Bone marrow aspirate concentrate (BMAC), together with fibrin glue (Tisseel, Baxter, UK) and Hyaluronic acid (HA) were used as a one-step cell therapy treating patients with ankle cartilage defects in our hospital. This therapy was proven to be safe, with patients demonstrating a significant improvement 12 months post-treatment. Enriched mesenchymal stem cells (MSCs) in BMAC are suggested inducers of cartilage regeneration, however, currently there is no point-of-care assessment for BMAC quality; especially regarding the proportion of MSCs within. This study aims to characterise the cellular component of CCR-generated BMAC using a point-of-care device, and to investigate if the total nucleated cell (TNC) count and patient age are predictive of MSC concentration. During surgery, 35ml of bone marrow aspirate (BMA) was collected from each patients’ iliac crest under anaesthesia, and BMAC was obtained via a commercial kit (Cartilage Regeneration kit, CCR, Innotec®, UK). BMAC was then mixed with thrombin (B+T) for injection with HA and fibrinogen. In our study, donor-matched BMA, BMAC and B+T were obtained from consented patients (n=12, age 41 ± 16years) undergoing surgery with BMAC therapy. TNC, red blood cell (RBC) and platelet (PLT) counts were measured via a haematology analyser (ABX Micros ES 60, Horiba, UK), and the proportion of MSCs in BMA, BMAC and B+T were assessed via colony forming unit-fibroblast (CFU-F) assays. Significant differences data in matched donors were tested using Friedman test. All data were shown as mean ± SD.Abstract
Objectives
Methods
Plantar Fasciitis is an extremely common and challenging problem that presents itself to foot and ankle practitioners. Many different treatment modalities are available for this condition, with little proven benefit. ECSWT was approved for use by the FDA for the treatment of chronic proximal plantar fasciitis in 2002 and NICE published guidance in 2009 recommending its use in refractory cases. Patients who diagnosed with ultrasound scan, and for whom other treatments were unsuccessful, underwent treatment on an outpatient basis. They had three 4–5 minute sessions, once a week. A Spectrum machine was used delivering 10 Hz waves in 500 preset pulses at 2 bar pressure, followed by 2000 preset pulses at 2.5 bar pressure. Pre- and 3 month post-treatment pain levels were recorded using a 10 point Visual Analogue Scale.Introduction:
Methods:
Forefoot deformities are common in the rheumatoid population and lead to abnormal loading, plantar callosities and A prospective observational study was set up to review 10 rheumatoid patients (20 feet) undergoing bilateral first MTP joint Introduction
Materials & Methods
Salvage procedures on the 1st MTPJ following failed arthroplasty, arthrodesis or hallux valgus surgery are difficult and complicated by bone loss. This results in shortened first ray and transfer metatarsalgia. We present our experience of using tri-cortical interposition grafts to manage this challenging problem. Between 2002 and 2009 our department performed 21, 1st MTPJ arthrodeses using a tri-cortical iliac crest interposition graft. Surgical fixation was achieved with a compact foot plate. We performed a retrospective review from the medical notes and radiographs along with American Foot and Ankle scores which were collected prospectively. We analysed the following parameters: time to radiological, requirement for further surgery, lengthening of 1st ray and any post operative complications.Background
Methods
To assess total knee arthroplasty function in osteoarthritic patients who had their arthroplasty aged 55 years or less. Self administered questionnaires were posted to 150 patients who had been registered on the Trent Regional Arthroplasty Register as having their TKA for osteoarthritis aged 55 or less. 85% of questionnaires were returned completed giving us information on 136 TKAs. The mean age of the patients at TKA was 51 yrs (Range 29 – 55 yrs.). Male 60: 67 Female. The mean follow-up was 44 months. 41% of patients had had no knee surgery prior to their TKA. 9 had had a corrective osteotomy. 51 patients had to give up work because of their osteoarthritic knee, only 17 got back to work after their TKA. 80% of patients felt that their arthroplasty had met or exceeded their pre-operative expectation in relieving pain though 41% continue to experience moderate or severe knee pain and 29% continue to have regular night pain. 62% of patients felt that they had been able to resume leisure activities to the same or better level than expected pre-operatively.
