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Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_III | Pages 465 - 465
1 Sep 2009
Izal I Ripalda P Acosta V Ochoa I Bea J Doblaré M Aranda P Escribano R Mora G Valentí J Gallego G Recalde I Gòmez-Ribelles J Pròsper F
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Hyaline cartilage is a support tissue with a poor capacity to self repair. In the last years, tissue engineering and cell therapy have focused its efforts in the development of scaffolds that may support the differentiation and the implantation of mesnechymal stem cells (MSC) in the site of lesions performed in femoral cartilage. Among synthetic materials used for the construction of these scaffolds, poly(L-lactic acid) (PLLA) is a suitable option, since some studies have offered promising results. The use of PLLA, nevertheles has an important handicap, as cell seeding easily results in a non uniform distribution and a poor density of cells, wich have been proposed as key steps for the differentiation of MSCs to chondrocytes. In our work we have cultured sheep MSCs, and proved its potentiallity by differentiation to chondrocytes in micromass culture. PLLA scaffolds 1 mm thick and 6 mm in diameter were characterized by determining their porosity and their mechanical properties, and subsequently were used to assay the seeding of MSCs. We measured efficiency and retention by quantification of DNA, and density and distribution by light microscopy of paraffin sections. Our results describe a simple technique of cell seeding by aspirating cells with a syringe that achieves a uniform distribution and a high density of cells. Finally 3D seeded MSCs were cultured with condrogenic medium containing TGF-β3 for 21 days and results analyzed by massons trichrome staining in paraffin embedded sections.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_II | Pages 329 - 329
1 May 2006
del Río J Valentí J Valentí A Duart J
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Purpose: The purpose of this review is to present our experience in prosthetic reconstruction after resection arthroplasty, its outcome and possible complications.

Materials and methods: We carried out a retrospective study of 23 hips reconstructed after an average of 2.2 years. Inclusion criteria were: having had a resection arthroplasty, a reconstruction with joint prosthesis and a minimum follow-up of one year. For evaluation we used the Merle d’Aubigne score for pain, walking and range of motion.

Results: The operated limb was lengthened 2.9 cm (1.2–4.8). The average for pain was 4.6, for range of motion 4.3 and walking 5.2. The overall outcome, 14.1 points, was considered acceptable. 47% had good or very good outcomes. All the patients improved their ability to walk. Four patients presented dislocation of the prosthesis after reconstruction and only one patient had a reinfection.

Conclusions: Prosthetic reconstruction after resection arthroplasty is technically difficult. This is due mainly to wear in the soft tissues and changes in the amount and quality of bone stock as a result of prior surgery. The biggest gain is seen in the ability to walk while there is less improvement in pain and range of motion. Candidates for reconstruction must be carefully selected to prevent complications and/or false expectations of always achieving excellent results.