Sustained superiority in KOOS subscores after matrix-associated chondrocyte implantation using spheroids compared to microfracture.

Purpose: To evaluate the safety and efficacy of matrix-associated autologous chondrocyte implantation (ACI) using spheroids in comparison to arthroscopic microfracture for the treatment of symptomatic cartilage defects of the knee.

Methods: In a prospective multicenter-controlled trial, patients aged between 18 and 50 years, with single symptomatic focal cartilage defects between 1 and 4 cm (mean 2.6 ± 0.

Continuous Wear of Night and Day Orthosis Is a Key Factor for Improvement of Fixed Equinus Deformity after the Transverse Vulpius Procedure.

Equinus foot deformity is secondary to either spasticity or contracture of the gastrocnemius-soleus complex. The plantar flexion is basically treated conservatively; several different surgical methods have been discussed. This paper focuses on the improvement of passive ankle dorsiflexion after a transverse Vulpius procedure in equinus foot deformity.

Safety and Efficacy of Matrix-Associated Autologous Chondrocyte Implantation With Spheroids for Patellofemoral or Tibiofemoral Defects: A 5-Year Follow-up of a Phase 2, Dose-Confirmation Trial.

Background: Matrix-associated autologous chondrocyte implantation (ACI) is a well-established treatment for cartilage defects. High-level evidence at midterm follow-up is limited, especially for ACI using spheroids (spherical aggregates of ex vivo expanded human autologous chondrocytes and self-synthesized extracellular matrix).

Purpose: To assess the safety and efficacy of 3-dimensional matrix-associated ACI using spheroids to treat medium to large cartilage defects on different locations in the knee joint (patella, trochlea, and femoral condyle) at 5-year follow-up.

Safety and efficacy of matrix-associated autologous chondrocyte implantation with spheroid technology is independent of spheroid dose after 4 years.

Purpose: The aim of this study was to investigate the effect of product dose in autologous chondrocyte implantation (ACI) for the treatment of full-thickness cartilage defects of the knee and to assess its influence on clinical and morphological mid-term outcome.

Methods: Seventy-five patients were included in this single-blind, randomised, prospective, controlled clinical trial. Patients were assigned randomly to three different dose groups [low (3-7 spheroids/cm), medium (10-30 spheroids/cm), or high (40-70 spheroids/cm)] and assessed using standardised clinical and morphological scoring systems (KOOS, IKDC, MOCART) for 4 years following the intervention.

Matrix-Associated Autologous Chondrocyte Implantation with Spheroid Technology Is Superior to Arthroscopic Microfracture at 36 Months Regarding Activities of Daily Living and Sporting Activities after Treatment.

Objective: Matrix-associated autologous chondrocyte implantation (ACI) and microfracture (MF) are well-established treatments for cartilage defects of the knee. However, high-level evidence comparing microfracture and spheroid technology ACI is limited.

Design: Prospective, phase III clinical trial with patients randomized to ACI ( = 52) or MF ( = 50).

Clinical outcome and success rates of ACI for cartilage defects of the patella: a subgroup analysis from a controlled randomized clinical phase II trial (CODIS study).

Aim: Cartilage defects of the patella are considered as a problematic entity. Purpose of the present study was to evaluate the outcome of patients treated with autologous chondrocyte implantation (ACI) for cartilage defects of the patella in comparison to patient with defects of the femoral condyles.

Patients And Methods: 73 patients with a follow-up of 5 years have been included in this subgroup analysis of the randomized controlled clinical trial (RCT).

A Prospective, Randomized, Open-Label, Multicenter, Phase III Noninferiority Trial to Compare the Clinical Efficacy of Matrix-Associated Autologous Chondrocyte Implantation With Spheroid Technology Versus Arthroscopic Microfracture for Cartilage Defects of the Knee.

