[Autologous chondrocyte implantation in the treatment of cartilage lesions of ankle joint]. / Transplantace kultivovaných autologních chondrocytu hlezenného kloubu.

PURPOSE OF THE STUDY: The authors present the results of surgical treatment of talar dome cartilage defects. They used the transplantation of autologous cultured chondrocytes in the form of a solid chondral graft. MATERIAL AND METHODS: Patients with chondral lesions categorized as grades II to IV by the Anderson classification or as grades II to IV by the Berndt and Harty classification were indicated for this treatment. After preoperative MRI examination, a small sample of healthy cartilage was harvested arthroscopically from the non-weight-bearing area of the talus and was sent to the Tissue Bank in Brno for chondrocyte cultivation. After 28 to 42 days the cultured chondrocytes were formed into a solid chondral graft, implanted at the damaged site of the talar dome and fixed with fibrin glue (Tissucol). RESULTS: Between July 2003 and October 2005 five patients, three males and two females, were treated using this method. Their age ranged from 22 to 46 years. Follow-up was 6 to 24 months, with an average of 12.6 months, and the patients were examined by MRI at 2 weeks, 2 and 6 months and at 1 year. The clinical results were evaluated on the basis of the Mazur and Weber scoring systems. CONCLUSIONS: A significant improvement in clinical function of the ankle joint was achieved in three patients and the condition remained unchanged in one patient. In one patient, the surgical outcome was too recent for evaluation, but the MRI results indicated tendency to good incorporation of the graft.

[Therapy of severe chondral defects of the patella by autologous chondrocyte implantation]. / Lécba hlubokých chondrálních defektu pately transplantací kultivovaných autologních chondrocytu.

PURPOSE OF THE STUDY: The aim of this study was to present the results of treatment of deep chondral defects of the patella by transplantation of a solid chondral graft formed by autologous cultured chondrocytes. MATERIAL AND METHODS: Indications for autologous chondrocyte implantation most frequently included acute trauma to the knee, particularly the patella, which resulted in a severe focal cartilage defect. The lesions were assessed on the basis of the Bessette and Hunter classification preoperatively, and on the Outerbridge classification during arthroscopy. A sample of healthy cartilage was harvested from a non-weight-bearing area of the trochlea femoris. After cultivation of chondrocytes for 28 to 42 days in the tissue bank, a solid chondral graft, prepared with the use of fibrin glue (Tissucol), was ready for implantation. RESULTS: Six patients, two males and four females (average age, 21.1 years; range, 13 to 39 years) were treated by this method in the period from July 2003 to October 2005. Follow-up ranged from 1 to 25 months, with an average of 18.5 months. The patients were examined postoperatively by magnetic resonance imaging (MRI) at 2 weeks, 2 and 6 months, and at 1 year. The clinical results were evaluated by the Meyers, the Tegner and the Lysholm knee scoring systems. Two of the six patients, in whom the follow-up period was shorter than 6 months, were not included in the evaluation. CONCLUSIONS: A significant improvement in knee function was recorded when the preoperative and final follow-up stages were compared, as well as on comparison with the healthy contralateral knee joint. MRI examination showed good graft incorporation in all patients.

[Ultrasonography as an auxiliary method in diagnosis of acute appendicitis]. / Ultrasonografie jako pomocná metoda v diagnostice akutní apendicitidy.

The diagnosis of acute appendicitis remains a difficult task for even the experienced surgeon. For this reason every supplementary examination affords help for the surgeon its diagnosis. The goal of our study was to evaluate the significance of ultrasonography (USG) in diagnosing right lower quadrant abdominal pain. 204 patients admitted for suspect acute appendicitis were evaluated retrospectively. The accuracy of USG was studied by comparing this finding with preoperative, histopathological findings respectively. In comparison leucocytosis was also studied. In our studied cohort, USG examination had a sensitivity of 88.4% and specificity of 93.0%. Leucocytosis for diagnosis gave a sensitivity of 88.6% and specificity of 60.0%.