Inflammation affects the viability and plasticity of equine mesenchymal stem cells: possible implications in intra-articular treatments

Mesenchymal stem cells (MSCs) are gaining relevance for treating equine joint injuries because of their ability to limit inflammation and stimulate regeneration. Because inflammation activates MSC immunoregulatory function, proinflammatory priming could improve MSC efficacy. However, inflammatory molecules present in synovial fluid or added to the culture medium might have deleterious effects on MSCs. Therefore, this study was conducted to investigate the effects of inflammatory synovial fluid and proinflammatory cytokines priming on viability and plasticity of equine MSCs. Equine bone marrow derived MSCs (eBM-MSCs) from three animals were cultured for 72 h in media supplemented with: 20% inflammatory synovial fluid (SF); 50 ng/mL IFN-γ and TNF-α (CK50); and 20 ng/mL IFN-γ and TNF-α (CK20). Proliferation assay and expression of proliferation and apoptosis-related genes showed that SF exposed-eBM-MSCs maintained their viability, whereas the viability of CK primed-eBM-MSCs was significantly impaired. Tri-lineage differentiation assay revealed that exposure to inflammatory synovial fluid did not alter eBM-MSCs differentiation potential; however, eBM-MSCs primed with cytokines did not display osteogenic, adipogenic or chondrogenic phenotype. The inflammatory synovial environment is well tolerated by eBM-MSCs, whereas cytokine priming negatively affects the viability and differentiation abilities of eBM-MSCs, which might limit their in vivo efficacy.

Dolor anterior de rodilla en pacientes operados de artroplastía de rodilla con o sin remplazo del componente patelar / Anterior knee pain in knee arthroplasty with or without a patellar component

Resumen: Introducción: La aparición de dolor patelofemoral postoperatorio en la artroplastía de rodilla, sobre todo en pacientes reumáticos, resultó en la incorporación de la sustitución del componente patelar en la mayoría de los diseños. Esta se convirtió en una parte estándar de la artroplastía total de rodilla; la controversia sobre si restituir o no el componente patelar continúa siendo debatida por los cirujanos ortopedistas que realizan artroplastías de rodilla. Objetivo: Realizar un análisis de la incidencia de dolor anterior de rodilla en pacientes sometidos a artroplastía primaria de rodilla con o sin remplazo del componente patelar. Material y métodos: Estudio observacional, retrospectivo, descriptivo y transversal de Enero de 2011 a Diciembre de 2013. Resultados: 54 individuos, 12 hombres (con un promedio de edad de 63 años) y 42 mujeres (con un promedio de edad de 71 años), que dieron un total de 64 rodillas intervenidas quirúrgicamente. Conclusión: No se encontró diferencia significativa en cuanto al dolor anterior de rodilla, en la función de la articulación patelofemoral y de la rodilla en los grupos de sujetos que fueron analizados con las diferentes escalas.

Abstract: Introduction: The appearance of patellofemoral pain after a knee arthroplasty, particularly in rheumatic diseases, resulted in the incorporation of the substitution of the patellar component in all designs. The replacement of the patella became a standard part of knee arthroplasty, but the controversy over whether to restore it or not continues among orthopedists that perform knee arthroplasties. Objective: To analyze the incidence of anterior knee pain in patients who underwent primary knee arthroplasty with or without replacement of the patellar component. Material and methods: Observational, retrospective, descriptive and transversal study from January 2011 to December 2013. Results: A total of 54 patients were included, 12 men (with an average age of 63 years) and 42 women (with an average age of 71 years), totaling 64 knees that were surgically intervened. Conclusion: This study found no significant difference in anterior knee pain and in the function of the patellofemoral joint and the knee in the groups of patients who were tested with the different scales.

Estudio comparativo de manejo de braquimetatarsia congénita mediante elongación por callotaxis / Comparative study of the management of congenital brachymetatarsia with elongation with callotaxis

La braquimetatarsia consiste en el acortamiento de 5 mm o más del arco parabólico metatarsal del pie, de uno o más de los metatarsianos; se relaciona directamente con el cierre prematuro del cartílago epifisario, o una prematura fusión de la línea epifisaria del extremo distal del metatarsiano, habitualmente el cuarto metatarsiano es el más afectado, predominio en el sexo femenino en relación de 25:1, afección bilateral 72%. Las causas pueden ser congénitas, post traumáticas o como parte de enfermedades específicas. Se realiza estudio prospectivo, comparativo de pacientes con diagnóstico de braquimetatarsia congénita, en el período comprendido de 2007-2008 y 2008-2012; el primer grupo consistió en siete pacientes de los cuales fueron seis niñas, un niño y en el segundo grupo: ocho pacientes, cinco niñas y tres niños. En el primer grupo se obtuvo un alargamiento de 21.1 mm en promedio, en el segundo grupo se obtuvo un alargamiento de 18 mm en promedio sin regresión, distrayendo 0.5 mm por día en ambos grupos. La elongación de los metatarsianos por callotaxis con minifijadores externos es un procedimiento satisfactorio para pacientes adolescentes próximos al cierre epifisario, teniendo mejores resultados con la distracción gradual a 0.5 mm por día.

Brachymetatarsia is the > 5 mm shortening of the metatarsal parabolic arc of the foot, in one or more metatarsals. It is directly related with the early closure of the epiphyseal cartilage or with early fusion of the epiphyseal line of the distal end of the metatarsal. The fourth metatarsal is usually the most affected one. Females are more commonly affected, with a female to male ratio of 25:1; 72% of cases have bilateral involvement. The causes may be congenital, posttraumatic or result from specific conditions. A prospective, comparative study was conducted of patients with a diagnosis of congenital brachymetatarsia seen in 2007-2008 and 2008-2012. Seven patients were included in the former period: six girls and one boy. Eight patients were included in the latter period: five girls and three boys. The mean shortening achieved in the first group was 21.1 mm; in the second one, 18 mm, without regression. The daily distraction in both groups was 0.5 mm. Metatarsal elongation by means of callotaxis with external fixators is an appropriate procedure for adolescent patients about to achieve epiphyseal closure. The best results are obtained with gradual distraction at a rate of 0.5 mm per day.

Látex bezoar / Látex bezoar

Os autores analisam os aspectos ecográficos e radiológicos de um caso de látex bezoar, tecendo consideraçöes sobre a árvore de onde se extrai o leite causador do corpo estranho gástrico