Background: Autologous chondrocyte implantation (ACI) and microfracture are established treatments for large, full-thickness cartilage defects, but there is still a need to expand the clinical and health economic knowledge of these procedures.

Purpose: To confirm the noninferiority of ACI compared with microfracture.

Study Design: Randomized controlled trial; Level of evidence, 2.

Improved accuracy in the assessment of vertebral cortical thickness by quantitative computed tomography using the Iterative Convolution OptimizatioN (ICON) method.

Vertebral whole bone strength is substantially affected by cortical bone properties. Disease and therapy may affect cancellous and cortical bone differently. Unlike Dual X-ray Absorptiometry (DXA), Quantitative Computed Tomography (QCT) permits selective assessment of cortical and cancellous bone, but image quality limits the accuracy.

[Debridement in Focal Cartilage Damage of the knee. Systematical review of the literature and recommendations of the working group "clinical tissue regeneration" of the German Society of Orthopaedics and Trauma (DGOU)].

Background: In clinical practice, there is still no definite treatment algorithm for focal, partial thickness cartilage lesions (grade II - III). It is well-established that debridement (shaving/lavage) of large degenerative cartilage lesions is not recommended, but there is no such recommendation in the case of focal, partial thickness cartilage defects.

Materials And Methods: The scientific rationale of cartilage shaving and joint lavage was investigated and a systematic analysis was performed of the literature on the clinical effect of cartilage debridement.

Chondrogenic potential of IL-10 in mechanically injured cartilage and cellularized collagen ACI grafts.

Objective: The application of adjunctive mediators in Autologous chondrocyte implantation (ACI) techniques might be useful for improving the dedifferentiated chondrocyte phenotype, to support neocartilage formation and inhibit post-traumatic cartilage destruction. In this study we examined if (a) interleukin 10 treatment can cause chondrogenic phenotype stabilization and matrix preservation in mechanically injured cartilage and if (b) IL-10 can promote chondrogenesis in a clinically applied collagen scaffold for ACI treatment.

Materials And Methods: For (a) bovine articular cartilage was harvested, subjected to an axial unconfined injury and treated with bovine IL-10 (1-10,000 pg/ng/ml).

Safety of three different product doses in autologous chondrocyte implantation: results of a prospective, randomised, controlled trial.

Background: This study was conducted to assess the efficacy and safety of the three dose levels of the three-dimensional autologous chondrocyte implantation product chondrosphere® in the treatment of cartilage defects (4-10 cm) of knee joints. We hereby report the safety results for a 36-month post-treatment observation period.

Methods: This was a prospective phase II trial with a clinical intervention comprising biopsy for culturing spheroids and their subsequent administration (level of evidence: I).

The Effect of Cell Dose on the Early Magnetic Resonance Morphological Outcomes of Autologous Cell Implantation for Articular Cartilage Defects in the Knee: A Randomized Clinical Trial.

Background: Although autologous chondrocyte implantation (ACI) has been established as a standard treatment for large full-thickness cartilage defects, the effect of different doses of autologous chondrocyte products on structural outcomes has never been examined.

Hypothesis: In ACI, the dose level may have an influence on medium-term magnetic resonance morphological findings after treatment.

Study Design: Randomized controlled trial; Level of evidence, 1.

[The German Cartilage Registry (KnorpelRegister DGOU) for evaluation of surgical treatment for cartilage defects: experience after six months including first demographic data].

The German Cartilage Registry (KnorpelRegister DGOU) has been introduced in October 2013 and aims on the evaluation of patients who underwent cartilage repair for symptomatic cartilage defects. It represents a nation-wide cohort study which has been introduced by the working group "Tissue Regeneration" of the Germany Society of Orthopaedic Surgery and Traumatology and is technically based upon a web-based remote data entry (RDE) system. The present article describes first experiences with the registry including patient and treatment characteristics.

[Revision surgery after implantation of a vertebral disc prosthesis].

