Kai-Uwe Lewandrowski

Concomitant Meniscal and Articular Cartilage Lesions in the Femorotibial Joint

The frequency of concomitant meniscal and articular cartilage lesions in the femorotibial joint was analyzed in a retrospective study of 1740 knee joints examined arthroscopically with the objective of determining pos sible correlations between the two knee joint abnormal ities. Articular cartilage lesions were found in 81.4% (N = 1416) of femorotibial joints examined and menis cal derangements were noted in 72.8% (N = 1268). In the medial compartment, concomitance was noted in 76.3% (821 of 1076) on the femoral condyles and in 48.6% (523 of 1076) on the tibial plateau. In the lateral compartment, 43.1 % (212 of 492) of the knees with deranged menisci had femoral and 55.1 % (271 of 492) had tibial articular lesions. Medial meniscal lesions were more frequently associated with femoral and tibial chondral degeneration than lateral meniscal derange ments (P < 0.001). Longitudinal, bucket-handle, and complex tears of the medial meniscus were signifi cantly more often associated with articular cartilage damage than horizontal cleavage, flap, or radial tears. Degeneration of the meniscus was highly correlated with chondral destruction in both compartments. No cause-and-effect relationship could be established, but practical implications of these findings are discussed.

Soluble Calcium Salts in Bioresorbable Bone Grafts

Bone is the second most implanted material in the body, after blood. There are over 450,000 bone graft (BG) procedures annually in the United States (2.2 million worldwide), with a market potential of

Enhancing Cortical Allograft Incorporation Processing by Partial Demineralization and Laser Perforation

400–600 million. Autografts and allografts are used in current BG procedures to repair defects caused by surgery, tumors, trauma, implant revisions, and infections, and also for joint fusion. However, drawbacks, such as the need for a second surgery to retrieve the graft (autograft), or the risk of viral infection, contamination, and long-term complications (allografts), make bioresorbable BG substitutes viable alternatives to autografts and allografts. Only 10% of these procedures use synthetic materials, because the currently approved synthetic grafts are considered to be inferior to the use of autograft or allograft. Significant problems include lack of resorbability, inclusion of animal- or marine-derived components, and poor handling characteristics.

Bioresorbable osteoconductive compositions for bone regeneration

The management of large skeletal defects continues to present a major challenge to orthopedic surgeons, particularly when the problem arises in young patients, in whom artificial devices and joint implants are likely to fail early. Both cemented (1,2) and uncemented (3–5) devices have significant complications in children and young adults. Therefore, development of a system that provides a biologic alternative seems eminently worthwhile.