Objective-To estimate the prevalence of hip osteoarthritis (OA hip) and hip dysplasia in a sample of Hong Kong men who were unselected with respect to hip symptoms. Methods-The postmicturition films of 999 men aged 60-75 years, consecutive attenders for intravenous urography between 1987 and 1990 at a regional hospital, were reviewed. OA hip was diagnosed as the occurrence of two or more features of OA using a modified version of the Kellgren and Lawrence scale, or a minimal joint space of 1.5 mm or less. Hip dysplasia was defined as a centre-edge angle of less than 250, or an acetabular depth of less than 9 mm. The results were compared with British data obtained by similar methods. Results-In the Hong Kong sample, the proportion of men with two or more features of osteoarthritis in at least one hip was about 50% that of the men in the British study (5. 4% and 11.000%, respectively).Severe joint space narrowing (of 1.5 mm or less) occurred in 0.7% of the hips in Hong Kong men, compared with 2% in the British men. The proportion of hips with centre-edge angles less than 250 was 4.5% in Hong Kong, compared with 3.6% in Britain, and the prevalence of shallow acetabular depth was greater in Chinese (14-5%) than in the British (2.1%). Radiographic measures of hip dysplasia were not associated with mni-mal joint space. Conclusions-Our results have confirmed the lower prevalence of radiographic hip osteoarthritis in Hong Kong men compared with British men. However, acetabular dysplasia was as prevalent among Chinese men as in the British sample. This is evidence against the hypothesis that variations in the frequency of hip osteoarthritis are caused by differences in the occurrence of hip dysplasia. (Ann Rheum Dis 1995; 54: 965-969)

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This in vivo pilot study explored the use of mesenchymal stem cell (MSC) containing tissue engineering constructs in repair of osteochondral defects. Osteochondral defects were created in the medial condyles of both knees of 16 miniature pigs. One joint received a cell/collagen tissue engineering construct with or without pretreatment with transforming growth factor b (TGF-b) and the other joint from the same pig received no treatment or the gel scaffold only. Six months after surgery, in knees with no treatment, all defects showed contracted craters; in those treated with the gel scaffold alone, six showed a smooth gross surface, one a hypertrophic surface, and one a contracted crater; in those with undifferentiated MSCs, five defects had smooth, fully repaired surfaces or partially repaired surfaces, and one defect poor repair; in those with TGF-b-induced differentiated MSCs, seven defects had smooth, fully repaired surfaces or partially repaired surfaces, and three defects showed poor repair. In Pineda score grading, the group with undifferentiated MSC, but not the group with TGF-b-induced differentiated MSCs, had significantly lower subchondral, cell morphology, and total scores than the groups with no or gel-only treatment. The compressive stiffness was larger in cartilage without surgical treatment than the treated area within each group. In conclusion, this preliminary pilot study suggests that using undifferentiated MSCs might be a better approach than using TGF-b-induced differentiated MSCs for in vivo tissue engineered treatment of osteochondral defects. ß

In our previous study, we found that cartilage fragments from osteoarthritic knee promoted chondrogenesis of mesenchymal stem cells. In this study, we further transformed the cartilage tissues into acellular cartilage matrix (ACM) and explored the feasibility of using ACM as a biological scaffold. Nonworn parts of cartilage tissues were obtained during total knee arthroplasty (TKA) surgery and were successfully fabricated into ACM powders. The ACM powders and human synovium-derived mesenchymal stem cells (SMSCs) were mixed into collagen gel for in vitro culture. Histological results showed a synergistic effect of ACM powders and chondrogenic growth factors in the formation of engineered cartilage. The findings of real-time polymerase chain reaction (PCR) suggested that ACM powders had the potential of promoting type II collagen gene expression in the growth factors-absent environment. Moreover, with growth factors induction, the ACM powders could reduce the hypertrophy in chondrogenesis of SMSCs. In summary, ACM powders could serve as a functional scaffold that benefited the chondrogenesis of SMSCs for cartilage tissue engineering.