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1.
Plant Biol (Stuttg) ; 25(6): 935-943, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37337431

ABSTRACT

The seed coat composition of white (JS 335) and black (Bhatt) soybean (Glycine max (L.) Merr) having different water permeability was studied. Phenols, tannins and proteins were measured, as well as trace elements and metabolites in the seed coats. The seed coat of Bhatt was impermeable and imposed dormancy, while that of JS 335 was permeable and seeds exhibited imbibitional injury. Bhatt seed coats contained comparatively higher concentrations of phenols, tannins, proteins, Fe and Cu than those of JS 335. Metabolites of seed coats of both genotypes contained 164 compounds, among which only 14 were common to both cultivars, while the remaining 79 and 71 compounds were unique to JS 331 and Bhatt, respectively. Phenols are the main compounds responsible for seed coat impermeability and accumulate in palisade cells of Bhatt, providing impermeability and strength to the seed coat. JS 335 had more cracked seed coats, mainly due to their lower tannin content. Alkanes, esters, carboxylic acids and alcohols were common to both genotypes, while cyclic thiocarbamate (1.07%), monoterpene alcohols (1.07%), nitric esters (1.07%), phenoxazine (1.07%) and sulphoxide (1.07%) compounds were unique to the JS 335 seed coat, while aldehydes (2.35%), amides (1.17%), azoles (1.17%) and sugar moieties (1.17%) were unique to Bhatt seed coats. This study provides a platform for isolation and understanding of each identified compound for its function in seed coat permeability.


Subject(s)
Glycine max , Water , Glycine max/metabolism , Water/metabolism , Seeds/metabolism , Permeability , Tannins/metabolism , Phenols/metabolism
2.
Musculoskelet Surg ; 107(1): 37-45, 2023 Mar.
Article in English | MEDLINE | ID: mdl-34389922

ABSTRACT

Arthroscopic ACL reconstruction is the current standard care of treatment for anterior cruciate ligament (ACL) injuries. Modified transtibial (mTT) and anteromedial portal (AMP) techniques aim at the anatomical placement of femoral tunnel. Controversy existed in the literature with regard to the outcome of these techniques. Hence, we designed a retrospective comparative study to analyse the clinical and functional outcomes of mTT and AMP techniques. We hypothesized that there would be no difference between the clinical and functional outcomes in mTT and AMP techniques. This retrospective observational study was conducted in consecutive patients who underwent arthroscopic ACL reconstruction using semitendinosus-gracilis (STG) quadrupled graft in our tertiary care centre with a minimum follow-up of two years. Out of 69 patients, 37 had undergone ACL reconstruction by mTT technique and remaining by AMP technique. All the patients were assessed clinically by anterior drawer, Lachman's, pivot shift and single-legged hop test. Lysholm Knee Scoring Scale and International Knee Documentation Committee (IKDC) subjective knee evaluation score were used for the functional status. Knee instability was assessed objectively by KT-1000 arthrometer. There was no statistically significant difference in baseline demographic characteristics between mTT and AMP groups. At the end of 2 years, no statistically significant difference was noted in the anterior drawer and Lachman's test. Though not significant, IKDC scores and Lysholm's scores showed a better outcome in the AMP group when compared to the mTT group. AMP group showed significantly better outcome with KT-1000 arthrometer. Based on the results obtained, we presume that overall both mTT and AMP have similar functional outcome. However, as AMP technique offers significantly improved subjective rotational stability on pivot shift test, better hop limb symmetry index and KT 1000 readings compared to mTT, we suggest AMP over mTT.


Subject(s)
Anterior Cruciate Ligament Injuries , Anterior Cruciate Ligament Reconstruction , Joint Instability , Humans , Anterior Cruciate Ligament/surgery , Retrospective Studies , Treatment Outcome , Arthroscopy/methods , Knee Joint/surgery , Femur/surgery , Anterior Cruciate Ligament Injuries/surgery , Anterior Cruciate Ligament Reconstruction/methods , Joint Instability/surgery
4.
Malays Orthop J ; 16(3): 104-112, 2022 Nov.
Article in English | MEDLINE | ID: mdl-36589364

