The clinical potential of meniscal progenitor cells.

Introduction: The meniscus is an important cushioning structure of the knee joint, with the maintenance of its normal structure and function playing a crucial role in protecting the joint from early degeneration. Stem/progenitor cells could be the key to help researchers to have a deeper understanding of the biological process of meniscal injury repair and may be important in the meniscus tissue regeneration processes. To the best of our knowledge, there is currently a lack of comprehensive reviews on existing research about the meniscus progenitor cells (MPCs).

Histological and Radiological Assessment of Endogenously Generated Repair Tissue Following a Chondral Harvest.

Objective: To examine repair tissue formed approximately 15 months after a chondral harvest in the human knee.

Design: Sixteen individuals (12 males, 4 females, mean age 36 ± 9 years) underwent a chondral harvest in the trochlea as a pre-requisite for autologous chondrocyte implantation (ACI) treatment. The harvest site was assessed via MRI at 14.

Phenotypic characterization of regional human meniscus progenitor cells.

Stimulating meniscus regeneration using meniscal progenitor cells has been suggested as a promising new strategy. However, there is a lack of studies which decisively identify and characterize progenitor cell populations in human meniscus tissues. In this study, donor-matched progenitor cells were isolated selective fibronectin adhesion from the avascular and vascular regions of the meniscus and chondroprogenitors from articular cartilage (n = 5).

Who are the 10%? - Non eligibility of cystic fibrosis (CF) patients for highly effective modulator therapies.

Background: The availability of mutation-specific cystic fibrosis modulator therapies has the potential to improve the lives of children and adults with cystic fibrosis. The frequency of mutations causing defects in the cystic fibrosis transmembrane conductance regulator (CFTR) function varies between sub-groups in multi-ethnic populations. The profile of patients eligible for CFTR modulator ivacaftor/tezacaftor/elexacaftor (Kaftrio™) therapy based on ethnicity has not been reported in the United Kingdom CF population.

Should the Tibiotalar Angle Be Measured Using an AP or Mortise Radiograph? Does It Matter?

Understanding the tibiotalar angle (TTA) is key to planning for deformity correction. The TTA is an important radiographic tool to determine alignment or malalignment of the ankle and hindfoot. Two methods of measuring the TTA have been described: the midline TTA (MTTA) and the lateral TTA (LTTA).

One- and two-stage surgical revision of peri-prosthetic joint infection of the hip: a pooled individual participant data analysis of 44 cohort studies.

One-stage and two-stage revision strategies are the two main options for treating established chronic peri-prosthetic joint infection (PJI) of the hip; however, there is uncertainty regarding which is the best treatment option. We aimed to compare the risk of re-infection between the two revision strategies using pooled individual participant data (IPD). Observational cohort studies with PJI of the hip treated exclusively by one- or two-stage revision and reporting re-infection outcomes were retrieved by searching MEDLINE, EMBASE, Web of Science, The Cochrane Library, and the WHO International Clinical Trials Registry Platform; as well as email contact with investigators.

Spinal cord infarction in a sick neonate from predominant haemorrhagic aetiology: a case report.

Introduction: Spinal cord injuries in new born infants following a traumatic delivery or umbilical cord catheterisation due to thromboembolism are well known. Cases with atraumatic acute onset of neonatal paraplegia have also been described in preterm babies or babies born small for gestational age with a stormy postnatal course related to ischaemic aetiology. We describe a rare case of infarction of the spinal cord from a predominant haemorrhagic aetiology.

Scapholunate ligament reconstruction using the palmaris longus tendon and suture anchor fixation in chronic scapholunate instability.

Background: Multiple reconstruction techniques have been described in the management of chronic scapholunate (SL) instability, either based on the capsulodesis or tenodesis principle. It is uncertain which surgical method produces the best patient outcomes. We describe results of a technique using palmaris longus (PL) tendon for surgical reconstruction of the SL ligament and provide functional outcomes scores.

Incidence of numerical variants and transitional lumbosacral vertebrae on whole-spine MRI.

Objectives: This study sets out to prospectively investigate the incidence of transitional vertebrae and numerical variants of the spine.

Materials And Methods: Over a period of 28 months, MRIs of the whole spine were prospectively evaluated for the presence of transitional lumbosacral vertebrae and numerical variants of the spine.

Results: MRI of the whole spine was evaluated in 420 patients, comprising 211 female and 209 male subjects.

A histological comparison of the repair tissue formed when using either Chondrogide(®) or periosteum during autologous chondrocyte implantation.

Objective: In this study, we compare the clinical and histological outcome between periosteum and Chondrogide(®) during autologous chondrocyte implantation (ACI).

Method: This study consisted of 88 patients having received ACI in the knee; 33 treated with Chondrogide(®) (ACI-C) and 55 with periosteum (ACI-P). Post-operative biopsies were taken at a mean of 16.

Rarely metastasizing soft tissue tumours.

Soft tissue tumours that rarely metastasize have been afforded their own subcategory in recent WHO classifications. This review discusses the nature of these tumours and the difficulty in constructing usefully simple classifications for heterogeneous and complex groups of tumours. We also highlight the specific rarely metastasizing soft tissue tumours that have been recently added to the WHO classification (phosphaturic mesenchymal tumour, pseudomyogenic haemangioendothelioma) and those entities where there have been recent important defining genetic discoveries (myxoinflammatory fibroblastic sarcoma, solitary fibrous tumour, myoepitheliomas).

