Implante de condrócitos homólogos em defeitos osteocondrais de cães: padronização da técnica e avaliação histopatológica / Homologous articular chondrocytes implantation in osteochondral defects of dogs: technique and histopathological evaluation standardization

Padronizou-se a metodologia para cultura de condrócitos em cães e avaliou-se seu implante em lesões osteocondrais, utilizando-se a membrana biossintética de celulose (MBC) como revestimento. Dez cães, adultos e clinicamente sadios, foram submetidos à artrotomia das articulações fêmoro-tíbio-patelares. Defeitos de 4mm de diâmetro e profundidade foram induzidos no sulco troclear de ambos os membros. MBC foi aplicada na base e na superfície das lesões. Os defeitos do membro direito foram preenchidos com condrócitos homólogos cultivados formando o grupo-tratado (GT); os do membro esquerdo, sem implante celular, foram designados grupo-controle (GC). A evolução pós-operatória foi analisada com especial interesse nos processos de reparação da lesão, por meio de histomorfometria e imuno-histoquímica para colágeno tipo II e sulfato de condroitina. A cultura de condrócitos homólogos apresentou alta densidade e taxa de viabilidade. Observou-se integridade do tecido neoformado com a cartilagem adjacente na avaliação histológica, em ambos os grupos. Na imuno-histoquímica, verificou-se predomínio de colágeno tipo II no GT. Morfometricamente, não houve diferença significativa entre o tecido fibroso e o fibrocartilaginoso entre os grupos. A cultura de condrócitos homólogos de cães foi exequível. O tecido neoformado apresentou qualidade discretamente superior associado ao implante homólogo de condrócitos, contudo não promoveu reparação por cartilagem hialina.

The aim of the study is to standardize the methodology to achieve canine chondrocytes culture, and evaluate its implant on osteochondral defects made in the femoral trochlear sulcus of dogs, using the cellulose biosynthetic membrane (CBM) as coating. Ten healthy adult dogs without locomotor disorders were used. All animals were submitted to arthrotomy of stifle joints and defects of four millimeters in diameter x four millimeters deep were done in the femoral trochlear sulcus of both limbs. CBM were applied in the lesion base and surface of all limbs. In the treated group (TG), defects of the right limb were filled with cultivated homologous chondrocytes, and in control group (CG), defects of the left limb were left without cellular implant. Postoperative follow up was done by histomorphometry and Collagen type II and anti-chondroitin sulfate immunohistochemistry. The homologous chondrocytes culture showed high density and viability rate. Upon immunohistochemistry the predominance of type II collagen in extracellular matrix of TG was verified. However, no significant statistical difference was observed between the groups upon histomorphometry analysis of fibrous and fibrocartilaginous tissues. Canine homologous chondrocytes culture was practicable. Neoformed tissue showed slightly higher quality in TG, but without promoting repair by the hyaline cartilage.

Hyphenated history: Osgood-Schlatter disease.

The language of orthopedics is rather interesting in that it often credits the original describers or those who popularized a disease process by attaching their names to the disease process in question. These so-called "eponyms" have become quite commonplace in our literature and offer important orthopedic historical insight. Often throughout history, the simultaneous discovery of a disorder is described by two independent researchers, resulting in a hyphenated eponym. Such is the case in the observations made by two physicians, Robert Bayley Osgood and Carl Schlatter, concerning overuse injuries of the tibial tubercle in adolescents. This disorder subsequently became known as "Osgood-Schlatter disease, and aspects of its hyphenated history are the focus of this paper.

Historical perspectives of osteochondrosis.

A famous historian, Toynbee, wrote that history was based on challenge and response. Certainly the development of our understanding of osteochondrosis dissecans in the dog fits this description. From the first indications of the disease to our present understanding took about 60 years. The times were right, for during this period improvements in anesthesiology, radiology, and surgery, along with the demands of clients coupled with the presence of skilled trained investigators and sharp practitioners, brought about a continually increasing mass of information about a new disease entity. It is proper for us to give credit to those gifted individuals who patiently worked to unravel each bit of information. Our current challenge is that much more remains to be done.