ABSTRACT

Introduction: The acromioclavicular joint (ACJ) is a major link connecting the upper limb to the torso. The acromioclavicular and coracoclavicular (CC) ligaments help in stabilising the joint. We feel it is prudent to address both these ligament injuries, to achieve optimum result. This study was undertaken to analyse the results of a simple frugal surgical technique we used to deal with this injury considering stabilisation for both these ligaments. Materials and methods: In this retrospective study, skeletally mature patients with Type III, IV or V ACJ dislocations who underwent open reduction and stabilisation of the joint with temporary K-wires, repair of the capsule and augmentation of CC ligaments with suture anchors were included. Clinico-radiological and functional outcome was evaluated. Functional assessment of the upper limb was analysed using the Disabilities of Arm, Shoulder, and Hand Score (DASH), Constant shoulder score (CSS) and Oxford shoulder score (OSS). Results: Clinical and radiological evaluation of the 32 patients who had completed two years from the index surgery, was done. Out of the 37 patients included initially, five were lost in follow-up. Majority of the subjects included were males and type V was the most common injury. Mean pre-operative CC distance on the affected side was 13.92±4.94mm. In the immediate post-operative radiograph, it was 7.63±2.08mm and in the final follow- up was 9.36±2.75mm. Measurements were taken by two independent investigators and inter, and intra-observer reliability were analysed by Interclass correlation coefficient. Excellent functional outcome was noted despite the 1.81±1.50mm average loss of correction. At final follow-up, mean DASH score was 4.67±4.18, Oxford shoulder score was 44.06±2.44 and Constant shoulder score was 86.37±5.81. The severity of the injury had no significant effect on the functional outcome post our method of stabilisation and rehabilitation. Conclusion: Bifocal fixation restores the multidirectional stability of the disrupted ACJ. Adequate radiological reduction, good functional outcome and simplicity of execution make this technique an undemanding one for use in regular practice.

5.
Article in English | WPRIM (Western Pacific) | ID: wpr-962217

ABSTRACT

@#Introduction: The acromioclavicular joint (ACJ) is a major link connecting the upper limb to the torso. The acromioclavicular and coracoclavicular (CC) ligaments help in stabilising the joint. We feel it is prudent to address both these ligament injuries, to achieve optimum result. This study was undertaken to analyse the results of a simple frugal surgical technique we used to deal with this injury considering stabilisation for both these ligaments. Materials and methods: In this retrospective study, skeletally mature patients with Type III, IV or V ACJ dislocations who underwent open reduction and stabilisation of the joint with temporary K-wires, repair of the capsule and augmentation of CC ligaments with suture anchors were included. Clinico-radiological and functional outcome was evaluated. Functional assessment of the upper limb was analysed using the Disabilities of Arm, Shoulder, and Hand Score (DASH), Constant shoulder score (CSS) and Oxford shoulder score (OSS). Results: Clinical and radiological evaluation of the 32 patients who had completed two years from the index surgery, was done. Out of the 37 patients included initially, five were lost in follow-up. Majority of the subjects included were males and type V was the most common injury. Mean pre-operative CC distance on the affected side was 13.92±4.94mm. In the immediate post-operative radiograph, it was 7.63±2.08mm and in the final follow- up was 9.36±2.75mm. Measurements were taken by two independent investigators and inter, and intra-observer reliability were analysed by Interclass correlation coefficient. Excellent functional outcome was noted despite the 1.81±1.50mm average loss of correction. At final followup, mean DASH score was 4.67±4.18, Oxford shoulder score was 44.06±2.44 and Constant shoulder score was 86.37±5.81. The severity of the injury had no significant effect on the functional outcome post our method of stabilisation and rehabilitation. Conclusion: Bifocal fixation restores the multidirectional stability of the disrupted ACJ. Adequate radiological reduction, good functional outcome and simplicity of execution make this technique an undemanding one for use in regular practice.

