The histologic appearance of the repair tissue of 3 different failed articular cartilage resurfacing procedures was similar and did not resemble normal articular cartilage.

ACL reconstruction significantly improves clinical results and stability of the knee. Difference in Lysholm score and stability between groups was not significant. Neither group showed higher tendency to graft failure within two years. Graft choice for reconstruction in female patients should be surgeon specific and individualised, as both grafts studied achieved comparable results.

BackgroundMesenchymal stromal cells attract much interest in tissue regeneration because of their capacity to differentiate into mesodermal origin cells, their paracrine properties and their possible use in autologous transplantations. The aim of this study was to investigate the safety and reparative potential of implanted human mesenchymal stromal cells (hMSCs), prepared under Good Manufacturing Practice (GMP) conditions utilizing human mixed platelet lysate as a culture supplement, in a collagenase Achilles tendon injury model in rats.MethodsEighty-one rats with collagenase-induced injury were divided into two groups. The first group received human mesenchymal stromal cells injected into the site of injury 3 days after lesion induction, while the second group received saline. Biomechanical testing, morphometry and semiquantitative immunohistochemistry of collagens I, II and III, versican and aggrecan, neovascularization, and hMSC survival were performed 2, 4, and 6 weeks after injury.ResultsHuman mesenchymal stromal cell-treated rats had a significantly better extracellular matrix structure and a larger amount of collagen I and collagen III. Neovascularization was also increased in hMSC-treated rats 2 and 4 weeks after tendon injury. MTCO2 (Cytochrome c oxidase subunit II) positivity confirmed the presence of hMSCs 2, 4 and 6 weeks after transplantation. Collagen II deposits and alizarin red staining for bone were found in 6 hMSC- and 2 saline-treated tendons 6 weeks after injury. The intensity of anti-versican and anti-aggrecan staining did not differ between the groups.ConclusionshMSCs can support tendon healing through better vascularization as well as through larger deposits and better organization of the extracellular matrix. The treatment procedure was found to be safe; however, cartilage and bone formation at the implantation site should be taken into account when planning subsequent in vivo and clinical trials on tendinopathy as an expected adverse event.

Palliative Schanz proximal femoral valgus osteotomy is considered a common option for treatment of irreducible hip dislocation in cerebral palsy. From 1992 to 2005, Schanz osteotomy was indicated on 55 occasions in 35 nonambulatory patients with the quadriplegic form of cerebral palsy aged 9-18. Postoperatively, the main emphasis focussed on clinical presentation, improvement of hip range of motion, and pain relief. X-rays were carried out at three, six, and 12 months postoperatively with subsequent average follow up 98±4.5 months. In all patients, the range of hip abduction and flexion increased. In 54 (98.2%) cases painful symptoms significantly improved. One patient (1.8%) had a subsequent femoral head excision because of persistent hip pain. Transient hip pain persisted in four patients (7.3%). Schanz valgus osteotomy improves the hip range of motion, relieves pain, and facilitates care of the patient. Schanz femoral osteotomy is a less invasive method compared to proximal femoral excision and should preferably be used in older children with neurogenic hip dislocation in whom reconstructive surgery is not indicated.Résumé L'ostéotomie de Schanz est considérée comme un traitement possible des luxations irréductible chez l'infirme moteur cérébral. De 1992 à 2005, une ostéotomie de Schanz a été réalisée 55 fois chez 35 patients non marchant et présentant une quadriplégie spastique, ces patients étaient âgés de 9 à 18 ans. La surveillance postopératoire a été centrée sur l'examen clinique, l'amélioration de la mobilité et l'amélioration des phénomènes douloureux. Les radios ont été réalisées à 3, 6 et 12 mois postopératoires avec un suivi moyen de 98 mois ± 4,5 mois. Chez tous les patients la mobilité de la hanche en abduction et en flexion s'est améliorée. Dans 54 cas (98,2%) la diminution de la douleur est significative. Un patient (1,8%) a nécessité d'une résection de la tête fémorale du fait de douleurs persistantes. Une douleur transitoire a persisté chez 4 patients (7,3%). L'ostéotomie de Schanz améliore la mobilité et la douleur de ces patients. Cette intervention est peu invasive comparée à la résection de l'extrémité supérieure du fémur et peut être préférée chez les enfants âgés présentant une luxation neurologique pour lesquels il n'est pas possible de réaliser une reconstruction de la hanche.