Autologous chondrocyte implantation is a NICE approved intervention however it involves the morbidity of two operations, a prolonged rehabilitation and substantial healthcare costs. This study describes a novel, one-step, bone marrow (BM) derived mesenchymal stem cell (MSC) transplantation technique for treating knee osteochondral lesions and presents our prospective clinical study investigating the success of this technique in 206 lesions over a 5 year period. The surgical technique involves harvesting BM from patients’ anterior superior iliac spines, centrifugation to isolate MSCs and seeding into a type 1 collagen scaffold (SyngenitTM Biomatrix). Autologous fibrin glue is used to secure the scaffold into the defect. Inclusion criteria included patients aged 15 – 55 years old with symptomatic osteochondral lesions >1cm2. Exclusion criteria included patients with ligament instability, uncorrected alignment, inflammatory arthropathy and a Body Mass Index >35 kg/m2. Outcome measures included the Modified Cincinnati Knee Rating System (MCKRS), complications and reoperations.Abstract
Background
Methodology
Patients presenting with loosening or a fracture between ipsilateral hip and knee replacements provide a unique reconstructive challenge. We present mid-term results of the cement-over megaprosthesis (COM) when managing these complex cases. A COM is cement-linked to the stem of a well-fixed existing implant. We report the largest series to date and show that this may be preferable to total femoral replacement in a cohort of patients who often have significant co-morbidities. A retrospective analysis of patients undergoing COM between 2002–2022 was performed. Primary outcomes were defined as implant survival, displayed with survival analysis. Secondary outcomes included mortality and surgical complications. Functional outcomes included Visual Analogue Score (VAS), EuroQol-5D-3L and Musculoskeletal Tumour Society (MSTS) score at one year post operatively.Abstract
Introduction
Methodology
