Objective: Long term efficacy of Aneurismal Bone Cysts (ABC ) treatment with Ethibloc.

Materials and Methods: Eighteen patients with ABC were treated with direct percutaneous Ethibloc injection. No severe complications were observed; three patients had a local leakage of Ethibloc through the injection site, self-resolving without complications. Follow-up lasted from 2 to 98 months.

Results: Seventeen patients showed a remarkable shrinkage of the cystic lesion with cortex thickening. The reduction of the lesion was not satisfactory for only one patient who has been successively operated on. Pain disappeared in 12 patients; it persisted in two and occurred occasionally in four, during follow-up.

Conclusions: In our experience the direct percutaneous Ethibloc injection is effective in the treatment of ABC and can be recommended as the first-choice treatment after a mandatory histological diagnosis; furthermore scleroembolization does not precludes any subsequent surgical approach. MRI must be considered in all the phases, including follow-up.

We report the clinical results and MRI findings observed in 50 patients who underwent collagen meniscus implant (CMI) between March 2001 and October 2003. Fifty patients affected by irreparable meniscal lesions or who had previously undergone partial medial meniscectomy were arthroscopically treated with CMI, a tissue engineering technique designed to promote meniscal regeneration. Average age at the time of surgery was 38.4 years. The average size of the lesion/defect was 4.3 cm. Additional procedures included 16 ACL reconstructions, eight high tibial osteotomies and two autologous chondrocyte implantations. All knees were evaluated according to the Lysholm II and Tegner activity scales. MRI was performed 6, 12 and 24 months postoperatively. Six arthroscopic examinations of the implant were performed at different times (6 to 16 months postoperatively).

Postoperative complications included saphenus neuroapraxia in three patients and CMI rupture in one patient who presented with persistent knee swelling. Follow-up averaged 16.5 months, with a minimum of 6 months. At the most recent evaluation, 46 patients showed an improvement in the clinical scores. A progressive, uniform signal was evident by MRI. At the second arthroscopic study, free fragments of the implant were observed in cases of CMI rupture. In another patient, partial resorption of CMI was observed at the posterior horn. The remaining four arthroscopic examinations demonstrated regeneration of meniscal-like tissue.

Clinical results achieved with CMI are promising. MRI proved to be an effective tool for monitoring the evolution of the implant and showed good correlation with clinical outcomes and arthroscopic findings at follow-up.

We prospectively evaluate clinical results and MRI findings on a series of 47 patients, with an average age of 31.7 years, treated by matrix-induced autologous chondrocyte implantation (MACI) for knee and ankle chondral defects.

As isolated lesions, the joints affected were 37 knees and five ankles. As combined lesions, there were four knees and one kissing lesion in the ankle. The average size of the defects was 3.5 cm². Clinical-functional evaluation was carried out according to ICRS, modified Cincinnati knee, Lysholm II and Tegner scales. The AOFAS score was used for the evaluation of the ankle. MRIs were taken before the operation as well as at 6, 12 and 24 months postoperatively. Among 10 second arthroscopic studies (four knees, six ankles), two biopsies were carried out after 2 years, from the medial femoral condyle and the patella, respectively. These specimens were evaluated by light microscopy, immunohistochemistry (type I and II collagen), SEM and TEM analysis.

Follow-up averaged 25.6 months. At the latest follow-up, knee scores improved after surgery. AOFAS did not improve in the patient with the kissing lesion. MRIs showed hyaline-like cartilage at the site of implantation in all treated joints with exception of the kissing lesion; four knees showed recurrence of subchondral bone oedema 1 year after surgery. Histological analysis on the biopsies revealed good definition of the tidemark and presence of type II collagen.

Clinical results and MRI findings support the efficacy of the MACI technique. Morphological findings are indicative for hyaline-like tissue formation in the implant site.