The authors think that the single-stage anterior autogenous bone grafting and instrumentation are a safe and effective method in the surgical management of spinal tuberculosis.

Large full-thickness defects of articular cartilage remain a major challenge to orthopedic surgeons because of unsatisfactory results of current therapy. Many methods, such as chondrectomy, drilling, cartilage scraping, arthroplasty, transplantation of chondrocytes, periosteum, perichondrium, as well as cartilage and bone, have been tried to repair articular cartilage defects. However, the results are far from satisfactory. In this study, we applied a tissue-engineering approach to the repair of articular cartilage defects of knee joints in a porcine model. Using isolated autologous chondrocytes, polyglycolic acid (PGA), and Pluronic, we have successfully in vivo-engineered hyaline cartilage and repaired articular cartilage defects. The surface of the repaired defects appeared smooth at 24 weeks postrepair. Histological examination demonstrated a typical hyaline cartilage structure with ideal interface healing between the engineered cartilage and the adjacent normal cartilage and underlying cancellous bone. In addition, glycosaminoglycan (GAG) levels in the engineered cartilage reached 80% of that found in native cartilage at 24 weeks postrepair. Biomechanical analysis at 24 weeks demonstrated that the biomechanical properties of the tissue-engineered cartilage were improved compared with those at an earlier stage. Thus, the results of this study may provide insight into the clinical repair of articular cartilage defects.

The modified Boytchev procedure, i.e., rerouting of the coracoid process with its attached conjoined tendon (short head of biceps and coracobrachialis) deep to the subscapularis and reattachment to its anatomical location, has been advocated for recurrent anterior glenohumeral instability with controversial clinical outcomes. We aimed to investigate the dynamic contribution of the conjoined tendon in situ or transferred to the glenohumeral articulation in stable and unstable shoulders. Eight cadaveric shoulders were tested with the arm in 90 degrees abduction and 90 degrees external rotation. A constant 1.5 kg anterior translation force was applied to the proximal humerus, combined with 0, 1.5, 3.0 kg of load applied to the conjoined tendon sequentially. Anterior displacement of the humeral head relative to the scapula was recorded before and after an imitation Bankart lesion was created, and after treated with the modified Boytchev procedure for the Bankart lesion. Application of load to the conjoined tendon significantly reduced anterior displacement of the humeral head either with the capsule intact or with Bankart lesion simulated. The most significant decrease of the anterior displacement occurred when the conjoined tendon was transferred beneath the subscapularis. Our findings show that the conjoined tendon per se has a stabilizing effect on stable and unstable shoulders and therefore provide scientific support for the treatment of recurrent shoulder instability using the modified Boytchev procedure.