PURPOSE OF THE STUDY: Retrospective case series looking at the use of Omnitech compression screws for the management of osteochondral fractures in skeletally immature patients. MATERIAL AND METHODS: Nine patients with a mean age of 14 were included in the study with a mean follow up of 26 months. RESULTS: The average KOOS, IKDC and Tegner Lysholm Scores were 86.7, 90.34 and 96.1 respectively. CONCLUSION: The use of Omnitech screws in the acute setting for skeletally immature patients shows excellent short-term outcomes.

• MeSH
• artroplastika subchondrální přístrojové vybavení   metody   MeSH
• chondrální fraktury diagnostické zobrazování   etiologie   chirurgie   MeSH
• kolenní kloub chirurgie   MeSH
• kostní šrouby * MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• mladiství MeSH
• následné studie MeSH
• retrospektivní studie MeSH
• vnitřní fixace fraktury přístrojové vybavení   metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Randomized controlled trials studying the efficacy and safety of matrix-applied characterized autologous cultured chondrocytes (MACI) versus microfracture (MFX) for treating cartilage defects are limited. PURPOSE: To compare the clinical efficacy and safety of MACI versus MFX in the treatment of patients with symptomatic cartilage defects of the knee. STUDY DESIGN: Randomized controlled clinical trial; Level of evidence, 1. METHODS: Patients enrolled in the SUMMIT (Demonstrate the Superiority of MACI implant to Microfracture Treatment) trial had ≥1 symptomatic focal cartilage defect (Outerbridge grade III or IV; ≥3 cm(2)) of the femoral condyles or trochlea, with a baseline Knee Injury and Osteoarthritis Outcome Score (KOOS) pain value <55. The co-primary efficacy endpoint was the change in the KOOS pain and function subscores from baseline to 2 years. Histological evaluation and magnetic resonance imaging (MRI) assessments of structural repair tissue, treatment failure, the remaining 3 KOOS subscales, and safety were also assessed. RESULTS: Of the 144 patients treated, 137 (95%) completed the 2-year assessment. Patients had a mean age of 33.8 years and a mean lesion size of 4.8 cm(2). The mean KOOS pain and function subscores from baseline to 2 years were significantly more improved with MACI than with MFX (pain: MACI, 37.0 to 82.5 vs MFX, 35.5 to 70.9; function: MACI, 14.9 to 60.9 vs MFX, 12.6 to 48.7; P = .001). A significant improvement in scores was also observed on the KOOS subscales of activities of daily living (MACI, 43.5 to 87.2 vs MFX, 42.6 to 75.8; P < .001), knee-related quality of life (MACI, 18.8 to 56.2 vs MFX, 17.2 to 47.3; P = .029), and other symptoms (MACI, 48.3 to 83.7 vs MFX, 44.4 to 72.2; P < .001) for patients treated with MACI compared with MFX. Repair tissue quality was good as assessed by histology/MRI, but no difference was shown between treatments. A low number of treatment failures (nonresponders: MACI, 12.5% vs MFX, 31.9%; P = .016) and no unexpected safety findings were reported. CONCLUSION: The treatment of symptomatic cartilage knee defects ≥3 cm(2) in size using MACI was clinically and statistically significantly better than with MFX, with similar structural repair tissue and safety, in this heterogeneous patient population. Moreover, MACI offers a more efficacious alternative than MFX with a similar safety profile for the treatment of symptomatic articular cartilage defects of the knee.

