Tissue engineering of biphasic joint cartilage transplants

In isolated posttraumatic or idiopathic joint defects the chondral layers and adjacent subchondral spongy bone are usually destructed. For regeneration we suggest the in vitro formation of a cartilage-coated biomaterial carriers (biphases) in order to fill the correspondingjoint defects. In this study Biocoral, a natural coralline material made of calcium carbonate, and calcite, a synthetic calcium carbonate, were used as supports for the cultivation of bovine chondrocytes in a three-dimensional polymer fleece. The cell-polymer-structure was affixed to the biomaterial with a fibrin-cell-solution. The artificial cartilage formed a new matrix and fused with the underlying biomaterial. The results indicate a promising technical approach to anchor tissue engineered cartilage in joint defects.

[Prophylactic surgery of the musculoskeletal system]

Prophylactic surgery on the musculoskeletal system has a wide range of indications, for example posttraumatic or non-traumatic malalignment of the lower extremities, joint instabilities or bony lesions with the risk of fracture and secondary malignant change. The goals of treatment include pain relief, improved function and redistribution of the physiological mechanical forces. Clinical experience over the past three decades has defined the current role of realignment of the lower limbs. Recent technological advances have further improved the surgical ability to assess and select patients who are candidates for realignment osteotomy or joint stabilization.

[Scapulo-thoracic dissociation. A missed injury?]

The scapulothoracic dissociation (SD) is a complex injury of the shoulder girdle, mostly associated with polytraumatized critically ill patients. This case report of 3 patients shows the variety of possible injuries combined with SD. Diagnosis and therapy in such a rare trauma, which is most likely seen in specialized trauma centres are being described. The 3 patients are presented from trauma to management, with remarks to various possibilities in treatment. Reports of other groups include multicenter studies with small numbers of patients, making it different to look for homogenity or defining standards, whereas current guidelines are being mentioned, including remarks on the management of these mostly polytraumatized and vitally endangered patients.