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The role of chondrocyte death in the pathogenesis of osteoarthritis (OA) has been largely discussed in literature, but its relative contribution is difficult to assess (1). Chondrocyte death, be it apoptotic, necrotic or chondroptotic, has been clearly documented in OA and a certain correlation between the degree of cartilage damage and chondrocyte apoptosis has been demonstrated (2;3). Conversely, the relationship between the different types of cell death and chondrocalcinosis (CC) is still little known, as well as the presence and role of chondroptotic cells. The aim of this research was to compare chondrocyte behavior in the cartilage of osteoarthritic and chondrocalcinotic knees, evaluating the different types of cell death by means of optical and electron microscopy. During total knee replacement surgeries, cartilage specimens of femoral condyle have been withdrawn and their transversal semithin sections, stained with toluidine blue and alizarin solutions, have been investigated by optical microscopy. From the same samples, thin sections were obtained for transmission electron microscopy to evaluate, at high magnification, the specific ultrastructural features of different types of cell death. Cartilage specimens from both conditions revealed a thickness reduction of superficial layer and a high number of empty lacunae in the middle layer. Calcium pyrophosphate crystals appeared in the samples of patients affected by CC. In osteoarthritic cartilage, numerous chondrocytes revealed necrotic features, whereas, in chondrocalcinotic tissue, the middle zone was characterized by morphological patterns suggestive of chondroptosis, such as chromatin condensation mostly localized at the nuclear periphery, mitochondria alterations, a marked increase in endoplasmic reticulum, the presence of a diffuse autophagic component and the extrusion of cellular material into the lacunae. In conclusion, a different distribution of cell death types seems to characterize the intermediate layers of cartilage specimens from patients affected by CC compared to OA., Italian Journal of Anatomy and Embryology, Vol. 121, No. 1 (Supplement) 2016

Osteoarthritis (OA) is one of the most common degenerative joint diseases which causes chronic disability in older populations (1). OA and crystal arthropathy frequently coexist, particularly in the knee. This combination, characterized by crystal accumulations of calcium pyrophosphate dihydrate (CCPD), is called chondrocalcinosis (2). The aim of this work was to investigate and compare the articular surface, the layered structure of cartilage and the chondrocyte behaviour in three different conditions: control, OA and chondrocalcinosis. Cartilages of femoral condyle have been evaluated by means of optical, transmission and environmental scanning electron microscopy with EDAX EDS system. In OA and CCPD deposition disease a collagen network disorganization appears, and crystals, in the latter condition, appear particularly stored in the degenerated area. Cartilage stratifications display a clear thickness reduction of superficial and middle layers, with a calcified tissue increase in the specimens of pathologic groups. Numerous chondrocytes in the articular surface of OA and chondrocalcinosis samples reveal necrotic features, while in the middle zone cells show morphological pattern suggestive of chondroptosis (3). In conclusion, cell behaviour knowledge appears to have a key role to understand cartilage disorders and to investigate their morpho-functional mechanisms., Italian Journal of Anatomy and Embryology, Vol. 120, No. 1 (Supplement) 2015

Purpose the aim of this study was to investigate the relationship between positive painful forced internal rotation (FIR) and lateral pulley instability in the presence of a pre-diagnosed posterosuperior cuff tear. The same investigation was conducted for painful active internal rotation (AIR). Methods a multicenter prospective study was conducted in a series of patients scheduled to undergo arthroscopic posterosuperior cuff repair. Pain was assessed using a visual analog scale (VAS) and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) was administered. The VAS score at rest, DASH score, and presence/absence of pain on FIR and AIR were recorded and their relationships with lesions of the lateral pulley, cuff tear patterns and shape of lesions were analyzed. Results the study population consisted of 115 patients (mean age: 55.1 years) recruited from 12 centers. The dominant arm was affected in 72 cases (62.6%). The average anteroposterior extension of the lesion was 1.61 cm. The mean preoperative VAS and DASH scores were 6.1 and 41.8, respectively. FIR and AIR were positive in 94 (81.7%) and 85 (73.9%) cases, respectively. The lateral pulley was compromised in 50 cases (43.4%). Cuff tears were partial articular in 35 patients (30.4%), complete in 61 (53%), and partial bursal in 19 (16.5%). No statistical correlation between positive FIR or AIR and lateral pulley lesions was detected. Positive FIR and AIR were statistically associated with complete lesions. Negative FIR was associated with the presence of partial articular tears. Conclusions painful FIR in the presence of a postero-superior cuff tear does not indicate lateral pulley instability. When a cuff tear is suspected, positive FIR and AIR are suggestive of full-thickness tear patterns while a negative FIR suggests a partial articular lesion. Level of evidence level I, validating cohort study with good reference standards.