Presence Of Cartilage Research Articles

Seven percent of primary anterior crucial ligament reconstruction patients have arthroscopic resection of cyclops lesions within 2 years: A cohort study of 2556 patients.

After anterior cruciate ligament reconstruction (ACL-R), a localised scar tissue called cyclops lesion may develop anterior to the graft causing knee extension deficits, pain, oedema, clicking and reduced knee function. This study determined the incidence of arthroscopic resection of a cyclops lesion within 2 years after ACL-R and investigated the associations of patient characteristics and surgical techniques with the need for arthroscopic resection of a cyclops lesion. This study included patients who underwent primary ACL-R with adult surgical technique from 2005 to 2019 at Aarhus University Hospital, Denmark. The cohort was identified in a national registry. To identify patients who had resected a cyclops lesion within the first 2 years after ACL-R, patients' surgical records were reviewed. In 2005-2019, 2556 patients underwent primary ACL-R; 176 developed cyclops lesions that were resected within 2 years, equivalent to an incidence of 6.9% (95% confidence interval [CI]: 5.9-7.9). When stratified by the femoral drilling technique used, this incidence was 8.9% (95% CI: 7.7-10.3) with the anteromedial technique and 1.9% (95% CI: 1.0-3.1) with the transtibial technique. The incidence was 8.5% (95% CI: 6.8-10.3) in women and 5.7% (95% CI: 4.6-7.1) in men. Age, graft choice and the presence of cartilage or meniscal lesions did not affect the incidence. The overall incidence of a cyclops lesion removal within 2 years post-ACL-R was 6.9%. This was five times higher with the anteromedial femoral drilling technique than with the transtibial technique. Women had a 47% higher incidence of cyclops lesion removal than men. This is relevant for the surgeon when planning an ACL-R. Level II.

A Faunistic Revision of Longnose Skates of the Genus Dipturus (Rajiformes: Rajidae) from the Southern Southwestern Atlantic Ocean, Based on Morphological and Molecular Evidence

The identity of longnose skates (Dipturus-Zearaja-like skates) in the southern cone of the Americas has been a topic of extensive debate. This study employs a comprehensive analysis encompassing morphometrics, claspers, and the examination of COI and NADH2 sequence data to conclusively demonstrate the existence of only two longnose skate species in the southwestern Atlantic Ocean, extending south of 35 °S. Notably, Dipturus argentinensis Díaz de Astarloa, Mabragaña, Hanner and Figueroa, 2008 is revealed as a junior synonym of D. trachyderma (Krefft and Stehmann, 1975). Dipturus leptocaudus (Krefft and Stehmann, 1975) remains a northern valid species, but the specimen from the Falkland Islands (Malvinas) is recognized as a misidentification of D. trachyderma. Zearaja flavirostris (Philippi, 1892) and Dipturus lamillai Concha, Caira, Ebert and Pompert, 2019 are confirmed as junior synonyms of Zearaja brevicaudata (Marini, 1933). These findings contradict the previous report of six species within the same region over the last decade and underscore the presence of D. trachyderma and Z. brevicaudata south of 35 °S in the southwestern Atlantic. Additionally, this study notes the occurrence of only one specimen of Z. chilensis (Guichenot, 1848) in the Falkland Islands (Malvinas), suggesting an unusual frequency of this eastern Pacific skate in the southern Southwest Atlantic. Given that clasper morphology serves as the key distinguishing trait between Dipturus and Zearaja species, we provided a detailed analysis of the clasper characteristics of the Atlantic D. trachyderma, unequivocally situating it within Dipturus. The diagnostic characteristics include: (i) the presence of cartilage with the distal portion referred to as the sentinel, a feature absent in Zearaja; (ii) longer ventral terminal cartilage with the distal end referred to as the funnel, compared to Zearaja; and (iii) a non-spatulate distal lobe, a distinctive trait specific to Dipturus.

Osteocondroma maxilar benigno: um relato de caso clínico

ABSTRACT Osteochondroma is a benign tumor that arises from bone tissue with the presence of cartilage, slow growing, commonly asymptomatic, and can impact structures as the lesion grows. The objective of this study was to report a clinical case of benign maxillary osteochondroma that occurred in a 55-year-old female patient. In the initial clinical examination, no signs and symptoms were found. In imaging studies, a radiopaque lesion was found associated with the buccal bone cortex of the maxilla, above dental element 21, with pedicled insertion and lobulated surface. Due to the particularities of the lesion, surgical excision was proposed. The histopathological examination indicated mature cartilaginous and bone tissue, confirming the suspicion of osteochondroma.

