Scaffold-free 3D cellulose acetate membrane-based cultures form large cartilaginous constructs.

Scaffold-free three-dimensional (3D) cultures provide clinical potential in cartilage regeneration. The purpose of this study was to characterize a scaffold-free 3D membrane-based culture system, in which human articular chondrocytes were cultivated on a cellulose acetate membrane filter, and compare it to pellet and monolayer cultures. Chondrocytes were expanded in monolayer culture for up to 5 passages, transferred to membrane-based or pellet cultures and harvested after 7 or 21 days. The chondrogenic potential was assessed by histology (toluidine blue, safranin-O), immunohistochemistry for collagen type II and quantitative analysis of collagen type II α(1) (COL2A1). Membrane-based cultures (P1) formed flexible disc-like constructs (diameter 4000 µm, thickness 150 µm) with a large smooth surface after 7 days. Positive safranin-O and collagen type II staining was found in membrane-based and pellet cultures at P1-3. Expression of COL2A1 after 7 days was increased in both culture systems compared to monolayer culture up to P3, whereas cells from monolayer > P3 did not redifferentiate. The best results for COL2A1 expression were obtained from membrane-based cultures at P1. After 21 days the membrane-based cultures did not express COL2A1. We concluded that membrane-based and pellet cultures showed the ability to promote redifferentiation of chondrocytes expanded in monolayer culture. The number of cell passages had an impact on the chondrogenic potential of cells. Membrane-based cultures provided the highest COL2A1 expression and a large, smooth and cartilage-like surface. As these are appropriate features for clinical applications, we assume that membrane-based cultures might be of use in cartilage regeneration if they displayed similar results in vivo.

[Quality of a multidisciplinary orthopaedic-rheumatological consultation]. / Qualität einer interdisziplinären Sprechstunde in der Rheumaorthopädie.

AIM: An interdisciplinary approach plays an important role in orthopaedic rheumatology. The aim of this study was to test the quality of an interdisciplinary consultation, which analyzed a pool of orthopaedic patients in terms of rheumatological disease. METHOD: Orthopaedic patients (n=100) were transferred to a multidisciplinary team of experts in a two-stage selection process. Patient data were examined with regard to diagnosis and therapy. A patient interview analyzed the course of disease and effects of the consultation. Patients were questioned on the development of pain, diagnostics and therapy as well as their general satisfaction. RESULTS: Rheumatological disease was diagnosed in 42% of patients, while specific anti-rheumatic therapy was started in 41%. An improvement in symptoms as a result of treatment was seen in 63% of cases. Patient examinations revealed an above-average level of satisfaction in 63% of patients. CONCLUSION: Interdisciplinary consultation led to improved and faster diagnosis and therapy of rheumatological diseases, which was positively evaluated by the pool of patients treated.

Shock wave therapy for femoral head necrosis-Pressure measurements inside the femoral head.

There is a persisting need for effective therapies of femoral head necrosis, a common bone disease. Promising clinical results have been stated for the treatment with extracorporeal shock waves (ESW). However, the effective remaining pressure in the target region inside the femoral head has never been determined. Aim of this study was to investigate whether ESW are able to propagate through bone without an excessive loss of pressure. The remaining ESW pressure generated by an electromagnetic device after passing a certain intraosseous distance within the femoral head was measured. Standardized holes were drilled in porcine femora and the absorption in relation to reference measurements in degassed water was determined. The results showed continuous attenuation of shock waves in bone. After a clinical relevant intraosseous distance of 10 mm an ESW pressure of approximately 50% remained. In conclusion, ESW have the potential to reach necrotic regions with therapeutic pressure levels and to effectively treat femoral head necrosis.