Gene therapy in orthopaedic surgery

Gene therapy has the potential to revolutionize the treatment of a variety of musculoskeletal disorders. In the past decade, more than 4,000 patients have been enrolled in clinical trials involving gene therapy. Gene therapy is becoming increasingly important in modern orthopedic clinical practice. It is important to discuss the issues that the physicians and scientists face when designing an experiment or a clinical trial involving gene therapy, along with the potential clinical applications for gene therapy in the treatment of patients with musculoskeletal problems

Gene therapy in orthopaedic surgery

Gene therapy has the potential to revolutionize the treatment of a variety of musculoskeletal disorders. In the past decade, more than 4,000 patients have been enrolled in clinical trials involving gene therapy. Gene therapy is becoming increasingly important in modern orthopedic clinical practice. It is important to discuss the issues that physicians and scientists face when designing an experiment or a clinical trial involving gene therapy, along with the potential clinical applications for gene therapy in the treatment of patients with musculoskeletal problems

Viability of Refrigerated Human Articular Cartilage / 대한정형외과연구학회지

PURPOSE: To determine the viability of human chondrocytes within refrigerated articular cartilage stored under conditions currently used clinically. MATERIALS AND METHODS: Osteochondral sections of human ankle taluses were stored at 4 degrees C in DMEM media for 1 to 42 days. Articular cartilage was harvested and evaluated for histologic changes and proteoglycan synthesis. RESULTS: By day 7, markedly decreased proteoglycan synthesis was observed. After 21 days, synthetic activity was virtually undetectable. Histologic specimens demonstrated chondrocyte death of a half of the cells from the superficial layer at day 7. Within 21 days, significant chondrocyte death was seen. CONCLUSION: These results suggest that proteoglycan synthetic activity and chondrocyte viability are markedly decreased in articular cartilage after cold storage for longer than 7 days.

The Pitfalls in Harvesting the Hamstring Tendons: Anatomic Considerations / 대한정형외과학회잡지

The purpose of this study was to evaluate the anatomical relationships of hamstring tendons to adjacent structures, especially to the saphenous nerve, and to measure the length of the semitendinosus and gracilis tendons in order to determine whether they are of sufficient length to make multiple stranded grafts. Twenty-eight fresh frozen knees(mean ages: 67.9 years) were dissected. The tendons of the sartorius, gracilis, and semitendinosus were exposed. The lengths of the semitendinosus and the gracilis, the widths of the fused portion of each tendon were measured. Also we checked the bifurcation point, the presence of the accessory insertion, cross point of saphenous nerve. The average lengths of the semitendinosus and the gracilis tendons were 32.32+/-2.88cm (mean+/-SI) and 23.14+/-2.79cm, respectively. The upper border of the gracilis tendon was located an average of 1.53cm from the prominence of the tibial tuberosity. The tendons of the gracilis and semitendinosus fused average of 3.66cm from their insertion and firmly adherent to sartorius tendon. The width of conjoined tendon was 2.94cm. The average distance between the saphenous nerve at its cross-over point and the tibial tuberosity was 9.71cm. Several key anatomic points are useful in the harvest of these tendons. Their conjoined insertion site is medial and distal to the tibial tubercle. They become distinct structures at a point that is further medial and slightly proximal. Tendon harvest is facillitated by identifying the tendons proximal to this point. The superficial medial collateral ligament lies deep to the tendons in this area and should not be disturbed. The accessory insertion of the semitendinosus tendon should be identified and transected to avoid tendon damage at harvest. Knee flexion may reduce the risk of injury to the saphenous nerve as it crosses the gracilis tendon. These results should be helpful to surgeon considering using the hamstring tendons as for ligament reconstruction of the knee.