Histopathological examination in evaluation of long-term results after osteocartilaginous transplantation.

OBJECTIVE: To assess long-term outcomes of osteocartilaginous transplantation for non-degenerative lesions of hyaline articular cartilage in the knee, by performing minibiopsies from the transplanted area and examining them histopathologically. PATIENTS AND METHODS: Forty-four patients with post-traumatic cartilage injuries of the bearing surfaces of the knee were enrolled in a prospective study, that included treatment with autologous osteocartilaginous grafts at the level of the lesion, "second look" arthroscopy and targeted minibiopsies at one year and five years postoperatively (six minibiopsies per patient). The collected tissue fragments were examined by optic microscopy. In order to integrate the histopathological findings in the clinical context, the function of the knee was also quantified by calculation of the International Cartilage Repair Society Score preoperatively, at one year and at five years postoperatively. RESULTS: Five years post-transplant the outcomes for 36 patients were available. One year post-transplant, the histopathological examination revealed the presence of hyaline cartilage in 165 of the 216 (76.39%) tissue samples collected and fibrocartilage in 51 (23.61%) respectively. Five years after surgery, the proportions of these findings were 159/216 (73.61%) for hyaline cartilage and 57/216 (26.39%) for fibrocartilage. The difference was not statistically significant (p>0.1).The evolution of the ICRS clinical score was from 38.57±3.42 preoperatively to 80.31±3.85 (p<0.0001) after one year and to 81.35±4.57, respectively at five years after surgery. CONCLUSIONS: Autologous osteocartilaginous transplantation brings hyaline articular cartilage at the level of the injured area. Approximately three quarters of the surface lesion remains covered by high quality hyaline cartilage that maintains its macroscopic structure and architecture for a long period of time.

Giant-cell tumor of the bone (GCTOB): clinical case.

Giant-cell tumor of the bone is a benign tumor, but with high local aggressiveness, even with risk of distant metastasis. From an epidemiological standpoint, giant-cell tumor of the bone accounts for 4-5% of primary bone tumors and ~20% of benign bone tumors; commonly affects adults between 20-40 years, slightly more common in females. We present the case of a 57-year-old woman, without significant pathological history, which, after clinical, imagistic and anatomopathological investigations, is diagnosed with giant cell tumor of the right distal radius. The patient underwent surgery and segmental resection of the tumor in oncological limits was performed, replacing the remaining bone defect with fibular autograft. The results were good, according to Mayo functional assessment score. This way, the wrist joint mobility and the carpal cartilage were preserved, providing a barrier against distal migration of any remaining tumoral cells, as well. In conclusion, we can state that in aggressive giant cell tumors located at the distal radius, the best therapeutic option is en bloc resection of the formation (lesion) with fibular autograft replacement of the bone defect.