Increased Production of Clusterin in Biopsies of Repair Tissue following Autologous Chondrocyte Implantation.

Objective: To characterize the immunolocalization of clusterin in the repair cartilage of patients having undergone autologous chondrocyte implantation (ACI) and evaluate correlation to clinical outcome.

Design: Full-depth core biopsies of repair tissue were obtained from 38 patients who had undergone ACI at an average of 18 ± 13 months previously (range 8-67 months). The biopsies were snap frozen, cryosectioned, and clusterin production immunolocalized using a specific monoclonal clusterin antibody and compared with normal and osteoarthritic cartilage.

Lubricin: Its Presence in Repair Cartilage following Treatment with Autologous Chondrocyte Implantation.

Objective: To determine if lubricin was present in the surface layer of repair cartilage formed after autologous chondrocyte implantation (ACI).

Design: Forty-three biopsies of repair tissue were taken from patients who had been treated with ACI 8 to 68 months previously (mean of 18.0 ± 14.

Midterm to long-term longitudinal outcome of autologous chondrocyte implantation in the knee joint: a multilevel analysis.

Background: Autologous chondrocyte implantation is a cell therapeutic approach for the treatment of chondral and osteochondral defects in the knee joint. The authors previously reported on the histologic and radiologic outcome of autologous chondrocyte implantation in the short- to midterm, which yields mixed results.

Purpose: The objective is to report on the clinical outcome of autologous chondrocyte implantation for the knee in the midterm to long term.

Increased circulating Dickkopf-1 in Paget's disease of bone.

Unlabelled: Dickkopf-1 (Dkk-1) is a secreted inhibitor of Wnt signaling which in adults regulates bone turnover. Dkk-1 over-production is implicated in osteolytic disease where it inhibits bone formation and stimulates bone breakdown. Recently it was reported that osteoblastic cells from Paget's disease of bone (PDB) over-expressed Dkk-1.

Is prolonged systemic antibiotic treatment essential in two-stage revision hip replacement for chronic Gram-positive infection?

When using a staged approach to eradicate chronic infection after total hip replacement, systemic delivery of antibiotics after the first stage is often employed for an extended period of typically six weeks together with the use of an in situ antibiotic-eluting polymethylmethacrylate interval spacer. We report our multi-surgeon experience of 43 consecutive patients (44 hips) who received systemic vancomycin for two weeks in combination with a vancomycin- and gentamicin-eluting spacer system in the course of a two-stage revision procedure for deep infection with a median follow-up of 49 months (25 to 83). The antibiotic-eluting articulating spacers fractured in six hips (13.

Articular cartilage: structure, injuries and review of management.

Introduction: Chondral and osteochondral injuries are commonly seen in today's clinical practice. Articular cartilage provides an ultimate low-friction gliding surface, which none of the artificial constructs have been able to replace successfully. Retrospective review of the knee arthroscopies has revealed an underestimated incidence of this complex problem.

Magnetic resonance imaging of appendicular musculoskeletal infection.

Appendicular skeletal infection includes osseous and extraosseous infections. Skeletal infection needs early diagnosis and appropriate management to prevent long-term morbidity. Magnetic resonance imaging is the best imaging modality to diagnose skeletal infection early in most circumstances.

Combined autologous chondrocyte implantation and allogenic meniscus transplantation: a biological knee replacement.

Meniscus deficient knees develop early osteoarthritis in the knee. Autologous Chondrocyte Implantation has provided a new dimension to the treatment of chondral defects in the knee, with 85% good to excellent results and a long-term durable outcome of up-to 11 years. However, it is contraindicated in meniscus deficient knees.

Histology and pathology of the human intervertebral disc.

The intervertebral disc is a highly organized matrix laid down by relatively few cells in a specific manner. The central gelatinous nucleus pulposus is contained within the more collagenous anulus fibrosus laterally and the cartilage end plates inferiorly and superiorly. The anulus consists of concentric rings or lamellae, with fibers in the outer lamellae continuing into the longitudinal ligaments and vertebral bodies.

Progressive massive osteolysis secondary to benign squamous epithelial colonisation in chronic osteomyelitis.

Although the rare complication of squamous cell carcinoma in chronic osteomyelitis is well known, benign squamous epithelial proliferation can also occur, causing osteolysis and fracture. The radiological and correlated pathological features of osteolysis from this benign complication of chronic osteomyelitis are presented.

MR appearance of autologous chondrocyte implantation in the knee: correlation with the knee features and clinical outcome.

Objective: To relate the magnetic resonance imaging (MRI) appearance of autologous chondrocyte implantation (ACI) in the knee in the 1st postoperative year with other knee features on MRI and with clinical outcome.

Design And Methods: Forty-nine examinations were performed in 49 patients at 1 year after ACI in the knee. Forty-one preoperative magnetic resonance (MR) examinations were also available.

A bio-assay for effectors of osteoclast differentiation in serum from patients with bone disease.

Unlabelled: Osteoclast differentiation and activity, and hence bone loss, depend on two opposing cytokines. Receptor activator of NF-(kappa)B ligand (RANKL) produced by osteoblasts and T-cells stimulates, while osteoprotegerin inhibits. Both of these cytokines are found in serum.