V. Havlas (Prague 6, CZ)
Department of Orthopaedics and Traumatology, 2nd Faculty of Medicine, Charles University Orthopedic dep.Presenter Of 2 Presentations
P060 - Fixation of Osteochondral Defects in Pediatric Knee Using Biodegradable Magnesium Screws and Pins.
Abstract
Purpose
Magnesium alloy based implants represent relatively new generation of bioabsorbable materials appearing to be a promising alternative to the currently most widely used polymers. The purpose of this study was to evaluate the short-term clinical and radiological outcomes of the fixation of unstable or displaced osteochondral fractures and osteochondritis dissecans lesions in the knee joint using MAGNEZIX® screws and pins in pediatric patients.
Methods and Materials
12 patients (5 girls, 7 boys) were included in the study. Inclusion criteria were 1 / age < 18 years; 2 / unstable or displaced osteochondral laesions caused by injury or due to osteochondritis dissecans, classified according to ICRS; 3 / fixation with MAGNEZIX implants; 4 / minimum FU 12 months. X-rays and clinical evaluation were performed 1 day, 6 weeks, 3, 6, and 12 months after the operation, MRI scans 12 months after the surgery.
Results
The mean age at surgery was 13.3 ± 1.6 years. A total of 25 screws were used in 11 patients, mean 2.4 ± 1 per patient, 4 pins were used in 1 patient. In 2 patients the fixation was combined with fibrin glue. The mean FU was 14.2 ± 3.3 months. No intraoperative complications occurred. VAS for pain demonstrated significant improvement (from 4.8 before surgery to 1.2 after surgery). All patients showed full recovery of function and showed no signs of pain 6 months after surgery. No adverse local reactions were observed during follow-up. Complete radiographic (x-ray and MRI) healing occurred in all cases. Mild radiolucent zones were observed around the implants in the range of 6 weeks - 3 months. Areas of hypodensity suggesting new bone deposition corresponding with the former implant sites were observed on MRI at 12 months.
Conclusion
Fixation of osteochondral fragments by MAGNEZIX screws and pins during short-term FU provides sufficient stability and leads to uncomplicated healing.
P234 - Efficacy Evaluation of Allogeneic MSC Derived from Umbilical Cord in Repair of Cartilage Defects: Preclinical Study on Large Animal Model
Abstract
Purpose
Mesenchymal stem cells (MSC) are investigated for years as promising tool of cartilage regeneration. Up today, at least three sources of MSC are applied in hundreds of studied, particularly bone marrow, adipose tissue and umbilical cord. Interestingly, in vitro studies indicate different potential of MSC from different sources to facilitate cartilage regeneration. However, the comparison of MSC from these sources to regenerate cartilage on large animal is missing. The aim of this study is to compare the efficacies of MSC from bone marrow and from umbilical cord on repair of cartilage defect employing porcine animal model.
Methods and Materials
The osteochondral defect 6 x 3 mm (diameter x height) was induced on the surface of articular cartilage of adult minipig and MSC (2.5 x 106 cells/defect) were implanted in the form of Chondrotissue® + MSC + autologous plasma + autologous serum. The experimental groups were Chondrotissue® + autologous porcine MSC from bone marrow, Chondrotissue® + porcine MSC from umbilical cord, Chondrotissue® + human MSC from umbilical cord. The control groups were Chondrotissue® and empty defect. Each group consists of 8 animals. At day of operation (day 0), 10 days after operation (day 10) and at day of termination (day 90) the blood samples were collected to analyze plasma for cytokines. After termination the samples of regenerated defect were collected for histological quantitative analysis of new cartilage formation, collagen type II and type I production.
Results
Analysis of plasma for cytokines did not reveal any significant changes caused by MSC implantation. The quantitative histological evaluation of cartilage defect regeneration did not show the significant differences between MSC from bone marrow and from umbilical cord.
Conclusion
Employing the large animal model of adult cartilage defect we did not observe any significant difference in cartilage defect regeneration treated by MSC from bone marrow and from umbilical cord.