6.
Int J Tuberc Lung Dis ; 25(9): 738-746, 2021 09 01.
Article in English | MEDLINE | ID: mdl-34802496

ABSTRACT

BACKGROUND: Half of India´s three million TB patients are treated in the largely unregulated private sector, where quality of care is often poor. Private provider interface agencies (PPIAs) seek to improve private sector quality of care, which can be measured in terms of case fatality and recurrence rates.METHODS: We conducted a retrospective cohort survey of 4,000 private sector patients managed by the PATH PPIA between 2014 and 2017. We estimated treatment and post-treatment case-fatality ratios (CFRs) and recurrence rates. We used Cox proportional hazards models to identify predictors of fatality and recurrence. Patient loss to follow-up was adjusted for using selection weighting.RESULTS: The treatment CFR was 7.1% (95% CI 6.0-8.2). At 24 months post-treatment, the CFR was 2.4% (95% CI 1.7-3.0) and the recurrence rate was 1.9% (95% CI 1.3-2.5). Treatment fatality was associated with age (HR 1.02, 95% CI 1.02-1.03), clinical diagnosis (HR 0.61, 95% CI 0.45-0.84), treatment duration (HR 0.09, 95% CI 0.06-0.10) and adherence. Post-treatment fatality was associated with treatment duration (HR 0.87, 95% CI 0.79-0.91) and adherence.CONCLUSIONS: We found a moderate treatment phase CFR among PPIA-managed private sector patient with low rates of post-treatment fatality and recurrence. Routine monitoring of patient outcomes after treatment would strengthen PPIAs and inform future post TB interventions.


Subject(s)
Private Sector , Tuberculosis , Cohort Studies , Humans , India/epidemiology , Retrospective Studies , Tuberculosis/diagnosis , Tuberculosis/drug therapy , Tuberculosis/epidemiology
7.
J Food Sci Technol ; 58(2): 777-786, 2021 Feb.
Article in English | MEDLINE | ID: mdl-33568871

ABSTRACT

In this present study, solid desiccant-based pressure-swing adsorption (PSA) dehumidifier was developed and the process parameters were optimized to deliver the air continuously at 0.1% relative humidity. Mint (Mentha arvensis) leaves are tested to study the drying characteristics at varied flow rates of dehumidified air in the drying chamber. The initial moisture content of 5.059 g water/g dry matter have been reduced to a safe storage level in 360 min at 0.160 m3/min volume low rate. The effective moisture diffusivity of the mint leaves was found in the range of 2.07534 × 10-11m2/s to 3.45817 × 10-11m2/s. The percentage of retention of ascorbic acid in dried mint leaves is increased by an increase in the volume flow rate of dry air and a maximum of 70.11% is achieved by 0.160 m3/min. The colour measurement and chlorophyll content of the dried samples indicated that the desiccant dehumidified air dryers are suitable for heat sensitive green leafy vegetables.

8.
Protein Sci ; 30(2): 438-447, 2021 02.
Article in English | MEDLINE | ID: mdl-33244804

ABSTRACT

Targeting protein-protein interactions for therapeutic development involves designing small molecules to either disrupt or enhance a known PPI. For this purpose, it is necessary to compute reliably the effect of chemical modifications of small molecules on the protein-protein association free energy. Here we present results obtained using a novel thermodynamic free energy cycle, for the rational design of allosteric inhibitors of HIV-1 integrase (ALLINI) that act specifically in the early stage of the infection cycle. The new compounds can serve as molecular probes to dissect the multifunctional mechanisms of ALLINIs to inform the discovery of new allosteric inhibitors. The free energy protocol developed here can be more broadly applied to study quantitatively the effects of small molecules on modulating the strengths of protein-protein interactions.


Subject(s)
HIV Integrase Inhibitors/chemistry , HIV Integrase/chemistry , HIV-1/enzymology , Molecular Dynamics Simulation , Allosteric Regulation , Humans , Thermodynamics
9.
West Indian med. j ; 69(4): 242-244, 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1515642

ABSTRACT

ABSTRACT Synovial chondromatosis or osteochondromatosis is a benign neoplastic condition arising from synovial tissue of joints, tendon sheath and bursa. The commonly involved joints are the knee, hip, shoulder, elbow and ankle. According to the author's knowledge, only four cases have been reported in the English literature, describing the extra-articular synovial chondro-matosis around the ankle joint. The peculiarity of the index case lies in its subtle clinical and radiological presentations which can create a diagnostic dilemma.

