Exploration of changes in spatial chondrocyte organisation in human osteoarthritic cartilage by means of 3D imaging.

Using two-dimensional top-down view microscopy, researchers have recently described chondrocytes as being spatially arranged in distinct patterns such as strings, double strings, and small and large clusters. Because of the seeming association of these changes with tissue degeneration, they have been proposed as an image-based biomarker for early osteoarthritis (OA) staging. The aim of our study was to investigate the spatial arrangement of chondrocytes in human articular cartilage in a 3D fashion and to evaluate the 3D changes of these patterns in the context of local tissue destruction. Decalcified femoral condyle resections from the load-bearing area were analysed in 3D for their spatial chondrocyte organisation by means of fluorescence microscopy and synchrotron-radiation micro-computed tomography (SR-µCT). In intact cartilage chondrocyte strings can be found in the superficial, transitional and deep zones. The proposed pattern changes accompanying tissue destruction could be located not just along the surface but also through all layers of cartilage. Each spatial pattern was characterised by a different cellular density (the only exception being between single and double strings with p = 0.062), with cellular density significantly increasing alongside the increase in local tissue degeneration as defined by the chondrocyte patterns. We can thus corroborate that the proposed cellular spatial changes are a three-dimensional function of local tissue degeneration, underlining their relevance as an image-based biomarker for the early diagnosis and description of OA.Clinical trial registration number: Project number of the ethics committee of the University of Tübingen:171/2014BO2.

Fivefold Fracture in a Perilunate Fracture Dislocation Involving Scaphoid, Capitate, Hamate, Triquetrum and Lunate: A Case Report.

This case report presents a very rare fracture combination in a perilunate dislocation including the scaphoid, capitate, hamate and triquetrum and the cornu anterior of the lunate, with an intact scapholunate ligament in a left wrist. An open reduction and internal fixation of the scaphoid, capitate, hamate and triquetrum was performed.

Value of the Two-Point Discrimination Test: Evaluation of 238 Isolated Finger Nerve Injuries.

Background: It may be difficult to diagnose a nerve injury on a finger or a hand under emergency settings. The goal of this study was to elaborate whether the clinical testing of two-point discrimination was a safe and reliable method in the diagnosis of acute finger nerve injuries. Methods: Through a retrospective assessment, patients' records were analyzed whether the result of the two-point discrimination test corresponded with the intraoperative findings of a damaged nerve. Patients with a prolonged or missing two-point discrimination, who had undergone surgery at our institution between the years 2008 and 2017, were included in the study. The control groups were identified in the same manner and as an additional group, patients with Dupuytren's contracture were included to serve as a healthy cohort regarding finger nerves. Results: A total of 249 patients with nerve lesion were enrolled in the study; apart from this, 25 patients with Dupuytren's contracture were included. The sensitivity of the two-point discrimination test was 99%, with a positive predictive value of 0.93 and with high inter-observer reliability. Conclusions: The two-point discrimination is a valid test to use in the routine examination of suspected nerve injuries on the hands and fingers; it is very reliable and safe for indicating surgical interventions.

[Preservation of the outer ear in a complex burn injury]. / Erhalt des äußeren Ohres bei einer komplexen Verbrennung.

Saving the outer ear in burn injuries is a challenging task for the treating surgeon that should not be underestimated. Burns which are initially evaluated as superficial, particularly in this region, often have a tendency to undergo progressive tissue destruction whereby conservative treatment is often no longer sufficient to preserve the skin of the auricle with the underlying cartilage. Various possibilities for saving the ear and for ear reconstruction are described, but in the case of severely burned patients it is often necessary to carry out a quick and relatively simple treatment. In the complicated case of a severely burned patient involving the external ear, a good cosmetic result could be finally obtained with preservation of form and function by means of an economical cartilage resection with subsequent adaptation.