Safety and efficacy of a single intra-articular injection of a novel enhanced protein solution (JTA-004) compared to hylan G-F 20 in symptomatic knee osteoarthritis: a randomized, double-blind, controlled phase II/III study.

Background: New minimally invasive treatments are vital to delay joint replacement surgery in patients with knee osteoarthritis. This study was designed to select the most effective among three formulations of an enhanced protein solution containing clonidine, hyaluronic acid, and human plasma (JTA-004), and compare the safety and efficacy of intra-articular administration of the selected formulation with a reference treatment (hyaluronic acid) in symptomatic knee osteoarthritis patients.

Methods: In this two-stage, double-blind, phase II/III study conducted in 12 Belgian centers, 50-79-year-old patients with primary knee osteoarthritis were randomized (1:1:1:1) to receive one dose of one of three JTA-004 formulations (differing in clonidine concentration [50 or 100 μg/ml] and volume [2 or 4 ml]) or the reference treatment (hylan G-F 20).

Hospital accreditation and patient care, a dilemma?

Despite the massive financial and human efforts of hospitals in the Flemish part of Belgium to increase quality through the path of external accreditation, so far this has not convinced the end user, in casu the patient. In this study of 307 hospital patients we conclude that the knowledge about accreditation is very limited to none existent (2%) in a sample of Belgian patients not working in medical practice and that patients do not choose their hospital care in accordance to the accreditation status of the hospital. We remain convinced that improving quality is a continuous concern for medical professionals and hospital management.

Diagnostic pitfalls in the differentiation between pyoderma gangrenosum and necrotizing fasciitis.

Pyoderma gangrenosum and necrotizing fasciitis are two rare pathologic entities with a similar clinical image, but a who require a very different management. In general physicians, orthopedics, dermatologists, plastic surgeons will hardly ever see it, but when they do it is very important to distinguish between both. In this paper with the focus on the practical approach ,we expose the diagnostic pitfalls in the differential diagnosis, explain how to prevent them and summarize the evidence on therapeutic management.

Fracture of the Tibial Baseplate in Bicompartmental Knee Arthroplasty.

Introduction. Bicompartmental knee arthroplasty (BKA) addresses combined medial and patellofemoral compartment osteoarthritis, which is relatively common, and has been proposed as a bridge between unicompartmental and total knee arthroplasty (TKA). Case Presentation.

Clinical Outcomes of Characterized Chondrocyte Implantation.

Objective: To assess the clinical outcome of patients treated with autologous chondrocyte implantation using ChondroCelect in daily practice.

Methods: The study is a cross-sectional analysis of an open-label, noninterventional cohort. The setting was a compassionate use program, involving 43 orthopaedic centers in 7 European countries.

Characterized chondrocyte implantation results in better structural repair when treating symptomatic cartilage defects of the knee in a randomized controlled trial versus microfracture.

Background: As the natural healing capacity of damaged articular cartilage is poor, joint surface injuries are a prime target for regenerative medicine. Characterized chondrocyte implantation uses an autologous cartilage cell therapy product that has been optimized for its biological potency to form stable cartilage tissue in vivo.

Purpose: To determine whether, in symptomatic cartilage defects of the femoral condyle, structural regeneration with characterized chondrocyte implantation is superior to repair with microfracture.

The reverse shoulder prosthesis (Delta III) in acute shoulder fractures: technical considerations with respect to stability.

The reverse shoulder prosthesis reverses the relationship between the scapular and humeral component, resulting in a mechanical advantage as the deltoid muscle is able to compensate for the rotator cuff deficiency. Based on this mechanical advantage, the reverse shoulder prosthesis has become an accepted alternative for the treatment of complex proximal humeral fractures. The purpose of this article is to discuss technical considerations related to stability in the use of the reverse shoulder prosthesis in acute shoulder fractures, based on clinical experience.