Discovery Of A Bone In Chimpanzee Hearts

The os cordis (heart bone) is a rare bone found only in a few animals in the world. We discovered an os cordis in some chimpanzees. The os cordis was found in males and females, and in young and old animals. It was not present in chimps with healthy hearts, only in those with severe heart disease. We also discovered that a tissue called cartilage was present around the bone. The presence of cartilage gives us clues about how and why these rare bones develop.

Acetabular cartilage abnormalities in elderly patients with femoral neck fractures.

Introduction: Both hemiarthroplasty (HA) and total hip arthroplasty (THA) are widely accepted surgical procedures for hip replacement following displaced femoral neck fractures. However, in cases involving an intact joint line before surgery, the choice between HA and THA remains debatable. This study investigated the prevalence of acetabular cartilage and labral abnormalities in elderly patients with femoral neck fractures. Methods: Thirty-seven patients underwent hip arthroplasty for femoral neck fractures between April 2020 and February 2021. After excluding 4 patients, 33 patients (6 men and 27 women; mean age = 82.2 [range = 67–98] years) with fractures in 12 left and 21 right hips were included. After femoral head removal during arthroplasty, the acetabulum was macroscopically examined for the presence of cartilage and labral lesions. Acetabular cartilage abnormalities were classified as either overall degeneration or partial damage according to the cartilage damage classification system. Results: Acetabular cartilage abnormalities, including overall degeneration or partial damage, were found in all hips (100%). Out of the 33 hips, overall degeneration, partial damage, and labral abnormalities were detected in 32 (96.9%), 16 (48.4%), and 9 (27.2%) hips, respectively. Discussion: In this study, most elderly patients with femoral neck fractures exhibited acetabular cartilage and labral abnormalities, which were already present at the time of surgery. Therefore, surgeons should carefully examine these abnormalities as they may impact postoperative outcomes such as pain and function.

Effect of the presence of the articular cartilage on the femoral component rotation in total knee arthroplasty in female and varus osteoarthritis knees

PurposeSurgical techniques for total knee arthroplasty (TKA) require femoral rotational corrections that alter the position of the surface of the posterior femoral joint especially in kinematic alignment. However, preoperative planning of TKA based on computed tomography (CT), without knowing the femoral cartilage thickness, may cause post-surgery failures in femoral rotation. Therefore, this study aimed to evaluate the effects of posterior condyle cartilage thickness on rotational alignment in the femoral component.MethodsThree-dimensional magnetic resonance imaging (MRI) scans were obtained for 139 male and 531 female osteoarthritis patients. The angles defined by the femoral posterior condylar axis (PCA) and the surgical transepicondylar axis (TEA) were evaluated with respect to the presence of cartilage. Additionally, these effects were evaluated with respect to patient gender and varus/valgus condition.ResultsIn all patients, the angle between the TEA and PCA was significantly greater in the presence of cartilage than in the absence of cartilage. This result was also seen in female patients. However, there was no difference in the TEA/PCA angle in male patients based on the presence of cartilage. The TEA/PCA angle was significantly greater in the presence of cartilage than in the absence of cartilage in the female varus group. However, there were no differences in the TEA/PCA angle based on the presence of cartilage in the male varus/valgus and female valgus groups. Cartilage thickness in the posterior femoral condyle was significantly greater on the lateral side than on the medial side in all and male patients. However, there was no difference between the genders regarding cartilage thickness.ConclusionSurgical planning for TKA based on CT does not consider articular cartilage and could lead to external malrotation of the femoral implant. Therefore, the effect of the remaining posterior condylar cartilage should be considered by surgeons to prevent over-rotation of the femoral component, especially in female varus knees.

Tissue and species identification in minced meat and meat products from Italian commercial markets by DNA microarray and histological approach.

