Exuberant articular cartilage response to osteoarthritis in femoral heads

Introduction: Osteoarthritis is an important cause of disability and dysfunction in the community. The incidence of osteoarthritis is rising with increasing obesity prevalence and longevity. Osteoarthritis is a degenerative joint disease with articular cartilage loss and reactive bone changes. Some cartilage regeneration with cartilage cell proliferation and cartilage matrix production do occur

Aim: To present a case of osteoarthritis with profound chondroid proliferation and discuss the possible reasons for this unusual reaction are discussed

Materials and methods: A 49 year old obese man decreased sensation on the left side corresponding to the L4 to S1 dermatomes after sustaining a low back injury while swimming. Investigations revealed osteoarthritis in his hip joints. He underwent bilateral total hip replacement during a 12 month period

Results: The femoral heads were very irregular with a polypoid appearance due to areas of florid cartilage proliferation with some ossification. The new cartilage had grown over damaged cartilage and bone. Features of usual osteoarthritis with frayed and fragmented cartilage, bone sclerosis and subchondral cyst formation were also seen

Conclusion: Exuberant chondrocyte proliferation and pronounced new cartilage formation, as seen in this case, are rarely observed in surgically removed specimens. This proliferative articular cartilage change in this patient is likely to represent an attempt at repair. The reason for these proliferation changes is unclear but according to the literature an imbalance between the catabolic and anabolic growth factors and cytokines may account for the changes

Cultura de condrócitos para o uso terapêutico: reconstituição de cartilagem / Culture of chondrocytes for the therapeutic use: restoration of cartilage

A cartilagem articular é um tecido avascular com números limitados de condrócitos, com capacidade limitada de reparo após uma lesão aguda. As técnicas disponíveis atualmente para o tratamento de lesões de cartilagem articular podem resultar em alívio dos sintomas, mas não na regeneração do tecido lesado. A geração de um substituto biológico que recomponha a cartilagem articular nativa requer células vivas que sejam capazes de sintetizar e manter a matriz cartilaginosa. A engenharia de tecidos constitui recentemente uma metodologia para reconstrução de novos órgãos e tecidos que foram lesados e apresentam dificuldades na reparação. Um dos maiores avanços no campo da engenharia de tecidos e dentro da medicina ortopédica, tem sido, o recrutamento de tecido do próprio paciente, que são dissociados em células e cultivadas sobre suportes biológicos ou sintéticos, conhecidos como scaffolds, para posterior realização de implante de condrócitos, com intuito de regenerar o tecido cartilaginoso lesado. Uma variedade de scaffolds como hidrogel e polímeros sintéticos, têm sido investigadas para a expansão dos condrócitos in vitro para o reparo da cartilagem lesada. Tais matrizes incluem: arcabouços à base de colágeno: gel de colágeno tipo I e II, esponjas de colágeno tipo II, ácido polilático e ácido poliglicólico, fibrina, óxido de polietileno, fibrina, peptídeos, alginato e gel de plaquetas. No presente trabalho desenvolvemos diferentes metodologias de cultura de condrócitos, utilizando scaffold sintético hidrogel de alginato e biológico gel de plaquetas obtido a partir do Plasma Rico em Plaquetas - PRP, além da cultura de condrócitos em pellet tridimensional, objetivando encontrar a melhor metodologia para a realização de implantes de condrócitos. Como modelo experimental escolhemos coelhos, tanto para coleta da cartilagem articular como para obtenção do plasma sanguíneo e realização dos implantes alogênicos...

Autogenous osteochondral mosaicoplasty for the treatment of femoral condylar articular defects [a preliminary report]

Eleven patients [eight males and three females, with the age range of 26-46 years, average 34 years] have been treated for full thickness cartilage lesions as the result of chondropathy, traumatic chondral defects and osteochondritis dissecans. An average of 4.5 grafts were used for the replacements. The mean follow-up time was 9.2 months [range 6-18 months]. Evaluation was done clinically, radiologically and by control arthroscopies at three-four months for all the patients. The overall results using the modified HSS knee scoring system was 93.5 [81-100] compared to 58.5 preoperatively, beside 8 patients were grade I and 3 patients were grade II, according to the cartilage repair assessment form of the International Cartilage Repair Society [ICRS]. No donor site morbidity was experienced

Diagnóstico y tratamiento de las lesiones osteocondrales / Diagnosis and treatment of the osteochondral lesions

Los defectos del cartílago articular rara vez curan espontáneamente. Usualmente éstos progresan, llegando a ser irreversibles, si no intervenimos quirúrgicamente. Muchas técnicas se han usado, incluyendo abrasión, drilling o perforaciones, microfracturas, injertos autologos o aloinjertos, y trasplante celular. En éste artículo se analizan las alternativas de diagnóstico clínico y por imágenes en las lesiones osteocondrales, así como las distintas alternativas terapéuticas para tratar éstos defectos

The Reaction of the Acetabular Articular Cartilage to Bipolar Hemiarthroplasty

An evaluation of the acetabular cartilage was performed grossly and histologically in a patient who had a bipolar hemiarthroploasty, which had served satisfactorily for 2 years until the femoral prosthetic head had been separated from the acetabular assembly due to creep deformation of the inner bearing polyethylene cup. This study indicates that the double-bearing bipolar prosthesis dose not necessarily have an advantage over the classical single-piece prosthesis in the prevention of acetabular cartilage wear.

Articular cartilage changes following venous congestion [an experimental study]

Induced passive venous congestion by femoral and saphenous veins ligation in 20 white adult rats was done to demonstrate the changes in the articular cartilage and subchondral zone of the knee joint after venous congestion. This is correlated with the changes seen in primary osteoarthritis