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Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_IV | Pages 621 - 621
1 Oct 2010
Tzioupis C Giannoudis P Gilbert T Kumta P Pape C Roy A Sfeir C Usas A
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Aim: The aim of the current study is to investigate if viscosupplemetation therapy will increase the effect of microfracture technique by acting the quality and quantity of the new cartilage after microfracture.

Material and Method: Full thickness chondral defects were created to intercondylar notch as a nonweightbearing area by using a handle drill bit. Microfracture holes between bridges were performed with a 1mm K wire.

The present study was performed on 30 mature white rabbits (male range, 2800–3500 gr). The right knees were accepted as study and left knees as control group. Group 1 was received intraarticular 0.1ml sodium hyaluronate treatment, rabbits in group 2 were received 0.1 ml Serum Physiologique once a week for three weeks. Biopsy was taken from both knees at the 3rd and 6th week. Histopathological evaluation was performed by a pathologist who is blind to study according to modified Mankin score.

Results: Although the difference of the scores between study and control group was not statistically different at the third week, it was seen different at the sixth week histologically.

Conclusion: Hyaluronic acid may be benefecial in the treatment of chondral lesion addition to arthroscopic microfracture technique.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_I | Pages 174 - 174
1 Mar 2006
Harwood P Giannoudis P Probst C Van Griensven M Krettek C Pape C
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Background /Methods: Abbreviated Injury Scale based systems; the ISS, NISS, and AISmax, are used to assess trauma patients. The merits of each in predicting outcome are controversial. A large prospective database was used to assess their predictive capacity using receiver operator characteristic curves.

Results: 13,301 adult patients met the inclusion criteria. All systems were significant outcome predictors for sepsis, multiple organ failure (MOF), length of hospital stay, length of ICU admission and mortality (p 0.0001). NISS was a significantly better predictor than the ISS for mortality (p 0.0001). NISS was equivalent to the AISmax for mortality prediction and superior in patients with orthopaedic injuries. NISS was significantly better for sepsis, MOF, ICU stay and total hospital stay (p 0.0001). Analysis of the ROC curves revealed that the traditional ISS cut-offs for severity of 16, 25 and 50 should be increased to 20, 30 and 55 to provide patients with equivalent outcome.

Conclusions: NISS is superior or equivalent to the ISS and AISmax for prediction of all investigated outcomes in a population of blunt trauma patients. As NISS is easier to calculate, its use is recommended to stratify patients for clinical and research purposes.