Autologous chondrocyte implantation for traumatic large cartilage defect.

OBJECTIVE: The authors report the immediate result (6 months) after Autologous Chondrocyte Implantation (ACI) in clinical and anatomic result with MRI. This is the first report ofACI that provides chondrocyte cells from a domestic lab. MATERIAL AND METHOD: ACI was done in a two-stage procedure, first stage via arthroscope to harvest cartilage and detect pathology. The authors found deep cartilage defect at grade 4 according ICRS, area 2.5 cm2 and near total meniscus tear. Meniscal repair and cartilage shaving were done. Harvesting 300 mg of cartilage was done in this stage. Four weeks later, the secondACl was done. Lateral para-patellar was used. Periosteum was used as chondrocyte suspension and by suture to the healthy cartilage, using prolene interrupted suture in conjunction with fibrin glue to seal the pocket after injecting the cell. Range of motion exercise started on day 2, assisted with continuous passive motion machine. Running and jumping were restricted for 9 months. RESULTS: No complication was found, full range of motion and walking was done at 7-8 weeks post operative. Visual analogue scale improved from 3 points to 0 point. MRI shows evidence of 100% filling of the repair tissue in defect site associated with hypertrophy of the repair tissue above chondral surface. CONCLUSION: Immediate result of ACI shows improvement in clinical and anatomic that present with MRI. Further follow up and case series is needed

Value of clinical findings, electrodiagnosis and magnetic resonance imaging in the diagnosis of root lesions in traumatic brachial plexus injuries.

OBJECTIVE: To evaluate the diagnostic value of clinical findings, electromyography and magnetic resonance imaging of root lesions in traumatic brachial plexus injuries MATERIAL AND METHOD: The authors clinically evaluated 175 cervical roots (C5-8, T1) in patients with traumatic brachial plexus injuries then with electromyography and magnetic resonance imaging (MRI). Each finding, taken alone and in combination with each other, was compared with the findings of exploratory surgery. RESULTS: The mean correlations of the clinical findings, electromyography and MRI in relation to the surgical findings were 60, 87 and 70 percent, respectively. The mean correlation was highest (90%) when the positive findings from the clinical, electromyographic or MRI investigations were combined. The correlation of the C5-6 root injuries was improved to 100% though the mean correlation was only 90%. CONCLUSION: The combination of clinical findings and electromyography correlated well with the surgical findings of root lesions caused by traumatic brachial plexus injury. MRI markedly improved identification only of C5-6 root injuries.