Assessment of the revisability of surgery after the endoprosthetic replacement of vertebral discs shows that the surgical approach depends on the time of revision surgery and the reason why it is carried out. Our experience is based on nine revision operations out of 152 cervical vertebra prostheses of the Bryan and Prodisc C types implanted from 2003 to 2007 and 312 endoprostheses of the Charité and Prodisc types implanted from 1999 to 2007. Our own results show differing approaches in perioperative or late postoperative revision operations.

[Crossover extremity transfers. Limb salvage in amputations with segmental defects].

Clinical conditions in which crossover extremity transfer should be considered are rare. In the case of bilateral amputation associated with extensive proximal segmental injury, ectopic implantation could be an additional concept for two-stage limb salvage. If replantation is impossible due to segmental damage of the amputated part, at least uninvolved tissue should be harvested for stump lengthening or improving soft-tissue at the ends.

A new symptomatic intra-articular cord-like structure associated with discoid meniscus.

We introduce a new, not yet described cord-like structure of the knee of children associated with discoid or enlarged menisci. This structure was responsible for knee pathology (loss of extension) in 3 cases. The patients (5 to 8 years of age) complained of knee pain without skeletal abnormality or trauma.

[Otto Hilgenfeldt (1900 to 1983)--an unusual approach for finger reconstruction].

Reconstructive surgery of detached extremities, especially fingers, has a long historical tradition. The first clinically correctly documented cases go back to the 19th century. During the first and second world wars numerous reports appeared about the surgical care of war victims.

[Indication, biomechanics and early results of artificial disk replacement].

Aim: Judgment of factors concerning the indication for the implantation of an artificial disc endoprosthesis, the rating of this operation and biomechanical considerations.

Method: Presentation of the indication and the value of a new operative concept in comparison to a so-called dynamic stabilization procedure (Dynesys' method). Indications for the operation are: unsuccessful, orthopedic conservative treatment for > 6 months, segmental pain, age < 45 years, evidence of an MRI demonstrable mono- or bisegmental disc degeneration with or without disc prolabation, exclusion of psychogenic disease and positive preoperative, diagnostic measures such as facet joint infiltration and discography.

[Disc replacement with the SB Charité endoposthesis - experience, preliminary results and comments after 35 prospectively performed operations].

Unlabelled: Aim of this prospective study was an investigation concerning the indication for the implantation of an artificial disc endoprosthesis and the rating of this operation.

Method: 35 patients with 11 bi- and 24 monosegmental implanted disc endoprosthesis were observed over an average follow-up of 14.7 months.

Arthroscopic all-inside meniscus repair using a new refixation device: a prospective study.

Purpose: To evaluate complications and clinical results after meniscus refixation using a new all-inside technique.

Type Of Study: Prospective clinical study.

Methods: This study reports clinical results of 37 patients after refixation of an unstable bucket-handle meniscus tear using a new all-inside technique (Mitek Meniscal Repair System; Mitek, Ethicon, Norderstedt, Germany).

[Necessary steps for implementing the Australian DRG system].

The introduction of the DRG-System will be followed by severe changes in the German hospitals. From the view of today departments or hospitals are threatened by closing if they do not deal with the new rules. A common implementation of this system by all participants of the health system is necessary before the introduction at 1.

[Effects of shaft length of finger joint prostheses on tension distribution in the bone].

In order to investigate the influence of stem length in finger joint prostheses on stress in the surrounding bone area, finite element (FEM) calculations of finger bones before and after prosthetic replacement of metacarpophalangeal joints with cementless implants of different stem length were performed. CT scans of the metacarpal bone and proximal phalanx before and after implantation of a prototype of a noncemented semiconstrained implant for the MP joint, which has been developed to replace metacarpophalangeal joints destroyed by rheumatoid arthritis, were analysed. The FEM calculations showed comparatively decreased differences of the von-Mises stress after implantation of intramedullary stems reaching the middle of the diaphysis.