Introduction: Antimicrobial peptides (AMP) are a novel class of antimicrobial agents effective against among others MRSA in vitro. Previously, we reported the release of AMP Dhvar-5 and hLF1-11 from different bone cements^(1,4). In this study we investigated the efficacy of calcium phosphate cement (Calcibon^®) loaded with hLF1-11 for the treatment of MRSA osteomyelitis in vivo.

Materials and Methods: Osteomyelitis was induced in 14 rabbits by MRSA, as described by Norden et al.⁽²⁾ After 3 weeks all animals were treated by a thorough local debridement and subsequent filling of the tibial cavity with Calcibon^® bone cement. Six control animals received Calcibon^® without additives and 8 animals received Calcibon^® loaded with 50 mg hLFl-11 per g cement powder. Treatment outcome was analyzed by microbiology, radiology and histology after 3 weeks follow-up.

Results: The results are shown in table 1. The number of CFU per gram of bone were significantly lower in the 50 mg hLFl-11 group (median 3.0x10³ CFU/g bone) compared to the control group (median 3.5xl0⁶ CFU/g bone).

Conclusion: This study demonstrates that hLFl-11 has the ability to cure an existing MRSA osteomyelitis in 5 out of 8 animals. The data suggest that the antimicrobial peptide, hLFl-11 in Calcibon^® is able to treat osteomyelitis in vivo.

We present the rationale and design of the DynaPort KneeTest. The test aims at measuring knee patients’ functional abilities in an unobtrusive, user-friendly way. Test persons wear several belts around their trunk and legs. The belts contain accelerometers, the signals of which are stored in a recorder, embedded in one of the belts. The knee test consists of a set of 29 tasks related to activities of daily life (“test items”). Accelerometer signals are analysed in terms of 30 “movement features” (accelerations, angles, durations, frequencies, and some dimensionless numbers). In data analysis, the beginning and end of each test item is marked by hand; otherwise, analysis is automatic.

We compared 140 knee patients with 32 healthy controls and found 541 of the 29 x 30 =870 test item movement feature combinations differed significantly between the two groups. From these 541 combinations the DynaPort knee score is calculated by the weighted averages of movement features per item, then weighted averages of items per cluster (locomotion, rising and descending, transfers, lifting and moving objects), and finally the average of the clusters. In an initial study the test-retest reliability of the knee test proved high, and the test turned out to be sufficiently responsive (0.7 patients’ standard deviations improvement after 24 months). However, it remains difficult to interpret the scores in more meaningful terms than merely “better” or “worse”. Extensive reliability studies in the future will further assess the validity of the test and provide more insight into the meaning of the scores.

The DynaPort knee test may thus become an important instrument for evaluating patients’ functional abilities in knee-related clinical practice and research.

We undertook a prospective MRI study to measure the retroversion of the humeral head in 33 consecutive infants with a mean age of 1 year 10 months (3 months to 7 years 4 months) who had an obstetric brachial plexus lesion (OBPL). According to a standardised MRI protocol both shoulders and humeral condyles were examined and the shape of the glenoid and humeral retroversion determined.

The mean humeral retroversion of the affected shoulder was significantly increased compared with the normal contralateral side (−28.4 ± 12.5° v −21.5 ± 15.1°, p = 0.02). This increase was found only in the children over the age of 12 months. In this group humeral retroversion was −29.9 ± 12.9° compared with −19.6 ± 15.6° in the normal shoulder (p = 0.009), giving a mean difference of 10.3° (95% confidence interval 3.3 to 17.3). This finding is of importance when considering the operative treatment for subluxation of the shoulder in children with an OBPL.