• MeSH
• artroplastika subchondrální metody   MeSH
• autologní transplantace MeSH
• chondrocyty patologie   transplantace   MeSH
• dospělí MeSH
• kloubní chrupavka zranění   chirurgie   MeSH
• kolenní kloub patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• mladý dospělý MeSH
• následné studie MeSH
• poranění kolena patologie   chirurgie   MeSH
• prospektivní studie MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH

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• MeSH
• artroplastika subchondrální metody   využití   MeSH
• artróza kolenních kloubů diagnóza   klasifikace   terapie   MeSH
• autologní transplantace metody   MeSH
• chondrocyty transplantace   MeSH
• injekce intraartikulární využití   MeSH
• kloubní chrupavka chirurgie   zranění   MeSH
• nemoci chrupavky etiologie   klasifikace   patologie   MeSH
• plazma bohatá na destičky MeSH
• poranění kolena chirurgie   MeSH
• viskosuplementace metody   MeSH
• Publikační typ
• přehledy MeSH

The aim of this study was to evaluate macroscopically, histologically and immunohistochemically the quality of newly formed tissue in iatrogenic defects of articular cartilage of the femur condyle in miniature pigs treated with the clinically used method of microfractures in comparison with the transplantation of a combination of a composite scaffold with allogeneic mesenchymal stem cells (MSCs) or the composite scaffold alone. The newly formed cartilaginous tissue filling the defects of articular cartilage after transplantation of the scaffold with MSCs (Group A) had in 60 % of cases a macroscopically smooth surface. In all lesions after the transplantation of the scaffold alone (Group B) or after the method of microfractures (Group C), erosions/fissures or osteophytes were found on the surface. The results of histological and immunohistochemical examination using the modified scoring system according to O’Driscoll were as follows: 14.7±3.82 points after transplantations of the scaffold with MSCs (Group A); 5.3±2.88 points after transplantations of the scaffold alone (Group B); and 5.2±0.64 points after treatment with microfractures (Group C). The O’Driscoll score in animals of Group A was significantly higher than in animals of Group B or Group C (p<0.0005 both). No significant difference was found in the O’Driscoll score between Groups B and C. The treatment of iatrogenic lesions of the articular cartilage surface on the condyles of femur in miniature pigs using transplantation of MSCs in the composite scaffold led to the filling of defects by a tissue of the appearance of hyaline cartilage. Lesions treated by implantation of the scaffold alone or by the method of microfractures were filled with fibrous cartilage with worse macroscopic, histological and immunohistochemial indicators.

• MeSH
• artroplastika subchondrální MeSH
• časové faktory MeSH
• chitosan metabolismus   MeSH
• chondrogeneze MeSH
• financování organizované MeSH
• hojení ran MeSH
• imunohistochemie MeSH
• kloubní chrupavka MeSH
• kolagen typu I metabolismus   MeSH
• kolenní kloub chirurgie   metabolismus   patologie   MeSH
• kultivované buňky MeSH
• miniaturní prasata MeSH
• modely nemocí na zvířatech MeSH
• nanostruktury MeSH
• poranění kolena chirurgie   metabolismus   patologie   MeSH
• prasata MeSH
• tkáňové podpůrné struktury MeSH
• transplantace mezenchymálních kmenových buněk MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH

• MeSH
• artroplastika subchondrální MeSH
• bisfosfonáty MeSH
• imunoterapie adoptivní MeSH
• kmenové buňky MeSH
• kostní dřeň MeSH
• měření bolesti MeSH
• osteonekróza MeSH
• osteotomie MeSH
• statiny MeSH
• výsledek terapie MeSH
• Publikační typ
• sborníky MeSH

• Konspekt
• Ortopedie. Chirurgie. Oftalmologie
• NLK Obory
• ortopedie
• angiologie

• MeSH
• artrodéza metody   využití   MeSH
• artroplastika subchondrální metody   využití   MeSH
• artróza kolenních kloubů * chirurgie   patologie   MeSH
• debridement metody   využití   MeSH
• kloubní chrupavka chirurgie   MeSH
• lidé MeSH
• luxace pately chirurgie   MeSH
• ortopedické výkony * metody   využití   MeSH
• osteotomie metody   využití   MeSH
• statistika jako téma MeSH
• tibie chirurgie   patologie   MeSH
• výsledky a postupy - zhodnocení (zdravotní péče) * MeSH
• Check Tag
• lidé MeSH