Experimental study on the role of intra‐articular injection of MSCs on cartilage regeneration in haemophilia

Mesenchymal stem cells (MSCs) therapy is a field in progress in cartilage repair strategies. We tried to investigate the functional properties of the joint and cartilage in experimental haemarthrosis (EH) after MSCs intra‐articular (IA) injection. One millilitre of fresh autologous blood was injected twice a week for three consecutive weeks in three groups including control haemophilia 10 days (n = 8), control haemophilia 38 days (n = 8) and MSCs (n = 8) group. In later, 10 days after the end of IA blood injections, MSCs IA injection was performed. Eight animals received no treatment as the normal control group. Thirty‐eight days after the end of IA blood injections, animals were sacrificed. Joint friction and stress‐relaxation tests were done, inflammatory cytokines of synovial membrane and scanning electron microscopy of the cartilage assessed. Joint friction decreased in MSCs in comparison to other groups and was significant with normal control group, (P = 0.011). The mechanical properties of cartilage showed no significant differences between groups. Tumour necrosis factor alpha and interleukin 1 beta decreased and IL‐4 very slightly increased in MSCs in comparison to the time‐matched control group. Scanning electron microscopy enabled acquisition of good structural properties of the surface and layers of the cartilage after MSCs injection. The hole induced in the medial plateau of the tibia bones, after inducing haemarthrosis, were covered with cartilage‐like structure. The results showed that MSCs IA injection has some beneficial effects on cartilage structure and function in haemarthrosis model and is promising in patients with haemophilia.     

Techniques and applications of in vivo diffusion imaging of articular cartilage

Early in the process of osteoarthritis (OA) the composition (water, proteoglycan [PG], and collagen) and structure of articular cartilage is altered leading to changes in its mechanical properties. A technique that can assess the composition and structure of the cartilage in vivo can provide insight in the mechanical integrity of articular cartilage and become a powerful tool for the early diagnosis of OA. Diffusion tensor imaging (DTI) has been proposed as a biomarker for cartilage composition and structure. DTI is sensitive to the PG content through the mean diffusivity and to the collagen architecture through the fractional anisotropy. However, the acquisition of DTI of articular cartilage in vivo is challenging due to the short T2 of articular cartilage (～40 ms at 3 Tesla) and the high resolution needed (0.5–0.7 mm in plane) to depict the cartilage anatomy. We describe the pulse sequences used for in vivo DTI of articular cartilage and discus general strategies for protocol optimization. We provide a comprehensive review of measurements of DTI of articular cartilage from ex vivo validation experiments to its recent clinical applications. J. Magn. Reson. Imaging 2015;41:1487–1504. © 2015 Wiley Periodicals, Inc.     

骨形态发生蛋白/碱性成纤维细胞生长因子复合材料修复关节软骨缺损的实验研究

目的探讨骨形态发生蛋白(bone morphogenetic protein,BMP)碱性成纤维细胞生长因子(basic fibroblast growthfactor,bFGF)复合材料在关节软骨缺损修复过程中的作用,为内源性修复关节软骨缺损提供实验基础。方法选用兔作为实验动物造成双侧股骨髁间窝全层软骨缺损,分别采用不同的材料(rhBMP2/PVP组、bFGF/PVP组、rhBMP2/bFGF/PVP组、PVP组)进行缺损修复,光镜及电镜下观察修复效果。结果术后8周rhBMP2/bFGF/PVP组软骨缺损已基本修复,12周时软骨修复更加光滑、完整。其余组软骨缺损修复效果不如rhBMP2/bFGF/PVP组。结论BMP具有诱导形成软骨的活性,与bFGF的复合物能增强软骨细胞增生,较单独应用BMP效果好,是生物学修复关节软骨缺损的良好材料。     

术中侧斜位 X线检查在桡骨远端骨折 40例的应用价值

目的术中通过附加侧斜位 X线检查观察桡骨远端螺钉与腕关节面的关系,从而评价桡骨远端骨折术后临床疗效。方法对 2018年 1月至 2020年 2月芜湖市第一人民医院桡骨远端骨折的 40例病人行切开复位锁定钢板内固定,术中常规拍摄正侧位 X线片,附加侧斜位 X线检查,保证锁定钢板远端螺钉未进入腕关节面,通过测量术后即刻、术后 3个月及末次随访时掌倾角、尺偏角及桡骨高度,观察术后并发症及评估末次随访时腕关节功能(采用 Dienst腕关节评分标准),从而评价其临床疗效。结果所有病人均获得随访,随访 8~12个月,平均 10.6个月。术后即刻、术后 3个月及末次随访掌倾角、尺偏角及桡骨高度差异无统计学意义( P>0.05)。术后均无内固定松动、断裂发生,无拇长屈肌腱断裂、创伤性关节炎、无畸形愈合及关节僵硬的发生,末次随访时腕关节功能评估为优 29例,良 10例,可 1例,优良率为 97.5%。结论术中侧斜位 X线检查可以保证远端锁钉不进入腕关节腔,可以尽可能地将钢板放置骨折远端,使骨折远端固定更加牢固,从而避免术后掌倾角、尺偏角及桡骨高度的丢失,临床疗效满意。     

Investigation of effects of levobupivacaine injection to rabbit knee joint on histopathologic changes of joint cartilage tissue and changes of serum biochemical parameters

The aim of this study is to evaluate the effects of intra‐articular levobupivacaine on rabbit knee articular cartilage and certain biochemical parameters in the blood. A total of 24 New Zealand rabbits were included to study. Blood sampling was carried out in all animals on the first day, then the subjects were randomly allocated either to the control group (Group C, n = 9) or to the levobupivacaine group (Group L, n = 15). Group C underwent each two intra‐articular injections of saline, 0.25 mL into the right knee and 0.50 mL into the left one. Group L was injected 0.25 mL (1.25 mg) of levobupivacaine into the right knee and 0.50 mL (2.5 mg) into the left one. The groups were divided randomly into three. Tissue and blood samples for histologic and biochemical examination were collected from Groups C1 and L1 on the first, C2 and L2 on the second, and C3 and L3 on the tenth day of the study. Interleukin‐1β (IL‐1 β), interleukin‐6 (IL‐6), tumor necrosis factor‐alpha (TNF‐α), and C‐reactive protein (CRP) levels were analyzed. No statistically significant differences could be detected when comparing either left or right joints within the same groups and with Group C and L (P > 0.05). Significant elevations of biochemical parameters were found in Group C. It is concluded that levobupivacaine does not lead to significant histologic changes in rabbit articular cartilage. Significant elevations of biochemical parameters being generally found in the C Group, it is thought that such elevations are not linked to levobupivacaine. Intra‐articular levobupivacaine may be a safe alternative for use in post‐operative analgesia.     

Art,Surgery and Transplantation

Abstract

Roy Calne (1930-) has elegantly cultivated the science and art of transplantation. Throughout his medical and artistic career his eyes have remained fully open not only to science and scientific advances but to any new developments that would enhance his art of painting as applied to his patients, colleagues, events and surgical operations related to transplantation. Calne contributed to and developed a new field through art in the understanding of the lives of his patients, the working of his colleagues and the application of surgical principles to the specialty in which he labours, surgical transplantation. The application of “Art, Surgery and Transplantation” should in many ways be the fountain of information and support for those seeking this way of therapy.