The Evaluation of Cartilage Regeneration Efficacy of Three-Dimensionally Biofabricated Human-Derived Biomaterials on Knee Osteoarthritis: A Single-Arm, Open Label Study in Egypt.

Full thickness cartilage defects in cases of knee osteoarthritis are challenging in nature and are difficult to treat. The implantation of three-dimensional (3D) biofabricated grafts into the defect site can be a promising biological one-stage solution for such lesions that can avoid different disadvantages of the alternative surgical treatment options. In this study, the short-term clinical outcome of a novel surgical technique that uses a 3D bioprinted micronized adipose tissue (MAT) graft for knee cartilage defects is assessed and the degree of incorporation of such graft types is evaluated via arthroscopic and radiological analyses. Ten patients received 3D bioprinted grafts consisting of MAT with an allogenic hyaline cartilage matrix on a mold of polycaprolactone, with or without adjunct high tibial osteotomy, and they were monitored until 12 months postoperatively. Clinical outcomes were examined with patient-reported scoring instruments that consisted of the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score and the Knee Injury and Osteoarthritis Outcome Score (KOOS). The graft incorporation was assessed using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score. At 12 months follow-up, cartilage tissue biopsy samples were taken from patients and underwent histopathological examination. In the results, at final follow-up, the WOMAC and KOOS scores were 22.39 ± 7.7 and 79.16 ± 5.49, respectively. All scores were significantly increased at final follow-up (p < 0.0001). MOCART scores were also improved to a mean of 82.85 ± 11.49, 12 months after operation, and we observed a complete incorporation of the grafts with the surrounding cartilage. Together, this study suggests a novel regeneration technique for the treatment of knee osteoarthritis patients, with less rejection response and better efficacy.

Does arthroscopic patellar denervation with high tibial osteotomy improve anterior knee pain?

PURPOSE: Patellofemoral (PF) joint osteoarthritis (OA) is a major cause of anterior knee pain. Combined PF and medial tibiofemoral (TF) OA is common in older adults. We evaluated the effect of arthroscopic patellar denervation (PD) in patients with combined TF and PFOA after malalignment correction. METHODS: Forty-five patients [females/males, 27/18; age, 30-59 years (45.5 ± 8.50); mean body mass index, 25.15 ± 3.04 kg/m2] were treated in our department from March 2017 to March 2019. The patients were randomised into 2 groups: group A included 22 patients who underwent open-wedge high tibial osteotomy (OWHTO) and arthroscopic PD and group B included 23 patients who underwent OWHTO without denervation. The effect of denervation was statistically and clinically evaluated using the Knee injury and Osteoarthritis Outcome Score (KOOS) and Kujala (anterior knee pain score) score. RESULTS: After 24 months, 40 patients were available for the final follow-up. The final values of KOOS and the Kujala score were significantly different between the groups (p < 0.001). For group A, the average KOOS improved from 42.73 to 72.38 (p < 0.001) and the Kujala score improved from 42 to 74.1 (p < 0.001), whereas in group B, the average KOOS improved from 39.22 to 56.84 (p < 0.001) and the Kujala score improved from 39.7 to 56.4 (p < 0.001). CONCLUSION: Adding arthroscopic PD to OWHTO relieves anterior knee pain in patients with combined TF and PFOA and improves knee joint function and quality of life. LEVEL OF EVIDENCE: Level I prospective randomised control clinical trial.

Orthopaedic publications from Egypt in the last five years: a bibliometric report.

INTRODUCTION: This review was done to find the trend for orthopaedic publications from Egypt in the last 5 years, detailing the specialties that are most published and comparing this with the surrounding Middle East region. METHODS: The search included orthopaedic-related articles published in journals that are listed in PubMed, including author affiliation from Egypt between 2013 and 2017. RESULTS: Four hundred eighty-one publications were found. The results showed that Trauma was the highest published branch while Arthroscopy has shown the highest increase since 2013 to become as Trauma by 2017. Two hundred seventy-two articles were published in Q1 and Q2 journals which represents 56.54% from the total publications. There were 1243 citations for these publications. The country ranking was between the fourth and fifth in Middle East region over the last five years. DISCUSSION: Publications are an important part of each country's research work. The trend for orthopaedic publication is showing an increase in subspecialty publications with a gradual increase in number of publications per year, while Egypt's position remains in the top five in the region.

Basics in hip chondrolabral lesions and state of the art.

Chondrolabral complex is a weak point along an histological transition zone. Most cartilage and labral lesions in the femoroacetabular impingement syndrome are located in this area. Different classifications are used to evaluate the severity and predict the prognosis of chondrolabral complex injuries. Acetabular Labrum Articular Disruption (ALAD) and Multicenter Arthroscopy of the Hip Outcomes Research Network (MAHORN) classifications are commonly used with a prognosis and treatment implication. Treatment of chondrolabral lesions detected on magnetic resonance imaging (MRI), should only be considered when clinical symptoms are presented. A wide range of treatment options include debridement with or without microfracture, repair or regenerate therapies. The future of hip joint preservation should be directed towards to the development of the treatment of chondrolabral injuries.