10.
Toxicol In Vitro ; 68: 104954, 2020 Oct.
Article in English | MEDLINE | ID: mdl-32738276

ABSTRACT

Skin temperature plays a certain role in the dermal absorption of substances, but the extent and mechanisms of skin temperatures-induced modulation in ranges caused by physiological thermoregulation or environmental conditions are largely unknown. The influence of dermal temperature on the absorption of the model lipophilic compound (anisole) and the model hydrophilic compounds (1,4-dioxane, ethanol) through human skin was investigated at three dermal temperatures (25, 32 and 39 °C) in an ex-vivo diffusion cell model. The substances were applied to the skin and transdermal penetration was monitored. All substances showed temperature dependent variations in their penetration behavior (3 h: 25-39 °C: 202-275% increase in cumulative, transdermally penetrated amounts). The relative differences in absorption in relation to temperature were greatest within 45 min after exposure (25-39 °C: 347-653% rise in cumulated penetration), although absolute amounts absorbed were small (45 min vs. 3 h: 4.5-14.5%). Regardless of blood circulation, skin temperature significantly influences the amount and kinetics of dermal absorption. Substance-dependent, temperature-related changes of the lipid layer order or the porous pathway may facilitate penetration. The early-stage modulation of transdermal penetration indicates transappendageal absorption, which may be relevant for short-term exposures. For both, toxicological evaluation and perfusion cell studies, it is important to consider the thermal influence on absorption or to perform the latter at a standardized temperature (32±1 °C).


Subject(s)
Skin Absorption , Skin/metabolism , Temperature , Anisoles/metabolism , Dioxanes/metabolism , Ethanol/metabolism , Humans
11.
Exp Neurol ; 329: 113319, 2020 07.
Article in English | MEDLINE | ID: mdl-32305418

ABSTRACT

Heterozygous mutations in the X-linked gene CASK are associated with intellectual disability, microcephaly, pontocerebellar hypoplasia, optic nerve hypoplasia and partially penetrant seizures in girls. The Cask+/- heterozygous knockout female mouse phenocopies the human disorder and exhibits postnatal microencephaly, cerebellar hypoplasia and optic nerve hypoplasia. It is not known if Cask+/- mice also display seizures, nor is known the molecular mechanism by which CASK haploinsufficiency produces the numerous documented phenotypes. 24-h video electroencephalography demonstrates that despite sporadic seizure activity, the overall electrographic patterns remain unaltered in Cask+/- mice. Additionally, seizure threshold to the commonly used kindling agent, pentylenetetrazol, remains unaltered in Cask+/- mice, indicating that even in mice the seizure phenotype is only partially penetrant and may have an indirect mechanism. RNA sequencing experiments on Cask+/- mouse brain uncovers a very limited number of changes, with most differences arising in the transcripts of extracellular matrix proteins and the transcripts of a group of nuclear proteins. In contrast to limited changes at the transcript level, quantitative whole-brain proteomics using iTRAQ quantitative mass-spectrometry reveals major changes in synaptic, metabolic/mitochondrial, cytoskeletal, and protein metabolic pathways. Unbiased protein-protein interaction mapping using affinity chromatography demonstrates that CASK may form complexes with proteins belonging to the same functional groups in which altered protein levels are observed. We discuss the mechanism of the observed changes in the context of known molecular function/s of CASK. Overall, our data indicate that the phenotypic spectrum of female Cask+/- mice includes sporadic seizures and thus closely parallels that of CASK haploinsufficient girls; the Cask+/- mouse is thus a face-validated model for CASK-related pathologies. We therefore surmise that CASK haploinsufficiency is likely to affect brain structure and function due to dysregulation of several cellular pathways including synaptic signaling and cellular metabolism.


Subject(s)
Genes, X-Linked/genetics , Guanylate Kinases/genetics , Haploinsufficiency/genetics , Intellectual Disability/genetics , RNA Processing, Post-Transcriptional/genetics , Synapses/genetics , Animals , Female , Guanylate Kinases/deficiency , Intellectual Disability/metabolism , Metabolic Networks and Pathways/genetics , Mice , Mice, Inbred C57BL , Mice, Transgenic , Synapses/metabolism
12.
J Basic Microbiol ; 60(3): 207-215, 2020 Mar.
Article in English | MEDLINE | ID: mdl-31960983

ABSTRACT

The treatment of Helicobacter pylori usually fails due to their ability to form biofilms and resistance to antibiotics. This might potentially lead to gastric carcinoma and mucosa-associated lymphoid tissue lymphoma. In the present study, we elucidate the potential role of N-acylhomoserine lactonase stabilized silver nanoparticles (AiiA-AgNPs) in treating biofilms produced by H. pylori. AiiA-AgNPs inhibited quorum sensing (QS) by degradation of QS molecules, thereby reducing biofilm formation, urease production, and altering cell surface hydrophobicity of H. pylori. AiiA-AgNPs showed no cytotoxic effects on RAW 264.7 macrophages at the effective concentration (1-5 µM) of antibiofilm activity. In addition, AiiA-AgNP in high concentration (80-100 µM) exhibited cytotoxicity against HCT-15 carcinoma cells, depicting its therapeutic role in treating cancer.


