Tissue on the Transferred Coracoid Graft After Latarjet Procedure: Histological and Morphological Findings.

BACKGROUND: Anterior shoulder instability is a debilitating condition that can require stabilization via a Latarjet procedure. PURPOSE: The aim of this study was to characterize the histological composition of the articular-sided surface of the coracoid bone graft after Latarjet procedure. Specific features of cells isolated from the coracoid and graft tissues were assessed. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Tissue samples were harvested from 9 consecutive patients undergoing arthroscopic debridement and screw removal after arthroscopic or open Latarjet procedure. Tissues were processed histologically. In 2 patients, the samples were analyzed to assess specific cellular properties. RESULTS: Safranin O staining indicated that glenoid tissues contained variable amounts of glycosaminoglycan (GAG) and round chondrocytic cells mainly organized in clusters. Graft tissues contained less GAG and were more cellular but were not organized in clusters and had variable morphological features. An association appeared to exist between the cartilage quality of glenoid tissues and that of the graft tissues. Cells isolated from glenoid and graft tissues exhibited similar proliferation capacity. CONCLUSION: The results of our analysis show that cells located at the articular-sided surface of transferred coracoid grafts demonstrate fibrocartilaginous properties and may have the capacity for chondral proliferation. Further studies are needed to confirm this observation and future application.

In vivo intra-articular negative pressure wound therapy effect on cartilage in a goat model.

This prospective, randomized, blinded pilot study determined if a difference was present in the histology and apoptotic rate of articular cartilage after application of a negative pressure wound therapy (NPWT) device to an uninjured joint surface compared to a control side using Capra hircus goats. The goats were euthanized at 3 or 7 days after surgery. The en bloc joint resection was divided into medial (direct sponge contact) and lateral compartments (no sponge contact; indirect NPWT). In the necropsied cartilage and menisci, there were no gross or histologic/morphometric differences identified by a blinded veterinary pathologist. The percentages of apoptotic and necrotic chondrocytes based on flow cytometry were not statistically different. This study demonstrated that there were no observable deleterious effects to uninjured cartilage from direct or indirect intra-articular NPWT placement. These data suggest that NPWT may be placed safely in an intra-articular position for up to 7 days. Further studies in humans are warranted.

Latent foreign body synovitis.

The differential diagnosis for monoarticular arthritis is extensive. Patient omissions from the history can compound this broad diagnostic dilemma. A case report is presented of a 32-year-old female with an eight-month history of isolated right first metatarsophalangeal joint (MTPJ) pain, after exhaustive, non-specific diagnostic evaluation. An open biopsy was performed, and a 3.5 cm wooden foreign body, believed to be the result of an injury 18 years prior, was excised from the 1st MTP. Open biopsy may be required as an important part of the workup for definitive diagnosis of a foreign body synovitis. A discussion regarding the presentation, clinical and diagnostic findings follows.