Tag Archives: knee

Results of Osteochondral Mosaic Grafting in a Sheep Model

Szántó A1, Gergely I2, Pop TS2, Russu O2, Zuh S2 Zazgyva Ancuţa2, Nagy Ö2

1 County Emergency Hospital, Miercurea Ciuc, Romania
2 University of Medicine and Pharmacy, Department of Orthopaedics and Traumatolog, Tîrgu Mureș, Romania

Objective: We present the results of an experimental study in sheep on using autogenous, cylindrical osteochondral grafts for treating cartilage defects in the knee. The aim was to produce hyaline or hyaline-like cartilage on weight-bearing surfaces through autogenous osteochondral transplantation using special instrumentation and the mosaicplasty technique.
Methods: We used a sheep model – cartilage defects were made in the knees of 16 young sheep from the Tigaia breed. At 4 and 8 weeks postoperatively macroscopic, radiologic and microscopic examinations were performed on the transplanted sites and the donor sites.
Results: We found that grafts incorporated well in the recipient sites, showing good survivorship. Joint congruency was maintained, with 75 to 80% hyaline cartilage at the transplanted site.
Conclusions: Our results lead us to conclude that mosaic-like osteochondral grafting is an excellent treatment method for repairing chondral defects in major joints.

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TNF-α and MMP-8 as Biomarkers for Diagnosing Knee Cartilage Lesions — Preliminary Results

Russu OM1, Gergely I1, Zazgyva Ancuţa1, Zuh SGy1, Nagy E2, Nagy Ö1, Pop TS1

1 Department of Orthopaedics and Traumatology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Department of Pharmaceutical Biochemistry, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

Objective: To analyse the correlations between the levels of Tumor Necrosis Factor α, Matrix Metalloproteinase 8, Interleukin 6 and the presence of cartilage lesions in the knee.
Methods: We studied 79 individuals divided in three groups – a group with cartilage lesions, a group with meniscal lesions and a control group. All patients underwent arthroscopic surgical interventions – either diagnostic or therapeutic. Venous blood samples and synovial fluid samples were obtained and we determined the levels of TNF-α, MMP-8 and IL-6 respectively. All study participants filled out the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Score questionnaire, based on which the IKDC score was calculated.
Results: we found higher levels of MMP-8 in both serum and synovial fluid for groups 1 and 2 compared to the control group, but no correlation between the serum and synovial fluid levels of MMP-8. The serum MMP-8 levels showed a significant negative correlation with the highest level of activity without pain and significant giving way. The synovial MMP-8 could be correlated to the IKDC score. Serum levels and synovial levels of TNF-α were in strong correlation. We found no association between serum and/or synovial TNF-α and MMP-8 levels.
Conclusions: We found that synovial MMP-8 concentrations showed a reverse correlation with the IKDC scores (an activity-based score) – thus MMP-8 might be a diagnostic and prognostic marker in knee osteoarthritis.

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Knee Arthroplasty: With or Without Patellar Component?

Sólyom Árpád1, Király Ildikó2, Benedek Csaba2, Fülöp Csongor1, Nagy Örs3, Bățagă Tiberiu1

1 Ist Orthopaedic and Trauma Clinic, Mureș County Emergency Clinical Hospital, Tîrgu Mureș, Romania
2 University of Medicine and Pharmacy of Tîrgu Mureș, Faculty of General Medicine, sixth year medical student, Tîrgu Mureș, Romania
3 IInd Orthopaedic and Trauma Clinic, Mureș County Hospital, Tîrgu Mureș, Romania

DOI: 10.1515/amma-2015-0052

Arthroplasty is used when there is irreversible damage to the articular cartilage of the knee. It involves implanting a bicompartimental (femoral and tibial components) or a tricompartimental (femoral, tibial and patellar components) prosthesis. It is a very invasive and costly operation, so our objective was to evaluate the necessity of the patellar component. Material and methods: We included 39 patients in the study: in 27 cases we used tricompartimental prosthesis, while the other 12 received only the bicompartimental components. Patients were evaluated preoperatively and postoperatively using the International Knee Documentation Comitee score. Results: We’ve found that there is little to no difference between the two groups regarding mobility and complication, however patients with bicompartimental arthroplasty complained of less pain. Conclusion: We’ve found that bicompartimental arthroplasty – being a less invasive procedure – is superior not only in terms of pain management, but is also associated with less bleeding and shorter intraoperative time. The revision is easier and the technique presents also financially advantages, for both the patient and the medical facility.

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