Subject(s)
Anti-Bacterial Agents/pharmacology , Biofilms/drug effects , Carboxylic Ester Hydrolases/pharmacology , Helicobacter pylori/drug effects , Quorum Sensing/drug effects , Silver/pharmacology , Animals , Anti-Bacterial Agents/chemistry , Antineoplastic Agents/chemistry , Antineoplastic Agents/pharmacology , Biofilms/growth & development , Carboxylic Ester Hydrolases/chemistry , Cell Line, Tumor , Cell Membrane/chemistry , Cell Membrane/drug effects , Cell Survival/drug effects , Helicobacter pylori/metabolism , Humans , Hydrophobic and Hydrophilic Interactions/drug effects , Metal Nanoparticles/chemistry , Mice , RAW 264.7 Cells , Silver/chemistry , Urease/metabolism
13.
Oecologia ; 190(2): 387-397, 2019 Jun.
Article in English | MEDLINE | ID: mdl-31147778

ABSTRACT

In a heterogeneous environment containing multiple patches that may deplete and renew, a forager should be able to detect the quality of food resources within and among patches and choose to exploit them to best maximize returns. From the predator's perspective, the behavioral responses of the prey in a patch will be perceived as depletion when they retreat to refuge and renewal when they reemerge. A predator encountering responsive prey should manage predation risk, and thus behavioral resource depression, by optimally timing its return time to the patch based on prey behavior. We evaluated the foraging decisions of a predator that encountered patches differing in size of the refuge and prey density. We used little egrets and goldfish as predators and prey in an environment that contained three patches (pools). We manipulated prey density and refuge size and availability (using covers) and observed predator foraging behavior. When the egret had previously caught a fish it did not discriminate between the pools, and the return time was similar for all cover types. The fish densities also did not affect the egret decisions to return to pools. However, when it failed to catch fish, it returned sooner to the pool containing the small cover than the larger one. Additionally, after failing to catch fish in patches containing the highest prey density, the egrets subsequently preferred to return to such patches sooner. We show experimentally that previous failures influence the foraging decisions of a predator choosing how quickly to return to a previously visited patch.


Subject(s)
Birds , Predatory Behavior , Animals , Fishes
14.
Astrobiology ; 19(6): 785-796, 2019 06.
Article in English | MEDLINE | ID: mdl-31081685

ABSTRACT

Carbonaceous meteorites provide clues with regard to prebiotic chemistry and the origin of life. Geological Survey of India recorded a carbonaceous chondrite meteorite fall in Mukundpura, India, on June 6, 2017. We conducted a study to investigate the microbial community that survived the meteorite impact. 16S rRNA metagenomic sequencing indicates the presence of Actinobacteria, Proteobacteria, and Acidobacteria in meteorite impact soil. Comparative phylogenetic analysis revealed an intriguing abundance of class Bacilli in the impact soil. Bacillus thermocopriae IR-1, a moderately thermotolerant organism, was isolated from a rock, impacted by the Mukundpura meteorite. We investigated the resilience of B. thermocopriae IR-1 to environmental stresses and impact shock in a Reddy shock tube. Bacillus thermocopriae IR-1 survived (28.82% survival) the effect of shock waves at a peak shock pressure of 300 kPa, temperature 400 K, and Mach number of 1.47. This investigation presents the first report on the effect of impact shock on B. thermocopriae IR-1. The study is also the first report on studying the microbial diversity and isolation of bacteria from impact crater soil immediately after meteorite impact event.


Subject(s)
High-Energy Shock Waves/adverse effects , Meteoroids , Microbial Viability/radiation effects , Microbiota/radiation effects , Soil Microbiology , Acidobacteria/genetics , Acidobacteria/isolation & purification , Acidobacteria/radiation effects , Actinobacteria/genetics , Actinobacteria/isolation & purification , Actinobacteria/radiation effects , Bacillus/genetics , Bacillus/isolation & purification , Bacillus/radiation effects , DNA, Bacterial/isolation & purification , Metagenomics , Microbiota/genetics , Origin of Life , Proteobacteria/genetics , Proteobacteria/isolation & purification , Proteobacteria/radiation effects , RNA, Ribosomal, 16S/genetics
15.
J Neuroimmunol ; 323: 119-124, 2018 10 15.
Article in English | MEDLINE | ID: mdl-30196824

