Autologous chondrocyte implantation (ACI) for cartilage defects of the knee: A guideline by the working group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Trauma (DGOU)

BACKGROUND

Autologous chondrocyte implantation (ACI) is an established and well-accepted procedure for the treatment of localised full-thickness cartilage defects of the knee.

METHODS

The present review of the working group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Trauma (DGOU) describes the biology and function of healthy articular cartilage, the present state of knowledge concerning therapeutic consequences of primary cartilage lesions and the suitable indication for ACI.

RESULTS

Based on best available scientific evidence, an indication for ACI is given for symptomatic cartilage defects starting from defect sizes of more than three to four square centimetres; in the case of young and active sports patients at 2.5cm(2), while advanced degenerative joint disease needs to be considered as the most important contraindication.

CONCLUSION

The present review gives a concise overview on important scientific background and the results of clinical studies and discusses the advantages and disadvantages of ACI.

LEVEL OF EVIDENCE

Non-systematic Review.

Continuous photochemistry: the flow synthesis of ibuprofen via a photo-Favorskii rearrangement

A new enabling technology for performing photochemical reactions in a continuous fashion is presented.

APOE and AGT in the Finnish p.Arg133Cys CADASIL population

BACKGROUND

CADASIL is an inherited systemic small vessel disease, the affected status of brain vessels leading to subcortical vascular dementia. The defective gene is NOTCH3 in which over 230 different pathogenic mutations have been identified. The clinical course of CADASIL is highly variable even within families. Previous studies have shown that additional genetic factors modify the phenotype.

AIMS AND METHODS

Altogether, 134 Finnish CADASIL patients with p.Arg133Cys mutation were analysed for possible associations between the apolipoprotein E (APOE) genotype, angiotensinogen (AGT) p.Met268Thr polymorphism or neutral p.Ala202Ala NOTCH3 polymorphism and earlier first-ever stroke or migraine.

RESULTS

We found no association between the APOE genotypes, AGT polymorphism, NOTCH3 polymorphism and earlier first-ever stroke or migraine.

CONCLUSIONS

The APOE, AGT and NOTCH3 polymorphism did not modify the onset of strokes or migraine in our CADASIL sample, which is one of the largest mutationally homogenous CADASIL populations published to date. International collaboration, pooled analyses and genomewide approaches are warranted to identify the genetic factors that modify the highly variable CADASIL phenotype.

Does enhancing consciousness for strategic planning processes support the effectiveness of problem-based learning concepts in biomedical education?

Interdisciplinary skills gain increasing importance in university and professional contexts. To support these interdisciplinary skills, problem-based learning (PBL) is regularly used in a course for biomedical education. In this study, we investigated whether enhancing consciousness for planning processes can support the effectiveness of PBL concepts in an intervention-control group design. Results indicated clear evidence for this: planning skills were associated with better PBL performance. Concluding, self-reflection of planning skills is useful to increase outcome performance of students in PBL courses.