The giant intra-articular osteochondroma of the knee is very rare and is probably result of synovial metaplasia of the fibrous capsule or of the adjacent connencive tissue of a joint, and of the fragment of articular cartilage. The gross findings and histology are consistent with the osteochondroma. The authors experienced a case of giant intra-articular osteochondroma of the right knee in a 19 years old man who had history of knee injury when he was 16 years old. The mass was excised and the symptome was relieved.
Cartilage, Articular ; Joints ; Knee Injuries ; Knee ; Metaplasia ; Osteochondroma

Treatment of articular cartilage lesions remains a clinical challenge. The uses of prosthetic joint replace allograft and/or autograft transplant carry a risk of complications due to infection, loosening of its component, immunological rejection and morbidity at the donor site. There has been an increasing interest in the management of cartilage damages, owing to the introduction of new therapeutic options. Tissue engineering as a method for tissue restoration begins to provide a potential alternative therapy for autologous grafts transplantations. We aimed to evaluate how well a tissue engineered neocartilage implant, consist of human articular chondrocytes cultured with the presence of autologous serum and mixed in a fresh fibrin derived from patient, would perform in subcutaneous implantation in athymic mice.
Biomechanics ; Cartilage, Articular/injuries ; Cartilage, Articular/physiology ; Cartilage, Articular/*transplantation ; Chondrocytes/*cytology ; Culture Media ; Mice, Nude ; *Orthopedic Procedures ; Serum ; *Tissue Engineering

PURPOSE: To investigate the relationship between classification based on simple radiographic findings and arthroscopic findings of the cartilage lesions in medial degenerative arthritis of the ankle joint. MATERIALS AND METHODS: We studied 41 ankles of 36 patients with asymmetrical narrowing of the medial joint space. Degenerative arthritis following fracture and those with generalized arthritic disease were excluded, but those with a history of ankle sprain were included. Standing radiographs of all patients were graded according to the Takakura classification and the Kellgren-Lawrence (K/L) classification. Arthroscopic findings were classified according to the depth, width, and anteroposterior dimension of articular cartilage damage. RESULTS: According to the Takakura classification, 29 ankles were classified as stage II, 7 cases as stage IIIA and 2 cases as stage IIIB. According to our classification of arthroscopic findings of 29 ankles in stage II, 1 ankle was graded as Grade I, 3 ankles as grade II, 10 ankles as grade III, and 15 ankles as grade IV. Spearman correlation coefficient between Takakura classification and arthroscopic classification was 0.342 (P=0.028), and coefficient between K/L classification and arthroscopic classification was 0.480 (P=0.001) CONCLUSION: Degenerative changes of the articular cartilage are more advanced than radiographic findings in many patients with ankle degenerative arthritis with asymmetrical narrowing of medial joint space. Therefore, we conclude that more aggressive effort should be made for correct diagnosis and treatment of degenerative arthritis.
Ankle Injuries ; Ankle Joint ; Ankle* ; Cartilage ; Cartilage, Articular* ; Classification* ; Diagnosis ; Humans ; Joints ; Osteoarthritis*

Chondral injuries are short of self-healing ability and need to surgical repair after articular cartilage injury. Conventional treatment includes debridement and drainage under arthroscope, micro-fracture, osteochondral autograft transplantation (OATS), mosaiplasty and osteochondral allografts (OCA), autologous chondrocyte implantation (ACI). Debridement and drainage could remove pain factor, and has advantages of simple operation, wide clinical application and early clinical effect. Micro-fracture and osteochondral autograft transplantation is suitable for small area of cartilage repair, while the further effect showed that fibrous cartilage permeated by drill could decrease postoperative clinical effect. Osteochondral autograft transplantation has better advantages for reconstruction complete of wear-bearing joint. Autologous chondrocyte implantation and allogeneic cartilage transplantation are suitable for large area of cartilage defect, postoperative survival of allogeneic cartilage transplantation is effected by local rejection reaction and decrease further clinical effect. Cartilage tissue engineering technology could improve repair quality of autologous chondrocyte implantation, and make repair tissue close to transparent cartilage, but has limit to combined subchondral bone plate, reactive bone edema, bone loss and bad axis of lower limb. New technology is applied to cartilage injury, and has advantages of less trauma, simple operation, rapid recover, good clinical effect and less cost;and could be main method for treat cartilage injury with surgical repair technology. How to improve repair quality with compression resistance and abrasive resistance are expected to be solved.
Cartilage, Articular ; injuries ; surgery ; Chondrocytes ; transplantation ; Humans ; Knee Injuries ; surgery ; Knee Joint ; surgery ; Transplantation, Autologous

OBJECTIVETo study the evaluation of bipolar radiofrequency (RFE) chondroplasty to cartilage injure.

METHODSSixteen goats underwent resection of anterior cruciate and medial meniscus to create cartilage injured model. Bipolar frequency energy chondroplasty were performed on injured articular cartilage 3 months after operation. The left knee was regarded as sham-operated control. The zero time effects and later changes of radiofrequency on cartilage surface and chondrocytes were observed.