Presenter Of 2 Presentations
P060 - Fixation of Osteochondral Defects in Pediatric Knee Using Biodegradable Magnesium Screws and Pins.
Abstract
Purpose
Magnesium alloy based implants represent relatively new generation of bioabsorbable materials appearing to be a promising alternative to the currently most widely used polymers. The purpose of this study was to evaluate the short-term clinical and radiological outcomes of the fixation of unstable or displaced osteochondral fractures and osteochondritis dissecans lesions in the knee joint using MAGNEZIX® screws and pins in pediatric patients.
Methods and Materials
12 patients (5 girls, 7 boys) were included in the study. Inclusion criteria were 1 / age < 18 years; 2 / unstable or displaced osteochondral laesions caused by injury or due to osteochondritis dissecans, classified according to ICRS; 3 / fixation with MAGNEZIX implants; 4 / minimum FU 12 months. X-rays and clinical evaluation were performed 1 day, 6 weeks, 3, 6, and 12 months after the operation, MRI scans 12 months after the surgery.
Results
The mean age at surgery was 13.3 ± 1.6 years. A total of 25 screws were used in 11 patients, mean 2.4 ± 1 per patient, 4 pins were used in 1 patient. In 2 patients the fixation was combined with fibrin glue. The mean FU was 14.2 ± 3.3 months. No intraoperative complications occurred. VAS for pain demonstrated significant improvement (from 4.8 before surgery to 1.2 after surgery). All patients showed full recovery of function and showed no signs of pain 6 months after surgery. No adverse local reactions were observed during follow-up. Complete radiographic (x-ray and MRI) healing occurred in all cases. Mild radiolucent zones were observed around the implants in the range of 6 weeks - 3 months. Areas of hypodensity suggesting new bone deposition corresponding with the former implant sites were observed on MRI at 12 months.
Conclusion
Fixation of osteochondral fragments by MAGNEZIX screws and pins during short-term FU provides sufficient stability and leads to uncomplicated healing.
P234 - Efficacy Evaluation of Allogeneic MSC Derived from Umbilical Cord in Repair of Cartilage Defects: Preclinical Study on Large Animal Model
Abstract
Purpose
Mesenchymal stem cells (MSC) are investigated for years as promising tool of cartilage regeneration. Up today, at least three sources of MSC are applied in hundreds of studied, particularly bone marrow, adipose tissue and umbilical cord. Interestingly, in vitro studies indicate different potential of MSC from different sources to facilitate cartilage regeneration. However, the comparison of MSC from these sources to regenerate cartilage on large animal is missing. The aim of this study is to compare the efficacies of MSC from bone marrow and from umbilical cord on repair of cartilage defect employing porcine animal model.
Methods and Materials
The osteochondral defect 6 x 3 mm (diameter x height) was induced on the surface of articular cartilage of adult minipig and MSC (2.5 x 106 cells/defect) were implanted in the form of Chondrotissue® + MSC + autologous plasma + autologous serum. The experimental groups were Chondrotissue® + autologous porcine MSC from bone marrow, Chondrotissue® + porcine MSC from umbilical cord, Chondrotissue® + human MSC from umbilical cord. The control groups were Chondrotissue® and empty defect. Each group consists of 8 animals. At day of operation (day 0), 10 days after operation (day 10) and at day of termination (day 90) the blood samples were collected to analyze plasma for cytokines. After termination the samples of regenerated defect were collected for histological quantitative analysis of new cartilage formation, collagen type II and type I production.
Results
Analysis of plasma for cytokines did not reveal any significant changes caused by MSC implantation. The quantitative histological evaluation of cartilage defect regeneration did not show the significant differences between MSC from bone marrow and from umbilical cord.
Conclusion
Employing the large animal model of adult cartilage defect we did not observe any significant difference in cartilage defect regeneration treated by MSC from bone marrow and from umbilical cord.