Adequate testing and adulterant detection of food products are required to assure its safety and avoid fraudulent activities. Adulteration/substitution of costlier meat with a cheaper or inferior meat is one of the most common fraudulence in meat industry. Aim of this study was to check the correct labelling of meat and ready to cook bovine meat products, combining the DNA microarray approach to identify the animal species with the histological examination, to check the composition and safety of meat. One hundred and one samples of bovine minced meat (Group 1) and ready to cook meat products (Group 2) were collected from supermarkets in Turin, Italy. DNA microarray revealed that 25.7% of samples were positive for species not declared on the label, swine being the most common. Histology showed the presence of cartilage, bone and glandular tissue. A higher presence of bacteria and inflammatory cells was detected in Group 1. Bacterial cells associated to inflammatory cells were detected with a higher score in Group 2. Sarcocystis spp. were present in 83.3% samples of Group 1 and 49.1% of Group 2. This study confirmed that the mislabelling of meat products is not uncommon. The combination of DNA microarrays and histology can increase the monitoring capacity in bovine meat industry.

Intra-articular and meniscal pathology according to anterior cruciate ligament injury pattern: both-bundle tear or selective bundle tear.

Background Articular cartilage injury and meniscal tear are usually combined with anterior cruciate ligament injury. Purpose We investigated the incidence of cartilage injury and traumatic meniscal tear according to the type of combined anterior cruciate ligament tear (both-bundle versus selective bundle tear). Material and Methods This retrospective study included 103 patients diagnosed with anterior cruciate ligament tear after knee joint magnetic resonance imaging and who underwent knee joint arthroscopy. Two radiologists evaluated articular cartilage injuries and meniscal tear independently. We used the chi-square test to analyze the association between type of anterior cruciate ligament bundle tear and presence of cartilage or meniscal injury in each reader. Results Cartilage injury presented a significantly higher prevalence in both-bundle tear than did selective bundle tear in reader 1 ( P = 0.004). In reader 2, both-bundle tear had a tendency for higher risk of cartilage injury, but this was not statistically significant ( P = 0.178). In meniscal injury, there was a statistically significant increase in the risk of associated meniscal injury in both-bundle tear versus selective bundle anterior cruciate ligament injury ( P = 0.019 and 0.021). The risk of accompanying traumatic meniscal lesion was significantly higher in both-bundle tear ( P = 0.036 and 0.018). Conclusion The incidence of accompanying meniscal injury, especially traumatic tears, is higher in both-bundle anterior cruciate ligament tear than in selective bundle tear. There was no significant difference in incidence of cartilage injury between both-bundle tear and selective bundle tear, although one of two readers showed a higher incidence in both-bundle tear.

THE MESOPTERYGIAL VEIN: A RELIABLE VENIPUNCTURE SITE FOR INTRAVASCULAR ACCESS IN BATOIDS.

Intravascular access in batoid species is commonly achieved using the ventral coccygeal or radial wing vessels. However, these approaches can be difficult because of the presence of cartilage, lack of specific landmarks, species variation, and small vessel size in many species. This study used postmortem contrast radiography and gross dissection to develop landmarks for a new, dependable vascular access in three Myliobatiform species commonly maintained in captivity: Atlantic stingray (Hypanus sabinus), cownose ray (Rhinoptera bonasus), and smooth butterfly ray (Gymnura micrura). The mesopterygial vein provides quick vascular access and is suitable for administration of large fluid volumes and intravascular drugs. It is located immediately ventrolateral to the metapterygium cartilage, which sits adjacent to the coelomic cavity and supports the caudal half of the pectoral fin. Using the pectoral girdle and cranial third of the metapterygium cartilage as landmarks, vascular access can be achieved by directing a needle medially at approximately a 30° (adult cownose rays) or 45° angle (Atlantic stingrays, juvenile cownose rays, smooth butterfly rays) toward the metapterygium cartilage. Differences in the degree of needle direction are due to species and age-specific shapes of the metapterygium cartilage. The mesopterygial vein is an alternate site of quick and reliable venous access in batoid species.

Influence exerted by bone-containing target body on thermoacoustic imaging with current injection**Project supported by the National Natural Science Foundation of China (Grant No. 51477161), the National Key Research and Development Program of China (Grant No. 2018YFC0115200), and the Fund from the Chinese Academy of Sciences (Grant No. YZ201507).

