evaluation was performed with a calibrated x-ray and the magnetic resonance (MR) imaging before and 6 to 7 months postinjection. Results A total of 34 knees were treated with BM MNC injections. Mean (±SD) age of patient group was 53.96 ± 14.15 years; there were 16 males, 16 females, KL grade II, 16; KL grade III, 18. The average injected count of BM MNCs was 45.56 ± 34.94 × 10 cells. At the endpoint of 12 months 65% of patients still had minimal perceptible clinical improvement of the KOOS total score. The mean improvement of KOOS total score was +15.3 and of the KSS knee score was +21.45 and the function subscale +27.08 ( P < 0.05) points. The Whole Organ Magnetic Resonance Imaging Score (WORMS) improved from 44.31 to 42.93 points ( P < 0.05). No adverse effects after the BM-MNC injection were observed. Conclusions The single dose BM MNC partially reduces clinical signs of the knee osteoarthritis stage II/III and in some cases, decreases degenerative changes in the joint building tissue over 12-month period.

The intra-articular injection of bone marrow-derived mononuclear cells is a safe manipulation with no side effects during the 12-month period. This treatment provides statistically significant clinical improvement between the starting point and 1, 3, 6, and 12 months after. When compared to hyaluronic acid treatment, better pain relief in the long-term period of mononuclear cell group was observed.

SummaryIntroduction.Total knee replacement (TKR) is still a challenging procedure for severe gonarthrosis patients. Deformities of knee joint (varus, valgus - more than 30 degrees), insufficiency of collateral ligaments and extensive bone loss could be a difficult problem to solve with standard knee endoprosthesis. Also in cases of revision - TKR the restoration of bone loss and regaining of stability of the joint could be a problem.Aim of the Study.The aim of our study was to analyse the results with Rotating - Hinge prosthesis after severe primary and revision TKR.Materials and Methods.34 patients (27 female, 7 male) were treated with Rotating - Hinge prosthesis during 12 years (first in 1997). Mean age of patients were 69 years. 17 operations were primary total knee arthroplasties and also 17 were revisions of the knee prosthesis. The Oxford Knee score was used for evaluation of patients satisfaction rate. The Knee Society Score was used to get objective functional results. For radiological analysis X-rays of knee joint in two projections were performed.Results.34 Oxford Knee score questionnaires were sent to patients, response we got from 27 patients (79%). Mean result from Oxford Knee score was 32 which is good. The same number of patients (34) were invited for examination using Knee Society score. The response were from 20 patients (59%). Mean result from Knee Society score was 83, which means excellent.Conclusions.Rotating-Hinge prosthesis allows to achieve good and excellent functional results and high patients satisfaction rate after severe primary and revision TKR. The biological age, general health condition, insufficiency of ligaments and previous infection in patients history have to be considered for choosing the tactics for each case.

Summary Introduction. Osteoarthritis of the knee is a common and frequently symptomatic illness. Total knee replacement (TKR) has evolved as an accepted, cost-effective and efficacious treatment modality for osteoarthritis and other forms of arthritic conditions of the knee joint. Preoperative planning is an important part of the surgical procedure. The inability to accurately determine the magnification factor of the radiograph is one of the major problems in analog preoperative planning of TKR. With the use of calibration objects, the digital images can be corrected for the magnification factor. Aim of the Study. We aimed to determine the reliability and accuracy of digital templating in the pre-operative work-up for TKR. Materials and Methods. A retrospective study was done in 105 caucasian adults, who had osteoarthritis of the knee. Digital templating was performed using a calibrating 25-mm metallic ball and Agfa Orthopaedic Tools digital software package by a surgeon not involved with the operation, who was blinded to the size of the implant inserted. The Press Fit Condylar Sigma Knee system was used in all the patients. Digital anteroposterior and lateral radiographs of the knee were used in measuring the implant size. The results from digital images were compared with the size of actual femoral and tibial implants used at the time of surgery. Results. The correct size of the implant was predicted in 73 of 105 (69,5%) of the femoral and 70 of 105 (66,7%) of the tibial components. The correct size of the whole system was predicted in 58 of 105 (55,2%) cases. The digital preoperative planning predicted 104 of 105 (99,0%) femoral and tibial implants and 103 of 105 (98,1%) whole systems to within one size. Conclusions. We conclude that digital templating using a calibrating 25-mm metallic ball and Agfa Orthopaedic Tools digital software is a reliable method of predicting the implant to within one size.