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Background: Microfracture, the standard of care, is recognized to be an incomplete solution for cartilage damage. BST-CarGel, a chitosan-based medical device, is mixed with autologous whole blood and is applied to a microfractured cartilage lesion in which it physically stabilizes the clot and guides and enhances marrow-derived repair. An international, multicenter, randomized controlled trial was conducted to evaluate BST-CarGel treatment compared with microfracture alone in the repair of cartilage lesions in the knee. Methods: Eighty patients between the ages of eighteen and fifty-five years with a single, symptomatic focal lesion on the femoral condyles were randomized to BST-CarGel and microfracture treatment (n = 41) or microfracture treatment alone (n = 39). The primary end points of repair tissue quantity and quality at twelve months were assessed by quantitative three-dimensional magnetic resonance imaging measuring the degree of lesion filling and T2 relaxation time with use of standardized one and twelve-month posttreatment scans. The secondary end point at twelve months was clinical benefit determined with the Western Ontario and McMaster Universities Osteoarthritis Index. The tertiary end point was quality of life determined by the Short Form-36. Safety was assessed through the recording of adverse events. Results: Patient baseline characteristics were similar in the two groups, although baseline lesion areas were slightly larger on quantitative magnetic resonance imaging for the BST-CarGel group compared with the microfracture group. Blinded quantitative magnetic resonance imaging analysis demonstrated that, at twelve months, when compared with microfracture treatment alone, BST-CarGel treatment met both primary end points by achieving statistical superiority for greater lesion filling (p = 0.011) and more hyaline cartilage-like T2 values (p = 0.033). The lesion filling values were 92.8% ± 2.0% for the BST-CarGel treatment group and 85.2% ± 2.1% for the microfracture treatment group, and the mean T2 values were 70.5 ± 4.5 ms for the BST-CarGel treatment group and 85.0 ± 4.9 ms for the microfracture treatment group. Western Ontario and McMaster Universities Osteoarthritis Index subscales for pain, stiffness, and function yielded equivalent improvement for both groups at twelve months, which were significant (p < 0.0001) from baseline. Treatment safety profiles were considered comparable. Conclusions: At twelve months, BST-CarGel treatment resulted in greater lesion filling and superior repair tissue quality compared with microfracture treatment alone. Clinical benefit was equivalent between groups at twelve months, and safety was similar. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

The article discusses the use of animal models for translational research on shoulder pathologies. These models were used for in vivo and in vitro shoulder research. In vivo are helpful in offering the means to model living phenomena, such tendon healing process and responses to surgery. In vitro models are significant in providing understanding of the functioning of the shoulder and for biomechanical experiments.

Background: The purpose of the study is to evaluate the effect of a selective epiphysiodesis of the ilioischial limb of the triradiate cartilage (TC) in an experimental dysplastic hip., Materials and Methods: A hip dysplasia was obtained in 23 New Zealand rabbits 3 weeks old by immobilizing the knee in extension with a K-wire, in 4 groups: (1) control group; (2) K-wire maintained until sacrifice; (3) K-wire removed 1 week later without epiphysiodesis; and (4) K-wire removed 1 week later with selective epiphysiodesis of the ilioischial limb of the TC. Radiographic evaluation was performed previous to knee immobilization, after K-wire removal and after sacrifice. Acetabular index (AI), Sharp's angle, ACM angle, acetabular floor thickness ratio (AFTR) were measured and presence of dysplasia, subluxation, or dislocation was noted. The acetabular version, the acetabular sector angles, and the pelvis rotation were obtained using CT evaluation. A morphology score was developed and a morphometric study of both proximal femur and acetabulum was performed., Results: No differences between groups in the radiographic assessment before immobilization or K-wire removal were found. All cases in group 2 showed dysplasia, subluxation, or dislocation of the hip. The radiographic assessment of group 4, compared with group 3, showed a lower AI (P=0.027), Sharp's angle (P=0.005), ACM angle (0.049), and AFTR (P=0.017). No differences between groups 1 and 4 regarding AI (P=0.08), Sharp's angle (P=0.484), and AFTR (P=0.639) were obtained. The morphology score was lower in group 4 than in groups 2 and 3. Group 4 showed a deeper acetabulum than group 2 (P=0.008) and group 3 (P=0.033), while it was similar to group 1 (P=0.364)., Conclusions: A selective epiphysiodesis of the ilioischial limb of the TC in a dysplastic hip normalized the radiographic measurements of the acetabulum and the acetabular deepness, and it improved the previous gross morphology of the capsule, labrum, and ligamentum teres in rabbits., Level of Evidence: Level II-therapeutic study.

The footprints of 1851 Congolese children were studied using the index of Chippaux-Smirak, Staheli's index of the arch, and Clarke's angle. The sample consisted of 906 girls and 945 boys aged between 3 and 12 years, including city children who wore shoes and children from rural areas who had gone barefoot. At the ages of 3 and 4 years, most feet were morphologically flat, but the proportion of flat feet decreased with age in both sexes. Boys had a greater tendency for flat feet. According to the three parameters studied there was a greater proportion of flat feet in the urban environment. By multiple regression analysis the three parameters we had studied identified age as the primary predictive factor for flat feet. As in previous studies in western populations, the girls had a higher inner arch than the boys and footwear had very little influence on the morphology of the foot.