Thermoacoustic imaging with current injection (TAI-CI) is a novel imaging technology that couples with electromagnetic and acoustic research, which combines the advantages of high contrast of the electrical impedance tomography and the high spatial resolution of sonography, and therefore has the potential for early diagnosis. To verify the feasibility of TAI-CI for complex bone-containing biological tissues, the principle of TAI-CI and the coupling characteristics of fluid and solid were analyzed. Meanwhile, thermoacoustic (TA) effects for fluid model and fluid–solid coupling model were analyzed by numerical simulations. Moreover, we conducted experiments on animal cartilage, hard bone and biological soft tissue phantom with low conductivity (0.5 S/m). By injecting a current into the phantom, the thermoacoustic signal was detected by the ultrasonic transducer with a center frequency of 1 MHz, thereby the B-scan image of the objects was obtained. The B-scan image of the cartilage experiment accurately reflects the distribution of cartilage and gel, and the hard bone has a certain attenuation effect on the acoustic signal. However, compared with the ultrasonic imaging, the thermoacoustic signal is only attenuated during the outward propagation. Even in this case, a clear image can still be obtained and the images can reflect the change of the conductivity of the gel. This study confirmed the feasibility of TAI-CI for the imaging of biological tissue under the presence of cartilage and the bone. The novel TAI-CI method provides further evidence that it can be used in the diagnosis of human diseases.

Hiperplasia bilateral del proceso coronoideo. Reporte de caso clínico con presentación inusual y revisión literaria.

The formation of a new joint between a pathologically enlarged coronoid process and the body of the malar bone is known as Jacob's disease. Hyperplasia of the coronoid process was first described in 1853 by von Langenbeck, and it was not until 1899 when Oscar Jacob described the disease that was named after him. Jacob's disease is an uncommon entity with only a few cases documented in the literature. The condition manifests at first with progressive limitation of the oral opening and facial asymmetry. The pain is infrequent and mainly affects young patients. Temporal muscle hyperactivity, cranial trauma, chronic displacement of the ipsilateral temporomandibular joint, endocrine stimuli and genetic alterations have been postulated as possible factors. The definitive diagnosis is by histopathology and it is necessary that bone hyperplasia is confirmed, as well as the presence of cartilage and synovial capsule forming the new joint between the malar bone and the coronoid process. We present a 10-year-old patient with a history of childhood trauma in the left preauricular region. It presented to our service with a history of progressive limitation of the oral opening. Computed tomography (CT) revealed an elongation of the bilateral coronoid process, in contact with homolateral zygomatic bone, causing its deformation. Surgery under general anesthesia was performed through the intraoral vestibular route. Histopathology confirmed the diagnosis of Jacob's disease. We review the literature regarding the etiology, pathogenesis, clinical characteristics, diagnosis and treatment of this condition.

Histopathological effects of septoplasty techniques on nasal septum mucosa: an experimental study.

The aim of this study is to evaluate the histopathological effects of septoplasty techniques on the nasal septal mucosa of rabbits with light and electron microscope. The study was performed on 21 rabbits between August 2016 and February 2017. Rabbits were randomly divided into three groups. In Group-1, while preserving the L-strut structure of the septum, cartilage resection, was performed by open technique septoplasty. In Group-2, the same procedure was done except the resected cartilage was crushed and put back in place. No surgical procedure was performed on the Control group. Postoperative 2nd month; the specimens were histopathologically evaluated by light and electron microscope in terms of changes in the morphology of septum mucosa, perichondrial thickness, cilia and goblet cell deprivation, loss in glands, fibrosis and inflammatory cell infiltration in the lamina propria. The deprivation in cilia, goblet cells, serous gland and increase in the amount of collagen fibers were examined in both Group-1 and 2. The difference in Group-1 and Group-2 were statistically significant in terms of presence of cilia, number of goblet cells and glands and increase in collagen fibers when compared to control (p < 0.001, p = 0.002, p = 0.020, p = 0.002, respectively). In terms of perichondrium thickness, statistically significant difference was found between the Control and Group-2 (p < 0.001). CONCLUSıON: In this study, histopathological findings supported that the presence of cartilage in the septum is necessary to prevent the mucosal changes. Long-term studies are needed to observe whether changes in the morphology of epithelium and gland proceed more than 2 months follow-up.