ABSTRACT

Antibodies against glutamic acid decarboxylase (GAD) are reported in association with numerous neurological conditions including temporal lobe epilepsy and limbic encephalitis. We report a case of Anti-GAD-Antibody associated encephalitis presenting with epilepsia partialis continua (EPC) progressing to a fulminant encephalopathy preferentially affecting the frontal lobes associated with coma and refractory status epilepticus. The abnormalities identified on MRI included marked bilateral frontal lobe involvement which has not been reported in other auto-immune encephalitides and may be specific for Anti-GAD-Antibody associated encephalitis. Similar to the majority of cases of Anti-GAD associated neurological disturbance no underlying malignancy was identified. Treatment with high dose corticosteriods, IVIG and plasmapheresis had minimal response, but escalation of treatment with rituximab and cyclophosphamide was associated with clinical improvement, reducing antibody titers and resolution of MRI changes.


Subject(s)
Autoantibodies/blood , Encephalitis/blood , Glutamate Decarboxylase/blood , Immunosuppression Therapy/methods , Immunosuppressive Agents/therapeutic use , Status Epilepticus/blood , Autoantibodies/drug effects , Autoantibodies/immunology , Diagnosis, Differential , Encephalitis/drug therapy , Encephalitis/immunology , Female , Glutamate Decarboxylase/immunology , Humans , Immunosuppressive Agents/pharmacology , Status Epilepticus/drug therapy , Status Epilepticus/immunology , Young Adult
16.
Proc SPIE Int Soc Opt Eng ; 101322017 Feb 11.
Article in English | MEDLINE | ID: mdl-28626289

ABSTRACT

Apodized Aperture Pixel (AAP) design, proposed by Ismailova et. al, is an alternative to the conventional pixel design1. The advantages of AAP processing with a sinc filter in comparison with using other filters include non-degradation of MTF values and elimination of signal and noise aliasing, resulting in an increased performance at higher frequencies, approaching the Nyquist frequency3. If high resolution small field-of-view (FOV) detectors with small pixels used during critical stages of Endovascular Image Guided Interventions (EIGIs) could also be extended to cover a full field-of-view typical of flat panel detectors (FPDs) and made to have larger effective pixels, then methods must be used to preserve the MTF over the frequency range up to the Nyquist frequency of the FPD while minimizing aliasing. In this work, we convolve the experimentally measured MTFs of an Microangiographic Fluoroscope (MAF) detector, (the MAF-CCD with 35µm pixels) and a High Resolution Fluoroscope (HRF) detector (HRF-CMOS50 with 49.5µm pixels) with the AAP filter and show the superiority of the results compared to MTFs resulting from moving average pixel binning and to the MTF of a standard FPD. The effect of using AAP is also shown in the spatial domain, when used to image an infinitely small point object. For detectors in neurovascular interventions, where high resolution is the priority during critical parts of the intervention, but full FOV with larger pixels are needed during less critical parts, AAP design provides an alternative to simple pixel binning while effectively eliminating signal and noise aliasing yet allowing the small FOV high resolution imaging to be maintained during critical parts of the EIGI.

17.
Bone Joint J ; 96-B(1): 54-8, 2014 Jan.
Article in English | MEDLINE | ID: mdl-24395311

ABSTRACT

The management of failed autologous chondrocyte implantation (ACI) and matrix-assisted autologous chondrocyte implantation (MACI) for the treatment of symptomatic osteochondral defects in the knee represents a major challenge. Patients are young, active and usually unsuitable for prosthetic replacement. This study reports the results in patients who underwent revision cartilage transplantation of their original ACI/MACI graft for clinical or graft-related failure. We assessed 22 patients (12 men and 10 women) with a mean age of 37.4 years (18 to 48) at a mean of 5.4 years (1.3 to 10.9). The mean period between primary and revision grafting was 46.1 months (7 to 89). The mean defect size was 446.6 mm(2) (150 to 875) and they were located on 11 medial and two lateral femoral condyles, eight patellae and one trochlea. The mean modified Cincinnati knee score improved from 40.5 (16 to 77) pre-operatively to 64.9 (8 to 94) at their most recent review (p < 0.001). The visual analogue pain score improved from 6.1 (3 to 9) to 4.7 (0 to 10) (p = 0.042). A total of 14 patients (63%) reported an 'excellent' (n = 6) or 'good' (n = 8) clinical outcome, 5 'fair' and one 'poor' outcome. Two patients underwent patellofemoral joint replacement. This study demonstrates that revision cartilage transplantation after primary ACI and MACI can yield acceptable functional results and continue to preserve the joint.