RESULTSAt zero time, the rough injured surface became smooth, and clefts were melted. Some chondrocytes were dead in the superficial layer, cells in deeper layer remained alive. Three months later, the surface of the articular was smoother than the sham-operated side. The histological modified Mankin' s score of cartilage was significantly higher than the sham-operated side (operated side 12 +/- 4; sham-operated side 14 +/- 5, P < 0.01). The result of Fluorescence-activated cell sorter (FACs) showed that there were no obvious difference of dead chondrocyte between operated side and sham-operated side, (24 +/- 10)% and (12 +/- 1)% (P > 0.05).

CONCLUSIONSBipolar radiofrequency energy (1 grade) does not create more chondrocyte death than the sham-operated side. Bipolar radiofrequency chondroplasty is an appropriate method to treat articular cartilage injury.

Animals ; Cartilage, Articular ; injuries ; pathology ; surgery ; Catheter Ablation ; Chondrocytes ; pathology ; Disease Models, Animal ; Female ; Goats ; Male

OBJECTIVETo study mosaicplasty a as method of autogenous osteochondral transplantation in the treatment of cartilaginous defects.

METHODSThe technique involves obtaining small cylindrical grafts from the non-weight bearing periphery of the femur at the patellar femoral joint, and transporting them to the prepared recipient site by arthroscopy.

RESULTSFifteen patients with defects cartilaginous received mosaicptasty osteochondral grafting. Follow up for 12 to 21 months (mean 15 months) showed good results.

CONCLUSIONThe treatment is indicated for patients with focal cartilaginous defects under the age of 45.

Adult ; Arthroscopy ; Bone Transplantation ; methods ; Cartilage, Articular ; injuries ; transplantation ; Female ; Follow-Up Studies ; Humans ; Male

OBJECTIVETo investigate the effect of rupture and reconstruction of the anterior cruciate ligament (ACL) on the degeneration of rabbit knee articular cartilage.

METHODS14 mature New Zealand white rabbits were divided into four groups. In group I, the ACL of the right knees in 7 rabbits was resected and immediately reconstructed, and the contralateral ACL was resected only in controll f group I. In group II, the ACL of the right knees in 7 rabbits was reconstructed 3 weeks after the ACL was resected and the contralateral joints in control group II, in which only a medial arthrotomy was performed. The rabbits were killed 8 weeks after the operation. The methods of ink straining, histology and SEM were used to analyze the changes in articular cartilage of the joints.

RESULTSThe results of ink method and HE straining were analyzed quantitatively. The degeneration of knee articular cartilage in group I was significantly weaker than that in control group I (Hc = 5.9889, P = 0.0144). The degeneration of knee articular cartilage in group II was as serious as that in control group I (Hc = 0.7143, P = 0.785).

CONCLUSIONSImmediate reconstruction of the ACL can effectively prevent articular cartilage from degeneration. Once the articular cartilage damaged moderately, delayed reconstruction of the ACL could not effectively reduce the development of degeneration. So once the ACL is ruptured, reconstruction should be performed in the early stage to restore the stability of knee joint to prevent the articular cartilage from degeneration.

Animals ; Anterior Cruciate Ligament Injuries ; Cartilage, Articular ; pathology ; Disease Models, Animal ; Knee Joint ; physiopathology ; Rabbits

Cartilage, Articular ; cytology ; injuries ; Cells, Cultured ; Chondrocytes ; transplantation ; Humans ; Transplantation, Autologous ; Wound Healing

OBJECTIVETo evaluate the value of T2 mapping in monitoring the repaired cartilage after matrix-associated autologous chondrocyte implantation/transplantation (MACI/MACT).

METHODSFour patients (10 plug cartilages) were examined three times by T2 mapping at 1, 3, and 6 months using a 3.0 Tesla MR scan system. Quantitative mean (full-thickness) T2 values were calculated in the transplanted area and control cartilage. Paired t-tests were used to compare the T2 values between transplanted and control cartilage. For analysis of longitudinal T2 values, one-way analyses of variance were performed among 1, 3, and 6 months after MACI.

RESULTSThe mean T2 values of the transplanted area at 1, 3, and 6 months after MACI were (82.40±15.23), (71.09±13.06), (53.80±4.86) ms, respectively. There were significant differences between the transplanted and control cartilage at 1 and 3 months (both P<0.01) after MACI, but not at 6 months (P=0.196). There were significant differences among T2 values of 1, 3, and 6 months after MACI in transplanted area (P=0.03).

CONCLUSIONT2 mapping provides a useful tool for monitoring the biochemical development of the transplanted cartilage and can be used to evaluate the cartilage repair noninvasively.

Adult ; Cartilage, Articular ; injuries ; surgery ; Cell Transplantation ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged

Fractures involving joints and about the joints provide complex problems with small comminuted fractures, surrounding soft tissue injuries and articular cartilage damage. Various problems are also encountered on the weight bearing surface, especially on the convex side of the distal Femur. Even though many auther had recommended kinds of management upto now, operative methods are more suggested in order to get good results regarding with the accurate anatomical reduction, rigid internal fixation and early joint motion. The clinical analysis of rnanagements of 20 cases of distai femoral fracture demonstrate that seperate dual incision-bilateral or right angle plane-to originate fracture site, and anatomical reduction & rigid internal fixation, early non-weight bearing ROM exercise of joint were sometimes mandatory to treat the displaced, comminuted fracture.
Cartilage, Articular ; Femoral Fractures ; Femur ; Fractures, Comminuted ; Joints ; Soft Tissue Injuries ; Weight-Bearing