Feasibility of 3D-printed models of the proximal femur to real bone: a cadaveric study

3D technology has increased popularity during the past decade due to recent advancements and has been described as a useful tool in several fields of medicine including orthopaedic surgery. Applications include preoperative planning, custom-made implants, patient-specific guides, etc. The aim of this study was to evaluate the similarity between 3D-printed models and cadaveric femoral heads, based on CT scans. Cadaveric study of 12 male hips. Computed tomography (CT) was performed and through a semi-automatic segmentation process created the 3D model. Using a 3D printer, the model was printed in ABS plastic. 1 observer performed several measurements in the cadaver, and a 2nd observer performed the same measurements in the 3D-printed model. A 3rd observer compared both measurements and performed the statistical analysis. There were no significant differences in the measurements of bony structures between the cadaveric specimens and the 3D-printed model (p > 0.05 in all cases). We found significant differences when comparing measurements containing a soft tissue element, for example the dimensions of the cartilage covered femoral head (p < 0.0001). 3D-printed models of the hip are accurate and feasible to the real bone and can thus be reliable for preoperative planning or other uses that may arise in orthopaedic surgery. Presence of cartilage must be considered when creating the 3D model from CT that considers bone but not cartilage.

The mode of interfragmentary movement affects bone formation and revascularization after callus distraction.

Callus distraction is sometimes associated with a delay in the maturation process and serious complications. It is believed that these complications are often caused by instability of the bone segment fixation. Typical fixation devices, such as ring-fixators, show significant deformations in all directions under external loading and muscle forces. This leads to axial compression and tension as well as shear movements in the healing area. Herein we investigated the hypothesis that the direction of interfragmentary movement after callus distraction affects the bone formation and revascularization during the maturation process. Two custom fixator systems were designed to apply a protocol of lateral callus distraction and subsequent cyclic stimulation of the regenerate tissue. One fixator system was used to apply either compressive or tensile stimulation while the other was used to apply shearing stimulation. The fixators were applied to the tibial surface of the right hind leg of sheep specimens. During lateral callus distraction, a titanium plate was elevated by 0.275 mm perpendicular to the long axis of the bone twice daily, resulting in a 5.5 mm gap at the end of the ten-day distraction phase. Following a seven-day consolidation phase, the regenerate in the gap between tibial cortex and titanium plate was stimulated once daily by cyclic movement for 120 cycles. The stimulation was applied for 18 days with amplitudes of 0.6 mm in compression (Group C) or tension (Group T), or a 1.0 mm shear amplitude (Group S). Seven weeks postoperatively the specimens were analyzed for quantity of bone formation, the presence of cartilage and fibrous tissue, and blood vessel density. There was a significantly higher blood vessel density (4.6 ± 1.6%) in Group C than in Group T (1.2 ± 0.4%) or Group S (1.0 ± 0.5%) (p < 0.01). The amount of bone was significantly higher in Group C (25.6% ± 13.0%) than in Group T (13.5 ± 4.9%) (p < 0.05). Group S showed a similar amount of bone (14.0 ± 10.7%) to Group T. The results show that bone formation and revascularization are dependent on the direction of interfragmentary movement and that the cyclic compression best stimulates the healing process.

Condrolipoma na orelha de um cão

Background: Lipoma is defined as a tumor composed of mature adipocytes, identical to the cells that form normal adult fat. Other elements may also be present, such as cartilaginous tissue. Chondrolipoma is characterized by the presence of differentiated cartilage islands spread within a typical lipoma, in which mucin and collagen can be observed around isles of chondrocytes. This condition affects mainly middle-aged or elderly dogs as well as elderly humans. In the scientific literature, chondrolipomas have not yet been described on the ear of dogs. Therefore, this study aimed to report a case of chondrolipoma on the ear of a dog and its histopathological and histochemical description.Case: A female, 10-year-old, Labrador retriever dog was admitted to the Veterinarian Hospital of the Federal University of Paraíba (UFPB), Areia, Brazil. The dog was presented with an ulcerated pendulous nodule on the ear, with a clinical evolution of approximately 7 months. A biopsy sample was taken and submitted to the Veterinary Histopathology Laboratory of the UFPB. Macroscopic evaluation revealed a pendulous and firm nodule, with a round apex, measuring 1.3cm in diameter. The epidermis covering the nodule exhibited an ulcer of 0.5cm in length. The nodule exhibited resistance to cutting and the surface was dark red with hard areas in the center. Sample was fixed in 10% formalin and routinely processed for histology, embedded in paraffin, and stained with hematoxylin and eosin (HE), alcian blue (AB), Masson’s trichrome (MT), and periodic acid-Schiff (PAS). Histopathological evaluation revealed that the nodule was encapsulated, formed by adipocytes of variable sizes. Adipocytes were well-differentiated and the nodule was defined as lipoma. Within the lipoma there was proliferation of chondrocyte islands in a bluish basophilic matrix. Adjacently, abundant fibrous connective tissue was found intertwined with blood vessels. Some vessels exhibited red blood cells in the vicinity, indicating hemorrhage. The epidermis covering the nodule was slightly acanthotic and moderately hyperkeratotic. MT staining marked the fibrous tissue in blue. AB staining revealed blue areas confirming the presence of mucin around cartilage islands. PAS staining revealed the presence of glycogen between mesenchymal cells, which included chondrocytes.Discussion: The diagnosis of chondrolipoma was concluded with the presence of a well-differentiated lipoma, randomly intertwined with cartilage islands, which were also well-differentiated and spread within a typical lipoma. Additionally, the presence of mucin and collagen around the isles of chondrocytes facilitated the diagnosis. Chondrocytes presented different phases of maturation. The case described here exhibited microscopic characteristics that were similar but somewhat different to those previously reported by other authors, in considering that the nodule was encapsulated, and did not exhibit cell atypia or mineralization in the cartilage islands. Most studies published used PAS and Masson’s trichrome staining techniques to confirm the diagnosis of chondrolipoma. However, alcian blue also aids in diagnosing this condition. The tumor developed for months before the dog was taken to a veterinarian, when it finally became ulcerated, which characterized it as non-invasive. Chondrolipoma is a benign tumor, which does not induce metastasis and once excised does not exhibit recurrence. In veterinary medicine, the presence of cartilage within a lipoma is a rare event.

