Structural and functional outcome of bone graft with first or second generation autologous chondrocyte implantation (ACI) in osteochondral defects has not been reported. Seventeen patients (mean age of 27±7 years, range 17–40), twelve with osteochondritis dissecans (OD) (ICRS Grade 3 and 4) and five with isolated osteochondral defect (OCD) (ICRS Grade 4) were treated with a combined implantation of a unicortical autologous bone graft with ACI (the Osplug technique). Functional outcome was assessed with Lysholm scores. The repair site was evaluated with the Oswestry Arthroscopy Score (OAS), MOCART score and ICRS II histology score. Formation of subchondral lamina and lateral integration of the bone grafts were evaluated from MRI scans.Background
Methods
A retrospective review of 80 patients with unilateral slipped capital femoral epiphysis from 1998–2012 was undertaken to determine the outcome of the unaffected hip. All patients were treated with either prophylactic single Richards screw fixation or observation of the uninvolved hip and were followed up for at least 12 months. The unaffected hip of 44 patients (mean age 12.6 years, range 9–17) had simultaneous prophylactic fixation and 36 patients (mean age 13.4 years, range 9–17.4) were managed with observation. Sequential slip of the unaffected hip was noted in 10 patients (28 per cent) in the observation group and only in 1 patient (2 per cent) in the group managed with prophylactic fixation. A Fisher's exact test showed significantly high incidence of sequential slip in unaffected hips when managed with regular observation (p-value 0.002). Only 3 cases had symptomatic hardware on the unaffected side after prophylactic fixation with one requiring revision of the metal work; one had superficial wound infection treated with antibiotics. No cases had AVN or chondrolysis.Methods
Results
Randomised controlled study evaluating new bone formation Regenerating new bone by cell therapy could provide therapeutic options in many conditions such as fracture non-unions and osteo-chondral defect regeneration in advance OA. In this randomised controlled study we evaluated the efficacy of new bone formation by bone marrow derived stromal cells (BMSC) in patients with non-union.Summary
Introduction
The potential of cells derived from human umbilical cord(UC) for orthopaedic cell engineering is evaluated by dissecting the UC into four distinct anatomical structures – cord lining (CL), Wharton's Jelly (WJ), umbilical cord artery (UCA) and umbilical cord vein (UCV). Cells from individual anatomical layers were grown by explant culture technique for 21 days. Tri-lineage differentiation and growth kinetics of cells from each layer were compared. Flowcytometry was done according to ISCT criteria to ascertain their surface antigen expressions. Cells from all four layers differentiated into bone, cartilage and fat. Osteogenic and chondrogenic differentiation was variable for each type of cells. All cells expressed surface antigens characteristic of mesenchymal stem cells (MSC). These cells can form a potential cell source in cell engineering to produce bone and cartilage although individual cell type needs to be characterised from each anatomical layer of UC and identify the best cell type for cell engineering.
