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Aims: This study aimed to evaluate the clinical application of the PJI-TNM classification for periprosthetic joint infection (PJI) by determining intraobserver and interobserver reliability. To facilitate its use in clinical practice, an educational app was subsequently developed and evaluated. Methods: A total of ten orthopaedic surgeons classified 20 cases of PJI based on the PJI-TNM classification. Subsequently, the classification was re-evaluated using the PJI-TNM app. Classification accuracy was calculated separately for each subcategory (reinfection, tissue and implant condition, non-human cells, and morbidity of the patient). Fleiss’ kappa and Cohen’s kappa were calculated for interobserver and intraobserver reliability, respectively. Results: Overall, interobserver and intraobserver agreements were substantial across the 20 classified cases. Analyses for the variable ‘reinfection’ revealed an almost perfect interobserver and intraobserver agreement with a classification accuracy of 94.8%. The category 'tissue and implant conditions' showed moderate interobserver and substantial intraobserver reliability, while the classification accuracy was 70.8%. For 'non-human cells,' accuracy was 81.0% and interobserver agreement was moderate with an almost perfect intraobserver reliability. The classification accuracy of the variable 'morbidity of the patient' reached 73.5% with a moderate interobserver agreement, whereas the intraobserver agreement was substantial. The application of the app yielded comparable results across all subgroups. Conclusion: The PJI-TNM classification system captures the heterogeneity of PJI and can be applied with substantial inter- and intraobserver reliability. The PJI-TNM educational app aims to facilitate application in clinical practice. A major limitation was the correct assessment of the implant situation. To eliminate this, a re-evaluation according to intraoperative findings is strongly recommended. Cite this article: Bone Joint Res 2024;13(1):19–27.

Cell therapy using induced pluripotent stem cell‐derived neurons is considered a promising approach to regenerate the injured spinal cord (SC). However, the scar formed at the chronic phase is not a permissive microenvironment for cell or biomaterial engraftment or for tissue assembly. Engineering of a functional human neuronal network is now reported by mimicking the embryonic development of the SC in a 3D dynamic biomaterial‐based microenvironment. Throughout the in vitro cultivation stage, the system's components have a synergistic effect, providing appropriate cues for SC neurogenesis. While the initial biomaterial supported efficient cell differentiation in 3D, the cells remodeled it to provide an inductive microenvironment for the assembly of functional SC implants. The engineered tissues are characterized for morphology and function, and their therapeutic potential is investigated, revealing improved structural and functional outcomes after acute and chronic SC injuries. Such technology is envisioned to be translated to the clinic to rewire human injured SC. [ABSTRACT FROM AUTHOR]

Abstract Cell therapy using induced pluripotent stem cell‐derived neurons is considered a promising approach to regenerate the injured spinal cord (SC). However, the scar formed at the chronic phase is not a permissive microenvironment for cell or biomaterial engraftment or for tissue assembly. Engineering of a functional human neuronal network is now reported by mimicking the embryonic development of the SC in a 3D dynamic biomaterial‐based microenvironment. Throughout the in vitro cultivation stage, the system's components have a synergistic effect, providing appropriate cues for SC neurogenesis. While the initial biomaterial supported efficient cell differentiation in 3D, the cells remodeled it to provide an inductive microenvironment for the assembly of functional SC implants. The engineered tissues are characterized for morphology and function, and their therapeutic potential is investigated, revealing improved structural and functional outcomes after acute and chronic SC injuries. Such technology is envisioned to be translated to the clinic to rewire human injured SC.

The aim of this work was to assess phenomena occurring during AgNP transport from nanocomposite Ag/alginate hydrogels under conditions relevant for potential biomedical applications as antimicrobial soft tissue implants. First, we have studied AgNP migration from the nanocomposite to the adjacent alginate hydrogel mimicking soft tissue next to the implant. AgNP deposition was carried out by the initial burst release lasting for ∼24 h yielding large aggregates on hydrogel surfaces and smaller clusters (∼400 nm in size) inside. However, the overall released content was low (0.67%) indicating high nanocomposite stability. In the next experimental series, release of AgNPs, 10–30 nm in size, from Ag/alginate microbeads in water was investigated under static conditions as well as under continuous perfusion mimicking vascularized tissues. Mathematical modeling has revealed AgNP release by diffusion under static conditions with the diffusion coefficient within the Ag/alginate hydrogel of 6.9x10–19 m2 s–1. Conversely, continuous perfusion induced increased AgNP release by convection with the interstitial fluid velocity estimated as 4.6 nm s–1. Overall, the obtained results indicated the influence of hydrodynamic conditions at the implantation site on silver release and potential implant functionality, which should be investigated at the experimentation beginning using appropriate in vitro systems. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III 45019]

Indirect evidence indicates that penaeids may have a W/Z sex heritability mechanism with the androgenic gland (AG) mediating masculine differentiation. The present study evaluated the immune response against grafts and the expression of primary and secondary male sexual characters in Litopenaeus vannamei females implanted with terminal ampoules and associated AGs. Experiments included grafting females at PL 34–48 . Grafting at PL 37 generated few cases of melanization exhibiting dark coloration covering parts or the whole implant while most implants showed white coloration, without any trace of melanization. Histology of melanized implants showed necrotic tissue, encapsulated by black depositions. These melanized capsules were externally surrounded by normal haemocytes and flat haemocytes in the middle. An experiment evaluating possible absorption of the grafts based on recovery, gross coloration, size of implants, and histology showed that Complete terminal ampoule-AG implants, Control-vas deferens implants and Abdominal muscle implants, recovered at day 7 and 15, exhibited gradual and statistically significant decrease in size, which was more evident for muscle implants. Grafts with normal appearance from this experiment remained viable during 7 and 15 days post-implantation; these tissues showed a normal cellular structure with neither signs of melanization nor haemocyte infiltration. Appendices masculinae did not develop in any implanted females or controls. Concerning petasma development, two females implanted with AG showed a male phenotype in their first endopodites, characterized by a straight shape at the distal region, a middle protuberance and absence of setae along the middle curved edge of the structure. Regenerated and intact endopodites of Control-proximal terminal ampoule females showed the typical female phenotype with a slender shape with a curved distal edge, without a middle protuberance, and with setae along the middle curved edge of endopodites. Implanted females showed no evidence of masculinization or abnormal development of oocytes. In the light of the present study the effects of AG transplantation on sex in penaeids should be further evaluated in younger PL stages. Statement of relevance This contribution presents new information on sex reversal technology on Litopenaeus vannamei based on androgenic gland implants . The findings are novel for the family Penaeidae concerning the immunological response to tissue grafting and the plasticity for sex reversal in this world aquaculture species. [ABSTRACT FROM AUTHOR]

Tissue implant management can be labor intensive because of multiple storage locations and cumbersome tracking systems. The purpose of this quality improvement (QI) project was to enhance patient safety and nursing satisfaction by upgrading our tissue-management facility and processes. We created a centralized storage room for tissue implants and staffed this room during all shifts. Tissue management was executed using tracking software and transportation devices that supported tissue receipt, storage, disposition, documentation, and reporting. Our project resulted in our full compliance with tissue implant requirements from the US Food and Drug Administration (FDA) and The Joint Commission. We also reduced our documentation error rate from 3% to less than 1%, and decreased the tissue-expiration rate by 1.1%. Tissues are now delivered to ORs, which allows RNs to focus on patient care rather than retrieval of implants. Monitoring of the tissue inventory has improved, resulting in the reduction of tissue wastage. [ABSTRACT FROM AUTHOR]

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