Nulligravida Female with Heterotopic Cartilage in Uterus: A Case Report with Historical Review

Abstract Background: The presence of cartilage in the uterine cavity is termed as heterotopic cartilage and a rare entity in cases of primary infertility. Endometrial metaplasia, heteroplasia, infections, retained endometrial tissue, and chronic irritation are being proposed as its etiology on literature, but none of them has been accepted as a single etiological agent till date. Menstrual irregularity, bleeding, infertility, and subfertility are common symptoms. This abnormal condition was first reported in 1925 by Neumann, and since then, 26 cases have been reported and ours is the 27th case in this series. Case Report: The present patient was a nulligravida patient admitted with menstrual irregularity and primary infertility. On diagnostic hysteroscopy, the uterine cavity was full of tissue, firm in consistency and whitish in color, and hysteroscopic-guided resection was done. Symptomatically, the patient was normal. Discussion: Endometrial metaplasia was suspected as pathology for this heterotopic car...

Clinical and radiographic results of arthroscopic partial lateral meniscectomies in stable knees with a minimum follow up of 20 years.

The purpose of this retrospective multicentric study was to evaluate the long-term effects of lateral meniscectomy and to identify those patients who are at the most risk of developing osteoarthritis (OA). Eighty-nine arthroscopic partial lateral meniscectomies in stable knees with a mean follow-up of 22 ± 3 years were included. The following influencing factors were analyzed: age, sex, body mass index (BMI), physical activity, alignment, the types of meniscal lesions, the extent of meniscal resections and the initially associated cartilage lesions. An independent examiner reviewed all patients, using subjective (KOOS and IKDC scores) and objective clinical and radiological evaluations (IKDC score). The contralateral knee was used as a reference to calculate the prevalence and the incidence of OA. The mean age at the time of surgery was 35 ± 13 years. The main location of the lesions was the mid-section of the lateral meniscus (79% of the cases). At the latest follow-up, 48% of the patients had an active lifestyle with as many as 48% of the patients enjoying moderate to intense physical activity 22 years after the procedure (vs. 71% before surgery). The KOOS score evolved from 82 to 69% during the same period. The prevalence of OA was 56% in the affected knee and the difference of prevalence between the operated and healthy knees was 44%. In those patients presenting with an OA of the operated knee and a normal contralateral knee, the incidence of OA was 53%. Predictors of OA were an age superior to 38 years at the time of surgery, obesity (BMI >30), and valgus malalignment as well as the presence of cartilage and degenerative meniscal lesions at the time of surgery. In the long term, arthroscopic partial lateral meniscectomy in stable knees without initial cartilage lesions might yield good to excellent results in young patients. Patients are at higher risk to develop symptomatic OA if they are over 40, having a high BMI, valgus malalignment and cartilage lesions at the time of surgery. This study provides precise guidelines for the surgical treatment of lateral meniscus tears. IV.