Subject(s)
Cartilage, Articular/surgery , Chondrocytes/transplantation , Chondromalacia Patellae/surgery , Knee Injuries/surgery , Osteochondritis Dissecans/surgery , Adolescent , Adult , Arthroscopy , Cartilage, Articular/injuries , Chronic Disease , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pain Measurement/methods , Reoperation/methods , Treatment Failure , Treatment Outcome , Young Adult
19.
J Bone Joint Surg Br ; 94(4): 488-92, 2012 Apr.
Article in English | MEDLINE | ID: mdl-22434464

ABSTRACT

Matrix-induced autologous chondrocyte implantation (MACI) is an established technique used to treat osteochondral lesions in the knee. For larger osteochondral lesions (> 5 cm(2)) deeper than approximately 8 mm we have combined the use of two MACI membranes with impaction grafting of the subchondral bone. We report our results of 14 patients who underwent the 'bilayer collagen membrane' technique (BCMT) with a mean follow-up of 5.2 years (2 to 8). There were 12 men and two women with a mean age of 23.6 years (16 to 40). The mean size of the defect was 7.2 cm(2) (5.2 to 12 cm(2)) and were located on the medial (ten) or lateral (four) femoral condyles. The mean modified Cincinnati knee score improved from 45.1 (22 to 70) pre-operatively to 82.8 (34 to 98) at the most recent review (p < 0.05). The visual analogue pain score improved from 7.3 (4 to 10) to 1.7 (0 to 6) (p < 0.05). Twelve patients were considered to have a good or excellent clinical outcome. One graft failed at six years. The BCMT resulted in excellent functional results and durable repair of large and deep osteochondral lesions without a high incidence of graft-related complications.


Subject(s)
Bone Transplantation/methods , Chondrocytes/transplantation , Collagen/therapeutic use , Knee Joint/surgery , Adolescent , Adult , Arthroscopy , Bone Transplantation/adverse effects , Cartilage, Articular/pathology , Female , Follow-Up Studies , Humans , Knee Injuries/surgery , Knee Joint/pathology , Magnetic Resonance Imaging , Male , Osteochondritis Dissecans/surgery , Treatment Outcome , Young Adult
20.
J Bone Joint Surg Br ; 94(4): 504-9, 2012 Apr.
Article in English | MEDLINE | ID: mdl-22434467

ABSTRACT

Autologous chondrocyte implantation (ACI) and mosaicplasty are methods of treating symptomatic articular cartilage defects in the knee. This study represents the first long-term randomised comparison of the two techniques in 100 patients at a minimum follow-up of ten years. The mean age of the patients at the time of surgery was 31.3 years (16 to 49); the mean duration of symptoms pre-operatively was 7.2 years (9 months to 20 years). The lesions were large with the mean size for the ACI group being 440.9 mm(2) (100 to 1050) and the mosaicplasty group being 399.6 mm(2) (100 to 2000). Patients had a mean of 1.5 previous operations (0 to 4) to the articular cartilage defect. Patients were assessed using the modified Cincinnati knee score and the Stanmore-Bentley Functional Rating system. The number of patients whose repair had failed at ten years was ten of 58 (17%) in the ACI group and 23 of 42 (55%) in the mosaicplasty group (p < 0.001). The functional outcome of those patients with a surviving graft was significantly better in patients who underwent ACI compared with mosaicplasty (p = 0.02).


Subject(s)
Cartilage, Articular/surgery , Chondrocytes/transplantation , Knee Joint/surgery , Adolescent , Adult , Arthroscopy/methods , Cartilage, Articular/injuries , Cell Culture Techniques , Debridement/methods , Female , Follow-Up Studies , Humans , Knee Injuries/pathology , Knee Injuries/rehabilitation , Knee Injuries/surgery , Knee Joint/physiopathology , Male , Middle Aged , Osteochondritis Dissecans/pathology , Osteochondritis Dissecans/rehabilitation , Osteochondritis Dissecans/surgery , Prospective Studies , Recovery of Function , Reoperation/methods , Treatment Outcome , Young Adult
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