Alexander Barié

Unicompartmental and bicompartmental knee osteoarthritis show different patterns of mononuclear cell infiltration and cytokine release in the affected joints

It is still controversial which cell types are responsible for synovial inflammation in osteoarthritic (OA) joints. The aim of this study was to quantify the mononuclear cell populations and their cytokines in patients with different knee OA subtypes. Synovial membrane (SM), synovial fluid (SF) and peripheral blood (PB) were harvested from patients with unicompartmental (UC) and bicompartmental (BC) knee OA. Frequencies of mononuclear cells were assessed by flow cytometry in PB and SM. Naive SF samples were analysed for a broad variety of cytokines by multiplex analysis. SM of both groups displayed a distinct mononuclear cell infiltration, with CD14+ macrophages being the major cell population, followed by CD4+ T cells and only small numbers of CD8+ T, CD19+ B and CD16+CD56+ natural killer (NK) cells. Between the two groups, SM of BC OA showed significantly higher amounts of mononuclear cells (135·7 ± 180 versus 805 ± 675 cells/mg, P = 0·0009) and higher CD4+ T cell presence (3·4 ± 4·6 versus 9·1 ± 7·5%, P = 0·0267). SF of BC OA displayed significantly higher concentrations for a number of proinflammatory cytokines [CXCL1, eotaxin, interferon (IFN)‐γ, interleukin (IL)‐7, IL‐8, IL‐9, IL‐12]. UC and BC OA show significant differences in their synovial inflammatory pattern. Whereas in UC OA CD14+ macrophages are the predominant cell population, BC OA has a higher inflammatory profile and seems to be driven by CD14+ macrophages and CD4+ T cells. Inclusion of clinical information into the analysis of cellular and molecular results is pivotal in understanding the pathophysiology of OA.

The impact of pain spread on the outcome of multidisciplinary therapy in patients with chronic musculoskeletal pain – A prospective clinical study in 389 patients

Background: Musculoskeletal pain represents a continuous process ranging from single‐site to multiple‐site pain, with an increase in pain sites accompanied by an increasing risk of chronification and the development of further comorbidities. Within this context, the impact of pain spread on therapy outcome is still unknown.

[Anterior cruciate ligament reconstruction using quadriceps tendon autograft and press-fit fixation].

BACKGROUND Reconstruction of the anterior cruciate ligament (ACL) is a widely used procedure, but up to now no results have been published on an implant-free technique using a quadriceps tendon autograft and press-fit fixation. METHODS A total of 112 patients with primary rupture of the anterior cruciate ligament were included in a prospective case control study and 106 patients could be evaluated postoperatively after a mean of 12.4 months (range 12-14 months). RESULTS The patients showed good to excellent results according to the Lysholm score in 81% and the International Knee Documentation Committee (IKDC) score in 86% of cases. Furthermore the anterior-posterior translation was less than 3 mm in 83% of the patients by testing with the KT-1000 arthrometer. Neither tunnel widening nor an increase of radiological joint degeneration was recorded by radiological examination. CONCLUSION Reconstruction of the ACL with an autologous quadriceps tendon and an implant-free technique yielded good results compared to established operative methods in the short-term and should be consistently followed-up for long-term confirmation.

Fremdmaterialfreie Rekonstruktion des vorderen Kreuzbandes mit autologer Quadrizepssehne

BACKGROUND Reconstruction of the anterior cruciate ligament (ACL) is a widely used procedure, but up to now no results have been published on an implant-free technique using a quadriceps tendon autograft and press-fit fixation. METHODS A total of 112 patients with primary rupture of the anterior cruciate ligament were included in a prospective case control study and 106 patients could be evaluated postoperatively after a mean of 12.4 months (range 12-14 months). RESULTS The patients showed good to excellent results according to the Lysholm score in 81% and the International Knee Documentation Committee (IKDC) score in 86% of cases. Furthermore the anterior-posterior translation was less than 3 mm in 83% of the patients by testing with the KT-1000 arthrometer. Neither tunnel widening nor an increase of radiological joint degeneration was recorded by radiological examination. CONCLUSION Reconstruction of the ACL with an autologous quadriceps tendon and an implant-free technique yielded good results compared to established operative methods in the short-term and should be consistently followed-up for long-term confirmation.

Arthroscopic Anterior Cruciate Ligament Reconstruction Using a Quadriceps Tendon-Patellar Bone Autograft in Press-Fit Fixation

Techniques for anterior cruciate ligament reconstruction that fix the transplant without using hardware offer a variety of advantages over conventional methods. The overall costs of the operation are reduced by eliminating implants, subsequent diagnosis using magnetic resonance imaging is not compromised by metal artifacts, and the conditions for any surgical revision are facilitated. Experimental and clinical investigations have demonstrated that most press-fit techniques are safe and reliable. To date, autologous patellar tendon with bone blocks has mainly been used for this purpose. The disadvantage of this transplant is that discomfort frequently occurs at the donor site. A technique for arthroscopic reconstruction of the anterior cruciate ligament with autologous quadriceps tendon-patellar bone block without using artificial materials to fix the transplant in place is described here. The use of oscillating hollow reamers to obtain a cylindrical patellar bone block and to position the drill channels permit secure femoral press-fit fixation. Tibial fixation of the transplant is achieved by means of a suture-bone bridge and additional bone block fixation of the tendon in the tunnel.

Fremdmaterialfreie Rekonstruktion des vorderen Kreuzbandes mit autologer Quadrizepssehne@@@Anterior cruciate ligament reconstruction using quadriceps tendon autograft and press-fit fixation

BACKGROUND Reconstruction of the anterior cruciate ligament (ACL) is a widely used procedure, but up to now no results have been published on an implant-free technique using a quadriceps tendon autograft and press-fit fixation. METHODS A total of 112 patients with primary rupture of the anterior cruciate ligament were included in a prospective case control study and 106 patients could be evaluated postoperatively after a mean of 12.4 months (range 12-14 months). RESULTS The patients showed good to excellent results according to the Lysholm score in 81% and the International Knee Documentation Committee (IKDC) score in 86% of cases. Furthermore the anterior-posterior translation was less than 3 mm in 83% of the patients by testing with the KT-1000 arthrometer. Neither tunnel widening nor an increase of radiological joint degeneration was recorded by radiological examination. CONCLUSION Reconstruction of the ACL with an autologous quadriceps tendon and an implant-free technique yielded good results compared to established operative methods in the short-term and should be consistently followed-up for long-term confirmation.