Assessment of Elbow Deformity with an Ultrasonic Motion Analysis System via Its Rotation Axis: A Cadaver Study

Background: Elbow deformities are frequently found in children following elbow trauma, and precise assessment of elbow deformity is difficult in current clinical practice, especially in the rotational component, even with computed tomographic (CT) images due to the presence of cartilage. Purpose: We are proposing a new method of assessing elbow deformity via the its rotational axis, calculated from data obtained by the motion analysis system, in order to provide orthopedic surgeons a better understanding of the elbow deformities before or during surgical corrections. Methods: Osteotomy was performed at the supracondylar region of humerus on a fresh-frozen cadaver, and the bone fragments were adjusted with a set of external skeletal fixator (ESF). Cycles of elbow flexion and extension were then performed passively, and the coordinates of the markers on both humerus and ulna were recorded by an ultrasonic motion analysis system. Mathematical algorithm was developed and the elbow rotation axis was determined by the normal vector of the best fitting plane calculated through random sample consensus (RANSAC) method. Five different elbow conditions in varus/valgus deformities as well as internal/ external rotations were created by adjusting the ESF, and three sets of data were collected for each condition. Results: The best fitting plane method was able to reduce the shifting of the marker positions from 11 mm to less than 4 mm, and the deformities calculated from each elbow rotation axis were found to be within 50 of the expected value.

Effect of cartilage implantation on synovial fibroblasts from patients with rheumatoid arthritis

BackgroundRheumatoid arthritis synovial fibroblasts (RASF) migrate to distant tissue sites and damage articular cartilage. Using novel markers of RASF subsets to identify lining and sublining layer RASF, we investigated the ability of RASF to undergo self-assembly, transmigration, and cartilage degradation in vivo. MethodsHealthy human cartilage was co-implanted subcutaneously into the flank of SCID mice together with RASF. On the contralateral flank, cartilage was implanted without cells. After 60 days, implants and blood were analysed. Human cells were detected with immunohistochemistry for species-specific antibodies. For in-vitro studies, RASF were isolated from patients with established rheumatoid arthritis and from healthy controls, and the expression of cellular markers was defined. FindingsRASF at the ipsilateral implant differentiated into distinct fibroblast subsets in the presence of cartilage. Cells proximal to cartilage expressed markers of a lining layer phenotype (GP38, FAP, VCAM-1, and Cadherin-11). These cells attached to, invaded, and degraded cartilage. Cells more distal to cartilage expressed sub-lining layer phenotype markers including CD248 and CD90. Cells expressing CD248 and CD90 were never observed in the lining layer (proximal to cartilage) and never invaded cartilage. The development of this stromal architecture mirrored that observed in vivo in the inflamed synovial membrane. This stromal pattern of distinct differentiation of lining layer and sub-lining layer was repeated in the contralateral implant that contained only cartilage. In addition, we showed that RASF in vitro could be directed towards either a lining layer (GP38, FAP, VCAM-1, and Cadherin-11) or sublining layer phenotype (CD248 and CD90) after cytokine treatment. The lining layer, but not sub-lining cell phenotype, was associated with increased cartilage degradation in vitro. InterpretationRASF have an activated cell phenotype ex vivo. In vitro and in vivo they display plasticity with the capacity to differentiate into distinct cell subpopulations that morphologically distinguish between the lining and sublining layer of the human joint. In-vivo cell subpopulation differentiation occurs locally at the site of engraftment and is the same as the lining anatomy observed at the site of origin. This occurrence is dependent on the release of tissue factors present in the joint microenvironment after cartilage damage. This inflammatory microenvironment is required for cartilage destruction by RASF. Cellular therapies targeting RASF specific subsets are an unexplored but important therapeutic target to modulate inflammation and might provide a way to minimise joint damage in patients with rheumatoid arthritis. FundingNone.

Cartilage differentiation in ependymoma: histogenetic considerations on a new case

The presence of cartilage in gliomas is a very unusual finding and has been mainly reported in ependymomas and in astrocytomas. A derivation of cartilage from neuroepithelial cells through a neuroepithelial-mesenchymal transition or directly from blood vessel-associated multipotent stromal elements has been proposed. We herein describe a further case of ependymoma with the presence of cartilage in a child affected by a tumor in the posterior fossa. In this case, only the last recurrence, characterized by focal areas of anaplasia, contained a nodule of cartilage. The immunohistochemical expression of fibronectin, tenascin-C, and CD44 was investigated, and the possible role of these molecules in the process of cartilage formation is discussed. Moreover, the literature on the subject is reviewed.