Brief communication: a case of congenital syphilis during the colonial period in Mexico City.

Congenital syphilis has been diagnosed very seldom in ancient populations. The case that we examined comes from San Jeronimo's Church (17th and 18th centuries AD; Mexico City). Coffin 43 contained an incomplete skeleton of an approximately 2-year-old infant. The pathological lesions of this skeleton include bilateral osteochondritis, diaphyseal osteomyelitis, and osteitis and/or periostitis on the long bones. The radiographic appearance depicts symmetrical osteomyelitic foci, particularly at the proximal extremity of both tibiae (Wimberger's sign). The skull exhibits hydrocephaly and periosteal changes on the vault, and the unerupted upper incisors evince dental hypoplasia and other pathological alterations reminiscent of Hutchinson's incisors. All these features strongly suggest a case of early congenital syphilis.

PIP: Debate continues over whether venereal syphilis originated in Europe or the New World. Evidence from skeletal remains suggests the occurrence of treponemal infections in both the New World and Europe before 1492, but the specimens interpreted as suggestive of venereal syphilis await a possible immunological test which could confirm the diagnosis. Venereal syphilis is the only kind of treponematosis which can easily be transmitted within the uterus, leading to congenital syphilis. Congenital syphilis is a very severe disease with a mortality rate of almost 50%. The authors examined the partial skeleton in coffin 43 exhumed in 1976 from the site of San Jeronimo's Church in the center of Mexico City. The skeleton dates from the colonial period of the 17th and 18th centuries, and belonged to a human of approximately two years old. Pathological lesions include bilateral osteochondritis, diaphyseal osteomyelitis, and osteitis and/or periostitis on the long bones. The radiographic appearance depicts symmetrical osteomyelitic foci, particularly at the proximal extremity of both tibiae, while the skull exhibits hydrocephaly and periosteal changes on the vault. The unerupted upper incisors show dental hypoplasia and other pathological alterations reminiscent of Hutchinson's incisors. These features strongly suggest a case of early congenital syphilis. The characteristics of congenital syphilis are described.

The history of Kienböck's disease.

The history of Kienböck's disease is outlined from its description in 1910 in Europe, to its acceptance as a disease entity in the United States, to the advent of therapeutic surgical treatment in 1950. The concepts developed during this period, such as the association of ulnar variance and Kienböck's disease, are the basis for many of the present day surgical interventions performed.

Osteochondritis dissecans 1887-1987. A centennial look at König's memorable phrase.

In 1887, König claimed that loose bodies in the knee joints of young persons had three causes: (1) very severe trauma; (2) lesser trauma causing contusion and necrosis; and (3) minimal trauma acting on an underlying lesion-for which he suggested the name osteochondritis dissecans. His thesis has stood the test of time. We still confuse the second and third categories but osteochondritis dissecans has been identified as an ossification defect.

Intervertebral osteochondrosis in ancient and modern populations.

Skeletal collections are often useful for determining the frequency and distribution of lesions that would otherwise go unnoticed in the living. This study examines a rather common spinal lesion for which there is little clinical or paleopathologic literature available. In such cases, the anterior aspect of the lower thoracic and lumbar vertebral plates display crescent-shaped lesions suggestive of a form of degeneration known as intervertebral osteochondrosis. A total of 2,628 skeletons from three early American Indian sites and one 20th-century medical-school cadaver population are examined for this lesion. Variables such as age, sex, weight, race, activity patterns, and other biocultural information are considered in relation to the frequency of this lesion. It is suggested that physical stress during the second and third decades of life is largely responsible for this condition. With advancing age the lesions are obliterated and, in effect, become indistinguishable from spondylosis deformans. Familiarity with this condition is necessary in order to better understand degenerative spinal disease and avoid confusion with other spinal diseases such as tuberculosis.